Blood sugar, diabetes, and supplements

Type 2 diabetes is spreading like a bushfire. An alarmingly many people have metabolic syndrome – or pre-diabetes – which is characterized by insulin resistance, hypertension, elevated cholesterol levels and abdominal obesity (apple-shaped body). Type 2 diabetes and metabolic syndrome are associated with enormous human and socio-economic costs. In this article, we will look closer at chromium, vitamin D, magnesium, and coenzyme Q10 plus relevant diet changes to see how they can positively affect blood sugar levels, cholesterol balance, and weight control. We will also take a closer look at supplements that are able to prevent diabetic neuropathy, a disorder that can lead to amputations.

Having stable blood sugar levels is vital for your energy levels, health and well-being. The brain and nerve cells normally use carbohydrate as fuel, whereas cells in tissues like the muscles and the heart are also able to make energy from fat and protein.
The body breaks down dietary carbohydrate into blood sugar (glucose) that is absorbed in the bloodstream. The pancreas then secretes insulin, a hormone that functions as a key by helping glucose enter the cells.
A main meal should ideally keep you full for four to six hours, possibly with help from an in-between snack. However, modern diets contain far too much carbohydrate, especially the refined and liquid forms that make you feel hungry again shortly after eating, so you feel tempted to snack. This is a vicious cycle because the increased carbohydrate intake increases the risk of insulin resistance, where cells have difficulty with taking up glucose from the blood. Because there is a natural limit to how much carbohydrate we can have in our blood or store in our liver in the form of glycogen, there is a risk of eventually developing non-alcoholic fatty liver disease (NAFLD) and metabolic syndrome with elevated cholesterol, hypertension, and abdominal obesity (apple-shaped body).
Metabolic syndrome, which is an early stage of type 2 diabetes, is linked to a host of different health problems, including chronic low-grade inflammation and damage to the heart, eyes, kidneys, and blood vessels, which is a direct cause of the poor quality of life, the reduced life expectancy, and the huge costs.
First and foremost, one must attempt to control blood sugar levels in a natural way, but it is important to realize that this can never replace vital medicine. In the following chapters, you can read more about studies that show how certain supplements can positively influence blood sugar levels and why it is a good idea to limit your carbohydrate intake. It is also important to try to maintain normal weight and waist circumference and that becomes a lot easier when your blood sugar levels are stable.

Chromium

Vitamin D

Magnesium

Vitamin B12, vitamin D and diabetic neuropathy

Q10 and statins

New dietary guidelines with fewer carbohydrates

Chromium

Chromium is part of chromodulin, a compound that attaches to insulin and enables it to get more glucose into the cells. Chromium, in other words, is a precondition of optimal carbohydrate turnover. You can think of this as getting better mileage with your car.
Chromium is found in various foods such as almonds, beans, nuts, fish, meat, and eggs. The agricultural soil lacks chromium and this results in chromium-depleted crops. In addition, our modern and refined diets only provide small quantities of the nutrient, and eating too many refined carbohydrates also tends to leach chromium from the body. A chromium supplement may be a good idea if you have unstable blood sugar or suffer from insulin resistance.
A number of studies have shown that chromium supplementation can help type 2 diabetics manage their blood sugar when they combine it with their normal treatment.
According to a placebo-controlled study published in Biological Trace Elements, the following improvements were observed in type 2 diabetics who took 200 micrograms of chromium per day for 12 weeks:

• Increased insulin sensitivity
• Reduced fasting blood glucose (a sign of improved glucose uptake)
• Lower blood pressure
• Reduced body weight
• Reduced levels of C-reactive Protein (CRP is an inflammation marker)
• Reduced levels of malondialdehyde (MDA is a marker of oxidative stress)
• Increased antioxidant capacity

Based on these findings, the scientists conclude that chromium supplementation has a positive impact on blood sugar levels and on cardiovascular health.

Chromium yeast has the best effect on blood sugar levels

The European Food Safety Authority (EFSA) has concluded that organic chromium yeast is absorbed up to 10 times better than synthetically manufactured chromium sources like chromium picolinate and chromium chloride. Always check the label before you buy chromium.

Did you know that elevated cholesterol is often a result of non-alcoholic fatty liver, which is caused by consuming too much carbohydrate?

Vitamin D

Vitamin D controls a host of different genes and numerous biochemical processes in the body, some of which are important for the blood sugar balance. For instance, the insulin-produce cells of the pancreas have vitamin D receptors, and similar receptors have been found in the brain’s hypothalamus, which helps regulate our appetite and metabolism
An American study published in Nutrients shows that high blood levels of vitamin D is linked to fewer biomarkers associated with metabolic syndrome, type 2 diabetes, and cardiovascular disease.
More specifically, the participants with the highest levels of vitamin D in their blood (75 nmol/L) had lower levels of triglycerides and homocysteine and higher levels of HDL cholesterol. Moreover, there were fewer cases of insulin resistance. This suggests that they had better carbohydrate turnover and a lower risk of developing diabetes. Participants with the highest blood levels of vitamin D also had better cardiovascular fitness (CVF).
Although the official threshold value for vitamin D is 50 nmol/L, it appears that levels in excess of 75 nmol/L are ideal in terms of carbohydrate turnover and the prevention of insulin resistance and type 2 diabetes.
As mentioned, type 2 diabetes is characterized by chronic low-grade inflammation, which can be quite harmful. Vitamin D, on the other hand, has some important anti-inflammatory properties.

Our own production of vitamin D and the use of supplements

At northern latitudes, people are only able to synthesize vitamin D in the skin during the summer period. During these months, one can easily produce between 30-100 micrograms of vitamin D on a single day, depending on how much time you spend in the sun and how much skin is exposed. Seniors and dark-skinned people, however, are challenged when it comes to making enough vitamin D. Even diabetics have difficulty with maintaining vitamin D levels because of impaired kidney function and/or being overweight.
High-dosed vitamin D supplements (20-80 micrograms) are available on the market. The actual need for the nutrient depends on factors such as sun exposure, age, skin type, BMI, or having chronic diseases like diabetes. Vitamin D is a lipid-soluble nutrient. With supplements, it is best to take vitamin D that is dispersed in oil in gelatin capsules. Also, make sure to get enough magnesium, as this nutrient is important for the body’s ability to utilize vitamin D.

Magnesium

Magnesium is primarily found in wholegrains, kernels, nuts, and cabbage or other coarse vegetables. Magnesium helps activate vitamin D in a process that primarily takes place in the kidneys. Magnesium also helps regulate blood levels of vitamin D by increasing the levels when they are low and decreasing them when they are high. This was shown in a study from Vanderbilt University in the United States.
In a large Japanese study that is published in Diabetic Medicine, scientists found that magnesium profoundly protected against type 2 diabetes among the Japanese people. This was particularly true for people with insulin resistance and excessive alcohol intake.
In the Framingham Offspring Study that monitored a group of people for a longer period of time, it turned out that higher magnesium intake increased insulin resistance and lowered the risk of type 2 diabetes. Several other studies show a similar trend.

Vitamin B12, vitamin D, and diabetic neuropathy

Diabetic neuropathy (nerve inflammation) is insidious and is often overlooked because the symptoms don’t occur until the very late stages of the disease. The neuropathy is caused by inflammation and damage to the part of the nervous system that controls the cardiovascular functions. This primarily affects the circulation in the feet and legs. In severe cases, amputation may be necessary. Diabetic neuropathy is linked to an increased risk of morbidity and death caused by cardiovascular failure and other causes. According to Christian Stevns Hansen, a Danish doctor, low blood levels of vitamin D and vitamin B12 are linked to an increased risk of diabetic neuropathy. However, this is preventable in the early stages if you make sure to get enough vitamin D and vitamin B12. Many diabetics lack vitamin B12 because they take metformin, which is known to lower levels of the nutrient. As mentioned earlier, many diabetics have difficulty with maintaining levels of vitamin D because of impaired kidney function and/or being overweight.
Also, beware that the body needs magnesium to activate vitamin D.

Q10 and statins

Q10 is a coenzyme that is important for the cellular energy turnover. Q10 is also a powerful antioxidant that helps protect against atherosclerosis. The body makes most of its own Q10 but the endogenous synthesis of the compound begins to decrease around the time we enter our twenties. In a study where type 2 diabetics received 200 mg of Q10 daily for three months, the scientists observed a reduction in levels of HbA1c, which is a measure used to determine blood glucose levels over a period of 8-12 weeks. In other words, Q10 improved the glucose uptake and blood sugar control in these patients. This study is supported by similar studies of diabetics.
Earlier research shows that daily supplementation with 200 mg of Q10 for three months reduces oxidative stress and the risk of atherosclerosis and cardiovascular disease. Moreover, cholesterol-lowering statins inhibit the endogenous Q10 synthesis. This may result in various side effects such as muscle aches, tiredness, breathing difficulty, impotence, and lack of vitality – simply because the cells cannot make enough energy.
Studies show that the use of statins (simvastatin in particular) increases the risk of type 2 diabetes by 10-40 percent.
It is possible to reduce statin-induced side effects with concomitant use of Q10 supplements that can compensate for the reduced endogenous synthesis of the compound. This was shown in a study from 2007, in which American scientists gave either 100 mg of Q10 or placebo to statin users who complained of aching muscles. It is comparatively difficult for the body to absorb Q10. Therefore, one must always make sure to take a supplement with documented bioavailability.
The aim, in the long run, is to treat the underlying cause of the elevated cholesterol. In many cases, it is because of metabolic syndrome and type 2 diabetes where unstable blood sugar is the actual problem.

New dietary guidelines with fewer carbohydrates

Ever since the 1970s, the general advice for everyone, including diabetics, has been to eat a low-fat diet with bread, potatoes and other carbohydrate sources. Now, a Danish study shows that it is better to cut down on your carbohydrate intake. The new study is carried out by researchers from Bispebjerg Hospital and the universities in Aarhus and Copenhagen. The study included 28 type 2 diabetics and lasted 12 weeks. For six weeks, the patients were fed a traditional diabetes diet, where around 60% of the energy came from carbohydrates. For another six weeks, the patients were given a low-carbohydrate diet with more protein and fat. The energy distribution was as follows: 40% came from fat, 30% came from protein, and 30% came from carbohydrate. The study participants were assigned to the two diets in random order.
This well-controlled study revealed that a diet with less carbohydrate, more protein, and more fat has the following positive effect in type 2 diabetics:

• It improves their glycemic control by lowering postprandial blood glucose
• It lowers levels of HbA1c, which is a measure of long-term blood glucose
• It reduces the amount of triglyceride in the liver and the blood
• It offers benefits for type 2 diabetics, even if they don’t lose weight

According to the Danish study, diabetics should choose non-starchy vegetables such as cabbage and other bitter vegetables and stick with sweets potatoes instead of regular potatoes. Also, diabetics should limit their intake of corn and sugar (refined flour, pasta, bread, candy, juice, etc.) and choose whole raw materials instead of industrially processed foods. It is also important to get plenty of protein and healthy fats with all main meals. The study is published in the science journal Diabetologica.
The Danish study is supported by numerous other studies that have been published over the years. In fact, in 1972, John Yudkin, a British professor, demonstrated that eating large quantities of sugar is bad for your health. But he was ignored by health authorities and the food industry.
Just for the record, many industrially processed foods contain a lot of sugar, and what makes it tricky is that sugar has many different names. Always check the label so you know what you are ingesting.

References

Alireza Farrokhian et al. The Influences of Chromium Supplementation on Metabolic Status in Patients with Type 2 Diabetes Mellitus and Coronary Heart Disease. Biological Trace Element Research 2020

Huang H et al Chromium supplementation for adjuvant treatment of type 2 diabetes mellitus: Results from a pooled analysis. Molecular Nutrition Food Research 2017 and 2018

EFSA: Scientific Opinion on ChromoPrecise cellular bound chromium yeast added for nutritional purposes as a source of chromium in food supplements and the bioavailability of chromium from this source. EFSA Journal 2012

Ganji V et al. Serum Vitamin D Concentration ≥75 nmol/L Is related to Decreased Cardiometabolic and Inflammatory Biomarkers, Metabolic Syndrome, and Diabetes; an Increased Cardiorespiratory Fitness in US Adults. Nutrients, 2020

The North American Menopause Society (NAMS) Vitamin D could lower the risk of developing diabetes. ScienceDaily 2019

Scott LaFee. Vitamin D Deficiency Linked to Greater Risk of Diabetes. UC San Diego Health. April 2018

Plasma 25-hydroxyvitamin concentration and risk of type 2 diabetes and pre-diabetes. 12-year cohort study. PLoS One 2018
Qi Dai et al. Magnesium status and supplementation influence vitamin D status and metabolism; results from a randomized trial. The American Journal of Clinical Nutrition 2018

Vanderbilt University Medical Center. Magnesium optimizes vitamin D status, study shows. ScienceDaily 2018

Hèctor Vàzquez-Lorente et al. Response of Vitamin D after Magnesium Intervention Postmenopausal Population from the Province of Granada, Spain. Nutrients. 2020

Anne Marie Uwitonze, Mohammed S Razzaque. Role of magnesium in Vitamin D Activation and Function. The Journal of the American Osteopathic Association. 2018

Christian Stevns Hansen. Almindelige vitaminer og mineraler er forbundne med alvorlige komplikationer hos diabetes patienter. Formidling af Ph.d. afhandlingen: Exploring new risk markers for diabetic cadiovascular autonomic neuropathy.

Will Chu. Co enzyme Q10 has potential to help chronic condition symptoms, review finds.

Alehagen U, et al. Cardiovascular mortality and N-Terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation. Int J Cardiol. 2012

Tor Ole Kjellevand. Kolesterol, venn eller fiende? Helsemagasinet Vitenskap og Fornuft. 2015

Pernille Lund: Q10 - fra helsekost til epokegørende medicin. Ny Videnskab 2014

Bispebjerg Hospital. Færre kulhydrater forbedrer type-2 diabetikeres evne til at regulere blodsukkeret. Nyhedsbrev 10. august 2019

Mads J Skytte et al. A Carbohydrate-reduced high-protein diet improves HbA1c and liver fat content in weight stable participants with type 2 diabetes: a randomized trial. Diabetologica. First online 23 July 2019

Pernille Lund. Sådan får du styr på dit blodsukker og din vægt. Ny videnskab 2013

Diabetes i Danmark | Viden og forskning | Diabetesforeningen

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