FAQ: Vitamins for Diabetes and Metabolic Control

 

What is diabetes?There are nearly 400 million people who suffer from diabetes worldwide. This is equivalent to around 8% of all men and women, with almost equal prevalence for both sexes. Diabetes mellitus refers to the group of metabolic diseases wherein there is persistent hyperglycemia (high blood sugar) over extended periods. The classifications of diabetes are:

 

  • Type 1 Diabetes Mellitus occurs when the body fails to produce insulin. This was previously known as “juvenile diabetes”, or “insulin-dependent diabetes”. Type 1 DM presents with the loss of the insulin-producing beta cells of the islets of Langerhans in the pancreas. However, the body still maintains its responsiveness to insulin. The cause of this condition is still unknown, although an autoimmune component has been considered.

 

  • Type 2 Diabetes Mellitus was previously known as “non insulin-dependent diabetes”, or “adult-onset diabetes”. This occurs when the cells of the body develop resistance, and eventually fail to respond, to insulin. The failure of insulin receptors to respond to insulin has been implicated in several studies. This has been associated with obesity and sedentary lifestyle. Other factors that have been shown to be risk factors include diets with excess consumption of sugar-sweetened drinks, white rice, and fatty foods.[1]

 

  • Gestational diabetes occurs when pregnant women who have no prior history of diabetes present with persistently elevated blood sugar levels.

 

What are the symptoms of diabetes?

 

Diabetes has a broad range of symptoms, though the classical presentation follows the 3P’s: polyphagia (increased hunger), polydipsia (increased thirst), and polyuria (frequent urination). The symptoms may develop rapidly, or gradually, depending on the type of diabetes. Other symptoms that can indicate diabetes include blurring of vision, frequent fatigue, slow healing of wounds, pins and needles sensation over the fingers and toes, pruritus (itch), and skin rashes.

 

How is diabetes treated?

 

Diabetes is treated with a combination of pharmaceutical therapy and lifestyle changes. Important lifestyle changes include the change in diet, with reduction in the consumption of simple sugars, and fatty foods. Exercise and physical activity are also emphasized. There are numerous drugs that have been developed to lower blood sugar, including metformin, glimepiride, voglibose, and others. For Type 1 diabetics, injection with insulin is necessary. The goal of diabetes therapy is to maintain blood sugar within the normal range, as well as to prevent any complications from diabetes.

 

How can vitamins be used to help people with diabetes?

 

Vitamins should be used with care in the treatment of people with diabetes.[2] They are best used when the patient suffers from, or is at risk for, nutritional deficiencies.[3]

 

  • Vitamin A – there is no evidence showing that diabetics are at risk for deficiency in Vitamin A. It is therefore recommended that vitamin A shoud be taken within the amount recommended for daily intake. There are numerous adverse effects associated with vitamin A overdose, such as the yellowing of the skin from excess beta-carotene, and the increased risk of liver fibrosis, osteoporosis, and birth defects.

 

  • Vitamin B – Methylfolate is a form of vitamin designated as vitamin B9, and usually comes in a dosage of 5mg. This has been shown to have potential positive effects on cognition for adults. Vitamin B3 (nicotinamide) has been shown in some studies to have potential protective effects for the beta cells of the pancreas, and can potentially protect residual function in patients with type 1 or type 2 diabetes. Methylcobalamin, or vitamin B12, can be provided as supplement to prevent nerve dysfunction. It can also be given in 5mg doses. Vitamin B supplementation has been shown to be safe in adults with diabetes, and can be considered to prevent deficiencies in vitamins B1, B6, B9, and B12.

 

  • Vitamin C – also known as ascorbic acid, this has been shown to be a potential anti-oxidant. Some studies have shown that diabetics may have depleted tissue stores of vitamin C, implying that supplementation may be beneficial. Supplementation with ascorbic acid can be useful in lowering formation of atherosclerotic plaques, improving wound healing, and preventing microangiopathies.

 

  • Vitamin D – can refer to vitamin D3 (cholecalciferol), which is produced by the body to help with the absorption of calcium, iron, magnesium, phosphate and zinc. Adequate stores of vitamin D can come from normal exposure to sunlight and proper diet, and a supplementation of 2500 IU can be given to prevent deficiency.

 

  • Vitamin E – also known as tocopherol. This has been shown to be an antioxidant capable of reducing oxidation of low density lipoproteins (LDLs) and stabilizing platelet membranes. The antioxidant effects has made it a potential tool to counteract the free radical damage associated with chronic conditions, such as cancer and cardiovascular disease. Low levels of vitamin E have also been shown in patients with diabetes. Some studies have shown that vitamin E can demonstrate cardioprotective effects, although further research is still needed. Supplementation with vitamin E has been reasonable for diabetics.

 

Prescription vitamins should be considered as supplementary only, and not a primary means of treatment for people with diabetes. The research showing their effectiveness in reducing the symptoms of diabetes, or in lowering the risk for the complications from diabetes, is minimal at best. The most effective treatment for diabetes is still compliance to the treatment regimen, and making effective lifestyle changes, such as diet and exercise.

 

[1] Malik VS, Popkin BM, Bray GA, Després JP, Hu FB (2010-03-23). “Sugar Sweetened Beverages, Obesity, Type 2 Diabetes and Cardiovascular Disease risk”. Circulation 121 (11): 1356–64. doi:10.1161/CIRCULATIONAHA.109.876185. PMC 2862465. PMID 20308626.

[2] O’Connell BS. 2001. Select vitamins and minerals in the management of diabetes. Diabetes Spectrum. 14(3):133-148.

[3] Chehade JM, Sheikh-Ali M, Mooradian AD. 2009. The role of micronutrients in managing diabetes. Diabetes Spectrum. 22(4):214-218.