“Hidden hunger” — low levels of essential vitamins or minerals -- is common among people with Type 2 diabetes, a new evidence review says.
Overall, as many as 45% of Type 2 diabetics are suffering multiple deficiencies in vitamins, minerals and electrolytes, researchers reported Jan. 28 in the journal BMJ Nutrition, Prevention & Health.
The review “exemplifies the double burden of malnutrition in action,” where people trying to manage their diabetes through diet wind up with nutritional deficiencies, concluded the research team led by Dr. Daya Krishan Mangal, an adjunct professor at the International Institute of Health Management Research in Jaipur, India.
For the evidence review, researchers pooled results from 132 prior studies involving more than 52,500 participants between 1998 and 2023.
Very low levels of vitamin D were the most common deficiency, affecting more than 60% of people with Type 2 diabetes.
Other common deficiencies included magnesium (42%), iron (28%) and vitamin B12 (22%).
People on the diabetes drug metformin were at higher risk for B12 deficiency, with 29% having low levels of that vitamin.
Women with diabetes were more likely to have vitamin deficiencies than men, 49% versus 43%, results show.
And diabetics in North and South America had the highest levels of vitamin deficiencies, with 54% suffering a lack of specific nutrients.
“The treatment of Type 2 diabetes often tends to focus on energy metabolism and macronutrients, but the identification of a higher prevalence of specific micronutrient deficiencies in those affected is a reminder that optimizing overall nutrition should always be a priority,” the research team concluded.
These deficiencies might cause people’s diabetes to become worse, as many different nutrients are involved in metabolism, researchers said. They also could cause other health problems.
On the other hand, nutritional deficiencies could be linked to developing Type 2 diabetes in the first place.
“Micronutrient deficiencies may influence glucose metabolism and insulin signalling pathways, leading to the onset and progression of Type 2 diabetes,” researchers wrote.