People living with type 2 diabetes may be hiding their vitamin deficiency, new research shows BMJ Nutrition, Prevention, Health Found.
About one in ten Americans suffer from diabetes. According to the Centers for Disease Control and Prevention, there are most (90%) Type 2. Research efforts show that these people are at an increasingly high risk of nutritional deficiency, especially if they live in the United States.
Vitamins, minerals and trace elements, including vitamin D, magnesium and calcium, are essential micronutrients that the body needs to function properly. Gül Bahtiyar, MDan internal medicine physician specializing in endocrinology, diabetes and metabolism at NYC Health + Hospitals, and was not involved in this study.
People can have genetic predispositions to certain nutritional deficiencies, but whether or not they are lacking is strongly linked to their diet, she added.
“A modern lifestyle that prioritizes convenience and speed often leads to a lack of nutritious whole foods in our diet,” Batya said. health. “Processed foods are convenient and readily available, but are usually stripped of essential micronutrients during the manufacturing process.”
A diet that is too expensive to produce ultra-processed foods that are popular in the American diet can cause type 2 diabetes in the first place. Continuing to eat excessive amounts of these foods can make the condition worse after a person develops it, Bathiard said.
The new study, led by Indian researchers, compiled data from 132 studies around the world that documented more than 52,000 nutritional deficiencies in type 2 diabetes.
They found that worldwide, around 60% of diabetics have low levels of vitamin D, while 42% and 29% have magnesium and vitamin B12 deficiency, respectively.
Approximately 45% of people with complications from the disease were deficient in multiple micronutrients. However, this rate was close to 54% of Americans.
In 49%, women were more likely to suffer from micronutrient deficiency than men.
Gender-based differences were not particularly surprising given that women tend to have lower vitamin D levels specifically. Beth Chelwonney, Lordreported by a nutritionist registered at the Human Nutrition Center for Cleveland Clinic Center. health.
She added that most people in the study were hospitalized when researchers collected data on micronutrient levels. This is why the measurements are low.
Previous studies have shown that around a third of the world have at least one nutritional deficiency, but that number is much lower in the US. In the United States, the percentage of micronutrient defects depends on many factors, including age, race, and gender assigned at birth. It also depends on the nutrients.
CDCs range from less than 1% of folic acid, vitamin A, vitamin E to about 10% of vitamin B6, vitamin D and iron in US populations. Vitamin D deficiency can be 31% among Black Americans (someone with dark skin has more melanin, so vitamin D cannot be derived from sunlight).
Multiple factors may explain the relationship between type 2 diabetes and higher than average nutritional deficiencies, he said. Daya Krishan Mangal, MDadjunct professor at IIHMR University in Jaipur and led the research.
She said that people have regular foods, metabolisms altered by diabetes, and the effects of certain diabetic drugs can all affect the way the body absorbs and utilizes nutrients.
“Those with diabetes may follow a restrictive diet to manage their blood sugar levels, which can lead to inadvertently inadequate micronutrients.” health.
Metformin, a widely prescribed drug for type 2 diabetes, has been shown to interfere with the body's ability to absorb vitamin B12. This malabsorption can have a snowman effect, exacerbating other defects that people with type 2 diabetes may already have, Bahtiyar said.
This new study found that people who took metformin had a higher prevalence of micronutrient deficiency, particularly vitamin B12. Approximately 29% of people with type 2 diabetes and taking metformin were deficient in vitamin B12.
“Vitamin B12 improves metabolism by breaking down foods that are more efficient at eating,” Czerwony said. healthadds that metformin interferes with the small intestine's ability to utilize B12.
Batiyar said that inadequate complications from type 2 diabetes and disease can lead to more micronutrient defects.
“Chronic conditions such as heart disease, neuropathy, and kidney disease can alter the body's ability to absorb and utilize essential micronutrients,” she said.
When people are making poor dietary choices, such as foods that are high in unhealthy fats, salt, sugar, or low in micronutrients, this “creates a vicious cycle and further complicates management of type 2 diabetes.” Bathiard said.
Even if you have no other conditions besides type 2 diabetes, your body can remove micronutrients if diabetes is inadequately managed.
“When blood sugar levels are high, the body tries to flush out excess glucose through the urine. This process flushes out magnesium and lowers the levels of these nutrients,” Batillard said.
Micronutrients are essential to how the body functions at the cellular level. Vitamins, minerals and trace elements are involved in the body's metabolism, including how the body produces and processes glucose, Batillard said.
For example, calcium and vitamin D play a major role in insulin resistance and secretion. At the same time, the body says magnesium helps move blood sugar into the cells and regulate how the body uses it.
A study published in 2024 found that zinc deficiency could destroy B cells. This plays an important role in glucose metabolism. Several studies have shown that zinc supplements can help people with type 2 diabetes manage their illnesses.
While routine micronutrient testing is not a protocol for managing type 2 diabetes, Mangal said people might want to talk to healthcare providers about screening.
“Regular screening for certain defects such as vitamin D and magnesium can help identify and address potential gaps in nutrition,” he said.
If the screening reveals a lack, it is always best to get extra nutrients from food on top of the supplement. However, people's diets may require them, especially if they do not contain a lot of vitamin B12, vitamin D or calcium.
“My advice to patients is to eat a variety of colorful fruits and vegetables and minimal processed foods,” Batiyar said. “Dealing with diabetes's micronutrient deficiency begins with lifestyle changes and healthy food choices. Food is a medicine.”