Diabetes and Antioxidant Stress: Using Vitamin Supplementation

Jeannette Y. Wick, RPh, MBA, FASCP
Published Online: Wednesday, March 28th, 2018
Although it's unclear how many people who have diabetes use complementary and alternative medications to lower blood glucose, researchers indicate that this is an ‘emerging trend.’ A number of complementary and alternative medications can potentially lower blood sugar, and many patients look at these substances as more natural than synthetic drugs. In fact, many vitamins have antioxidant potential that may augment synthetic antihyperglycemic medications.

Many researchers believe that diabetes increases blood concentrations of the end products of lipid peroxidation (thiobarbituric acid reactive substances and serum malondialdehyde). This causes stress and increases cell membrane leaking. It can also inactivate membrane-bound enzymes and surface receptors.

The journal Diabetology & Metabolic Syndrome has published a systematic review and meta-analysis of vitamins that have antioxidant potential and their use among patients who have type 2 diabetes mellitus (T2DM). The findings discuss a total of 12 studies that looked at antioxidant outcomes. The vitamins that were studied most often included B, C, D and E.

Vitamin E was related to significant reduction of blood glucose and glycated hemoglobin compared to placebo. The researchers suggest that vitamin E may reduce damage incurred from free radicals on structural and functional components of cells and vessel walls.

Vitamins C and E and glutathione, all of which are nonenzymatic antioxidants, seem to be able to interrupt free radical chain reactions. There is intense interest in administering these vitamins in combination. Some evidence indicates that long-term use of dietary supplements, including multivitamin or mineral complexes may improve C-reactive protein, HDL cholesterol, serum homocysteine, blood pressure, and incidence of diabetes.

The researchers had insufficient data to make any conclusions about vitamin D supplementation.

Doses ranged from 500 to 3000 mg/day for vitamin C; from 400 to 1600 IU/day for vitamin E; and from 500 to 200,000 IU/day for vitamin D.

Vitamin supplementation with vitamins E and C may help reduce diabetes complications and enhance antioxidant capacity. Further studies are needed before clinical recommendations can be formulated, but these supplements are generally well tolerated with few adverse effects, if any.

Reference
 
Balbi ME, Tonin FS, Mendes AM, et al. Antioxidant effects of vitamins in type 2 diabetes: a meta-analysis of randomized controlled trials. Diabetol Metab Syndr. 2018;10:18.


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