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Decreasing Vitamin C Intake, Low Serum Vitamin C Level and Risk for US Adults with Diabetes
Hongbing Sun1, Jonathan Karp2, Kevin M Sun3
1Environmental Health Laboratory, Department of Earth and Chemistry, Rider University, 2083 Lawrenceville Road, Lawrenceville, NJ 08648, USA.
Abstract:
Vitamin C (VC) intakes, serum VC, fasting plasma glucose, and A1c levels of 25,206 adult men and 26,944 adult women with 6807 type 2 and 428 type 1 diabetes from the NHANES database between 1999 and 2018 were analyzed. Our hypothesis is that low VC intake and serum VC level may be a health risk for US adults with diabetes. Analyses revealed total VC intake below the estimated average requirement (EAR) increased from 38.1% to 46.5% between 1999-2018. VC intake and serum VC levels were inversely associated with markers of pre-diabetes and type 2 diabetes, namely, fasting plasma glucose and A1c levels. Risks of type 2 diabetes increased in adults with VC intake below the EAR and with no VC supplement (odds ratio 1.20, 95% CI 1.1-1.3 and 1.28, 95% CI 1.18-1.40, respectively). Median survivor years of diabetic adults with lower and deficient serum VC were shorter than that of diabetic adults with normal serum VC. Mortality risks of type 2 diabetes with low VC intake and/or deficient serum VC levels were elevated compared to those with adequate VC intake and normal serum VC (HR 1.25, 95% CI 1.05-1.49 and 1.84, 95% CI 1.10-3.08, respectively). Observation of declining VC intake and deleterious consequences of low serum VC in US adults with diabetes suggests encouragement of VC intake, including VC supplementation of 500-1000 mg/day, may be beneficial for pre-diabetic and diabetic US adults.
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