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A high-dose B-vitamin combination comprising folic acid (vitamin B9), pyridoxine (vitamin B6), and cyanocobalamin (vitamin B12). This specific formulation was evaluated in the DIVINe (Diabetic Intervention with Vitamins to Improve Nephropathy) trial, led by researchers at the John P. Robarts Research Institute. The intervention was designed to lower elevated plasma homocysteine levels (hyperhomocysteinemia), a common condition in diabetic nephropathy patients linked to increased vascular risk. Despite the biochemical success in lowering homocysteine, the clinical trial found that the treatment resulted in a significant decrease in glomerular filtration rate (GFR) and an increase in composite vascular events (myocardial infarction, stroke, revascularization, and all-cause mortality) compared to placebo.
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