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      Marion J. Franz, MS, RD, CDE, is a Nutrition/Health Consultant at Nutrition Concepts by Franz, Inc., Minneapolis, MN.

       Chapter 3 Micronutrients and Diabetes

      Joshua J. Neumiller, PharmD, CDE, CGP, FASCP

Highlights

       Requirements for Micronutrients: Dietary Reference Intakes

       Requirements for Micronutrients in Diabetes

       Micronutrient Effects on Glucose and Insulin Homeostasis

       Definition and Regulation of Supplements

       Summary

Highlights Micronutrients and Diabetes

      • Dietary reference intakes (DRIs) are reference values that are quantitative estimates of nutrient intakes to be used for planning and assessing diets for healthy people. DRIs consist of four reference intakes: Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI), and Tolerable Upper Intake Level (UL).

      • Many micronutrients are involved in carbohydrate and/or glucose metabolism as well as with insulin release and sensitivity. This information, however, is frequently extrapolated beyond what is supported by research findings, and clinical data for most micronutrients for the treatment of diabetes are inconclusive.

      • Supplements are defined as any product that is intended to supplement the diet. Dietary supplements contain one or more of the following: vitamin, mineral, herb or other botanical, or amino acid. Unlike drugs, supplements do not need to undergo efficacy or safety testing before being marketed.

      • Currently, there is insufficient evidence to support the routine use of supplements for the treatment of diabetes. There are, however, select groups of individuals who may benefit, such as people with poor glycemic control and/or people with a documented deficiency of a given micronutrient or vitamin. Compelling data from well-designed, long-term studies are needed before supplement products can be recommended for widespread