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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, OBJECTIVE, METHODS, RESULTS. Meshes: Adult, Blood Glucose, Body Mass Index, Copper, Diabetes Mellitus, Type 1, Dietary Supplements, Double-Blind Method, Female, Glycated Hemoglobin A, Humans, Insulin, Lipid Peroxidation, Lipoproteins, LDL, Lipoproteins, VLDL, Male, Middle Aged, Placebos, Thiobarbituric Acid Reactive Substances, Vitamin E.
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Are effects of long-term supplementation with moderate pharmacologic doses of vitamin E saturable and reversible in patients with type 1 diabetes? Context: Vitamin E supplementation has been proposed as adjunctive therapy to counteract the increased LDL oxidation in diabetes and thus prevent or delay cardiovascular complications. The objective of this study was to investigate the effect of a moderate pharmacologic dose of vitamin E for </=1 y in patients with type 1 diabetes. The study was double blind and the subjects were randomly assigned to 2 groups: the supplemented group (group S; n = 22) received 250 IU (168 mg) RRR-alpha-tocopherol 3 times/d for 1 y and the placebo group (group P; n = 22) received a placebo for 6 mo followed by 250 IU (168 mg) RRR-alpha-tocopherol 3 times/d for an additional 6 mo. Serum vitamin E doubled after 3 mo of supplementation, from a mean (+/-SD) of 36.9 +/- 10.9 to 66.4 +/- 18.3 micromol/L (P: < 0.0005). Although lipid profiles, glycated hemoglobin, and blood biochemistry values did not change significantly, copper-induced in vitro peroxidizability of LDL and VLDL decreased after 3 mo of supplementation: the production of thiobarbituric acid-reactive substances decreased by 30-60% (P: < 0. 005) and the lag time for the appearance of fluorescent products increased from 107 +/- 25 to 123 +/- 30 min in group S (P: = 0.002 compared with group P). Vitamin E supplementation for an additional 3-9 mo resulted in no further changes in serum vitamin E and lipoprotein peroxidizability. Values returned to baseline after supplementation ended.
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Because the improvement in lipoprotein peroxidizability is saturable and reversible, life-long supplementation with vitamin E should be considered in patients with type 1 diabetes. Final Decision: yes