For this study, researchers analyzed data from 132 studies that had been published between 1998 and 2023. The pooled data was formed by a total of more than 52,000 study participants with type 2 diabetes to look for micronutrient deficiencies, including vitamins, minerals, and electrolytes.

Upon analysis, scientists found the pooled prevalence of micronutrient deficiencies among people with type 2 diabetes was about 45%.

“(This) indicates that every second person with type 2 diabetes has one or the other micronutrient deficiency,” Mangal explained. “These micronutrients are essential at the cellular level and in glucose metabolism. We found that micronutrient deficiency is common among diabetics.”

“We must look for more robust research findings to incriminate the deficiency of micronutrients with causation and glycemic control and inform diabetic management protocols on routine screening for these deficiencies and supplementation,” he added.

The researchers also reported the amount of micronutrient deficiencies was higher in women with type 2 diabetes than men.

“This variation could be due to differences in lifestyle and dietary practices,” Mangal said. “However, no causation has yet been established.”

Of all the micronutrients studied, Mangal and his team found that vitamin D was the most common missing micronutrient, affecting 60.5% of participants.

“Vitamin D deficiency is the most common deficiency found among diabetic patients. Vitamin D plays a role in insulin production and utilization at cellular levels. However, we must gather more information on the causal association between vitamin D deficiency and the causation of diabetes and its complications,” Mangal said.

After vitamin D, 42% of participants were deficient in magnesium, 29% in vitamin B12, and 28% in iron.

“Our findings suggest that approximately 45% of individuals with type 2 diabetes exhibit multiple micronutrient deficiencies. This highlights the potential for targeted nutritional interventions to complement existing treatments for diabetes management. Addressing these deficiencies could improve glycemic control, reduce the risk of complications, and enhance overall health outcomes.”
— Daya Krishan Mangal, MD

“Additionally, identifying and correcting micronutrient deficiencies may open avenues for preventative strategies, particularly for individuals at high risk of developing complications amongst those having type 2 diabetes,” Mangal added. “However, further research is needed to establish causal relationships and determine the effectiveness of such interventions in both prevention and treatment contexts.”

MNT spoke with Toni Isabella, RN, BSN, CDCES, manager of The MOLLY Diabetes Education and Management Center for Adults and Children at Hackensack University Medical Center in New Jersey about this study.

Isabella said it’s not surprising that micronutrient deficiencies are common in people with type 2 diabetes for several interconnected reasons, including increased urinary excretion, medication side effects, insulin resistance, and increased oxidative stress.

“Understanding the role of specific nutrients in the development of type 2 diabetes can lead to targeted dietary recommendations and interventions to prevent or delay the onset of the disease, especially in high-risk individuals,” she continued. “This could have a significant impact on public health, given the growing global prevalence of diabetes.”

MNT also spoke with Pouya Shafipour, MD, a board certified family and obesity medicine physician at Providence Saint John’s Health Center in Santa Monica, CA, about this study.

Shafipour commented that almost everyone has a lower amount of vitamin D due to working all day indoors and not going outside in the middle of the day when vitamin D levels are highest, and that he was a little skeptical of the study’s results.

“Vitamin D is a steroid hormone — it’s not really a vitamin per se and it has over 100 different functions in the body,” he explained. “It is a very essential vitamin, but at the same time, it’s also very controversial now. The (American Association of Clinical Endocrinologists) advises against checking vitamin D, because they’re saying optimizing the level hasn’t shown to be very beneficial and it is a costly lab, as most insurances don’t cover it.”

Shafipour said more comprehensive, double-blind studies are needed regarding vitamins.

“The problem with vitamins is that they don’t get enough attention,” he explained. “Usually, we get a blanket statement from more academic societies that say don’t take a vitamin, vitamins are ineffective.”

“I think if there is research about vitamins, especially about the top four or five essential ones, they’ll also greatly help Western medicine doctor-patient relationships because most people usually (go) for this to alternative medicine doctors,” Shafipour added.

MNT also talked to Monique Richard, MS, RDN, LDN, a registered dietitian nutritionist and owner of Nutrition-In-Sight, for her tips on how readers can make sure they are getting the proper amount of micronutrients in their diet to possibly help prevent type 2 diabetes.

“First and foremost, I encourage clients and patients to focus on understanding what their body needs from food and why,” Richard explained. “Food is our fuel. We need carbohydrates, protein and fat (macronutrients). In each of those categories we need a variety of food, high in quality, in order to meet the daily needs of micronutrients (vitamins, minerals, electrolytes, phytochemicals).”

“Many people are under the impression that they can simply buy vitamins and minerals not consumed or included in their diet,” she continued.

“When needs are not being met by food, supplements alone are not a sufficient substitute for essential vitamins and minerals. They don’t come in the synergistic package like they do in whole food — a form our bodies utilize and recognize for the benefit of operating and fully functioning,” Richard said.

For those at a high risk of developing type 2 diabetes, Richard suggested:

• focusing on complex carbohydrates such as whole grains, beans and lentils, nuts, seeds, vegetables, and fruits with their skin and pulp.
• understanding the amount of protein per day needed divided up fairly equally per meal for satiation, muscle and enzyme support, and meeting needs.
• meeting protein needs from a variety of foods rich in protein such as beans, nuts, nut butters, seeds, whole grains, fatty fish, dairy, poultry, eggs, and other animal products.
• consuming healthy fats from whole foods such as nuts, seeds, olives, and protein sources (eggs, dairy, etc.).
• adding in herbs and spices, which are rich in antioxidants and phytochemicals that support insulin sensitivity.
• decreasing the amount of added sugar in the diet, which will decrease the amount of circulating glucose in the body that, in turn, decreases insulin response and preserves pancreatic function.

“Type 2 diabetes mellitus is complex and multifactorial. It is not caused by one specific nutrient deficiency or by one specific behavior. It is a serious condition that can have devastating consequences if unchecked, but it does not have to. It can be managed — in some cases, even reversed — but for most, it is an opportunity for us to learn how to help our bodies help itself.”
— Monique Richard, MS, RDN, LDN