TYPE 2 DIABETES MELLITUS

ANTIOXIDANT STATUS IN PATIENTS WITH VARIATION IN DURATION

Abstract

Objectives: To access the Antioxidant Status in Patient with Variation in Duration
of Type 2 Diabetes Mellitus. Data source: 90 selected patients suffering from Type 2 Diabetes
Mellitus (DM) and 30 subjects as control group. Design of study: Case Control Study. Setting:
Rawal Institute of Health Sciences, Islamabad. Period: July 2013 – March 2014. Materials
& methods: Out of 120 selected subjects, 90 were of DM type 2and 30 were assigned as
control group (group 1). Based on duration, patients of DM type 2 were divided into; group
2, 3 and 4; group 2 – patients with DM (type 2) duration less than 5 years, group 3 - with DM
duration between 5-10 years and group 4 - with duration of DM more than 10 years. Smokers,
renal failure, coronary artery disease, thyroid disease and previous antioxidant treatment
patients were excluded from the study. Diabetes mellitus type 2 was diagnosed according to
the standards set by American Diabetes Association. The fasting plasma glucose levels were
measured by glucose oxidase method; HbA1c by automated kit on Cobas Integra of Roche.
The TAC was measured by calorimetric TAC Assay Kit (BioVision) while Vitamin C and E were
measured by using ELISA Kit (HUMAN). Cut off values for HbA1c was taken as ≤6%; FBS
≤110 mg/dl; TAC ≥1.16 mmol/L; Vitamin C ≥2 mg/dl; Vitamin E ≥ 9.5nmol/ml. Results: As
the duration of type 2 diabetes increases, it was seen that vitamin C levels and TAC levels in
all groups except between groups 1 & 2 decreased significantly; however, anti-oxidant vitamin
E, was found to be significantly decreased in all the groups as the duration increases. A
significantly increased level of HbA1c were noticed in groups 2, 3 and 4 as compared to group
1 as the duration of diabetes increases; however, the levels were found to be non-significant
when group 4 was compared with that of group 2 and group 3. When fasting blood sugar
was compared between the diabetic groups a significant increased levels were noticed in all
the groups with the exception between group 3 and 4. A significant differences between each
group and within the groups was observed when Hb1Ac, vitamin E, vitamin C, &TAC were
compared using ANOVA. A statistical significant correlation was observed when HbA1c was
correlated with FBS; however, it shows an inverse relationship with TAC, vitamin C and vitamin
E. A significant inverse correlation of FBS was noticed with TAC, vitamin C, and vitamin E. A
significant positive correlation was seen when TAC was correlated with vitamin C and vitamin E.
A similar trend of significant positive correlation was seen when vitamin C was correlated with
vitamin E. Conclusions: The levels of total anti-oxidant capacity, vitamin C, and vitamin E
gradually decrease with duration of diabetes and are associated with oxidative stress. These
antioxidant vitamins (vitamin C and vitamin E) should be supplemented in diabetics to increase
their quality of life. TAC status may be taken as early marker to detect complications in diabetic
type 2 patients especially of longer duration.