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Cited by 68Antioxidant Activity and Oxidative StressNatural Antidiabetic Agents StudiesDiabetes, Cardiovascular Risks, and Lipoproteins

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

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Asbaghi, Omid, Nazarian, Behzad, Yousefi, Mojtaba, Anjom-Shoae, Javad, Rasekhi, Hamid, Sadeghi, Omid·2023·Nutrition Journal
DOI 10.1186/s12937-023-00840-1PMC PMC9936725
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Abstract

Since a 2014 meta-analysis, several randomized controlled trials (RCTs) evaluating the effect of vitamin E intake on glycemic indices and insulin resistance in adults with diabetes have reached inconsistent conclusions. Therefore, we updated the previous meta-analysis to summarize the current evidence in this regard. Online databases including PubMed, Scopus, ISI Web of Science, and Google Scholar were searched to identify relevant studies published up to September 30, 2021, using relevant keywords. Random-effects models were used to obtain overall mean difference (MD) comparing vitamin E intake with a control group. In total, 38 RCTs with a total sample size of 2171 diabetic patients (1110 in vitamin E groups and 1061 in control groups) were included. Combining the results from 28 RCTs on fasting blood glucose, 32 RCTs on HbA1c, 13 RCTs on fasting insulin, and 9 studies on homeostatic model assessment for insulin resistance (HOMA-IR) showed a summary MD of -3.35 mg/dL (95% CI: -8.10 to 1.40, P = 0.16), -0.21% (95% CI: -0.33 to -0.09, P = 0.001), -1.05 µIU/mL (95% CI: -1.53 to -0.58, P < 0.001), and -0.44 (95% CI: -0.82 to -0.05, P = 0.02), respectively. This indicates a significant lowering effect of vitamin E on HbA1c, fasting insulin and HOMA-IR, while no significant effect on fasting blood glucose in diabetic patients. However, in subgroup analyses, we found that vitamin E intake significantly reduced fasting blood glucose in studies with an intervention duration of < 10 weeks. In conclusion, vitamin E intake has a beneficial role in improving HbA1c and insulin resistance in a population with diabetes. Moreover, short-term interventions with vitamin E have resulted in lower fasting blood glucose in these patients. This meta-analysis was registered in PROSPERO with code CRD42022343118.

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Research works printed but not linked: 64

  1. [1]American Diabetes Association Diagnosis and classification of diabetes mellitus Diabetes Care 2012 35 Suppl 1 S64 71 10.2337/dc12-s064 22187472 PMC3632174 · DOI
  2. [2]Kerner W Brückel J Definition, classification and diagnosis of diabetes mellitus Exp Clin Endocrinol Diabetes 2014 122 7 384 6 10.1055/s-0034-1366278 25014088 · DOI
  3. [3]Asbaghi O Sadeghian M Effects of zinc supplementation on lipid profile in patients with type 2 diabetes mellitus: A systematic review and meta-analysis of randomized controlled trials Nutr Metab Cardiovasc Dis 2020 30 8 1260 71 10.1016/j.numecd.2020.03.021 32451277 · DOI
  4. [4]Minter BE Lowes DA Differential effects of MitoVitE, α-tocopherol and trolox on oxidative stress, mitochondrial function and inflammatory signalling pathways in endothelial cells cultured under conditions mimicking sepsis Antioxidants Basel) 2020 9 3 195 10.3390/antiox9030195 32110961 PMC7139367 · DOI
  5. [5]Bavani NG Saneei P Magnesium intake, insulin resistance and markers of endothelial function among women Public Health Nutr. 2021 24 5777 10.1017/s1368980021001063 33719988 PMC10195414 · DOI
  6. [6]Chua GHI Phang SCW Vitamin E levels in ethnic communities in malaysia and its relation to glucose tolerance, insulin resistance and advanced glycation end products: a cross-sectional study Nutrients. 2020 12 12 3659 10.3390/nu12123659 33261162 PMC7761176 · DOI
  7. [8]Schwingshackl L Lampousi AM Olive oil in the prevention and management of type 2 diabetes mellitus: a systematic review and meta-analysis of cohort studies and intervention trials Nutr Diabetes. 2017 7 4 e262 10.1038/nutd.2017.12 28394365 PMC5436092 · DOI
  8. [9]Fitó M Estruch R Effect of the Mediterranean diet on heart failure biomarkers: a randomized sample from the PREDIMED trial Eur J Heart Fail. 2014 16 5 543 50 10.1002/ejhf.61 24574190 · DOI
  9. [10]Paolisso G D'Amore A Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients Diabetes Care. 1993 16 11 1433 7 10.2337/diacare.16.11.1433 8299431 · DOI
  10. [11]Rafraf M Bazyun B Impact of vitamin E supplementation on blood pressure and Hs-CRP in type 2 diabetic patients Health Promot Perspect. 2012 2 1 72 9 10.5681/hpp.2012.009 24688920 PMC3963652 · DOI
  11. [12]Shadman Z Taleban FA Effect of conjugated linoleic acid and vitamin E on glycemic control, body composition, and inflammatory markers in overweight type2 diabetics J Diabetes Metab Disord. 2013 12 1 42 10.1186/2251-6581-12-42 23870044 PMC7976596 · DOI
  12. [13]Udupa AS Nahar PS Study of comparative effects of antioxidants on insulin sensitivity in type 2 diabetes mellitus J Clin Diagn Res. 2012 6 9 1469 73 10.7860/jcdr/2012/4464.2535 23285432 PMC3527772 · DOI
  13. [14]Koay YY Tan GCJ A phase IIb randomized controlled trial investigating the effects of tocotrienol-rich vitamin e on diabetic kidney disease Nutrients. 2021 13 1 258 10.3390/nu13010258 33477404 PMC7830596 · DOI
  14. [15]Ng YT Phang SCW The effects of tocotrienol-rich vitamin E (Tocovid) on diabetic neuropathy: a phase ii randomized controlled trial Nutrients 2020 12 5 1522 10.3390/nu12051522 32456230 PMC7284602 · DOI
  15. [16]Tan SMQ Chiew Y Tocotrienol-rich vitamin E from palm oil (Tocovid) and its effects in diabetes and diabetic nephropathy: a pilot phase ii clinical trial Nutrients 2018 10 9 1315 10.3390/nu10091315 30227659 PMC6164742 · DOI
  16. [17]Khatami PG Soleimani A The effects of high-dose vitamin E supplementation on biomarkers of kidney injury, inflammation, and oxidative stress in patients with diabetic nephropathy: A randomized, double-blind, placebo-controlled trial J Clin Lipidol 2016 10 4 922 9 10.1016/j.jacl.2016.02.021 27578124 · DOI
  17. [18]Stonehouse W Brinkworth GD Short term effects of palm-tocotrienol and palm-carotenes on vascular function and cardiovascular disease risk: A randomised controlled trial Atherosclerosis. 2016 254 205 14 10.1016/j.atherosclerosis.2016.10.027 27760402 · DOI
  18. [19]Ward NC Wu JH The effect of vitamin E on blood pressure in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial J Hypertens. 2007 25 1 227 34 10.1097/01.hjh.0000254373.96111.43 17143195 · DOI
  19. [20]Ble-Castillo JL Carmona-Díaz E Effect of alpha-tocopherol on the metabolic control and oxidative stress in female type 2 diabetics Biomed Pharmacother. 2005 59 6 290 5 10.1016/j.biopha.2005.05.002 15932790 · DOI
  20. [21]Hashemi S Sarbolouki S Adiponectin and glycemic profiles in type 2 diabetes patients on eicosapentaenoic acid with or without vitamin E Acta Endo (Buc) 2014 2014 10 84 96 10.4183/aeb.2014.84 · DOI
  21. [22]Xu R Zhang S Influence of vitamin E supplementation on glycaemic control: a meta-analysis of randomised controlled trials PLoS One. 2014 9 4 e95008 10.1371/journal.pone.0095008 24740143 PMC3989270 · DOI
  22. [23]Bril F Biernacki DM Role of vitamin E for nonalcoholic steatohepatitis in patients with type 2 diabetes: a randomized controlled trial Diabetes Care. 2019 42 8 1481 8 10.2337/dc19-0167 31332029 · DOI · Paper page
  23. [24]Dalan R Goh LL Impact of Vitamin E supplementation on vascular function in haptoglobin genotype stratified diabetes patients (EVAS Trial): a randomised controlled trial Nutr Diabetes. 2020 10 1 13 10.1038/s41387-020-0116-7 32341356 PMC7186220 · DOI
  24. [25]Dass AS Narayana S Effect of Vitamin E and omega 3 fatty acids in type 2 diabetes mellitus patients J Adv Pharm Technol Res. 2018 9 1 32 6 10.4103/japtr.JAPTR_309_17 29441322 PMC5801585 · DOI
  25. [26]El-Aal AA El-Ghffar EAA 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 Metab Syndr. 2018 12 4 483 9 10.1016/j.dsx.2018.03.013 29571976 · DOI
  26. [27]Hejazi N Dabbaghmanesh MH Effects of vitamin E on fasting and postprandial oxidative stress, inflammatory markers, glucose status, insulin resistance, blood pressure and pulse rate in type-2 diabetic patients: a randomized clinical trial Galen Medical J 2015 4 3 67 74 10.31661/gmj.v4i3.333 · DOI
  27. [28]Rafraf M Bazyun B Vitamin E improves serum paraoxonase-1 activity and some metabolic factors in patients with type 2 diabetes: no effects on nitrite/nitrate levels J Am Coll Nutr. 2016 35 6 521 8 10.1080/07315724.2015.1116896 26886716 · DOI
  28. [29]Tan GCJ Tan SMQ Tocotrienol-rich vitamin E improves diabetic nephropathy and persists 6–9 months after washout: a phase IIa randomized controlled trial Ther Adv Endocrinol Metab 2019 10 2042018819895462 10.1177/2042018819895462 31903178 PMC6933598 · DOI
  29. [30]Shamseer L Moher D Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation Bmj. 2015 350 g7647 10.1136/bmj.g7647 25555855 · DOI · Paper page
  30. [31]Asbaghi O Sadeghian M The effects of green coffee extract supplementation on glycemic indices and lipid profile in adults: a systematic review and dose-response meta-analysis of clinical trials Nutr J. 2020 19 1 71 10.1186/s12937-020-00587-z 32665012 PMC7362645 · DOI
  31. [32]Sherafati N Bideshki MV Effect of supplementation with Chlorella vulgaris on lipid profile in adults: A systematic review and dose-response meta-analysis of randomized controlled trials Complement Ther Med 2022 66 102822 10.1016/j.ctim.2022.102822 35331862 · DOI
  32. [34]Higgins JP Altman DG The cochrane collaboration's tool for assessing risk of bias in randomised trials Bmj. 2011 343 d5928 10.1136/bmj.d5928 22008217 PMC3196245 · DOI · Paper page
  33. [35]Hozo SP Djulbegovic B Estimating the mean and variance from the median, range, and the size of a sample BMC Med Res Methodol 2005 5 13 10.1186/1471-2288-5-13 15840177 PMC1097734 · DOI · Paper page
  34. [36]Brondani LA Assmann TS Meta-analysis reveals the association of common variants in the uncoupling protein (UCP) 1–3 genes with body mass index variability PLoS One. 2014 9 5 e96411 10.1371/journal.pone.0096411 24804925 PMC4013025 · DOI
  35. [37]Zahedi H Djalalinia S Dietary inflammatory potential score and risk of breast cancer: systematic review and meta-analysis Clin Breast Cancer. 2018 18 4 e561 e70 10.1016/j.clbc.2018.01.007 29486982 · DOI
  36. [38]Campoy C Baena RM Effects of metabolic control on vitamin E nutritional status in children with type 1 diabetes mellitus Clin Nutr. 2003 22 1 81 6 10.1054/clnu.2002.0596 12553954 · DOI
  37. [39]Jain SK McVie R Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children Diabetes Care. 2000 23 9 1389 94 10.2337/diacare.23.9.1389 10977039 · DOI
  38. [40]Crinò A Schiaffini R A randomized trial of nicotinamide and vitamin E in children with recent onset type 1 diabetes (IMDIAB IX) Eur J Endocrinol. 2004 150 5 719 24 10.1530/eje.0.1500719 15132730 · DOI
  39. [41]Farvid MS Jalali M Comparison of the effects of vitamins and/or mineral supplementation on glomerular and tubular dysfunction in type 2 diabetes Diabetes Care 2005 28 10 2458 64 10.2337/diacare.28.10.2458 16186280 · DOI
  40. [42]Sharma A Kharb S Evaluation of oxidative stress before and after control of glycemia and after vitamin E supplementation in diabetic patients Metabolism 2000 49 2 160 2 10.1016/s0026-0495(00)91117-x 10690938 · DOI
  41. [43]Rajanandh MG Kosey S Assessment of antioxidant supplementation on the neuropathic pain score and quality of life in diabetic neuropathy patients - a randomized controlled study Pharmacol Rep 2014 66 1 44 8 10.1016/j.pharep.2013.08.003 24905305 · DOI
  42. [44]SamaniKeihan G Gharib MH A comparison between the effect of cuminum cyminum and vitamin E on the level of leptin, paraoxonase 1, HbA1c and oxidized LDL in diabetic patients Int J Mol Cell Med. 2016 5 4 229 35 28357199 PMC5353984
  43. [45]de Oliveira AM Rondó PH The effects of lipoic acid and α-tocopherol supplementation on the lipid profile and insulin sensitivity of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial Diabetes Res Clin Pract 2011 92 2 253 60 10.1016/j.diabres.2011.02.010 21371770 · DOI
  44. [46]Giannini C Lombardo F Effects of high-dose vitamin E supplementation on oxidative stress and microalbuminuria in young adult patients with childhood onset type 1 diabetes mellitus Diabetes Metab Res Rev 2007 23 7 539 46 10.1002/dmrr.717 17266173 · DOI
  45. [47]Winterbone MS Sampson MJ Pro-oxidant effect of alpha-tocopherol in patients with type 2 diabetes after an oral glucose tolerance test–a randomised controlled trial Cardiovasc Diabetol 2007 6 8 10.1186/1475-2840-6-8 17316429 PMC1819366 · DOI
  46. [48]Baliarsingh S Beg ZH The therapeutic impacts of tocotrienols in type 2 diabetic patients with hyperlipidemia Atherosclerosis 2005 182 2 367 74 10.1016/j.atherosclerosis.2005.02.020 16159610 · DOI
  47. [49]Boshtam M Rafiei M Long term effects of oral vitamin E supplement in type II diabetic patients Int J Vitam Nutr Res 2005 75 5 341 6 10.1024/0300-9831.75.5.341 16477766 · DOI
  48. [50]Economides PA Khaodhiar L The effect of vitamin E on endothelial function of micro- and macrocirculation and left ventricular function in type 1 and type 2 diabetic patients Diabetes 2005 54 1 204 11 10.2337/diabetes.54.1.204 15616030 · DOI
  49. [51]Manzella D Barbieri M Chronic administration of pharmacologic doses of vitamin E improves the cardiac autonomic nervous system in patients with type 2 diabetes Am J Clin Nutr 2001 73 6 1052 7 10.1093/ajcn/73.6.1052 11382659 · DOI
  50. [52]Feng D Bursell SE von Willebrand factor and retinal circulation in early-stage retinopathy of type 1 diabetes Diabetes Care 2000 23 11 1694 8 10.2337/diacare.23.11.1694 11092294 · DOI
  51. [54]Gazis A White DJ Effect of oral vitamin E (alpha-tocopherol) supplementation on vascular endothelial function in Type 2 diabetes mellitus Diabet Med 1999 16 4 304 11 10.1046/j.1464-5491.1999.00049.x 10220204 · DOI
  52. [55]Duntas L Kemmer TP Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus Curr Ther Res 1996 57 9 682 90 10.1016/S0011-393X(96)80073-7 · DOI
  53. [56]Fuller CJ Chandalia M RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus Am J Clin Nutr 1996 63 5 753 9 10.1093/ajcn/63.5.753 8615360 · DOI
  54. [57]Reaven PD Herold DA Effects of Vitamin E on susceptibility of low-density lipoprotein and low-density lipoprotein subfractions to oxidation and on protein glycation in NIDDM Diabetes Care 1995 18 6 807 16 10.2337/diacare.18.6.807 7555507 · DOI
  55. [59]Colette C Pares-Herbute N Platelet function in type I diabetes: effects of supplementation with large doses of vitamin E Am J Clin Nutr. 1988 47 2 256 61 10.1093/ajcn/47.2.256 2963532 · DOI
  56. [60]Park S Choi SB Effects of alpha-tocopherol supplementation and continuous subcutaneous insulin infusion on oxidative stress in Korean patients with type 2 diabetes Am J Clin Nutr. 2002 75 4 728 33 10.1093/ajcn/75.4.728 11916760 · DOI
  57. [61]Tütüncü NB Bayraktar M Reversal of defective nerve conduction with vitamin E supplementation in type 2 diabetes: a preliminary study Diabetes Care 1998 21 11 1915 8 10.2337/diacare.21.11.1915 9802743 · DOI
  58. [62]Selvaraj N Bobby Z Oxidative stress: does it play a role in the genesis of early glycated proteins? Med Hypotheses 2008 70 2 265 8 10.1016/j.mehy.2007.04.049 17693039 · DOI
  59. [63]Piarulli F Sartore G Relationship between glyco-oxidation, antioxidant status and microalbuminuria in type 2 diabetic patients Diabetologia 2009 52 7 1419 25 10.1007/s00125-009-1367-y 19401824 · DOI
  60. [64]Tosatti JAG Alves MT The role of the mediterranean dietary pattern on metabolic control of patients with diabetes mellitus: a narrative review Adv Exp Med Biol 2021 1307 115 28 10.1007/5584_2020_513 32253710 · DOI
  61. [65]Gray B Swick J Vitamin E and adiponectin: proposed mechanism for vitamin E-induced improvement in insulin sensitivity Nutr Rev 2011 69 3 155 61 10.1111/j.1753-4887.2011.00377.x 21348879 · DOI
  62. [66]Ikemoto M Okamura Y A relative high dose of vitamin E does not attenuate unweighting-induced oxidative stress and ubiquitination in rat skeletal muscle J Physiol Anthropol Appl Human Sci 2002 21 5 257 63 10.2114/jpa.21.257 12491823 · DOI
  63. [67]Afzali H JafariKashi AH The effects of magnesium and vitamin E co-supplementation on wound healing and metabolic status in patients with diabetic foot ulcer: A randomized, double-blind, placebo-controlled trial Wound Repair Regen 2019 27 3 277 84 10.1111/wrr.12701 30693609 · DOI
  64. [68]Li F Pei L Influence of omega-3 fatty acid and vitamin co-supplementation on metabolic status in gestational diabetes: A meta-analysis of randomized controlled studies Eur J Obstet Gynecol Reprod Biol 2020 247 191 7 10.1016/j.ejogrb.2020.02.024 32145487 · DOI

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Authors
Asbaghi, O., Nazarian, B., Yousefi, M., Anjom-Shoae, J., Rasekhi, H., & Sadeghi, O.
Affiliations
  • Shahid Beheshti University (IR)
  • Lorestan University of Medical Sciences (IR)
  • Yasuj University of Medical Sciences (IR)
  • The University of Adelaide (AU)
  • National Nutrition and Food Technology Research Institute (IR)
  • Isfahan University of Medical Sciences (IR)
Corresponding author
  • Rasekhi, Hamid
  • Sadeghi, Omid
ORCID
Venue
Nutrition Journal
Publisher
Springer Science and Business Media LLC
Published
2023-02-17
Volume
22
Issue
1
Pages
10-10
ISSN
1475-2891 (ISSN-L)
DOI
10.1186/s12937-023-00840-1
PMC
PMC9936725
OpenAlex
W4321241824
Cited by
68
References
3
Citations by year
2026: 15 · 2025: 21 · 2024: 21 · 2023: 11
FWCI
1.35
Type
journal article
Language
en
Open access
Licence
Locations
  • Nutrition Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Shahid Beheshti University of Medical Sciences
Topics
  • Health Sciences › Medicine › Biochemistry › Antioxidant Activity and Oxidative Stress
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Natural Antidiabetic Agents Studies
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords
vitamin E, diabetes mellitus, glycemic control, insulin resistance, HbA1c, fasting blood glucose, fasting insulin, HOMA-IR, dietary supplementation
MeSH terms
Glycemic Control, Adult, Blood Glucose, Diabetes Mellitus, Diabetes Mellitus, Type 2, Glycated Hemoglobin, Humans, Insulin, Insulin Resistance, Randomized Controlled Trials as Topic, Dietary Supplements

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