Research studies are collecting evidence that patients with both type I and type II diabetes may benefit from vitamin, mineral and antioxidant supplements.

Studies have found that diabetics tend to have lower levels of a variety of nutrients when compared to healthy subjects. It has been suggested that the use of vitamin and mineral supplements plays a specific role in preventing metabolic disorders common to diabetes.

Let's take a look at foods that contain the nutrients that should form an essential part of the diabetic's diet, and a new vitamin and mineral supplement called 'Diabion' produced by Merck, which has been specially formulated to contain those nutrients that are lacking in diabetics.

Vitamin A
In diabetics a deficiency of vitamin A can lead to night blindness and may aggravate the condition known as retinopathy (deterioration of the blood vessels in the retina of the eye that often accompanies diabetes).

Vitamin A, or its precursor beta-carotene that is transformed into vitamin A in the body, are found in the following foods:

• Foods containing beta-carotene such as broccoli, spinach, pumpkin, butternut, sweet potatoes, carrots, yellow peaches, apricots, paw paw, spanspek, mangoes.
• Foods containing vitamin A, which include fish oils, fortified margarine, bread and maize meal, liver, fatty fish and egg yolk.

Vitamin B1 (thiamine)
Thiamine is an important co-factor, which is used in the body to assist with the metabolism of carbohydrates. Seeing that the metabolism of carbohydrates is often negatively affected in diabetes, supplementing this important B vitamin makes good sense. Adequate supplies of vitamin B1 are also necessary to maintain healthy nerve function.

Vitamin B1 is found in the following foods:
Grains and cereals, including fortified breakfast cereals, bread and maize meal, meat (particularly lean pork), poultry, fish, liver, and legumes (an important food for diabetics).

Vitamin B6 (pyridoxine)
Vitamin B6 plays an important role in the metabolism of proteins, carbohydrates and fats, and prevents diabetic neuropathy, which often characterises diabetes. Vitamin B6 is known to assist with the control of blood glucose levels and it may reverse metabolic abnormalities and improve carbohydrate tolerance in diabetic patients.

Vitamin B6 is found in the following foods:
Wheat germ, meat, liver and other organ meats, whole-grain cereals, soy beans, peanuts, fortified cereals and green vegetables.

Vitamin B12 (cyanocobalamin)
Vitamin B12 deficiency causes degeneration of the spinal cord and nervous system, and using a B12 supplement can prevent diabetic neuropathy (deterioration of nerves).

Food sources of vitamin B12 include:
Foods of animal origin such as liver, lean meat, egg yolk and dairy products.

Folic acid
Deficiencies of folic acid lead to anaemia and deterioration of nerves and the eye (neuropathy and retinopathy, respectively).

Food sources of folic acid include:
Liver and other organ meats, yeast, green leafy vegetables, like broccoli and spinach, and fortified bread and maize meal.

Vitamin C (ascorbic acid)
Vitamin C assists in wound healing, which is important in diabetes because patients often experience problems with wounds that simply won't heal.

Vitamin C also helps to improve defective vasodilation (expansion of the blood vessels) and normalises the function of blood vessels in diabetic patients with concomitant coronary artery disease.

Finally, vitamin C is a powerful antioxidant.

Good food sources of vitamin C are:
Citrus fruit (oranges, grapefruit, naartjies, lemons), strawberries, spanspek, guavas, berries, broccoli, Brussels sprouts, spinach, cabbage, green peppers, turnips.

Vitamin E (alpha-tocopherol)
Diabetes is characterised by an increased production of so-called 'free radicals', which can damage body cells and cause various degenerative conditions such as heart disease and cancer. Vitamin E is a good antioxidant that binds with free radicals and prevents tissue damage.

Food sources of vitamin E include:
Plant oils (olive, sunflower and other cooking and salad oils), wheat germ, green leafy vegetables, nuts and legumes.

Chromium
Research has shown that chromium plays a vital role in the metabolism of glucose, insulin and blood fats. Chromium supplementation can be used to improve the metabolism of glucose intolerance.

Food sources of chromium:
Chromium is primarily found in bakers and brewer's yeast.

Magnesium
Secondary magnesium deficiency in diabetes is relatively common. This can lead to retinopathy and micro-angiopathy. It has also been suggested that magnesium can help reduce the risk of sudden death caused by arrhythmias or heart spasms.

Magnesium food sources include:
Cereals, nuts, legumes, meat and milk.

Selenium
Selenium has been found to stimulate glucose uptake, a process that is often impaired in diabetics. In addition, selenium regulates metabolic processes such as glycolysis (breakdown of glucose), gluconeogenesis (metabolic utilisation of glucose), fatty acid synthesis and other important metabolic processes.

Food sources of selenium include:
Cereals, fish, lean meat.

Zinc
This mineral improves glycaemic control in diabetics and reduces the severity of peripheral neuropathy.

The following foods are good sources of zinc:
Meat, wholegrains, legumes and seafood such as oysters.

All the vitamins and minerals mentioned above have been included in the Diabion formulation. Patients should take one capsule once a day.

If you suffer from diabetes, you need to boost your intake of these protective nutrients, either by eating foods rich in vitamins and minerals, or by using a supplement. For further information about Diabion, contact Sandy at Merck (011 372-5000).

Always keep in mind that diabetics need to consult a clinical dietician so that he/she can work out the correct diet and portion plan for you. You will not achieve proper glucose and insulin control without the correct diet – one that is tailored to your specific needs. – (Dr Ingrid van Heerden, DietDoc, August 2005)

(Contact the South African Podiatry Association on 0861 100 249 to find out more about free diabetic foot screenings. Phone the above number for details of your closest participating practitioner.

For more information on care and support of diabetes visit Diabetes South Africa or phone them on 011 886 3721 / 3765.

(Reference: Minerals, Vitamins offer some protection, Brief reports, Inside Out, Vol 1, No 1, April-June 2004)