DiabetesSource

by R. Keith Campbell RPh, FAADE, CDE

Last month, I addressed natural products related to treating diabetes. They were summarized as being overhyped, with very few legitimate outcome studies to prove their safety and effectiveness. Although it is challenging to find good studies in the diabetes literature, many studies have been done related to the use of vitamins and minerals (V/M) in diabetes patients.

Most of the articles are published in nutrition journals, however, and do not get reported in the diabetes literature. It is known that there is a long lapse of time from the moment fruits and vegetables are picked, to when they’re processed, shipped, and finally make it to grocery stores. In addition, many are irradiated and sprayed or injected with chemicals to keep them looking fresh. These practices, combined with the fact that less than 10 percent of the US population eats the adequate number of fruits and vegetables each day, suggests that daily supplementation with vitamins and minerals might make sense.

Most healthcare providers, in their one-hour lecture on nutrition, are told that if a patient is eating a balanced, healthy diet then there is no need for supplements. Yet, it is recommended that children, pregnant mothers, the elderly, those under stress, alcoholics, and individuals taking a long list of medications that interfere with vitamin absorption SHOULD take a vitamin/mineral supplement. The challenge then is to determine what V/M to take and in what dose. This is not an easy problem to solve.

There is emerging evidence to show that certain anti-oxidants like resveratrol may also be of benefit to diabetes patients, though these anti-oxidants are not really categorized as V/M.

Supplements

I have now had diabetes for 62 years. I have kept up on the V/M-related diabetes literature for over 40 years. I have concluded that most patients with diabetes would benefit from taking daily supplements of the following V/M:

• Vitamin D: 2000 IU daily for adults and 800 IU for children depending on their serum levels of vitamin D3. Many patients do not get adequate vitamin D due to not being in the sun (for fear of skin cancer).
• Magnesium has an impact on over 300 enzyme systems in the body, and foods containing Magnesium are not recommended for people with diabetes. In addition, if a person has high blood glucose levels, they urinate out magnesium. It is guesstimated that up to 80 percent of diabetes patients have low body stores of Magnesium. I personally take two Slow-Mag tablets daily.
• Zinc has been shown to assist in the healing process and can impact diabetes. There are Zinc supplements available that also provide B vitamins, plus vitamin C.
• Omega 3 fish oils are known to be beneficial in managing lipid disorders and are recommended for diabetes patients.
• B vitamins can impact many body functions and have been promoted for healthy nerves and eyes in diabetes patients.
• Vitamin C is a good anti-oxidant and should be recommended. I take at least 750 mg daily.

For patients taking any of the statin lipid lowering drugs, Coenzyme Q10 should be taken each day. I used 300 mg but we do not have good studies to prove what an effective dose is. One can also build a case for taking sustained release Alpha Lipoic Acid for its impact on neuropathy. Patients using metformin can also develop low levels of Vitamin B12.

Note also that calcium is recommended, especially for women, for bone health. Patients can develop other conditions like iron deficiency anemia, which would require iron supplements.

Most individuals can get a daily supplement by going to a drug store and purchasing a multiple vitamin product. I decide whether or not to take a V/M based on making sure that it is SAFE for me, and if it has any evidence that it could be beneficial to me as a person with diabetes. I want to believe that I am making a good choice by using the supplements, but some of my critics say that I am only developing expensive urine, as I excrete possibly unneeded micronutrients.

Please consult your healthcare provider and pharmacist to find out which V/M supplements are SAFE for YOU before beginning a new regimen.

Sources

R. Keith Campbell, "Magnesium and Diabetes: A Clinical Concern?" Practical Diabetology, Vol. 6, No. 3, May/June, 1987, pg. 8.

R. Keith Campbell, "Leading Diabetes Pharmacist Talks About Daily Vitamin Supplements," Diabetes Interview, March 1994, pg. 1, 12-13, 385.

R. Keith Campbell, "Vitamins and Minerals Essential for Good Health; Some Have Special Benefits," Diabetes in the News, May/June 1994, Vol. 13, No. 3, pg. 20-22.

R. Keith Campbell, Susan L. Thom, "Micronutrients and Diabetes: The Supplementation Controversy," Diabetes Spectrum, Vol. 8, No. 4, July/August 1995, pg. 238-246.