High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes

• Published in: Diabetes care Vol. 22; no. 8; pp. 1245 - 1251
• Main Authors: BURSELL, S.-E, CLERMONT, A. C, AIELLO, L. P, AIELLO, L. M, SCHLOSSMAN, D. K, FEENER, E. P, LAFFEL, L, KING, G. L
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Alexandria, VA American Diabetes Association 01.08.1999
• Subjects: Adolescent; Adult; Analysis of Variance; Associated diseases and complications; Biological and medical sciences; Creatinine - metabolism; Cross-Over Studies; Diabetes Mellitus, Type 1 - drug therapy; Diabetes Mellitus, Type 1 - metabolism; Diabetes. Impaired glucose tolerance; Diabetic Retinopathy - drug therapy; Diabetic Retinopathy - metabolism; Dietary Supplements; Dose-Response Relationship, Drug; Double-Blind Method; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Male; Medical sciences; Metabolic Clearance Rate; Middle Aged; Plasminogen Activator Inhibitor 1 - blood; Regional Blood Flow - drug effects; Retinal Vessels - drug effects; Treatment Outcome; Vitamin E - adverse effects; Vitamin E - therapeutic use; Endocrinopathy; Kidney disease; Human; Immunopathology; Urinary system disease; Retinopathy; Autoimmune disease; E-Vitamins; Blood flow; Eye disease; Nephropathy; Insulin dependent diabetes; Complication; Biological effect; Hemodynamics; Supplementation
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.22.8.1245

High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type 1 diabetes. S E Bursell , A C Clermont , L P Aiello , L M Aiello , D K Schlossman , E P Feener , L Laffel and G L King Beetham Eye Institute, Joslin Diabetes Center, Boston, Massachusetts, USA. Abstract OBJECTIVE: To determine the effectiveness of vitamin E treatment in normalizing retinal blood flow and renal function in patients with <10 years of type 1 diabetes. RESEARCH DESIGN AND METHODS: An 8-month randomized double-masked placebo-controlled crossover trial evaluated 36 type 1 diabetic and 9 nondiabetic subjects. Subjects were randomly assigned to either 1,800 IU vitamin E/day or placebo for 4 months and followed, after treatment crossover, for a further 4 months. Retinal blood flow was measured using video fluorescein angiography, and renal function was assessed using normalized creatinine clearance from timed urine collections. RESULTS: After vitamin E treatment, serum levels of vitamin E were significantly elevated (P<0.01) in both type 1 diabetic and control patients. Hemoglobin A1c was not affected by vitamin E treatment. Diabetic patient baseline retinal blood flow (29.1+/-7.5 pixel2/s) was significantly (P = 0.030) decreased compared with that of nondiabetic subjects (35.2+/-7.2 pixel2/s). After vitamin E treatment, diabetic patient retinal blood flow (34.5+/-7.8 pixel2/s) was significantly increased (P<0.001) and was comparable with that of nondiabetic subjects. Additionally, vitamin E treatment significantly (P = 0.039) normalized elevated baseline creatinine clearance in diabetic patients. CONCLUSIONS: Oral vitamin E treatment appears to be effective in normalizing retinal hemodynamic abnormalities and improving renal function in type 1 diabetic patients of short disease duration without inducing a significant change in glycemic control. This suggests that vitamin E supplementation may provide an additional benefit in reducing the risks for developing diabetic retinopathy or nephropathy.