When we think about risk factors for insulin resistance, pre-diabetes, and type-2 diabetes, we typically think of factors like weight, sedentary lifestyle, dietary habits, hyperlipidemia, and family history of the disease. On the other hand, it’s very rare that we think about nutritional deficiencies as risk factors for these metabolic concerns.
In this article, I’ll share nutritional deficiencies that may contribute to the development of diabetes, and I’ll also share nutritional deficiencies that your patients who have been diagnosed with diabetes are especially at risk for.
Which Nutritional Deficiencies May Increase Patients’ Risk for Insulin Resistance and Diabetes?
A cohort study evaluated 903 adults and found them to be normoglycemic via fasting plasma glucose and oral glucose tolerance testing. [1] These patients’ vitamin D levels were also checked. Follow-up continued for a total of thirty to thirty-two years. By the end of the study, 47 of the patients had become diabetic and 337 of them had been diagnosed with pre-diabetes.
The study authors reported that lower vitamin D levels were associated with increased risk of being diagnosed with diabetes. The study authors further noted that further research was needed in order to determine whether or not high 25-hydroxyvitamin D levels would be preventative in the development of type-2 diabetes or whether or not high levels would protect against the transition from pre-diabetes to type-2 diabetes.
While we need more robust research conducted on humans to come to a definite conclusion, pre-clinical research may shed some light on exactly how low vitamin D levels could be associated with increased risk for type-2 diabetes. First of all, we know from pre-clinical research that 1,25-dihydroxyvitamin D stimulates the pancreatic β-cells, leading to them secreting insulin. [2]
As such, low vitamin D levels are associated with decreased insulin release and, as a result, elevated blood sugar levels. Low vitamin D levels could also contribute to diabetes diagnoses because of vitamin D’s role in inflammation modulation; specifically, low vitamin D levels have been associated with an increase in inflammatory markers like C-reactive protein. Additionally, the effect of skipping breakfast, which is more common in individuals with lower vitamin D levels, may further exacerbate the risk of developing type-2 diabetes by causing blood sugar fluctuations and impaired glucose metabolism.
What Nutritional Deficiencies Are Diabetic Patients Particularly at Risk for?
According to research, there are a few nutritional deficiencies that diabetic patients are especially at risk for. Diabetes management requires adequate levels of several vitamins and minerals, which function as cofactors in metabolic processes. Key micronutrients include:
Vitamin B Complex: This includes B1 (thiamin), B2 (riboflavin), B6 (pyridoxine), B12, niacin, biotin, and folic acid. These vitamins play critical roles in energy metabolism and nerve function, which are particularly important for diabetics due to the risk of neuropathy.
Vitamin C: An antioxidant that may help mitigate oxidative stress associated with diabetes.
Minerals: Important minerals include:
Zinc: Involved in insulin synthesis and secretion.
Chromium: Enhances insulin action and glucose metabolism.
Magnesium: Deficiency can lead to insulin resistance and is common in diabetics, especially those with poorly controlled blood sugar levels.
Selenium and Manganese: These trace elements also play antioxidant defense and metabolic regulation roles.
[To learn more about incorporating intravenous nutrient therapy into your practice, click IV Nutritional Therapy Course Information.]
What Are the Impacts of Micronutrient Deficiencies in Type 1 and Type 2 Diabetes?
Micronutrient deficiencies can lead to several adverse effects in individuals with diabetes:
Impaired Metabolic Function: Deficiencies can disrupt glucose homeostasis, leading to increased insulin resistance and poorer glycemic control.
Increased Risk of Complications: Chronic deficiencies may contribute to complications such as neuropathy, nephropathy, and cardiovascular diseases. For example, low magnesium levels are linked to an increased risk of cardiovascular issues in diabetic patients.
Oxidative Stress: Many micronutrients have antioxidant properties. Their deficiency can increase oxidative stress, further complicating diabetes management and progression.
IV Therapy for Managing Micronutrient Deficiency in Diabetes
Micronutrient deficiencies in individuals with diabetes can worsen the condition and lead to complications. Adequate intake of essential vitamins and minerals improves metabolic control and reduces diabetes-related risks. Furthermore, addressing these deficiencies through strategies such as IV therapy can boost Metformin compliance in new diabetics, as improved nutrient levels may enhance overall treatment effectiveness.
IV therapy can be an effective adjunct, directly delivering these nutrients into the bloodstream to optimize metabolic function and overall health, though it should be used cautiously and under medical supervision.
Benefits of IV Therapy for Diabetic Micronutrient Deficiencies
IV therapy can be a valuable tool in managing micronutrient deficiencies in individuals with diabetes. Some key benefits include:
Enhanced nutrient absorption: Delivering vitamins and minerals directly into the bloodstream bypasses the digestive system, ensuring maximum absorption.
Rapid replenishment of deficiencies: IV therapy can quickly restore depleted levels of essential micronutrients.
Customized formulations: IV treatments can be tailored to address specific deficiencies and individual needs.
Improved metabolic function: Adequate levels of key vitamins and minerals support proper insulin function and glucose metabolism.
IV Therapy for Specific Deficiencies
IV therapy can be used to address various micronutrient deficiencies in diabetics:
High-dose Vitamin C: Helps boost the immune system and prevent cell damage from free radicals.
B-Complex Vitamins: Supports energy production and nerve health.
Zinc, Chromium, Magnesium: Helps improve insulin sensitivity and glucose control.
Considerations for IV Therapy in Diabetes
While IV therapy can be beneficial, it's important to note:
Underlying deficiencies: Supplementation is most effective when deficiencies are present.
Dosage: Excessive intake of certain vitamins like E, C, or A should be avoided.
Monitoring: Regular monitoring of micronutrient status is recommended to guide supplementation needs.
Complementary to other treatments: IV therapy should be used in conjunction with standard diabetes management strategies.
Summary
In conclusion, research suggests that several nutritional deficiencies may be associated with insulin resistance, pre-diabetes, and diabetes. Specifically, preliminary research suggests that low levels of vitamin D may be associated with a greater likelihood of being diagnosed with diabetes.
Additionally, once patients have been diagnosed with diabetes, they may be at greater risk for magnesium and/or zinc deficiency. If they are taking metformin, they may also be at greater risk for vitamin B12 deficiency as well. As providers, we can be proactive about our patients’ potential for increased risk of developing these nutritional deficiencies by making recommendations that will support optimal levels, making it less likely that our patients will experience the worse prognosis that oftentimes accompanies these nutritional deficiencies.
Related blog post: Micronutrient Deficiency in Celiac Disease
References
[1] Park, S. K., Garland, C. F., Gorham, E. D., BuDoff, L., & Barrett-Connor, E. (2018). Plasma 25-hydroxyvitamin D concentration and risk of type 2 diabetes and pre-diabetes: 12-year cohort study. PloS one, 13(4), e0193070. https://doi.org/10.1371/journal.pone.0193070
[2] Lips, P., Eekhoff, M., van Schoor, N., Oosterwerff, M., de Jongh, R., Krul-Poel, Y., & Simsek, S. (2017). Vitamin D and type 2 diabetes. The Journal of steroid biochemistry and molecular biology, 173, 280–285. https://doi.org/10.1016/j.jsbmb.2016.11.021
[3] Tosiello L. (1996). Hypomagnesemia and diabetes mellitus. A review of clinical implications. Archives of internal medicine, 156(11), 1143–1148.
[4] Schmidt, L. E., Arfken, C. L., & Heins, J. M. (1994). Evaluation of nutrient intake in subjects with non-insulin-dependent diabetes mellitus. Journal of the American Dietetic Association, 94(7), 773–774. https://doi.org/10.1016/0002-8223(94)91947-x
[5] Walker A. F. (2007). Potential micronutrient deficiency lacks recognition in diabetes. The British journal of general practice : the journal of the Royal College of General Practitioners, 57(534), 3–4.
[6] Myers, S. A. (2015). "Zinc Transporters and Zinc Signaling: New Insights into Their Role in Type 2 Diabetes", International Journal of Endocrinology, 2015 (167503), 1-7. https://doi.org/10.1155/2015/167503
[7] Adams, J. F., Clark, J. S., Ireland, J. T., Kesson, C. M., & Watson, W. S. (1983). Malabsorption of vitamin B12 and intrinsic factor secretion during biguanide therapy. Diabetologia, 24(1), 16–18. https://doi.org/10.1007/BF00275941
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