First and foremost, diabetes should ALWAYS be managed principally with diet.  However, in the short term, until the changes are fully implemented, there are supplements that can be powerful players in improving your health.

The standard ones like fish oil and chromium are the first supplements that come to mind.  The B vitamins are not the supplements that come to mind first, but maybe they should.

B12, B6, folic acid and betaine are considered “methylation factors” because they are required by the body to undergo a process called methylation.  Methylation is an absolutely essential process for hundreds of reactions in the body that include turning genes on or off, protecting against DNA damage, healthy dilation of blood vessels and formation of neurotransmitters. 

The conversion of folic acid (or rather, the activation of folacin, which is the form found in our foods) to its active form, 5-methyltetrahydrofolate (5-MTF) is done by an enzyme called methyltetrahydrofolate reductase, or MTHFR.  This enzyme, MTHFR, is linked to a wide variation of genetic uniquenesses called SNPs (single nucleotide polymorphisms).  This means that, in different people, this enzyme may run faster or slower because of these differences.   Because this pathway is very important for the healthy growth of a developing infant in the womb, a prenatal vitamin containing folic acid is now recommended for all women of child bearing age.

In general, because the methylation cycle is involved in some many aspects of physiology, it may be difficult to pin down exactly why this particular study saw such dramatic benefits with folic acid supplementation.  Regardless, the use of 5 mg (this is a high dosage–most supplemental forms of folic acid contain up to 800 mcg, or .8 mg) for 2 months.  An 8% drop in HbA1c levels and a 20% improvement in insulin action were seen.  These are pretty strong changes given how simple, safe and inexpensive this level of supplementation is.

The only thing I would add is that, although they did not do this in the study, make sure you combine folic acid supplementation with B12 as they play in the same circles and deficiency of one can be masked by supplementation of the other.  This would become more important with long term supplementation.

James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.


Please note: I reserve the right to delete comments that are offensive or off-topic.


  1. Please look into this more, From my understanding and experience IF you have a Mutation with MTHFR you need METHYL Folate, NOT the synthetic Folic acid.
    Also if someone has this Mutation with MTHFR then they Also need Methyl B12, not just regular b12. THis is Very Important to know the difference with these. Especially with MTHFR. Forty percent have one mutation that lowers their Efficiency to something like 55 to 70%. Ten % have a double mutation thand that can lower the efficiency to 7 to 10% . See this link http://nwhealthcare.net/index.php?id=64
    This Dr. is very well informed on MTHFR, and is a MD who treats this. Also see Dr Neil Rawlins four part lecture on you tube. http://www.youtube.com/watch?v=ZA8GUIRqIkE
    Dr.s need to get more educated about this and to give out the Correct information. Many are treating this with Limited information and mistreating it in my view. Please look into this further.

  2. Kari, The research on the methyl forms is just not that supportive as of yet. I’m always open to new research, but given the massive cost difference between the other supplemental forms, to me this just does not make sense at this point. Given how enzymes work in the body, if you give enough of a the substrate (folic acid), the sluggish enzymes will pick up speed and get the job done (by producing the needed 5-methyl form). I have never seen anything to the contrary.

    However, on the B12, I completely agreee. The methyl form is the preferred form for the brain. There are some articles embedded somewhere on my site that actually suggest that the cyano forms will undo some of what we’re trying to achieve with cobalamin.

    Thanks for the feedback!

    Dr. Bogash

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