Impact of Vitamin C as an Adjuvant Agent on Glycemic Indices in Type 2 Diabetes Mellitus: Randomized Clinical Trial

Authors

  • Shabzain Ishrat
  • Talea Hoor
  • Muhammad Sajid Abbas Jaffri
  • Shizma Junejo
  • Mehreen Lateef

DOI:

https://doi.org/10.51985/MYDD5410

Keywords:

Correlation, Fasting blood sugar, HbA1c, Random blood sugar, Type 2 diabetes mellitus, Vitamin C.

Abstract

Objectives: To evaluate the effects of adjuvant vitamin C therapy with oral hypoglycemic on FBS, RBS and HbA1c and
to find out the correlation of Vitamin C with glycemic indices.
Study Design & Settings: This randomized open label clinical trial was conducted at Bahria University Medical & Dental
College (BUMDC) in collaboration with NMC, Karachi from October 2018 to April 2019.
Methodology: A total of 160 known type -2 males and females, uncomplicated diabetics, aged 40-65 years with FBS=
200 mg/dl, HbA1c = 8.5% and diabetes duration > 5years were enrolled from diabetic clinic of NMC after written informed
consent. They were divided into control group and treatment group by sealed envelope technique. Control group received
oral hypoglycemic drugs while treatment group received vitamin C 500 mg per orally BD with oral hypoglycemic drugs
with advice of diet control and daily exercise. Patients were subjected to FBS, RBS and HbA1c at baseline and at the end
of 90 days. SPSS version 23.0 was used for data analysis.
Results: In control group FBS and RBS reduced by1mg /dl and 7mg/dl from day-0 to 90. In treatment group FBS reduced
by 14mg/dl and RBS reduced by 21mg/dl from day-0 to 90. HbA1c increased by 0.7% in control group and decreased
by 0.4 % in treatment group at the end of 90 days. Negative correlation is observed between Vitamin C and glycemic
indices.
Conclusion: Adjuvant vitamin C therapy with oral hypoglycemic drugs in type-2 diabetics reduced FBS, RBS and HbA1c
and exhibited negative correlation with glycemic parameters.

References

Sin YT, Joyce LMW, Yan JS, Su SW, Safa AME, Sean HT et al. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2018; 13(1): 364-372. doi: 10.1016/j.dsx.2018.10.008.

Jay SS, George LB, Ezio B, Tamara D, Robert HE, Leif G et al.. Differentiation of Diabetes by pathophysiology, natural history, and prognosis. Diabetes 2017; 66: 241-255. doi: 10.2337/db16-0806

Steven EK, Mark EC, Stefano DP. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet 2014; 383: 1068-83. doi: 10.1016/S0140-6736(13)62154-6.

Susanna D, Parinya C. The double burden of diabetes and global infection in low and middle income countries. Trans R Soc Trop Med Hyg 2019; 113: 56-64. doi: 10.1093/trstmh/try124.

American Diabetes Association. Classification and diagnosis of Diabetes: Standards of medical care in Diabetes 2020. Diabetes Care 2020; 43(Suppl. 1): S14-S31. https://doi.org/10.2337/dc20-S002

Paul ZZ, Dianna JM, William HH, Jonathan ES. Diabetes: a 21st century challenge. Lancet Diabetes Endocrinol 2014; 2: 56-64. doi: 10.1016/S2213-8587(13)70112-8.

Yanling W, Yanping D, Yoshimasa T, Wen Z. Risk factors contributing to type 2 Diabetes and recent advances in the treatment and prevention. Int J Med Sci 2014; 11(11): 1185-1200. doi: 10.7150/ijms.10001

Yan Z, Sylvia HL, Frank BH. Global aetiology and epidemiology of type 2 diabetes mellitus and its complications. Nature Reviews 2018; 14: 88-98. doi: 10.1038/nrendo.2017.151.

Asima Z, Attya B, Fazal J, Xingbin W, Peter J, Aysha K et al. Prevalence of type 2 diabetes–associated complications in Pakistan. International Journal of Diabetes in Developing Countries 2015; 36(2): 179-188. Doi 10.1007/s13410-015-0380-6

Sultan AM, Inam Z, Ishfaq AB, Shoukat AA. Type 2 diabetes mellitus in Pakistan: Current prevalence and future forecast. J Pak Med Assoc 2016; 66(12): 1637-1642.

Konstantinos P, Maciej B, Eleni B, Manfredi R, Michael E. Complications of Diabetes 2017. Journal of Diabetes Research 2018; 2018. Available from https://doi.org/10.1155/2018/3086167 Accessed on: 31-10-2020

Charles F, Alexandra K, Konstantinos I, Pavlos D, Manolis K, Kiriakos D. Microvascular complications of type 2 Diabetes Mellitus. Current Vascular Pharmacology 2020; 18(2): 117-124. Doi 10.2174/1570161117666190502103733

Shakir K, Abdul KN, Faizania S, Tausif AR, Muhammad JY. Oxidative stress in patients with type 2 Diabetes Mellitus. Journal of Rawalpindi Medical College 2014; 18(1): 29-31.

Surapon T. Oxidative stress, insulin resistance, dyslipidemia and type 2 diabetes mellitus. World Journal of Diabetes 2015; 6(3): 456-480. doi: 10.4239/wjd.v6.i3.456.

Asmat U, Abad K, Ismail K. Diabetes mellitus and oxidative stress––A concise review. Saudi Pharmaceutical Journal 2016; 24: 547-553. doi: 10.1016/j.jsps.2015.03.013.

Renée W, Jinny W, Richard G, Paula S, Elizabeth F, Chris F et al. Inadequate Vitamin C status in prediabetes and type 2 Diabetes Mellitus: Associations with glycaemic control, obesity and smoking. Nutrients 2017; 9(997): doi:10.3390/nu9090997

Abolfazl A, Gholamali J, Saeed N, Javad S. An overview of the characteristics and function of Vitamin C in various tissues: Relying on its antioxidant function. Zahedan J Res Med Sci 2016; 18(11): e4037. Doi: 10.17795/zjrms-4037

Andrzej G, Krzysztof P. Albert Szent-Györgyi (1893-1986): The scientist who discovered vitamin C. Clinics in Dermatology 2013; 31: 327-331. doi: 10.1016/j.clindermatol.2012.08.001.

Sudha JD, Reshma LR. Vitamin C: Sources, functions, sensing and analysis. Intech Open 2017. Available from http://dx.doi.org/10.5772/intechopen.70162

Ali AE, Eman AAE, Asmaa AG, Mohammed RZ, Mahmoud MS. The effect of vitamin C and/or E supplementations on type 2 diabetic adult males under metformin treatment: A single-blinded randomized controlled clinical trial. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 2018; Available from https://doi.org/10.1016/j. dsx.2018.03.013

Mason SA, Bodil R, Luc JCL, Jo S, Glenn DW. Ascorbic acid supplementation improves postprandial glycaemic control and blood pressure in individuals with type 2 diabetes: Findings of a randomized cross-over trial. Diabetes Obes Metab 2019;21(3):674-685. DOI: 10.1111/dom.13571.

Gillani SW, Syed ASS, Mohi IMA, Mirza RB. Combined effect of metformin with ascorbic acid versus acetyl salicylic acid on diabetes related cardiovascular complication; a 12 month single blind multicenter randomized control trial. Cardiovasc Diabetol 2017; 16(103): https://doi.org/10.1186/s12933-017-0584-9 .

Okafor HK, Ofoegbu HK, Nlebedim AO. Oral hypoglycemic agent and ascorbic acid supplementation therapy synergistically ameliorates blood glucose, serum lipid and inflammatory response in type 2 diabetes mellitus patients. J Anal Pharm Res 2016; 3(4): 00063. DOI: 10.15406/japlr.2016.03.00063

Mahmoudabadi MMS, Ali RR. Effect of EPA and vitamin C on superoxide dismutase, glutathione peroxidase, total antioxidant capacity and malondialdehyde in type 2 diabetic patients. Oman Medical Journal 2014; 29(1): 39-45. doi: 10.5001/omj.2014.09.

Kotb A, Khaldun MA. Effect of vitamin C on blood glucose and glycosylated hemoglobin in type II diabetes mellitus. World Journal of Analytical Chemistry 2015; 3(1A): 6-8. DOI:10.12691/wjac-3-1A-2

Downloads

Published

2021-07-01

How to Cite

Ishrat, S., Hoor, T., Jaffri, M. S. A. ., Junejo, S., & Lateef, M. (2021). Impact of Vitamin C as an Adjuvant Agent on Glycemic Indices in Type 2 Diabetes Mellitus: Randomized Clinical Trial. Journal of Bahria University Medical and Dental College, 11(3), 102–106. https://doi.org/10.51985/MYDD5410

Issue

Section

Original Articles

Most read articles by the same author(s)

1 2 > >>