Open Access
Article
Therapeutic interventions and oxidative stress in diabetes
Shilpa Rahangdale1,Susie Yim Yeh1,Atul Malhotra1,Aristidis Veves1
1
Sleep Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston MA, USA
DOI: 10.2741/3240 Volume 14 Issue 1, pp.192-209
Published: 01 January 2009
(This article belongs to the Special Issue Nitric oxide, superoxide and peroxynitrite in cardiovascular diseases)
Abstract

Many therapeutic agents that are used in patients with diabetes mitigate oxidative stress. These agents are of particular interest because oxidative stress is elevated in diabetes and is thought to contribute to vascular dysfunction. Agents that merely quench already formed reactive oxygen species have demonstrated limited success in improving cardiovascular outcomes. Thus, although vitamin E, C, and alpha lipoic acid appeared promising in animal models and initial human studies, subsequent larger trials have failed to demonstrate improvement in cardiovascular outcomes. Drugs that limit the production of oxidative stress are more successful in improving vascular outcomes in patients with diabetes. Thus, although statins, ACE inhibitors, ARBs and thiazolinediones are used for varied clinical purposes, their increased efficacy in improving cardiovascular outcomes is likely related to their success in reducing the production of reactive oxygen species at an earlier part of the cascade, thereby more effectively decreasing the oxidative stress burden. In particular, statins and ACE inhibitors/ ARBs appear the most successful at reducing oxidative stress and vascular disease and have potential for synergistic effects.

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Shilpa Rahangdale, Susie Yim Yeh, Atul Malhotra, Aristidis Veves. Therapeutic interventions and oxidative stress in diabetes. Frontiers in Bioscience-Landmark. 2009. 14(1); 192-209.