The C.A.M. Report
Complementary and Alternative Medicine: Fair, Balanced, and to the Point
  • About this web log

    This blog ran from 2006 to 2016 and was intended as an objective and dispassionate source of information on the latest CAM research. Since my background is in pharmacy and allopathic medicine, I view all CAM as advancing through the development pipeline to eventually become integrated into mainstream medical practice. Some will succeed while others fail. But all are treated fairly here.

  • About the author

    John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.

  • Common sense considerations

    The material on this weblog is for informational purposes. It is not medical advice or counsel. Be smart, consult your health professional before using CAM.

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    B vitamins to treat diabetic kidney disease?

    Hyperhomocysteinemia (high blood levels of homocysteine) increases the risk of blood vessel complications in people with diabetes. Supplementation with B vitamins (pyridoxine, folic acid, B12) reduces these levels.

    Researchers in Canada report the results of the (Diabetic Intervention with Vitamins to Improve Nephropathy [DIVINe]) study, which was designed to determine whether B-vitamin therapy might slow progression of diabetic kidney disease and prevent vascular complications.

    First, the details.

    • 238 participants with type 1 or 2 diabetes and a diagnosis of diabetic nephropathy were randomly assigned to a treatment group for 36 months.
      • 1 tablet per day of B vitamins containing folic acid (2.5 mg), vitamin  B6 (25 mg), and vitamin B12 (1 mg)
      • Matching placebo
    • Changes in glomerular filtration rate (kidney function) were recorded.
    • The needs for dialysis and a composite outcome of heart attack, stroke, revascularization (surgery to improve blood flow), and death due to any cause were recorded.
    • Blood levels of homocysteine were also measured.
    • Neither the patients nor researchers knew the treatment given — double blind.

    And, the results.

    • Kidney function significantly decreased in the B-vitamin group vs placebo.
    • There was no difference in the need for dialysis.
    • The composite outcome occurred significantly more often in the B-vitamin group.
    • Homocysteine blood levels decreased significantly in the B-vitamin group compared with an increase with placebo.

    The bottom line?

    The authors concluded, “Given the recent large-scale clinical trials showing no treatment benefit, and our trial demonstrating harm, it would be prudent to discourage the use of high-dose B vitamins as a homocysteine-lowering strategy outside the framework of properly conducted clinical research.”

    Furthermore, the American Heart Association and the American Diabetes Association tell us that taking B vitamins to lower homocysteine is not recommended for otherwise healthy diabetics either.

    5/5/10 21:34 JR

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