The Diabetes Control & Complications Trial established that diabetics won't get complications if the blood sugar is normal, but their six times elevated risk of heart disease remains. Hence, I take supplements to protect me from heart disease, as well as to protect my general health. If there should be any doubt about vitamin status, the truth can be determined with the Spectracell test which looks at how long white blood cells survive in growth medium low in one nutrient: If the cells die quickly, there can be no doubt of a deficiency in that nutrient. If taking supplements for a period of time doesn't improve the test result, I change the brand of supplement until the test show repletion.

The antioxidants lessen free radical activity and so retards ageing. I think of them protecting my fat from rancidity (called "lipid peroxidation") and preventing damage to my DNA. Diabetics have more damaged DNA, which means they have inadequate antioxidant protection. Age spots mean excess free radical activity. Antioxidants help with heart disease because oxidized LDL cholesterol is closely correlated with heart disease, and because they normalize the excessive clotting tendency of diabetics' blood (better than aspirin) which lessens heart attacks.

The antioxidants work as a team: vitamin C revitalizes vitamin E and the others, and is itself revitalized by a selenium-dependant enzyme, glutathione peroxidase. Vitamin A and its precursor, beta-carotene, protect the skin and mucous membranes. Vitamin C protects the watery parts like the blood serum, E protects the cell membranes, and so on. You can, however, have too much of a good thing - after all, without the oxidation of glucose, we'd have no way to power our metabolic processeses.

  • Vitamin C: 2+ grams: the studies are crystal clear: the more C, the less disease, and one fourth of all Americans get less than 65% of the RDA of 60mg, which is itself far too low! Vitamin C transport is insulin-dependent, which is to say that insulin resistance causes some sort of intra-cellular scurvy. Beyond correcting the diabetic tendency towards increased clotting, C lessens infections, allergies, heart disease and stroke, heart attacks, gout, gallstones, obesity, cataracts and glaucoma. It supports the adrenal glands, improves wound healing and lowers blood pressure, blood fats, blood sugar and glycosolated hemoglobin. Should be taken with the bioflavonoid quercetin with which it is found in food. The sicker you are, the more you need.: before antibiotics, it was used in India in intravenous 100 gram quantities to combat cholera which killed almost all the control group who received no C. I take it buffered with calcium and magnesium. Vitamin C blocks the so-called sorbitol pathway more effectively than the prescription drug aminoguanidine without its side effects, lessening complications such as cataracts.
  • Vitamin E: 800IU lessens inflamation, cataracts, macular degeneration, lung problems and neuropathy while protecting against heart disease by both lowering LDL cholesterol and lessening its oxidation. Lowers glycosolation, triglycerides and clotting tendency. Low vitamin E raises the chance of contracting Type II diabetes by four times.
  • beta-carotene: I hope I get plenty from the colored vegetables I eat, like green, red and yellow peppers because the fall of beta-carotene levels with age is associated with increased mortality
  • Selenium: at least 200 mcg per day because it's vital for the kind of immunity which protects against cancer, and levels fall with age.
  • Lipoic acid: has been used in Europe with great success to lower glycosolation.

One or more of the carbohydrate metabolism factors are probably depleted in every diabetic:

  • The Vitamins B work together and so should be taken as a team. I take a supplement containing 100mg of the major players. The Bs are depleted by diuretics, cooking, sugar, caffeine and alcohol. B1 (thimain) protects against and reverses neuropathy and cardiomyopathy. B2 is an antioxidant and regenerates glutathione, a major player in detoxification; low levels of B2 appear to cause cracks at the corners of the mouth. B3 (niacinamide) lowers insulin requirement and preserves beta cells at high doses; supplements cut Type I diabetes by 50% in schoolchildren; B6 (pyridoxine) acts as a diuretic and lowers blood pressure while dilating the blood vessels by promoting beneficial prostaglandins; stabilizes the blood sugar and lessens clotting, glycosolation and homocysteine (a strong risk factor for heart attacks and strokes: the Harvard Physicians with the lowest levels had 50% more heart attacks); also helps carpal tunnel syndrome and improves memory. Folic acid is widely deficient, and, with B6 and B12, reduce homocysteine, a strong risk factor for heart disease; also helps in peripheral vascular disease and phlebitis. B12 is depleted in vegetarians and by smoking and ageing; a deficiency can mimic neuropathy and Alzheimers or present as depression or insomnia; lowers homocysteine. Biotin at heroic doses of 15 mg or more halts neuropathies, leg cramps and restless leg syndrome, and lowers insulin requirements by lowering blood sugar - it acts like insulin.
  • Chromium: 400 mcg taken as picolinate or glucose tolerance factor lowers insulin resistance in those people deficient in it by increasing insulin receptor activity, probably the people who are depleted in it. Chromium is so low as to be indetectable in the aortas of heart attack victims, but present in the aortas of accident victims. Sugar (but not unrefined carbohydrates) causes its excretion, and it is very difficult to replenish the body's store with supplements.
  • Vanadyl sulfate at 25mg to 100mg per day somehow mimics insulin's action and lowers insulin. The effect persists for some weeks after ceasing its administration.
  • Magnesium (I take 600mg) is necessary for prostacyclin and prostaglandin E1 production, which dilate the blood vessels and lessen the clotting tendency; further, it lessens the excitability of the heart muscle, lowers blood pressure, corrects irregular heart rhythms, lessens the clotting tendency, and stabilizes the blood sugar. Together, these effects reduce the chances of heart attack and a host of other health threats. Depleted soils and food refining means that most people get less than the RDA. Since magnesium isn't stored, the body clearly expects it to be present in every bite - and every episode of magnesium deficiency is likely to do more damage. With this many benefits and such a clear cut national deficiency, I can't understand why nothing (except "further monitoring" by the USDA) is being done about it.
  • Manganese (10mg) is usually low in diabetics which worsens glucose handling. The heart muscle is depleted of manganese in heart disease. Manganese also has an antioxidant function in Mn-SOD, the manganese-dependent superoxide dismutase enzyme which protects the mitochondria, the tiny cellular fireplaces in which glucose and fatty acids are burned for energy.
  • Copper deficiency severely worsens glucose tolerance and raises insulin levels. I'm don't test as deficient so I don't take it. However, copper supplements should be chelated because copper ions actually promote free radical production in the so-called Fenton reaction. This is also true of iron - taking the ferrous sulfate which is often prescribed for anemia is fraught with risk according to what I read in Antioxidant Adaptation, its Role in Free Radical Pathology (Steven Levine and Parris Kidd, Allergy Research Group, 1985). Copper and zinc work together in CuZn-SOD, the enzyme which protects against free radicals within the cell outside the mitochondria.
  • Calcium and magnesium work as a team, so I take them in a 1:1 ratio.
  • Zinc (20mg) is essential for immunity and wound healing, and has a vital antioxidant function with copper.

The essential fatty acids are the first to be burned for energy when the glucose metabolism is compromised, and so are generally depleted in diabetics:

  • Evening Primrose Oil provides gamma-linolenic acid (GLA), the precursor of the beneficial prostaglandin E1 which dilates the blood vessels and lessens the clotting tendency; thus, it lowers blood pressure, lessens the risk of heart disease and combats the deterioration of ageing. GLA production falls with age, and is inhibited by high blood sugar and low magnesium or zinc. Most diabetics have a blockage of the D6D enzyme which makes GLA. This diagram from my book Food for Vitality shows how evening primrose oil corrects the metabolic blockage in diabetes; and this one shows that you'll likely feel terrible if your prostaglandin E1 is low.
  • The Omega 3 fatty acids cause my insulin resistance to skyrocket if I take them as supplements, so I eat cold ocean fish like salmon and sardines instead. Flaxseed contains the basic omega 3 fatty acid, linolenic acid, but cold ocean fish have the elaborate derivatives needed for brain structure and so forth already made.

And finally, I take these because they help me sleep:

  • Melatonin is released from the pineal gland when the lights go out; it is made from the neurotransmitter serotonin while the lights are on.
  • 5-hydroxy tryptophan or 5-HTP is the immediate precursor of serotonin and passes through the blood-brain barrier, boosting supplies of serotonin. Low serotonin is associated with irritability and depression, and very low levels are found in the homicidal. 5-HTP is as effective or more effective at raising serotonin as the popular Serotonin Reuptake Inhibitors such as Prozac.

Can There Be Any Doubt?

The Third Report on Nutrition Monitoring in the United States found vitamin E intake to be below the RDA for all groups, while vitamin B6, folic acid, zinc, copper, magnesium, potassium and selenium were below the RDA or were low in serum in subgroups. This nutritional catastrophe deserves immediate action but instead there are only recommendations for further nutrition monitoring!

That the food supply has less than the RDA of a nutrient doesn't necessarily mean a deficiency. Nevertheless, studies show that diabetics are, in fact, often depleted. However, the American Diabetes Association maintains that supplements are unnecessary, even harmful:

"People with diabetes have the same requirements for vitamins and minerals as people without diabetes. If you are eating a variety of foods, rich in vegetables, fruits, cereals, and grains, then you are most likely getting all the vitamins and minerals you need. Large doses of micronutrients have not been shown to help diabetes or blood glucose control. In fact, large doses of some vitamins, especially those that are fat soluble, can be harmful. If you think you may not be getting all the vitamins and minerals you need, check with your dietician before resorting to supplements. A few changes in your food choices may correct any nutritional deficiency." American Diabetes Association Complete Guide to Diabetes 1997 p. 240-41

I let my membership lapse when I read this in a prior edition. No possible interpretation of the scientific literature cited here supports any part of this extraordinary statement. If someone drinks a huge amount of water, he will lose vitamins and minerals in his excess urine. When a diabetic's blood sugar exceeds his kidneys' "renal threshold", urine output increases, carrying vitamins and minerals out of the body along with the excess glucose. Even well-controlled diabetics have high blood sugar from time to time, so one might expect diabetics tend to be low in micronutrients, especially those relevant to diabetic complications such as magnesium (heart disease), zinc (poor immunity) and chromium (insulin resistance). And this is what is found.

Since diabetics have difficulty metabolizing glucose, their cells turn to fats for energy. The essential fatty acids are the easiest to burn, so most diabetics are deficient in them. Diabetic neuropathy responds to essential-oil-rich evening primrose oil and the vitamin which helps its metabolisation, B6.

As to large doses of fat-soluble vitamins being potentially harmful, such harm has actually been reported vanishingly rarely.

A likely reference for the ADA stance (note similarity of the first line) reads as follows:

The nutritional requirements of people with diabetes do not differ from those of the population at large. However, people with diabetes have an increased prevalence of disease requiring special consideration such as hypertension, renal failure, and congestive heart failure; additionally, the use of diuretics and other medications may affect requirements for vitamins and minerals. NIDDM is most common in older generations in whom general nutrition may not be adequate. International Life Sciences Institute Present Knowledge in Nutrition 7th ed. 1996 p. 452

What a contrast!

The ILSI is conservative to a fault but they make the ADA look wildly prejudiced, in the sense of having formed an adverse opinion without examination of the facts. Curiously, the major contributors to the ADA are the suppliers of insulin, needles, glucose meters and the other paraphernalia of diabetes care, while the trustees of the International Life Sciences Institute come from the major food refiners.

The Road to Hell is Paved with Good Intentions

It is sobering to think of the sickness and premature death consequent on the American Diabetes Association's recommendation of a low fat, high carbohydrate diet without supplements. Had the ADA stuck to its original ketogenic diet for the treatment of diabetes, it seems likely to me that complications of diabetes would be rare today instead of epidemic, even without supplements. The numbers are staggering, and the human tragedy they represent is heart breaking.

I think I prefer my own advice:-

Diabetics are almost all nutritionally depleted because vitamins and minerals are lost in their urine, because they generally have medical conditions which increase requirements, because their bodies burns more essential fatty acids for energy, and because diabetics' diets are often themselves deficient. The optimum levels of some protective vitamins cannot be achieved with food alone. Supplements can dramatically lessen the risk of heart disease and stroke in diabetics, and correction of deficiencies can, along with exercise, lessen the severity of the condition.

Back to Home, or on to what this diet does: ketosis ...