The Role of Natural Antioxidant Products That Optimize Redox Status in the Prevention and Management of Type 2 Diabetes

Abstract

The worldwide prevalence of type 2 diabetes (T2D) and prediabetes is rapidly increasing, particularly in children, adolescents, and young adults. Oxidative stress (OxS) has emerged as a likely initiating factor in T2D. Natural antioxidant products may act to slow or prevent T2D by multiple mechanisms, i.e., (1) reducing mitochondrial oxidative stress, (2) preventing the damaging effects of lipid peroxidation, and (3) acting as essential cofactors for antioxidant enzymes. Natural antioxidant products should also be evaluated in the context of the complex physiological processes that modulate T2D-OxS such as glycemic control, postprandial OxS, the polyol pathway, high-calorie, high-fat diets, exercise, and sleep. Minimizing processes that induce chronic damaging OxS and maximizing the intake of natural antioxidant products may provide a means of preventing or slowing T2D progression. This “optimal redox” (OptRedox) approach also provides a framework in which to discuss the potential benefits of natural antioxidant products such as vitamin E, vitamin C, beta-carotene, selenium, and manganese. Although there is a consensus that early effective intervention is critical for preventing or reversing T2D progression, most research has focused on adults. It is critical, therefore, that future research include pediatric populations.

The Role of Glutathione and Its Precursors in Type 2 Diabetes

“…Insulin resistance, pancreatic betacell dysfunction, and abnormally high glucagon levels are the major etiological factors that cause high blood glucose levels [26,27]. The progression of T2D starts with insulin resistance followed by prediabetes, overt T2D with fasting blood glucose level above 126 mg/dL, and finally vascular damage [7,27]. T2D is, however, a multifactorial disease with alterations in lipid and protein metabolism as well as complex interactions between organs, tissues, cell types, and subcellular compartments/organelles.…”

“…OxS is usually defined as Sa physiologically significant alteration in redox status resulting from an overproduction of reactive oxygen species (ROS) and/or a deficiency in antioxidant protective mechanisms [6]. It is important, however, to also consider how antioxidants, such as GSH, interconnect with the complex pathophysiological risk factors that modulate T2D redox status [7]. GSH is the major cytosolic water-soluble chemical antioxidant and clinical evidence suggests that patients with T2D have a GSH deficiency [8].…”

Foods, Dietary Supplements, and Herbal Products Treating the Diseases of the 21st Century: Moving from Traditional to Scientific Research

“…The latter not only typically occurs in obese individuals, but also represents one of the putative pathophysiological mechanisms linking obesity, gut microbiota dysbiosis, and COVID-19 severity (144). Indeed, obesityrelated gastrointestinal microbiota dysbiosis, in concert with increased gut permeability (145), contributes to inflammation by promoting systemic endotoxemia which is the direct consequence of the leak of lipopolysaccharides (LPS) through the dysfunctional gut barrier (146). Ultimately, this inflammatory status, fueled by gut microbiota dysbiosis, amplifies the so-called "cytokine storm, " thereby predisposing subjects with obesity to more severe COVID-19 symptoms and increased risk of death (147).…”

“…However, ambiguities remain since the studies did not consider the damaging effects of reductive stress that precedes oxidative stress in hyperglycemia on mitochondria and malfunctioning feedback mechanisms (142). Nonetheless, the importance of reducing the physiological factors that cause oxidative stress in conjunction with the use of natural antioxidant products, known as the "optimal redox" (OptRedox) approach, is being studied as a public health policy to stem the rising incidence of T2DM in global populations, particularly those of the very young (145). Instead of the common "detect and treat" medical practice of redox medicine, a more targeted use of inhibitors and agonists impacting oxidative stress linked biochemical pathways is hypothesized as a more successful therapeutic approach, while supporting empirical proof is currently a pipedream (108).…”

Mechanism of the antidiabetic action of Nigella sativa and Thymoquinone: a review

“…However, ambiguities remain since the studies did not consider the damaging effects of reductive stress that precedes oxidative stress in hyperglycemia on mitochondria and malfunctioning feedback mechanisms ( 142 ). Nonetheless, the importance of reducing the physiological factors that cause oxidative stress in conjunction with the use of natural antioxidant products, known as the “optimal redox” (OptRedox) approach, is being studied as a public health policy to stem the rising incidence of T2DM in global populations, particularly those of the very young ( 145 ). Instead of the common “detect and treat” medical practice of redox medicine, a more targeted use of inhibitors and agonists impacting oxidative stress linked biochemical pathways is hypothesized as a more successful therapeutic approach, while supporting empirical proof is currently a pipedream ( 108 ).…”