Effects of vitamin E supplementation on glycaemic control in type 2 diabetes: systematic review of randomized controlled trials
Article first published online: 9 JUN 2010
© 2010 The Authors. JCPT © 2010 Blackwell Publishing Ltd
Journal of Clinical Pharmacy and Therapeutics
Volume 36, Issue 1, pages 53–63, February 2011
How to Cite
Suksomboon, N., Poolsup, N. and Sinprasert, S. (2011), Effects of vitamin E supplementation on glycaemic control in type 2 diabetes: systematic review of randomized controlled trials. Journal of Clinical Pharmacy and Therapeutics, 36: 53–63. doi: 10.1111/j.1365-2710.2009.01154.x
- Issue published online: 4 JAN 2011
- Article first published online: 9 JUN 2010
- Received 11 February 2009, Accepted 16 November 2009
- glycaemic control;
- systematic review;
- type 2 diabetes;
- vitamin E supplementation
What is known and objective: Lowering haemoglobin A1c (HbA1c) has clearly been shown to reduce microvascular complications of diabetes and possibly macrovascular disease and vitamin E has been suggested as a possibly useful intervention. Our aim is to evaluate the effect of vitamin E supplementation on glycaemic control in type 2 diabetes.
Methods: Clinical studies of vitamin E were identified from computerized searches of MEDLINE, EMBASE, EBM reviews and the Cochrane Library up until November 2008. Historical searches of reference lists of relevant articles were also undertaken. To be included in our review, a study had to be: (i) a randomized controlled trial comparing vitamin E monopreparation against placebo or no treatment in patients with type 2 diabetes, (ii) lasting at least 8 weeks, and (iii) reporting glycated haemoglobin or HbA1c. There was no language restriction. Study selection, data extraction and study quality assessment were performed by three reviewers with disagreement resolved by discussion. Treatment effect was estimated with the mean difference in the changes of HbA1c from baseline to final assessment between the vitamin E and the control groups.
Results: Nine trials involving 418 patients were included in this review. Vitamin E supplementation did not improve glycaemic control in the full set of type 2 diabetes patients. It was effective only in a subgroup of patients with inadequate glycaemic control at baseline (HbA1c≥8%) and in those whose baseline serum vitamin E levels were below normal ranges. The pooled mean difference in the changes of HbA1c was −0·58% (95% CI −0·83% to −0·34%; P < 0·00001) which was the same for both subgroups of patients.
What is new and conclusions: The evidence suggests no beneficial effect of vitamin E supplementation in improving glycaemic control in unselected patients with type 2 diabetes. However, HbA1c may decrease with vitamin E supplementation in patients with inadequate glycaemic control or low serum levels of vitamin E. This shows the importance of targeting therapy. Due to the limitations of the available evidence, further studies are warranted. Also, the safety and long-term benefit of such supplements remain to be determined before its clinical benefit can be established unequivocably.