Building Competency in Diabetes Education THE ESSENTIALS

5-24 | CHAPTER 5

MICRONUTRIENTS

Despite various claims concerning the benefits of vitamin and mineral supplements in the treatment of diabetes, there is insufficient evidence to recommend routine supplementation (35). As with the general population, people with diabetes should be encouraged to obtain daily vitamin and mineral requirements from a well-balanced diet following Canada’s Food Guide. Antioxidant supplements (vitamin E, vitamin C or beta-carotene) have not demonstrated benefits in glycemic control or CVD outcomes (96-98), and there are concerns about their long term safety; for example, long-term beta-carotene supplementation may be harmful in smokers (97-99). To reduce the risk of neural tube defects, women who are not planning pregnancy but are able to become pregnant should take a supplement of 1.0 mg of folic acid every day. There is some controversy surrounding recommendations for vitamin D. The Diabetes Canada clinical practice guidelines supports Health Canada’s guidelines, which recommend supplementation with 10 μ g (400 IU) vitamin D per day for people >50 years of age (35,100). Osteoporosis Canada recommends routine vitamin D supplementation (400-2000 IU) for all Canadian adults year round (101) and the Canadian Cancer Society recommends that Canadian adults talk to their doctor about taking 1,000 IU a day during fall and winter months (102). The need for vitamin and mineral supplementation should be assessed on an individual basis.