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Health News Archive 368 - Diabetes
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Folate and Vitamin B6 Boost Heart Health for Type-1 Diabetics

Children with type-1 diabetes could benefit from high-dose folate and vitamin B6 supplements to boost their cardiovascular health, according to a new clinical trial published in the journal Pediatrics.

Type-1 diabetes occurs when people are not able to produce any insulin after the cells in the pancreas have been damaged, thought to be an autoimmune response.  Sixty-five percent of diabetics die from heart attack and stroke, and people with diabetes are reported to have a two to four higher chance of developing cardiovascular disease.  “Effective intervention with an apparently safe, inexpensive adjunct such as folate or vitamin B-6 at an early stage in childhood, in addition to optimization of metabolic control, could have a major impact on long-term diabetic vascular complications,” wrote lead author Karen MacKenzie.

The new study, from the University of Adelaide in Australia and the Wellington School of Medicine in New Zealand, reports that the cardiovascular health of people with type-1 diabetics could benefit from high-dose folate and/or vitamin B6 supplements.  This is the first time that such benefits associated with these B vitamins have been reported.

The randomized, double-blind, placebo-controlled study evaluated 122 children (average age 14) with type-1 diabetes and normal blood folate levels.  Researchers assigned the children to one of four experimental groups: Five milligrams of folate and placebo; 100 milligrams vitamin B6 and placebo; five mg folate plus 100 mg vitamin B6; two placebo tablets.

High-resolution ultra-sound was used to measure flow-mediated dilation (FMD) at baseline, at two and four hours after the first dose, and after four and eight weeks of supplementation. FMD measures changes in the diameter of blood vessels that are associated with increased blood flow.

Two hours after the first dose of folate, FMD was found to have increased significantly from 1.88 per cent to 10.46 per cent, with no additional increase at four hours.  The vitamin B6 supplement only lead to an immediate (at two hours) effect on FMD, increasing from 4.7 per cent to 8.36 per cent, with no further changes at four hours.  No significant changes were observed for the placebo group.

After eight weeks, the researchers found that FMD was significantly increased in all three intervention groups. Folate only supplementation led to an increase in FMD of about 7%, while vitamin B6 led to an increase of almost 5%.  The combined supplement of vitamin B6 and folate led to an increase in FMD of about 7.75 per cent at the end of the eight-week intervention period.  No significant differences were observed for the placebo groups.

“We have shown for the first time that, among children with type-1 diabetes and normal folate status, both high-dose folate and high-dose vitamin B6 normalize endothelial function within two hours, an effect that is maintained over eight weeks with high-dose folate and/or vitamin B6,” wrote the authors.

MacKenzie and her co-workers propose that the B vitamins offer benefits independent of homocysteine levels, which may be due to antioxidant effects, and possibly a direct interaction with nitric oxide synthase which boosts nitric oxide production.

"Because type 1 has autoimmune implications it is too early to speculate that vitamin B6 and folic acid affects mostly cardiovascular health. We would suggest a future area of research as Type-2 diabetes and this combination therapy," said Matt Hunt of the British charity Diabetes UK.

Source: MacKenzie KE. Folate and Vitamin B6 Rapidly Normalize Endothelial Dysfunction In Children With Type 1 Diabetes Mellitus. Pediatrics 2006; 118: 242-253.

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