The effects of vitamin C supplementation on glycemic control in patients with type 2 diabetes: A systematic review and meta-analysis

Nosratabadi, Saeed; Ashtary‐Larky, Damoon; Hoseini, Fatemeh; Namkhah, Zahra; Mohammadi, Shooka; Salamat, Shekoufeh; Nadery, Maryam; Yarmand, Sazin; Zamani, Mohammad; Asbaghi, Omid

doi:10.1016/j.dsx.2023.102824

Cited by 9 publications

(4 citation statements)

References 39 publications

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“…Since higher dietary intakes and circulating concentrations of vitamin C have been associated with a lower risk of diabetes morbidity and mortality [6,7], increasing vitamin C intake in people with diabetes to account for their higher requirements may help attenuate the progression of the disease to more severe complications. In support of this premise, meta-analyses of intervention studies have indicated that supplementation with vitamin C can improve dysregulated glycaemic and lipid markers and cardiovascular risk factors in people with diabetes [33][34][35]. Furthermore, preliminary research has indicated the potential benefit of vitamin C in diabetic foot disease [36,37].…”

Section: Discussionmentioning

confidence: 96%

Estimating Vitamin C Intake Requirements in Diabetes Mellitus: Analysis of NHANES 2017–2018 and EPIC-Norfolk Cohorts

Carr,

Lunt,

Wareham

et al. 2023

Antioxidants

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Vitamin C is an essential enzyme cofactor and antioxidant with pleiotropic roles in human physiology. Circulating vitamin C concentrations are lower in people with diabetes mellitus, suggesting a higher dietary requirement for the vitamin. We interrogated the NHANES 2017–2018 and EPIC-Norfolk datasets to compare vitamin C requirements between those with and without diabetes mellitus using dose–concentration relationships fitted with sigmoidal (four-parameter logistic) curves. The NHANES cohort (n = 2828 non-supplementing adults) comprised 488 (17%) participants with diabetes (self-reported or HbA1c ≥ 6.5%). The participants with diabetes had a lower vitamin C status (median [IQR]) than those without (38 [17, 52] µmol/L vs. 44 [25, 61] µmol/L, p < 0.0001), despite comparable dietary intakes between the two groups (51 [26, 93] mg/d vs. 53 [24, 104] mg/d, p = 0.5). Dose–concentration relationships indicated that the group without diabetes reached adequate vitamin C concentrations (50 µmol/L) with an intake of 81 (72, 93) mg/d, whilst those with diabetes required an intake of 166 (126, NA) mg/d. In the EPIC-Norfolk cohort, comprising 20692 non-supplementing adults, 475 (2.3%) had self-reported diabetes at baseline. The EPIC cohort had a lower BMI than the NHANES cohort (26 [24, 28] kg/m2 vs. 29 [25, 34] kg/m2, p < 0.0001). Correspondingly, the EPIC participants without diabetes required a lower vitamin C intake of 64 (63, 65) mg/d while those with diabetes required 129 (104, NA) mg/d to reach adequate circulating vitamin C status. C-reactive protein concentrations were strongly correlated with body weight and BMI and provided a surrogate biomarker for vitamin C requirements. In conclusion, people with diabetes had 1.4 to 1.6 fold higher requirements for vitamin C than those without diabetes. This corresponds to additional daily vitamin C intake requirements of ~30–40 mg for people with diabetes, equating to a total daily intake of at least 125 mg/d.

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Section: Discussionmentioning

confidence: 96%

Estimating Vitamin C Intake Requirements in Diabetes Mellitus: Analysis of NHANES 2017–2018 and EPIC-Norfolk Cohorts

Carr,

Lunt,

Wareham

et al. 2023

Antioxidants

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“…It has been indicated that incorporating antioxidant-rich foods into the diet may enhance the treatment of patients with T2DM [103]. Given the antioxidant properties of SIL, it is hypothesized that it may be particularly effective in improving CVD risk factors; however, further evidence is required to fully support this assertion.…”

Section: Discussionmentioning

confidence: 99%

Impacts of Supplementation with Silymarin on Cardiovascular Risk Factors: A Systematic Review and Dose–Response Meta-Analysis

Mohammadi,

Asbaghi,

Afrisham

et al. 2024

Antioxidants

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It has been suggested that silymarin (SIL) supplementation has positive effects on cardiovascular health and reduces the risk of cardiometabolic syndrome (CMS). This systematic review and dose–response meta-analysis assessed the impacts of SIL administration on cardiovascular risk factors. A systematic search of multiple databases was performed to identify eligible controlled trials published up to January 2023. The analysis used a random-effects model and included 33 trials with 1943 participants. It was revealed that SIL supplementation led to a notable reduction in serum levels of fasting blood glucose (FBG) (weighted mean difference (WMD): −21.68 mg/dL, 95% CI: −31.37, −11.99; p < 0.001), diastolic blood pressure (DBP) (WMD: −1.25 mmHg; 95% CI: −2.25, −0.26; p = 0.013), total cholesterol (TC) (WMD: −13.97 mg/dL, 95% CI: −23.09, −4.85; p = 0.003), triglycerides (TG) (WMD: −26.22 mg/dL, 95% CI: −40.32, −12.12; p < 0.001), fasting insulin (WMD: −3.76 mU/mL, 95% CI: −4.80, −2.72; p < 0.001), low-density lipoprotein (LDL) (WMD: −17.13 mg/dL, 95% CI: −25.63, −8.63; p < 0.001), and hemoglobin A1C (HbA1c) (WMD: −0.85%, 95% CI: −1.27, −0.43; p < 0.001) in the SIL-treated groups compared to their untreated counterparts. In addition, there were no substantial differences in body mass index (BMI), systolic blood pressure (SBP), C-reactive protein (CRP), body weight, and high-density lipoprotein (HDL) between the two groups. These outcomes suggest that SIL consumption reduces certain CMS risk factors and has favorable impacts on lipid and glycemic profiles with potential hypotensive effects. These findings should be supported by additional trials with larger sample sizes and longer durations.

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“…The antioxidative properties of vitamins E and C as well as Se and Zn may ameliorate the inflammation of adipocytes that is thought to contribute to insulin resistance [57,[97][98][99]115]. Furthermore, the role of selenoproteins in the regulation of cellular functions and of Zn in the insulin-signaling pathway and clearance were mentioned in the literature as important mechanisms that could help to explain the effects of supplementation with these minerals on glucose metabolism [99,126].…”

Section: Effects Of Micronutrient Supplementation On Glucose Homeostasismentioning

confidence: 99%

“…The effects of some of the micronutrients on glucose homeostasis were dosedependent. The doses recommended in meta-analyses to achieve optimal effects were ≥4000 IU/day for vitamin D [89], between 400 and 700 mg/day for vitamin E [57], ≥1000 mg/day for vitamin C [115], ≥5 mg/day for vitamin B9 [116], 200 µg/day for Se [118], and ≥30 mg for Zn [119].…”

Section: Effects Of Micronutrient Supplementation On Glucose Homeostasismentioning

confidence: 99%

The Importance of Micronutrient Adequacy in Obesity and the Potential of Microbiota Interventions to Support It

Rudzka,

Kapusniak,

Zielińska

et al. 2024

Applied Sciences

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Micronutrient deficiencies co-occur with obesity throughout the world. While many factors may contribute to this, microbiota dysbiosis is certainly one that has received a lot of attention in recent years. This work aimed to review the current state of knowledge on the role of micronutrients in obesity and the effects of interventions in microbiota on the micronutrient status of humans. Gathered evidence suggested that the supplementation of most of the deficient micronutrients for people with excess weight may have a considerable, positive impact on lipid and glucose homeostasis and a small effect on weight loss. Interestingly, the doses of micronutrient supplementation that allowed for achieving the best results for most of the minerals and vitamins exceeded the tolerable upper intake levels. To avoid negative effects associated with an overdose of vitamins and minerals, applying microbiota interventions could be considered. Pro- and prebiotics were shown to improve the micronutrient status of humans, and several publications indicated that when applied together with vitamins and minerals, they could give greater benefits than each of these treatments alone. Therefore, supplementation with vitamins, minerals, and pro/pre/synbiotics in obesity treatment plans may be recommended; however, further research is required to mitigate risks and optimize the effects achieved.

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The effects of vitamin C supplementation on glycemic control in patients with type 2 diabetes: A systematic review and meta-analysis

Cited by 9 publications

References 39 publications

Estimating Vitamin C Intake Requirements in Diabetes Mellitus: Analysis of NHANES 2017–2018 and EPIC-Norfolk Cohorts

Estimating Vitamin C Intake Requirements in Diabetes Mellitus: Analysis of NHANES 2017–2018 and EPIC-Norfolk Cohorts

Impacts of Supplementation with Silymarin on Cardiovascular Risk Factors: A Systematic Review and Dose–Response Meta-Analysis

The Importance of Micronutrient Adequacy in Obesity and the Potential of Microbiota Interventions to Support It

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