A toZ Cap — Complete Multivitamin & Multimineral Supplement

Standard adult dose: 1 capsule daily, preferably after a meal.

Do not exceed the recommended dose unless directed by a physician. Take with a full glass of water.

Paediatric dosing: as directed by physician based on age-appropriate formulation.

Patients with diabetes mellitus are at significantly higher risk of micronutrient deficiencies due to:

• Glucosuria-driven urinary loss of water-soluble vitamins (B-complex, C) and minerals (magnesium, zinc)
• Metformin therapy — long-term use depletes Vitamin B12 and folate; all patients on metformin should monitor B12 levels annually
• Renal complications — diabetic nephropathy increases urinary loss of multiple nutrients and impairs vitamin D activation
• Dietary restriction — carbohydrate and calorie limitations may inadvertently reduce micronutrient intake

Key micronutrients for glycaemic health:

• Vitamin B12: Prevents and may slow progression of diabetic peripheral neuropathy — essential for all metformin users
• Vitamin B6 (Pyridoxine): Supports nerve function and may reduce neuropathy symptoms
• Vitamin D3: Deficiency is associated with insulin resistance, worsened glycaemic control, and increased risk of Type 2 diabetes — supplementation improves insulin sensitivity in deficient patients
• Magnesium: Magnesium deficiency is highly prevalent in Type 2 diabetes and impairs insulin receptor function — correcting deficiency improves glycaemic control
• Zinc: Required for insulin synthesis, storage, and secretion from pancreatic beta cells; deficiency impairs wound healing (critical in diabetic foot)
• Vitamin C: Antioxidant protection against oxidative stress-related diabetic complications; supports wound healing and collagen synthesis
• Folic acid + B12: Reduce elevated homocysteine — an independent cardiovascular risk factor commonly elevated in diabetics
• Selenium: Supports glutathione-based antioxidant defences impaired in diabetes; however, excess selenium (>400 mcg/day) may impair glucose tolerance — avoid high-dose supplementation beyond the multivitamin

• Metformin and B12: If taking metformin, check serum B12 annually — supplement separately at higher doses (500–1000 mcg/day) if deficient, as multivitamin doses may be insufficient to correct established deficiency
• Iron and blood glucose tests: High-dose iron supplementation may falsely alter HbA1c readings — inform your laboratory if on high-dose iron
• Fat-soluble vitamins (A, D, E, K) — toxicity risk: Do not take additional fat-soluble vitamin supplements concurrently without medical advice, as these accumulate in the body
• Niacin (B3) in high doses: Pharmacological doses of niacin (not present in multivitamins) can worsen glycaemic control — the nutritional dose in A toZ Cap is safe
• Timing with medications:
  — Take 2 hours apart from tetracycline and fluoroquinolone antibiotics (mineral chelation)
  — Take 2 hours apart from thyroid medications (calcium/iron reduce absorption)
  — Take with food to minimise nausea from iron content
• Renal impairment: Patients with moderate-to-severe diabetic nephropathy (eGFR <30 ml/min) should consult their nephrologist — some minerals (potassium, magnesium, phosphate) may accumulate in renal failure

Medical Disclaimer

The information provided here is for educational and informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Nutritional supplements should complement, not replace, a balanced diet and appropriate medical treatment. Always consult your doctor or pharmacist before starting any supplement, especially if you have diabetes, renal disease, or are taking prescription medications. DiabetesStore.com.bd does not endorse self-medication. Seek medical advice for any persistent symptoms.