Antioxidants and Diabetes: A Closer Look

APRIL 17, 2019
Officials with the FDA note that health care professionals should never use dietary supplements to treat a disease.  However, there is emerging evidence that antioxidants can be used to improve, but not halt, certain disease states that have high oxidative stress. Diabetes is one such example.

Researchers report that diabetics have increased blood concentrations of the byproduct from lipid peroxidation, called thiobarbituric acid reactive substances.The presence of these substances in high amounts are markers of excessive free radicals that can lead to damage to cell membranes. It is thought that antioxidants can intervene and bring the body back into a more natural state with less oxidative stress.

The journal Diabetology & Metabolic Syndrome recently published a systematic review and meta-analysis that looked at 12 randomized control trials to see the effects of vitamins B, C, D, and E in patients with type 2 diabetes.The researchers concluded that vitamin E may be a valuable strategy for controlling diabetes complications and enhancing antioxidant capacity. Vitamin E is oil soluble and has a strong affinity for cell membranes that are mainly made up of lipids and fats. Vitamin E is also used in grocery stores to keep raw meat looking fresh by preventing it from turning a grayish brown when exposed to air. It is also used in fish oils to prevent the oil from turning rancid. It was no surprise that it performed so well in the meta-analysis. To a lesser degree, vitamin C also performed well. It is water soluble and can go where vitamin E cannot, since oil and water do not mix. Vitamin C is known for keeping freshly cut fruit from becoming discolored when cut open and exposed to air.

The meta-analysis briefly mentioned good results from glutathione, a water soluble antioxidant that many people believe is the most potent antioxidant that our body manufactures. It is currently being used in hospitals to counteract the negative effects of toxin exposure.

Unfortunately, the meta-analysis did not mention Alpha-lipoic acid (ALA). ALA is another potent antioxidant that our bodies make, and is used in hospitals to counteract nerve toxicities that can be associated with chemotherapy. It is soluble in water and oil and therefore can go anywhere in the body. It has been used in patients with diabetes. Fifty to 62 percent of patients treated with ALA perceived more than 50% reduction in neuropathic symptoms in the Sydney 2 trial, which included 181 patients.3 The ALA treated group felt an improvement in several areas, including pain, paresthesia, and sleep numbness.4
 
Combining Antioxidants?
In nature, antioxidants are found together in groups. Never does a fruit or vegetable contain just one antioxidant alone. Even vitamin E is found in groups called tocotrienols. Along that same train of thought, multiple studies have noted antioxidant synergy. These biochemicals lose and gain electrons as they perform the desired reactions. After the desired action occurs, the biochemical has to either get rid of the extra electron, or find more electrons so that it can begin again and perform the same desired actions. With synergy, the antioxidants toss the unncessary electrons back and forth to regenerate their abilities.

Are there any other conditions that antioxidants are being used?
Antioxidants are being used experimentally in patients with dementia, systemic inflammation, cancers, and heart disease. Smoking, excessive alcohol intake, and illicit drug use can lead to heart damage in people as young as in their 30s. There are biomarkers proving that the oxidative damage from these choices are affecting the heart muscle.1

Bad health is a downward spiral and can be accelerated by oxidative stress. Researchers are working hard to understand how they can effectively and reliably intervene in disease states. Until they do, we must intervene with our lifestyle choices, when we can.

References
1.     Frijhoff J, Winyard PG, Zarkovic N, et al. Clinical Relevance of Biomarkers of Oxidative Stress. Antioxid Redox Signal. 2015;23(14):1144-1170.
2.     Antioxidant effects of vitamins in type 2 diabetes: a meta-analysis of randomized controlled trials. Diabetol Metab Syndr. 2018;10:18.
3.     Ametov AS, Barinov A, Dyck PJ, et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: the SYDNEY trial. Diabetes Care. 2003; 26:770.
4.     Ziegler D, Ametov A, Barinov A, et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care. 2006; 29:2365.
 
 
 
 
 

Gunda Siska, PharmD
Gunda Siska, PharmD
Gunda Siska, PharmD, has worked in various fields within the pharmaceutical industry as a licensed pharmacist for more than 20 years. She is currently a staff hospital pharmacist assisting nurses and doctors with drug prescribing, administration, and dispensing, as well as independently monitoring and dosing highly toxic and dangerous drugs. For 2 years, she was concurrently a consultant pharmacist for skilled nursing facilities and nursing homes. Dr. Siska is a member of the New Mexico Society of Health-System Pharmacists and the American Academy of Anti-Aging Medicine. Follow her on Twitter @GundaSiska
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