ABSTRACT
For many years, the pathophysiology of type 2 diabetes remained obscure, and insulin resistance was thought to be the leading cause of metabolic dysregulation. However, in recent years, a feedback loop that operates to ensure integration of glucose homeostasis and maintenance of glucose concentration in a narrow range has been recognized. The metabolic derangement associated with diabetes causes secondary pathophysiologic changes in multiple organ systems that impose a heavy burden of morbidity and mortality from macrovascular and microvascular complications. Ascorbic acid (vitamin C) is a hydrophilic antioxidant that resets tocopherol in the phase it was in before being oxidized. It is a cofactor in several enzymatic reactions whose deficiency causes symptoms of scurvy. Carotenoids are lipophilic antioxidants that exist in chloroplasts and chromoplasts of plants and some photosynthetic bacteria and fungi.
