I'm diabetic SINCE I WAS 13 YRS OLD. I M 36 NOW. GOT A HEART ATTACK FEW MONTHS BACK and angioplasty WAS DONE. JUST GOT MY HOMOCYSTEINE LEVEL ON ADVISE OF A FRIEND. ITS 36 AGAINST RHE NORMAL VALUE OF BELOW 15. VITAMIN B12 VALUE IS WITH IN RANGE AND HBA1C VALUE IS 8.8 FOR THREE MONTHS AVG. PLEASE advise ON HIGH HOMOCYSTEINE LEVELS AND ITS RISK FACTOR. OR IS IT COMMON IN PATIENTS WHO GOT A ATTACK.

Dr. Vivek KadambiEndocrinologist31yrs exp

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I prefer to keep Homocysteine level below 10. For this it is important to optimize B group vitamins particularly B12 and Folic acid. For B12 it is important to aim for a level of around 1000 pg/mL. The best way to achieve this is through sublingual B12 Tablets or periodic injections. Oral Folic acid tablets is quite effective except in those with genetic MTHFR defficiency. Ofcourse, it is equally important to make positive life lifestyle changes. Smoking, in particular, can significantly deplete B12. Metformin is another drug used by Diabetics that deplts B12. Lastly I would add that one should not treat raised Homocysteine level in isolation. Optimization of other vitamins (such as Vit D), balancing metabolic factors and hormones is crucial. This will also help in better management of Diabetes Mellitus. 

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