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Diabetes
Chapter 16. Vitamin E and Vascular Protection in Diabetes
Andrew P. Levy , Hagit Goldenstein , John Ward
The increased oxidative stress associated with diabetic patients is partly due to increased reactivity of the iron within the heme pocket of hemoglobin. Haptoglobin, a plasma protein, functions as an antioxidant by binding to hemoglobin and preventing it from initiating oxidative chain reactions. Haptoglobin has two alleles, 1 and 2, which form three different phenotypes that differ in their antioxidant capabilities. Haptoglobin 2–2 is inferior to Haptoglobin 1–1 as an antioxidant. Due to the decreased antioxidant function of Haptoglobin 2–2, diabetic individuals carrying this phenotype suffer from increased rates of oxidative stress and increased incidence of cardiovascular complications. In several epidemiological studies, oral supplementation with vitamin E proved therapeutic for this group, with a decrease in cardiovascular complications and improved high-density lipoprotein (HDL) function. Those findings led to the conclusion that vitamin E should be given to Haptoglobin 2–2 diabetic individuals as a preventive therapy against cardiovascular complications of diabetes.
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