Diabetes mellitus is an epidemic that is gaining global concern. Chronic hyperglycemia in diabetes induces the excess production of free radicals. The deleterious effects of excess free radicals are encountered by endogenous antioxidant defense system. Imbalance between free radicals production and antioxidants defense mechanisms leads to a condition known as "oxidative stress". Diabetes mellitus is associated with augmented oxidative stress that induced micro-and macrovascular complications, which presents a significant risk for cardiovascular events. Low vitamin D levels in the body have also been reported to be associated with the pathogenesis of diabetes and enhanced oxidative stress. The article is to review available literature and summarize the relationship between oxidative stress and vitamin D levels in diabetes. We also review the effects of vitamin D analogs supplementation in improving oxidative stress in diabetics.
Microvascular endothelial function was significantly reduced in diabetic nephropathy patients with deficient vitamin D levels compared with those with nondeficient levels.
Alfacalcidol did not have an effect on microvascular endothelial function in DN patients. Alfacalcidol significantly improved CSBP with trends of improvement in arterial stiffness and peripheral BP. Alfacalcidol appears to be more beneficial in vitamin D-deficient patients.
Vitamin D is known to play a crucial role in mineral homeostasis and bone metabolism. Recent discoveries showed that the vitamin also regulate the inflammatory mediators. A number of studies have reported on the association of low vitamin D levels with increased level of inflammatory parameters; which predisposes to atherosclerosis and development of cardiovascular diseases (CVD). Since inflammation is implicated in the pathogenesis of CVD, measurement of inflammatory marker levels has been proposed as a method to improve the prediction of these events. In this review, the mechanism of inflammation and role of vitamin D in combating inflammation are discussed
Objectives
To assess microvascular reactivity and glycemic parameters in GDM compared to age and GA matched controls.
Methods
This study involved 21 GDM patients and 31 controls. Microvascular reactivity was assessed using LDF and PORH. Microvascular parameters; PORHmax, PORHpeak, and time to peak perfusion (Tp) were recorded after the release of 3 minutes’ upper arm occlusion. HOMA‐IR was performed to evaluate insulin resistance.
Results
Average age and GA for subjects were 32.9 years and 29.2 weeks. Mean FBG and a 2‐hour postprandial for GDM and controls were 4.87 ± 0.71 vs 3.99 ± 0.59 mmol/L; P < 0.001 and 9.50 ± 1.8 vs 5.67 ± 1.0 mmol/L; P < 0.001. Fasting insulin (13.88 ± 18.9 vs 8.37 ± 11.0 μLU/mL; P = 0.031) and HOMA‐IR (3.14 ± 4.6 vs 1.52 ± 2.2; P = 0.004) were higher in GDM. Tp was prolonged in GDM (16.27 ± 4.3 vs 13.86 ± 2.1 seconds; P = 0.011). Positive correlations were seen between Tp and FBG and 2‐hour postprandial levels.
Conclusion
Tp was prolonged in GDM compared to age‐matched controls, indicating impaired microvascular reactivity.
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