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  • Dr Mehmet Yildiz

    The Promising Role of Vitamin E Supplementation for Managing Type II Diabetes

    2024-01-10


    The impact of Vitamin E on cancer outcomes has been uncertain, but its potential benefits for diabetes management look promising, according to a 2023 meta-analysis.

    This story is for information and awareness purposes. It does not include health advice.

    As a chronic health condition, diabetes can lead to other health conditions, like heart disease, kidney and vision problems. Type II diabetes is a chronic condition affecting millions of people worldwide. Diabetes is one of the leading causes of death in the 21st century. Currently, 442 million people live with diabetes. As documented in this paper, it was estimated to hit 693 million by 2025.

    The main issue for diabetes is elevated blood glucose and the body’s inability to manage it due to hormonal imbalances such as insulin resistance and hyperinsulinemia (excessive insulin release).

    Since I wrote about many supplements, including vitamins and minerals, some subscribers inquired about my lack of coverage of Vitamin E, a widely used antioxidant. I told them I used to take small doses of vitamin E until 2006, believing it could prevent cancer based on assumptions about its antioxidant properties.

    Despite the hype in those days, I explained to them my perspective shifted after significant studies like the Women’s Health Study and the SELECT (The Selenium and Vitamin E Cancer Prevention Trial), which indicated that vitamin E might not be as effective for preventing cancer and some trials suggested potential harm around 2006.

    As vitamin E exists in many foods, my preference is to get it from whole foods, which can easily meet the recommended dietary intake, which is 15 mg for men and women. [source]

    “Naturally occurring vitamin E exists in eight chemical forms (alpha-, beta-, gamma-, and delta-tocopherol and alpha-, beta-, gamma-, and delta-tocotrienol) with varying levels of biological activity.”

    Then, these discerning readers wanted to know my thoughts about whether vitamin E supplementation could be beneficial for other conditions. Supplements usually include around 250 mg or more, equating to around 1700% of RDA.

    I told them vitamin E is used as an antioxidant supplement for some conditions, but it is not primarily used for treating a specific disease. Its antioxidant properties can help protect cells from damage caused by free radicals.

    This inquiry inspired me to write this short article to share my perspectives on the potential benefits of vitamin E for diabetes.

    Effect of vitamin E intake on glycemic control and insulin resistance in diabetic patients

    In light of this, instead of citing hundreds of articles or 38 clinical trials, I’d like to share insights from a recent meta-analysis published in BMC Nutrition, a journal affiliated with Springer Nature, a reputable and peer-reviewed journal. The title of the paper is:

    “Effect of vitamin E intake on glycemic control and insulin resistance in diabetic patients: an updated systematic review and meta-analysis of randomized controlled trials”

    I want to introduce and explain the key points of this comprehensive paper because recent studies show promising effects of vitamin E supplementation in managing diabetes.

    Why does this meta-analysis matter?

    According to this 2023 meta-analysis, some recent studies suggest that vitamin E, as an antioxidant, might help improve the function of cells in people with diabetes. Writers of those papers assert that vitamin E may favorably impact blood sugar and insulin resistance.

    In addition, some studies also indicate that low vitamin E levels are linked to higher risks of diabetes-related problems. Apart from health benefits, economically, vitamin E is cheaper than other supplements and medications used for diabetic patients.

    The authors of this meta-analysis found these variables promising, but they were concerned that results from different studies regarding vitamin E supplementation are mixed.

    For example, some studies showed positive effects on blood sugar control, but others didn’t. This confusion motivated the researchers to review newer studies to understand how vitamin E affected blood sugar and insulin resistance in various types of diabetes.

    So, this meta-analysis looked at various studies investigating the impact of vitamin E on blood sugar levels and insulin resistance in people with diabetes.

    They found that when all the captured and analyzed data from different studies were combined, vitamin E positively affected certain aspects, which I will summarize in the next section. First, let me give you a brief background of this critical analysis.

    Using the PRISMA protocol, researchers investigated papers indexed in PubMed, Scopus, and Web of Science databases until September 30, 2021.

    They included only randomized controlled trials involving diabetic patients covering type I, type II, and diabetic nephropathy patients aged 18 or above, excluding children. They did not include open clinical trials as they were incomplete.

    They collected information about each study, analyzing study details, participant characteristics, specifics about the vitamin E used, outcomes measured, and relevant statistics. To evaluate the reliability of the studies, they used the Cochrane quality assessment tool.

    The Cochrane quality assessment tool is a set of criteria for evaluating the risk of bias in randomized controlled trials. It examines key aspects like randomization, blinding, and reporting to ensure the methodological quality of studies in systematic reviews and meta-analyses.

    This tool is vital in scientific studies because each domain is rated as low, high, or unclear risk of bias, providing a structured approach to assessing the reliability of study results.

    The main points these researchers looked at were the sugar levels when fasting, known as fasting glucose, the HbA1c level, which reflects average blood sugar over time, and the fasting insulin level.

    They also checked another measure called the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR) to understand insulin resistance.

    HOMA-IR is a mathematical method used to assess insulin resistance based on fasting glucose and insulin levels. It quantitatively measures how well the body responds to insulin and estimates the degree of insulin resistance.

    Researchers examined how these measures changed on average and how much they varied during the intervention.

    They used a random-effects model for the meta-analysis, accounting for within and between-study variations. They evaluated heterogeneity and conducted subgroup analyses.

    Heterogeneity refers to the variability or diversity among studies in a meta-analysis. It reflects differences in study populations, methods, and results. High heterogeneity indicates substantial variety among studies, requiring caution in interpreting overall results, while low heterogeneity suggests greater consistency.

    To address study dependencies, non-linear effects, and publication bias, they performed sensitivity analysis, fractional polynomial modeling, and Egger’s test, respectively. The research used the Stata 11.2 tool.

    This tool is commonly used in academia for quantitative data analysis because it includes valuable features for conducting regression analyses, hypothesis testing, and various statistical procedures.

    The statistical significance was set at p < 0.05. For results to be considered statistically significant, the p-value must be below 0.05. Simply, it indicates that the observed findings are unlikely due to chance alone.

    In summary, they adopted a rigorous and systematic approach to offer a more lucid perspective than previous studies.

    The research was complex and comprehensive.

    A total of 38 randomized controlled trials (RCTs) were part of this analysis. They involved 2,171 diabetic patients (1,110 in vitamin E groups and 1,061 in control groups). The analysis covered data from 28 RCTs on fasting blood glucose, 32 RCTs on HbA1c, 13 RCTs on fasting insulin, and nine studies on homeostatic model assessment for insulin resistance (HOMA-IR).

    For example, some studies used a combination treatment, where vitamin E was given with other treatments like metformin, eicosapentaenoic acid, or lipoic acid in one group. The control group received only the other treatment.

    After this background, I’d like to summarize the findings of this rigorous and complex analysis.

    After examining papers on vitamin E’s impact, seven found it significantly lowered fasting blood glucose, two reported an increase, and others showed no significant effects. Three studies reported a significant reduction in HOMA-IR; the rest did not find a significant impact.

    The analyses were conducted both including and excluding studies that involved combination treatments. The goal was to ensure the accuracy of the findings by assessing the impact of studies.

    Conclusive Results of the Meta-Analysis

    Vitamin E intake can reduce HbA1c, fasting insulin, and the Homeostatic Model Assessment for Insulin Resistance in diabetic patients.

    I explained HbA1c in the article Why You Need These 7 Tests for Blood Sugar and Insulin Ailments.

    The most efficient range of vitamin E dosage for reducing HbA1c is between 500 and 1300 mg/day, and for lowering fasting insulin is between 400 and 700 mg/day. Out of this range, no significant effect was observed.

    In total, 28 studies involving 1410 participants (727 in the vitamin E group and 683 in the control group) provided information on how vitamin E affects fasting blood glucose.

    Surprisingly, vitamin E intake did not significantly affect fasting blood glucose in the overall analysis.

    Further studies are needed to clarify the effects of vitamin E on glycemic indices in diabetic patients, especially in combination with other therapeutic strategies.

    Conclusions

    So, researchers concluded that Vitamin E intake positively affects diabetic patients, notably those with Type 2 Diabetes.

    The key points are it can significantly lower HbA1c, fasting insulin, and HOMA-IR levels.

    Even though vitamin E intake did not significantly affect fasting blood glucose in the overall analysis, there was a notable reduction in fasting blood glucose in studies lasting less than ten weeks.

    One key analysis outcome was identifying the optimal dosage for controlling HbA1c and insulin levels (between 400 and 700 mg/day).

    However, researchers pointed out that for type I diabetic patients and those with diabetic nephropathy or neuropathy, there are limited available studies. Further research, especially with low bias risk, must explore vitamin E’s impact on these specific patient groups.

    This study highlights the potential role of vitamin E in diabetes management. Nevertheless, it’s crucial for patients not to self-supplement with this vitamin.

    Studies from the early and late 2000s show that excessive vitamin E intake can lead to severe side effects, especially for specific health conditions.

    Therefore, patients should only consider vitamin E supplementation under the guidance of qualified healthcare professionals who have access to medical history.

    Vitamin E is found in whole foods like vegetables, fruits, nuts, seeds, fish, and meat. However, the amount can vary. Factors like cooking methods and dietary habits influence absorption.

    A balanced diet with these food groups generally ensures sufficient vitamin E intake for people without medical conditions.

    Vitamin E deficiency is rare in healthy people. However, people with certain medical conditions or a rare inherited disorder (abetalipoproteinemia) may be at risk of deficiency. Healthcare professionals can measure vitamin E via blood tests.

    Thank you for reading my perspectives. I wish you a healthy and happy life.

    To inform my new readers, I wrote numerous articles that might inform and inspire you. My topics include brain and cognitive function, significant health conditions, longevity, nutrition/food, valuable nutrients, ketogenic lifestyle, self-healing, weight management, writing/reading, science, technology, business, and humor.

    I compile my health and wellness stories on my blog, EUPHORIA. My posts do not include professional or health advice. I only document my reviews, observations, experiences, and perspectives to provide information and create awareness.


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