Atherosclerosis constitutes a major cause of complications of diabetes. The mechanisms involved include, oxidative modification of low density lipoproteins (LDL) through a multitude of endogenous mediators including homocysteine and angiotensin II. Assessment of supplementation with either low-dose ACE inhibitor or a combination of antioxidants to the treatment regimens of type 2 diabetics with CAD on some markers of atherosclerosis. Thirty subjects, of the same socio-economic background, were recruited and divided into 3 groups. Group I included 10 healthy individuals. The 20 diabetic subjects with CAD were randomly distributed into of group II and group III. Treatment of patients in group II was supplemented by a once daily tablet containing antioxidant combination. Supplementation in group III patients consisted of 12.5 mg daily dose of the ACE inhibitor, captopril. Compared to the healthy individuals, diabetic patients showed hyperglycemia, elevated glycated hemoglobin, increased oxidative stress, depressed antioxidant defense, hyperhomocysteinemia and elevated levels of oxidized LDL autoantibodies. The results of a three month follow-up of type 2 diabetic patients indicated that both adjunct treatments improved all parameters tested, including glycemic control, oxidative stress, and hyperhomocysteinemia. However, the titer of circulating ox-LDL autoantibodies, which declined very rapidly, was not a good prognostic indicator for atherosclerosis.

Conclusion: The observed shift in the disease indices towards normal levels make the use of both adjuvant therapies in type 2 diabetics with atherosclerotic CAD worth pursuing in a larger clinical study.

Type 2 diabetes, atherosclerosis, antioxidants, low dose captopril