THE ROLE OF VITAMIN B COMPLEX AS AN ADJUVANT THERAPY FOR DIABETIC NEPHROPATHY IN PEDIATRIC PATIENTS WITH TYPE 1 DIABETES

Abstract

Background and Objectives: Diabetic nephropathy (DN) is a major microvascular complica¬tion of type 1 diabetes mellitus (T1DM). Although with established conventional therapy for glycemic and blood pressure control in patients with DN, and the use of inhibitors of the renin–angiotensin–aldosterone system (RAAS), a significant proportion of diabetic patients develop chronic kidney disease and progress to end-stage renal disease, indicating a need for additional treatments. Evidence for deficiencies of vitamins B1 and B12 in T1DM has been described in several publications. The role of vitamin B supplementation in preventing microvascular complications of diabetes has already been a focus of research for some years. Homocysteine levels are elevated in T1DM patients with DN. Supplementation of folic acid and vitamin B12 is known to reduce homocysteine levels. A combined therapy with vitamin B1 (thiamine) and vitamin B6 (pyridoxine) in patients with type 2 diabetes and nephropathy significantly decreased glycation of nuclear DNA in leukocytes. We studied the role of oral supplementation with vitamin B complex as an adjuvant therapy for diabetic nephropathy in children and adolescents with T1DM and assessed its relation to glycemic control, microalbuminuria and cystatin C as a marker of nephropathy.