Diabetes is a chronic metabolic disorder that affects millions of people worldwide. Managing diabetes effectively involves a comprehensive approach, including a healthy diet, regular physical activity, proper medication use (if required), and regular monitoring of blood glucose levels. However, one often overlooked aspect of diabetes management is the importance of essential nutrient like vitamin B12. This article explores the crucial role of vitamin B12 for diabetics and why maintaining adequate levels of this nutrient is essential for overall health.
Understanding Vitamin B12:
B vitamins are particularly important for overall health. And vitamin B12, also known as cobalamin, is a key micronutrient that your body needs to function well. It is a water-soluble vitamin that plays a critical role in energy production, formation of red blood cells, maintaining healthy nerve cells, proper brain function, production of DNA, and the metabolism of proteins and fats.
With vitamin B9*, vitamin B6** and other nutrients, it controls blood levels of the amino acid homocysteine ( high levels of which are linked to the early development of heart disease, often associated with low B12 levels). The homocysteine amino acid has also been linked to cognitive decline in Alzheimer’s and Parkinson’s disease. Vitamin B12 has been found to protect against dementia, heart disease, stroke, and osteoporosis.
*Vit B -9 sources include chickpeas, pulses, spinach, mango, peanuts, sunflower seeds, oats, quinoa etc.
**Vit B -6 sources include chicken, salmon, tuna, walnut, peanut, chickpeas, maize, whole grain cereals, green leafy vegetables, bananas, potatoes etc.
The average adult should get about 2.2 micrograms of vitamin B12 a day. Since B12 cannot be made by the body, it has to be procured from food or supplements. This vitamin is primarily obtained from animal-based foods such as meat, fish, eggs, and dairy products, button mushrooms, dried shiitake mushrooms, nori (in sushi) and nutritional yeast.
Vitamin B12 Deficiency and Diabetes
Recent studies have found that, diabetes, particularly type 2 diabetes, is associated with an increased risk of vitamin B12 deficiency. Several factors contribute to this association. Firstly, individuals with diabetes may have dietary restrictions or follow specific eating patterns that limit their intake of animal-based foods, leading to inadequate vitamin B12 consumption. Moreover, medication used for pre-diabetes, diabetes or PCOD such as metformin, can interfere with the absorption of vitamin B12 in the body, further increasing the risk of deficiency. The severity of vitamin B12 deficiency may depend heavily on the age of the patient and how long one has been taking metformin. Older patients are also at a higher risk of developing a deficiency in B12. With age, there is a decrease in stomach acid which is needed to free this vitamin from food for its absorption. B12 deficiency may also contribute to diabetic neuropathy.
Patients with type 1 diabetes are also at a higher risk for developing B12 deficiency. In order for vitamin B12 to be absorbed, it binds with an important protein called intrinsic factor produced in the stomach. Those with type 1 diabetes have autoantibodies to the intrinsic factor. The antibodies prevent the B12 from binding to the intrinsic factor resulting in a deficiency.
The Significance of Vitamin B12 for Diabetics
Diabetic Neuropathy: Diabetes can lead to a condition called diabetic neuropathy, which is nerve damage resulting from high blood sugar levels over time. Diabetic neuropathy often affects the peripheral nerves, causing symptoms such as numbness, tingling, pain, and weakness in the extremities. Vitamin B12 is crucial for maintaining healthy nerve function, and a deficiency in this vitamin can exacerbate neuropathy symptoms or contribute to nerve damage. Adequate vitamin B12 levels may help support nerve health and potentially alleviate some diabetic neuropathy symptoms.
Energy Production: Vitamin B12 is involved in the metabolism of carbohydrates and fats, which are primary sources of energy for the body. Diabetics often experience fluctuations in blood sugar levels, and adequate vitamin B12 levels can help support energy production and overall metabolic function.
Heart Health: Diabetes increases the risk of heart diseases such as heart attacks and strokes. Vitamin B12, along with other B vitamins like folate, helps regulate homocysteine levels in the blood. Elevated homocysteine levels are associated with an increased risk of heart problems, and maintaining sufficient vitamin B12 levels can help lower this risk.
Mood and Cognitive Function: Depression and cognitive decline are more prevalent in individuals with diabetes. Vitamin B12 plays a crucial role in maintaining healthy brain function and supporting the production of neurotransmitters involved in mood regulation. Ensuring adequate vitamin B12 levels may contribute to improved mental health and cognitive performance in diabetics.
Managing Vitamin B12 Levels
To ensure optimal vitamin B12 levels, diabetics should consider the following:
Dietary Sources: Include lean meats, fish, eggs, dairy products, mushrooms and fortified cereals. If following a vegetarian or vegan diet, alternative sources such as fortified plant-based milk or B12 supplements may be necessary.
Early detection and treatment is important. Fortunately, if you have a B12 deficiency, it’s relatively easy to get a diagnosis and start a treatment plan.
Look out for Vit B12 deficiency symptoms: Vitamin B12 deficiency symptoms are wide-ranging, affecting both physical and mental wellbeing. The symptoms include weakness and fatigue, numbness, or tingling in the hands, legs, and feet, peripheral neuropathy, anemia, lightheadedness, ringing in the ears, rapid heartbeat and shortness of breath, difficulty in thinking, reasoning remembering and concentrating, sore and red tongue, balance problems and troubled walking. Some of these side effects, particularly nervous system side effects and psychiatric problems, can be irreversible if not treated promptly.
Regular Monitoring: Regular blood tests can help monitor vitamin B12 levels and detect any deficiencies. The healthy range of B12 levels is between 200 and 900 nanograms per milliliter (ng/mL). Individuals that are at the lower end of this scale may need to start taking B12 supplements, especially if they have diabetes. You can also check methylmalonic acid (MMA) levels in your blood or urine. High levels can indicate a B12 deficiency.
Supplementation: In cases of vitamin B12 deficiency, supplements may be prescribed. The form of vitamin B12 in most supplements is cyanocobalamin, but other forms include adenosylcobalamin, methylcobalamin, and hydroxycobalamin. Supplements are available in tablet, capsule, soft gel, liquid, and nasal forms. Vitamin B12 is also given as an intramuscular injection in cases of a deficiency.
Many nutrients interact with each other to increase or decrease the absorption of the other nutrient. Taking a vitamin B12 supplement with a vitamin C supplement can reduce the amount of vitamin B12 in the body. It’s best to take the vitamin C supplement two or more hours after taking a vitamin B12 supplement.
Vitamin B12 is a crucial nutrient that plays a significant role in the overall health and well-being of individuals with diabetes. By understanding the importance of maintaining adequate vitamin B12 levels and taking appropriate measures to ensure proper intake, diabetics can support their nerve health and well-being. Early detection of vitamin B12 deficiency through routine screening could reduce their risk of developing irreversible, painful and potentially disabling nerve damage.
