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Supplementing Can Help With Management of Diabetic Symptoms
The mainstay of diabetes treatment is insulin or other diabetic medications, a well-balanced low glycemic diet and regular exercise. There are also claims that certain vitamins, minerals and herbal supplements can help with diabetes control.
While many of the claimed supplements have no supporting scientific evidence, there is evidence that vitamin D and B12 are often deficient in diabetics. Supplementing can help with diabetes control and reduce the symptoms caused by the deficiency.
Before supplementing, however, it is best to get your blood checked for specific deficiencies. Repeat testing is also advisable, as you may need to adjust the dose as your body reaches normal vitamin levels. The best place to start is by seeing your doctor or specialist.
In diabetics, low vitamin D increases the risk of developing cardiovascular disease (heart attacks, strokes), which is the leading cause of death in diabetics.
Studies have shown vitamin D supplements may help prevent death of the cells that produce insulin, may enhance insulin production, and may increase the body’s sensitivity to insulin — all of which improve control of blood sugar levels. This can reduce many of the side effects of diabetes, such as kidney disease and poor circulation.
Studies have found many diabetics have deficient vitamin D levels. This may be because they more frequently develop diseases that affect vitamin D, such as intestinal, liver or kidney disease. Certain medications can also affect vitamin D metabolism.
Vitamin D can be produced by exposure to sunlight and is helped by daily exercise. It is also present in certain foods, such as oily fish. But many of us do not get enough sunlight or eat enough of the right foods to obtain sufficient vitamin D.
The people most at risk are those with very dark skin (who do not absorb as much sunlight), people who avoid the sun, people who spend most of their time indoors, and people who cover up completely.
The aim of vitamin D supplementation is to maintain blood levels of 50 ng/mL. Most studies indicate this can be achieved with daily supplementation of 4000 IU. Supplementation with 1200 mg of calcium per day is also recommended.
The scientific jury is still out on whether or not diabetics should supplement with magnesium. Magnesium is required for vitamin D function, for conversion to its active form and for transport around the body.
Magnesium is also needed for insulin activity, to help with insulin-mediated uptake of sugar into cells. Like vitamin D, low magnesium is linked to cardiovascular disease, type 2 diabetes, nerve dysfunction and bone disorders, among others.
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Many diabetics may be low in magnesium, but the ratio of magnesium to calcium may be more important than the magnesium levels by themselves. If the ratio is either too low or too high, this can lead to problems.
In particular, a low ratio may increase the risk of cardiovascular disease. There is some concern that with calcium supplementation to prevent osteoporosis, many people have calcium to magnesium ratios that are too high.
Unfortunately, however, there are limited studies currently available to safely advise magnesium supplementation, but listen out for new developments in this area. Calcium supplements to prevent osteoporosis are still advised.
Many diabetics have low vitamin B12. Metformin, the most common type 2 diabetic drug, inhibits absorption of vitamin B12 from the intestines.
Up to 30 percent of people taking metformin may have vitamin B12 deficiency. Type 1 diabetics also have an increased risk of developing pernicious anemia. This disease specifically affects absorption of vitamin B12 from the gut.
Vitamin B12 deficiency is also more common in vegetarians, in people with certain conditions, such as pancreatitis and celiac disease, and with certain medications.
Low vitamin B12 can cause anemia and neurological deficits. Symptoms include fatigue, weakness, constipation, loss of appetite, weight loss, memory and thinking difficulties, and numbness or tingling in the hands and feet.
Vitamin B12 also helps the digestive system maintain steady sugar levels. If you are suffering from symptoms, ask your doctor to perform a blood test to check for vitamin B12 deficiency. If lacking, daily supplements or a yearly injection may help.
Metformin can reduce the absorption of folic acid from the intestines, as well. Diabetics who become pregnant are at increased risk of having babies with birth defects if they do not take a folic acid supplement in the early stages of pregnancy.
Diabetics of childbearing age are advised to take folic acid supplements of 400 mcg per day. Folic acid supplementation may also reduce the risks of diabetic cardiovascular disease in other patients, but studies are not yet conclusive.
Recent studies have suggested supplementing the mineral chromium can improve control of blood sugar levels in diabetics. However, long-term studies on the safety of chromium supplementation and of combining it with other supplements have not yet been conducted. Again, watch for developments in this area.
While there are theoretical reasons for taking vitamins B6, E, C and H, again the evidence in these areas is still lacking.
A number of herbal and other medications are purported to help control blood sugar levels. Vanadyl does have insulin-like properties and clinical trials are currently underway to determine its safety and benefits.
Berberine, purslane, gymnema, banana leaf extract and pterocarpus marupium are Chinese and Indian medicine, plant-derived products that may help control blood sugar levels.
Limited studies indicate they may in fact lower blood sugar levels; however, we don’t yet know how they do this and what harm they might be doing in the process. Berberine, for example, may have detrimental effects on the liver and because of the suspected way it works, you certainly shouldn’t combine use with metformin.
Vitamins are like medications — they play an important part in body functioning. Excesses may be as harmful as having too little.
It is advised to stick to drugs that are regulated, have a known dosage, and have trials to prove their safety and effectiveness. Various supplements can also interact with other medications you might be taking. For this reason, it is always good to talk to your doctor before taking any supplements.