Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jun 15, 2023; 14(6): 919-929
Published online Jun 15, 2023. doi: 10.4239/wjd.v14.i6.919
Insights on antioxidant therapeutic strategies in type 2 diabetes mellitus: A narrative review of randomized control trials
Dharmsheel Shrivastav, Pradeep Kumar Dabla, Jitender Sharma, Aroop Viswas, Rashid Mir
Dharmsheel Shrivastav, Amity Institute of Biotechnology, Amity University Rajasthan, Jaipur 303002, India
Pradeep Kumar Dabla, Jitender Sharma, Aroop Viswas, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Delhi 110002, India
Rashid Mir, Department of Medical Lab Technology, Faculty of Applied Medical Sciences, University of Tabuk, Tabuk 71491, Saudi Arabia
Author contributions: Shrivastav D conceptualized the study, retrieved the articles, analyzed the data, tabulated the findings, and drafted and proofread the manuscript; Dabla PK and Sharma J reviewed the data, analyzed the information, guided the inclusion of information, and drafted and proofread the manuscript; Viswas A helped in information retrieval and inclusion of findings; Mir R provided intellectual inputs and proofread the manuscript; Dabla PK conceived & guided the study, provided intellectual inputs, guided the inclusion of information, proofread at all steps, and approved the final version of the manuscript; and all authors contributed to and approved the submitted version.
Conflict-of-interest statement: The authors declare no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Pradeep Kumar Dabla, MD, Professor, Department of Biochemistry, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, Geeta Colony Road, Delhi 110002, India. pradeep_dabla@yahoo.com
Received: December 19, 2022
Peer-review started: December 19, 2022
First decision: January 5, 2023
Revised: January 11, 2023
Accepted: May 11, 2023
Article in press: May 11, 2023
Published online: June 15, 2023
ARTICLE HIGHLIGHTS
Research background

Type 2 diabetes mellitus (T2DM) is a condition that affects how the glucose is metabolized for energy. When there is an imbalance between the creation and removal of free radicals, oxidative stress can occur, which affects how the body regulates glucose and insulin, leading to the development and worsening of diabetes and related complications. Taking antioxidant supplements may be a promising way to prevent and treat T2DM.

Research motivation

T2DM is a chronic metabolic disorder with increasing prevalence worldwide, and oxidative stress is implicated in its complications. Antioxidants may counteract this process and can help in improving the metabolic pathways.

Research objectives

To review the current evidence on the role of oxidative stress in the pathogenesis of T2DM and to evaluate the effectiveness of antioxidants as a potential therapy for managing diabetes and its complications.

Research methods

We systematically searched the electronic database PubMed by keywords. Randomized control trials (RCTs) evaluating the effect of antioxidant therapy on glycemic control and oxidant and antioxidant status as primary outcomes were included. The outcomes considered were: A reduction in blood glucose; changes in oxidative stress and antioxidant markers. Full-length papers of the shortlisted articles were assessed for the eligibility criteria and 17 RCTs were included.

Research results

The administration of fixed-dose antioxidants significantly reduced fasting blood sugar and glycated hemoglobin, and was associated with decreased malondialdehyde and advanced oxidation protein products and increased total antioxidant capacity.

Research conclusions

The modern lifestyle and environmental factors can contribute to oxidative stress, which plays a significant role in the development of metabolic disorders such as pre-obesity, obesity, and T2DM. The use of antioxidants through a balanced diet and/or supplementation can reduce oxidative stress, which may mitigate the development and complications of T2DM. Antioxidants can also reduce low-grade inflammation associated with various diseases. Further follow-up research is needed to determine the optimal timing and dosage of antioxidant therapy for diabetic patients.

Research perspectives

Future research should focus on identifying new antioxidants and their mechanisms of action in reducing oxidative stress and preventing or managing T2DM. Additionally, studies on the effectiveness of antioxidant supplementation in combination with other therapies, such as exercise and medication, should be conducted. Further investigation is also needed to determine the optimal timing and dosage of antioxidant supplementation for diabetes prevention and treatment.