Type 2 Diabetes Mellitus According to the World Health Organization (WHO), there are more than 346 million individuals with diabetes, of which 90% are type 2. Global estimations for the year 2030 predict an epidemic increase that will reach 366 million. According to the National Nutrition and Health Survey of 2006 (ENSANUT2005), there are 6.4 million type 2 diabetic subjects in Mexico. According to the calculation of the sample size, the investigators will include 120 adults with type 2 diabetes mellitus selected from the outpatient preventive medicine offices of health centres in the State of Mexico who will divided in two groups: supplement and placebo (60 per group). After having been invited to participate and obtaining the informed consent, study subjects will be evaluated for dietary information, as well as biochemical biomarkers of metabolic control, anthropometric, immune and inflammatory markers, gut microbiota and oxidative stress, before beginning the trial, and after 12 and 24 weeks of supplementation. They will have a monthly follow-up visit for evaluation of adherence and adverse effects, as well as delivery of the supplement.
Subjects will be randomly allocated to a supplementation with 1000 mg vitamin C, 400 IU vitamin D and 10 mg of zinc or placebo group, during 24 weeks. Subjects and researchers will be blinded to the supplement or placebo in order to guarantee double-blinding.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
120
Subjects will be randomly allocated to a supplementation of vitamin C 1000mg, vitamin D 400 IU and zinc 10 mg or an identical placebo. Subjects and researchers will be blinded to the supplement or placebo in order to guarantee double-blinding
Subjects will be randomly allocated to a supplementation of an identical placebo. Subjects and researchers will be blinded to the supplement or placebo in order to guarantee double-blinding
Change in glycemia from baseline to 12 and 24 weeks
Measured in plasma with a Selectra II automated equipment with Randox reactants, in mg/dL
Time frame: Baseline, 12 and 24 weeks
Change in glycosilated Hemoglobin (Hb1Ac) from baseline to 12 and 24 weeks
Measured in plasma with a Selectra II automated equipment with Randox reactants, in percentage
Time frame: Baseline, 12 and 24 weeks
Change in plasma insulin from baseline to 12 and 24 weeks
Multiplex Technology in a Milliplex Luminex Equipment with Merck-Millipore reactants, in uU/mL
Time frame: Baseline, 12 and 24 weeks
Change in Homeostatic Model Assesment for Insulin Resistance (HOMA-IR) from baseline to 12 and 24 weeks
Calculated from: HOMA-IR = (insulin x glucose)/405
Time frame: Baseline, 12 and 24 weeks
Change in plasma cytokines from baseline to 12 and 24 weeks
Tumor Necrosis Factor alfa (TNFα), Interferon gamma (IFN-γ), Interleukins 1 beta, 4, 6 and 10 (IL-1β, IL4, IL-6, IL10) \& transforming growth factor beta (TGF-β), measured with Multiplex Technology in a Milliplex Luminex Equipment with Merck-Millipore reactants, in pg/mL
Time frame: Baseline, 12 and 24 weeks
Change in plasma adipokines from baseline to 12 and 24 weeks
Adiponectin, resistin and leptin, measured with Multiplex Technology in a Milliplex Luminex Equipment with Merck-Millipore reactants, in pg/mL
Time frame: Baseline, 12 and 24 weeks
Change in additional plasma inflammatory markers from baseline to 12 and 24 weeks
Apolipoproteins A and B, C-reactive protein, vascular cell adhesion protein (V-CAM), intercellular adhesion molecule (I-CAM), complement proteins C-3 and C-4, measured with Multiplex Technology in a Milliplex Luminex Equipment with Merck-Millipore reactants, in pg/mL
Time frame: Baseline, 12 and 24 weeks
Change in lipid profile from baseline to 12 and 24 weeks
Total cholesterol, HDL-, LDL-, Very Low Density Lipoprotein (VLDL)-cholesterol and triacylglycerides, measured in plasma with a Selectra II automated equipment with Randox reactants, in mg/dL
Time frame: Baseline, 12 and 24 weeks
Changes in markers of oxidative stress from baseline to 12 and 24 weeks
Malondialdehyde (QuantiChromTM), Thiobarbituric acid reactive substances (TBARS Assay Kit), carbonylated proteins (colorimetric), antioxidant capacity (QuantiChromTM Antioxidant Assay Kit), catalase (EnzyChromTM Catalase Assay Kit), superoxide dismutase (EnzyChromTM Superoxide Dismutase Assay Kit) and glutathion peroxidase (metaphosphoric acid SIGMA ALDRICH y EnzyChromTM GSH/GSSG Assay Kit, measured with various commercial kits, in U/μL
Time frame: Baseline, 12 and 24 weeks
Changes in lymphocyte subpopulations from baseline to 12 and 24 weeks
Cluster of desgination 4, 8, 17 and 19 (CD4+, CD8+, CD17+ and CD19+), measured by flow cytometry (Becton Dickinson Facs AriaMR de 6 canales), in percentage
Time frame: Baseline, 12 and 24 weeks
Changes in Intestinal microbiota patterns from baseline to 12 and 24 weeks
Analyzed with a Illumina sequencing equipment and Mothur y Stamp softwares, in percentage
Time frame: Baseline, 12 and 24 weeks
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