Safety First: Supplements are unregulated by the Food and Drug Administration (FDA). For the safest products, look for the United States Pharmacopeia (USP) seal on the bottle. That means the supplement meets the standards of the USP. Can’t find it? Ask your pharmacist for help or visit Operation Supplement Safety. 

Whether you’re looking to reach your recommended daily intake of vitamins and minerals or hoping to remedy diabetes complications, there’s a world of supplements to consider—along with potential drug interactions, conflicting information, and safety issues.

Whether or not a supplement has clinical evidence to suggest it helps with diabetes or related complications, the bigger question to ask is, are you going to be harmed by taking this supplement or vitamin?

Daily Dose

Many think that a supplement contains the same vitamins and minerals as whole foods, so why not just pop a pill? It’s because vitamins and minerals are best absorbed through food.

Think of it like this—whole foods contain a mix of minerals, enzymes, fiber, and other substances that may help your body absorb and use these nutrients. Eating a well-balanced meal is much healthier than a multivitamin. It’s not clear whether vitamins and minerals have the same effect in the body when taken in supplement form.

If you have a true vitamin deficiency, however, a supplement may be helpful. Americans are most commonly deficient in vitamins D and B12, calcium, and iron. The only way to know whether you’re deficient is through blood work, but you might see some signs. If you’re experiencing symptoms you think a supplement could fix, consult your doctor before trying to remedy the problem yourself.  

Supplements that impact blood sugar

Supplements may cause unwelcome—or dangerous—side effects, especially if they interact with your medications. While some ingredients could intensify the effects of your diabetes meds, causing hypoglycemia (low blood sugar, also called blood glucose), others may have the opposite effect, leading to hyperglycemia (high blood sugar).

Research on many supplements is inconclusive. Talk to your health care provider before you start taking chromium, vitamin E, St. John’s wort, or niacin.

• Chromium
  A chromium deficiency may lead to high blood sugar levels. It may be worth a try if you’re deficient in chromium, but that’s very rare. Steer clear if you’ve been diagnosed with kidney disease. Chromium supplements might further damage the kidneys and worsen the disease.
• Vitamin E & St. John’s Wort
  Both vitamin E and the herb St. John’s wort can have dangerous interactions with blood-thinning drugs used to treat heart disease—increasing your bleeding risk. Among people with heart disease being treated with the blood thinner warfarin, those most likely to experience bleeding events have higher levels of vitamin E in their bodies. Other studies have found that St. John’s wort amplifies the effect of blood thinners. Avoid these supplements if you’re taking a blood-thinning medication. Besides warfarin, those include apixaban, dabigatran, heparin, and rivaroxaban.
• Niacin
  Some people take niacin to raise HDL (“good”) cholesterol, but it can also affect your diabetes management. Niacin raises fasting glucose levels (your blood sugar levels when you are not eating) for people with diabetes, meaning the risks may outweigh the benefits. And while niacin can raise HDL cholesterol, there’s no evidence that this leads to a lower risk of cardiovascular disease. A chat with your health care provider can help you determine if this is safe for you to take.

Confused about what to take? Unless your health care provider recommends a specific vitamin or supplement, it’s probably not all that helpful—or economical—to add another pill to your regimen. 

Other common supplements

Here’s what you need to know about other common supplements:

• A B12 supplement can be helpful if you have type 2 diabetes and are deficient in the vitamin. People who take metformin for type 2 diabetes have lower levels of vitamin B12. If you’re on metformin, talk to your health care provider about periodically being tested for a B12 deficiency. 
• Vitamin C and E supplements won’t ward off diabetes and diabetes complications. Until the research shows a clear benefit, it’s best to pass on these.
• The jury’s still out on vitamin D. There is an association between higher concentrations of vitamin D in the blood during childhood and a lower risk of type 1 diabetes. More research is needed to understand the link, but here’s one thing experts can agree on: if you’re deficient in vitamin D, a supplement can help.
• Cinnamon isn’t as effective as your type 2 diabetes medication. Cinnamon supplements do nothing to help people with type 2 achieve treatment goals or provide a reliable drop in blood sugar. However, since cinnamon is fragrant seasoning, you can use it flavor your food instead of sugary condiments. Enjoy a sprinkling of cinnamon on oatmeal instead of taking supplements.
• Alpha-lipoic acid (ALA) reduces pain from diabetic neuropathy. ALA injections, which are available only in Europe, improve symptoms of neuropathy in the short term. Results are mixed with oral supplements, which are available in the United States. 

The takeaway

At the end of the day, be sure to talk with your diabetes team before making changes—your health care provider can help you figure out if it’s a good idea to add a vitamin or supplement to your routine.