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Related Concept Videos

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Type 2 diabetes, characterized by insulin resistance, arises when the insulin receptors on cells lose responsiveness to insulin, diminishing the cell's capacity to take up glucose, resulting in elevated blood glucose levels. To receive a diagnosis of Type 2 diabetes, a series of blood glucose tests are necessary to assess whether the blood glucose falls within normal parameters. If the result is out of the normal range, a patient may be diagnosed as prediabetic or diabetic, depending on the...
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Insulin-replacement therapy usually includes both long-acting insulin (basal) and short-acting insulin (to cater to postprandial needs). In a diverse group of type 1 diabetes patients, the average daily insulin dose is typically 0.5-0.7 units/kg body weight. However, obese patients and pubertal adolescents may need more due to insulin resistance.
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Pune GSH supplementation study: Analyzing longitudinal changes in type 2 diabetic patients using linear mixed-effects

Arjun Kolappurath Madathil1, Saroj Ghaskadbi2, Saurabh Kalamkar2

  • 1Biology Division, Indian Institute of Science Education and Research, Pune, India.

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|March 30, 2023
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Summary

Oral glutathione (GSH) supplementation improved glycemic control and reduced oxidative stress in Indian Type 2 diabetic patients. Elder patients particularly benefited from reduced HbA1c and increased insulin levels.

Keywords:
8-OHdGGSH supplementationHbA1celderly diabetic populationmixed-effects modelstype 2 diabetes

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Area of Science:

  • Biochemistry
  • Endocrinology
  • Clinical Nutrition

Background:

  • Oxidative stress and DNA damage are implicated in Type 2 diabetes (T2D) pathogenesis.
  • Glutathione (GSH), a key antioxidant, may be depleted in T2D.
  • Oral GSH supplementation is being explored as an adjuvant therapy for T2D.

Purpose of the Study:

  • To evaluate the efficacy of oral GSH supplementation in restoring GSH levels and reducing oxidative DNA damage in T2D patients.
  • To analyze the longitudinal changes in glycemic control markers (HbA1c, fasting insulin) and oxidative stress markers (8-OHdG) in T2D patients receiving GSH.
  • To investigate age-related differences in response to oral GSH supplementation in T2D.

Main Methods:

  • A 6-month clinical study involving Indian T2D patients receiving standard antidiabetic treatment plus oral GSH.
  • Longitudinal data analysis using a linear mixed-effects (LME) model to assess individual and overall changes in GSH, 8-OHdG, HbA1c, and fasting insulin.
  • Independent modeling of age cohorts (elderly vs. younger) to identify differential responses.

Main Results:

  • Oral GSH significantly restored erythrocytic GSH levels (108 µM/month) and reduced 8-OHdG (18.5 ng/μg DNA/month).
  • Elderly T2D patients showed greater reductions in 8-OHdG (24 ng/μg DNA/month) and significant improvements in HbA1c (0.1%/month) and fasting insulin (0.6 µU/mL/month).
  • GSH replenishment was faster in younger individuals, while 8-OHdG reduction was more rapid in elders. GSH changes correlated with glycemic and oxidative stress markers in elders.

Conclusions:

  • Oral GSH supplementation is effective in replenishing GSH stores and mitigating oxidative DNA damage in T2D patients.
  • Elderly T2D patients experience distinct benefits, including improved glycemic control and insulin sensitivity, suggesting personalized therapeutic targets.
  • GSH supplementation holds promise as an adjuvant therapy for managing T2D, with potential age-specific benefits.