Korean J Fam Pract. 2018; 8(1): 113-117  https://doi.org/10.21215/kjfp.2018.8.1.113
Association between Vitamin C and Type 2 Diabetes Mellitus in Korea: Korean National Health and Nutrition Examination Survey 2012-2015
Jin Young Kim, Hee Jeong Kim, Ji Yun Jeong, Yu Ri Choe*
Department of Family Medicine, Chonnam National University Hwasun Hospital, Hwasun, Korea
Yu Ri Choe
Tel: +82-61-379-7290, Fax: +82-61-379-7289
E-mail: hiyuriya@naver.com
ORCID: http://orcid.org/0000-0002-4557-2323
Received: March 15, 2017; Revised: July 27, 2017; Accepted: August 20, 2017; Published online: February 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Micronutrients play an important role in the development, progression, and complications of diabetes mellitus (DM). Specifically, vitamin C appears to be associated with DM, although its precise role remains unclear. The purpose of this study was to determine the association between vitamin C intake and DM.
Methods: The data for this study were obtained from the Korean National Health and Nutrition Examination Survey 2012–2015. A total of 6,548 individuals (2,542 men and 4,006 women) were involved in this analysis. The participants were divided into two groups according to daily vitamin C intake. The first group included participants ingesting ≥90 mg/day of vitamin C per day. The second group included participants ingesting <90 mg/day of vitamin C per day, which is lower than the recommended daily dose. Logistic regression analysis was performed to determine the association between vitamin C intake and DM.
Results: Overall, 2,801 (44.9 weighted %) individuals had an inadequate intake of vitamin C of <90 mg/day. Multiple logistic regression analysis revealed that male sex, age, waist circumference, family income, hypertension, and dyslipidemia were associated with an increased prevalence of DM. The odds ratio for DM with inadequate vitamin C intake was 1.41 (95% confidential interval [CI], 1.72–1.70) and this was statistically significant.
Conclusion: Inadequate daily vitamin C intake (<90 mg/day) is associated with an increased prevalence of DM.
Keywords: Ascorbic Acid; Dietary Supplements; Diabetes Mellitus; Korea
  1. Valdés-Ramos R, Guadarrama-López AL, Martínez-Carrillo BE, BenítezArciniega AD. Vitamins and type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets 2015; 15: 54-63.
    Pubmed KoreaMed CrossRef
  2. Mandl J, Szarka A, Bangheyl G. Vitamin C: update on physiology and pharmacology. Br J Pharmacol 2009; 157: 1097-110.
    Pubmed KoreaMed CrossRef
  3. Will JC, Byers T. Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 1996; 54: 193-202.
    Pubmed CrossRef
  4. Jacob RA, Sotoudeh G. Vitamin C function and status in chronic disease. Nutr Clin Care 2002; 5: 66-74.
  5. Bsoul SA, Terezhalmy GT. Vitamin C in health and disease. J Contemp Dent Pract 2004; 5: 1-13.
  6. Afkhami-Ardekani M, Shojaoddiny-Ardekani A. Effect of vitamin C on blood glucose, serum lipids & serum insulin in type 2 diabetes patients. Indian J Med Res 2007; 126: 471-4.
  7. Naziroğlu M, Simşek M, Simşek H, Aydilek N, Ozcan Z, Atilgan R. The effects of hormone replacement therapy combined with vitamins C and E on antioxidants levels and lipid profiles in postmenopausal women with Type 2 diabetes. Clin Chim Acta 2004; 344: 63-71.
    Pubmed CrossRef
  8. Oyenihi AB, Ayeleso AO, Mukwevho E, Masola B. Antioxidant strategies in the management of diabetic neuropathy. Biomed Res Int 2015; 2015:515042.
    Pubmed KoreaMed CrossRef
  9. Christie-David D, Girgis C, Gunton J. Effects of vitamins C and D in type 2 diabetes mellitus. Nutr Diet Suppl 2015; 2015: 7: 21-8.
  10. Sinclair AJ, Taylor PB, Lunec J, Girling AJ, Barnett AH. Low plasma ascorbate levels in patients with type 2 diabetes mellitus consuming adequate dietary vitamin C. Diabet Med 1994; 11: 893-8.
    Pubmed CrossRef
  11. Harding AH, Wareham NJ, Bingham SA, Khaw K, Luben R, Welch A, et al. Plasma vitamin C level, fruit and vegetable consumption, and the risk of new-onset type 2 diabetes mellitus: the European prospective investigation of cancer--Norfolk prospective study. Arch Intern Med 2008; 168: 1493-9.
    Pubmed CrossRef
  12. Sargeant LA, Wareham NJ, Bingham S, Day NE, Luben RN, Oakes S, et al. Vitamin C and hyperglycemia in the European Prospective Investigation into Cancer--Norfolk (EPIC-Norfolk) study: a population-based study. Diabetes Care 2000; 23: 726-32.
    Pubmed CrossRef
  13. Lee HS, Hong KH, Yoon CH, Kim JM, Kim SM. Effect of Korean Turbid Rice Wine (Takju) Lees extract on blood glucose in the db/db mouse. J Korean Soc Food Cult 2009; 24: 219-23.
  14. Park TS, Lee SY, Kim HJ, Kim KT, Kim YJ, Jeong IH, et al. Extracts of adlay, barley and rice bran have antioxidant activity and modulate fatty acid metabolism in adipocytes. Korean J Food Nutr 2009; 22: 456-62.
  15. Shim JE, Paik HY, Shin CS, Park KS, Lee HK. Vitamin C nutriture in newly diagnosed diabetes. J Nutr Sci Vitaminol (Tokyo) 2010; 56: 217-21.
  16. Lee YH, Kim DJ. Diabetes risk score for Korean adults. J Korean Diabetes 2013; 14: 6-10.
  17. Oh K, Lee J, Lee B, Kweon S, Lee Y, Kim Y. Plan and Operation of the 4th Korea National Health and Nutrition Examination Survey (KNHANES IV). Korean J Epidemiol 2007; 29: 139-45.
  18. Philips KM, Tarragó-Trani MT, Gebhardt SE, Exler J, Patterson KY, Haytowitz DB, et al. Stability of vitamin C in frozen raw fruit and vegetable homogenates. J Food Compos Anal 2010; 23: 253-9.
  19. Levine M, Wang Y, Padayatty SJ, Morrow J. A new recommended dietary allowance of vitamin C for healthy young women. Proc Natl Acad Sci U S A 2001; 98: 9842-6.
    Pubmed KoreaMed CrossRef
  20. Ting HH, Timimi FK, Boles KS, Creager SJ, Ganz P, Creager MA. Vitamin C improves endothelium-dependent vasodilation in patients with non-insulindependent diabetes mellitus. J Clin Invest 1996; 97: 22-8.
    Pubmed KoreaMed CrossRef
  21. Burkholder-Cooley NM, Rajaram SS, Haddad EH, Oda K, Fraser GE, JaceldoSiegl K. Validating polyphenol intake estimates from a food-frequency questionnaire by using repeated 24-h dietary recalls and a unique methodoftriads approach with 2 biomarkers. Am J Clin Nutr 2017; 105: 685-94.
    Pubmed CrossRef
  22. Fraser GE, Jaceldo-Siegl K, Henning SM, Fan J, Knutsen SF, Haddad EH, et al. Biomarkers of dietary intake are correlated with corresponding measures from repeated dietary recalls and Food-Frequency Questionnaires in the Adventist Health Study-2. J Nutr 2016; 146: 586-94.
    Pubmed KoreaMed CrossRef
  23. Jwa SC, Ogawa K, Kobayashi M, Morisaki N, Sago H, Fujiwara T. Validation of a food-frequency questionnaire for assessing vitamin intake of Japanese women in early and late pregnancy with and without nausea and vomiting. J Nutr Sci 2016; 5: e27.
    Pubmed KoreaMed CrossRef

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