Type 2 diabetes mellitus (T2DM) and its associated complications are major global health issues due to the high rates of diabetes-related morbidity and mortality. Nephropathy, retinopathy and neuropathy are among the many consequences of T2DM that are often present upon diagnosis or develop during the course of the disease.
The correlation between T2DM and oxidative stress is well known. This is due to hyperinsulinaemia and hyperglycaemia that increase the production of reactive oxygen species, hence contributing to the rise in oxidative stress. There have been several meta-analyses exploring the effects of vitamin E supplementation on inflammation and oxidative stress. However, these studies mainly focused on tocopherols (the regular vitamin E) rather than tocotrienols (the more potent form of vitamin E). There is growing in vitro and in vivo evidence of the beneficial effects of palm tocotrienols/tocopherol complex (Palm TRF) in T2DM.
HbA1c (glycated haemoglobin) is an important marker of long-term glycemic control with the ability to reflect the cumulative glycemic history of the preceding two to three months. HbA1c is currently regarded as the test of choice for monitoring and chronic management of diabetes since it is a reliable marker of chronic glycemia and correlates well with the likelihood of long-term diabetic problems.
The potential of Palm TRF in reducing HbA1c has recently been reported in a systematic review and meta-analysis that was published in the journal Advances in Nutrition. This is the first systematic review and meta-analysis of palm TRF supplementation's effects on HbA1c, blood pressure and Hs-CRP in patients with T2DM which was carried out by researchers from Monash University Malaysia.
We look forward to engaging and working with brand owners to facilitate the development of science-driven cardiometabolic products utilising TocoGaia
- Bryan See, Vice President of PhytoGaia
The pooled effect size was estimated by the meta-analysis using data from a total of 11 studies. The studies were chosen based on criteria including randomised controlled trials (RCTs), compared supplementation of tocotrienols with placebo, patients with T2DM and/or with microvascular complications and study time frame of within 10 years (2012-2023). Study sample size ranged from 43 to 300 patients with T2DM ranging in age from 50 to 70 years old. Generally, the studies used palm oil-derived TRF as the intervention and the dosage of tocotrienol-rich fractions ranged from 200 mg to 420 mg of total mixed tocotrienols.
The current meta-analysis offers proof in favour of the hypothesis that Palm TRF supplementation is linked to a significant reduction in HbA1c. Patients with T2DM who took palm TRF supplementation at a dose of 250–400 mg showed a significant reduction in HbA1c level. The reduction is most notable when the intervention lasts less than six months, and the effectiveness is improved if the patients have had diabetes for less than ten years. Clinically significant HbA1c reduction is essential to prevent cardiac mortality and micro- and macrovascular problems in patients with diabetes.
Despite the fact that serum Hs-CRP and systolic and diastolic blood pressure did not significantly decrease, Palm TRF may still be beneficial in these circumstances. Future long-term randomised trials should be carried out to evaluate the effects of palm TRF in T2DM as well as the patient’s baseline levels of Palm TRF and dietary habits.
"Diabetes mellitus is a chronic disease and growing epidemic. T2DM has significant economic, social and health burdens not only for the individual but also on their families, careers, as well as the healthcare system. Nowadays, it is commonly acknowledged that co-morbidities such as obesity, diabetes mellitus and hypertension increase the risk contracting COVID-19,” said Dr Ariati Aris, Scientific Affairs Specialist at PhytoGaia.
“This review provided insight into the potential value of Palm TRF in the development of effective dietary supplements for people with T2DM, especially in reducing HbA1c,” added Dr Ariati Aris.
“Tocotrienols, also known as "the Super Vitamin E," are potent antioxidants with a myriad of cardiometabolic health benefits. They contribute to improving our overall health and well-being. TocoGaia - a full spectrum of tocotrienols/tocopherol complex naturally extracted from palm fruits - could potentially serve as an additional solution that may help patients with T2DM. We look forward to engaging and working with brand owners to facilitate the development of science-driven cardiometabolic products utilising TocoGaia,” commented Bryan See, Vice President of PhytoGaia.