The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog is intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at www.Vicus.com, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    B vitamins to treat diabetic kidney disease?

    Hyperhomocysteinemia (high blood levels of homocysteine) increases the risk of blood vessel complications in people with diabetes. Supplementation with B vitamins (pyridoxine, folic acid, B12) reduces these levels.

    Researchers in Canada report the results of the (Diabetic Intervention with Vitamins to Improve Nephropathy [DIVINe]) study, which was designed to determine whether B-vitamin therapy might slow progression of diabetic kidney disease and prevent vascular complications.

    First, the details.

    • 238 participants with type 1 or 2 diabetes and a diagnosis of diabetic nephropathy were randomly assigned to a treatment group for 36 months.
      • 1 tablet per day of B vitamins containing folic acid (2.5 mg), vitamin  B6 (25 mg), and vitamin B12 (1 mg)
      • Matching placebo
    • Changes in glomerular filtration rate (kidney function) were recorded.
    • The needs for dialysis and a composite outcome of heart attack, stroke, revascularization (surgery to improve blood flow), and death due to any cause were recorded.
    • Blood levels of homocysteine were also measured.
    • Neither the patients nor researchers knew the treatment given — double blind.

    And, the results.

    • Kidney function significantly decreased in the B-vitamin group vs placebo.
    • There was no difference in the need for dialysis.
    • The composite outcome occurred significantly more often in the B-vitamin group.
    • Homocysteine blood levels decreased significantly in the B-vitamin group compared with an increase with placebo.

    The bottom line?

    The authors concluded, “Given the recent large-scale clinical trials showing no treatment benefit, and our trial demonstrating harm, it would be prudent to discourage the use of high-dose B vitamins as a homocysteine-lowering strategy outside the framework of properly conducted clinical research.”

    Furthermore, the American Heart Association and the American Diabetes Association tell us that taking B vitamins to lower homocysteine is not recommended for otherwise healthy diabetics either.

    5/5/10 21:34 JR

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