Abstract
Reactive oxygen species (ROS) overproduction and ROS-signaling pathways activation attack the eyes. We evaluated the oxidative stress (OS) and the effects of a daily, core nutritional supplement regimen containing antioxidants and omega 3 fatty acids (A/ω3) in type 2 diabetics (T2DM). A case-control study was carried out in 480 participants [287 T2DM patients with (+)/without (−) diabetic retinopathy (DR) and 193 healthy controls (CG)], randomly assigned to a daily pill of A/ω3. Periodic evaluation through 38 months allowed to outline patient characteristics, DR features, and classic/OS blood parameters. Statistics were performed by the SPSS 24.0 program. Diabetics displayed significantly higher circulating pro-oxidants (p = 0.001) and lower antioxidants (p = 0.0001) than the controls. Significantly higher plasma malondialdehyde/thiobarbituric acid reactive substances (MDA/TBARS; p = 0.006) and lower plasma total antioxidant capacity (TAC; p = 0.042) and vitamin C (0.020) was found in T2DM + DR versus T2DM-DR. The differential expression profile of solute carrier family 23 member 2 (SLC23A2) gene was seen in diabetics versus the CG (p = 0.001), and in T2DM + DR versus T2DM − DR (p < 0.05). The A/ω3 regime significantly reduced the pro-oxidants (p < 0.05) and augmented the antioxidants (p < 0.05). This follow-up study supports that a regular A/ω3 supplementation reduces the oxidative load and may serve as a dietary prophylaxis/adjunctive intervention for patients at risk of diabetic blindness.
Highlights
Diabetes mellitus (DM) is a multifactorial-polygenic disease characterized by chronic hyperglycemia and altered metabolism of carbohydrates, lipids, and proteins
Additional factors play critical roles in managing diabetics had retinopathy (DR) at any stage [1,2,3,4,5,6,19,26,27,28], with a special interest in diabetics without clinically detectable retinopathy and those suffering from the early DR stage [37,38]
The results of the present study reveal the importance of multicenter collaborative works in DR research to better managing the diabetic retina
Summary
Diabetes mellitus (DM) is a multifactorial-polygenic disease characterized by chronic hyperglycemia and altered metabolism of carbohydrates, lipids, and proteins. There are two major clinical forms: Insulin-dependent DM (type 1: T1DM) and non-insulin-dependent DM (type 2: T2DM), being the latter the most common presentation, accounting for 90% of all diabetics [1]. DM displays alarming growth rates worldwide, being a serious health concern with an estimated number of affected people of 600 million by the year 2030 [2,3]. Microvascular changes are clinically manifested during the natural course of DM. Population studies reported that 20% of diabetics had retinopathy (DR) at the time of diagnosis [4]. The main pathogenic mechanisms in the diabetic retina include the activation of oxidative stress (OS), advanced glycation end-product generation, inflammation, activation of protein kinase C, polyol, and hexosamine pathways, etc. A series of endogenous/exogenous risk factors have been pointed as contributing highly to the DR initiation and progression [6]
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