Multiple Vitamin Prevents Infections in Diabetics

People with diabetes can reduce their risk of infection by taking a multiple vitamin and mineral supplement, according to a report in Annals of Internal Medicine (2003;138:365–71). The results of this study represent an important advance in diabetes care as they provide a safe, low-cost method of preventing one of the common complications of diabetes.

In this double-blind study, 51 middle-aged or elderly individuals with type 2 (adult onset) diabetes were randomly selected to receive a nutritional supplement (providing approximately one- to four-times the recommended dietary allowance [RDA] for most nutrients) or a placebo for one year. Ninety-three percent of participants in the placebo group reported at least one infection during the study, compared with only 17% in the group receiving the supplement. The multivitamin and mineral supplement produced an 81.7% reduction in the incidence of infections, a highly statistically significant improvement.

People with diabetes are especially prone to infection. This increased risk may be due in part to deficiencies of various vitamins and minerals that are needed for the immune system to function properly. Certain abnormalities of metabolism occur in diabetes that could lead to nutritional deficiencies. For example, diabetics are known to excrete excessive amounts of zinc in their urine, while failing to compensate with an increase in the absorption of zinc from food. Zinc deficiency can lead to a number of different defects in immune function. People with diabetes also have difficulty transporting vitamin C (another important nutrient for the immune system) from the bloodstream into cells. Because glucose (sugar) appears to compete with vitamin C for uptake into cells, an elevated blood sugar level may lead to tissue deficiencies of vitamin C. Vitamin B6, another key nutrient for the immune system, also is frequently low in people with diabetes.

It is not clear from this study which nutrient or nutrients were most responsible for preventing infections; indeed, it is likely that different people benefited from different nutrients. However, multiple vitamin and mineral preparations are generally inexpensive, so it seems reasonable to recommend such a product for most diabetics, even though it might include some nutrients they don't need.

In addition to reducing the risk of infections, there is evidence that certain vitamins and minerals might help prevent other complications of diabetes including heart disease, impaired wound healing, nerve damage, and vision loss. In most cases, multiple vitamin and mineral preparations pose little or no risk to people with diabetes. However, diabetics with advanced kidney disease may experience a potentially dangerous buildup of some nutrients if they take a supplement. Such individuals should use nutritional supplements only under the supervision of a doctor.

Alan R. Gaby, MD, an expert in nutritional therapies, testified to the White House Commission on CAM upon request in December 2001. Dr. Gaby served as a member of the Ad-Hoc Advisory Panel of the National Institutes of Health Office of Alternative Medicine. He is the author of Preventing and Reversing Osteoporosis (Prima, 1994), and co-author of The Natural Pharmacy, 2nd Edition (Healthnotes, Prima, 1999), the A–Z Guide to Drug-Herb-Vitamin Interactions (Healthnotes, Prima, 1999), Clinical Essentials Volume 1 and 2 (Healthnotes, 2000), and The Patient’s Book of Natural Healing (Prima, 1999). A former professor at Bastyr University of Natural Health Sciences, in Kenmore, WA, where he served as the Endowed Professor of Nutrition, Dr. Gaby is the Chief Medical Editor for Healthnotes, Inc.

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