Vitamin B12 deficiency is common among patients with type 2 diabetes mellitus (T2D). Although metformin therapy is the principal factor , advanced age with types DM,nutritional deficiency,and malabsorption are other contributing factors (1) The proposed mechanisms for deficiency include impairment of calcium-dependent absorption from the gut, alteration in small bowel motility resulting in bacterial overgrowth, and a reduction in intrinsic factor levels (2).Several studies have reported that metformin-induced vitamin B12 deficiency contributes to the high prevalence and/or worsening of existing peripheral neuropathy in patients with T2D (3).