A Review on Oxidative Stress and Role of Antioxidants in Diabetes Mellitus

Review Article

Austin Endocrinol Diabetes Case Rep. 2016; 1(1): 1006.

A Review on Oxidative Stress and Role of Antioxidants in Diabetes Mellitus

Jebur AB¹, Mokhamer MH² and El-Demerdash FM³*

¹Department of Biology, Ministry of Education, Iraq

²Zoology Department, Damanhour University, Egypt

³Department of Environmental Studies, University of Alexandria, Egypt

*Corresponding author: Fatma M El-Demerdash, Department of Environmental Studies, University of Alexandria, Institute of Graduate Studies and Research, 163 Horreya Avenue, P.O. Box 832, Alexandria 21526, Egypt

Received: November 24, 2016; Accepted: December 20, 2016; Published: December 22, 2016


Diabetes is a wide spread systemic disease affecting a significant proportion of the population worldwide. There is increasing evidence that increased production and/or ineffective scavenging of Reactive Oxygen Species (ROS) may play a critical role in chronic diseases. Highly reactive ROS determines chemical changes in virtually all cellular components, leading to lipid peroxidation. Production of ROS and disturbance in antioxidant defense system in diabetic objects have been reported. Therefore, it seems reasonable that antioxidants can play an important role in the improvement of diabetes. There are many studies on the effects of antioxidants in the modulation of diabetes. The aim of this review was to summarize the central role of oxidative stress in the pathogenesis of diabetes and the prospective role of antioxidants to overcome lipid peroxidation through their free radicals scavenging properties.

Keywords: Oxidative stress; Antioxidants; Diabetes mellitus


Diabetes Mellitus (DM) is a chronic disease characterized with either insulin deficiency or insulin resistance. Insulin is a hormone which is secreted by beta cells in the Langerhans Islets of pancreas and playing a role in carbohydrate metabolism regulation in association with glucagon. Regarding the insulin’s effects on carbohydrates, almost in all tissues (except brain), insulin increases the facilitated diffusion of glucose into cells and shows an effect to reduce the blood glucose levels. Insulin secretion is related with increasing glucose level. It has been shown that it is closely related with intracellular enzymes and has a stimulating effect on transcription of glucokinase, pyruvate kinase, phosphofructo kinase and fructose-2,6 biphosphatase that are glycolytic and an inhibitory effect on transcription of phosphoenolpyruvatecarboxykinase that is gluconeogenetic. Besides being the primary regulator of carbohydrate metabolism, insulin also has an important effect on lipid and protein metabolisms that are interrelated with carbohydrate metabolism [1].

Types of diabetes mellitus

Diabetes mellitus has two broad categories defined as type1 (T1DM) and type2 (T2DM). Both types problems are the same, people suffer from diabetes mellitus needing to use external insulin usage for their life, T1DM divided two subunits. The first one is immunologic type T1DM, it is characterized pathologically by pancreatic beta cells destruction, and the second one is named idiopathic T1DM, is characterized with insulin deficiency, and in this type pancreatic beta cell destruction does not occurred. Type II diabetes (Non-Insulin dependent) is due to insulin secretory defect and insulin resistance. Gestational diabetes mellitus is any form of intolerance to glucose with onset or first recognition of pregnancy [2]. Both types of diabetes mellitus complications are classified as acute and chronic complications. Acute metabolic complications; diabetic ketoacidosis, ketoacidosis coma, hyperosmolar non-ketosis coma, lactic acidosis coma and hyperglycemia coma as a result of treatment complication. Diabetic effect of different tissues and organs are classified into chronic diabetic complication as neuropathy, nephropathy, and retinopathy, and macrovascular complications as atherosclerosis, paresis, myocardial infarction and gangrene. In general, complications of diabetes mellitus can be categorized into metabolic acute complications and systemic late complications [3,4].

Oxidative stress and antioxidants

Oxygen is one of the important components of life. However in some circumstances, this oxygen may be a killer of cells when it generates reactive species that causes necrosis, organ damage [5] and ultimately the cell death (Table 1). Reactive nitrogen and carbon species also cause oxidation by the generation of certain mechanism that interferes with the normal physiological processes inside the cell [6]. Oxidative stress can be defined as a disturbance in the balance between oxidants and antioxidants due to different factors such as aging, drug actions and toxicity, inflammation and/or addiction [7]. It is in general, excess formation or/and insufficient removal of highly reactive molecules. Oxygen is highly reactive specie that has the ability to become part of potentially harmful and damaging molecules; free radicals. Oxidative stress causes healthy cells of the body to lose their function and structure by attacking them. It is when the antioxidant level is limited that this damage can become debilitating and cumulative leading to several diseases [8].