A Mutivitamin and Mineral Supplement Should Be One of the Foundations of a Nutritional Program for Type 2 Diabetics

Multivitamin and Mineral Supplement Decreases Infections in Type 2 Diabetics Reference: Barringer T, Kirk J, Santaniello A, et al. Effects of a multivitamin and mineral supplement on infection and quality of life. Ann Intern Med 2003;138:365-71. Design: Randomized, double-blind, placebo-controlled Participants:130 community-dwelling adults stratified by age (45 to 64 years or > 65 years) and the presence or absence of type 2 diabetes. Participants were stratified by age and diabetes because increasing age and presence of diabetes are associated with decreased immune function and increased likelihood of micronutrient deficiency and susceptibility to infection. The overall sample of participants was predominately female, white and between the ages of 45 and 64 years. Two thirds of the sample were overweight and obese and approximately 30% had type 2 diabetes. Study Medication and Dosage: Multivitamin mineral supplement (see below for list of ingredients) or placebo, one tablet q.d. The placebo tablet contained 120 mg calcium, 100 mg magnesium and 3.4 mg riboflavin. The ingredients for the placebo were chosen so the tablet would look and smell similar to the complete multivitamin mineral supplement and would cause the same changes in color in the participant's urine. Both preparations were prepared by Tischon Corporation (Westbury, NY). Duration: One year Outcome Measures: The primary end point of this study was the incidence of participant-reported infection and infection-associated absenteeism. The secondary end point, quality of life, was assessed at baseline and at 12 months by a proxy measure of physical and mental health obtained by using the Medical Outcome Study12-Item Short Form (SF-12). Nutritional status was assessed with a 3-day food diary that participants kept at baseline and at 6 months. Nutrient deficiency, for the purpose of this study, was defined as intake below the 33rd percentile of the recommended daily allowance (RDA) for zinc, selenium, iron, folic acid, or vitamins A, C, E or B6.Key Findings: At baseline, diabetic participants were more likely than non-diabetic participants to be deficient in one or more micronutrients (33% vs. 19%; p = 0.06). Seventy-three percent of the participants in the placebo group experienced one or more infection-related illnesses compared to 43% in the treatment group (p < style="font-weight: bold;">The results of this one-year trial suggest that a mutivitamin and mineral supplement should be one of the foundations of a nutritional program for type 2 diabetics. The high incidence of micronutrient deficiencies in this population affect not only immune function but have also been associated with some diabetic complications such as neuropathy and cardiovascular disease. A larger clinical trial is needed to determine whether these findings can be extended to prevention of chronic diseases/complications as well in these populations.