Can Folic Acid halt the rise of Type 2 Diabetes?
The incidence of diabetes worldwide is continually rising. In 2021 it was estimated that 10.3% of the global population had been diagnosed with diabetes, and it is expected to reach around 12.2% in 2045.
The latest scientific research concludes that folic acid supplementation can reduce the causes of type 2 diabetes and cardiovascular disease (CVD).
Causes and complications
Type 2 diabetes elevates blood glucose levels in the blood leading to hyperglycemia, which is characterised by an inability to keep down fluids or an extreme thirst; it can lead to serious long-term complications. (See our article Diabetes)
Patients living with type 2 diabetes are at higher risk of developing CVDs than healthy individuals. Contributing factors to the development of CVD in type 2 diabetes include hyperinsulinemia (excess levels of insulin circulating in the blood relative to the level of glucose), obesity, hypertension (high blood pressure), hypertriglyceridemia (high amounts of triglycerides – fats – in the blood), hypercholesterolemia (high cholesterol), and homocysteinemia (an abnormally high level of homocysteine in the blood).
Homocysteine is a non-proteinogenic α-amino acid, high levels of which are regarded as a potential biomarker for CVDs. Studies have also reported a link between homocysteine and inflammation.
Function of Folic Acid
Folic acid or folate is is a water-soluble vitamin (vitamin B9) that supports healthy cell growth and division. The body requires folate to metabolise amino acids. Recent evidence has shown that folate deficiency is associated with an increased level of homocysteine, thereby increasing the risk of CVD in type 2 diabetes.
The findings from nine trials involving a sample of 426 participants in this study indicate that folic acid supplementation in type 2 diabetes may reduce homocysteine levels.
Conclusion
The evidence analysed in this study suggests that folic acid supplementation in type 2 diabetes reduces homocysteine and may mitigate CVDs. However, due to the limited number of trials analysed, no effects were observed concerning some of the inflammatory markers.
Thus, though potentially positive, the findings should be read with caution as further research is necessary, particularly regarding the relationship folic acid and inflammation.
References
Mokgalaboni K, Mashaba G R, Phoswa W N, et al. Folic acid supplementation on inflammation and homocysteine in type 2 diabetes mellitus: Systematic review and meta-analysis of randomized controlled trials. Nutr. Diabetes 14, 22 (2024).