Vitamins for diabetics: selection algorithm and contraindications

In this article we will tell you:

1. Is it possible to take vitamins if you have diabetes mellitus type 1 and 2?
2. Essential vitamins and minerals for type 1 and type 2 diabetics
3. Vitamins for eyes for diabetes
4. Algorithm for choosing a vitamin complex for patients with diabetes
5. Use of vitamins for diabetes during pregnancy
6. Vitamins for children with diabetes
7. Contraindications and overdose of vitamins for diabetes

Diabetes

is a serious, chronic disease that can cause numerous long-term complications if not properly controlled. The most important factor in preventing serious complications of diabetes is strict control of blood sugar levels through diet and dietary supplements, since elevated glucose levels can cause all sorts of serious problems.

Is it possible to take vitamins if you have diabetes mellitus type 1 and 2?

Diabetes affects your body's ability to make or use insulin, a hormone that allows your body to convert glucose (sugar) into energy.

Insulin

is a natural hormone. Your pancreas produces and releases it when you eat. Insulin helps transport glucose from the bloodstream to cells throughout the body, where it is used for energy.

The impact of diabetes on your body also depends on your type. There are two main types of diabetes: type 1 and type 2.

Type 1 diabetes mellitus (T1DM), also called juvenile diabetes or insulin-dependent diabetes, is a disorder of the immune system. Your own immune system attacks the insulin-producing cells in your pancreas, destroying your body's ability to produce insulin. With T1D, you need to take insulin to live.

Type 2 diabetes mellitus (T2DM) is associated with insulin resistance. It used to occur in older people, but now more and more younger people are being diagnosed with T2DM. This is the result of poor lifestyle, poor diet and exercise.

With T2DM, your pancreas stops using insulin effectively. This causes problems with the ability to extract sugar from the blood and transfer it to cells for energy. Eventually, this may lead to the need to take insulin.

Early phases such as insulin resistance (prediabetes) can be effectively controlled through diet, exercise and careful blood sugar monitoring. It may also prevent the full development of T2DM.

If left untreated, it can lead to potential complications including heart disease, stroke, kidney and nerve damage.

For example, women with diabetes are twice as likely to have another heart attack after their first. Their risk of heart failure is four times higher than women without diabetes. Men with diabetes are 3.5 times more likely to develop erectile dysfunction (ED).

It is important to remember that diabetes can be controlled. In some cases, remission may even occur if you change your lifestyle in time.

Type 2 diabetes can develop slowly. Symptoms may be mild and easy to ignore at first. Early symptoms may include

:

1. constant hunger;
2. lack of energy;
3. fatigue;
4. weight loss;
5. excessive thirst;
6. frequent urination;
7. dry mouth;
8. itchy skin;
9. blurred vision.

As the disease progresses, symptoms become more severe and potentially dangerous.

If your blood glucose levels have been high for a long time, symptoms may include:

• yeast infections;
• slow-healing cuts or sores;
• dark spots on the skin, a condition known as acanthosis nigricans;
• leg pain;
• numbness of the limbs or neuropathy.

If you have two or more of these symptoms, you should see a specialist. Without treatment, diabetes can become life-threatening.

Research has shown that deficiencies in essential nutrients contribute to the development of some chronic complications of diabetes, while proper use of dietary supplements can help diabetics control their glucose levels by lowering their blood pressure and protecting their bodies from diabetic complications.

When glucose levels increase, the removal of chromium, calcium, and magnesium accelerates. The need for antioxidants also increases as oxidative stress develops. Vitamin deficiency is due to other reasons

:

• All diabetics need to follow a special diet. They are prohibited from many foods that are a source of essential microelements.
• The disease is accompanied by frequent urination. Many essential minerals, such as potassium, are excreted in the urine.
• A fat metabolism disorder develops and weight increases. This impairs the absorption of many vitamins.

That's why it's so important to know what vitamins you need to take if you have diabetes. Properly chosen drugs help compensate for the lack of nutrients, strengthen the immune system, and speed up metabolic processes. The supply of essential microelements is necessary to prevent complications and improve the patient’s well-being.

Essential vitamins and minerals for type 1 and type 2 diabetics

People with diabetes have higher requirements for many nutrients, especially water-soluble vitamins and minerals.

A significant role in the occurrence and development of type 1 and type 2 diabetes mellitus is played by two factors that lead to structural and functional changes in cell membrane lipids: lipid peroxidation and excessive formation of free radicals.

In a healthy person, the body maintains a balance between the rate of lipid peroxidation and the activity of the antioxidant system (vitamins A, E, C, superoxide dismutase, catalase, etc.). In diabetes mellitus, this balance is disturbed: the rate of formation of free radicals is higher than the rate of their neutralization. In this regard, one of the areas of treatment for diabetes is the administration of antioxidants (vitamins A, E, C, lipoic acid, selenium) to eliminate oxidative stress.

Vitamin A (retinol)

is necessary to prevent eye pathologies that often develop with this disease.

Taking retinol strengthens the immune system and increases the permeability of cell membranes.

Vitamin A neutralizes highly toxic forms of oxygen that are continuously produced during the normal functioning of any cell. With an overwhelming number of diseases, including diabetes, the amount of toxic forms of oxygen increases sharply.

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It should be noted that vitamin A undergoes autoxidation with the formation of peroxide compounds, so its intake must be combined with other antioxidant compounds (vitamins C and E, selenium, etc.), which increases its biological activity

Vitamin E (tocopherol)

is an antioxidant that helps prevent the negative effects of oxidative stress. It neutralizes the effects of free radicals on cells, protecting the patient from complications. Additional tocopherol intake:

• normalizes blood pressure;
• improves the condition of skin and hair;
• restores blood supply to the retina;
• slows down aging.

B vitamins

– these are the most important microelements that participate in all metabolic processes and in the functioning of many organs.
High glucose levels and taking glucose-lowering medications impair their absorption. Therefore, diabetics are recommended to take them regularly
:

1. Thiamine

   (B1) normalizes carbohydrate metabolism and activates blood circulation. Helps prevent retinopathy and neuropathy.

2. Riboflavin

   (B2) stimulates the production of hemoglobin, protects the eyes from pathologies, and normalizes digestion.

3. Niacin

   (B3) strengthens the walls of blood vessels, reduces cholesterol levels, regulates microcirculation.

4. Pantothenic acid

   (B5) regulates the functioning of the adrenal glands, helps overcome stress.

5. Pyridoxine

   (B6) is necessary for diabetics to prevent disorders of the nervous system. This trace element also improves insulin absorption and prevents the development of neuropathy.

6. Biotin

   (B7) acts similarly to insulin, increasing its effectiveness. It normalizes energy metabolism and stimulates the synthesis of fatty acids.

7. Folic acid

   (B9) stimulates protein metabolism, improves blood supply and tissue regeneration.

8. Cyanocobalamin

   (B12) is important for all types of metabolic processes. It improves appetite and liver function.

Vitamin C (ascorbic acid)

participates in metabolism, increases the effectiveness of insulin, strengthens the immune system, regulates blood clotting.

Oxidative stress causes a deterioration in insulin secretion, and vitamin C therapy stops the damaging effects of free radicals and reduces the severity of insulin resistance

Vitamin D (calciferol)

- prevents the development of osteoporosis and skin diseases, strengthens bones and teeth, normalizes the functioning of the heart muscle.

Research shows that taking vitamin D in the form of alpha-calcidol and cholecalciferol improves the course of the disease.

Study

: The Effects of Vitamin D Supplementation in Newly Diagnosed Type 1 Diabetes Patients: Systematic Review of Randomized Controlled Trials

It also allows the absorption of phosphorus and calcium, and is an immunomodulator - its deficiency is accompanied by frequent viral/bacterial infections.

Alpha lipoic acid

has been used successfully in Germany for the treatment of diabetic neuropathy for over 30 years.

This vitamin-like substance is often described as "nature's ideal antioxidant" as it can neutralize water- or fat-soluble free radicals both inside and outside cells.

Although the main factor in the treatment of diabetic neuropathy with alpha lipoic acid is considered to be its antioxidant effects, it has also been shown to improve blood glucose metabolism, blood flow to peripheral nerves, and stimulate nerve fiber regeneration.

It is also important not to forget about minerals that increase immunity in diabetes:

• Selenium

  is a strong antioxidant that protects tissues from oxidative stress. It prevents the appearance of cataracts and normalizes the functions of the pancreas.

• Iron

  – necessary for normalizing carbohydrate and lipid metabolism and strengthening the immune system.

• Chromium

  – participates in carbohydrate metabolism, improves the absorption of insulin, increases its activity. It is needed to prevent cataracts. This mineral helps with dieting as it reduces cravings for sweets.

• Zinc

  – improves the patient’s condition and prevents many complications. It reduces cholesterol levels and activates insulin synthesis. Zinc accelerates tissue regeneration and strengthens the immune system.

• Magnesium

  – This mineral is required by all diabetics. It regulates the conduction of nerve impulses and improves the condition of the retina.

  Clinical studies have shown that magnesium supplements enhance insulin action, improve body response, glucose tolerance, and red blood cell membrane fluidity in patients with diabetes.

  Note: Consult a specialist about magnesium supplementation if you have severe kidney failure or are currently on dialysis.

• Manganese

  plays an exceptional role in the pathogenesis of diabetes mellitus. Manganese activates target ligands involved in insulin synthesis and gluconeogenesis. It has been established that manganese deficiency causes type 2 diabetes mellitus and leads to the development of complications such as liver steatosis.

Multivitamin complex

Good results are obtained with drugs specially designed for patients with diabetes mellitus with disorders of carbohydrate and lipid metabolism. Such complex preparations contain an optimal ratio of essential substances and microelements, which will help restore metabolism and replenish the deficiency of their reserves in the body.

Let's look at the most well-known names of vitamins that endocrinologists prescribe for diabetes:

• Alphabet,
• Vervag Pharma,
• Complivit Diabetes,
• Doppelhertz Active.

Alphabet Diabetes

The vitamin complex was created taking into account the metabolic characteristics of a diabetic’s body. The drug contains substances that prevent the development of diabetes complications. And succinic and lipoic acid improve glucose metabolism. The course of treatment is 30 days, tablets are taken 3 times a day with meals.

The drug contains herbal components, and also includes 13 vitamins and 9 microelements

Vervag Pharma

The drug is a complex of multivitamins that is prescribed to diabetics to reduce the risk of developing hypovitaminosis, dysfunction of the central nervous system and decreased immunity.

The complex includes 11 types of vitamins and 2 microelements

The complex contains chromium, which reduces appetite and eliminates excess intake of sweet foods. The substance also enhances the effect of hypoglycemic hormone and reduces glucose levels in the bloodstream.

The course of treatment is 1 month, therapy with a multivitamin complex is carried out 2 times a year. The drug should be taken after meals, as it contains fat-soluble substances that are better absorbed after eating.

Complivit Diabetes

It is a dietary supplement designed to cover the daily requirement for vitamins and microelements in patients with diabetes. Regular intake of the complex improves the functioning of the pancreas, normalizes biochemical processes, and reduces blood sugar levels.

The complex contains 12 vitamins and 4 microelements

The supplement contains ginkgo biloba extract, which improves microcirculation, helping to prevent the occurrence of diabetic microangiopathy. The therapeutic course is 30 days, tablets are taken once a day with meals.

The selection of a vitamin complex depends on the stage of the disease and the patient’s condition. When choosing a drug, it is necessary to take into account the properties and biological role of the vitamin in the body; for example, an overdose of peredoxin can neutralize the effect of insulin. Regardless of the choice of drug, it is necessary to adhere to the treatment regimen and avoid overdose.

Vitamins for eyes for diabetes

Hypertension, atherosclerosis, diabetes mellitus - these diseases entail an increased risk of impaired blood supply to the eyes.

Most vitamin complexes, dietary supplements and other similar non-drug products that have a positive effect on the eyes can be divided into three main groups

:

• based on carotenoids – contain primarily beta-carotene and/or lutein;
• based on anthocyanins;
• universal - they contain both carotenoids and anthocyanins.

However, for normal eye function, other vitamins and microelements listed above are needed. They can also be part of one or another complex.

Algorithm for choosing a vitamin complex for patients with diabetes

The first thing you need to carefully study is the composition. You need to look not only at what vitamins and other substances are contained in a certain complex, but also at their percentage.

Manufacturers often include a large number of auxiliary components in their products that do not affect vision in any way.

You should also find out if there have been any studies done on the vitamins that have caught your attention. Usually, information about studies and their confirmed effectiveness and safety is in the instructions.

In addition, the instructions must indicate contraindications and possible side effects.

.

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From the instructions you will learn how and with what frequency it is recommended to take vitamins.

Vitamins are offered in different forms.

It can be:

• pills;
• capsules;
• solutions - they are produced for those who for some reason cannot swallow tablets and capsules, and are most often intended for children.

Taking multivitamin/multimineral supplements has been shown to improve immunity to infectious diseases in people with diabetes.

The choice of a vitamin complex should be based on the criterion of high potential.

That is, capable of providing a level of daily intake of water-soluble vitamins at least three to five times higher than the RDI

(Recommended Daily Intake),
minimum RDI for fat-soluble vitamins
, as well as a full spectrum of mineral compounds.

There are several other natural foods that can help improve blood sugar control.

Chief among them are supplements consisting of high-viscosity dietary fiber

, such as
PGX, and herbal extracts containing Gymnema sylvestre, cinnamon, mulberry and flavonoid-rich plant extracts.

Recent studies have shown that flavonoids are extremely important in preventing long-term complications, especially in the case of diabetic retinopathy.

Flavonoid-rich extracts have many different mechanisms of beneficial action.

Choose from the following products:

1. Blueberry extract (25% anthocyanidins): 160-320 mg per day.
2. Grape seed or pine bark extracts (95% procyanidol oligomers): 150-300 mg per day.
3. Green tea extract (total >80% polyphenols): 150-300 mg per day.
4. Milk thistle extract (70% silymarin: 210-350 mg per day.

One fundamental truth that is rarely explained to patients with type 2 diabetes is that in almost every case it is caused by poor diet and lifestyle choices.

Findings from the US government's Third National Health and Nutrition Examination Survey clearly support this claim: 69% of people with type 2 diabetes either did not exercise at all or exercised irregularly, 62% ate less than five servings of fruit and vegetables per day, and 82% were overweight or obese.

Among patients with prediabetes, at least 150 minutes per week of physical activity was associated with a 58 percent reduction in the risk of developing diabetes. In the same study (known as the Diabetes Prevention Program), the drug metformin was found to reduce the risk of developing diabetes by only 31 percent.

While lifestyle changes are important, diet alone can also be quite effective in treating and even eliminating type 2 diabetes.

Study

: How could dietary patterns have a role in prevention, progression, or management of diabetes mellitus?

The most convincing scientific approach prescribes a low-carbohydrate diet. This regimen not only ensures lower blood glucose levels, but also helps in cases of high cholesterol, heart disease and hypertension.

The need for microelements depends on the age of the patient, the type and severity of the disease, and the presence of complications. Therefore, you should not decide on your own what vitamins to take if you have diabetes. A specialist will help you determine which vitamins you need most.

The whole truth about vitamins

The word “vitamin” is familiar to everyone, this is a fact. What do you associate it with? With fruits, vegetables, berries or with colorful tablets with bright smells in plastic jars? With the sun or with yellow capsules? Or maybe with fatty drops in darkened glass bottles?

Let me remind you that there are 13 vitamins: 4 of them are fat-soluble - A, D, E, K, 9 are water-soluble - C and numerous B vitamins. Most vitamins are not synthesized in the human body. In this regard, they must be supplied regularly with food. The exception is vitamin D, which is formed in the skin under the influence of ultraviolet radiation, and several vitamins synthesized by bacteria in our intestines.

Why are vitamins needed?

Vitamins, although in extremely small doses, are vital for us. Without them, the body cannot function normally. Unlike proteins, fats and carbohydrates, vitamins are not a source of energy, which means they do not contain calories and are not a building material. They perform another important role - they facilitate the occurrence of chemical reactions in the body. We use them every day when we see, breathe, think, talk. Vitamins can cure us from such terrible, but already rare diseases as scurvy, night blindness, pellagra, beriberi.

Here are some examples of vitamin deficiencies from history. During long voyages to other continents, sailors ate canned food and dry rations, and they developed a disease unknown at that time, which was later called scurvy. Severe drowsiness appeared, arms and legs swelled, teeth fell out, gums bled, and bruises appeared everywhere. In the end, the sailors died from hemorrhages in various organs. Historians believe that in those days, sailors died from scurvy more often than from storms, shipwrecks and wars combined. Ship owners accounted for 50% of crew mortality from scurvy on any long voyage. Infections were considered the initial cause of scurvy. It was not immediately clear that the culprit of the disease was a lack of vitamin C, and to cure scurvy, it was enough to feed the sailors oranges.

The main idea: we need vitamins, the human body practically does not know how to synthesize them, so they need to be consumed externally.

Do I need to take additional vitamins?

Fortunately, everything described above has become a thing of history, and today it is difficult to find a person with scurvy, beriberi (vitamin B1 deficiency) and other types of vitamin deficiencies. Sailors now eat foods enriched with vitamins.

But there were many more questions. Where can I get vitamins? Are there enough of them in the fruits and vegetables we eat? Should medications containing vitamins be taken by everyone or only children – growing organisms? Do men need them for strength, mental workers for productive brain activity, women for beauty, and older people for health? Are they important for those planning pregnancy and pregnant women, because their need for vitamins is higher? And, besides, both planning parents need folic acid to prevent the development of a neural tube defect in the fetus, right? Should a breastfed baby be given vitamin D drops? Do high doses of vitamin C help with colds? Who and how much is missing vitamins today? Everyone? Pregnant? Children? Sick? There are a lot of questions. Let's try to figure it out together.

Nowadays they write a lot about the fact that modern, industrially grown vegetables and fruits have few vitamins compared to their predecessors from the 60s and 70s. It’s one thing to have grandma’s lumpy apples with worm holes, grown on fertile soil in a known place without pesticides, which spoil quickly. It’s completely different to have equally smooth red shiny apples from Poland or tasteless pears from China.

At the same time, the body is very smart: if there are few vitamins in food, it enhances their absorption, if there are many, it removes the excess in the urine. And yet, debates about whether or not it is necessary to take additional vitamins are ongoing, since it is difficult to establish the amount of substances that have reliably entered the tissues when taking artificial vitamins.

Recent research suggests that if your diet is complete and varied, then neither you nor your children need additional vitamins. To date, there is no evidence in favor of universal multivitamin intake. However, there are several groups of people who may benefit from vitamins:

• Elderly people, mostly in nursing homes
• Vegetarians and vegans
• Pregnant and nursing
• Premature babies

And even for these categories it is better not to take ready-made complexes of many vitamins and minerals, but to initially find out the deficiency of specific substances. For example, vegans who completely exclude animal products, i.e. meat, fish, dairy products, eggs, gelatin, it is necessary to consume additional vitamin B 12 in the form of supplements.

The main idea: it’s worth spending a little time and effort and thinking about your diet, making it complete and varied.

Vitamins and diabetes

A reasonable question arises: should people with diabetes take vitamins or not? Let's look at the research and current recommendations.

The Russian guidelines for the management of patients with diabetes from 2021 state: “The intake of vitamins (in the absence of clinical signs of vitamin deficiency) and antioxidants is not recommended due to insufficient knowledge of the long-term results of their use.”

A similar document for Canadian doctors says that people with diabetes should eat a balanced diet to ensure they get all the nutrition they need. Taking multivitamins is not recommended. Additional vitamin D intake at a dose of 400 IU (10 mg) per day is recommended for people over 50 years of age. Additional intake of folic acid in a dose of 0.4-1.0 mg per day is recommended for women planning pregnancy. The need to take other artificial vitamins should be decided on an individual basis.

The European Society of Cardiology, together with the diabetes community, emphasizes in its guidance that the use of vitamin supplements to reduce the risk of developing type 2 diabetes or cardiovascular risk in people with diabetes is not recommended.

The European Dietary Guidelines for People with Diabetes agree with other European societies and emphasize that there is no evidence to support vitamin supplementation for people with diabetes.

The main idea: to date, there are no studies proving the benefits of taking multivitamins for people with diabetes, either for the prevention of complications or for their treatment.

B vitamins

There is an opinion that B vitamins should be included in the list of drugs for the treatment of diabetes. But to date, the positive effect of taking B vitamins neither for the prevention nor for the treatment of diabetes complications, including polyneuropathy, has not been proven. Who really needs extra B vitamins?

• Patients taking metformin for a long time may experience a deficiency of vitamin B12 (cyanocobalamin). To determine whether you need additional use, contact your doctor.
• Anyone planning to become parents is recommended to take folic acid in a dose of 0.4 - 0.8 mg daily. Pregnant women up to 12 weeks should take 5 mg of this vitamin regularly.
• If you are vegan, don't forget to take extra vitamin B12.

Vitamin C

In the 70s, Lymus Pauling's theory was popular: he proposed using large doses of vitamin C - 1000 mg per day or more - for rapid recovery from colds and cancer. The author of the method himself consumed 12,000 mg of ascorbic acid per day.

Now there is a lot of controversy around Pauling's theory, but there is still no clear answer. There are studies that regularly taking vitamin C speeds up recovery from ARVI by 10%. This effect is not observed if you start taking ascorbic acid when you are already sick. Taking vitamin C as a supplement is not recommended either as a treatment for ARVI or as a means of getting rid of cancer.

Interestingly, people who consume vitamin C in the form of fruits and vegetables are less likely to develop lung, breast, and colon cancer. However, this trend is not observed among those who took vitamin C in the form of dietary supplements.

Instead of conclusion : 5 servings of vegetables and fruits daily will provide the body with the required amount of vitamin C.

Vitamin D

The exception is vitamin D. Experts agree that it is still worth taking vitamin D supplements - this has been proven in numerous studies.

Vitamin D can enter the human body with food: there is a lot of it in sea fish, beef liver, egg yolk, and milk. In addition, it is formed in the skin under the influence of ultraviolet radiation. This happens when the sun is active and bright. Excessive exposure to sunlight can lead to photoaging—dry skin, wrinkles and age spots, and an increased risk of melanoma (skin tumors).

If you live north of latitude 33, then for six months in the autumn-winter period, ultraviolet radiation (UVB) does not reach the Earth's surface. The fact is that the rays of the specified spectrum reach the planet when the sun is at an angle of 35 degrees or more. Unfortunately, in autumn and winter in Russia the angle of incidence of rays is less. You can check this on the Internet using the UV index of your place of residence. For sufficient production of vitamin D by the skin when exposed to sunlight, the UV index must be at least 2.

The optimal level of vitamin D is now being actively studied. It is considered normal within the range of 30-100 ng/ml. To ensure such a concentration of the essential substance in the blood, it is necessary to take vitamin D supplements daily. Vitamin D should be taken from the morning until 12 o'clock.

Studies have shown that people who took vitamin D3 supplements lived longer. In addition, there is evidence that children who received vitamin D drops from birth are less likely to develop type 1 diabetes in adulthood.

Breastfed newborns are prescribed vitamin D drops, since mothers' milk does not contain enough of it. Children from 1 month to 2 years of age are recommended to take vitamin D throughout the year, from 2 to 5 years - in the autumn-winter period, from September to May. The usual dose for a child is 400-500 IU per day, but it is better to consult a doctor to select the dose specifically for your baby.

Preserving vitamins

With any heat treatment, the loss of vitamins accelerates. Vitamin C is destroyed when heated to 60 0C and during oxidation. Fat-soluble vitamins A, D, E, K are well preserved when exposed to high temperatures. Vitamins A, D, B2 are destroyed by exposure to sunlight. Vitamin PP is not destroyed by boiling, exposure to light or exposure to oxidizing agents. B vitamins are stable when heated in an acidic environment; in alkaline and neutral environments they are partially destroyed and turn into a decoction. How to preserve vitamins in foods as much as possible?

• Eat more fresh vegetables, fruits, berries and herbs.
• Choose fruits or vegetables that are in season and eat them when they are ripe rather than picked unripe.
• Reduce heat treatment time if possible. Do not cook food longer than indicated on the package. Remember that prolonged heat treatment of foods can increase their glycemic index.
• Place food in already boiling water, not in warm or cold water.
• Cut vegetables into large pieces when cooking. It's even better to boil them whole with their skins on.
• It is healthier to steam vegetables than to boil them.
• Replace heat treatment. Do not cook berries with sugar, it is better to freeze them. Instead of boiling apples for jam or baking them, dry the slices.
• Remember about pickling: sauerkraut retains vitamin C.
• Freeze, freeze and freeze again! This method preserves more vitamins than drying, canning, or pickling. Frozen fruits contain more vitamins than those stored for a long time and sold in stores.
• After defrosting, food should be cooked immediately; do not refreeze it.

“The ability of vitamins to save lives has given rise to a strong belief that they can work miracles for every person, regardless of what exactly their body is lacking. And as a result, our faith in vitamins has become based more on speculation than on facts. If a modern person begins to take vitamins, it is not at all in order to overcome night blindness, pellagra, beriberi,” writes Katherine Price in her book “Vitamania.” Think about it! Journalist Price suffers from type 1 diabetes and is trying to understand the real benefits of vitamins, so if you still have questions, be sure to read Vitamania.

Just recently, no one knew anything about vitamins. 100 years have passed, and invaluable information about their importance for our lives has become available to us. It is quite possible that in the future we will discover something unexpected about our diet - something that we are not even aware of now.

Use of vitamins for diabetes during pregnancy

Increased blood sugar during pregnancy is one of the most common metabolic disorders in an expectant mother. The so-called gestational diabetes mellitus (GDM) or pregnancy diabetes is diabetes that appears during pregnancy and is limited to the duration of pregnancy.

A woman's risk of gestational diabetes is one of the most common obesity-related pregnancy problems. This risk increases significantly if the pregnant woman has an increased BMI >25 kg/m2. The risk of HD in mothers with third-degree obesity (BMI ≥40 kg/m2) increases 8.5 times compared to mothers with normal weight.

During pregnancy, the production of sex hormones (estrogens and progesterone, hCG) and the hormone cortisol, which suppress the action of insulin, sharply increases. As a result, blood glucose levels increase in pregnant women. High blood sugar during pregnancy negatively affects both the health of the woman herself and the health of the fetus, and therefore requires timely diagnosis and subsequent correction.

HD increases the following risks: limited fetal growth, excessive fetal growth or macrosomia (birth weight >4000 g), susceptibility to obesity throughout life, impaired glucose tolerance and development of type II diabetes mellitus in later life, and metabolic disorders in the infant.

During pregnancy, a woman needs to add only 300 calories to her usual diet, and even then only in the last 2 trimesters! A woman with diabetes mellitus additionally requires mandatory carbohydrate monitoring to compensate for carbohydrate metabolism.

Obese pregnant women may be deficient in a number of nutrients at the same time as a result of eating micronutrient deficient foods.

Recommended amounts of vitamins and minerals

per day during pregnancy and lactation according to WHO recommendations:

• Vitamin A, mcg 800.0
• Thiamine (vitamin B1), mg 1.4
• Riboflavin (vitamin B2), mg 1.4
• Niacin (vitamin B3), mg 18.0
• Vitamin B6, mg 1.9
• Vitamin B12, mcg 2.6
• Vitamin C, mg 55.0
• Vitamin D, mcg 5.0
• Vitamin E, mg 15.0
• Folic acid, mcg 600.0
• Iron, mg 27.0
• Zinc, mg 10.0
• Copper, mg 1.15
• Selenium, mcg 30.0
• Iodine, mcg 250.0
• Calcium, g 1.5–2.0

A balanced, proper diet before and during pregnancy provides the body with all the necessary nutrients, with the exception of folic acid and iodine.

Some pregnant women with diabetes may need dietary supplements. The specialist must individually assess the situation of each pregnant woman to determine which multivitamin and mineral supplements she needs.

For example, you cannot take retinol/vitamin A preparations. Therefore, you need to know what vitamins and how many active substances they contain.

The use of high doses carries a risk of overdose, especially if a pregnant woman is taking several drugs at the same time.

What to consider when choosing

Vitamin complexes are not at all as harmless as they might seem at first glance. Therefore, only a doctor who knows exactly how risky it is to use a particular drug in the case of a particular patient should prescribe the right drug.

There is not always a need to take special vitamins, especially with type II diabetes. Therefore, sometimes the doctor prescribes regular vitamins, if necessary.

For example, for a woman with diabetes, a doctor may recommend vitamins for the skin, hair and nails to improve the appearance of the skin. Many vitamins are selected individually, and not in combination, because the body must always have a balance of all substances.

Vitamins for children with diabetes

Currently, the incidence of type 2 diabetes among young people has increased to approximately 5,000 new cases per year. The reasons for this are complex, but risk factors for type 2 diabetes in children include

:

• overweight or body mass index higher than normal;
• high birth weight;
• being born to a mother who had diabetes during pregnancy;
• having a close relative with type 2 diabetes;
• sedentary lifestyle.

The symptoms of type 2 diabetes in children are the same as in adults.

You can help reduce your child's risk by encouraging him to eat well and be physically active every day. Organize your meals in such a way as to ensure that your diet contains all the necessary vitamins:

If, according to specialists, you need vitamins for your child, be sure to read the instructions to clarify at what age you can take this or that complex or dietary supplement.

So, some of them significantly improve the condition.

Studies have shown that in children suffering from type 1 diabetes, long-term intake (3 months) of vitamin E in a daily dose of 100 IU significantly reduces the content of malondialdehyde and glycated hemoglobin while simultaneously increasing the content of glutathione in erythrocytes.

Study

: Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children

results

Table 1. Baseline data on patients

25(OH)D: serum 25-hydroxy vitamin D; DBP: diastolic blood pressure; BMI: body mass index; HDL: high density lipoprotein; LDL: low density lipoprotein; MSLC: muscle strength of the left hand; MSP: muscle strength of the right hand; SAS: systolic blood pressure.

• By the end of the study, a slight increase in serum 25(OH)D , while in the control group there was a slight decrease (26% of patients in the main group and 48% of the control group had 25(OH)D < 20 ng/ml);

• Muscle strength of the hand increased significantly in the main group, and remained unchanged in the control group;

• At the beginning of the study, BMI in the study and control groups did not differ, but by the end of the study in the control group, a larger number of patients gained weight;

• There were no significant changes in the main group in biochemical parameters (fasting glucose, postprandial glucose, HbA1c, triglycerides) and blood pressure (both SBP and DBP)

• At the same time, in the control group, SBP increased significantly.

Table 2. Comparison of basic parameters before and after taking vitamin D

Picture 1.

Muscle strength of the right hand before and after vitamin D supplementation

Figure 2.

Muscle strength of the left hand before and after vitamin D supplementation

Contraindications and overdose of vitamins for diabetes

There are vitamins where the daily norms of vitamins can be ten or even twenty times higher, increasing the risk of hypervitaminosis

It concerns primarily fat-soluble vitamins: A, D, E and K. The body can cope with too much consumption of water-soluble vitamins by excreting them in the urine. Another situation occurs when there is an excess of fat-soluble vitamins.

Excess Vitamin D

manifested by nausea, vomiting, itchy skin, pain in the head and eyes, diarrhea, increased urination, as well as the deposition of excess calcium in soft tissues, in the liver, kidneys, lungs, heart and blood vessels.

Excess vitamin E

may cause gastrointestinal upset, feelings of fatigue and weakness, as well as drowsiness, headaches, muscle weakness, and diplopia. An overdose of this vitamin occurs, but rarely.

Vitamin A

in too large doses can cause nausea, blurred vision, fatigue, heaviness, irritability, lack of appetite, vomiting, headache, hair loss, itching, cracked and bleeding lips.

Vitamin K overdose

, which regulates the blood clotting process, leads to the breakdown of red blood cells and, consequently, to anemia.

The human body is especially sensitive to an overdose of vitamin C. Its excess can lead to crystallization of salts and the formation of kidney stones, and taking very large doses can lead to disturbances in the gastrointestinal tract and nervous system. In addition, excess vitamin C causes skin rashes.

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Its consumption in large doses has a bad effect, especially on the following category of people: pregnant women, patients with diabetes, people with lens cataracts and thrombophlebitis.

In addition to the harmful effects, an excess of certain elements provokes a decrease or loss in the body of other substances it needs. Thus, in addition to the consequences of hypervitaminosis, there is a deficiency of minerals and other vitamins that affect the processes occurring in the body.

Before you include vitamin supplements in your daily diet, you should consult a specialist. As a rule, vitamins are prescribed in monthly courses with breaks of 2-3 months.

Properly selected vitamins will help a diabetic strengthen the body, compensate for substances vital for the body, and slow down the development of complications.

Why does diabetes increase the need for vitamins and minerals?

Each patient requires an individual selection of vitamins and minerals.

Vitamins for type I and type II diabetics are similar. However, in this article we will focus on the vitamins necessary for type 2 diabetes. One of the main reasons for taking vitamins, in this case, is a decrease in cell sensitivity to insulin. That is, if in the first type of diabetes insulin is not produced, then in the second there is enough of it, but the cells do not fully perceive it.

To combat this problem, a whole range of measures is used, including physical exercise, diet and vitamin therapy, taking medications and other methods prescribed by a doctor. If you take all the necessary measures and get enough vitamins and minerals, you can achieve a condition that is equivalent to curing type II diabetes.

Also, the need to take vitamins is due to a number of other reasons:

1. One of the mandatory conditions for maintaining normal sugar levels in diabetes mellitus is following a diet. However, such a diet often turns out to be unbalanced and does not contain the required amount of nutrients.
2. Taking some medications, such as metformin, reduces vitamin B12 levels. Its deficiency can lead to problems with the gastrointestinal tract, nervous system and even vision.
3. When the functioning of the pancreas is disrupted, the production of not only insulin, but also vitamin D occurs. With a lack of this vitamin, bones, muscles and kidneys suffer.
4. With the development of pathology, there is a disruption in the absorption of necessary elements in the gastrointestinal tract, caused both by the disease itself and by taking drugs that control sugar.
5. Due to elevated glucose levels, patients experience an increased urge to urinate, and many useful substances are washed out along with the urine.

A lack of vitamins leads to a deterioration in general condition and various serious consequences.