Sherin M. Al Zinati¹,Amin T. Hamed², Ashraf Al Swirky³

1.     Master Degree in Pharmacology , Faculty of Pharmacy, Al Azhar University

2.     Associated Professor of Pharmacology, Faculty of Pharmacy, Al Azhar University

3.     PHD in Endocrinology, Department of Endocrinology, Al Shifa Hospital

ABSTRACT

­Background: Persistent hyperglycemia causes increases in the production of free radicals especially reactive oxygen species (ROS) which promotes the development of many complications of diabetes mellitus.

Objectives: To evaluate the effect of vitamin C alone or in combination with vitamin E as adjunctive therapy in reducing the serum level of glucose, glycosylated hemoglobin and lipid profile in type 2 diabetic patients in Gaza strip.

Methods: To achieve this purpose sixty type 2 diabetic patients were selected from Palestine Medical Relief Society  and some UNRWA health centers in Gaza Strip. All patients were treated with metformin and divided into three groups ,but two patients withdrawn due to incompliance. The first group (n=20) continued on metformin therapy only(control group).The second group(n=19) was treated with vitamin C along with metformin  ,whereas the third group(n=19) was treated with vitamins C and E combination together with metformin .All patients were followed up for three months.  A number of biochemical tests were carried out for each patients on the start and at the end of the experimental protocol :including fasting blood sugar (FBS), glycosylated hemoglobin(HbA1c) and lipid profile (TG,TC,LDL,HDL).

Results: showed significant reduction in FBS ,HbA1c and lipid profile among patients who used vitamin C (G2)and vitamin C and E (G3)compared to the control group after three months of treatment. the reductions in FBS , HbA1c  and TG were more significant in G3 than G2, while the reduction in total cholesterol(TC) was similar in both groups. The reduction in LDL was more significant in G2 than G3. Intake of vitamin C alone or vitamins C and E combination  caused a small increases in HDL-cholesterol, these increases were not significant.

Conclusions: The study revealed that the use of antioxidants like vitamin C alone or the combination of vitamin C and E can provide a good glycemic control and reduce TG ,TC, and LDL-cholesterol levels significantly and improve HDL-cholesterol level.

Recommendations: Increase awareness about the relationship between chronic diabetic disease and oxidative stress. Recommend the use of antioxidants as adjunctive therapy for type 2 diabetic patients as they give good glycemic control and improve the lipid profile in order to delay or ovoid chronic complications of diabetes mellitus. Further studies on a larger number of patients and for a longer follow-up periods to assess the long effect of antioxidants on glycemic control and lipid profile in type 2 diabetic patients.