Homocysteine & Diabetes Complications

Facts About Diabetes

Diabetes has reached epidemic proportions. Over 18 million people in the United States have diabetes and approximately 95% of those have Type 2 Diabetes.

Diabetes is the fifth-deadliest disease in the United States and accounts for over $90 billion in medical treatment.

World-wide, it is projected that 125 million people have been diagnosed with diabetes and that number is expected to rise to over 220 million by the year 2010.

Homocysteine is associated with the major diabetes complications.

  • Cardiovascular Disease
  • Hypertension
  • Nephropathy
  • Stroke
  • Retinopathy
  • Peripheral Vascular Disease
  • Neuropathy

Diabetes Complications

Diabetes occurs because there is too much glucose (sugar) in the blood. High glucose levels can lead to serious health problems over time.

Patients diagnosed with diabetes are at a higher risk for complications compared to non-diabetics.

Diabetes is a major risk factor for heart disease and stroke. It is also the leading cause of adult blindness, chronic kidney disease, and leg and foot amputations not caused by injury.

Homocysteine & Cardiovascular Disease

Heart disease strikes people with diabetes twice as often as people without diabetes. In fact, it is estimated that 75% of all Type 2 Diabetes patients in the United States die from cardiovascular complications.1

Elevated homocysteine has been shown to be a stronger risk factor for cardiovascular disease in Type 2 Diabetes patients compared to non-diabetic patients.2

Elevated homocysteine has been established as an independent risk factor for overall mortality in type 2 diabetes patients. Researchers suggest that lowering homocysteine may reduce the risk of cardiovascular death.3

Homocysteine and Hypertension4

Hypertension is the medical term for high blood pressure. Approximately 70% of Type 2 Diabetes patients have high blood pressure.4

Hypertension is a major risk factor for heart disease and stroke and also increases the risk of diabetes-related kidney failure.

Researchers suggest that homocysteine may start a chain of reactions in the body that can lead to high blood pressure. Studies have found that as homocysteine levels increase, so does the risk for high blood pressure.

Homocysteine and Diabetic Nephropathy

Diabetic Nephropathy is the medical term for diabetes-induced kidney disease.5

High glucose levels can cause kidney disease and ultimately kidney failure by injuring the vessels in the kidney that are responsible for filtering waste.

Diabetic nephropathy is the most frequent cause of dialysis in the United States.5

Elevated homocysteine is the most common cardiovascular risk factor in patients with chronic kidney failure.6

Homocysteine levels have been shown to be associated with the prevalence and the severity of kidney failure in diabetes patients.5

Homocysteine & Stroke

The risk for stroke is 2 to 4 times higher among people with diabetes.7 Diabetic patients also have a higher recurrence rate and worse outcome of stroke.

Elevated homocysteine has been shown to be a stronger risk factor for stroke in diabetics compared to non-diabetics.2

Elevated homocysteine is also an independent predictor of recurrent stroke.8

Homocysteine & Diabetic Retinopathy

Diabetic Retinopathy is the medical term for diabetes-related eye disease.

High glucose levels can lead to blurred vision or blindness by damaging the small vessels that lead to the eyes.

Diabetic Retinopathy is the leading cause of blindness among adults in the United States, accounting for up to 24,000 new cases of blindness each year.9

Elevated homocysteine levels are associated with the prevalence and severity of retinopathy in type 2 diabetes patients.9

Homocysteine and Peripheral Vascular Disease

Peripheral vascular disease (PVD) is a disease of the vessels leading to the feet, legs, arms and hands due to plaque build-up.

PVD represents a major chronic complication of diabetes and contributes to the high rate of mortality.

Elevated homocysteine levels are associated with an increased risk of developing peripheral vascular disease.10

Elevated homocysteine levels are a stronger risk factor for peripheral vascular disease in patients with diabetes than those free of the disease.2

Homocysteine and Diabetic Neuropathy

Diabetic Neuropathy is the medical term for diabetes-induced nerve damage. It affects up to 70% of people with diabetes.11

High glucose causes chemical changes in the nerves that impair their ability to send signals. This nerve damage can lead to pain or numbness in the feet, legs, and hands, as well as slowed digestion of food in the stomach. In severe cases, it can play a role in foot and leg amputations.

Diabetic Neuropathy is the number one cause of non-traumatic amputations in the United States. More than 60% of non-traumatic lower-limb amputations in the U.S. occur among people with diabetes. Elevated homocysteine increases the risk of developing neuropathy in patients with Type 2 Diabetes.

Who should be tested for elevated Homocysteine levels?

Elevated homocysteine may add to overall cardiovascular risk through its synergistic interactions with traditional cardiovascular risk factors.12

There is a growing belief that an elevated homocysteine level in high risk patients should prompt further investigation and initiation of a homocysteine therapy.

Patient groups at high risk include those with:

  • Family history of Cardiovascular Disease
  • Diabetes
  • Smokers
  • High blood pressure
  • High cholesterol
  • Kidney Failure

Ask your doctor about Homocysteine and if Metanx® is right for you.

1 Audelin MC, et al. Homocysteine and cardiovascular disease in diabetes mellitus. Atherosclerosis. 2001 Dec;159(2):497-511.
2 Hoogeveen EK, et al. Hyperhomocysteinemia is associated with an increased risk of cardiovascular disease, especially in non-insulin-dependent diabetes mellitus: a population-based study. Arterioscler Thromb Vasc Biol. 1998 Jan;18(1):133-8.
3 Hoogeveen EK, et al. Hyperhomocysteinemia increases risk of death, especially in type 2 diabetes : 5-year follow-up of the Hoorn Study. Circulation. 2000 Apr 4;101(13):1506-11
4 Lim U, et al. Homocysteine and blood pressure in the Third National Health and Nutrition Examination Survey, 1988-1994. Am J Epidemiol. 2002 Dec 15;156(12):1105-13.
5 Emoto M, et al. Impact of insulin resistance and nephropathy on homocysteine in type 2 diabetes. Diabetes Care. 2001 Mar; 24(3):533-8.
6 Bostom, AG et al. Elevated fasting total plasma homocysteine levels and cardiovascular disease outcomes in maintenance dialysis patients: A prospective study. Arterioscler Thormb Vasc Biol, 1997; 11:2554-58.
7 Tanne D, et al. Prospective study of serum homocysteine and risk of ischemic stroke among patients with preexisting coronary heart disease Stroke. 2003 Mar;34(3):632-6. Epub 2003 Feb 20.
8 Boysen G, et al. Homocysteine and risk of recurrent stroke. Stroke. 2003 May;34(5):1258-61. Epub 2003 Apr 17.
9 Hoogeveen EK, et al. Hyperhomocysteinemia is associated with the presence of retinopathy in type 2 diabetes mellitus: the Hoorn study. Arch Intern Med. 2000 Oct 23;160(19):2984-90.
10 Kuan YM, et al. Homocysteine: an aetiological contributor to peripheral vascular arterial disease. ANZ J Surg. 2002 Sep; 72(9):668-71.
11 Ambrosch A, et al. Relation between homocysteinaemia and diabetic neuropathy in patients with Type 2 diabetes mellitus. Diabet Med. 2001 Mar;18(3):185-92.
12 Becker A, et al. Hyperhomocysteinaemia is associated with coronary events in type 2 diabetes. J Intern Med. 2003 Mar;253(3):293-300