Role of vitamins and minerals in prevention and management of type 2 diabetes mellitus.

Vitamins and minerals play an important role in glucose metabolism, so understanding the impact of vitamin and mineral deficiencies and the potential utility of supplementation is relevant to the prevention and/or management of type 2 diabetes mellitus (DM). This review investigates current evidence for relationships between selected nutrients - vitamin B complex, antioxidants (vitamin A, C, E and carotenoids), calcium, vitamin D, vitamin K, magnesium, sodium, and potassium - and glucose metabolism. The investigation reveals current evidence is not strong enough for supplementation with minerals and vitamins to be recommended on a large scale for the prevention or management of DM. In order to prevent deficiencies and maintain health, the majority of diabetic individuals should receive daily vitamins and minerals within the ranges of recommended values from consumption of natural food sources and/or fortified foods. Further studies including large samples and longer follow-up periods are necessary to ascertain the benefits of mineral and vitamin supplementation to subsets of individuals who are at increased risk for DM or its complications.

Alendronate treatment of established primary osteoporosis in men: 3-year results of a prospective, comparative, two-arm study.

Our trial was a 3-year, open-label, prospective, comparative, clinical study comparing the effects of oral alendronate (ALN), 10 mg daily, and alfacalcidol (AC), 1 microg daily, on bone mineral density (BMD), fracture events, height, back pain, safety and tolerability in 134 men with established primary osteoporosis. All men received 500 mg calcium daily. BMD was measured at the lumbar spine and femoral neck using dual-energy X-ray absorptiometry (DXA). Spine radiographs were obtained at baseline and every 12 months thereafter, and were evaluated by a radiologist blinded to treatment assignment. At 3 years, AC-treated patients showed a significant mean increase of 3.5% in lumbar spine BMD, compared with a mean increase of 11.5% in men receiving ALN ( p<0.0001 between groups). The corresponding increases in femoral neck BMD were 2.3% and 5.8% for the AC and ALN groups, respectively ( p=0.0015 between groups). Over 3 years, new vertebral fractures occurred in 24.2% of the AC-treated patients and in 10.3% of the ALN-treated patients ( p=0.040). ALN-treated patients also had a significantly lower height loss. There were no between-group differences regarding nonvertebral fractures or changes in back pain. Both therapies were well tolerated, with a compliance rate >90%. We conclude that although AC has significant effects on BMD, ALN has greater effects on BMD and fracture efficacy.

Transfer of alkaline earth elements in mothers' milk and doses from 45Ca, 90Sr and 226Ra.

An international programme of work is currently under way to develop methods for calculating doses to infants from ingestion of radionuclides present in mothers' milk. This paper considers the special case of the alkaline earth elements. Models have been developed for 45Ca, 90Sr and 226Ra and the sensitivity of results to various changes in parameter values is discussed. A complication when calculating doses from intakes of radium is that the International Commission on Radiological Protection has previously recommended that doses from decay products of radium should be calculated using element-specific biokinetic models (so-called independent biokinetics). An extension of this method to the models for breastfeeding is proposed. Preliminary estimates of the doses received by the infant for a number of maternal intake scenarios show that doses to the infant can exceed the corresponding adult dose, such as for 45Ca (ratio = 3.1) while, in other cases such as 90Sr, the infant dose can be a significant fraction of the adult dose.