Hi Dennis R. and Alan S.:

We find statistics that some type 2 diabetics as having equivalent risks
factors for heart attacks as non-diabetics who had previous heart
attacks. Also some reports support folic acid supplementation while show
negatives for vitamin C diabetic women. This points out that diabetes
can effect the way the body processes a number of things including
drugs.  Some components of foods have there impact on drugs and
supplements as well. Our decisions can be ultra conservative or
engaging in consumption without regard as well as anything in between
when it comes to food, drugs, and supplements. Consequently, YMMV!
Mega doses of polyphenols like quercetin or resveratrol are being used
in clinical trials
(http://clinicaltrials.gov/ct2/show/NCT00065676?term=Quercetin&rank=2
and http://clinicaltrials.gov/ct2/results?term=resveratrol).

"Vitamin C intake from supplements was positively related to mortality
from all CVD, CAD, and stroke among postmenopausal women who reported
diabetes at baseline. No such association was observed among women who
did not have diabetes at baseline.

Although the reasons for accelerated atherosclerosis in diabetic
subjects are still not completely understood, CVD risk in diabetes
largely depends on both diabetes-related variables such as glycemic
control, diabetes duration, proteinuria, and overall artery disease as
well as the classic risk factors blood pressure, smoking, and
dyslipidemia (13). We adjusted for most classic risk factors. Although
we did not measure blood pressure or blood lipids, typically these have
not been correlated strongly with vitamin C intake (14, 15).
Furthermore, because vitamin C supplement users tend to have healthy
behaviors and diet patterns, consumers of high amounts of vitamin C
likely had lower blood pressures and lower atherogenic blood lipid
concentrations than did consumers of low amounts. Adjustment for these
factors would likely strengthen the association. Moreover, vitamin C
intake was not associated with medication type or duration of diabetes;
therefore, the severity of diabetes is unlikely to be a strong
confounder in the association between vitamin C consumption and CVD
mortality.

Nevertheless, there is still a possibility that patients with more
severe diabetes tend to consume more vitamin C, including that from
supplements. Vitamin C is a known antioxidant, and patients with type 2
diabetes might interpret general advice to consume more vegetables and
fruit to include supplemental vitamin C. However, if this were true,
other nutrients with characteristics similar to vitamin C for which
similar recommendations exist should also show a positive association
with CVD mortality. However, vitamin E and ß-carotene intakes were not
associated with CVD mortality, and folate intake showed an inverse
association. Therefore, we think that confounding was an unlikely
explanation of the positive association between supplementary vitamin C
and CVD among these postmenopausal women with diabetes. [...]Recently,
the Nurses' Health Study reported a beneficial effect of vitamin C
supplements among diabetic persons and among all study subjects in the
only other study that explored the relation among diabetic persons (27).
Although a reduced risk of fatal and nonfatal CAD was observed in the
entire group of women who took high doses of vitamin C supplements, the
results for diabetic women who took high doses of vitamin C supplements
(ie, ≥300 mg) were not presented separately. In partial agreement with
the findings in the women in the Nurses' Health Study, the diabetic
women in the Iowa Women's Health Study who took 1–99 mg vitamin C/d
showed a weak inverse trend." Source: Does supplemental vitamin C
increase cardiovascular disease risk in women with diabetes? -
http://www.ajcn.org/cgi/content/full/80/5/1194

Diabetes can also effect the way some vitamins such as C operate in the
body. A good case in point involves the cell/tissue types that use a
glucose transporters to transfer ascorbic acid (vitamin C) from the
extracellular space into cells. Some glucose transporters are also used
to move glucose into the cell/tissue so they are competing particularly
at high blood glucose levels. The ascorbic acid is converted into an
oxidized form prior to the transfer into cells. "Some aspects of the
reported effects of flavonoids on transport inhibition are generally
consistent given the structural similarities of glucose, dehydroascorbic
acid, and ascorbic acid. However, some reported findings are surprising
because of the distinct transport mechanisms for these substrates.
Glucose is transported by facilitated sodium-independent glucose
transporters GLUT1-GLUT4, GLUT6, GLUT8 and by sodium-dependent
transporters SGLT1 and SGLT2 (12-18). Dehydroascorbic acid transport is
sodium-independent and is mediated by only GLUT1, GLUT3, and GLUT4
(19-21). No glucose transporters transport ascorbate (20). Ascorbate
transport is sodium-dependent and is mediated by ascorbate transporters
SVCT1 and SVCT2, neither of which transport glucose and dehydroascorbic
acid (22, 23)." Source: Flavonoid Inhibition of Sodium-dependent Vitamin
C Transporter 1 (SVCT1) and Glucose Transporter Isoform 2 (GLUT2),
Intestinal Transporters for Vitamin C and Glucose -
http://www.jbc.org/cgi/content/full/277/18/15252. (For other finds -
ascorbic+acid+GLUT2+ diabetes+blood+glucose - http://tinyurl.com/55xdn2)

The same data base for the Iowa Women longitudinal study concerning
dietary sources of fibers and magnesium. Look at the relative risks in
the following report:
"Conclusion: These data support a protective role for grains
(particularly whole grains), cereal fiber, and dietary magnesium in the
development of diabetes in older women."
http://www.ajcn.org/cgi/content/full/71/4/921

TABLE 4. Multivariate-adjusted relative risks of incident type 2
diabetes across quintiles of energy-adjusted dietary fiber and magnesium
intakes among 35988 Iowa women, 1986–1992 -
http://www.ajcn.org/cgi/content/full/71/4/921/T4
The source of the fiber effects the relative risks.

Frank

Mirror images of the natural vitamins tend not to work as well as the
natural
vitamins, and sometimes cause problems.  The usual ways of making synthetic
vitamins tend to turn out roughly matching amounts of vitamins matching the
natural ones, and their mirror images.

In alt.support.diabetes Alan S <loralgtweightandcarbs@gmail.com> wrote:

The danger with interpreting the results of lots of medical research
is that they find it too expensive or difficult to measure what they
really want to achieve, such as reduced risk of dying, and substitute
something generally supposed to correlate well with risk of dying and
easily measureable, such as something a standard lab blood test can
find in your blood. So you can end up taking a supplement or
medication which improves the lab measurements your doc makes, but
doesn't actually improve your health or longevity.

I actually consider longevity to be one of these pseudo end points
which are adopted for convenience of discovery instead of what I'm
really interested in, which is what state I'll be in for the last five
or ten years of my life. Will I be shuffling around confused, in pain,
and needing care, or will I be alert, mobile, happily doing my own
shopping, cooking, and housework, and enjoying life? Research which
simply looks at date of death misses that very important point.

That's why I raise a sceptical eyebrow at these cheapskate longevity
studies :-)

Vitamin E comes in 8 forms, alpha, beta, gamma, and
delta, and tocopherol or tocotrienol, and each of these
come in either d ("right-handed") or l ("left-handed")
varieties at three sites.  Natural vitamin E is all d,
but the synthetic version has equal amounts of all dl
combinations (ddd, ddl, ..., lll), and is considered
equivalent to 45% as much ddd.

Partly because of the FDA, just about all on the market
in the US is alpha tocopherol, sometimes d, but mostly
the mixture described above, usually labeled dl.  I recall
back when the proportions of the eight types was on the
label, but I have seen little recently with other than
just the alpha variety.  It is easy to convert the other
types to the alpha variety by replacing the hydrogens
in two sites to methyl groups, and the FDA considers
400 mg to mean 400 mg of alpha.

Now if you want to get 400 mg of vitamin E from food, to
get it from the richest natural sources, cod liver oil
or wheat germ oil, you would have to get more than 1500
calories from the oil.  The current RDA of 45 mg is much
easier.

I would like to see the statistical analysis used
for this.  I have a major mistrust of the way
medical statisticians "handle" their data.

Err, there are 4 forms of natural tocopherols alpha, beta, gamma, and
delta.
Whereas synthetic vitamin E is all alpha and there are eight
variations in that in the side chain, rrr (the one natural form), srr,
rsr, rrs, ssr, rss, srr,
and sss as I recall. Moreover of the natural forms that function
as vitamin E there are two families on natural chemicals besides
the tocopherols, tocotrienols, and a marine (fish) form whose spelling
escapes me at the moment.

Taking huge dose of alpha compete for absorption with beta, gamma,
and delta. And synthetic alpha form mention earlier have
a shorter biological half life. Nor should be assumed that
the serum alpha e measure is the be all and end of all of
the E's. It is possible that the other E's such as gamma
may have importance in specific compartments at least
according to some idea out there in the ether.

I take a high gamma supplement for at least part of my
supplemental dose. Though I will add, I had an intake
study and was found to have one of the highest natural intake
of E that the instructor had ever seen at least in my diet
over those three days. She said the VAST majority
of people struggle to get 15 milligrams
much less than the 45 to 60 milligrams of alpha E I got
in my diet. And I was getting fairly large dose of the other
other forms beta, gamma, delta not included in the
nutrient charts. Most people diet even dietican
designed diet leave alot to be desired. Too much
common sense and FAR FAR too little good sense.
Common sense is rarely ever good on any topic.

I dare you to to get a gram of alpha lipoic acid out of any diet or
100 milligrams of benfotiamine out of roasted garlic.
By the time one is diabetic, natural diet in my opinion
is too late and more aggressive measure make much
more sense, IMO. When the pain of  neuropathy comes
blame your "natural' diet and your Doctors.