Monitoring oxidative stress enables predictions of personalised glucose targets in diabetic patients

Abstract

The principal cause of hyperglycemia mediated post diabetic complications PDCs is oxidative stress OS Therefore establishing a quantitative relationship between OS andglycemic status GS of a diabetic individual could help in deciding how much and how longOS should be controlled via external anti glycemic treatment To monitor serial changes inOS as measured by glutathione or GSH an OS marker a group of newly diagnosed type2 diabetic patients kept on anti diabetic treatment were followed for the period of 8 weeks A cluster analysis performed on the GSH values pooled from non diabetics and diabeticsbefore and after therapy 0 and 8 weeks show that GSH can be used to classify individualsbased upon their diabetic status independently of glucose That is GSH can be an excellentanti oxidant to monitor along with glucose in defining diabetes status Further GSHlevels are found to be inversely correlated with the GS of diabetic individuals We propose aphysiological minimal mathematical model to capture a quantal dose response relationshipbetween GSH and glucose for each diabetic patient Individualised diabetic GSH glucosecurves are parameterised by maximal glutathione level Gtot glucose concentration whenGSH is half maximal v and slope of the curve k Finally to relax the assumptions imposedin the physiological model a statistical phenomenological model is proposed to captureOS GS trajectories in diabetic patients We show that a phenomenological model is a statisticallybetter and simple alternative to the physiological minimal model We propose thatindividually parameterised GSH glucose curves can be helpful in deciding optimal glucosecontrol strategies through which OS is maximally controlled Thus glucose targets can bepersonalised based upon the OS state of an individual I newline newline