The role of vitamins and minerals in the treatment of diabetes
Type 2 diabetes is spreading like a bushfire and is the major cause of vision loss, kidney failure, heart attacks, strokes, and leg amputations. Many people have insulin resistance, the early stage of type diabetes that is associated with fatigue, untimely hunger, and increasing weight. The diet plays a major role and according to a new review article that is published in Human Nutrition and Metabolism, various B vitamins, vitamin D, vitamin K, vitamin E, and zinc influence insulin resistance and diabetes treatment. Previous research has also shown that chromium and magnesium play a role in insulin resistance and blood sugar regulation.
The number of diabetics increased from 108 million in 1980 to 422 million in 2014, and the alarming growth rate continues to skyrocket. In 2019 alone, an estimated two million people died of diabetes complications such as kidney disease and cardiovascular disease.
Type 2 diabetes is a lifestyle disease that typically occurs as a result of consuming too many carbohydrates and too much processed food. This burdens the pancreas and its production of insulin, the hormone that carries glucose into our cells. Over time, people develop insulin resistance, which is a condition that impairs the ability of cells to take up glucose from the blood, and where insulin levels are permanently elevated. As a result of this, people don’t feel satiated and develop cravings for so-called fast carbohydrates such as white bread, pizza, candy, soft drinks, alcohol, or other types of energy “fixes”. The liver is also burdened by the huge quantity of carbohydrates (especially fructose, sweeteners, and juice) and ends up working as a fat factory. The elevated insulin levels are also linked to oxidative stress and chronic inflammation, which speeds up the progression of the disease.
The early stage of type 2 diabetes is called metabolic syndrome and characterized by apple-shaped body type, overweight, insulin resistance, elevated cholesterol levels, elevated blood lipids, and hypertension.
Because diet plays a major role in the development of diabetes, the new review article aimed at looking at how vitamins and minerals affect insulin resistance and the treatment of diabetes.
B vitamins
B vitamins are mainly found in coarse greens, liver, meat, and fish. Vitamin B12 is only found in animal foods. B vitamins support a variety of enzyme processes that are important for our hormones, nervous system, immune system, etc. Folic acid, vitamin B6, and vitamin B12 help the body break down an amino acid called homocysteine. Elevated blood levels of homocysteine can cause damage to the circulatory system. Factors like eating a strictly plant-based diet or using metformin for treating type 2 diabetes can increase the risk of a vitamin B12 deficiency. According to a meta-analysis published in Journal of Clinical Nutrition, type 1- and type 2 diabetics can reduce their cardiovascular mortality by making sure to get enough folic acid from their diets or by taking supplements. A Danish study showed that supplementation with vitamin B12 and vitamin D is useful as part of the prevention and treatment of diabetic neuropathy, which can otherwise lead to amputations and other serious complications.
Vitamin B6 and its active form, P-5-P (pyridoxal 5-phosphate), are involved in around 160 different enzyme processes that are important for our energy production, blood sugar levels, magnesium utilization, and antioxidant protection. Studies show a link between lack of P-5-P (active vitamin B6), insulin resistance, and diabetes.
Vitamin D
The sun is our primary source of vitamin D but an estimated one billion people worldwide have too low blood levels of the nutrient. Most cells in the body have vitamin D receptors (VDR). The vitamin is believed to control 10 percent of our genes. Vitamin D is important for our pancreas, the production of insulin precursors, the immune defense, and for regulating inflammatory processes. Lack of vitamin D during childhood increases the risk of developing type 1 diabetes later in life, and lack of vitamin D also increases the risk of type 2 diabetes.
Studies show that high-dosed vitamin D supplementation increases insulin sensitivity and lowers the risk of developing diabetes. Vitamin D supplementation also lowers long term blood sugar (HbA1c)
Vitamin K
We primarily get vitamin K1 from dark leafy greens. We need vitamin K1 for blood coagulation, and a healthy and well-functioning gut flora is able to convert vitamin K1 into vitamin K2. We also get vitamin K2 from butter, soft cheese, egg yolks, and fermented foods like sauerkraut and Natto. Vitamin K2 is needed for the activation of the MGP protein that clears calcium from the bloodstream, and for osteocalcin, the protein that embeds calcium in our bones. Because of this dual role, vitamin K2 prevents atherosclerosis and osteoporosis at the same time.
In the review article, the authors write that vitamin K2 has a positive impact on the body’s turnover of carbohydrates and fats. One study showed that 36 months of vitamin K2 supplementation increased insulin sensitivity in old men and women. Vitamin K2 is also believed to improve the capacity of some molecules called ligands that are important for blood sugar regulation.
Vitamin E
Good sources of vitamin E are unspoiled plant oils, avocados, nuts, kernels, seeds, egg yolks, and dairy products. Vitamin E serves as an antioxidant that protects against oxidative stress. That way, the vitamin reduces the risk of atherosclerosis and diabetic neuropathy, which can otherwise result in amputation. Vitamin E is also believed to lower long term blood sugar (HbA1c) in type 2 diabetics.
Zinc
Zinc is mainly found in shellfish, meat, dairy products, legumes, nuts, and kernels. Zinc from animal food sources has better absorption in the body. Zinc supports hundreds of enzyme processes and important antioxidants that protect cells against oxidative stress. Animal studies have demonstrated that zinc supplementation improves the metabolism of carbohydrates and fats. It has been seen that zinc activates the signaling pathways of various kinases that are important for blood sugar regulation. Zinc can also improve the effect of insulin, regulate the cellular insulin receptors, and support a healthy balance between blood lipids such as LDL and HDL cholesterol. The new review article only focuses on zinc in relation to diabetes, but minerals like chromium and magnesium are also important for preventing and treating diabetes and its early stages.
Chromium
Chromium is primarily found in almonds, meat, shellfish, beans, and cocoa beans. It is also found in smaller quantities in corn, fruit, vegetables, and dairy products. Chromium is part of a substance called chromodulin that attaches to the inside of the cellular insulin receptors, thereby increasing the cells’ glucose uptake. At the same time it stimulates tyrosine kinase, which is an enzyme that amplifies the cells’ glucose conversion. Lack of chromium therefore increases the risk of insulin resistance and unstable blood sugar.
According to a Chinese study, blood levels of chromium are inversely related to metabolic syndrome in adults. The European Food Safety Authority (EFSA) refers to scientific studies showing that chromium supplementation can increase insulin sensitivity, lower fasting blood sugar levels, reduce triglycerides, and improve the LDL/HDL ratio. According to EFSA, pharmaceutical-grade chromium yeast is the best chromium source because it is absorbed up to 10 times better than other sources such as chromium picolinate and chromium chloride.
Magnesium
Magnesium is primarily found in coarse greens. The mineral supports at least 300 different enzyme processes that are important for our nervous system, circulatory system, immune system, and for the body’s activation of vitamin D. A review article published in Advanced Biomedical Research states that magnesium is important for the pancreas and its functions, insulin, interactions with cellular insulin receptors, and the liver’s glucogenesis (production of glucose or glycogen from other substances than carbohydrates).
The authors of the new review article conclude that magnesium supplementation can improve cellular insulin sensitivity and the uptake of glucose in cells, while lowering oxidative stress and chronic inflammation. They believe that magnesium supplementation is therefore useful in the prevention and treatment of diabetes.
Other ways to control blood sugar levels and improve therapy for type 2 diabetes
- Lower your intake of carbohydrates - especially the refined and liquid carbohydrates such as white flower, sugar, chips, pizza, juice, soft drinks, café latte, and alcohol
- Focus more on protein, healthy fats, and a diet with lots of vegetables. This helps lower your carbohydrate uptake and puts less strain on the pancreas by improving satiety, so you don’t eat as much.
References:
Samer Younes. The role of micronutrients in the treatment of diabetes. Human Nutrition and Metabolism. 2024
Gong Xiaohua et al. Severe Vitamin D Deficiency Is Associated With Increased Expression of Inflammatory Cytokines in Painful Diabetic Peripheral Neuropathy. Frontiers in Nutrition. 2021
Christian Stevns Hansen. Almindelige vitaminer og mineraler er forbundet med alvorlige komplikationer hos diabetespatienter. Formidling af Ph.d. afhandlingen: Exploring new risk markers for diabetic cardiovascular autonomic neuropathy.
Azadehalsadat et al. The Therapeutic Effects of Magnesium in Insulin Secretion and Insulin resistence. Advanced Biomedical Research 2022
Sijing Chen et al. Association of plasma chromium with metabolic syndrome among Chinese adults: a case-control study. Nutrition Journal. 2020
Pernille Lund. Sådan får du styr på dit blodsukker og din vægt. Ny Videnskab. 2013
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