Evaluation of the impact of Rutin and Vitamin C combination on Oxidative stress, insulin sensitivity and lipid profile in type 2 diabetic patients

Abstract

Type 2 diabetes accounts for more than 90% of diabetes patients, leading to microvascular and macrovascular complications that cause severe psychological and physical distress to patients and caregivers, and putting a huge burden on healthcare systems. Diabetes mellitus is a major risk factor for atherosclerosis and today coronary heart disease is the most common cause of death in these patients..One of the pathogenic mechanisms that can explain this increased risk of diabetes is the imbalance between pro-oxidants and antioxidants that results in oxidative stress (OS). Hyperglycemia results in glucose, non-enzymatic glycation and monocyte dysfunction auto-oxidation, resulting in increased free radical production. This is further compounded by lower antioxidant levels and contributes to oxidative damage, demonstrated by the high levels of lipid and DNA peroxidants found in these patients. Increasing antioxidant defenses would be one way to combat this increased oxidative stress (OS). Increasing dietary intakes and providing antioxidant supplements are the obvious approaches. Vitamin C serves as a reduction agent in free radical oxidation processes and can therefore serve as an antioxidant. Vitamin C is an important human antioxidant, able to scavenge free radicals from oxygen. Vitamin C is structurally similar to glucose and can be used in some chemical reactions to avoid non-enzymatic protein glycosylation. Many lines of evidence suggest that vegetable and medicinal plant flavonoids have beneficial effects on diabetes by improving glycemic control, lipid profile, and antioxidant status. Rutin is a flavonoid found in many plants and has a wide range of biological effects including anti-inflammatory, antioxidant, neuroprotective, nephroprotective, and hepatoprotective. Rutin's proposed antihyperglycemic mechanisms involve reduced carbohydrate absorption from the small intestine, tissue gluconeogenesis inhibition, increased tissue glucose absorption, stimulation of beta-cell insulin secretion, and