Angiogenesis, Inflammation & Therapeutics | Online ISSN  2207-872X
RESEARCH ARTICLE   (Open Access)

Antioxidant Vitamin B Group Supplementation Induces Immune Function, Glycemic Control, and Reduces Infection Risk in Type 2 Diabetes Mellitus: A Randomized Controlled Trial

Mohammad Chand Jamali 1*, Manjusha Sudhadevi 2

+ Author Affiliations

Journal of Angiotherapy 8(10) 1-11 https://doi.org/10.25163/angiotherapy.8109995

Submitted: 31 July 2024  Revised: 11 October 2024  Published: 13 October 2024 

Abstract

Background: Diabetes mellitus is associated with impaired immune function and increased susceptibility to infections, with oxidative stress and inflammation playing significant roles in disease progression. Micronutrient deficiencies, particularly in antioxidants, are common among diabetic patients and may exacerbate these complications. This study aimed to evaluate the impact of antioxidant vitamin supplementation on oxidative stress, inflammation, and infection frequency in diabetic patients. Methods: This randomized, placebo-controlled study enrolled diabetic patients from multiple centers and assigned them to either a supplementation group receiving specific doses of vitamins (including vitamins C, E, and B complex) or a placebo group. Baseline data included demographic, clinical, and biochemical characteristics. Plasma antioxidant levels, inflammatory markers, and infection frequencies were assessed at baseline, three months, and twelve months for long-term effects. Statistical analyses compared group differences over time and assessed the association between supplementation and clinical outcomes. Results: At three months, patients in the supplementation group showed significant increases in plasma antioxidant levels and reductions in inflammatory markers compared to the placebo group (p < 0.05). Frequencies of infections over the initial three-month period were lower in the treatment group (15%) compared to the placebo (25%) (p < 0.05). Over the twelve-month follow-up, infection rates continued to be lower in the treatment group (20% vs. 30%), indicating a sustained effect of supplementation on infection risk in diabetic patients. Conclusion: Antioxidant vitamin supplementation in diabetic patients significantly improved plasma antioxidant levels, reduced inflammatory markers, and was associated with a lower incidence of infections over both short and long-term follow-ups.

Keywords: Vitamin supplementation, diabetes mellitus, antioxidants, inflammatory markers, infection rate

References

Ahmed, A. M. (2002). History of diabetes mellitus. Saudi Medical Journal, 23, 373-378.

Ahn, H. J., Min, K. W., & Cho, Y. O. (2011). Assessment of vitamin B6 status in Korean patients with newly diagnosed type 2 diabetes. Nutrition Research and Practice, 5(1), 34-39.

Alberti, K., Davidson, M. B., DeFronzo, R. A., Drash, A., Genuth, S., Harris, M. I., et al. (1998). Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care, 21(Suppl. 1), S5.

Amin, T. T., Al-Sultan, A. I., & Ali, A. (2008). Overweight and obesity and their association with dietary habits, and sociodemographic characteristics among male primary school children in Al-Hassa, Kingdom of Saudi Arabia. Indian Journal of Community Medicine, 33, 172-181.

Bruyère, O., Cavalier, E., Souberbielle, J.-C., Bischoff-Ferrari, H., Beaudart, C., Buckinx, F., Reginster, J.-Y., & Rizzoli, R. (2014). Effects of vitamin D in the elderly population: Current status and perspectives. Archives of Public Health, 72(1), 3.

Chandra, R. K. (1991). 1990 McCollum Award Lecture. Nutrition and immunity: Lessons from the past and new insights into the future. American Journal of Clinical Nutrition, 53(5), 1087–1101.

Charokopou, M., Sabater, F., Townsend, R., Roudaut, M., McEwan, P., & Verheggen, B. (2015). Methods applied in cost-effectiveness models for treatment strategies in Type 2 diabetes mellitus and their use in health technology assessments: A systematic review of the literature from 2008 to 2013. Current Medical Research and Opinion, 32, 1-12.

Cole, G., Leonard, B., Hammond, S., & Fridinger, F. (1998). Using stages of behavioral change constructs to measure the short-term effects of a worksite-based intervention to increase moderate physical activity. Psychological Reports, 82, 615-618.

Cuerda, C., Luengo, L. M., Valero, M. A., Vidal, A., Burgos, R., Calvo, F. L., & Martínez, C. (2011). Antioxidants and diabetes mellitus: Review of the evidence. Nutrición Hospitalaria, 26(1), 68-78.

Danaei, G., Finucane, M. M., Lu, Y., Singh, G. M., Cowan, M. J., Paciorek, C. J., et al. (2011). National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: Systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2.7 million participants. The Lancet, 378, 31-40.

Davies, R., Roderick, P., & Raftery, J. (2003). The evaluation of disease prevention and treatment using simulation models. European Journal of Operational Research, 150, 53-66.

Frank, L. L. (1957). Diabetes mellitus in the texts of old Hindu medicine (Charaka, Susruta, Vagbhata). American Journal of Gastroenterology, 27, 76-95.

Gallacher, S. J., Thomson, G., Fraser, W. D., Fisher, B. M., Gemmell, C. G., & MacCuish, A. C. (1995). Neutrophil bactericidal function in diabetes mellitus: Evidence for association with blood glucose control. Diabetic Medicine: A Journal of the British Diabetic Association, 12(10), 916–920.

Golden, S. H., Peart-Vigilance, C., Kao, W. H., & Brancati, F. L. (1999). Perioperative glycemic control and the risk of infectious complications in a cohort of adults with diabetes. Diabetes Care, 22(9), 1408–1414.

Jamison, D. T., Breman, J. G., Measham, A. R., Alleyne, G., Claeson, M., Evans, D. B., et al. (2006). Diabetes: The pandemic and potential solutions. Washington, DC: World Bank.

Jeon, C. Y., & Murray, M. B. (2008). Diabetes mellitus increases the risk of active tuberculosis: A systematic review of 13 observational studies. PLoS Medicine, 5(7), e152.

Khatib, O. (2004). Noncommunicable diseases: Risk factors and regional strategies for prevention and care. Eastern Mediterranean Health Journal, 10, 778-788.

Ludwig, D. S., Peterson, K. E., & Gortmaker, S. L. (2001). Relation between consumption of sugar-sweetened drinks and childhood obesity: A prospective, observational analysis. The Lancet, 357, 505-508.

Lumey, L. H., & Van Poppel, F. W. (1994). The Dutch famine of 1944-45: Mortality and morbidity in past and present generations. Social History of Medicine, 7, 229-246.

Manolescu, D. C., Sima, A., & Bhat, P. V. (2009). All-trans retinoic acid lowers serum retinol-binding protein 4 concentrations and increases insulin sensitivity in diabetic mice. Journal of Nutrition, 140(2), 311-316.

Manzetti, S., Zhang, J., & van der Spoel, D. (2014). Thiamin function, metabolism, uptake and transport. Biochemistry, 53(5), 821-835.

Movva, S., Alluri, R. V., Venkatasubramanian, S., Vedicherla, B., Vattam, K. K., Ahuja, Y. R., & Hasan, Q. (2011). Association of methylene tetrahydrofolate reductase C677T genotype with type 2 diabetes mellitus patients with and without renal complications. Genetic Testing and Molecular Biomarkers, 15(4), 257-261.

Narayan, K. V., Zhang, P., Kanaya, A. M., Williams, D. E., Engelgau, M. M., Imperatore, G., et al. (2006). Diabetes: The pandemic and potential solutions. Washington, DC: World Bank.

Pomposelli, J. J., Baxter, J. K., 3rd, Babineau, T. J., Pomfret, E. A., Driscoll, D. F., Forse, R. A., & Bistrian, B. R. (1998). Early postoperative glucose control predicts nosocomial infection rate in diabetic patients. JPEN Journal of Parenteral and Enteral Nutrition, 22(2), 77–81.

Rafighi, Z., Shiva, A., Arab, S., & Mohd Yousof, R. (2013). Association of dietary vitamin C and E intake and antioxidant enzymes in type 2 diabetes mellitus patients. Global Journal of Health Science, 5(3), 183-187.

Reece, E. A., & Homko, C. J. (1998). Diabetes mellitus in pregnancy. What are the best treatment options? Drug Safety, 18, 209-220.

Rees, K., Guraewal, S., Wong, Y. L., Majanbu, D. L., Mavrodaris, A., Stranges, S., Kandala, N. B., Clarke, A., & Franco, O. H. (2010). Is vitamin K consumption associated with cardio-metabolic disorders? A systematic review. Maturitas, 67(2), 121-128.

Sazonov, V., Maccubbin, D., Sisk, C. M., & Canner, P. L. (2013). Effects of niacin on the incidence of new-onset diabetes and cardiovascular events in patients with normoglycemia and impaired fasting glucose. International Journal of Clinical Practice, 67(4), 297-302.

Seidell, J. C. (1998). Dietary fat and obesity: An epidemiologic perspective. American Journal of Clinical Nutrition, 67(3 Suppl.), 546S-550S.

Shaw, J. E., Sicree, R. A., & Zimmet, P. Z. (2010). Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Research and Clinical Practice, 87, 4-14.

Shearer, M. J., Fu, X., & Booth, S. L. (2012). Vitamin K nutrition, metabolism, and requirements: Current concepts and future research. Advances in Nutrition, 3, 182-195.

Tucker, D. M., & Palmer, A. J. (2011). The cost-effectiveness of interventions in diabetes: A review of published economic evaluations in the UK setting, with an eye on the future. Primary Care Diabetes, 5, 9-17.

Valerius, N. H., Eff, C., Hansen, N. E., Karle, H., Nerup, J., Søeberg, B., & Sørensen, S. F. (1982). Neutrophil and lymphocyte function in patients with diabetes mellitus. Acta Medica Scandinavica, 211(6), 463–467.

Weinstein, M. C., Toy, E. L., Sandberg, E. A., Neumann, P. J., Evans, J. S., Kuntz, K. M., et al. (2001). Modeling for health care and other policy decisions: Uses, roles, and validity. Value in Health, 4, 348-361.

Whiting, D. R., Guariguata, L., Weil, C., & Shaw, J. (2011). IDF diabetes atlas: Global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Research and Clinical Practice, 94, 311-321.

World Health Organization. (2000). Obesity: Preventing and managing the global epidemic. Geneva, Switzerland: World Health Organization.

Zatalia, S. R., & Sanusi, H. (2017). The role of antioxidants in the pathophysiology, complications and management of diabetes mellitus. Acta Medica Indonesiana, 45(2), 141-147.

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