Association of Dietary Vitamin B12 Intake, Nutrition Knowledge and Peripheral Neuropathy in Patients with Type 2 Diabetes Mellitus: a Cross-Sectional Study.
Abstract
Background Type 2 diabetes mellitus (T2DM) is rapidly increasing in India, with rural communities facing greater challenges due to limited nutrition literacy and micronutrient deficiencies. Dietary vitamin B12 inadequacy and poor vitamin B12 status have been implicated in neuropathy, yet evidence linking nutrition knowledge, B12 intake and neuropathy risk in rural Indian populations in patients with diabetes is limited. This study assessed nutrition knowledge, vitamin B12 intake, glycemic control and neuropathy prevalence among adults with T2DM in rural Telangana. Methods A cross-sectional study was conducted among 150 adults aged above 20 years with established T2DM. Data collected included demographics, anthropometry, fasting and postprandial glucose and glycated hemoglobin (HbA1c). Neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI) and Vibration Perception Threshold (VPT). Nutrition knowledge was evaluated using a validated modified Dietary Knowledge Questionnaire (DKQ), while vitamin B12 intake was estimated using the Cobalamin Intake in North Indians by Food Frequency Questionnaire (COIN-FFQ). Results Participants (mean age 52.8 ± 11.26 years) showed poor glycemic control (fasting glucose 169.88 mg/dL, postprandial glucose 242.33 mg/dL, HbA1c 7.95%). Nutrition knowledge was inadequate in 44% of participants. Estimated dietary vitamin B12 intake was 4.28 ± 2.36 µg/day, and neuropathy was present in 44.66%. Weak but significant correlations were observed between body mass index (BMI) and B12 (negative), B12 and HbA1c (positive), and nutrition knowledge and HbA1c (negative). No association was found between B12 intake and neuropathy. Conclusion The findings highlight poor glycemic control, low nutrition literacy and high prevalence of neuropathy, emphasizing the need for targeted nutrition education and routine screening for vitamin B12 status in rural T2DM populations.