The Importance of a Daily Multivitamin and Mineral For People with Diabetes and Prediabetes
By Melissa Diane Smith
© Copyright 2005 by Melissa Diane Smith
This article was first published in the online newsletter, June 21, 2005, Issue 265.

With all the single nutrient or herbal supplements that come in vogue and get hyped from month to month, we as health educators and practitioners need to be reminded of the therapeutic value of a daily multivitamin and mineral supplement for people with diabetes. Supplementation with a well-formulated multivitamin and mineral supplement is simple, convenient and cost-effective, especially considering the many health benefits it offers.

A wide range of vitamins and minerals affect glucose metabolism and insulin function, yet people with diabetes routinely don't get enough micronutrients. In research conducted in Germany, diets of type 2 diabetic patients were analyzed and found to be deficient in one or more of 22 nutrients evaluated. More alarming, a whopping 97 percent of the diabetic patients did not obtain three to seven nutrients in the recommended amounts from their diets.

Putting overweight people on weight-reducing, lower-calorie diets - a central strategy in the treatment of diabetes - makes nutrient deficiencies worse. Most of the diets of non-weight-reducing patients in the above study were deficient in 1 to 6 nutrients, but weight-reducing diets were deficient in 3 to 12 nutrients. Furthermore, more than half of the vitamins and minerals from the diets of people on weight-reducing diets tested lower than 50 percent of the Dietary Reference Intakes (DRIs). So, even in a clinical environment where diabetic nutrition counseling and information are available, multiple micronutrient deficiencies from diets are common. Just to meet the DRIs, a multi-nutrient supplement to the diet is needed.

And research shows that a daily multivitamin and mineral supplement does indeed offer real health and quality-of-life benefits for people with type 2 diabetes. In a study reported in the Annals of Internal Medicine in 2003, supplementation with a multivitamin and mineral supplement reduced infection and illness-related absenteeism in diabetic patients by startling numbers. Only 17 percent of diabetic patients who took a multivitamin and mineral supplement experienced an infectious illness - such as an upper respiratory tract infection or influenza-like illness - compared to 93 percent of patients who took a placebo. Equally impressive, no diabetic patients who took the supplement reported one or more absentee days from illness during the 12-month study period, compared to 89 percent of diabetic patients who received the placebo.

Therapeutic Nutrients to Look for in a Multi-Supplement
The value of a daily multivitamin and mineral supplement cannot be underestimated. However, not all multivitamin and mineral supplements are created equal. The best multi-supplement should provide nutrients to fill in the nutritional gaps that people with diabetes frequently have and extra nutrients that are especially beneficial for those with diabetes and prediabetes. The most therapeutic nutrients, according to the research, are:
  • Chromium as chromium picolinate, the form that stands out in scientific studies. In people with type 2 diabetes, regular use of chromium picolinate reduces blood sugar, insulin and hemoglobin A1c levels as well as the common diabetic symptoms of excessive thirst, frequent urination and fatigue. Chromium picolinate supplementation also reduces insulin resistance in people with both diabetes and prediabetes.

  • Magnesium, another mineral critical for healthy insulin function. In one study of nonobese elderly subjects, magnesium supplements improved insulin response and action, and glucose handling.

  • Vanadium, another mineral. Animal studies -- and a few human studies -- have shown vanadium as vanadyl sulfate to lower fasting blood sugar levels or improve insulin sensitivity in cases of diabetes. Vanadium works by mimicking insulin, thereby helping cells to absorb glucose more effectively.

  • Alpha-lipoic acid, a vitamin-like antioxidant that has been used in the treatment of diabetic polyneuropathy in Germany for the past few decades. Type 2 diabetes is characterized by oxidative stress -- higher levels of dangerous free radicals in the body without adequate levels of antioxidants to counteract them. However, alpha-lipoic acid quenches a wide variety of free radicals. Plus, it directly or indirectly regenerates other antioxidants, such as vitamins E and C, coenzyme Q10, and glutathione, thereby reducing the number of free radicals and boosting the antioxidant network to protect against complications associated with oxidative stress, such as polyneuropathy. Alpha-lipoic acid also lowers blood sugar and insulin levels, reduces insulin resistance, and improves insulin sensitivity, according to both animal and some human studies. Supplementation in humans has been found to lower glucose, boost the efficiency of its burning, and improve insulin sensitivity in overweight diabetic patients.

  • Other antioxidants including vitamins C and E. As mentioned earlier, people with diabetes have increased oxidative stress and a greater need for antioxidants. But antioxidants work better together as a network than when used alone. Vitamin C is the body's principal water-soluble antioxidant and vitamin E is the body's principal fat-soluble antioxidant. Vitamin C also seems to edge out some of the glucose in the system or improve its disposal. And vitamin E has been shown to reduce blood glucose levels and improve insulin action in people with type 2 diabetes.

  • Lutein, another antioxidant that appears to prevent free radical damage in the macula and retina of the eyes. Studies have even shown improvements in vision from supplementation with lutein in patients with macular degeneration and in patients with cataracts. People who have diabetes are at higher risk for developing macular degeneration and cataracts. Therefore, they likely could benefit from supplementation even more.
Nutrients and Ingredients to Watch Out For
Practitioners should evaluate multi-supplements based on the nutrients and ingredients they don't have in them as well. Copper and iron are two minerals to avoid. While both are essential for health, they can pose problems for people with insulin resistance, metabolic syndrome, and diabetes at high amounts. Research shows that people who have diabetes have higher copper levels than people who don't have diabetes, and people with diabetic complications such as retinopathy, hypertension, or microvascular disease have higher copper levels than people without diabetic complications. Other studies show an increased risk of type 2 diabetes in women with higher iron levels and a high prevalence of unexplained iron overload in those who have metabolic syndrome, a prediabetic condition.

Excesses of either copper or iron can increase free radical activity, and people with the high blood glucose levels that can occur with metabolic syndrome and diabetes already have high levels of free radicals in their bodies. Excessive levels of copper or iron oxidize and damage tissues, age the body, and greatly increase the risk of coronary heart disease. To be on the safe side, it's best to recommend supplements without iron and copper unless a legitimate iron or copper deficiency is diagnosed.

Also be on the lookout for supplements that don't have fillers, such as sugar, artificial colors and flavors, or common allergens, such as gluten, wheat, dairy, yeast and corn. For general health promotion, it's good to avoid all these unnecessary ingredients.

Few multi-supplements fit the criteria of providing the most well-researched, beneficial nutrients for people with diabetes and prediabetes with none of the bad. One that does, though - and one I've used with great success in my nutrition counseling practice - is Alpha Betic, developed by Abkit.

Research backs up the therapeutic value of a once-a-day multivitamin and mineral supplement. As health educators, we should act on that research and spread the word to our clients and patients to improve their health.
Selected References
AgainstThe Grain Nutrition

© Copyright 2002 -
All rights reserved. Reproduction of material without written permission is strictly prohibited.