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Metformin Metformin is a drug used to treat diabetes mellitus. The anti-diabetic drug decreases the level of sugar produced by the liver from the blood stream and increases its uptake by the body. Metformin is about thirty percent more effective in prevention of mortality due to diabetes mellitus type II than insulin, glibenclamide and chlorpropamide. (1). Metformin reduces the glucose level by non-pancreatic mechanism without promoting the secretion of insulin rather it improves the activity of the secreted insulin. Metformin triggers adenosine monophosphate kinase (AMPK) by reducing the rate of gluconeogenesis and affects the process of glucogenolysis which reduces the production of glucose by the liver. This drug is known for its uniqueness for not causing hypoglycemia. It has been observed that intake of metformin for several years resulted in weight gain of 10 kg while glibenclamide and insulin resulted in increase in 3kgs and 6kgs respectively (2). Various cross-sectional studies have reported vitamin B12 deficiency among type II diabetes mellitus patients. Vitamin B12 deficiency among such patients is related with the increased use of metphormin among such patients. About 5.8 % to 33% of the patients with intake of metformin among type II diabetes mellitus patients have been reported with vitamin B12 deficiency. Pflipson et al. explained that vitamin B12 deficiency is the condition with vitamin B12 concentrations <100pg/ml or raised serum methylmalonic acid of >243 nmol/L or homocysteine concentrations of >11.9 nmol/L if the serum vitamin B12 concentrations were 100-350pg/ml. Qureshi et al. defined vitamin B12 deficiency as < 150pg/ml (4).