Die Mitochondriopathie Diabetes mellitus – Intervention mit (Mikro-)Nährstoffen: Update 2023

Zusammenfassung

Bei diabetischer Stoffwechsellage kommt es in den Mitochondrien zur massiven Bildung von Superoxidradikalen, wodurch diabetesspezifische Signalwege aktiviert werden. Oxidativer und nitrosativer Stress mit Inflammation verknüpfen bei genetischer Prädisposition und ungünstigem Lebensstil den Typ-2-Diabetes mit schwerwiegenden Folgeerkrankungen wie Angio- und Neuropathien. Neben einer frühzeitigen Diagnostik und optimalen Stoffwechseleinstellung sollte bei Diabetes mellitus rechtzeitig durch Interventionen in die pathologischen Prozesse der Angio- und Neuropathien eingegriffen werden. Eine vielversprechende komplementär- und präventivmedizinische Therapieoption ist die gezielte frühzeitige Supplementierung mitochondrienprotektiver, antioxidativer und den Kohlenhydratstoffwechsel-regulierender (Mikro-)Nährstoffe wie Vitamin C, Coenzym Q10, B-Vitamine, Vitamin D, Vitamin K und Magnesium.

Schlüsselwörter

Mitochondriopathie - Diabetes Mellitus - Prävalenz - Angiopathien - reaktive Sauerstoffspezies - diabetesspezifische Signalwege - Folgeerkrankungen - Mikronährstoffe - Vitamin C - Coenzym Q10

Publication History

Article published online:
13 December 2023

• Literatur

• 1 GBD 2021 Diabetes Collaborators. Global, regional, and national burden of diabetes from 1990 to 2021, with projections of prevalence to 2050: a systematic analysis for the Global Burden of Disease Study 2021. Lancet 2023; 402: 203-234
• 2 Armstrong DG, Boulton AJM, Bus SA. Diabetic foot ulcers and their recurrence. N Engl J Med 2017; 376: 2367-2375
• 3 Deutsche Diabetes Gesellschaft. Fakten zu Diabetes – Stand November 2022 https://www.ddg.info/fileadmin/user_upload/Gesundheitsbericht_2022_final.pdf oder https://www.ddg.info/ddg-factsheet
• 4 Ferguson D, Finck BN. Emerging therapeutic approaches for the treatment of NAFLD and type 2 diabetes mellitus. Nat Rev Endocrinol 2021; 17: 484-495
• 5 Yang L, Guo Q, Leng J. et al. Late onset of type 2 diabetes is associated with mitochondrial tRNATrp A5514G and tRNASer(AGY) C12237T mutations. J Clin Lab Anal 2022; 36: e24102
• 6 Bansal S, Burman A, Tripathi AK. et al. Advanced glycation end products: Key mediator and therapeutic target of cardiovascular complications in diabetes. World J Diabetes 2023; 14: 1146-1162
• 7 Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes 2005; 54: 1615-1625
• 8 Griffin ME, Thompson JW, Xiao Y. et al. Functional glycoproteomics by integrated network assembly and partitioning. bioRxiv. 2023 2023.06.13.541482
• 9 Brownlee M. Biochemistry and molecular cell biology of diabetic complications. Nature 2001; 414: 813-820
• 10 Shumaev KB, Kosmachevskaya OV, Nasybullina EI. et al. Role of Nitric Oxide-Derived Metabolites in Reactions of Methylglyoxal with Lysine and Lysine-Rich Protein Leghemoglobin. Int J Mol Sci 2022; 24: 168
• 11 Liu M, Gong C, Shen X. et al. Mitochondrial dynamics-related genes DRP1 and OPA1 contributes to early diagnosis of cognitive impairment in diabetes. BMC Geriatr 2023; 23: 484
• 12 Walle H, Gröber U, Spitz J. Diabetes adé – Mach einfach mit! Das Buch für Diabetiker – und alle, die es nicht werden wollen. Stuttgart: Hirzel; 2017
• 13 Brownlee M. Diabetische Komplikationen: Pathobiologie der hyperglykämischen Schädigung und möglich Bedeutung für die Therapie. in: Komplikationen des Diabetes mellitus – Internationaler Experten-Wokshop, Rom. Stuttgart: Thieme; 2009: 1-8
• 14 Mason SA, Keske MA, Wadley GD. et al. Effects of Vitamin C Supplementation on Glycemic Control and Cardiovascular Risk Factors in People With Type 2 Diabetes: A GRADE-Assessed Systematic Review and Meta-analysis of Randomized Controlled Trials. Diabetes Care 2021; 44: 618-630
• 15 Mason SA, Parker L, van der Pligt P. et al. Vitamin C supplementation for diabetes management: A comprehensive narrative review. Free Radic Biol Med 2023; 194: 255-283
• 16 Juraschek SP, Guallar E, Appel LJ, Miller ER. Effects of vitamin C supplementation on blood pressure: a meta-analysis of randomized controlled trials. Am J Clin Nutr 2012; 95: 1079-1088
• 17 Zu G, Sun K, Li L. et al. Mechanism of quercetin therapeutic targets for Alzheimer disease and type 2 diabetes mellitus. Sci Rep 2021; 11: 22959
• 18 Alehagen U, Johansson P, Björnstedt M. et al. Cardiovascular mortality and N-terminal-proBNP reduced after combined selenium and coenzyme Q10 supplementation: a 5-year prospective randomized double-blind placebo-controlled trial among Swedish citizens. Int J Cardiol 2013; 167: 1860-1866
• 19 Alehagen U, Aaseth J, Alexander J. et al. Supplemental selenium and coenzyme Q10 reduce glycation along with cardiovascular mortality in an elderly population with low selenium status – A four-year, prospective, randomised, double-blind placebo-controlled trial. J Trace Elem Med Biol 2020; 61: 126541
• 20 Gröber U, Schniertshauer D, Friedrichsen HP. et al. Kardioprotektive und pleiotrope Effekte von Coenzym Q10. Zs f Orthomol Med 2022; 20: 20-27
• 21 Liang Y, Zhao D, Ji Q. et al. Effects of coenzyme Q10 supplementation on glycemic control: A GRADE-assessed systematic review and dose-response meta-analysis of randomized controlled trials. The Lancet, eClin Med 2022; 52: 101602
• 22 Zhang SY, Yang KJ, Zeng LT. et al. Effectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Int J Endocrinol 2018; 2018: 6484839
• 23 An WanS, Luo Y. et al. Micronutrient Supplementation to Reduce Cardiovascular Risk.. J Am Coll Cardiol 2022; 80 (24) 2269-2285
• 24 Thornalley PJ, Babaei-Jadidi R, Al AliH. et al. High prevalence of low plasma thiamine concentration in diabetes linked to a marker of vascular disease. Diabetologia 2007; 50 (10) 2164-2170
• 25 Rabbani N, Thornalley PJ. Emerging role of thiamine therapy for prevention and treatment of early-stage diabetic nephropathy. Diabetes Obes Metab 2011; 13 (07) 577-683
• 26 Babaei-Jadidi R, Karachalias N, Ahmed N. et al. Prevention of incipient diabetic nephropathy by high-dose thiamine and benfotiamine. Diabetes 2003; 52 (08) 2110-2120
• 27 Stracke H, Gaus w, Achenbach U. et al. Benfotiamine in diabetic polyneuropathy (BENDIP): results of a randomised, double blind, placebo-controlled clinical study. Exp Clin Endocrinol Diabetes 2008; 116 (10) 600-605
• 28 Raj V, Ojha S, Howarth FC. Therapeutic potential of benfotiamine and its molecular targets.. Eur Rev Med Pharmacol Sci 2018; 22 (10) 3261-3273
• 29 Choi HJ, Choi H. et al. Vitamin K2 supplementation improves insulin sensitivity via osteocalcin metabolism: a placebo-controlled trial. Diabetes Care 2011; 34 (09) e147
• 30 Iwamoto J, Sato Y, Takeda Y, Matsumoto H.. Bone quality and vitamin K2 in type 2 diabetes: review of preclinical and clinical studies. Nutr Rev 2011; 69 (03) 162-167
• 31 Dalmeijer GW, van der Schouw YT, Magdeleyns E. et al. The effect of menaquinone-7 supplementation on circulating species of matrix Gla protein. Atherosclerosis 2012; 225 (02) 397-402
• 32 Theuwissen E, Teunissen KJ, Spronk HM. et al. Effect of low-dose supplements of menaquinone-7 (vitamin K2 ) on the stability of oral anticoagulant treatment: dose-response relationship in healthy volunteers. J Thromb Haemost 2013; 11 (06) 1085-1092
• 33 Karamzad N, Faraji E, Adeli S. et al. Effects of MK-7 Supplementation on Glycemic Status, Anthropometric Indices and Lipid Profile in Patients with Type 2 Diabetes: A Randomized Controlled Trial. Diabetes Metab Syndr Obes 2020; 13: 2239-2249
• 34 Mitri J, Pittas AG. Vitamin D and diabetes. Endocrinol Metab Clin North Am 2014; 43 (01) 205-232
• 35 Gröber U, Holick MF.. Diabetes Prevention: Vitamin D Supplementation May Not Provide Any Protection If There Is No Evidence of Deficiency! Nutrients. 2109 11: 2651
• 36 Pittas AG, Dawson-Hughes B, Sheehan P. et al. Vitamin D Supplementation and Prevention of Type 2 Diabetes. N Engl J Med 2019; 381 (06) 520-530
• 37 Gröber U, Holick MF. Vitamin D: Die Heilkraft des Sonnenvitamins. 4., aktual. Aufl., Stuttgart: Wissenschaftliche Verlagsgesellschaft; 2020
• 38 Abugoukh TM, Sharaby AA, Elshaikh AO. et al. Does Vitamin D Have a Role in Diabetes? Cureus 2022. 14 (10) e30432
• 39 Gröber U, Schmidt J, Kisters K.. Magnesium in Prevention and Therapy. Nutrients. 2015; 7 (9) 8199-8226
• 40 Gröber U. Magnesium and Drugs. Int J Mol Sci 2019; 20 (9) pii: E2094.
• 41 Rosanoff A, West C, Elin RJ. et al. Recommendation on an updated standardization of serum magnesium reference ranges. Eur J Nutr 2022; 61 (07) 3697-3706
• 42 Zou ZG, Rios FJ, Montezano AC, Touyz RM. TRPM7, Magnesium, and Signaling. Int J Mol Sci 2019; 20 (08) pii: E1877.
• 43 Dong JY, Xun P, He K. Magnesium intake and risk of type 2 diabetes: meta-analysis of prospective cohort studies. Diabetes Care 2011; 34 (09) 2116-2122
• 44 Palmer BF, Clegg DJ. Electrolyte and acid-base disturbances in patients with diabetes mellitus.. N Engl J Med 2015; 373 (06) 548-559
• 45 Rosique-Esteban N, Guasch-Ferre M, Hernandez-Alonso P. et al. Dietary Magnesium and Cardiovascular Disease: A Review with Emphasis in Epidemiological Studies. Nutrients 2018; 10 (02) 168
• 46 Liu M, Dudley JrSC. Magnesium. Oxidative Stress, Inflammation, and Cardiovascular Disease. Antioxidants (Basel) 2020; 09 (10) 907
• 47 Zhao B, Zang L, Zhao J. et al. Association of Magnesium Intake With Type 2 Diabetes and Total Stroke: An Updated Systematic Review and Meta-Analysis.. BMJ Open 2020; 10 (03) e032240
• 48 Rooney MR, Alonso A, Folsom AR. Serum magnesium and the incidence of coronary artery disease over a median 27 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) Study and a meta-analysis. Am J Clin Nutr 2020; 111 (01) 52-60