When it comes nutrition for diabetes, macronutrients such as carbohydrates, fat and protein are often the key focus and micronutrients like vitamins and minerals can be an afterthought. One important micronutrient to consider in the dietary management of diabetes is vitamin B12; let’s explore why.
What is Vitamin B12 and why is it needed in the diet?
Vitamin B12 is a water-soluble vitamin that is found naturally in some foods, is added to foods via fortification,is available as a dietary supplement and is prescribed medically at higher doses as an injection. It is required to create DNA and red blood cells, helps in the development of our central nervous system and supports healthy skin and nails. Our body cannot make vitamin B12 so we must get it from food or supplements. Low levels of vitamin B12 can cause symptoms of fatigue, pale skin, chest pain, dizziness and headache. More severe and longer-term vitamin B12 deficiency can cause irregular heartbeat and peripheral neuropathy.
What are good dietary sources of vitamin B12?
Vitamin B12 is primarily found in animal products such as red meat, poultry, fish, eggs and dairy products. Common vitamin B12 fortified foods include breakfast cereals, plant milks, and nutritional yeasts. It is also sold as a dietary supplement in multivitamins, combined with other B vitamins (B complex), as well as by itself in forms listed as cyanocobalamin, adenosylcobalamin, methylcobalamin, and hydroxycobalamin. Vitamin B12 is absorbed in the body via a two-step process that involves stomach acid, and a protein also present in the stomach called intrinsic factor. The recommended daily amount of vitamin B12 for most adults is 2.4 micrograms. For those that need much higher doses of vitamin b12 or to correct a deficiency more rapidly, they can receive an injection prescribed by a doctor.
Why is Vitamin B12 important for diabetes management?
Attention to getting enough vitamin B12 is important to people with diabetes for multiple reasons which include:
- Metformin use- this commonly prescribed medication to treat type 2 diabetes, is linked to lower vitamin B12 levels, likely because it hinders absorption of the vitamin. The risk of lower vitamin B12 levels increases with higher Metformin doses and longer time of use. If you are taking Metformin, it is wise to discuss getting B12 levels checked by your doctor to determine if dietary intervention/supplementation is needed.
- Inflammatory bowel disease (IBD)- a gastrointestinal condition that causes lower nutrient absorption, is more common in people with type 1 diabetes than in the general population. If you have both type 1 diabetes and IBD it is very important to discuss vitamin B12 status with your healthcare team.
- Neuropathy- diabetes and vitamin B12 deficiency each independently can cause damage to the body’s nerves, called neuropathy. There is some research that suggests that when they occur together it can increase the severity of the neuropathy, namely peripheral neuropathy, so discussing this and your vitamin B12 status with your medical team is important if you have both conditions.
Paying attention to micronutrients in your diet like vitamin B12, namely if you have diabetes, is important. Do not hesitate to talk with your healthcare team if you are concerned about your vitamin B12 status.