oa Utility of vitamins in the prevention of type 2 diabetes mellitus and its complications: A public health perspective

Background and Objectives: The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and certain sub-populations appear especially vulnerable to developing the disease. In Qatar, the prevalence of T2DM in the adult population is approximately twice that in the USA. Qatar is ranked sixth in the world for diabetes prevalence. Risk of disease in the country is increasing with an apparent doubling of incidence in children from 1997 to 2007. To reduce T2DM risk and progression, preventative strategies need to be implemented on a population-wide scale with minimal cost and effort and without adverse effect. Our objective was to examine the utility of micronutrients in the prevention of type 2 diabetes and its complications and to evaluate the pathway(s) through which these dietary factors exert their effect. Methods: We searched the available literature linking oxidation, inflammatory signaling pathways, and micronutrient intake to T2DM. Results: The rise of T2DM rates is thought to be due, in part, to genetic factors that interact with lifestyle factors including, but not limited to, poor nutrition, lack of physical activity and obesity. However, chronic low-grade inflammation resulting from oxidative stress and imbalances in the innate immune system has been also linked to the pathogenesis of T2DM. Reducing inflammation via modulation of oxidative stress and the innate immune response could lead to a status of improved insulin sensitivity and delayed disease onset. Dietary supplementation with anti-inflammatory and antioxidant micronutrients might present a feasible strategy toward the prevention of T2DM at the population level, particularly in vulnerable sub-populations. Conclusion: Several lines of evidence support the concept of employing micronutrients as a preventative measure for T2DM via attenuating inflammation and modulating oxidative stress. This approach may be introduced as part of a population-based strategy to curb the rising incidence of T2DM in Qatar and facilitate developing public health policies and actions for disease prevention and control.