Effect of folic acid supplementation on indices of glycemic control, insulin resistance and lipid profile in patients with type 2 diabetes mellitus

This study was performed to determine the effects of supplementation of folate on indices of glycemic control, insulin resistance and lipid profile in in men with type 2 diabetes, under metformin [at least 1500mg daily] treatment. This was a double-blind randomized controlled clinical trial, in which 68 men with type 2 diabetes participated with written consents. Patients were randomly divided in two groups; folic acid Smg/day and placebo. All the patients received the tablets for 8 weeks. Anthropometric and nutrient intakes data were obtained from each patient, and baseline and 8th week fasting blood glucose, HbA1C, serum insulin, insulin resistance, serum total cholestrol, TG, LDL-C, HDL-C, serum folate and plasma homocysteine were measured. Supplementation with folic acid led to 6.3 percent decrease in HbA1C [P=0.019], 9.5 percent decrease in fasting blood glucose [P=0.006], 15.1 percent decrease in serum insulin [P=0.028], 17.2 percent decrease in insulin resistance [P=0.043] and 20 percent decrease in plasma homocysteine [P<0.001], 18.4 percent increase in serum folate [P<0.001]. No significant changes occurred in the placebo group [P>0.05]. A pharmacological dose of folic acid supplementation decreased plasma level of homocysteine and improved glycemic control, insulin resistance and folate levels, a finding which sugqests a safe and inexpensive therapy for lowering homocysteine and improving the overall management of diabetic patients

[Evaluation of the level of plasma homocysteine in patients with type 2 diabetes mellitus under metformin treatment and its correlation with serum total antioxidant capacity, malondialdehyde, creatinine, insulin resistance and glycemic control]

In patients with diabetes, elevated homocysteine levels have been reported to be associated with endothelial dysfunction, insulin resistance, dyslipidemia, poor control of disease, nephropathy, macroangiopathy and oxidative stress. Thus, this observational study was performed to determine the plasma homocysteine level and its correlation with clinical, biochemical and nutritional variables. This study was performed on 70 men with type 2 diabetes under metformin [at least 1500 mg daily] treatment. Regarding plasma homocysteine, patients were divided into two groups: 31patients with normal homocysteine [group 1: Hcy<15 micro mol/L] and 39 patients with hyperhomocysteinemia [group 2: Hcy>15 micro mol/L]. 55.1% patients had hyperhomocysteinemia but none of them had folate and B12 deficiency. Significant differences between the two groups were found for serum folate, total antioxidant capacity and creatinine. No differences were found for insulin resistance and glycemic control. Multiple stepwise linear regression analysis using plasma homocysteine as a dependent variable and all other clinical and laboratory parameters as independent variables indicated that age [beta=0.344], creatinine [beta=0.351], vitamin B12 [beta=0.235], total antioxidant capacity [beta=0.285] and malondialdehyde [beta=0.245] were independently associated with homocysteine concentration. No correlation was found between the homocysteine and glycemic control, HOMA-IR and intake of B vitamins and caffeine. Further studies with a large sample size are required to assess the association of plasma homocysteine with total antioxidant capacity and other biomarkers of oxidative stress in type2 diabetes