The relationship of B vitamins to diabetes mellitus

Czech version

Authors: Štefan Sotak
Authors‘ workplace: I. interní klinika LF UPJŠ, Košice
Published in: Čas. Lék. čes. 2025; 164: 316-320
Category: Review Article

Overview

Vitamins, together with trace elements, belong to the group of essential nutrients called micronutrients, as they are needed by the human body in relatively small quantities. Their deficiency usually develops over a longer period, and therefore most often manifests itself in patients with chronic diseases, malnutrition or insufficient supplementation within the framework of long-term artificial nutrition. B vitamins are water-soluble vitamins that are primarily related to hematopoiesis and the nervous system; their deficiency can cause various anemias and neuropathies. However, the relationships of all B vitamins to various types of diabetes mellitus and their complications have also been described. B vitamins are related to glucose metabolism, their reduced serum level can be a risk factor for the onset and development of diabetes mellitus. Supplementation of individual vitamins is relevant for the prevention and/or therapy of diabetes mellitus and its complications.

Keywords:

B vitamins – diabetes mellitus – obesity.

Sources

Hanna M, Jaqua E, Nguyen V et al. B Vitamins: functions and uses in medicine. Perm J 2022; 26 : 89–97.
Godoy-Parejo C, Deng C, Zhang Y et al. Roles of vitamins in stem cells. Cell Mol Life Sci 2020; 77 : 1771–1791.
Peng M, Zhang Y, Weng X et al. Thiamine and METTL14 in diabetes management with intensive insulin therapy. Biomedicines 2025; 13 : 980.
Oh SH, Witek RP, Bae SH et al. Detection of transketolase in bone marrow-derived insulin-producing cells: benfotiamine enhances insulin synthesis and glucose metabolism. Stem Cells Dev 2009; 18 : 37–46.
Rad MG, Sharifi M, Meamar R et al. Long term administration of thiamine disulfide improves FOXO1/PEPCK pathway in liver to reduce insulin resistance in type 1 diabetes rat model. Biomed Pharmacother 2024; 177 : 117053.
Khan MU, Mubeen M, Chohan HK et al. Correlation of fasting blood sugar and glycated hemoglobin (HbA_1c) with thiamine levels in diabetic patients. Cureus 2023; 15: e46178.
Ziegler D, Reiners K, Strom A et al. Association between diabetes and thiamine status –⁠ A systematic review and meta-analysis. Metabolism 2023; 144 : 155565.
Vine J, Mehta S, Balaji L et al. Thiamine as adjunctive therapy for diabetic ketoacidosis (DKAT) trial protocol and statistical analysis plan: a prospective, single-centre, double-blind, randomised, placebo-controlled clinical trial in the USA. BMJ Open 2024; 14: e077586.
Coggeshall JC, Heggers JP, Robson MC et al. Biotin status and plasma glucose in diabetics. Ann N Y Acad Sci 1985; 447 : 389–392.
McCarty MF. In type 1 diabetics, high-dose biotin may compensate for low hepatic insulin exposure, promoting a more normal expression of glycolytic and gluconeogenic enzymes and thereby aiding glycemic control. Med Hypotheses 2016; 95 : 45–48.
Kibirige D, Mwebaze R. Vitamin B₁₂ deficiency among patients with diabetes mellitus: is routine screening and supplementation justified? J Diabetes Metab Disord 2013; 12 : 17.
Visentin M, Diop-Bove N, Zhao R et al. The intestinal absorption of folates. Annu Rev Physiol 2014; 76 : 251–274.
Raghuvanshi DS, Chakole S, Kumar M. Relationship between vitamins and diabetes. Cureus 2023; 15: e36815.
González-Ortiz M, Martínez-Abundis E, Robles-Cervantes JA et al. Effect of thiamine administration on metabolic profile, cytokines and inflammatory markers in drug-naïve patients with type 2 diabetes. Eur J Nutr 2011; 50 : 145–149.
Alaei Shahmiri F, Soares MJ, Zhao Y et al. High-dose thiamine supplementation improves glucose tolerance in hyperglycemic individuals: a randomized, double-blind cross-over trial. Eur J Nutr 2013; 52 : 1821–1824.
Liu C, Duan W, Xu W. Association of dietary niacin intake with diabetes in adults in the United States. Exp Clin Endocrinol Diabetes 2023; 131 : 354–361.
McKenney J. New perspectives on the use of niacin in the treatment of lipid disorders. Arch Intern Med 2004; 164 : 697–705.
Xiang D, Zhang Q, Wang YT. Effectiveness of niacin supplementation for patients with type 2 diabetes: A meta-analysis of randomized controlled trials. Medicine (Baltimore) 2020; 99: e21235.
Li LO, Hu Y-F, Wang L et al. Early hepatic insulin resistance in mice: a metabolomics analysis. Mol Endocrinol 2010; 24 : 657–666.
Gogna N, Krishna M, Oommen AM et al. Investigating correlations in the altered metabolic profiles of obese and diabetic subjects in a South Indian Asian population using an NMR-based metabolomic approach. Mol Biosyst 2015; 11 : 595–606.
Ma T, Liu T, Xie P et al. UPLC-MS-based urine nontargeted metabolic profiling identifies dysregulation of pantothenate and CoA biosynthesis pathway in diabetic kidney disease. Life Sci 2020; 258 : 118160.
Ahn HJ, Min KW, Cho Y-O. Assessment of vitamin B₆ status in Korean patients with newly diagnosed type 2 diabetes. Nutr Res Pract 2011; 5 : 34–39.
Song Y, Cook NR, Albert CM et al. Effect of homocysteine-lowering treatment with folic Acid and B vitamins on risk of type 2 diabetes in women: a randomized, controlled trial. Diabetes 2009; 58 : 1921–1928.
Unoki-Kubota H, Yamagishi S, Takeuchi M et al. Pyridoxamine, an inhibitor of advanced glycation end product (AGE) formation ameliorates insulin resistance in obese, type 2 diabetic mice. Protein Pept Lett 2010; 17 : 1177–1181.
Zhang Y, Ding Y, Fan Y et al. Influence of biotin intervention on glycemic control and lipid profile in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Front Nutr 2022; 9 : 1046800.
Furukawa Y. Enhancement of glucose-induced insulin secretion and modification of glucose metabolism by biotin. Nihon Rinsho 1999; 57 : 2261–2269.
Satapathy S, Bandyopadhyay D, Patro BK et al. Folic acid and vitamin B₁₂ supplementation in subjects with type 2 diabetes mellitus: A multi-arm randomized controlled clinical trial. Complement Ther Med 2020; 53 : 102526.
Lai JS, Pang WW, Cai S et al. High folate and low vitamin B₁₂ status during pregnancy is associated with gestational diabetes mellitus. Clin Nutr 2018; 37 : 940–947.
Asbaghi O, Ashtary-Larky D, Bagheri R et al. Folic Acid supplementation improves glycemic control for diabetes prevention and management: a systematic review and dose-response meta-analysis of randomized controlled trials. Nutrients 2021; 13 : 2355.
Hong SM, Woo HW, Kim MK et al. A prospective association between dietary folate intake and type 2 diabetes risk among Korean adults aged 40 years or older: the Korean Multi-Rural Communities Cohort (MRCohort) Study. Br J Nutr 2017; 118 : 1078–1088.
Zhang F, Huai R, Jia F et al. Association between mixed dietary B vitamin intake and insulin resistance in US middle-aged and older adults without diabetes: the Bayesian kernel machine regression approach. Asia Pac J Clin Nutr 2022; 31 : 768–779.
Zhu Y, Ying T, Xu M et al. Joint B vitamin intake and type 2 diabetes risk: the mediating role of inflammation in a prospective Shanghai cohort. Nutrients 2024; 16 : 1901.
Karakousis ND, Pyrgioti EE, Georgakopoulos PN et al. Vitamin B₁₂ and diabetic foot: α mini-review. Int J Low Extrem Wounds 2025; 24 : 299–302.
Sayedali E, Yalin AE, Yalin S. Association between metformin and vitamin B₁₂deficiency in patients with type 2 diabetes. World J Diabetes 2023; 14 : 585–593.
Ge Y, Huang S, Li Y et al. Pregnancy thiamine and riboflavin intake and the risk of gestational diabetes mellitus: a prospective cohort study. Am J Clin Nutr 2023; 117 : 426–435.
Tsokkou S, Tzintros ST, Konstantinidis I et al. Assessment of environmental risk factors for gestational diabetes mellitus: a ten-year systematic review and meta-analysis. J Clin Med 2025; 14 : 1646.
Muthuraman N, Vijayselvi R, Sudhakar PY et al. Assessment of serum biotin levels and its association with blood glucose in gestational diabetes mellitus. Eur J Obstet Gynecol Reprod Biol X 2023; 17 : 100181.
Wald NJ. Folic acid and neural tube defects: discovery, debate and the need for policy change. J Med Screen 2022; 29 : 138–146.
Owen MD, Baker BC, Scott EM et al. Interaction between metformin, folate and vitamin B₁₂ and the potential impact on fetal growth and long-term metabolic health in diabetic pregnancies. Int J Mol Sci 2021; 22 : 5759.
Krishnaveni GV, Hill JC, Veena SR et al. Low plasma vitamin B₁₂ in pregnancy is associated with gestational 'diabesity' and later diabetes. Diabetologia 2009; 52 : 2350–2358.
Kurian SJ, Baral T, Unnikrishnan MK et al. The association between micronutrient levels and diabetic foot ulcer: a systematic review with meta-analysis. Front Endocrinol (Lausanne) 2023; 14 : 1152854.
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; 22 : 5418.
Karaganis S, Song XJ. B vitamins as a treatment for diabetic pain and neuropathy. J Clin Pharm Ther 2021; 46 : 1199–1212.
Koutsikos D, Agroyannis B, Tzanatos-Exarchou H. Biotin for diabetic peripheral neuropathy. Biomed Pharmacother 1990; 44 : 511–514.
Demirci B, Demir O, Dost T et al. Protective effect of vitamin B₅ (dexpanthenol) on cardiovascular damage induced by streptozocin in rats. Bratisl Lek Listy 2014; 115 : 190–196.
Title LM, Ur E, Giddens K et al. Folic acid improves endothelial dysfunction in type 2 diabetes –⁠ an effect independent of homocysteine-lowering. Vasc Med 2006; 11 : 101–109.
Dagher Z, Park YS, Asnaghi V et al. Studies of rat and human retinas predict a role for the polyol pathway in human diabetic retinopathy. Diabetes 2004; 53 : 2404–2411.
Deshmukh SV, Prabhakar B, Kulkarni YA. Water soluble vitamins and their role in diabetes and its complications. Curr Diabetes Rev 2020; 16 : 649–656.
Katare R, Caporali A, Emanueli C et al. Benfotiamine improves functional recovery of the infarcted heart via activation of pro-survival G6PD/Akt signaling pathway and modulation of neurohormonal response. J Mol Cell Cardiol 2010; 49 : 625–638.
Institute of Medicine (US) standing committee on the scientific evaluation of dietary reference intakes and its panel on folate, other B vitamins, and choline. Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B₆, folate, vitamin B₁₂, pantothenic acid, biotin, and choline. National Academies Press (US), Washington (DC), 1998.

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