Department of Endocrinology & Metabolism, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, 700020 West Bengal, India.
Decision Sciences Area, Indian Institute of Management Lucknow, Uttar Pradesh 226013, India.
J Diabetes Res. 2022 Sep 1;2022:3886710. doi: 10.1155/2022/3886710. eCollection 2022.
Excessive intracellular glucose in insulin-independent tissues including nerve, nephron, lens, and retina invites mishandling of metabolism of glucose resulting in a background of increased oxidative stress, advanced glycation end products (AGE) formation, lipid peroxidation, and failure of antioxidant defense systems in type 2 diabetes mellitus (T2DM). All these detrimental biochemical anomalies ultimately attack biological membranes and especially capillary beds of the retina, resulting in the breakdown of the inner blood-retinal barrier and the initiation of diabetic retinopathy (DR). If these disarrays are corrected to a large extent, the development of DR can be avoided or delayed. In this prospective clinical trial, 185 patients with T2DM who received B vitamins, vitamin C, and vitamin E along with antidiabetic medication for five years demonstrated a slower rate of the development of DR and reduced abnormal biochemical mediators like reactive oxygen species (ROS), malondialdehyde (MDA), AGE, and vascular endothelial growth factor (VEGF) compared to 175 T2DM individuals who were treated with only antihyperglycemic drugs.
在胰岛素非依赖性组织中，如神经、肾小球、晶状体和视网膜，细胞内的葡萄糖过多会导致葡萄糖代谢异常，从而增加氧化应激、晚期糖基化终产物（AGE）形成、脂质过氧化和抗氧化防御系统的失败，这些都与 2 型糖尿病（T2DM）有关。所有这些有害的生化异常最终都会攻击生物膜，特别是视网膜的毛细血管床，导致内血视网膜屏障的破坏，并引发糖尿病性视网膜病变（DR）。如果这些失调在很大程度上得到纠正，DR 的发展就可以避免或延迟。在这项前瞻性临床试验中，185 名接受 B 族维生素、维生素 C 和维生素 E 以及降糖药物治疗 5 年的 T2DM 患者与仅接受降血糖药物治疗的 175 名 T2DM 患者相比，DR 的发展速度较慢，并且异常生化介质如活性氧（ROS）、丙二醛（MDA）、AGE 和血管内皮生长因子（VEGF）的水平也有所降低。
