Micronutrients and Diabetes

Dr Jedha, Host

Hello wonderful people, thanks so much for joining me. In a recent episode, we talked about why nutrition—not dieting—is the foundation of treating type 2 diabetes and prediabetes. We explored how good nutrition isn’t just about eating fewer carbohydrates. It’s about nourishing your body with plenty of vegetables, quality protein, healthy fats, and mostly minimally processed foods. In other words, it’s about the quality of your overall eating pattern.

One of the things I mentioned briefly was that when you eat this way, you’re providing your body with the vitamins, minerals and other nutrients it needs to function well. Today, I want to explore that idea a little further, because I think it’s one of the most overlooked areas of diabetes nutrition.

When most people think about nutrition, they think about the nutrients that provide energy—carbohydrates, protein and fat. These are called macronutrients because we need them in relatively large amounts.

But there are another group of nutrients called micronutrients. 

So, what exactly are micronutrients?

When we talk about nutrition, we often divide nutrients into two main groups: macronutrients and micronutrients.

Macronutrients are the nutrients we need in relatively large amounts. These are carbohydrates, protein and fat. They provide the energy, or fuel, that keeps our bodies going.

Micronutrients are different. These are the vitamins and minerals we need in much smaller amounts. They don’t provide calories or energy, but they’re absolutely essential for good health.

In fact, they help drive thousands of chemical reactions throughout your body every single day.

They help convert the food you eat into energy. They support healthy nerves and muscles. They help keep your immune system working properly. They contribute to healthy bones, your heart, your brain and your eyes. They help repair cells, protect against oxidative stress, and support normal hormone function.

Importantly for people with prediabetes and type 2 diabetes, many micronutrients are directly involved in glucose metabolism and insulin function. In other words, they help your body process and use the food you’re eating.

I like to think of it this way. If macronutrients are the fuel for your car, micronutrients are the spark plugs, engine oil and all the other components that keep the engine running smoothly. Without them, the engine doesn’t perform as well, no matter how much fuel you put in the tank.

And here’s something many people don’t realize. Research consistently shows that people with prediabetes and type 2 diabetes are more likely to have deficiencies in several important vitamins and minerals than the general population.

That doesn’t mean everyone is deficient. But it does mean it’s worth understanding which nutrients are most commonly affected, why these deficiencies occur, and most importantly, what you can do about them.

So you might be curious to understand, why are micronutrient deficiencies more common in people with prediabetes and type 2 diabetes?

Well, there isn’t one simple answer. It’s usually a combination of several different factors.

The first is diet quality.

Many people develop type 2 diabetes after years of eating a diet high in ultra-processed foods and relatively low in vegetables, nuts, seeds, seafood and other nutrient-rich whole foods. Even if someone is getting plenty of calories, they may not be getting enough vitamins and minerals. In other words, it’s entirely possible to be overfed but undernourished.

The second reason is that diabetes itself can affect the way your body handles certain nutrients. For example, when blood sugar remains elevated for long periods, your kidneys filter more glucose into the urine. Because water follows glucose, people with higher blood sugar often lose more fluid, and along with that, greater amounts of some nutrients, particularly magnesium.

Another factor is that living with diabetes places extra demands on the body. Higher levels of inflammation and oxidative stress mean your body is constantly repairing and protecting tissues. Many vitamins and minerals are involved in those important processes, so maintaining adequate levels becomes even more important.

Medications can also play a role. One of the best-known examples is metformin. It’s an excellent medication for many people, but long-term use can reduce the absorption of vitamin B12. That’s why many healthcare professionals recommend checking B12 levels from time to time in people taking metformin.

And finally, some of the same things that increase the risk of deficiencies in the general population also apply to people with diabetes. Things like getting older, digestive conditions that affect nutrient absorption, or simply not eating a wide enough variety of nutritious foods.

So while diabetes doesn’t automatically mean you’ll develop a vitamin or mineral deficiency, it does increase the risk. And that’s one of the reasons paying attention to the quality of your overall diet is just as important as paying attention to carbohydrates.

So, let’s take a look at some of the micronutrients that are most commonly affected, starting with one that’s probably the best known—vitamin D.

Vitamin D is best known for keeping our bones healthy, but it also plays important roles in immune function, muscle health and glucose metabolism.

Vitamin D deficiency is the most common micronutrient deficiency seen in people with type 2 diabetes. Studies suggest that around six out of ten people have low vitamin D levels, and deficiency is also more common in people with prediabetes.

While low vitamin D is linked with poorer metabolic health, studies haven’t consistently shown that everyone with diabetes benefits from taking vitamin D supplements. So rather than thinking of vitamin D as a treatment for diabetes, the goal is simply to make sure you’re not deficient.

You can obtain vitamin D through sensible sun exposure, along with foods such as oily fish, eggs and fortified dairy products. If you’re at higher risk of deficiency, it’s worth discussing testing with your doctor.

The take-home message? Vitamin D deficiency is common and worth identifying and treating if present, but it’s one piece of the bigger nutrition puzzle—not a magic bullet for diabetes.

Another nutrient that deserves just as much attention—and perhaps even more when it comes to blood sugar regulation—is magnesium. If you’ve listened to this podcast for a while, you’ll know I covered magnesium in much more detail back in Episode 48.

Magnesium is involved in hundreds of chemical reactions throughout the body, including many that help insulin work properly and allow glucose to move into your cells. When magnesium levels are low, those processes become less efficient, which can contribute to insulin resistance.

Unfortunately, magnesium deficiency is common in people with type 2 diabetes. Some people simply don’t eat enough magnesium-rich foods, while others lose more magnesium through their urine when blood sugar remains elevated.

Many of the foods we already encourage as part of a healthy eating pattern are naturally rich in magnesium, such as leafy green vegetables, nuts, seeds, legumes and avocado are all excellent sources. And if needed, supplementation can help. 

The take-home message? Magnesium plays an important role in healthy glucose metabolism, and getting enough through a varied, whole-food diet is one of the simplest ways to support your overall health. If you’d like a much deeper dive into magnesium, including supplements and deficiency symptoms, go back and listen to Episode 48.

The next nutrient is vitamin B12, and this one is particularly important if you’re taking metformin, which we discussed in detail in episode 125.

Vitamin B12 helps keep your nerves healthy and is essential for making red blood cells and supporting normal brain function. The challenge is that long-term metformin use can reduce the absorption of vitamin B12, increasing the risk of deficiency.

One of the reasons this matters is that vitamin B12 deficiency can cause symptoms such as tiredness, weakness, numbness or tingling in the hands and feet. Those nerve symptoms can sometimes look very similar to diabetic neuropathy, making deficiency easy to overlook.

Vitamin B12 deficiency can usually be identified with a simple blood test. And corrected with foods or supplementation. Foods rich in vitamin B12 include meat, seafood, eggs and dairy products.

The take-home message? If you’re taking metformin, especially over the long term, it’s worth talking to your doctor about checking your vitamin B12 levels from time to time.

Other nutrients worth paying attention to

While vitamin D, magnesium and vitamin B12 are probably the best-known deficiencies in people with prediabetes and type 2 diabetes, they’re certainly not the only ones.

Vitamin C is another nutrient that’s often overlooked. It’s well known for supporting the immune system, but it’s also a powerful antioxidant that helps protect our cells from oxidative stress. Interestingly, research suggests that many people with prediabetes and type 2 diabetes have lower vitamin C levels, even when their dietary intake appears to be adequate.

Potassium is another important mineral. It plays a key role in muscle and nerve function, fluid balance and healthy blood pressure. Many potassium-rich foods are also foods we encourage every day, including leafy greens, avocado, mushrooms, tomatoes and other non-starchy vegetables.

Zinc, folate and several other vitamins and minerals also play important roles in insulin function, wound healing, immune health and normal metabolism. While deficiencies can occur, they’re usually less common and often reflect an overall lack of variety in the diet rather than a problem with just one nutrient.

When you step back and look at the bigger picture, there’s an important lesson here. The nutrients we’ve talked about today don’t work in isolation. They’re part of a complex network, with each one supporting different functions throughout the body.

That’s why I generally don’t recommend chasing individual vitamins or minerals unless there’s a good reason. Instead, I encourage people to focus on eating a wide variety of nutrient-dense whole foods. When you do that, you’re naturally supplying your body with hundreds of vitamins, minerals and beneficial plant compounds that work together to support better health.

The take-home message? Rather than asking, “Which supplement should I take?” a better question is, “How can I eat a more nutrient-rich diet?” That’s the best place to start and where the biggest gains are usually made.

So, should everyone with prediabetes or type 2 diabetes be taking a handful of vitamin and mineral supplements?

For most people, the answer is no.

Supplements certainly have an important place when a deficiency has been identified, or when someone is at higher risk because of a medical condition, medication or dietary restriction. But they’re exactly what the name suggests—a supplement to a healthy diet, not a substitute for one.

The foundation should always be real, nutrient-dense food.

That’s one of the reasons I place so much emphasis on vegetables, quality protein, healthy fats, nuts, seeds and other minimally processed foods. They’re not just lower in carbohydrate than many processed foods; they’re naturally packed with the vitamins, minerals, fiber and thousands of other beneficial compounds your body needs to function well.

So while lowering carbohydrates helps improve blood sugar, nourishing your body with high-quality foods helps improve your overall health. And that’s really the message I hope you take away from today’s episode.

Nutrition isn’t just about what you remove from your plate. It’s also about what you put on it.

Every colourful vegetable, every handful of nuts or seeds, every piece of fish, every egg and every nourishing meal is another opportunity to provide your body with the nutrients it needs to support healthy blood sugar, a healthier metabolism and better long-term health.

And that’s the take-home message. Don’t just think about avoiding foods that raise your blood sugar. Think about feeding your body the nutrients it needs to thrive.

When you nourish your body well, you’re giving it the best possible chance to work well.

Thank you so much for joining me today. If you found this episode helpful, I’d really appreciate it if you could leave a rating or review on your favorite podcast app or head to our website at Type2diabetestalk.com/review. It helps more people discover the podcast and supports us in continuing to create free, evidence-based education for people living with prediabetes and type 2 diabetes.

Until next time, take care.

Dr Jedha, over and out.