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I just posted this on the Health & Nutrition board, and it occurred to me to see if there's a board here for people with diabetes. I see you've just started up,'s my post.


A study published last month in the ANNALS OF INTERNAL MEDICINE (randomized, controlled, double-blinded, etc etc) using healthy middle-aged volunteers for 1 year compared taking a daily vitamin/mineral supplement to a placebo. Overall, the rate of infections was dramatically lower in the supplement group (43% of the subjects, compared to 73% in the placebo group). Closer analysis identified the diabetic subgroup (type 2 diabetes) as fully responsible for this difference. Restricting the analysis to the diabetics in each group, only 17% on the daily supplement experienced an infection during the study year, compared to 93% on the placebo. Pretty impressive!

Here's the review in an e-mailing that I get, which is more detailed than the abstract. The abstract, though, includes a thought not presented in this review, that diabetics tend to suffer from nutritional microdeficiencies--and thus the noticeable benefit from a supplement.


Annals of Internal Medicine, March 4, 2003 (Volume 138, Number 5)

Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. A Randomized, Double-Blind, Placebo-Controlled Trial
Barringer TA, Kirk JK, Santaniello AC, Foley KL, Michielutte R
Annals of Internal Medicine. 2003;138(5):365-371

Although 40% of the US population is estimated to take multivitamin supplements, the benefits of multivitamin therapy for the average adult remain nebulous.[1] Previous research has yielded conflicting results as to whether multivitamin therapy prevents infection.[2,3] The authors of this study used a rigorous double-blind, placebo-controlled study design to further investigate this issue.

Participants in the study were all at least 45 years old. Subjects were excluded from participation if they had a history of a variety of medical diseases, substance abuse, or treatment with immunosuppressive agents. Thus the cohort for this study consisted mainly of healthy, middle-aged adults.

A total of 158 people enrolled in the study. They were followed up for nutritional deficiencies as well as stress, physical activity, and tobacco use throughout the trial. Enrollees were randomized to receive either placebo or a standard multivitamin of a composition that reflected the normal distribution of vitamins and minerals found in most commercial preparations. The main outcome of the trial was the frequency and duration of infections, which were measured by daily symptom logs recorded by the patients. Quality of life was also measured.

During the 1-year trial period, 42% of participants suffered upper respiratory infections, 19% had influenza-like syndromes, and 12% had gastrointestinal infections. Seven percent of subjects had lower respiratory infections, and less than 2% had urinary tract infections. No infections requiring hospitalization were recorded during the study period.

Seventy-three percent of the placebo group suffered infection-related illness, compared with only 43% of the multivitamin group (P < .001). These infections led to a 57% rate of any infection-related absenteeism in the placebo group vs only 21% in the multivitamin group (P < .001). A detailed review of these data revealed that these differences were almost entirely due to subjects with diabetes. The prevalence of infection for diabetic participants was 93% in the placebo group vs 17% in the multivitamin group (relative risk = 0.18; 95% confidence interval, 0.07%-0.44%; P < .001). No diabetic patient in the multivitamin group reported absenteeism from work, compared with 89% of diabetics in the placebo group.

Participants older than or younger than 65 years had similar frequencies of infection, and multivitamin use did not help older adults more than their middle-aged peers. There was no difference in quality of life scores between the multivitamin and placebo groups.

This study was limited by the self-reported nature of symptoms along with the fact that, although the authors took pains to blind subjects to their treatment, most patients could identify their randomized group.

Multivitamin use is an incredibly common practice among the general population that defies any foundation in science. Other than specific indications such as known nutritional deficiencies and pregnancy, it is difficult to find an evidence-based reason to recommend multivitamin treatment to patients. However, this quality research demonstrates that a simple, safe intervention of a multivitamin a day may prevent common infections in diabetic patients. Further research should focus on this at-risk population to determine whether not only minor infections but also serious ones, such as foot ulcers, may be ameliorated by multivitamins. An editorial accompanying the article also espouses the use of multivitamins in developing countries, where micronutrient deficiencies are more common.[4]

Ervin RB, Wright JD, Kennedy-Stephenson J. Use of dietary supplements in the United States , 1988-94. Vital Health Stat 11. 1999;i-iii:1-14.
Chavance M, Herbeth B, Lemoine A, Zhu BP. Does multivitamin supplementation prevent infections in healthy elderly subjects? A controlled trial. Int J Vitam Nutr Res. 1993;63:11-16.
Chandra RK. Effect of vitamin and trace-element supplementation on immune responses and infection in elderly subjects. Lancet. 1992;340:1124-1127.
Fawzi W, Stampfer MJ. A role for multivitamins in infection? Ann Intern Med. 2003;138:430-431.

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