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What is DiaChoice?

"Experience the benefits of DiaChoice, a powerful neuropathy support supplement crafted with a blend of essential vitamins an

 

DiaChoice - Comprehensive Neuropathy Support Supplement​

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DiaChoice is a meticulously crafted supplement designed to provide robust support for individuals dealing with neuropathy. This advanced formula integrates a potent blend of vitamins, minerals, and other essential nutrients, each selected based on scientific research to promote nerve health, alleviate discomfort, and enhance overall well-being. Formulated from over a hundred scientific sources, DiaChoice represents a holistic approach to managing neuropathy and supporting nerve function.

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Key Benefits:

  • Nerve Health Support: DiaChoice contains ingredients known to support and maintain healthy nerve function, crucial for individuals experiencing neuropathy.

  • Antioxidant Protection: The supplement includes powerful antioxidants that help combat oxidative stress, a significant factor contributing to nerve damage.

  • Energy and Metabolism Boost: Essential B vitamins in DiaChoice play a critical role in energy production and metabolic processes, helping to maintain overall vitality.

  • Enhanced Cellular Function: The ingredients support cellular health and function, which is vital for maintaining healthy nerve cells and reducing neuropathic symptoms.

 

Why Choose DiaChoice?

DiaChoice is your trusted partner in managing neuropathy. Its comprehensive blend of scientifically-backed ingredients is designed to help you maintain an active, comfortable, and healthy lifestyle. With a formulation based on over a hundred scientific sources, you can trust DiaChoice to provide the support you need. For more detailed information on the scientific sources behind DiaChoice, please visit the link provided on our website.

Directions for Use:

One Capsule Twice a day

  • Take 1 capsule with or right after your breakfast meal

  • Take 1 capsule with or right after your dinner meal

  • Take each dose with enough water

  • For best results, DO NOT take it without meal Or take them as directed by your healthcare provider


Safety Information:
Consult with your healthcare provider before starting any new supplement, especially if you are pregnant, nursing, have a medical condition, or are taking other medications. Keep out of reach of children.

Disclaimer:
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.


Experience the difference with DiaChoice, your comprehensive solution for neuropathy support.

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Ingredients ​

This advanced formula integrates 19 effective ingredients and selected based on over a hundred scientific sources to promote nerve health, alleviate discomfort, and enhance overall well-being. These carefully chosen components work synergistically to deliver comprehensive support for nerve function and overall vitality.

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  • Vitamin C (as Ascorbic acid)

  • Vitamin D (as cholcalciferol)

  • Vitamin E (as d-alpha tocopheryl succinate)

  • Vitamin B1 (as thiamine mononitrate)

  • Vitamin B2 (riboflavin)

  • Vitamin B3 (as niacinamide)

  • Vitamin B6 (as pyridoxine HCl)

  • Folate (as 5-methyltetrahydrofolate)

  • Vitamin B12 (as methylcobalamin)

  • Magnesium (as magnesium oxide)

  • Zinc (as zinc oxide)

  • Selenium (as selenium glycinate)

  • Copper (as copper gluconate)

  • Chromium (as chromium picolinate)

  • Alpha Lipoic Acid

  • CO Q-10

  • Acetyl L-Carnitine

  • GliSODin (Superoxide Dismutase)

  • Vanadium (as vanadium chelate)

Vitamin C

The detailed explanation and scientific Resources​​​​​​​​

Diabetic neuropathy, a complication of diabetes resulting from prolonged high blood sugar levels, causes nerve damage and impairs nerve function. Vitamin C, also known as ascorbic acid, is a crucial nutrient that offers several benefits in managing this condition. Primarily, Vitamin C is a powerful antioxidant that helps reduce oxidative stress by neutralizing free radicals. Oxidative stress is a major factor contributing to nerve damage in diabetic patients. By protecting nerve cells from oxidative damage, Vitamin C supports overall nerve health and function.

​In addition to its antioxidant properties, Vitamin C is essential for collagen synthesis, which is vital for maintaining the integrity of blood vessels. Healthy blood vessels ensure an adequate supply of nutrients and oxygen to the nerves, which is crucial for their proper functioning. This nutrient also modulates the body's inflammatory response. Since chronic inflammation is a common problem in diabetes that exacerbates nerve damage, reducing inflammation with Vitamin C can help mitigate the progression of diabetic neuropathy.

Furthermore, Vitamin C enhances immune function, providing additional protection to nerves from damage. Some studies suggest that Vitamin C can improve insulin sensitivity and glucose metabolism, aiding in better blood sugar control and potentially reducing the risk of further nerve damage. Clinical evidence supports the beneficial effects of Vitamin C supplementation in diabetic patients, showing improvements in blood vessel function, reductions in oxidative stress and inflammatory markers, and overall alleviation of diabetic neuropathy symptoms.


Scientific Resources for Vitamin C selection:

 

1- NIH-Vitamin C, Fact Sheet for Health Professionals (click to review)​​

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2- The Role of Vitamin C in Reducing Pain Associated With Diabetic Neuropathy :​

  • Article info:  Bai A, Abdullah F, Kumar J, Lal A, Abbas M, Sandesh R, Naz S, Shahid S, Anees F, Memon S. The Role of Vitamin C in Reducing Pain Associated With Diabetic Neuropathy. Cureus. 2021 Jun 24;13(6):e15895. doi: 10.7759/cureus.15895. PMID: 34327108; PMCID: PMC8309111.​​​

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  • A section of the article's conclusion: Vitamin C plays a synergistic role in reducing pain in patients with diabetic neuropathy. It improves QOL due to its analgesic properties. Moreover, it is cost-effective and appears to be a safe and adjuvant therapy for specific pain relief. Patients should be encouraged to take vitamin C along with pharmacological management to get maximum relief from pain.​​​​​​​​​​​

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3- Association of vitamin C status in diabetes mellitus: prevalence and predictors of vitamin C deficiency​​

  • Article info:  D, P., Puvvada, R. & M, V. Association of vitamin C status in diabetes mellitus: prevalence and predictors of vitamin C deficiency. Futur J Pharm Sci 6, 30 (2020). https://doi.org/10.1186/s43094-020-00040-2​

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  • A section of the article's conclusion: There is a definite prevalence of vitamin C deficiency in type 2 diabetes mellitus patients. Also, there is an inverse relationship between the fasting blood sugar levels, body mass index, and vitamin C levels. Signifi- cant negative correlation has been observed between glycated hemoglobin levels with serum vitamin C levels. Vitamin C is an important antioxidant vitamin that is necessary for scavenging of these free radicals and prevention of further complication of diabetes mellitus. There is a necessity to increase the supply of vitamin C to diabetes mellitus patients as they may be beneficial in managing the glycemic control and preventing further complications.

 

4-EFFECT OF ASCORBIC ACID SUPPLEMENTATION ON DIABETIC NEUROPATHY​

  • Article info:  Hazem, Maha; Doba, Mohamed; Saleh, Omayma; El-Mongui, Azza

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  • A section of the article's conclusion: This study suggests that ascorbic acid supplementation early in the course of diabetes is simple and may have long term benefits in preventing the occurrence or attenuating the progression of diabetic complications including neuropathy.

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Vitamin D (as cholcalciferol)​

Diabetic neuropathy, a common complication of diabetes, involves nerve damage primarily due to prolonged high blood sugar levels. Vitamin D, known for its role in bone health, also plays a crucial role in managing diabetic neuropathy. One of the primary benefits of Vitamin D is its anti-inflammatory properties. Chronic inflammation is a significant factor in the development and progression of diabetic neuropathy. Vitamin D helps modulate the immune response and reduce inflammation, thereby protecting nerves from further damage.

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Vitamin D also plays a role in maintaining nerve health directly. It promotes the production of neurotrophins, which are essential for the growth, survival, and differentiation of neurons. By supporting neuronal health and regeneration, Vitamin D helps mitigate the symptoms of diabetic neuropathy and aids in nerve repair. Additionally, Vitamin D influences calcium homeostasis and neuronal function, which are critical for nerve signal transmission and overall nerve health.

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Moreover, Vitamin D deficiency is commonly observed in individuals with diabetes and is associated with increased risk and severity of neuropathy. Supplementing Vitamin D can help improve insulin sensitivity and glucose metabolism, contributing to better blood sugar control. This, in turn, can reduce the risk of nerve damage and the progression of diabetic neuropathy. Clinical studies have shown that Vitamin D supplementation in diabetic patients can lead to significant improvements in neuropathic pain and overall nerve function, highlighting its potential as a therapeutic option in managing diabetic neuropathy.​​

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Scientific Resources for Vitamin D selection:

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1- NIH-Vitamin D, Fact Sheet for Health Professionals (click to review).

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​2- Vitamin D in the Prevention and Treatment of Diabetic Neuropathy​​​

  • Article info: Putz Z, Tordai D, Hajdú N, Vági OE, Kempler M, Békeffy M, Körei AE, Istenes I, Horváth V, Stoian AP, Rizzo M, Papanas N, Kempler P. Vitamin D in the Prevention and Treatment of Diabetic Neuropathy. Clin Ther. 2022 May;44(5):813-823. doi: 10.1016/j.clinthera.2022.03.012. Epub 2022 Apr 12. PMID: 35428527.

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  • A section of the article's conclusion: A number of studies have suggested that vitamin D deficiency can play a significant role in the development of peripheral neuropathy, diabetic foot ulcers, as well as cardiovascular autonomic neuropathy in patients with type 2 diabetes. Vitamin D supplementation might serve as an effective adjuvant therapy for neuropathic pain and may slow or stop the progression of neural damage.​​​

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​3- Does Vitamin D Affect Diabetic Neuropathic Pain and Balance?

  • Article info:  Sari A, Akdoğan Altun Z, Arifoglu Karaman C, Bilir Kaya B, Durmus B. Does Vitamin D Affect Diabetic Neuropathic Pain and Balance? J Pain Res. 2020 Jan 16;13:171-179. doi: 10.2147/JPR.S203176. PMID: 32021406; PMCID: PMC6970609.

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  • A section of the article's conclusion: Vitamin D replacement therapy reduced neuro- pathic pain and improved balance in patients with DN. However, further studies examining the effects of vitamin D on nerve cells at molecular and electrophysiological levels and prospective studies focusing on the long-term effects of itamin D replacement therapy on DN are warranted. However, the results of the present study suggest that a vitamin D replacement schedule might be planned in addition to anti- diabetic treatment to address vitamin D deficiency in patients with diabetes in order to resolve neuropathic pain symptoms and to alleviate balance impairment associated with DN.

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4- The impact of vitamin D supplementation on peripheral neuropathy in a sample of Egyptian pre-diabetic individuals

  • Article info:  Reda Halawa M, Zaky Ahmed I, Fawzy Abouelezz N, Roushdy Mohamed N, Hany Abdelaziz Khalil N, Mahmoud Ali Hendawy L. The impact of vitamin D supplementation on peripheral neuropathy in a sample of Egyptian prediabetic individuals. F1000Res. 2021 Aug 16;10:817. doi: 10.12688/f1000research.55221.2. PMID: 35222988; PMCID: PMC8851293.

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  • A section of the article's conclusion: This study found that vitamin D supplementation in pre- diabetics with peripheral neuropathy and hypovitaminosis D improves neuropathy in those patients as assessed by McGill and DN4 scores, as well as glycemic parameter namely HbA1c, FBG and 2h-PPG.​​​

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​5- Dose vitamin D supplementations improve peripheral diabetic neuropathy? A before-after clinical trial

  • Article info:  Ghadiri-Anari A, Mozafari Z, Gholami S, Khodaei SA, Aboutorabi-Zarchi M, Sepehri F, Nadjarzade A, Rahmanian M, Namiranian N. Dose vitamin D supplementations improve peripheral diabetic neuropathy? A before-after clinical trial. Diabetes Metab Syndr. 2019 Jan-Feb;13(1):890-893. doi: 10.1016/j.dsx.2018.12.014. Epub 2018 Dec 20. PMID: 30641826.

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  • A section of the article's conclusion: Oral supplementation of vitamin D 3 (50,000 IU) once weekly for 12 weeks was associated with improvement in the serum level of vitamin D and significant decrease in the symptoms and sign of diabetic neuropathy. So serum vitamin D level should be checked in persons with diabetic neuropathy and low levels of it should be corrected in order to reducing neuropathy severity.

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​6- High-Dose Vitamin D Supplementation Improves Microcirculation and Reduces Inflammation in Diabetic Neuropathy Patients

  • Article info:  Karonova T, Stepanova A, Bystrova A, Jude EB. High-Dose Vitamin D Supplementation Improves Microcirculation and Reduces Inflammation in Diabetic Neuropathy Patients. Nutrients. 2020 Aug 20;12(9):2518. doi: 10.3390/nu12092518. PMID: 32825324; PMCID: PMC7551635.

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  • A section of the article's conclusion: The study demonstrated that high-dose cholecalciferol therapy (40,000 IU/week) for 24 weeks resulted in 25(OH)D normalization and was associated with reduction in neuropathy severity, as well as improvement in skin microcirculation and cytokines profile (decrease in proinflammatory IL-6 and increase in anti-inflammatory IL-10), in patients with T2DM and DPN. Our findings suggest that vitamin D deficiency may be a modifiable factor which affects diabetic peripheral neuropathy and requires timely identification and correction with cholecalciferol at doses of more than 5000 IU/day. ​

​7- Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation

  • Article info:  Alam U, Fawwad A, Shaheen F, Tahir B, Basit A, Malik RA. Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation. J Diabetes Res. 2017;2017:7928083. doi: 10.1155/2017/7928083. Epub 2017 Dec 28. PMID: 29445752; PMCID: PMC5763097.

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  • A section of the article's conclusion: A significantly improved neuropathy-specific quality of life is observed following a single high-dose intramuscular treatment with vitamin D3 in patients with painful diabetic neuropathy, particularly those with vitamin D deficiency.

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  • Vitamin E (as d-alpha tocopheryl succinate)

​Diabetic neuropathy, a common and painful complication of diabetes, results from chronic high blood sugar levels that cause nerve damage. Vitamin E, a fat-soluble antioxidant, plays a significant role in protecting nerve health and mitigating the effects of diabetic neuropathy. One of the primary benefits of Vitamin E is its potent antioxidant properties. It helps neutralize free radicals and reduce oxidative stress, which is a major contributor to nerve damage in diabetic patients. By protecting nerve cells from oxidative damage, Vitamin E supports overall nerve function and health.

In addition to its antioxidant effects, Vitamin E has anti-inflammatory properties. Chronic inflammation is a significant factor in the development and progression of diabetic neuropathy. By reducing inflammation, Vitamin E helps protect nerves from further damage and supports the repair processes. This anti-inflammatory action can alleviate pain and other symptoms associated with neuropathy.

Vitamin E also plays a role in maintaining the integrity of cell membranes and improving blood flow. It helps preserve the structure and function of neurons by protecting the lipid components of nerve cell membranes from oxidative damage. Improved blood flow ensures that nerves receive adequate nutrients and oxygen, which is crucial for their function and regeneration. Clinical studies have shown that Vitamin E supplementation can lead to significant improvements in neuropathic pain and overall nerve function in diabetic patients, highlighting its potential as a therapeutic option in managing diabetic neuropathy.​​

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Scientific Resources for Vitamin E selection:

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1- NIH-Vitamin E, Fact Sheet for Health Professionals (click to review)

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2- The Effects of Tocotrienol-Rich Vitamin E (Tocovid) on Diabetic Neuropathy: A Phase II Randomized Controlled Trial

  • Article info:  Ng YT, Phang SCW, Tan GCJ, Ng EY, Botross Henien NP, M Palanisamy UD, Ahmad B, Abdul Kadir K. The Effects of Tocotrienol-Rich Vitamin E (Tocovid) on Diabetic Neuropathy: A Phase II Randomized Controlled Trial. Nutrients. 2020 May 23;12(5):1522. doi: 10.3390/nu12051522. PMID: 32456230; PMCID: PMC7284602.

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  • A section of the article's conclusion: All in all, this is the first clinical trial to illustrate that tocotrienol-rich vitamin E (Tocovid) supplementation for eight weeks is able to improve DPN as assessed by nerve conduction velocity improvements in median sensory, sural sensory and tibial motor nerves. These improvements also correlate with elevation in serum NGF levels after eight weeks of supplementation with Tocovid compared to placebo. Based on this clinical trial, Tocovid most probably acts through the pathway involving NGF—and not the oxidative stress or chronic inflammatory pathogeneses—to improve DPN.

 

3-Treatment of diabetes mellitus‐associated neuropathy with vitamin E and Eve primrose

  • Article info:  Ogbera AO, Ezeobi E, Unachukwu C, Oshinaike O. Treatment of diabetes mellitus-associated neuropathy with vitamin E and Eve primrose. Indian J Endocrinol Metab. 2014 Nov;18(6):846-9. doi: 10.4103/2230-8210.140270. PMID: 25364681; PMCID: PMC4192992.

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  • A section of the article's conclusion: The combination of vitamin E and EP oil is effective and safe in the management of mild to moderate neuropathy and in individuals with DM who have severe neuropathy and may have to resort to other management options.

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4- Tocotrienol-Rich Vitamin E (Tocovid) Improved Nerve Conduction Velocity in Type 2 Diabetes Mellitus Patients in a Phase II Double-Blind, Randomized Controlled Clinical Trial

  • Article info:  Chuar PF, Ng YT, Phang SCW, Koay YY, Ho JI, Ho LS, Botross Henien NP, Ahmad B, Abdul Kadir K. Tocotrienol-Rich Vitamin E (Tocovid) Improved Nerve Conduction Velocity in Type 2 Diabetes Mellitus Patients in a Phase II Double-Blind, Randomized Controlled Clinical Trial. Nutrients. 2021 Oct 25;13(11):3770. doi: 10.3390/nu13113770. PMID: 34836025; PMCID: PMC8618591.

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  • A section of the article's conclusion: This is the final report on the double-blind, placebo-controlled, multicentre, random- ized controlled clinical trial, which showed that improvements in nerve conduction velocity in median and sural sensory nerves persist for up to 12 months, whereas improvements in the tibial motor nerve were only observed until 6 months post-baseline. The effects on nerve conduction velocity diminished after 6 months of washout.

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5- Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes: a preliminary study​

  • Article info:  Tütüncü NB, Bayraktar M, Varli K. Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes: a preliminary study. Diabetes Care. 1998 Nov;21(11):1915-8. doi: 10.2337/diacare.21.11.1915. PMID: 9802743.

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  • A section of the article's conclusion: This study shows that defective nerve conduction in diabetic subjects with mild-to- moderate peripheral neuropathy may be improved by pharmacological doses of vitamin E supplementation. Further studies with a larger number of patients for longer periods of time are needed​​​

 

6-Assessment of antioxidant supplementation on the neuropathic pain score and quality of life in diabetic neuropathy patients - a randomized controlled study

  • Article info:  Rajanandh MG, Kosey S, Prathiksha G. Assessment of antioxidant supplementation on the neuropathic pain score and quality of life in diabetic neuropathy patients - a randomized controlled study. Pharmacol Rep. 2014 Feb;66(1):44-8. doi: 10.1016/j.pharep.2013.08.003. Epub 2014 Jan 30. PMID: 24905305.

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  • A section of the article's conclusion: The study concluded that vitamin-E is a natural antioxidant and it is found to be effective in reducing pain score in diabetic neuropathy patients.

  • Vitamin B1 (as thiamine mononitrate)

Diabetic neuropathy, a debilitating complication of diabetes, occurs due to prolonged high blood sugar levels causing nerve damage. Vitamin B1, also known as thiamine, plays a critical role in managing this condition. Thiamine is essential for glucose metabolism, acting as a cofactor for several enzymes in the Krebs cycle, which helps convert glucose into energy. In diabetes, chronic hyperglycemia can lead to a functional deficiency of thiamine, impairing glucose metabolism and increasing the production of harmful byproducts that contribute to nerve damage. Supplementing with thiamine can help restore normal glucose metabolism, reducing the accumulation of these harmful byproducts and mitigating nerve damage.

One of the key benefits of Vitamin B1 in diabetic neuropathy is its role in preventing and repairing nerve damage. Thiamine is crucial for maintaining the health and function of the nervous system. It helps support the structure and function of neurons, and its deficiency can lead to nerve degeneration and dysfunction. By ensuring adequate levels of thiamine, supplementation can help protect nerves from damage and support their repair and regeneration, improving overall nerve health.

Additionally, thiamine has been shown to reduce oxidative stress and inflammation, both of which are significant contributors to the development and progression of diabetic neuropathy. Oxidative stress and chronic inflammation can cause extensive damage to nerve cells, exacerbating neuropathic symptoms. Thiamine’s antioxidant properties help neutralize free radicals and reduce oxidative damage, while its anti-inflammatory effects help lower inflammation levels, providing a protective effect on nerves. Clinical studies have demonstrated that thiamine supplementation can significantly improve symptoms of diabetic neuropathy, including reducing pain, improving nerve conduction, and enhancing overall nerve function, making it a valuable therapeutic option for managing this condition.

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Scientific Resources for Vitamin B1 selection:

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1- NIH-Vitamin B1, Fact Sheet for Health Professionals (click to review)

 

2- Thiamine and diabetes: back to the future?

  • Article info:  Beltramo E, Mazzeo A, Porta M. Thiamine and diabetes: back to the future? Acta Diabetol. 2021 Nov;58(11):1433-1439. doi: 10.1007/s00592-021-01752-4. Epub 2021 Jun 5. PMID: 34091762; PMCID: PMC8505293.

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  • A section of the article's conclusion: Several subsequent reports confirmed that neuropathic symptoms and deficits, and nerve conduction velocity, were significantly improved by thiamine/benfotiamine administra- tion in subjects with diabetic neuropathy.

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3- Clinical Trial Assessing the Efficacy of Gabapentin Plus B Complex (B1/B12) versus Pregabalin for Treating Painful Diabetic Neuropathy

  • Article info:  Mimenza Alvarado A, Aguilar Navarro S. Clinical Trial Assessing the Efficacy of Gabapentin Plus B Complex (B1/B12) versus Pregabalin for Treating Painful Diabetic Neuropathy. J Diabetes Res. 2016;2016:4078695. doi: 10.1155/2016/4078695. Epub 2016 Jan 17. PMID: 26885528; PMCID: PMC4739211.

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  • A section of the article's conclusion: One of this trial’s strengths is that it shows that vitamins B1 and B12 have a synergistic effect in combination with gaba- pentin in PDN treatment, since pain intensity reduction was obtained with 50% of the GBP dose required as monother- apy. Likewise, regarding GBP dose reduction, there are less adverse events (vertigo). 

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4- Benfotiamine in Diabetic Polyneuropathy (BENDIP): Results of a Randomised, Double Blind, Placebo-controlled Clinical Study

  • Article info:  Stracke H, Gaus W, Achenbach U, Federlin K, Bretzel RG. Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomised, double blind, placebo-controlled clinical study. Exp Clin Endocrinol Diabetes. 2008 Nov;116(10):600-5. doi: 10.1055/s-2008-1065351. Epub 2008 May 13. PMID: 18473286.

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  • A section of the article's conclusion: Benfotiamine may extend the treatment option for patients with diabetic polyneuropathy based on causal influence on impaired glucose metabolism. Further studies should confirm the positive experiences.

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5- Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy

  • Article info:  Nix WA, Zirwes R, Bangert V, Kaiser RP, Schilling M, Hostalek U, Obeid R. Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy. Diabetes Res Clin Pract. 2015 Jan;107(1):157-65. doi: 10.1016/j.diabres.2014.09.058. Epub 2014 Oct 8. PMID: 25458341.

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  • A section of the article's conclusion: In conclusion, our study showed that PLP deficiency was prevalent in patients with type 2 diabetes, especially in patients with incipient nephropathy characterized by micro-albuminuria. Type 2 diabetes was also associated with other alterations in vitamin B6 metabolism, including relative increases in PMP and pyridoxic acid, as well as with vitamin B1 deficiency. 

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6- Thiamine Level in Type I and Type II Diabetes Mellitus Patients: A Comparative Study Focusing on Hematological and Biochemical Evaluations

  • Article info:  Anwar A, Ahmed Azmi M, Siddiqui JA, Panhwar G, Shaikh F, Ariff M. Thiamine Level in Type I and Type II Diabetes Mellitus Patients: A Comparative Study Focusing on Hematological and Biochemical Evaluations. Cureus. 2020 May 8;12(5):e8027. doi: 10.7759/cureus.8027. PMID: 32528766; PMCID: PMC7282352.

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  • A section of the article's conclusion: The study results revealed that FBS, RBS, HbA1c, triglyceride, and total cholesterol levels were
    significantly higher in both type I and type II diabetes patients compared to controls. Furthermore, HDL and serum thiamine levels were found to be significantly lower in both type I
    and type II diabetic patients than in controls.

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7- Neuroprotective Effects of Thiamine and Precursors with Higher Bioavailability: Focus on Benfotiamine and Dibenzoylthiamine

  • Article info:  Sambon M, Wins P, Bettendorff L. Neuroprotective Effects of Thiamine and Precursors with Higher Bioavailability: Focus on Benfotiamine and Dibenzoylthiamine. Int J Mol Sci. 2021 May 21;22(11):5418. doi: 10.3390/ijms22115418. PMID: 34063830; PMCID: PMC8196556.

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  • Article link: ​

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  • A section of the article's conclusion: Thiamine (vitamin B1) is essential for brain function because of the coenzyme role of thiamine diphosphate (ThDP) in glucose and energy metabolism. In order to compensate thiamine deficiency, several thiamine precursors with higher bioavailability were developed since the 1950s. Among these, the thioester benfotiamine (BFT) has been extensively studied and has beneficial effects both in rodent models of neurodegeneration and in human clinical studies. dysfunction of beta-cells and impaired glucose tolerance in thiamine deficiency and suggestion of a link of impaired glucose tolerance with dietary thiamine indicates that thiamine therapy may have a future role in prevention of type 2 diabetes.

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8- The potential role of thiamine (vitamin B1) in diabetic complications

  • Article info:  Thornalley PJ. The potential role of thiamine (vitamin B1) in diabetic complications. Curr Diabetes Rev. 2005 Aug;1(3):287-98. doi: 10.2174/157339905774574383. PMID: 18220605.

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  • A section of the article's conclusion: Dysfunction of beta-cells and impaired glucose tolerance in thiamine deficiency and suggestion of a link of impaired glucose tolerance with dietary thiamine indicates that thiamine therapy may have a future role in prevention of type 2 diabetes.

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9-Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy

  • Article info:  Abbas ZG, Swai AB. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East Afr Med J. 1997 Dec;74(12):803-8. PMID: 9557427.

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  • A section of the article's conclusion: Diabetic peripheral neuropathy in Dar es Salaam is associated with thiamine deficiency. Vitamin B2 (riboflavin) A precursor of coenzymes called FAD and FMN, which are needed for flavoprotein enzyme reactions, including activation of other vitamins​​​​​​​​​​

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Vitamin B2 (riboflavin)

Diabetic neuropathy is a serious complication of diabetes, characterized by nerve damage due to prolonged high blood sugar levels. Vitamin B2, also known as riboflavin, plays a supportive yet crucial role in managing diabetic neuropathy. Riboflavin is a vital component of the body's energy production processes, as it is a precursor to the coenzymes FAD (flavin adenine dinucleotide) and FMN (flavin mononucleotide). These coenzymes are essential for various biochemical reactions, including those involved in the Krebs cycle and electron transport chain, which are critical for cellular energy production. By supporting efficient energy metabolism, riboflavin ensures that nerve cells receive the energy they need to function properly, which is particularly important in the context of diabetic neuropathy, where nerve function is compromised.

Beyond its role in energy production, riboflavin has antioxidant properties that can help protect nerve cells from oxidative stress. In diabetes, chronic hyperglycemia leads to increased production of reactive oxygen species (ROS), which can cause significant oxidative damage to nerve cells. Riboflavin's role in regenerating the antioxidant glutathione, one of the body's most powerful antioxidants, helps neutralize these harmful ROS and reduce oxidative stress, thereby protecting nerves from further damage.

Additionally, riboflavin contributes to the maintenance and repair of myelin, the protective sheath around nerves. Proper myelination is crucial for the efficient transmission of nerve impulses, and damage to myelin is a hallmark of diabetic neuropathy. By supporting myelin health and repair, riboflavin helps preserve nerve function and reduce neuropathic symptoms. While the role of riboflavin in diabetic neuropathy is not as extensively studied as some other B vitamins, its contributions to energy production, antioxidant defense, and myelin maintenance make it a valuable component in a comprehensive approach to managing diabetic neuropathy.

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Scientific Resources for Vitamin B2 selection:

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1- NIH-Vitamin B2, Fact Sheet for Health Professionals (click to review)

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2- Efficacy and safety of the combined metabolic medication, containing inosine, nicotinamide, riboflavin and succinic acid, for the treatment of diabetic neuropathylinical trial (CYLINDER)

  • ​​Article info:  Kharitonova T, Shvarts YG, Verbovoy AF, Orlova NS, Puzyreva VP, Strokov IA. Efficacy and safety of the combined metabolic medication, containing inosine, nicotinamide, riboflavin and succinic acid, for the treatment of diabetic neuropathy: a multicenter randomized, double-blind, placebo-controlled parallel group clinical trial (CYLINDER). BMJ Open Diabetes Res Care. 2022 Jun;10(3):e002785. doi: 10.1136/bmjdrc-2022-002785. PMID: 35680173; PMCID: PMC9185393.

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  • A section of the article's conclusion: Combination of succinic acid, inosine, nicotin- amide, and riboflavin is a new and safe treat- ment, which may be offered to patients with mild and moderate numbness, paresthesias and burning resulting from diabetic polyneuropathy, in addition to standard therapy in order to reduce symptoms.

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3- Important of B-Complex Vitamins in Treatment Protocol in Diabetic Patients

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  • Article info:  

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  • A section of the article's conclusion: Vitamin B2 riboflavin participates of co-enzyme FAD which required for glucose metabolism . These vitamins (B2, B3 and B12) are essential for diabetic patients.​​​​​​​​​​​​​​​​​​​​

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  • Vitamin B3 (as Niacinamide)

Diabetic neuropathy is a common and debilitating complication of diabetes, caused by chronic high blood sugar levels leading to nerve damage. Vitamin B3, also known as niacin or nicotinic acid, plays a significant role in managing diabetic neuropathy due to its involvement in various metabolic and cellular processes. Niacin is a precursor to the coenzymes NAD+ (nicotinamide adenine dinucleotide) and NADP+ (nicotinamide adenine dinucleotide phosphate), which are essential for energy production, DNA repair, and cellular metabolism. These coenzymes are crucial in the Krebs cycle and oxidative phosphorylation, processes that generate ATP, the primary energy source for cells, including nerve cells. Adequate levels of niacin ensure that nerve cells receive sufficient energy to function properly, which is particularly important in diabetic neuropathy, where nerve function is impaired.

Niacin also has potent antioxidant properties that can help protect nerve cells from oxidative stress, a significant factor in the development and progression of diabetic neuropathy. Chronic hyperglycemia in diabetes leads to the overproduction of reactive oxygen species (ROS), which can cause oxidative damage to nerve cells. Niacin, through its role in NADPH production, supports the regeneration of glutathione, one of the body's most powerful antioxidants, helping to neutralize ROS and reduce oxidative stress, thereby protecting nerves from further damage.

In addition to its antioxidant effects, niacin has anti-inflammatory properties and can improve blood flow, which is beneficial for nerve health. Niacin causes vasodilation, or the widening of blood vessels, which enhances blood flow to the nerves. Improved circulation ensures that nerves receive adequate oxygen and nutrients, which are essential for their repair and maintenance. Moreover, niacin can modulate inflammatory responses, reducing chronic inflammation that contributes to nerve damage in diabetic neuropathy. Clinical studies have shown that niacin supplementation can improve symptoms of diabetic neuropathy, including reducing pain, improving nerve conduction, and supporting overall nerve function, making it a valuable therapeutic option in managing this condition.​

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Scientific Resources for Vitamin B3 selection:

 

​1- NIH-Vitamin B3, Fact Sheet for Health Professionals (Click to review)​

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2- Nicotinamide as a Foundation for Treating Neurodegenerative Disease and Metabolic Disorders​

  • Article info:  Maiese K. Nicotinamide as a Foundation for Treating Neurodegenerative Disease and Metabolic Disorders. Curr Neurovasc Res. 2021;18(1):134-149. doi: 10.2174/1567202617999210104220334. PMID: 33397266; PMCID: PMC8254823.

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  • A section of the article's conclusion: Nicotinamide plays a critical role for the treatment of both neurodegenerative diseases and metabolic disorders, such as DM. In neuronal and vascular systems, nicotinamide protects against oxidative stress, anoxia, excitotoxicity, ethanol-induced neuronal injury, Aß toxicity, ultraviolet light, age-related vascular disease, mitochondrial dysfunction, and vascular mimicry during cancer. In regard to metabolic disorders, nicotinamide reduces insulin resistance, blocks skeletal muscle atrophy during DM, maintains normal fasting blood glucose, improves glucose utilization, blocks excess lactate production, and protects pancreatic β-cell function.

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3-Methylcobalamin, Pyridoxine and Nicotinamide in Diabetic Neuropathy: A Review​

  • Article info:  Langade, Deepak & S, Jayaram & Khobragade, Akash. (2009). Methylcobalamin, pyridoxine and nicotinamide in diabetic neuropathy: A review. 20. 17-21.​​

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  • A section of the article's conclusion: A combination of methylcobalamin, pyridoxine and nicotinamide thus has synergistic effect on the damaged nerves in diabetic neuropathy which protects the nerves from further damage, restores its structural and functional integrity and causes a recovery of function.

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4- Functional and biochemical evidence indicating beneficial effect of Melatonin and Nicotinamide alone and in combination in experimental diabetic neuropathy​

  • Article info:  Negi G, Kumar A, Kaundal RK, Gulati A, Sharma SS. Functional and biochemical evidence indicating beneficial effect of Melatonin and Nicotinamide alone and in combination in experimental diabetic neuropathy. Neuropharmacology. 2010 Mar;58(3):585-92. doi: 10.1016/j.neuropharm.2009.11.018. Epub 2009 Dec 11. PMID: 20005237.

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  • A section of the article's conclusion:Melatonin and Nicotinamide alone as well as in combination ameliorated the f unctional deficits along with improvement in pain parameters. The combination also demonstrated an essential reversal of biochemical alterations. Nitrotyrosine and Poly ADP Ribose (PAR) immunopositivity was significantly decreased in sciatic nerve micro sections of treatment group. The results of this study advocate that simultaneous inhibition of oxidative stress-PARP activation cascade may prove usef ul for the pharmacotherapy of DN.

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​5- Efficacy and safety of the combined metabolic medication, containing inosine, nicotinamide, riboflavin and succinic acid, for the treatment of diabetic neuropathy: a multicenter randomized, double-blind, placebo- controlled parallel group clinical trial (CYLINDER)

  • Article info:  Kharitonova T, Shvarts YG, Verbovoy AF, Orlova NS, Puzyreva VP, Strokov IA. Efficacy and safety of the combined metabolic medication, containing inosine, nicotinamide, riboflavin and succinic acid, for the treatment of diabetic neuropathy: a multicenter randomized, double-blind, placebo-controlled parallel group clinical trial (CYLINDER). BMJ Open Diabetes Res Care. 2022 Jun;10(3):e002785. doi: 10.1136/bmjdrc-2022-002785. PMID: 35680173; PMCID: PMC9185393.

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  • A section of the article's conclusion: The combined medication SINR (Cytoflavin) has demon- strated efficacy, as reflected by alleviation of DPN symp- toms, and safety in patients with type 2 diabetes mellitus.

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  • Vitamin B6 (as pyridoxine HCl)

Diabetic neuropathy, a significant and often painful complication of diabetes, occurs due to chronic high blood sugar levels leading to nerve damage. Vitamin B6, also known as pyridoxine, plays a vital role in managing diabetic neuropathy by supporting nerve health and function. Vitamin B6 is essential for the synthesis of neurotransmitters such as serotonin, dopamine, and gamma-aminobutyric acid (GABA), which are crucial for proper nerve signal transmission. Adequate levels of Vitamin B6 help ensure that nerve cells communicate effectively, which is particularly important in the context of diabetic neuropathy, where nerve function is compromised.

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In addition to its role in neurotransmitter synthesis, Vitamin B6 is involved in maintaining the health of myelin, the protective sheath that surrounds nerves. Proper myelination is essential for the efficient transmission of nerve impulses. Damage to the myelin sheath, a hallmark of diabetic neuropathy, can lead to impaired nerve function and increased pain sensitivity. By supporting myelin synthesis and repair, Vitamin B6 helps preserve nerve function and reduce the symptoms of neuropathy.

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Furthermore, Vitamin B6 possesses antioxidant and anti-inflammatory properties that contribute to its neuroprotective effects. In diabetes, chronic hyperglycemia leads to increased oxidative stress and inflammation, both of which can damage nerve cells. Vitamin B6 helps neutralize free radicals, reducing oxidative damage, and modulates the body's inflammatory response, helping to protect nerves from further injury. Clinical studies have shown that Vitamin B6 supplementation can alleviate symptoms of diabetic neuropathy, including reducing neuropathic pain, improving nerve conduction, and enhancing overall nerve health. This makes Vitamin B6 a valuable component in the management of diabetic neuropathy, particularly when used in combination with other B vitamins.

 

Scientific Resources for Vitamin B6 selection:

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1- NIH-Vitamin B6, Fact Sheet for Health Professionals (click to review)

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2- Impact of vitamin B6 deficiency on the severity of diabetic peripheral neuropathy – A cross sectional study

  • Article info:  Khobrani M, Kandasamy G, Vasudevan R, Alhossan A, Puvvada RC, Devanandan P, Dhurke R, Naredla M. Impact of vitamin B6 deficiency on the severity of diabetic peripheral neuropathy - A cross sectional study. Saudi Pharm J. 2023 May;31(5):655-658. doi: 10.1016/j.jsps.2023.03.005. Epub 2023 Mar 10. PMID: 37181142; PMCID: PMC10172568.

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  • A section of the article's conclusion:  There is a 51.8% prevalence of pyridoxine deficiency among diabetic neuropathy patients. There also exists a strong inverse rela- tionship with glycemic markers. Significant direct correlation is observed with nerve conduction velocity. Pyridoxine also has prop- erties of antioxidant which may be utilized for the management of Diabetic Neuropathy.​

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3-Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy​

  • Article info:  Abbas ZG, Swai AB. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East Afr Med J. 1997 Dec;74(12):803-8. PMID: 9557427.

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  • A section of the article's conclusion: Diabetic peripheral neuropathy in Dar es Salaam is associated with thiamine deficiency. 

 

​4- The Role of Vitamin B6 in Peripheral Neuropathy: A Systematic Review

  • Article info:  Muhamad R, Akrivaki A, Papagiannopoulou G, Zavridis P, Zis P. The Role of Vitamin B6 in Peripheral Neuropathy: A Systematic Review. Nutrients. 2023 Jun 21;15(13):2823. doi: 10.3390/nu15132823. PMID: 37447150; PMCID: PMC10343656.

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  • A section of the article's conclusion: Low vitamin B6 levels can be seen in patients suffering from peripheral neuropathy of various etiologies.Many studies have suggested a subjective improvement of neuropathy symptoms in patients suffering from PN of various etiologies after receiving B6 supplementation.

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​5- The Influence of Pyridoxine in Diabetic Peripheral Neuropathy

  • Article info:  Levin ER, Hanscom TA, Fisher M, Lauvstad WA, Lui A, Ryan A, Glockner D, Levin SR. The influence of pyridoxine in diabetic peripheral neuropathy. Diabetes Care. 1981 Nov-Dec;4(6):606-9. doi: 10.2337/diacare.4.6.606. PMID: 6751736.

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  • A section of the article's conclusion:  To determine the role of pyridoxine in the treatment of diabetic peripheral neuropathy, 18 symptomatic diabetic patients were treated with vitamin B or placebo in a double-blind controlled study. Only one 6 patient had a low plasma pyridoxal phosphate level at the start of the study. After 4 mo of treatment with pyridoxin hydrochloride (50 mg three times daily) 6 of 9 pyridoxine-treated and 4 of 9 placebo-treated patients noted significant relief from their neuropathic symptoms. 

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​6- Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy

  • Article info:  Nix WA, Zirwes R, Bangert V, Kaiser RP, Schilling M, Hostalek U, Obeid R. Vitamin B status in patients with type 2 diabetes mellitus with and without incipient nephropathy. Diabetes Res Clin Pract. 2015 Jan;107(1):157-65. doi: 10.1016/j.diabres.2014.09.058. Epub 2014 Oct 8. PMID: 25458341.

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  • A section of the article's conclusion: Low vitamin B6 levels can be seen in patients suffering from peripheral neuropathy of various etiologies.Many studies have suggested a subjective improvement of neuropathy symptoms in patients suffering from PN of various etiologies after receiving B6 supplementation.​

  • Folate (as 5-methyltetrahydrofolate)

Diabetic neuropathy, a debilitating complication of diabetes, is characterized by nerve damage resulting from chronic high blood sugar levels. Folate, a B-vitamin also known as Vitamin B9, plays a vital role in the management of diabetic neuropathy by supporting nerve health and protecting against cellular damage. Folate is essential for DNA synthesis, repair, and methylation processes, which are crucial for maintaining healthy nerve cells and ensuring their proper function. Adequate folate levels help preserve the integrity of nerve cells and support their ability to repair themselves, which is particularly important in the context of diabetic neuropathy where nerve function is compromised.

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A significant aspect of folate's role in diabetic neuropathy is its involvement in homocysteine metabolism. Elevated homocysteine levels are commonly observed in individuals with diabetes and are associated with an increased risk of vascular damage, impaired blood flow, and oxidative stress, all of which contribute to nerve damage. Folate is a key cofactor in the conversion of homocysteine to methionine, thereby lowering homocysteine levels and reducing the associated risks of nerve damage. By improving vascular health and promoting better blood flow to the nerves, folate helps mitigate the progression of neuropathy.

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In addition to its effects on homocysteine metabolism, folate has antioxidant and anti-inflammatory properties that provide further protection to nerve cells. Chronic hyperglycemia in diabetes leads to increased oxidative stress and inflammation, which can cause significant damage to nerves. Folate helps reduce oxidative stress by participating in the regeneration of important antioxidants and modulates inflammatory responses, reducing the inflammation that contributes to nerve injury. Clinical studies have indicated that folate supplementation can improve symptoms of diabetic neuropathy, including reducing pain and improving nerve conduction, making it a valuable nutrient in the comprehensive management of diabetic neuropathy

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Scientific Resources for Vitamin B6 selection:

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​1-NIH-Vitamin B9, Fact Sheet for Health Professionals (Click to review)

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2-Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients

  • Article info:  Mottaghi T, Khorvash F, Maracy M, Bellissimo N, Askari G. Effect of folic acid supplementation on nerve conduction velocity in diabetic polyneuropathy patients. Neurol Res. 2019 Apr;41(4):364-368. doi: 10.1080/01616412.2019.1565180. Epub 2019 Feb 7. PMID: 30730785.

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  • A section of the article's conclusion: At 16 weeks, in the supplemented group, serum levels of folic acid (p < 0.001) increased, homocysteine concentrations decreased (p < 0.001), with no change in serum vitamin B12 levels. There was a significant increase in sensory sural amplitude (p < 0.001), and components of motor nerves, including amplitude (p = 0.001) and velocity (p < 0.001), but decreased onset latency of peroneal (p = 0.019) and tibial (p = 0.011) motor nerves.

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​3- L-Methylfolate in Diabetic Peripheral Neuropathy: A Narrative Review​

  • Article info:  Christofides EA, Valentine V. L-Methylfolate in Diabetic Peripheral Neuropathy: A Narrative Review. Endocr Pract. 2023 Aug;29(8):663-669. doi: 10.1016/j.eprac.2023.04.005. Epub 2023 Apr 21. PMID: 37088147.

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  • A section of the article's conclusion: Preclinical and clinical studies have found that LMF can be used to treat the underlying causes of DPN and provide long-lasting symptomatic relief.​

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​4- Metanx in type 2 diabetes with peripheral neuropathy: a randomized trial

  • Article info:  Fonseca VA, Lavery LA, Thethi TK, Daoud Y, DeSouza C, Ovalle F, Denham DS, Bottiglieri T, Sheehan P, Rosenstock J. Metanx in type 2 diabetes with peripheral neuropathy: a randomized trial. Am J Med. 2013 Feb;126(2):141-9. doi: 10.1016/j.amjmed.2012.06.022. Epub 2012 Dec 5. PMID: 23218892.

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  • A section of the article's conclusion: LMF-MC-PLP appears to be a safe and effective therapy for alleviation of peripheral neuropathy symptoms, at least in the short term. ​​​​​​​​​​​​​​​

  • Vitamin B12 (as methylcobalamin)

Diabetic neuropathy is a serious complication of diabetes, characterized by nerve damage resulting from prolonged high blood sugar levels. Vitamin B12, also known as cobalamin, plays a critical role in the management of diabetic neuropathy by supporting nerve health and preventing further damage. Vitamin B12 is essential for the maintenance of the myelin sheath, a protective covering that surrounds and insulates nerve fibers. Proper myelination is crucial for the efficient transmission of nerve impulses, and damage to the myelin sheath is a key feature of diabetic neuropathy. By ensuring adequate levels of Vitamin B12, supplementation can help preserve myelin integrity, improve nerve function, and reduce symptoms such as pain and numbness.

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In addition to its role in myelin maintenance, Vitamin B12 is involved in DNA synthesis and repair, which are vital for the health and regeneration of nerve cells. It also plays a key role in the production of red blood cells, which are necessary for delivering oxygen to tissues, including nerves. Adequate oxygenation is crucial for nerve function and repair, particularly in the context of diabetic neuropathy where nerve damage is prevalent.

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Vitamin B12 also has neuroprotective properties that help reduce oxidative stress and inflammation, both of which are significant contributors to nerve damage in diabetic patients. Chronic hyperglycemia can lead to increased production of reactive oxygen species (ROS) and promote inflammatory processes that damage nerves. Vitamin B12 acts as a cofactor in the regeneration of methionine, a process that reduces homocysteine levels. Elevated homocysteine is associated with increased oxidative stress and inflammation, so by lowering homocysteine, Vitamin B12 helps protect nerves from further damage. Clinical studies have demonstrated that Vitamin B12 supplementation can significantly improve symptoms of diabetic neuropathy, such as pain and sensory loss, as well as enhance overall nerve function, making it a valuable therapeutic option for managing this condition.​

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Scientific Resources for Vitamin B12 selection:

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1- NIH-Vitamin B12, Fact Sheet for Health Professionals (Click to review)

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2- Clinical Trial Assessing the Efficacy of Gabapentin Plus B Complex (B1/B12) versus Pregabalin for Treating Painful Diabetic Neuropathy

  • Article info:  Mimenza Alvarado A, Aguilar Navarro S. Clinical Trial Assessing the Efficacy of Gabapentin Plus B Complex (B1/B12) versus Pregabalin for Treating Painful Diabetic Neuropathy. J Diabetes Res. 2016;2016:4078695. doi: 10.1155/2016/4078695. Epub 2016 Jan 17. PMID: 26885528; PMCID: PMC4739211.

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  • A section of the article's conclusion: One of this trial’s strengths is that it shows that vitamins B1 and B12 have a synergistic effect in combination with gaba- pentin in PDN treatment, since pain intensity reduction was obtained with 50% of the GBP dose required as monotherapy. 

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3- Association between neuropathy and B-vitamins: A systematic review and meta-analysis

  • Article info:  Stein J, Geisel J, Obeid R. Association between neuropathy and B-vitamins: A systematic review and meta-analysis. Eur J Neurol. 2021 Jun;28(6):2054-2064. doi: 10.1111/ene.14786. Epub 2021 Mar 15. PMID: 33619867.

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  • A section of the article's conclusion: PN is associated with lowered plasma vitamin B12 and elevated methylmalonic acid and homocysteine. Overall, interventional studies have suggested that B-vitamins could improve symptoms of PN. 

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​4-Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial

  • Article info:  Didangelos T, Karlafti E, Kotzakioulafi E, Margariti E, Giannoulaki P, Batanis G, Tesfaye S, Kantartzis K. Vitamin B12 Supplementation in Diabetic Neuropathy: A 1-Year, Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients. 2021 Jan 27;13(2):395. doi: 10.3390/nu13020395. PMID: 33513879; PMCID: PMC7912007.

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  • A section of the article's conclusion: The treatment of patients with DN with 1 mg of oral methylcobalamin for twelve months increased plasma B12 levels and improved all neurophysiological parameters, sudomotor function, pain score, and QoL, but it did not improve CARTS and MNSIE.

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​5-Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study

  • Article info:  Alvarez M, Sierra OR, Saavedra G, Moreno S. Vitamin B12 deficiency and diabetic neuropathy in patients taking metformin: a cross-sectional study. Endocr Connect. 2019 Oct 1;8(10):1324-1329. doi: 10.1530/EC-19-0382. PMID: 31518991; PMCID: PMC6790897.

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  • A section of the article's conclusion: Vitamin B12 deficiency is highly prevalent, especially in patients with diabetic neuropathy. In this study an inverse correlation was found between diabetic neuropathy and the plasma level of vitamin B12.

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6- Prevention and Management Strategies for Diabetic Neuropathy

  • Article info:  Smith S, Normahani P, Lane T, Hohenschurz-Schmidt D, Oliver N, Davies AH. Prevention and Management Strategies for Diabetic Neuropathy. Life (Basel). 2022 Aug 3;12(8):1185. doi: 10.3390/life12081185. PMID: 36013364; PMCID: PMC9410148.

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  • A section of the article's conclusion: There are important links between vitamin B12 deficiency, peripheral neuropathy and the treatment of diabetes. Firstly, vitamin B12 deficiency is an independent cause of peripheral neuropathy, and its exclusion is required for a diagnosis of DN [4]. Second, metformin, a T2DM treatment, can lead to vitamin B12 deficiency. 

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7-Topical citicoline and vitamin B12 versus placebo in the treatment of diabetes-related corneal nerve damage: a randomized double-blind controlled trial

  • Article info:  Fogagnolo P, Melardi E, Tranchina L, Rossetti L. Topical citicoline and vitamin B12 versus placebo in the treatment of diabetes-related corneal nerve damage: a randomized double-blind controlled trial. BMC Ophthalmol. 2020 Aug 1;20(1):315. doi: 10.1186/s12886-020-01584-w. PMID: 32738875; PMCID: PMC7395393.

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  • A section of the article's conclusion: Cit-B12 ameliorated both morphology and function of corneal nerves in patients with diabetes, thus suggesting a neuroregenerative effect.

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  • Magnesium (as magnesium oxide)

Diabetic neuropathy is a common and debilitating complication of diabetes, characterized by nerve damage caused by prolonged high blood sugar levels. Magnesium, an essential mineral involved in numerous physiological processes, plays a significant role in the management of diabetic neuropathy by supporting nerve health, reducing inflammation, and mitigating oxidative stress. Magnesium is critical for proper nerve function as it is involved in the regulation of nerve signal transmission, muscle contraction, and the maintenance of normal nerve excitability. Adequate magnesium levels help ensure that nerves function properly, which is particularly important in diabetic neuropathy, where nerve damage can lead to pain, tingling, and numbness.
 

Magnesium also has potent anti-inflammatory and antioxidant properties that provide protection against the cellular damage associated with diabetic neuropathy. Chronic hyperglycemia in diabetes leads to increased production of reactive oxygen species (ROS) and promotes inflammatory processes, both of which can damage nerves. Magnesium helps reduce oxidative stress by supporting the function of various antioxidant enzymes that neutralize ROS, thereby protecting nerve cells from oxidative damage. Additionally, magnesium's ability to modulate inflammatory responses helps decrease chronic inflammation, which is a key factor in the progression of diabetic neuropathy.
 

Another important aspect of magnesium's role in diabetic neuropathy is its involvement in improving vascular function and blood flow. Magnesium helps regulate blood pressure and supports the relaxation of blood vessels, ensuring adequate blood flow to nerves. Proper blood flow is essential for delivering oxygen and nutrients to nerve cells, which is critical for their repair and maintenance. By improving vascular health, magnesium contributes to the prevention and mitigation of nerve damage associated with diabetic neuropathy. Clinical studies have shown that magnesium supplementation can lead to improvements in symptoms of diabetic neuropathy, such as pain reduction and improved nerve conduction, highlighting its potential as a therapeutic option in managing this condition.

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Scientific Resources for Magnesium selection:

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1- NIH- Magnesium, Fact Sheet for Health Professionals (click to review)

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2- Association between serum magnesium and common complications of diabetes mellitus

  • Article info:  Zhang Y, Li Q, Xin Y, Lv W, Ge C. Association between serum magnesium and common complications of diabetes mellitus. Technol Health Care. 2018;26(S1):379-387. doi: 10.3233/THC-174702. PMID: 29758962; PMCID: PMC6004978.

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  • A section of the article's conclusion: Diabetic retinopathy, diabetic nephropathy, diabetic neuropathy and diabetic macrovascular disease are associated with serum magnesium concentration. We should pay more attention to diabetic patients with low serum magnesium level but still in the normal range. The impact of serum magnesium level on the process and prediction of diabetes mellitus worthy of further study.

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​3- Improving neuropathy scores in type 2 diabetic patients using micronutrients supplementation

  • Article info:  Farvid MS, Homayouni F, Amiri Z, Adelmanesh F. Improving neuropathy scores in type 2 diabetic patients using micronutrients supplementation. Diabetes Res Clin Pract. 2011 Jul;93(1):86-94. doi: 10.1016/j.diabres.2011.03.016. Epub 2011 Apr 14. PMID: 21496936.

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  • A section of the article's conclusion: These studies suggest that micronutrients supplementation might ameliorate diabetic neuropathy symptoms.

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​4- Magnesium and Pain

  • Article info:  Shin HJ, Na HS, Do SH. Magnesium and Pain. Nutrients. 2020 Jul 23;12(8):2184. doi: 10.3390/nu12082184. PMID: 32718032; PMCID: PMC7468697.

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  • A section of the article's conclusion: lower serum magnesium levels are observed in patients with diabetic neuropathy [74], correlated with diabetic macro- and microvascular complications [73,75]. The therapeutic and preventive roles of magnesium against diabetic peripheral neuropathy were proven in several studies. 

 

​5- Long term magnesium supplementation influences favourably the natural evolution of neuropathy in Mg-depleted type 1 diabetic patients (T1dm)​

  • Article info:  De Leeuw I, Engelen W, De Block C, Van Gaal L. Long term magnesium supplementation influences favourably the natural evolution of neuropathy in Mg-depleted type 1 diabetic patients (T1dm). Magnes Res. 2004 Jun;17(2):109-14. PMID: 15319143.

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  • A section of the article's conclusion: Under stable metabolic control long term Mg supplementation is able to restore a normal Mg status and influence favourably the natural evolution of PNP as compared to non supplemented T1dm controls.​​​​​​

  • Zinc (as zinc oxide)

Diabetic neuropathy is a significant complication of diabetes, resulting from prolonged high blood sugar levels that lead to nerve damage. Zinc, an essential trace mineral, plays a crucial role in the management of diabetic neuropathy by supporting nerve health, enhancing antioxidant defense, and modulating inflammatory responses. Zinc is involved in numerous enzymatic reactions and cellular processes, including DNA synthesis, protein production, and cell division, all of which are vital for maintaining healthy nerve cells and facilitating their repair.

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One of the key benefits of zinc in diabetic neuropathy is its antioxidant properties. Chronic hyperglycemia in diabetes increases the production of reactive oxygen species (ROS), which can cause oxidative stress and lead to nerve damage. Zinc plays a critical role in the activity of antioxidant enzymes, such as superoxide dismutase (SOD), which help neutralize ROS and protect nerve cells from oxidative damage. By reducing oxidative stress, zinc helps prevent further nerve damage and supports the overall health of the nervous system.

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Zinc also has anti-inflammatory effects that are beneficial in the context of diabetic neuropathy. Inflammation is a significant factor in the progression of nerve damage in diabetes. Zinc helps modulate the body's inflammatory response by inhibiting the production of pro-inflammatory cytokines and promoting the activity of anti-inflammatory molecules. This reduction in inflammation can alleviate pain and other symptoms associated with neuropathy, as well as slow the progression of nerve damage.

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Additionally, zinc plays a role in improving immune function and supporting wound healing, which are particularly important for individuals with diabetes who are at higher risk of infections and complications. Proper immune function helps protect nerves from infections that could exacerbate neuropathy, while zinc’s involvement in tissue repair aids in the recovery of damaged nerves. Clinical studies have indicated that zinc supplementation can improve symptoms of diabetic neuropathy, including reducing pain and improving nerve function, making it a valuable component in the comprehensive management of this condition.

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Scientific Resources for Zinc selection:

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​1- NIH-Zinc, Fact Sheet for Health Professionals (click to review)

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2- Zinc deficiency correlates with severity of diabetic polyneuropathy

  • Article info:  Hussein M, Fathy W, Hassan A, Elkareem RA, Marzouk S, Kamal YS. Zinc deficiency correlates with severity of diabetic polyneuropathy. Brain Behav. 2021 Oct;11(10):e2349. doi: 10.1002/brb3.2349. Epub 2021 Sep 14. PMID: 34521153; PMCID: PMC8553312.

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  • A section of the article's conclusion: There was a statistically significant positive correlation between zinc serum level and conduction velocity of median nerve (motor branch), ulnar nerve (motor branch), peroneal nerve and sural nerve in diabetic patients with peripheral neuropathy. 

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3- Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis

  • Article info:  Jayawardena R, Ranasinghe P, Galappatthy P, Malkanthi R, Constantine G, Katulanda P. Effects of zinc supplementation on diabetes mellitus: a systematic review and meta-analysis. Diabetol Metab Syndr. 2012 Apr 19;4(1):13. doi: 10.1186/1758-5996-4-13. PMID: 22515411; PMCID: PMC3407731.

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  • A section of the article's conclusion: This is the first comprehensive systematic review and meta-analysis of studies evaluating the effects of oral Zinc supplementation in patients with diabetes mellitus. We summarize the data from 25 studies, involving a total of 1,362 patients. Although there is a considerable het- erogeneity amongst the studies, our data shows several beneficial metabolic and clinical effects due to Zinc sup- plementations in patients with diabetes mellitus, namely improved glycaemic control and lipid parameters, with probable improvement in anti-oxidant status.​​​​​​​​​​​​​​​

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​4- Diabetic neuropathy and zinc therapy.​

  • Article info:  Hayee MA, Mohammad QD, Haque A. Diabetic neuropathy and zinc therapy. Bangladesh Med Res Counc Bull. 2005 Aug;31(2):62-7. PMID: 16967811.

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  • A section of the article's conclusion: Zinc therapy helps in achieving better glycemic control and improvement in peripheral neuropathy as assessed by MNCV.

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5- Oral zinc therapy in diabetic neuropathy​

  • Article info:  Gupta R, Garg VK, Mathur DK, Goyal RK. Oral zinc therapy in diabetic neuropathy. J Assoc Physicians India. 1998 Nov;46(11):939-42. PMID: 11229219.

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  • A section of the article's conclusion: Oral zinc supplementation helps in achieving better glycemic control and improvement in severity of peripheral neuropathy as assessed by MNCV.

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​6- Evaluation of the therapeutic efficacy of dressings with ZnO nanoparticles in the treatment of diabetic foot ulcers

  • Article info:  Loera-Valencia R, Neira RE, Urbina BP, Camacho A, Galindo RB. Evaluation of the therapeutic efficacy of dressings with ZnO nanoparticles in the treatment of diabetic foot ulcers. Biomed Pharmacother. 2022 Nov;155:113708. doi: 10.1016/j.biopha.2022.113708. Epub 2022 Sep 23. PMID: 36162373.

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  • A section of the article's conclusion: The results in this study reveal the potential of CAZnODs for safely improving the healing of diabetic foot ulcers in Latin American (Mexican) patients and it establishes a highly translatable precedent for nanoparticle therapeutics in the management of T2D in the developing world.​​​​​​​​​​​​​​​

  • Selenium (as selenium glycinate)

Diabetic neuropathy is a common and debilitating complication of diabetes, characterized by nerve damage due to prolonged high blood sugar levels. Selenium, a vital trace mineral, plays an important role in managing diabetic neuropathy by supporting antioxidant defenses, reducing inflammation, and promoting overall nerve health. Selenium is a key component of several selenoproteins, including glutathione peroxidase, an enzyme that plays a critical role in protecting cells from oxidative damage. Given that chronic hyperglycemia in diabetes leads to increased oxidative stress, selenium's ability to enhance antioxidant defenses is crucial in preventing and mitigating nerve damage associated with diabetic neuropathy.

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Selenium's antioxidant properties help neutralize reactive oxygen species (ROS), which are harmful byproducts of cellular metabolism that can cause significant damage to nerve cells. By reducing oxidative stress, selenium helps protect nerve cells from degeneration, thereby preserving nerve function and potentially alleviating symptoms of neuropathy, such as pain, tingling, and numbness.

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In addition to its antioxidant effects, selenium also exhibits anti-inflammatory properties, which are beneficial in the context of diabetic neuropathy. Chronic inflammation is a significant contributor to nerve damage in diabetes, and selenium helps modulate the inflammatory response by reducing the production of pro-inflammatory cytokines. This reduction in inflammation can slow the progression of neuropathy and ease the pain and discomfort associated with the condition.

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Moreover, selenium supports immune function, which is particularly important for individuals with diabetes who may be more susceptible to infections and complications. A well-functioning immune system can help protect against additional factors that could worsen neuropathy. Clinical studies suggest that adequate selenium levels are associated with a reduced risk of developing neuropathy and that selenium supplementation may help improve symptoms in those with diabetic neuropathy, making it a valuable nutrient in the comprehensive management of this condition.

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Scientific Resources for Selenium selection:

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​1- NIH- Selenium, Fact Sheet for Health Professionals (Click to review)

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​2- Correlating Blood Selenium Levels in Type 2 Diabetes Mellitus with Peripheral Neuropathy and Factors Contributing to Associated Lesion Development

  • Article info:  Xu H, Wen Q, Ye M. Correlating Blood Selenium Levels in Type 2 Diabetes Mellitus with Peripheral Neuropathy and Factors Contributing to Associated Lesion Development. Altern Ther Health Med. 2024 Apr;30(4):180-184. PMID: 37883776.

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  • A section of the article's conclusion: In conclusion, our study reveals a remarkable relationship between Se levels and DPN in individuals with T2DM.

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​3- The role of antioxidant micronutrients in the prevention of diabetic complications

  • Article info:  Bonnefont-Rousselot D. The role of antioxidant micronutrients in the prevention of diabetic complications. Treat Endocrinol. 2004;3(1):41-52. doi: 10.2165/00024677-200403010-00005. PMID: 15743112.

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  • A section of the article's conclusion: This article reviews the use of minerals (vanadium, chromium, magnesium, zinc, selenium, copper) and vitamins or cofactors (tocopherol [vitamin E], ascorbic acid [vitamin C], ubidecarenone [ubiquinone; coenzyme Q], nicotinamide, riboflavin, thioctic acid [lipoic acid], flavonoids) in diabetes, with a particular focus on the prevention of diabetic complications. 

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  • Copper (as copper gluconate)

Diabetic neuropathy is a prevalent complication of diabetes characterized by nerve damage resulting from prolonged high blood sugar levels. Copper, an essential trace mineral, plays a significant role in the maintenance and functioning of the nervous system, making it relevant in the context of diabetic neuropathy. Copper acts as a critical cofactor for numerous enzymes involved in vital biological processes, including energy production, antioxidant defense, and connective tissue formation, all of which contribute to nerve health and function.

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One of the key roles of copper in managing diabetic neuropathy is its involvement in antioxidant defense mechanisms. Copper is a component of the enzyme copper-zinc superoxide dismutase (Cu,Zn-SOD), which plays a crucial role in neutralizing superoxide radicals and reducing oxidative stress. In diabetes, chronic hyperglycemia leads to increased production of reactive oxygen species (ROS), causing oxidative damage to nerve cells and contributing to the development and progression of neuropathy. Adequate copper levels support the optimal functioning of Cu,Zn-SOD, thereby protecting nerve cells from oxidative damage and aiding in the preservation of nerve function.

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Additionally, copper is essential for the synthesis and maintenance of myelin, the protective sheath that surrounds nerve fibers and facilitates efficient transmission of nerve impulses. Enzymes such as lysyl oxidase, which require copper as a cofactor, are involved in the cross-linking of collagen and elastin, contributing to the structural integrity of myelin and connective tissues. Proper myelination is critical for nerve signal conduction, and disruptions in myelin integrity are a hallmark of diabetic neuropathy. By supporting myelin formation and maintenance, copper helps ensure effective nerve communication and reduces the risk of neuropathic symptoms such as pain, numbness, and tingling.

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Furthermore, copper plays a role in maintaining proper immune function and possesses anti-inflammatory properties, which are beneficial in managing diabetic neuropathy. Chronic inflammation is a contributing factor to nerve damage in diabetes, and copper-dependent enzymes help modulate inflammatory responses, reducing inflammation and preventing further nerve injury. Additionally, copper is involved in energy metabolism through its role in cytochrome c oxidase, a key enzyme in the mitochondrial electron transport chain, ensuring that nerve cells have sufficient energy to function and repair themselves effectively.

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Maintaining appropriate copper levels is essential, as both deficiency and excess can have detrimental effects on health. Deficiency may impair antioxidant defenses and myelin formation, exacerbating neuropathic conditions, while excess copper can lead to oxidative stress and toxicity. Therefore, ensuring balanced copper intake through diet or supervised supplementation can be a valuable component in the comprehensive management of diabetic neuropathy, supporting nerve health, reducing oxidative stress and inflammation, and promoting proper nerve function.

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Scientific Resources for cooper selection:

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1- NIH- Copper, Fact Sheet for Health Professionals​ (click to review)

 

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2- The Role of Copper Intake in the Development and Management of Type 2 Diabetes: A Systematic Review

  • Article info:  Eljazzar S, Abu-Hijleh H, Alkhatib D, Sokary S, Ismail S, Al-Jayyousi GF, Tayyem R. The Role of Copper Intake in the Development and Management of Type 2 Diabetes: A Systematic Review. Nutrients. 2023 Mar 29;15(7):1655. doi: 10.3390/nu15071655. PMID: 37049495; PMCID: PMC10096611.

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  • A section of the article's conclusion: Individuals should receive an adequate dietary amount of copper that is within the RDA levels (900 µg/day) in order to avoid copper deficiency or toxicity.

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3- Analysis of Serum and Urinal Copper and Zinc in Chinese Northeast Population with the Prediabetes or Diabetes with and without Complications​​

  • Article info:  Xu J, Zhou Q, Liu G, Tan Y, Cai L. Analysis of serum and urinal copper and zinc in Chinese northeast population with the prediabetes or diabetes with and without complications. Oxid Med Cell Longev. 2013;2013:635214. doi: 10.1155/2013/635214. Epub 2013 Sep 22. PMID: 24175012; PMCID: PMC3794628.

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  • A section of the article's conclusion: We clearly showed the positive association of serum Cu levels with Hb1Ac levels in all T2D patients;

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4- Pancytopenia Complicated with Peripheral Neuropathy Due to Copper Deficiency: Clinical Diagnostic Review

  • Article info:  Imataki O, Ohnishi H, Kitanaka A, Kubota Y, Ishida T, Tanaka T. Pancytopenia complicated with peripheral neuropathy due to copper deficiency: clinical diagnostic review. Intern Med. 2008;47(23):2063-5. doi: 10.2169/internalmedicine.47.1323. Epub 2008 Dec 1. PMID: 19043262.

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  • A section of the article's conclusion:  Neuropathy was completely recovered after the supplementation by Cu.However, the relative deficiency of Cu due to an excess of Zn might be associated with peripheral neuropathy.​​​

  • Chromium (as chromium picolinate)

Diabetic neuropathy is a serious complication of diabetes, characterized by nerve damage due to prolonged high blood sugar levels. Chromium, an essential trace mineral, plays a role in managing diabetic neuropathy primarily through its impact on glucose metabolism and insulin sensitivity. Chromium enhances the action of insulin, the hormone responsible for regulating blood sugar levels, by increasing insulin receptor activity and improving the efficiency of glucose uptake by cells. By helping to maintain stable blood glucose levels, chromium can reduce the risk of further nerve damage in diabetic patients, making it a valuable nutrient in the management of diabetic neuropathy.

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One of the key benefits of chromium in the context of diabetic neuropathy is its ability to improve insulin sensitivity. Poor insulin sensitivity, or insulin resistance, is a common issue in individuals with type 2 diabetes, leading to elevated blood glucose levels that can cause oxidative stress and inflammation—both major contributors to nerve damage. By improving the body’s response to insulin, chromium helps lower blood glucose levels, thereby reducing the oxidative stress and inflammation that exacerbate nerve damage in diabetic neuropathy.

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Chromium also plays a role in modulating oxidative stress, which is particularly relevant in diabetes. Chronic hyperglycemia leads to the overproduction of reactive oxygen species (ROS), resulting in oxidative damage to nerves. Although chromium is not a direct antioxidant, its ability to stabilize blood sugar levels indirectly reduces the production of ROS, thereby helping to protect nerve cells from oxidative damage. This reduction in oxidative stress can help slow the progression of diabetic neuropathy and alleviate some of the symptoms, such as pain, tingling, and numbness.

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Furthermore, chromium’s effects on glucose metabolism extend to its potential anti-inflammatory benefits. By improving blood sugar control, chromium may reduce the chronic low-grade inflammation often seen in diabetes, which contributes to the development and worsening of neuropathy. Clinical studies have suggested that chromium supplementation can improve glycemic control in diabetic patients and may have a positive impact on the symptoms of diabetic neuropathy, making it a useful component in the comprehensive management of this condition.

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Scientific Resources for Chromium selection:

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​1- NIH- Chromium, Fact Sheet for Health Professionals (click to review)

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​2- Cluster and Factor Analysis of Elements in Serum and Urine of Diabetic Patients with Peripheral Neuropathy and Healthy People

  • Article info:  Guo W, Zhou Q, Jia Y, Xu J. Cluster and Factor Analysis of Elements in Serum and Urine of Diabetic Patients with Peripheral Neuropathy and Healthy People. Biol Trace Elem Res. 2020 Mar;194(1):48-57. doi: 10.1007/s12011-019-01747-x. Epub 2019 May 28. PMID: 31140035; PMCID: PMC6987062.

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  • Article link: 

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  • A section of the article's conclusion: Zinc supplementation could prevent disease progression to diabetes by controlling blood glucose and insulin resistance while improving β-cell function. Diabetic patients are with lower serum Cr while many trials have confirmed that Cr supplementation altered high glucose status and slowed progression of complications.

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​3- The role of antioxidant micronutrients in the prevention of diabetic complications

  • Article info:  Bonnefont-Rousselot D. The role of antioxidant micronutrients in the prevention of diabetic complications. Treat Endocrinol. 2004;3(1):41-52. doi: 10.2165/00024677-200403010-00005. PMID: 15743112.

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  • A section of the article's conclusion: This article reviews the use of minerals (vanadium, chromium, magnesium, zinc, selenium, copper) and vitamins or cofactors (tocopherol [vitamin E], chrom ascorbic acid [vitamin C], ubidecarenone [ubiquinone; coenzyme Q], nicotinamide, riboflavin, thioctic acid [lipoic acid], flavonoids) in diabetes, with a particular focus on the prevention of diabetic complications. Results show that dietary supplementation with micronutrients may be a complement to classical therapies for preventing and treating diabetic complications. Supplementation is expected to be more effective when a deficiency in these micronutrients exists.

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​4- Comparison of Chromium and Iron Distribution in Serum and Urine among Healthy People and Prediabetes and Diabetes Patients

  • Article info:  Zhou Q, Guo W, Jia Y, Xu J. Comparison of Chromium and Iron Distribution in Serum and Urine among Healthy People and Prediabetes and Diabetes Patients. Biomed Res Int. 2019 Feb 24;2019:3801639. doi: 10.1155/2019/3801639. PMID: 30915353; PMCID: PMC6409039.

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  • A section of the article's conclusion: We confirmed serum Cr levels were lower in the T2DCON, DR, DPN, and DN population than that of the control, which is consistent with findings of other investigators ​​​

  • Alpha Lipoic Acid

Diabetic neuropathy is a common and debilitating complication of diabetes, characterized by nerve damage due to prolonged high blood sugar levels. Alpha-lipoic acid (ALA) is a naturally occurring compound that plays a significant role in the management of diabetic neuropathy due to its potent antioxidant properties and its ability to improve glucose metabolism. ALA is both water- and fat-soluble, allowing it to act as a universal antioxidant that can protect nerve cells from oxidative damage, which is a key factor in the development and progression of diabetic neuropathy.

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One of the primary mechanisms through which ALA benefits individuals with diabetic neuropathy is by reducing oxidative stress. Chronic hyperglycemia in diabetes leads to an overproduction of reactive oxygen species (ROS), which can cause significant oxidative damage to nerve cells, contributing to neuropathy. ALA not only directly scavenges free radicals, thereby reducing oxidative stress, but it also helps regenerate other antioxidants such as glutathione and vitamins C and E. This broad antioxidant action helps protect nerves from further damage and supports the overall health of the nervous system.

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In addition to its antioxidant effects, ALA has been shown to improve blood flow and nerve conduction, which are often compromised in diabetic neuropathy. ALA enhances endothelial function, leading to improved microcirculation and better delivery of oxygen and nutrients to nerve tissues. This improved blood flow helps reduce the symptoms of neuropathy, such as pain, burning, and numbness, and supports nerve repair and regeneration.

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Furthermore, ALA improves glucose metabolism by enhancing insulin sensitivity. This helps lower blood sugar levels, reducing the hyperglycemia-induced oxidative stress and inflammation that contribute to nerve damage. Clinical studies have demonstrated that ALA supplementation can significantly reduce symptoms of diabetic neuropathy, such as pain and discomfort, and improve quality of life for patients. Due to its multiple beneficial effects, ALA is considered a valuable therapeutic option in the comprehensive management of diabetic neuropathy, particularly for reducing oxidative stress, improving nerve function, and alleviating neuropathic pain.

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Scientific Resources for ALA selection:

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​1- NIH- ALA, Fact Sheet for Health Professionals (click to review)

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​2- Treatment with 𝛼-Lipoic Acid over 16 Weeks in Type 2 Diabetic Patients with Symptomatic Polyneuropathy Who Responded to Initial 4-Week High-Dose Loading

  • Article info:  Garcia-Alcala H, Santos Vichido CI, Islas Macedo S, Genestier-Tamborero CN, Minutti-Palacios M, Hirales Tamez O, García C, Ziegler D. Treatment with α-Lipoic Acid over 16 Weeks in Type 2 Diabetic Patients with Symptomatic Polyneuropathy Who Responded to Initial 4-Week High-Dose Loading. J Diabetes Res. 2015;2015:189857. doi: 10.1155/2015/189857. Epub 2015 Aug 4. PMID: 26345602; PMCID: PMC4539458.

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  • A section of the article's conclusion: In this multicenter enriched enrolment randomized with- drawal open-label study we demonstrated that in respon- ders to initial 4-week high-dose (600 mg tid) administra- tion of ALA, subsequent treatment with ALA (600 mg qd) over 16 weeks effectively diminished neuropathic symptoms, whereas ALA withdrawal was associated with a higher use of rescue analgesic drugs in type 2 diabetic patients with symptomatic DSPN.

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3- Oral Alpha Lipoic Acid Treatment for Symptomatic Diabetic Peripheral Neuropathy: A Randomized Double-Blinded Placebo-Controlled Study​

  • Article info:  El-Nahas MR, Elkannishy G, Abdelhafez H, Elkhamisy ET, El-Sehrawy AA. Oral Alpha Lipoic Acid Treatment for Symptomatic Diabetic Peripheral Neuropathy: A Randomized Double-Blinded Placebo-Controlled Study. Endocr Metab Immune Disord Drug Targets. 2020;20(9):1531-1534. doi: 10.2174/1871530320666200506081407. PMID: 32370731.

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  • A section of the article's conclusion: ALA-treated patients had significantly better results regarding almost all the outcome parameters (NSS, NDS, VAS, VPT). 

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4- Alpha-Lipoic Acid and Diabetic Neuropathy

  • Article info:  Vallianou N, Evangelopoulos A, Koutalas P. Alpha-lipoic Acid and diabetic neuropathy. Rev Diabet Stud. 2009 Winter;6(4):230-6. doi: 10.1900/RDS.2009.6.230. Epub 2009 Dec 30. PMID: 20043035; PMCID: PMC2836194.

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  • A section of the article's conclusion: Recently, trials have been conducted with neuropathic diabetes patients who received 600 mg alpha-lipoic acid. The treatment reduced pain, paresthesias, and numbness.

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5- Effects of Oral Alpha-Lipoic Acid Treatment on Diabetic Polyneuropathy: A Meta-Analysis and Systematic Review

  • Article info:  Hsieh RY, Huang IC, Chen C, Sung JY. Effects of Oral Alpha-Lipoic Acid Treatment on Diabetic Polyneuropathy: A Meta-Analysis and Systematic Review. Nutrients. 2023 Aug 18;15(16):3634. doi: 10.3390/nu15163634. PMID: 37630823; PMCID: PMC10458197.

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  • A section of the article's conclusion: Treatment with ALA had favorable effects on sensory symptoms, but not on muscle power, VPT, or nerve conduction. Moreover, ALA provided symptom relief with a dose- dependent response relative to the placebo for TSS and global satisfaction. Thus, nutritional supplementation for diabetic complications may be a preventive strategy in diabetic care.

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6- Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy

  • Article info:  Ziegler D, Gries FA. Alpha-lipoic acid in the treatment of diabetic peripheral and cardiac autonomic neuropathy. Diabetes. 1997 Sep;46 Suppl 2:S62-6. doi: 10.2337/diab.46.2.s62. PMID: 9285502.

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  • A section of the article's conclusion: In conclusion, intravenous treatment with alpha-lipoic acid (600 mg/day) over 3 weeks is safe and effective in reducing symptoms of diabetic peripheral neuropathy, and oral treatment with 800 mg/day for 4 months may improve cardiac autonomic dysf unction in NIDDM.

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7- Efficacy and Safety of Antioxidant Treatment With a-Lipoic Acid Over 4 Years in Diabetic Polyneuropathy The NATHAN 1 trial

  • Article info:  Ziegler D, Low PA, Litchy WJ, Boulton AJ, Vinik AI, Freeman R, Samigullin R, Tritschler H, Munzel U, Maus J, Schütte K, Dyck PJ. Efficacy and safety of antioxidant treatment with α-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care. 2011 Sep;34(9):2054-60. doi: 10.2337/dc11-0503. Epub 2011 Jul 20. PMID: 21775755; PMCID: PMC3161301.

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  • A section of the article's conclusion: Four-year treatment with ALA in mild-to-moderate DSPN did not influence the primary composite end point but resulted in a clinically meaningful improvement and prevention of progression of neuropathic impairments and was well tolerated.

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8- Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: A monocentric, randomized, double-blind, placebo-controlled clinical trial

  • Article info:  Esposito C, Ugo Garzarella E, Santarcangelo C, Di Minno A, Dacrema M, Sacchi R, Piccinocchi G, Piccinocchi R, Daglia M. Safety and efficacy of alpha-lipoic acid oral supplementation in the reduction of pain with unknown etiology: A monocentric, randomized, double-blind, placebo-controlled clinical trial. Biomed Pharmacother. 2021 Dec;144:112308. doi: 10.1016/j.biopha.2021.112308. Epub 2021 Oct 12. PMID: 34649217.

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  • A section of the article's conclusion: Since the management of idiopathic pain is challenging for physicians, the use of ALA food supplements could be a feasible option, based on its safety and efficacy compared to commonly-used analgesic drugs.​​

  • CO Q-10

Diabetic neuropathy is a common and debilitating complication of diabetes, marked by nerve damage that results from prolonged high blood sugar levels. Coenzyme Q10 (CoQ10), a naturally occurring antioxidant and an essential component of the mitochondrial electron transport chain, plays a significant role in managing diabetic neuropathy by supporting cellular energy production, reducing oxidative stress, and improving mitochondrial function.

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One of the primary mechanisms through which CoQ10 benefits individuals with diabetic neuropathy is by enhancing mitochondrial function. Mitochondria are the powerhouses of the cell, responsible for generating ATP, the energy currency of the cell. In diabetic neuropathy, mitochondrial dysfunction is a key factor that contributes to nerve damage. CoQ10 is crucial for the efficient production of ATP, and by supporting mitochondrial function, CoQ10 helps ensure that nerve cells have the energy they need to function properly and repair themselves. This is particularly important in diabetic neuropathy, where energy deficits in nerve cells can exacerbate the condition.

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CoQ10 also plays a vital role as a powerful antioxidant. Chronic hyperglycemia in diabetes leads to an overproduction of reactive oxygen species (ROS), which can cause significant oxidative stress and damage to nerve cells. CoQ10 helps neutralize these free radicals, reducing oxidative damage and protecting nerve cells from further injury. This antioxidant effect is crucial in slowing the progression of diabetic neuropathy and alleviating symptoms such as pain, tingling, and numbness.

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Additionally, CoQ10 has anti-inflammatory properties that contribute to its neuroprotective effects. Inflammation is a major contributor to nerve damage in diabetic neuropathy, and CoQ10 helps modulate the inflammatory response, reducing the chronic inflammation that can exacerbate nerve damage. By decreasing oxidative stress and inflammation, CoQ10 not only protects existing nerve cells but also supports the repair and regeneration of damaged nerves.

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Clinical studies have shown that CoQ10 supplementation can improve symptoms of diabetic neuropathy, such as reducing pain and improving nerve conduction. Furthermore, CoQ10's ability to enhance overall mitochondrial function and reduce oxidative stress makes it a valuable therapeutic option in the comprehensive management of diabetic neuropathy, helping to protect nerve health and improve quality of life for individuals with this condition.

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Scientific Resources for Co Q10 selection:

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​1- NIH- Co Q10, Fact Sheet for Health Professionals (click to review)

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​2- The effect of ubiquinone in diabetic polyneuropathy: A randomized double blind placebo-controlled study

  • Article info:  Hernández-Ojeda J, Cardona-Muñoz EG, Román-Pintos LM, Troyo-Sanromán R, Ortiz-Lazareno PC, Cárdenas-Meza MA, Pascoe-González S, Miranda-Díaz AG. The effect of ubiquinone in diabetic polyneuropathy: a randomized double-blind placebo-controlled study. J Diabetes Complications. 2012 Jul-Aug;26(4):352-8. doi: 10.1016/j.jdiacomp.2012.04.004. Epub 2012 May 16. PMID: 22595020.

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  • A section of the article's conclusion: Twelve weeks treatment with ubiquinone improves clinical outcomes and nerve conduction parameters of diabetic polyneuropathy; furthermore, it reduces oxidative stress without significant adverse events.

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3- Dietary and Nutritional Supplementation for Painful Diabetic Neuropathy: A Narrative Review

  • Article info:  Apergi K, Papanas N. Dietary and Nutritional Supplementation for Painful Diabetic Neuropathy: A Narrative Review. Exp Clin Endocrinol Diabetes. 2023 Dec;131(12):646-655. doi: 10.1055/a-2188-1745. Epub 2023 Oct 9. PMID: 37813369.

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  • A section of the article's conclusion: According to the preliminary research, supplementation with vitamin E, B- complex, omega-3 fatty acids, CoQ10 or N-acetylcysteine seems to be associated with promising results in improving PDN symptoms

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​4- Effects of coenzyme Q10 supplementation on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials

  • Article info:  Liang Y, Zhao D, Ji Q, Liu M, Dai S, Hou S, Liu Z, Mao Y, Tian Z, Yang Y. Effects of coenzyme Q10 supplementation on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials. EClinicalMedicine. 2022 Aug 3;52:101602. doi: 10.1016/j.eclinm.2022.101602. PMID: 35958521; PMCID: PMC9358422.

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  • A section of the article's conclusion: The major findings of meta-analysis showed that CoQ10 supple- mentation statistically reduced fasting glucose, fasting insulin, HbA1c, and HOMA-IR. This means that CoQ10 supplementation might have beneficial effects in glyce- mic control.

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5- Supplementation of Coenzyme Q10 among Patients with Type 2 Diabetes Mellitus

  • Article info:  Shen Q, Pierce JD. Supplementation of Coenzyme Q10 among Patients with Type 2 Diabetes Mellitus. Healthcare (Basel). 2015 May 21;3(2):296-309. doi: 10.3390/healthcare3020296. PMID: 27417763; PMCID: PMC4939545.

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  • A section of the article's conclusion: Restoration of CoQ10 level among patients with T2DM by supplementation of exogenous CoQ10 could potentially alleviate oxidative stress, preserve mitochondrial function, and eventually lead to improvement of glycemic control.

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6- Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial

  • Article info:  Amini P, Sajedi F, Mirjalili M, Mohammadi Y, Mehrpooya M. Coenzyme Q10 as a potential add-on treatment for patients suffering from painful diabetic neuropathy: results of a placebo-controlled randomized trial. Eur J Clin Pharmacol. 2022 Dec;78(12):1899-1910. doi: 10.1007/s00228-022-03407-x. Epub 2022 Oct 22. PMID: 36273066.

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  • A section of the article's conclusion:  Our data support the idea that diabetic patients suffering from PDN may benefit from using antioxidant and anti-inflammatory supplements like CoQ10

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7- Complementary therapy in diabetic patients with chronic complications: a pilot study

  • Article info:  Palacka P, Kucharska J, Murin J, Dostalova K, Okkelova A, Cizova M, Waczulikova I, Moricova S, Gvozdjakova A. Complementary therapy in diabetic patients with chronic complications: a pilot study. Bratisl Lek Listy. 2010;111(4):205-11. PMID: 20586147.

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  • A section of the article's conclusion: The data show that supportive therapy with PL along with the antioxidants hydrosoluble CoQ10, alpha-lipoic acid and vitamin E is an effective way of controlling the complications of type 2 diabetes ​​​

 

  • Acetyl L-Carnitine

Diabetic neuropathy is a significant complication of diabetes, characterized by nerve damage resulting from prolonged high blood sugar levels. Acetyl-L-carnitine (ALC), a naturally occurring amino acid derivative, plays an important role in managing diabetic neuropathy by supporting nerve health, enhancing mitochondrial function, and reducing oxidative stress.

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One of the primary mechanisms through which ALC benefits individuals with diabetic neuropathy is by improving mitochondrial function. ALC facilitates the transport of fatty acids into the mitochondria, where they are used for energy production. Efficient energy production is crucial for nerve cells, particularly in diabetic neuropathy, where energy deficits contribute to nerve damage. By enhancing mitochondrial function, ALC helps ensure that nerve cells have the energy necessary for proper function and repair, which can mitigate the effects of neuropathy.

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ALC also exhibits neuroprotective properties through its ability to reduce oxidative stress and support nerve regeneration. Chronic hyperglycemia in diabetes leads to the overproduction of reactive oxygen species (ROS), causing oxidative damage to nerve cells. ALC acts as an antioxidant, helping to neutralize ROS and protect nerve cells from further damage. Additionally, ALC has been shown to stimulate the production of nerve growth factors, which are essential for the repair and regeneration of damaged nerves. This ability to promote nerve regeneration is particularly beneficial in the context of diabetic neuropathy, where nerve damage is a central issue.

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Furthermore, ALC has been found to reduce neuropathic pain, a common and debilitating symptom of diabetic neuropathy. The exact mechanism is not fully understood, but it is believed that ALC's effects on nerve regeneration, mitochondrial function, and oxidative stress contribute to its pain-relieving properties. Clinical studies have demonstrated that ALC supplementation can improve symptoms of diabetic neuropathy, including reducing pain and improving nerve conduction velocities, making it a valuable therapeutic option in the comprehensive management of this condition.

Overall, ALC's ability to enhance mitochondrial function, reduce oxidative stress, and support nerve regeneration makes it an effective supplement for managing diabetic neuropathy and improving the quality of life for those affected by this condition.

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Scientific Resources for ALC selection:

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​1- Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review

  • Article info:  Di Stefano G, Di Lionardo A, Galosi E, Truini A, Cruccu G. Acetyl-L-carnitine in painful peripheral neuropathy: a systematic review. J Pain Res. 2019 Apr 26;12:1341-1351. doi: 10.2147/JPR.S190231. PMID: 31118753; PMCID: PMC6498091.

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  • A section of the article's conclusion: ALC is an effective and safe treatment in painful periph- eral neuropathy, especially in diabetic patients. 

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​2- Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial

  • Article info:  Li S, Chen X, Li Q, Du J, Liu Z, Peng Y, Xu M, Li Q, Lei M, Wang C, Zheng S, Zhang X, Yu H, Shi J, Tao S, Feng P, Tian H. Effects of acetyl-L-carnitine and methylcobalamin for diabetic peripheral neuropathy: A multicenter, randomized, double-blind, controlled trial. J Diabetes Investig. 2016 Sep;7(5):777-85. doi: 10.1111/jdi.12493. Epub 2016 Mar 28. PMID: 27180954; PMCID: PMC5009142.

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  • A section of the article's conclusion: In summary, ALC is as effective as MC in improving clinical symptoms and neurophysiological parameters in diabetic patients with DPN with good tolerance. 

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3- Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo controlled study

  • Article info:  De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R D. 2002;3(4):223-31. doi: 10.2165/00126839-200203040-00001. PMID: 12455197.

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  • A section of the article's conclusion: LAC was effective and well tolerated in improving neurophysiological parameters and in reducing pain over a 1-year period. LAC is, therefore, a promising treatment option in patients with diabetic neuropathy.

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​4- Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials​

  • Article info:  Sima AA, Calvani M, Mehra M, Amato A; Acetyl-L-Carnitine Study Group. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care. 2005 Jan;28(1):89-94. doi: 10.2337/diacare.28.1.89. PMID: 15616239.

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  • A section of the article's conclusion: These studies demonstrate that ALC treatment is efficacious in alleviating symptoms, particularly pain, and improves nerve fiber regeneration and vibration perception in patients with established diabetic neuropathy.

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5-Identification of Factors Associated With Sural Nerve Regeneration and Degeneration in Diabetic Neuropathy

  • Article info:  Hur J, Sullivan KA, Callaghan BC, Pop-Busui R, Feldman EL. Identification of factors associated with sural nerve regeneration and degeneration in diabetic neuropathy. Diabetes Care. 2013 Dec;36(12):4043-9. doi: 10.2337/dc12-2530. Epub 2013 Oct 7. PMID: 24101696; PMCID: PMC3836098.

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  • A section of the article's conclusion: ALC treatment alleviated pain symptoms but had no effect on sural nerve conduc- tion velocities (NCVs), amplitudes, or MFD (6). Our initial demographic anal- yses of these participants revealed that elevated serum triglycerides measured at trial onset correlated with DN pro- gression after correcting for baseline DN severity and clinical factors, such as sex, age, duration and types of diabetes, insulin treatment, ALC treatment, and HbA1c (7). 

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  • GliSODin (Superoxide Dismutase)

Diabetic neuropathy is a prevalent and debilitating complication of diabetes, characterized by nerve damage resulting from prolonged high blood sugar levels and associated oxidative stress. GliSODin®, a patented oral form of superoxide dismutase (SOD) combined with gliadin for enhanced bioavailability, plays a significant role in managing diabetic neuropathy by strengthening the body's antioxidant defenses, reducing oxidative stress, and supporting overall nerve health. As a powerful antioxidant enzyme, SOD is essential for neutralizing superoxide radicals, thereby preventing cellular damage and contributing to the maintenance of healthy nervous system function.

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One of the primary mechanisms through which GliSODin® benefits individuals with diabetic neuropathy is by mitigating oxidative stress, a key contributor to nerve damage in diabetes. Chronic hyperglycemia leads to the excessive production of reactive oxygen species (ROS), including superoxide radicals, which cause oxidative damage to nerve cells and impair their function. GliSODin® enhances the body's ability to neutralize these harmful superoxide radicals by increasing endogenous SOD levels, thus protecting nerve cells from oxidative injury and preventing further degeneration. This reduction in oxidative stress helps to alleviate common symptoms of diabetic neuropathy such as pain, tingling, and numbness.

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In addition to its antioxidant effects, GliSODin® exhibits anti-inflammatory properties that further contribute to its neuroprotective benefits. Inflammation plays a significant role in the progression of diabetic neuropathy by exacerbating nerve damage and impairing nerve repair mechanisms. By reducing pro-inflammatory cytokine production and modulating the inflammatory response, GliSODin® helps to create a more favorable environment for nerve regeneration and healing. Furthermore, some studies suggest that enhanced antioxidant protection provided by GliSODin® may improve vascular function, promoting better blood flow and nutrient delivery to peripheral nerves, which is crucial for their health and repair. Collectively, these effects make GliSODin® a valuable adjunct in the comprehensive management of diabetic neuropathy, supporting nerve function and improving quality of life for those affected by this condition.

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Scientific Resources for SOD selection:

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​1- Combination of alpha lipoic acid and superoxide dismutase leads to physiological and symptomatic improvements in diabetic neuropathy

  • Article info:  Bertolotto F, Massone A. Combination of alpha lipoic acid and superoxide dismutase leads to physiological and symptomatic improvements in diabetic neuropathy. Drugs R D. 2012 Mar 1;12(1):29-34. doi: 10.2165/11599200-000000000-00000. PMID: 22329607; PMCID: PMC3586118.

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  • A section of the article's conclusion: Our study is the first to show that treatment with a combination of ALA and SOD leads to an improvement both in symptomatology and in electroneurographic parameters in patients af- fected by DN.

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2- Efficacy and Safety of the Combination of Superoxide Dismutase, Alpha Lipoic Acid, Vitamin B12 and Carnitine for 12 Months in Patients with Diabetic Neuropathy​

  • Article info:  Didangelos T, Karlafti E, Kotzakioulafi E, Kontoninas Z, Margaritidis C, Giannoulaki P, Kantartzis K. Efficacy and Safety of the Combination of Superoxide Dismutase, Alpha Lipoic Acid, Vitamin B12, and Carnitine for 12 Months in Patients with Diabetic Neuropathy. Nutrients. 2020 Oct 23;12(11):3254. doi: 10.3390/nu12113254. PMID: 33114210; PMCID: PMC7690794.

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  • A section of the article's conclusion: In conclusion, in the present study, the administration of the combination of the four elements in one tablet for 12 months in patients with DMT2 resulted in an improvement in all indices of peripheral neuropathy including neurophysiological parameters, pain, and quality of life

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​3- Lower serum extracellular superoxide dismutase levels are associated with polyneuropathy in recent-onset diabetes

  • Article info:  Strom A, Kaul K, Brüggemann J, Ziegler I, Rokitta I, Püttgen S, Szendroedi J, Müssig K, Roden M, Ziegler D. Lower serum extracellular superoxide dismutase levels are associated with polyneuropathy in recent-onset diabetes. Exp Mol Med. 2017 Nov 17;49(11):e394. doi: 10.1038/emm.2017.173. PMID: 29147011; PMCID: PMC5704187.

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  • A section of the article's conclusion: In conclusion, patients with recently diagnosed type 1 and type 2 diabetes show evidence of systemic oxidative stress despite good glycemic control. Reduced SOD3 concentration was associated with diminished nerve conduction attributes and DSPN, pointing to a role of impaired extracellular antioxidative defense of superoxide in the evolution of early DSPN. ​​​​​​

  • Vanadium (as vanadium chelate)

Diabetic neuropathy, a common and challenging complication of diabetes, results from prolonged high blood sugar levels leading to nerve damage. Vanadium, particularly in its chelated form for better bioavailability, plays a promising role in the management of diabetic neuropathy through its effects on glucose metabolism, insulin sensitivity, and potential neuroprotective properties.

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One of the primary mechanisms by which vanadium benefits individuals with diabetic neuropathy is its insulin-mimetic properties. Vanadium chelate can enhance insulin sensitivity by mimicking the action of insulin and improving the efficiency of glucose uptake by cells. This ability to improve insulin signaling helps regulate blood glucose levels more effectively, thereby reducing hyperglycemia-induced damage to nerves. By stabilizing blood sugar levels, vanadium can mitigate one of the key factors that contribute to the progression of diabetic neuropathy, namely chronic hyperglycemia.

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Vanadium also has potential antioxidant effects, which can be particularly beneficial in diabetic neuropathy. Chronic hyperglycemia increases the production of reactive oxygen species (ROS), leading to oxidative stress, which damages nerve cells and exacerbates neuropathic symptoms. Vanadium chelate may help reduce oxidative stress by enhancing the body's antioxidant defenses, thereby protecting nerve cells from oxidative damage. This protective effect can help preserve nerve function and reduce symptoms such as pain, tingling, and numbness associated with diabetic neuropathy.

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Furthermore, some studies suggest that vanadium may have direct neuroprotective effects. By influencing signaling pathways involved in cell survival and neuroprotection, vanadium chelate may help protect nerves from the toxic effects of high glucose levels and support nerve repair processes. While the exact mechanisms are still being studied, the combined effects of improved glucose metabolism, reduced oxidative stress, and potential direct neuroprotection make vanadium chelate a valuable component in the management of diabetic neuropathy. Clinical studies have shown that vanadium supplementation can improve glycemic control and may have a positive impact on the symptoms of diabetic neuropathy, offering a complementary approach to traditional treatments for this condition.

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Scientific Resources for Vanadium selection:

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​1- Vanadium Compounds with Antidiabetic Potential

  • Article info:  Amaral LMPF, Moniz T, Silva AMN, Rangel M. Vanadium Compounds with Antidiabetic Potential. Int J Mol Sci. 2023 Oct 27;24(21):15675. doi: 10.3390/ijms242115675. PMID: 37958659; PMCID: PMC10650557.

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  • A section of the article's conclusion: Vanadium administration was found to alleviate several diabetes-related metabolic changes while offering two advantages over insulin: it is orally active and seems to avoid the risk of hypoglycemia.

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2- Vanadium treatment of type 2 diabetes: A view to the future​

  • Article info:  Thompson KH, Lichter J, LeBel C, Scaife MC, McNeill JH, Orvig C. Vanadium treatment of type 2 diabetes: a view to the future. J Inorg Biochem. 2009 Apr;103(4):554-8. doi: 10.1016/j.jinorgbio.2008.12.003. Epub 2008 Dec 24. PMID: 19162329.

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  • A section of the article's conclusion: Vanadium compounds can be used to mitigate insufficient insulin response in diabetes mellitus. They cannot entirely substitute for lack of insulin (as in type 1 diabetes), but they can reduce reliance on exogenous insulin, or perhaps substitute for other oral hypoglycemic agents, in type 2 diabetes. 

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3- The role of antioxidant micronutrients in the prevention of diabetic complications

  • Article info:  Bonnefont-Rousselot D. The role of antioxidant micronutrients in the prevention of diabetic complications. Treat Endocrinol. 2004;3(1):41-52. doi: 10.2165/00024677-200403010-00005. PMID: 15743112.

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  • A section of the article's conclusion: This article reviews the use of minerals (vanadium, chromium, magnesium, zinc, selenium, copper) and vitamins or cofactors (tocopherol [vitamin E], ascorbic acid [vitamin C], ubidecarenone [ubiquinone; coenzyme Q], nicotinamide, riboflavin, thioctic acid [lipoic acid], flavonoids) in diabetes, with a particular focus on the prevention of diabetic complications. Results show that dietary supplementation with micronutrients may be a complement to classical therapies for preventing and treating diabetic complications.

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