Vitamin supplements in type 2 diabetes mellitus management: A review

Research Progress on the Relationship between Vitamins and Diabetes: Systematic Review

Diabetes is a serious chronic metabolic disease that causes complications over time, bringing serious public health challenges that affect different countries across the world. The current clinical drugs for diabetes may lead to adverse effects such as hypoglycemia and liver and abdominal distension and pain, which prompt people to explore new treatments for diabetes without side effects. The research objective of this review article is to systematically review studies on vitamins and diabetes and to explain their possible mechanism of action, as well as to assess the role of vitamins as drugs for the prevention and treatment of diabetes. To achieve our objective, we searched scientific databases in PubMed Central, Medline databases and Web of Science for articles, using "vitamin" and "diabetes" as key words. The results of numerous scientific investigations revealed that vitamin levels were decreased in humans and animals with diabetes, and vitamins show promise for the prevention and/or control of diabetes through anti-inflammation, antioxidation and the regulation of lipid metabolism. However, a few studies showed that vitamins had no positive effect on the development of diabetes. Currently, studies on vitamins in the treatment of diabetes are still very limited, and there are no clinical data to clarify the dose-effect relationship between vitamins and diabetes; therefore, vitamins are not recommended as routine drugs for the treatment of diabetes. However, we still emphasize the great potential of vitamins in the prevention and treatment of diabetes, and higher quality studies are needed in the future to reveal the role of vitamins in the development of diabetes.

Saliva sampling strategies affecting the salivary glucose measurement

Characterized by sustained elevated blood glucose levels, diabetes mellitus has become one of the largest global public health concerns by imposing a heavy global burden on socio-economic development. To date, regular blood glucose level check by performing a finger-prick test has been a routine strategy to monitor diabetes. However, the intrusive nature of finger blood prick tests makes it challenging for individuals to maintain consistent testing routines. Recently, salivary glucose measurement (SGM) has increasingly become a non-invasive alternative to traditional blood glucose testing for diabetes. Despite that, further research is needed to standardize the collection methods and address the issues of variability to ensure accurate and reliable SGM. To resolve possible remaining issues in SGM, we here thoroughly explored saliva sampling strategies that could impact the measurement results. Additionally, the effects of supplements taken, mouth washing, gum chewing, and smoking were collectively analyzed, followed by a continuous SGM over a long period, forming the stepping stone for the practical transitional development of SGM in non-invasive diabetes monitoring.

Associations of Dietary Antioxidants with Glycated Hemoglobin and Insulin Sensitivity in Adults with and without Type 1 Diabetes

Type 1 diabetes (T1D) has been associated with increased risks of atherosclerotic cardiovascular disease, and poor glycemic control and oxidative stress play a major role in its pathology. There is a lack of data on the role of dietary antioxidant micronutrients, including vitamins and trace elements, in glycemic control in T1D. The aim of this study is to examine associations of dietary intakes of micronutrients with glycemic status. We report data from a cross-sectional analysis from the coronary artery calcification in type 1 diabetes (CACTI) study (n = 1257; T1D: n = 568; nondiabetic controls: n = 689) collected between the years 2000 and 2002. Participants completed a validated food frequency questionnaire, a physical examination, and biochemical analyses. Linear regression was used to examine the associations of dietary antioxidant micronutrients with HbA1c and estimated insulin sensitivity (eIS) in models adjusted for relevant covariates and stratified by diabetes status. In adults with T1D, we observed higher dietary manganese intake associated with higher eIS in the model adjusted for age, sex, diabetes duration, and total calories. In nondiabetic controls, higher intake of manganese associated with lower HbA1c and higher eIS values that persisted in models adjusted for all relevant covariates. On the other hand, dietary copper revealed a positive association with HbA1c in models adjusted for all covariates, except BMI and plasma lipids. No associations were noted for vitamins C and E and dietary carotenoids in either group. These findings reveal dietary antioxidant micronutrients, especially trace elements such as copper and manganese deserve special attention in glycemic control in adults with T1D as well as in nondiabetic controls.This trial is register with NCT00005754.

Cabbage (Brassica oleracea var. capitata): A food with functional properties aimed to type 2 diabetes prevention and management

Type 2 diabetes mellitus (T2DM) is increasing the prevalence worldwide at an alarming rate, becoming a serious public health problem that mainly affects developing countries. Functional food research is currently of great interest because it contributes to developing nutritional therapy strategies for T2DM prevention and treatment. Bioactive compounds identified in some plant foods contribute to human health by mechanisms of action that exert biological effects on metabolic pathways involved in the development of T2DM. Hence, vegetables with high bioactive compounds content may be a source of functional value for the control of T2DM. Cabbages varieties (Brassica oleracea var. capitata) such as green (GCB), white (WCB), and red (RCB) are foods consumed (raw or cooked) and cultivated in different regions of the world. Scientific evidence shows that cabbage has multi-target effects on glucose homeostatic regulation due to its high content of bioactive compounds. It has also been shown to decrease damage to organs affected by T2DM complications, such as the liver and kidney. Additionally, it could contribute as a preventive by attenuating problems underlying the development of T2DM as oxidative stress and obesity. This review highlights the functional properties of cabbage varieties involved in glucose regulation and the main mechanisms of the action exerted by their bioactive compounds. In conclusion, cabbage is a valuable food that can be employed as part of nutritional therapy or functional ingredient aimed at the prevention and treatment of T2DM.

VK2 regulates slow-twitch muscle fibers expression and mitochondrial function via SIRT1/SIRT3 signaling

OBJECTIVES

Skeletal muscle accounts for 80% of whole body insulin-stimulated glucose uptake, and it plays a key role in preventing and curing obesity and insulin resistance (IR). Vitamin K2 (VK2) plays a beneficial role in improving mitochondrial function through SIRT1 signaling in high-fat diet (HFD)-induced mice and palmitate acid (PA)-treated C₂C₁₂ cells. A previous study also found VK2 increases oxidative muscle fibers and decreases glycolytic muscle fibers in obesity-induced mice, however, the underlying molecular mechanism of effect of VK2 on increasing oxidative fibers have not been well established.

METHODS

C57BL/6 male mice were induced IR using HFD fed. Animals received HFD for eight weeks, and different doses of VK2 were supplemented by oral gavage for the last eight weeks were randomly and equally divided into seven groups. C₂C₁₂ cells were exposed to different doses of PA for 16 h to mimic insulin resistance in vivo. Skeletal muscle types and mitochondrial function evaluated. C₂C₁₂ cells were transfected with SIRT1 siRNA.

RESULTS

The present study first revealed that VK2 intervention also alleviated plasma non-esterified fatty acid levels that contribute to obesity-induced IR, VK2 administration also could effectively increase the proportion of slow-twitch fibers by improving mitochondrial function via SIRT1 signaling pathway in both HFD-fed mice and PA-exposed cells. However, the benefits of VK2 were abrogated in C₂C₁₂ transfected with SIRT1 siRNA in PA-treated C₂C₁₂ cells. Thus, SIRT1 is partially required for VK2 improvement the proportion of slow-twitch fiber in PA-treated C₂C₁₂ cells.

CONCLUSION

Naturally occurring VK2 increases slow-twitch fibers by improving mitochondrial function and decreasing non-esterified fatty acid levels via partially SIRT1/SIRT3 signaling pathway. These data have potential importance for the therapy for a number of muscular and neuromuscular diseases in humans.

The Dual Role of Vitamin K2 in "Bone-Vascular Crosstalk": Opposite Effects on Bone Loss and Vascular Calcification

Osteoporosis (OP) and vascular calcification (VC) represent relevant health problems that frequently coexist in the elderly population. Traditionally, they have been considered independent processes, and mainly age-related. However, an increasing number of studies have reported their possible direct correlation, commonly defined as “bone-vascular crosstalk”. Vitamin K2 (VitK2), a family of several natural isoforms also known as menaquinones (MK), has recently received particular attention for its role in maintaining calcium homeostasis. In particular, VitK2 deficiency seems to be responsible of the so-called “calcium paradox” phenomenon, characterized by low calcium deposition in the bone and its accumulation in the vessel wall. Since these events may have important clinical consequences, and the role of VitK2 in bone-vascular crosstalk has only partially been explained, this review focuses on its effects on the bone and vascular system by providing a more recent literature update. Overall, the findings reported here propose the VitK2 family as natural bioactive molecules that could be able to play an important role in the prevention of bone loss and vascular calcification, thus encouraging further in-depth studies to achieve its use as a dietary food supplement.

Hepatic lipidosis in fattening turkeys: A review

The conditions on turkey fattening farms, including management, housing, and feeding, have been constantly improved recently in favour of animal health. Many studies deal scientifically with poultry health. However, specifically concerning liver health, there are still open questions regarding the influence of dietary factors on the metabolism and function of the liver. Consideration of the factors that could influence and alter liver metabolism is therefore of critical relevance. The liver, as a major metabolic organ, is the main site of fat synthesis in turkeys. Under certain conditions, fat can excessively accumulate in the liver and adversely affect the birds’ health. The so-called hepatic lipidosis (HL) in fattening turkeys has been known for years. This disease has unacceptable economic and animal welfare impacts, with high animal losses up to 15% within only a few days. To date, little is known about the causes and the metabolic changes in fattening turkeys leading to HL despite the increasing focus on health management and animal welfare. To understand what is different in turkeys compared to other species, it is necessary to discuss the metabolism of the liver in more detail, including HL-associated gross and microscopic lesions. In the current review, aspects of liver structure and lipid metabolism with special regard to lipogenesis are explained to discuss all dietary factors attributing to the development and prevention of HL. As part of the prevention of the HL, dietetics measures can be helpful in the future.

Effect of Vitamin E Supplementation on Deposition and Gene Expression Profiling of Abdominal Fat in Broiler Chickens

The aim of this study was to study the regulation of abdominal fat deposition by DL-α-tocopherol acetate (vitamin E) in broilers. Diets supplemented with 50 IU vitamin E significantly diminished abdominal fat deposition in broilers at day 35. Transcriptome sequencing results for abdominal fat tissues of the control (FC) and 50 IU vitamin E-supplemented (FT) groups identified 602 differentially expressed genes (DEGs), which were enriched in cellular process, cell and cell part, and binding Gene Ontology terms. Pathway functional analysis revealed that the DEGs were enriched in 42 metabolic pathways. Notably, the most enriched pathway, fatty acid biosynthesis, was found to play a key role in lipid metabolism. Further, the key regulators of lipid metabolism, including fatty acid synthase, acetyl-CoA carboxylase alpha, and acyl-CoA synthetase long-chain family member 1, demonstrated decreased expression following vitamin E supplementation. Herein, we have identified pathways and genes regulated by vitamin E, thereby providing novel insights into the nutrients regulating abdominal fat deposition in broilers.

Use and abuse of dietary supplements in persons with diabetes

The dietary supplement industry has estimated sales of over $30 billion in the US and over $100 billion globally. Many consumers believe that dietary supplements are safer and possibly more effective than drugs to treat diabetes. The sheer volume of the literature in this space makes compiling them into one review challenging, so much so that primarily narrative reviews currently exist. By applying the interactive database supplied by the Office of Dietary Supplements at the National Institutes of Health, we identified the top 100 ingredients that appeared most often in dietary supplement products. One-hundred different keyword searches using the ingredient name and the word diabetes were performed using a program developed to automatically scrape PubMed. Each search was retained in a separate Excel spreadsheet, which was then reviewed for inclusion or exclusion. The studies that met the inclusion criteria were evaluated for effect of reducing and controlling diabetes. The PubMed scrape resulted in 6217 studies. For each keyword search only the most recent 100 were retained, which refined the total to 1823 studies. Of these 425 met the screening criteria. The ingredients, fiber, selenium and zinc had the most studies associated with improvement in diabetes. Several popular supplement ingredients (phosphorus, pantothenic acid, calcium, magnesium, glutamine, isoleucine, tyrosine, choline, and creatine monohydrate) did not result in any studies meeting our screening criteria. Our study demonstrates how to automate reviews to filter and collapse literature in content areas that have an enormous volume of studies. The aggregated set of studies suggest there is little clinical evidence for the use of dietary supplements to reduce or control diabetes.

Circulating vitamin E and cardiometabolic measures: a Mendelian randomization analysis

Although a large body of literature reported that high intake of vitamin E played a possible role in reducing risk of cardiometabolic diseases, conflicting results were also found in some observational studies due to confounding factors. Hence, we used a Mendelian randomization study as an alternative way to examine the causality between circulating vitamin E and cardiometabolic diseases. Summary-level data were extracted from consortia and three single nucleotide polymorphisms were used as instrumental variables. Our study showed that a one-SD increase in circulating vitamin E levels was causally associated with an increased risk of coronary artery disease [odds ratio (OR) 3.16 (95%CI 1.74, 5.73); p = 1.91 × 10^-3] at the Bonferroni-adjusted level of significance (p<0.005). Moreover, a one-SD increase in circulating vitamin E levels was associated with a 0.572-SD increase in low density lipoprotein cholesterol (mg/dl), a 0.693-SD increase in total cholesterol (mg/dl), and a 1.45-SD increase in triglyceride (mg/dl), but a 0.502-SD decrease in high density lipoprotein cholesterol (mg/dl) at the Bonferroni-adjusted level of significance (p<0.0028). Our findings indicated that genetically elevated vitamin E was associated with increased risk of coronary artery disease, suggesting an adverse causality between circulating vitamin E and coronary artery disease.

Daily consumption of fruit-flavored yoghurt enriched with vitamins B contributes to lower energy intake and body weight reduction, in type 2 diabetic patients: a randomized clinical trial

Fruit-yoghurt enriched with vitamins B promotes body weight reduction and improves vitamin B status and homocysteine levels in T2DM patients.

Nutraceuticals and Diet-based Phytochemicals in Type 2 Diabetes Mellitus: From Whole Food to Components with Defined Roles and Mechanisms

BACKGROUND

Over the past decades, the development and use of an array of prescription medications have considerably improved the clinical management of type 2 diabetes mellitus and the quality of life of patients. However, as our knowledge of the associated risk factors and approaches to its management increases, the increasing roles of diet and the composition of the diet in the etiology and successful management of diabetes mellitus are being illuminated. Presently, a lot of attention is being given to nutraceuticals and certain phytochemicals that are integral parts of the human diet. It is believed that a clearer understanding of their roles may be crucial to 'non-invasive' or minimallyintrusive management, with regards to daily living of patients. In this review, an overview of nutraceutical components and phytochemicals that may be of benefit, or had been known to be beneficial in diabetes mellitus is given. Also, how the roles of such dietary components are evolving in the management of this disorder is highlighted. Lastly, the obstacles that need to be overcome before nutraceuticals can be considered as options for the clinical management of diabetes mellitus areconsidered.

CONCLUSION

Despite studies that demonstrate their efficacy, no nutraceutical or food-derived compound has been formally adopted as a direct replacement for any class of antidiabetic drugs.

The How-To for Type 2: An Overview of Diagnosis and Management of Type 2 Diabetes Mellitus

This article presents an overview of type 2 diabetes diagnosis and management. A brief discussion of epidemiology, including incidence, prevalence, and etiology, provides the basis for the importance of the discussion. The review then proceeds to outline diagnostic criteria and follow-up monitoring guidelines. Recommendations for evidence-based lifestyle measures and current pharmacologic options are addressed. A priority on individualized, holistic care with patient-specified goals and the management of comorbidities is emphasized.