1. Introduction
Cardiovascular disease is amajor cause of morbidity and mortality in
patients with type 2 diabetes mellitus (T2DM). In 2004, death due to
cardiovascular complication in the diabetic population aged 65 years
or older was around 68% [1]. Clearly, there is an urgent need for interventions
that can reduce the morbidity and mortality associated with
cardiovascular disease in patients with T2DM.
There are several factors responsible for this increased risk. Various
authors have suggested that reactive oxygen species (ROS) contribute
to the increased burden of cardiovascular disease in people with
T2DM, due to an increased production of reactive oxygen species that
produce structural changes in lipoproteins that markedly increase
their atherogenic potential.
Vitamin E is known to have an antioxidant property that decreases
ROS levels. In the past, preclinical and observational studies motivated
some cardiologists to prescribe vitamin E for patients with T2DM. Clinical
trials did not support the ability of vitamin E supplementation to
provide cardiovascular protection in genetically unselected populations
with T2DM. However, some investigators have suggested that vitamin E
can reduce cardiovascular disease events in subpopulations of patients
with T2DM.
The topic of this review is important because diabetes is a common
condition with high rates of incidence and prevalence. It is estimated
that between 2009 and 2034, the number of diabetic patients in the
United States will increase from 23.7 million to 44.1 million [5]. Also,
if the use of vitamin E is shown to have positive effects in a clearly
identified group of T2DM patients, the cost associated with care in this
population can be significantly reduced.