Therapeutic effects of dietary antioxidative supplements on the management of type 2 diabetes and its complications; umbrella review of observational/trials meta-analysis studies

Ozra Tabatabaei-Malazy; Maryam Peimani; Shahrzad Mohseni; Shekoufeh Nikfar; Mohammad Abdollahi; Bagher Larijani

doi:10.1007/s40200-022-01069-1

Therapeutic effects of dietary antioxidative supplements on the management of type 2 diabetes and its complications; umbrella review of observational/trials meta-analysis studies

J Diabetes Metab Disord. 2022 Jun 20;21(2):1833-1859. doi: 10.1007/s40200-022-01069-1. eCollection 2022 Dec.

Authors

Ozra Tabatabaei-Malazy^{1

2}, Maryam Peimani³, Shahrzad Mohseni², Shekoufeh Nikfar^{2

4

5

6}, Mohammad Abdollahi^{2

4

7

8}, Bagher Larijani²

Affiliations

¹ Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
² Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
³ Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁴ Personalized Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
⁵ Evidence-Based Evaluation of Cost-Effectiveness and Clinical Outcomes Group, Pharmaceutical Sciences Research Center (PSRC), Tehran University of Medical Sciences, Tehran, Iran.
⁶ Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy and Pharmaceutical Policy Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁷ Toxicology and Diseases Group, Pharmaceutical Sciences Research Center, Tehran University of Medical Sciences, Tehran, Iran.
⁸ Department of Toxicology and Pharmacology, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Controversial data on the effects of vitamins (V) and nutrients on the management of type 2 diabetes mellitus (T2DM) is available. Thus, it is aimed to clarify the role of vitamins and nutrients through an umbrella review regarding the available observational/ trials meta-analyses.

Methods: All meta-analyses of observational and clinical trials conducted on the impact of vitamins and nutrients in T2DM published until 5^th June 2021 in PubMed or Web of Sciences were included in this review. Also, the meta-analysis on children, pregnant women, type 1 DM, or in vivo/in vitro studies was excluded. Search results were reported according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis (PRISMA) flowchart.

Results: The overall of 93 papers (99 studies) consisting of 75 trials and 24 observational studies were included. Most studies were conducted on the effect of VD and alpha-lipoic acid (ALA) in both genders. Consumption of VD or its analogous; 20 IU/d to 450,000 IU/once for 3 weeks to 7 years showed to have a positive effect on the parameters of glucose hemostasis. Moreover, an inverse association was observed between VD level and T2DM risk. Daily consumption of 1200 mg VC for at least 12 weeks improved lipid profile and glucose hemostasis parameters. Furthermore, VB and medications for diabetic polyneuropathy (DPN) increased nerve conduction velocity. Vitamins K and E were showen to not have significant impact on T2DM. ALA had a beneficial effect on DPN symptoms after 2-4 weeks of intake of at least 300 mg/d. T2DM risk was reduced by doubling ALA intake. The effective daily doses of chromium, zinc and coenzyme Q10 on lipid profile and glucose hemostasis parameters were > 200 mg, < 25 mg, and < 200 mg, respectively.

Conclusion: This umbrella review suggests that dietary vitamins and nutrients can result in protective impacts the complications associated with T2DM. However, due to discrepancies between the results of the trials and observational studies is essential to conduct long-term high-qualified studies to prove the beneficial therapeutic effects of the vitamins and nutrients on T2DM and its complications.

Keywords: Antioxidants; Diabetes complications; Diabetes mellitus; Dietary supplements; Umbrella review.

Publication types

Review