Q: I am a recently diagnosed type 2, 32-year-old female. My diagnosis was a real wake-up call and I immediately started eating better. I’ve lost 40 pounds and am continuing to lose weight.
I have been taking a multivitamin for women. Is this enough or should I switch to one of the multivitamins specifically for people with diabetes?
Also, should I take extra C and E supplements, in addition to a multivitamin? How about calcium supplements? And, on top of everything else, should I take daily aspirin?
A: Congratulations on your 40-pound weight loss! As you know, weight loss and increased physical activity are the primary treatments for type 2 diabetes.
Because uncontrolled diabetes can lead to a loss of nutrients in the urine, I would recommend a nutritional assessment by a registered dietitian, who can help determine if your meal plan is nutritionally sound.
As for calcium, the requirement for someone your age is 1,000 mg. per day. While dark green vegetables supply some calcium, it is hard to meet these requirements if you do not take it in dairy products. An 8-ounce glass of low-fat milk has approximately 300 mg. of calcium. Unless you consume enough dairy products, I would recommend a calcium supplement with vitamin D, which aids in calcium absorption.
Vitamins C and E are both antioxidants, which have been proposed to help protect people from cardiovascular disease. Current research does seem to indicate that vitamin E, at 100-400 IU, has some protective power for people with diabetes. Vitamin C should, in theory, work in the same manner, but the evidence has yet to be proven in human trials. Since vitamins, at the levels needed for an antioxidant effect, work as a medication in your body, I encourage you to discuss this issue with your health care provider before starting them. There are known side effects from large doses of either of these vitamins. That being said, at our clinic physicians often recommend these supplemental daily doses:
- 400 IU vitamin E
- 500-1,000 milligrams vitamin C
- 1,000 micrograms folic acid
The American Diabetes Association is now recommending an enteric coated aspirin in doses of 81-325 mg. per day for people with diabetes if they are at risk for heart disease. Again, I would recommend that you discuss this with your health care provider because there are risks involved and not everyone is a candidate for aspirin therapy.
Patricia A. O’Connell, MS, RD, CDE
Joslin Center for Diabetes
New Britain, Connecticut