ABSTRACT
Diabetes mellitus is a chronic disease characterized by high blood glucose levels that result from defects in insulin production, insulin transport and/or utilization, or both, and leads to retinopathy, neuropathy, and nephropathy. Despite dietary and lifestyle recommendations and use of glucose-controlling medications, the incidence of diabetes continues to increase in the USA. Increased oxidative stress and chronic inflammation are involved in the initiation and progression of diabetes, and diabetes-related complications. Changes in the circulating and cellular microRNAs levels in diabetic patients were described, and their significance in diagnosis and in developing new therapeutic agents, was indicated. Animals and human studies using a single micronutrient or aspirin in diabetes showed inconsistent results varying from no effects to transient benefits on some risk factors. The reasons for inconsistent results were discussed. A single micronutrient cannot simultaneously reduce oxidative stress and inflammation. To achieve this goal, reduction of these biochemical defects at the same time is required for the prevention and improved management of diabetes. To accomplish this, enhancing the levels of cytoprotective enzymes including antioxidant enzymes by activating Nrf2/ARE pathway, and dietary and endogenous antioxidants, is essential. A mixture of micronutrients that would achieve the above goal was proposed.
