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糖尿病及其相关并发症:抗氧化剂在糖尿病治疗与护理中的作用。

Diabetes and the associated complications: The role of antioxidants in diabetes therapy and care.

作者信息

Dilworth Lowell, Stennett Dewayne, Facey Aldeam, Omoruyi Felix, Mohansingh Shada, Omoruyi Felix O

机构信息

Department of Pathology, The University of the West Indies, Mona Campus, Kingston, Jamaica.

The Transitional Year Programme, University of Toronto, Toronto, ON M5S 2E8, Canada.

出版信息

Biomed Pharmacother. 2024 Dec;181:117641. doi: 10.1016/j.biopha.2024.117641. Epub 2024 Nov 13.

Abstract

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by high blood sugar levels (hyperglycemia). Poorly managed diabetes can lead to complications affecting multiple organ systems. Antioxidants play a crucial role in reducing oxidative stress caused by reactive oxygen species (ROS), primarily triggered by uncontrolled high blood sugar levels in diabetes. Antioxidants like vitamin C, E, selenium, and alpha-lipoic acid, when used as supplements, have shown promise in reducing oxidative stress markers and improving antioxidant status in laboratory and animal studies and diabetic patients. Antioxidant supplementation may help reduce the risk of diabetic complications such as neuropathy, nephropathy, retinopathy, and cardiovascular disease. Additionally, antioxidants also have anti-inflammatory properties, which could be beneficial in reducing inflammation associated with diabetes. Antioxidant supplementation has been shown to enhance endothelial function, insulin sensitivity, and glucose metabolism, thereby aiding in glycemic control and overall diabetic management. Combining antioxidants with certain medications may have therapeutic benefits, such as effectively neutralizing free radicals and enhancing the regulation of antioxidant defense systems. This review presents an update on diabetes, the sources of free radical generation, the body's natural defense mechanisms, the clinical evidence regarding using antioxidants in managing diabetic complications, and the potential new therapeutic approaches. Overall, antioxidant supplementation may offer some benefits in managing diabetic complications. However, further studies are needed to understand the mechanisms of action, determine the optimal supplementation, explore potential interactions with other medications, and conduct long-term studies to establish the possible use of antioxidants for optimal benefits in diabetes care.

摘要

糖尿病(DM)是一种以高血糖水平(高血糖症)为特征的慢性代谢紊乱疾病。糖尿病管理不善会导致影响多个器官系统的并发症。抗氧化剂在减轻由活性氧(ROS)引起的氧化应激方面起着关键作用,而活性氧主要由糖尿病中不受控制的高血糖水平引发。像维生素C、E、硒和α-硫辛酸等抗氧化剂,在实验室研究、动物研究以及糖尿病患者中,作为补充剂使用时,已显示出在降低氧化应激标志物和改善抗氧化状态方面的前景。补充抗氧化剂可能有助于降低糖尿病并发症的风险,如神经病变、肾病、视网膜病变和心血管疾病。此外,抗氧化剂还具有抗炎特性,这可能有助于减轻与糖尿病相关的炎症。补充抗氧化剂已被证明可以增强内皮功能、胰岛素敏感性和葡萄糖代谢,从而有助于血糖控制和整体糖尿病管理。将抗氧化剂与某些药物联合使用可能具有治疗益处,例如有效中和自由基并增强抗氧化防御系统的调节。本综述介绍了糖尿病的最新情况、自由基产生的来源、人体的自然防御机制、使用抗氧化剂治疗糖尿病并发症的临床证据以及潜在的新治疗方法。总体而言,补充抗氧化剂在管理糖尿病并发症方面可能会带来一些益处。然而,需要进一步研究来了解其作用机制、确定最佳补充剂量、探索与其他药物的潜在相互作用,并进行长期研究以确定抗氧化剂在糖尿病护理中实现最佳益处的可能用途。

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