Antioxidant
Vitamins Helpful in Diabetic Ketoacidosis Treatment
Administering
antioxidant vitamins during treatment of diabetic ketoacidosis may
minimize oxidative stress and associated complications.
That,
according to researchers at the University of Oklahoma, Oklahoma City,
and other centers.
Dr.
Diana M. Lee and colleagues note that oxidative stress "plays an
important role in the chronic complications of insulin-dependent
diabetes mellitus." Both hyperketonemia as well as hyperglycemia
can lead to an increase in oxygen-derived free radicals, they say.
To
investigate oxidative stress, before, during and after treatment for
diabetic ketoacidosis, the researchers studied 6 patients with the
condition. The findings appear in the July- August issue of the
Journal of Diabetes and its Complications.
Cholesteryl
ester ratios were used as a marker of oxidative stress based on the
rationale that longer chain fatty acids are more susceptible to
peroxidative damage than shorter chain fatty acids, the researchers
explain. Lower ratios of longer to shorter chain esterified fatty
acids indicates greater loss of polyunsaturated fatty acids to
oxidative damage.
The
ratio of C20 to C16 fatty acids at 120 hours post-treatment was
significantly decreased in comparison with values at pretreatment and
at 6 to 8 and 24 hours. The ratio of C18 to C16 was also decreased in
comparison with the ratio at 6 to 8 hours, indicating "an
increase in lipid peroxidation after correction of diabetic
ketoacidosis," the investigators say.
Evaluation
of plasma levels of the antioxidant vitamins A, C and E showed that
vitamin A was below normal at pretreatment and increased at 120 hours.
Vitamin C was normal at pretreatment and fell to low normal at 24
hours. Although the difference was not significant, vitamin E was
normal at pretreatment and decreased to below normal at 24 and 120
hours.
In
light of these findings, the researchers conclude that administering
antioxidant vitamins during such treatment "could be beneficial
in minimizing oxidative stress and possibly both the acute and chronic
complications of insulin-dependent diabetes mellitus." J
Diabetes Complications 2002;16:294-300.
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