Vitamins are vital for life, and, ideally, should be maintained in adequate levels in the foods we eat. With over-farming and genetic modification of foods, the vitamin and mineral content today may not supply the nutrients of the foods past, or even meet what is necessary for optimal health. Add in fast foods, convenience foods, and high fat and sugar choices (some very cleverly disguised), and the ability to meet nutritional requirements becomes questionable.

A large longitudinal study found that adults who used vitamin supplements were 24% less likely to develop diabetes than those who did not. The protective effect of vitamins remained when adjusted for age, race or ethnicity, education, cigarette smoking, systolic blood pressure, use of antihypertensive medication, serum cholesterol, body mass index, exercise, alcohol consumption, fruit and vegetable intake, percent calories from fat, and total energy intake. Clearly, vitamins are an important part of health maintenance.

Vitamin B₃ (Niacin, Niacinamide, Nicotinamide)

Niacin plays an important role in fat, cholesterol, and carbohydrate metabolism. It is an essential component of the glucose-tolerance factor, giving it a key role in hypoglycemia and diabetes. Niacin has been shown to be deficient in people with diabetes.

Niacinamide, a water-soluble amide of nicotinic acid, has been used successfully to prevent or delay the onset of type 1 diabetes, lowering the incidence from 15-20 per 100,000/year to 8 per 100,000/year. Treatment with high-dose niacinamide appears to delay rather than completely reverse disease development in those with preexisting type 1 diabetes. However, treatment of ‘at risk’ groups, in the majority of studies, shows promise in disease prevention.

Lipid profiles in people with diabetes have been improved with niacin supplementation. Niacin has been shown to increase HDL, decrease triglycerides, and decrease LDL in patients with or without diabetes. HbAlc levels remained unchanged in this study, however, another study found extended release niacin improved both HbAlc and lipid profile in diabetics.

Self-medication of high-dose niacin should be discouraged. Flushing, stomach irritation, and hepatic damage may occur with high doses. In normal individuals, niacin has been known to cause insulin resistance. Because of the capacity to disrupt blood sugar control, diabetics taking any form of niacin must monitor their glucose closely.

Vitamin B₆ (Pyroxidine), B_n (Cobalamin), and Folk Acid (Folate)

Vitamins B₆ and Bi₂ have been shown to be deficient in people with diabetes, especially those with diabetic neuropathy. Further, B₁₂ absorption is reduced by metformin. B₆ prevents the glycosylation of proteins, and may be a safe treatment for gestational diabetes. Studies have shown that folate, B₆, and Bi₂ reduce homocysteine levels in diabetics.

Biotin

Biotin supplementation has been shown to enhance insulin sensitivity and increase the activity of glucokinase. Biotin significantly lowers fasting blood sugar and improves glucose control in both type 1 and type 2 diabetes. Insulin requirements must be monitored with high-dose biotin supplementation.

Vitamin C (Ascorbic Acid)

Because the transport of vitamin C into cells is facilitated by insulin, it is often deficient in people with diabetes. High doses of vitamin C have been found to inhibit aldose reductase, inhibiting the conversion of D-glucose to d-sorbitol, then to fructose. Left unchecked, sorbitol and fructose accumulate in cells, causing damage to glucose insensitive tissues: the eye lens, renal glomeruli, and peripheral nerves, exacerbating many of the common complications of diabetes.

Vitamin E

Vitamin E appears to play a significant role in preventing diabetes. In a 4-year prospective study, a low plasma vitamin E was associated with a 3.9-fold increase in risk of diabetes. A 1 µmol/l decrement in serum vitamin E corresponded with a 22% increment in diabetes risk. Supplementation of vitamin E not only improves the action of insulin, but also has a number of beneficial effects that may prevent long-term complications of diabetes.

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