Thursday 29 February 2024

A beginner’s guide to vitamin B12 – benefits, deficiency, and diet tips

From restless.co.uk

Many of us are taking steps to improve our health and boost our immune systems. We’ve previously written about the importance of nutrients like iron and vitamin D in maintaining immune health, but vitamin B12 is another key nutrient our body relies on.

Vitamin B12 deficiency is more common in older adults – affecting around one in 20 people aged 65 to 74 and one in 10 people aged 75 or over. But given the wide range of symptoms and the gradual rate at which they can appear, the condition can often be overlooked or confused with something else.

Luckily, there are plenty of foods that can be added to your diet to make sure you’re getting enough of this vital vitamin.

Below, we’ll explore the benefits of vitamin B12, how to spot the signs of deficiency, and which vitamin B12-rich foods you could incorporate into your meals.

WHAT IS VITAMIN B12?

Vitamin B12, also known as cobalamin, is one of eight B vitamins that play an essential part in keeping our bodies healthy.

It’s important for supporting the function of nerve cells, making red blood cells, DNA formation, and producing energy. But, there are many other benefits of B12, which we’ll look at in more detail below.

Our bodies can’t produce vitamin B12, so we need to get it from our diet. B12 is found naturally in animal products, but it’s also added to certain foods and is available as a supplement. People who have very low B12 levels might also get a B12 injection under recommendation from their GP.

Vitamin B12 is only needed in only very small amounts. According to the NHS, the recommended daily allowance (RDA) of vitamin B12 is around 1.5 micrograms for healthy adults.

WHY IS VITAMIN B12 IMPORTANT?

Vitamin B12 plays a critical role in several of our body’s key processes and there are powerful health benefits to making sure that we have enough in our diet. For example…

1. It can help to produce red blood cells

If you don’t have enough B12 in your system, your body can’t produce red blood cells as efficiently.

Then, because the red blood cells aren’t developed properly, they can’t move from your bone marrow into your bloodstream at a fast enough rate. This can lead to anaemia and cause symptoms like muscle weakness and fatigue.

2. It supports healthy, skin, hair, and nails

Because vitamin B12 is so crucial for producing new cells, you need adequate levels for healthy hair, skin, and nails.

B12 deficiencies can lead to hyperpigmentation of the skin, vitiligo, changes to your hair, nail discolouration, and angular stomatitis – where the corners of your mouth become red and cracked.

3. It may support bone health and prevent osteoporosis

One study found that people with low levels of B12 had a lower bone mineral density, which can increase the risk of osteoporosis.

4. It may help to keep your eyes healthy

Vitamin B12 is thought to reduce the risk of age-related macular degeneration – an eye disease that impacts your central vision.

Studies suggest that B12 may lower levels of homocysteine – an amino acid in the blood that’s linked to age-related macular degeneration.

5. It may help to reduce depression

Vitamin B12 plays a crucial role in producing serotonin, also known as the ‘happy hormone’, due to its effect on mood. Vitamin B12 deficiency is linked to decreased serotonin production, which can result in a depressed mood.

Studies show that people suffering from depression showed improved symptoms when receiving both B12 supplements and antidepressants, compared to people who received antidepressants alone.

To find out more about how to ease the symptoms of depression, take a look at our article; 10 things you can do to help yourself through feelings of depression.

6. It may promote brain health and improve memory

Vitamin B12 is thought to lower the risk of brain atrophy – which is the loss of neurons in the brain and linked to memory loss and dementia.

One study of patients with dementia showed that supplementing vitamin B12 and omega-3 fatty acids slowed mental deterioration. Another study found that low levels of B12 can cause poor memory performance.

7. It may help to improve energy levels

While there’s no solid evidence which proves that vitamin B12 can give you an energy boost, all B vitamins play a crucial role in the body’s energy production.

Plus, one of the most common signs of vitamin B12 deficiency is tiredness and a lack of energy.

8. It may improve heart health

Aside from being linked to macular degeneration, the amino acid homocysteine is also linked to an increased risk of heart disease. 

Studies show that B12 helps decrease homocysteine levels, which may lower the risk of heart disease.

SIGNS OF VITAMIN B12 DEFICIENCY

Signs of vitamin b12 deficiency

Making sure that we get enough vitamin B12 is incredibly important for our health, and the good news is that because our bodies can store B12 for several years, serious B12 deficiency is rare.

Some of the most common signs of B12 deficiency include…

1. Pale or jaundiced skin

Due to the problems that low levels of B12 cause to your body’s red blood cell production, a common symptom of B12 deficiency is looking pale.

Being deficient in red blood cells can also cause an excess of bilirubin – a red/brown-coloured substance that the liver produces – to circulate in our blood. Having large amounts of bilirubin in your body can cause the skin and whites of your eyes to have a yellow tinge too.

2. Weakness or fatigue

As red blood cells transport oxygen to your body’s cells, when you’re deficient in B12, you may feel tired and weak.

3. Pins and needles

Because B12 supports the function of nerve cells, long-term B12 deficiency can put you at risk of nerve damage.

One of the first symptoms that your nerves are beginning to become damaged is the sensation of pins and needles.

4. Changes to mobility

If left untreated, the damage that B12 deficiency can cause to your nervous system can affect your balance and coordination – and even lead to changes in how you walk and move. It can also increase your risk of falling, which can lead to a range of injuries.

5. Breathlessness and dizziness

B12 deficiency can cause anaemia, so a common symptom is feeling short of breath or dizzy, particularly when you physically exert yourself.

6. Changes in mood

Many people suffering from B12 deficiency report changes in mood and may exhibit signs of depression.

7. Mouth ulcers and inflamed tongue

People suffering from B12 deficiency sometimes have glossitis, which is a red and inflamed tongue that can look smoother than normal.

Other oral symptoms like mouth ulcers are also sometimes seen.

12 FOODS THAT ARE HIGH IN VITAMIN B12

12 foods that are high in vitamin b12

Because the body can’t make B12 by itself, we need to get it from our diet or from supplements.

Vitamin B12 is mainly found in animal products – like meat, fish, and eggs. However, many common plant-based foods are fortified with B12, and can be good sources of this vitamin too.

So, which foods are good sources of vitamin B12?

1. Animal liver and kidneys

Organ meats, like livers and kidneys, are very rich in vitamin B12.

Lamb’s liver is also especially high in copper and selenium, which help the body produce red blood cells and act as powerful antioxidants.

2. Clams

Clams are packed with nutrients and contain very high amounts of vitamin B12. They also contain iron and plenty of antioxidants.

3. Eggs

Eggs are a great source of B vitamins – especially B2 and B12. Egg yolks contain more B12 than egg whites, and the B12 in yolks is easier to absorb too.

4. Fortified cereals

These days, almost all cereals are fortified with nutrients (including B12), so these are a great source of plant-based B12.

Cereals also usually contain vitamin Afolateiron, and calcium, which are essential for building healthy bones, making red and white blood cells, and supporting immune health.

5. Sardines

Sardines are especially nutritious because aside from being high in vitamin B12, they also contain high amounts of the minerals phosphorus, calcium, and potassium.

These help to regulate blood pressure, maintain strong bones and teeth, and manage how your body uses energy. As they’re a good source of omega-3 fatty acids, they also have many other health benefits.

6. Tuna

Tuna contains high concentrations of B12, particularly in the darker muscles right underneath the skin. Tuna is also high in phosphorus, selenium, and vitamins A and B3 – which can protect your eyes, lower LDL cholesterol, and help prevent heart disease.

7. Milk and yoghurt

A cup of milk or yoghurt a day can make for an excellent source of vitamin B12, and is also a reliable source of calcium and vitamin D.

Yoghurt also contains probiotics – which are particularly beneficial for digestive health.

8. Cheese

Cheese is another rich source of vitamin B12. Swiss cheese (at 36% daily value per ounce) and mozzarella (at 27% daily value per ounce) have some of the highest amounts.

The daily value (DV) is the percentage of the recommended dietary allowance. One ounce of cheese is roughly equal to a slice of cheese that’s large enough to cover the surface of a standard slice of bread.

9. Non-dairy milk

Non-dairy milks – like oat, almond, rice, and soya milk – are fortified with high amounts of B12 and are another great source of plant-based B12.

10. Trout

Rainbow trout contains plenty of healthy fats and B vitamins – including vitamin B12.

It also contains minerals such as manganese, phosphorus, and selenium, which can improve bone health, reduce inflammation, and grow and repair cells.

11. Salmon

Salmon might be most known for containing high levels of omega-3 fatty acids, but it’s also a great source of B vitamins, including B12.

12. Nutritional yeast

Nutritional yeast is a key ingredient of any vegan kitchen, and it’s a great plant-based source of many vitamins, (including B12), as well as protein and minerals.

CAN YOU GET ALL THE B12 YOU NEED FROM YOUR DIET ALONE?

While it’s possible to get all the vitamin B12 you need from the foods you eat, in certain cases, a B12 supplement might be useful – particularly if you’re at greater risk of becoming deficient.

People most at risk of a B12 deficiency are those who don’t get enough in their diet, or who aren’t able to absorb enough from the foods they eat. This can include older adults, pregnant or breastfeeding women, and people who…

  • are taking antacids long-term
  • are taking the diabetes drug metformin
  • have had bowel or stomach surgery
  • are following a plant-based diet

However, while vegans are more at risk of B12 deficiency because B12 is only naturally found in animal products, you don’t have to automatically take supplements if you follow a plant-based diet.

The amount of B12 needed each day is small, and because many plant-based foods are fortified with high levels of B12, it’s entirely possible that you can still get enough from your diet alone.

However, it’s important for vegans to check that the foods that they eat do contain B12. 

If you’d like some ideas for recipes that are particularly rich in vitamin B12, then check out these meal ideas from Eat This Much. And, if you follow a plant-based diet, take a look at these vegan recipes that are high in B12 from Live Kindly.

WHAT TO DO IF YOU'RE WORRIED YOU'RE NOT GETTING ENOUGH B12

What to do if you're worried you're not getting enough B12

It’s important to be aware that not all vitamin B12 deficiency is caused by health problems or diet. It can also be caused by a lack of intrinsic factors (proteins required to absorb B12).

A lack of intrinsic factors becomes more common as we get older, and is linked with pernicious anaemia – an autoimmune condition that affects your stomach.

If you’re worried you’re not getting enough B12 from your diet, you should make an appointment with your GP to get a blood test. If your B12 levels are low, your GP will also be able to advise you on supplementation.

According to the NHS, there isn’t any evidence to suggest that taking extra B12 causes any harm (unless you’re pregnant or breastfeeding), but it’s still important to make sure that any supplements are safe dosage-wise. Adults shouldn’t take more than 2mg a day of B12 supplements unless specifically advised to by their GP.

Vitamin B12 supplements come in many forms, including as a liquid, pills that you swallow, chewable sweets, or even supplements that dissolve under your tongue.

If your levels are exceptionally low (which can be determined by a blood test), your GP might offer you a vitamin B injection.

FINAL THOUGHTS...

Vitamin B12 is a vital nutrient that your body needs for many different purposes, and being deficient can lead to health complications. 

Most people are able to get enough B12 from their diet alone, as it’s found in many animal products and fortified foods. But, those at risk of B12 deficiency should have a chat with their GP or health practitioner about the possibility of taking supplements – because dosages will vary according to your individual needs.

For more tips on essential vitamins and minerals, head over to the diet and nutrition section of our website.

https://restless.co.uk/health/healthy-body/a-beginners-guide-to-vitamin-b12-benefits-deficiency-and-diet-tips/?utm_campaign=24-02-29&utm_source=midweek-email&utm_medium=email&utm_content=midweek-email-general-24-02-29&bsft_clkid=6beea64a-2b18-4ca6-bb8c-3f1436bdd224&bsft_uid=7e4bbf6c-1c5d-4033-98b6-b63187fc0584&bsft_mid=eaf76447-f05f-4fbd-b570-fd284f9c3667&bsft_eid=8ca8591f-4181-4b02-9aae-0486cfb4caca&bsft_txnid=4f3deaeb-c361-4fd2-9f25-095945db81ee&bsft_mime_type=html&bsft_ek=2024-02-29T06%3A30%3A30Z&bsft_aaid=3fb5a0c8-1d80-4f30-8749-7b9799f02c6c&bsft_lx=7&bsft_tv=24 

Health Highlights: Heart health and diabetes + start a walking program

From newsroom.osfhealthcare.org

It's a good idea to keep an eye on your heart's health. 

But Ash Al-Dadah, MD, a cardiologist with OSF HealthCare, estimates that more than half of the people with advanced heart disease who come through his door also have diabetes. 

That puts them at greater risk for heart disease and related issues. 

His advice? Listen to your body. Shortness of breath and chest pain are hallmark symptoms. 

Also, look for open sores or wounds or burning in your calves. Keeping a healthy diet is also important.

“It’s a tough task. But with repetition and practice comes perfection. If you keep doing it daily, you’ll be able to master your diet in order to reduce your glucose levels and get control over your diabetes. It also leads to weight loss, which is the most helpful thing reduce the risk of diabetes complications," Dr. Al-Dadah says. 

Mastering your diet looks like cutting out high carb foods, being active and monitoring both your glucose levels and what you eat. 

Speaking of being active, it's no secret that walking is good for you. 

Walking improves fitness, reduces pain, eases depression and helps with circulation and posture. 

It may sound counterintuitive, but walking also increases our serotonin levels and reduces fatigue. 

It's especially good for older adults. According to Nancy Dagefoerde, a nurse practitioner with the OSF Cardiovascular Institute, for people 60 and older, the more steps taken, the lower their risk for cardiovascular disease.

“Heart health or cardiovascular risk increases as we age. So, if a person is sedentary, they're adding to that risk, and it's also important for balance and movement in general and just overall health and reduction of health problems," Dagefoerde says. "That's why it is especially important for older people.”

Dagefoerde says the benefit of walking slowly is it burns more calories and is easier on the joints. Brisk walking helps fight developing heart disease, cancer and dementia.

https://newsroom.osfhealthcare.org/health-highlights-heart-health-and-diabetes--start-a-walking-program/ 

Wednesday 28 February 2024

These diabetes devices are set to launch in 2024

From drugdeliverybusiness.com

The diabetes space continues to innovate, and it doesn’t look like that’s stopping any time soon, with 2024 set to be another banner year.

At the end of 2023, we compiled a list of the 10 biggest diabetes technology stories of the year. Some of those stories didn’t end in 2023, though, as a few major product launches loom on the horizon.

New CGMs, insulin pumps and combinations of the two will all be coming to the market over the next several months. Here are some of the most highly-anticipated product launches set to take place in the diabetes space in 2024 — plus some of the tech that’s already launched:

Diabetes launches on the horizon

Medtronic’s new pump-sensor combo

In January, Medtronic won CE mark for its MiniMed 780G automated insulin delivery system with the Simplera Sync sensor.

Medtronic MiniMed 780G automated insulin delivery system with Simplera Sync CGM Sensor
The MiniMed 780G with the Simplera Sync CGM and accompanying devices. [Image courtesy of Medtronic]
Simplera Sync, a disposable, all-in-one continuous glucose monitor (CGM), eliminates the need for fingersticks and overtape. It features an improved user experience at half the size of previous Medtronic sensors with a simple, two-step insertion process.

MiniMed 780G, an automated insulin delivery system, offers meal detection technology and provides automatic adjustments and corrections to sugar levels every five minutes. This occurs for both basal (background) and bolus (mealtime) insulin needs. The system already has commercial availability in geographies including the U.S. and Europe in tandem with the Guardian 4 sensor.

Medtronic plans to make MiniMed 780G with Simplera Sync available in Europe through a limited release in spring 2024. It then expects a phased commercial launch in the summer of 2024. While still investigational in the U.S., the combination could still see a stateside launch if clearance comes soon enough.

The company also began rolling out its InPen smart insulin pen system with Simplera in Europe at the end of last year.

Dexcom’s 15-day CGM for non-insulin users

Nearly one year ago, Dexcom launched its next-generation G7 CGM. Now, the company is set for its next major product launch.

Dexcom Stelo glucose monitor
The Stelo glucose monitor. [Image courtesy of Dexcom]
Dexcom announced in January of this year that it submitted its new sensor, Stelo, to the FDA for review. The company expects to launch Stelo, which is designed for people with type 2 diabetes who don’t use insulin, this coming summer. San Diego-based Dexcom designed Stelo for a 15-day wear with a cash-pay option. It features a software experience tailored specifically for non-insulin users.

At the company’s June Investor Day event, it revealed its plans to bring the new product to market in the U.S. in 2024. According to Dexcom, the target population includes approximately 70% of Americans with diabetes.

The device features a 15-day wear with a cash-pay option. It offers a software experience tailored specifically for non-insulin users. The device won’t “bother” users with the alerts and alarms geared toward insulin users, Dexcom CEO Kevin Sayer told Drug Delivery Business News shortly after the company’s submission to the FDA. Rather, it just offers the insights that users desire.

Stelo exists on the current G7 platform, so Sayer said manufacturing is already in place on the current lines the company has. He also believes the company should get reimbursement for the device over time and create a class of products for the target population.

The company expects to launch Stelo in the U.S. in the summer of 2024.

Insulet’s new pump

Already a leader in the insulin patch pump market with its Omnipod devices — the latest being the Omnipod 5 — Insulet found a way to expand its target population even further.

Insulet Omnipod GO basal-only insulin delivery system
The Omnipod GO insulin delivery system. [Image courtesy of Insulet]
In April 2023, the company received FDA clearance for its Omnipod GO long-acting insulin delivery device.

Omnipod GO, which received clearance for people with type 2 diabetes aged 18 or older, covers the basal-only insulin population. The target population typically takes daily injections of long-acting insulin.

The first-of-its-kind, standalone, wearable insulin delivery system provides a fixed rate of continuous, rapid-acting insulin for 72 hours. It features a tubeless and waterproof pod offered in seven different pre-programmed daily rates. These rates range from 10 to 40 units per day.

Insulet said it developed the product to serve the type 2 diabetes population earlier in their treatment journey. This technology starts them on pod therapy — built on Insulet’s longstanding Omnipod platform — for insulin delivery, rather than daily injections. If a patient becomes insulin-intensive, Insulet offers a seamless transition to another Omnipod product that fits their needs.

The company earmarked a launch for some time in 2024.

These diabetes products already began rolling out this year

Tandem Mobi

Tandem Diabetes Care announced in February that it kicked off the U.S. commercial launch of its Mobi insulin patch pump.

Tandem Mobi Insulin Pump with App
The Mobi automated insulin pump with the accompanying mobile app. [Image courtesy of Tandem Diabetes Care]
The San Diego-based company says Mobi, which is fully controllable from a mobile app, is the world’s smallest durable automated insulin delivery (AID) system. It received FDA clearance for people with diabetes ages six and up in July 2023.

Mobi features a 200-unit insulin cartridge and an on-pump button to provide an alternative to phone control for insulin boluses. It comes in at less than half the size of the existing Tandem pump system, the t:slim X2 pump. Mobi can fit in a coin pocket, clip to clothing or go on the body with an adhesive sleeve.

The system features the same Control-IQ technology that powers the established t:slim X2. Control-IQ, an advanced hybrid closed-loop automated insulin delivery feature, predicts and helps prevent high and low blood sugar. It leads to improved time in range throughout the day and night.

Dexcom ONE+

In Europe, Dexcom has been offering its G6 CGM platform through a differentiated offering called Dexcom ONE.

Dexcom One+ real-time continuous glucose monitor CGM system
The ONE+ system, featuring a sensor, reader, smartphone, smartwatch and applicator. [Image courtesy of Dexcom]
In the early part of this year, the company kicked off a European launch of the next version of this offering: Dexcom ONE+. It began rolling out the system in Spain, Belgium and Poland in February and followed that with a launch in the Netherlands a week later. In some countries, the system replaces the previous-generation Dexcom One sensor.

ONE+ uses Dexcom’s established sensor design, with the company incorporating feedback from users and healthcare professionals to build it. The company said this ensured an easy-to-use, highly effective CGM experience for people treating type 1 or type 2 diabetes with insulin.

This version of the platform utilizes the latest-generation G7 sensor. ONE+ also adds certain notes at certain moments, like meals, insulin administration and sports activities. The system replaces the traditional fingersticks to provide a clear picture of how daily choices affect glucose levels.

CGM/AID pairings

Insulet Omnipod 5 Abbott FreeStyle Libre 2 Plus
The Omnipod 5 with the Abbott FreeStyle Libre 2 Plus. [Image courtesy of Insulet]
All of these products were already relatively established in the diabetes space, but they now have new utility, thanks to a series of integrations between CGMs and automated insulin delivery systems announced over the past few months. All of this integration gives people with diabetes more options in terms of how they want to measure glucose and have insulin delivered.

The noteworthy updates include:

These diabetes technologies aren’t yet authorized but could be coming

Embecta’s patch pump

Embecta, the BD Diabetes spinoff, has developed a proprietary, disposable pump for people with type 2 diabetes. The company provided analysts with some details on the makeup of the open-loop system earlier this year. It also has a closed-loop version under development to follow. That version features an embedded algorithm that requires Embecta to run a clinical study.

CEO Dev Kurdikar recently told Drug Delivery Business News that the pump “is going to be a vital part” of Embecta’s strategy.

The company in January announced that it submitted the patch pump to the FDA for clearance.

Modular Medical’s insulin pump

Modular Medical modd1 insulin pump
The MODD1 insulin pump. [Image from Modular Medical]
In January, Modular Medical announced that it completed the submission of its MODD1 insulin pump to the FDA for clearance.

Modular Medical designed the 90-day MODD1 with new microfluidics technology to allow for the low-cost pumping of insulin. Its new intuitive design makes the product simple to use and easier to prescribe.

The pump has a reservoir size of 300 units/3mL. Users can monitor the pump activity with their cell phone and do not require an external controller. The pump uses a provided, single-use, disposable battery.

CEO Jeb Besser said the company expects initial questions from the FDA during the quarter ending June 30, 2024. A launch this year may be farfetched but could still loom on the horizon.

PharmaSens’ patch pump

PharmaSens closed out 2023 by submitting an application for FDA approval for its Niia Essential insulin patch pump system.

PharmaSens Niia Essential insulin patch pump
The Niia Essential insulin patch pump. [Image from PharmaSens on LinkedIn]
Niia Essential, the first of three patch pumps from PharmaSens, features a patient-centric design aimed at enhancing ease of use. The company says it aims to address unmet needs in the diabetes management market.

PharmaSens designed its basal-bolus patch pump to combine the ease of an insulin pen with the advantages of a sophisticated pump. It features a 3 mL reservoir, offering extended usage periods and access to reimbursed patch pump therapy. PharmaSens says the design positions Niia Essential as one of the most compact patch pumps on the market.

PharmaSens expects a favourable FDA review and said it is already gearing up for a market launch once that approval comes.

https://www.drugdeliverybusiness.com/these-diabetes-devices-are-set-to-launch-in-2024/