Everyone should have vitamin B12 and vitamin D tested in their regular blood tests, especially if they have diabetes or have risk factors for diabetes. A recent study conducted in China found that vitamin D deficiency (hydroxyvitamin D less than 20 ng/mL) is more common in diabetic patients, and that diabetic patients who are vitamin D deficient are more likely to have diabetes than diabetic patients who are not vitamin D deficient. In comparison, the risk of nerve damage was found to be significantly higher. (Diabetes treatment clinical practice, March 2024:209:111585). A number of previous papers have found an association between vitamin D deficiency and nerve damage in diabetic patients (Diabetes Meta Tab Resolution Revised Edition2023 October;39(7):e3679; CreusJanuary 2021 5;13(1):e12506).
Vitamin B12 deficiency is also associated with diabetic nerve damage, and the greater the vitamin B12 deficiency, the more frequently nerve damage occurs. High doses of metformin for diabetes treatment were associated with an increased risk of vitamin B12 deficiency and nerve damage (EU Endocrine Society Endocrine SelectionOctober 2019;8(10):1324-1329).
Many people with diabetes don’t know they have diabetes
Diabetes and prediabetes are very common in North America. More than 40 million adults in North America have diabetes and 100 million are prediabetic, so nearly one in two adults will suffer from the harmful side effects of diabetes. Both diabetes and prediabetes are at increased risk for nerve damage called peripheral neuropathy, and vitamin B12 or vitamin D deficiency both significantly increase the risk of nerve damage.
Even if your fasting blood sugar level is normal (less than 100 mg/dL), diabetes cannot be ruled out. Up to 30 percent of diabetics do not know they have diabetes because their fasting blood sugar levels are said to be normal. High blood sugar levels (above 100) after meals are often called prediabetes, and also increase the risk of heart attack, stroke, and other effects of diabetes, even if traditional fasting blood sugar tests are normal (diabetes meta tab, 2022. 48101395).
Treatment of diabetes can increase the risk of vitamin B12 deficiency, as some of the recommended treatments are plant-based diets that are more likely to be deficient in vitamin B12 (vitamin B12 is found in foods such as meat, fish, and poultry). (only found in animal foods such as . Therefore, all prediabetics and diabetics are at significantly increased risk of nerve damage caused by diabetes itself, and the recommended diabetes treatments include unrefined vegetables, unmilled whole grains, , to significantly increase your intake of beans, seeds, and nuts. None of them contain vitamin B12.
Vitamin D deficiency increases nerve damage in diabetics
Virtually all of the harmful side effects of diabetes are associated with inflammation. This is an overactive immune system that attacks and destroys a person’s own cells, just as it attacks and destroys bacteria that try to enter the bloodstream. Vitamin D reduces inflammation and prevents an overactive immune system from destroying cells. A lack of vitamin D increases insulin resistance, which means the body is unable to respond to insulin, causing blood sugar levels to rise and damage every cell in the body. High vitamin D levels reduce insulin resistance and lower blood sugar levels in diabetics (diabetic metatab syndrome2013;5:8).
diabetes risk factors
•Overweight
• 65 years of age or older
• Not physically active
• Sitting for long periods of time.
• Had diabetes during pregnancy.
• Delivered a baby weighing more than 9 pounds.
• Large waist circumference (men – 40 inches or more, women – 35 inches or more)
• Can pinch more than 2.5 inches of skin and fat next to the belly button
• Blood pressure is above 135/90.
• LDL (bad) cholesterol greater than 100 mg/dL
• HDL (good) cholesterol is less than 40 mg/dL
• HbA1c greater than 5.7 percent (38.8 mmol/mol) (HbA1c is a blood test that measures sugar attached to the outer membrane of red blood cells)
• Smoke or live with someone who smokes.
• Consume alcohol regularly.
• Not getting 7-9 hours of sleep on a regular basis
• High triglycerides (more than 150 mg/dL)
• Have polycystic ovary syndrome
• Have a mental illness (schizophrenia, depression, bipolar disorder, etc.).
• You have obstructive sleep apnea syndrome.
I recommend
Low levels of vitamin B12 and D are common, so I think everyone should get a blood test for vitamin B12 and D during their regular health checkup. This is especially important if you have risk factors for diabetes, even if you have not been diagnosed with diabetes or prediabetes. Low blood levels of vitamin D and B12 increase the risk of serious nerve damage. These deficiencies can be easily corrected with supplements. Please check with your doctor.
Dr. Gabe Mirkin is a villager.Learn more about www.drmirkin.com
