Folate: Friend In Diabetes

Diabetes is a dangerous disease and is found in large number of patients these days. This disease is very hard to control, which makes it still more complicated. These subjects should follow a strict diet and drug regimen and they should also try to keep their blood sugar in the normal range.

Diet can be of different types depending on the level of severity. It can be a vegetarian diet or a typical meat diet. A vegetarian diet is considered to be more accurate and beneficial one when compared to the typical meat diet. This is because vegetarian diet has a large number of varieties and is as nutritious as the meat diet.

Folate

Folate is a vitamin, which is essential to cell proliferation and survival. Lack of folate has been linked with serious birth defects but it is also associated with increased levels of cancer and heart disease. The importance of folate in the diet is beginning to be appreciated, particularly by pregnant women. Folate also has an essential role in the formation of DNA and in manufacturing blood cells and it contributes to the formation of haem - the iron constituent of haemoglobin.

The major sources of folate are all plant based and so most vegetarians have considerably higher intakes than meat eaters. Some studies show that only vegetarians and vegans achieve the recommended intake of this vitamin.

Inadequate folic acid intake, allows a substance called homocysteine to prosper and contribute to carotid artery thickening. According to a recent survey 40 per cent of the population is not consuming enough folate to keep homocysteine levels low and this may well account for a fair proportion of heart disease in them.

Increased levels of homocysteine in the blood raises the risk of heart disease to levels equivalent to smoking and powerfully increases the risk associated with high blood pressure.

How does it affect Diabetics?

The impact of lack of folate has been widely studied in concern to heart diseases but recently different studies are also aiming to study its impact on people with diabetes.

How folate makes its way to the retina and how diseases such as diabetes interfere with the journey are questions being pursued by researchers. The vascular destruction of the retina that can occur in diabetics, called diabetic retinopathy, is the leading cause of blindness in working-age adults.

Any Studies?

The researchers are focusing on the transport of folate to the retina's photoreceptor cells. Photoreceptor cells are metabolically active cells that take in light and constantly shed old protein. They are without any obvious supply of folate, such as blood, to help make new protein.

This part of the retina doesn't have a blood supply, so it can't just get vitamins from the blood. A thin layer of cells called the retinal pigment epithelium stands between the nearest blood supply and this part of the retina; the researchers believe a transport mechanism similar to the one that takes valuable nutrients such as folate from the mother across the placenta to her developing baby also is at work in this portion of the eye.

Researchers predicted that the only source of folate to photoreceptor cells would be from the retinal pigment epithelium because there is no other source of nourishment for these cells. Folate transport, when reduced anywhere in the body results in increased levels of homocysteine. Homocysteine is an excitatory amino acid risk factor for cardiovascular disease. The vascular destruction of the retina occurring in diabetics, called diabetic retinopathy, is the leading cause of blindness in working-age adults

Researchers have already found that one protein is needed to bring folate from the blood to the retinal pigment epithelium and are studying the second, which takes folate from the cell and supplies it to the retina.

Every cell has the gene for folate transporter protein but the gene has to be expressed in order to have a functional protein. Diabetes is one condition, which disrupts the expression of the folate transporter gene.

If there is a problem with the folate transport mechanism, an embryo may die because DNA synthesis is critical to the developing baby and the very rapid cell division required for growth. It's believed that many spontaneous abortions may have something to do with a defect in folate transfer.

But there also can be a less dramatic reduction of folate transport, resulting in conditions such as low birth weight for the babies of diabetic mothers.

The researchers hypothesize that when folate transport is diminished, and the transporters can't be fixed, something as simple as taking folate supplements may compensate by simply making more folate available. At present, folate supplements are not routinely prescribed for diabetics.

Researchers also point out that not all diabetics will have significant vision problems, so a number of factors, including diet and glucose management, likely make some people's eyes fare better.

It is also predicted that the folate supplements may help protect type 2 diabetics from cardiovascular damage associated with endothelial nitric oxide synthase uncoupling. The findings of a study suggest that folate can be used to improve nitric oxide status and to restore endothelial function in patients with type 2 diabetes. These results provide a strong rationale for the initiation of studies that investigate whether supplementation with folic acid prevents future cardiovascular events in this patient group.

How About Children?

Most importantly, a joint Australian-New Zealand study has found that folate can help children who suffer from type-1 diabetes.

These researchers say that the cells lining the blood vessels of diabetics show signs of malfunction years before eye and renal damage become apparent.

This study, which involved 36 diabetic children receiving daily folate tablets for eight weeks, found the function of their blood vessels improved significantly.

In spite of all these data showing evidence that folate intake may decrease diabetes and other complications, still researchers stress that it is not a cure for the disease. Hence it is conclusively stated by considering all the previous data and present studies that an increased folate intake might help subjects with diabetes in better management of the disease.