Alarming Study Reveals Half of Diabetics Are Missing Essential Nutrients

Women and those in the Americas are at higher risk, and the study underscores the importance of addressing not just energy metabolism but also overall nutrition. Researchers call for targeted interventions and further studies to explore the causes and solutions to these deficiencies, according to a pooled data analysis published in the journal BMJ Nutrition, Prevention & Health.

Micronutrient deficiencies, where levels of essential vitamins and minerals are too low for proper bodily function, are commonly found in people with type 2 diabetes.

The analysis highlights vitamin D as the most commonly deficient micronutrient, with women at greater risk than men. These deficiencies, often referred to as “hidden hunger,” pose a significant health challenge.

Researchers explain that type 2 diabetes is influenced by factors such as genetic predisposition, environmental conditions, sedentary lifestyles, unhealthy diets, and obesity. Previous studies suggest that micronutrients play a critical role in the disease’s development, potentially impacting glucose metabolism and insulin signaling pathways.

To estimate the global prevalence of micronutrient deficiencies in people with type 2 diabetes, researchers reviewed databases to identify relevant studies and pooled the available data for analysis.

The final analysis included 132 studies involving 52,501 participants, published in multiple languages between 1998 and 2023. Nearly all the studies (except for three) were conducted in hospital settings.

The analysis revealed that 45% of people with type 2 diabetes globally have micronutrient deficiencies (vitamins, minerals, and electrolytes), with the prevalence slightly lower (40%) among those with diabetes-related complications. Regional differences were attributed to varying dietary habits, lifestyle factors, and cultural practices.

Vitamin D deficiency was the most common, affecting 60.5% of individuals with type 2 diabetes. Magnesium deficiency was also widespread, affecting 42%, while iron deficiency impacted 28%. Vitamin B12 deficiency was reported in 29% of participants and was even more frequent among those taking metformin.

Further stratification of the pooled data showed that prevalence was higher in women with the condition than in men at nearly 49%, and highest among patients in the Americas (54%).

Most of the included studies were cross-sectional, making it difficult to establish causality, nor was it clear whether the micronutrient deficiency preceded poor glycaemic control or was a consequence of it, caution the researchers.

And as there are no valid population-based studies looking at micronutrient deficiency, it’s impossible to draw comparisons between patients with type 2 diabetes and the general population, they add.

“This systematic review exemplifies the double burden of malnutrition in action, whereby nutritional deficiencies and diet-related non-communicable diseases, such as type 2 diabetes, co-exist,” comments Shane McAuliffe, Visiting Senior Academic Associate, NNEdPro Global Institute for Food, Nutrition and Health, which co-owns the journal.

“The treatment of type 2 diabetes often tends to focus on energy metabolism and macronutrients, but the identification of a higher prevalence of specific micronutrient deficiencies in those affected is a reminder that optimizing overall nutrition should always be a priority.

“The findings should help to focus research and policy initiatives aimed at furthering our understanding of the causes and effects of these deficiencies and the potential for targeted and tailored interventions.”

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