What are diabetes nutritional supplements?

A nutrition supplement is a product taken by mouth containing an ingredient intended to supplement the diet, e.g. a specific vitamin or mineral. Diabetes-specific nutritional supplements can offer extra nutritional support to support those with diabetes, as they usually focus on meeting the dietary needs of those living with the condition and aiding with blood sugar control.

So what are some of the most common diabetes-specific supplements?

Vitamin B12

B12 supplementation is a commonly recommended supplement for people with diabetes, especially for those who take higher doses of metformin (diabetes medication) to control type 2 diabetes. This is because metformin use has been linked to vitamin B12 deficiency in many living with diabetes¹. 

Vitamin B12 deficiency can cause symptoms such as anemia, peripheral neuropathy, depression, and cognitive impairment1. Therefore, it would be good for you to speak to your healthcare professional about getting tested to find out if you have a B12 deficiency before taking B12 supplements.

Vitamin D

Known as the “sunshine vitamin”, the link between vitamin D deficiency is believed to be linked to type 2 diabetes and is currently being studied ^2,3. Insufficiency of the vitamin can hinder glycemic control⁴, and supplements can help improve blood glucose control⁵. 

Vitamin D is shown to benefit those with type 2 diabetes by improving insulin reaction in the body, enhancing glucose transportation, and indirectly affecting insulin secretion via calcium6. Vitamin D also supports the normal function of the immune system9. People with type 2 diabetes who have vitamin D deficiency are at higher risk of developing diabetes-related complications, including damage to the nerves and eyes⁸. Sources of vitamin D include red meat, egg yolks, and oily fish such as salmon and sardines. 

Zinc

Zinc is an essential mineral that exists in all human cells and is involved in various processes in the body. Higher zinc intake is associated with a lowered risk of type 2 diabetes. It functions as an antioxidant that can protect insulin and cells from being attacked by free radicals (cell-damaging unstable atoms). In addition, zinc contributes to the normal function of the immune system⁹.

The human body can’t naturally produce or store zinc. Those with diabetes have lower blood zinc levels than individuals without diabetes ^10,11,12. Other than diabetes-specific supplementation, zinc can also be sourced from foods such as beans, nuts, and seafood like crab and lobster.

Chromium

Chromium is a nutrient that can be found in everyday food sources. These include egg yolks, coffee, nuts, green beans, and broccoli. Those with diabetes have lower chromium levels in the body than those without diabetes ^10,11,12. 

Chromium can contribute to the maintenance of normal blood glucose levels¹³. Long-term use of chromium can also help reduce the incidence of diabetes symptoms such as fatigue, thirst, and frequent urination in those living with the condition¹⁴. 

Monounsaturated fatty acids (MUFAs)

MUFAs are a healthy type of fat found in foods such as olive oil, nuts (i.e., almonds, cashews, pecans), avocados, and peanut oil. A higher intake of MUFAs can increase protection against heart disease by improving various factors that affect heart disease risk¹⁵. In addition, these healthy fats are shown to lower total and LDL (low-density lipoprotein) or bad cholesterol levels while maintaining HDL levels (high-density lipoprotein) or good cholesterol. 

MUFAs can also provide health benefits for blood vessel function, with some research suggesting that they may benefit the regulation of blood sugar and insulin levels¹⁵. 

Diabetes-specific formulas

Diabetes-specific formulas typically contain low glycemic index (GI) and slow-digesting carbs (i.e., whole grains, barley, brown rice) that cause a gradual rise in blood sugar levels, helping improve glycemic response16. In simpler terms, the glycemic response is the effect that food or meals have on blood glucose after consumption. 

Formulations such as this contain high-quality protein and have a high content of MUFAs and fiber. This blend of nutrients delays the process where your stomach empties itself, which is important to help with sugar spikes and keep you full. This formulation also assists in slowing the absorption of carbs in the digestive system.

Build supplementation into your management plan

By equipping yourself with the correct information on supplementation, you can work out a truly effective plan that works for you when combined with other lifestyle modification steps like doing regular physical activity, diet planning, and taking medication for the best results. If you consider supplements, make sure you discuss options that work best for you with your healthcare professional.

^* Glucerna includes slow release carbohydrates to help minimise blood sugar spikes among people living with diabetes.

^** Devitt, A.A., Oliver, J.S., Hegazi, R.A. and Mustad, V.A., 2012. Glycemia targeted specialized nutrition (GTSN) improves postprandial glycemia and GLP-1 with similar appetitive responses compared to a healthful whole food breakfast in persons with type 2 diabetes: a randomized, controlled trial. Journal of Diabetes Research and Clinical Metabolism, 1(20), pp.1-18. 

^*** Source: Euromonitor International Limited; total global retail sales in 2020 for diabetic diet enhancer drinks that are not marketed as a meal replacement product. Euromonitor and Abbott calculation based in part on Lifestyle Nutrition custom homescan panel database and Health Shopper survey for Abbott’s custom Diabetes Nutrition category for the 52 weeks ending January 2nd, 2021 time period, Total US All Outlet. Copyright © 2021, NielsenIQ Consumer LLC., and Euromonitor Passport Consumer Health 2021.

¹ Reinstatler L, Qi YP, Williamson RS, Garn JV, Oakley GP. Association of biochemical B12 deficiency with metformin therapy and vitamin B12 supplements: the National Health and Nutrition Examination Survey, 1999–2006. Diabetes care. 2012 Feb 1;35(2):327-333

² Berridge MJ. Vitamin D deficiency and diabetes. Biochemical Journal. 2017 Apr 15;474(8):1321-32.

³ Angellotti E, Pittas AG. The role of vitamin D in the prevention of type 2 diabetes: to D or not to D?. Endocrinology. 2017 Jul 1;158(7):2013-21.

⁴ Kostoglou-Athanassiou I, Athanassiou P, Gkountouvas A, Kaldrymides P. Vitamin D and glycemic control in diabetes mellitus type 2. Therapeutic advances in endocrinology and metabolism. 2013 Aug;4(4):122-8.

⁵ Mousa A, Naderpoor N, Teede H, Scragg R, de Courten B. Vitamin D supplementation for improvement of chronic low-grade inflammation in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials. Nutrition reviews. 2018 May 1;76(5):380-94. 

⁶ Teresa Martin, RD, CDE, LD and R. Keith Campbell, RPh, CDE, FASHP. Vitamin D and Diabetes. Diabetes Spectrum 2011 May; 24(2): 113-118.

⁷ EFSA Panel on Dietetic Products, Nutrition and Allergies (NDA). Scientific Opinion on the substantiation of health claims related to vitamin D and normal function of the immune system and inflammatory response (ID 154, 159), maintenance of normal muscle function (ID 155) and maintenance of normal cardiovascular function (ID 159) pursuant to Article 13 (1) of Regulation (EC) No 1924/2006. EFSA Journal. 2010 Feb;8(2):1468.

⁸ Luo BA, et al. Nutrients; Lv WS, et al. J Endocrinol Invest. Vitamin D deficiency defined as 25-hydroxyvitamin D < 20 μg/ml. Complications refer to damage to the nerves and eyes. 2017;9(3); 2015;38(5):513-8.

⁹ EFSA Panel on Dietetic Products NaA. Scientific Opinion on the substantiation of health claims related to zinc and function of the immune system (ID 291, 1757), DNA synthesis and cell division (ID 292, 1759), protection of DNA, proteins and lipids from oxidative damage (ID 294, 1758), maintenance of bone (ID 295, 1756), cognitive function (ID 296), fertility and reproduction (ID 297, 300), reproductive development (ID 298), muscle function (ID 299), metabolism of fatty acids (ID 302), maintenance of joints (ID 305), function of the heart and blood vessels (ID 306), prostate function (ID 307), thyroid function (ID 308), acid-base metabolism (ID 360), vitamin A metabolism (ID 361) and maintenance of vision (ID 361) pursuant to Article 13(1) of Regulation (EC) No 1924/2006. EFSA Journal. 2009;7(9):1229.

¹⁰ Badran M, Morsy R, Soliman H, Elnimr T. Assessment of trace elements levels in patients with type 2 diabetes using multivariate statistical analysis. Journal of Trace Elements in Medicine and Biology. 2016 Jan 1;33:114-9. 

¹¹ Basaki M, Saeb M, Nazifi S, Shamsaei HA. Zinc, copper, iron, and chromium concentrations in young patients with type 2 diabetes mellitus. Biological Trace Element Research. 2012 Aug;148(2):161-4.  

¹² Kazi TG, Afridi HI, Kazi N, Jamali MK, Arain MB, Jalbani N, Kandhro GA. Copper, chromium, manganese, iron, nickel, and zinc levels in biological samples of diabetes mellitus patients. Biological trace element research. 2008 Apr;122(1):1-8.

¹³ Havel PJ. A scientific review: the role of chromium in insulin resistance. Diabetes Educator. 2004;30(3 SUPPL.):2-14. 

¹⁴ William T. Cefalu, MD1 and Frank B. Hu, MD, PHD. Role of Chromium in Human Health and in Diabetes. Diabetes Care 2004 Nov; 27(11): 2741-2751.

¹⁵ Sanz-París A, Matía-Martín P, Martín-Palmero Á, Gómez-Candela C, Robles MC. Diabetes-specific formulas high in monounsaturated fatty acids and metabolic outcomes in patients with diabetes or hyperglycaemia. A systematic review and meta-analysis. Clinical Nutrition. 2020 Nov 1;39(11):3273-82.

¹⁶ Mottalib A, Mohd-Yusof BN, Shehabeldin M, Pober DM, Mitri J, Hamdy O. Impact of diabetes-specific nutritional formulas versus oatmeal on postprandial glucose, insulin, GLP-1 and postprandial lipidemia. Nutrients. 2016 Jul;8(7):443.