Issue 122 Item 9 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.