NOVEL NITRIC OXIDE FORMULATION CAN MITIGATE DIABETES SYMPTOMS
by David Daniels
Nitric oxide is a naturally occurring molecule in the body that plays an important role in blood circulation and overall health. People with low levels of nitric oxide are at greater risk for high blood pressure, coronary artery disease, impaired vision, depression and cognitive decline. Additionally, Nitric Oxide (NO) is significantly lower in people that present with both Type I and Type II diabetes.
The global prevalence of diabetes in adults was reported to be 10.5% (536.6 million people) in 2021, reaching up to 12.2% (783.2 million) in 2045.1 Type 2 Diabetes (T2D), accounting for approximately 90% of diabetes cases, is related to macrovascular and microvascular complications, with an overall prevalence of 32.2% and 12.0%, respectively2,3. In addition, cardiovascular disease (CVD) mortality is estimated to constitute 50.3% of all deaths in patients with T2D2. Both endothelium (ET) and vascular smooth muscle (VSM) layer are functionally impaired in diabetic vessels4,5, and vascular complications account for the most significant part of diabetes-associated morbidity and mortality6.
There are numerous concomitant health issues related to diabetes beyond the obvious cardiovascular and hypertensive issues, not the least of which is skin wounds. Complications related to diabetes wound care include slow healing wounds due to poor blood circulation and nerve damage, increased risk of infection, gangrene development, tissue necrosis, bone infection (osteomyelitis), sepsis (bloodstream infection), and ultimately, amputation of affected limbs if left untreated, primarily affecting the feet due to the high prevalence of diabetic neuropathy in that area.7
Nitric oxide (NO) is a molecule that helps regulate blood vessels and metabolism. People with diabetes often have lower levels of NO, which can contribute to high blood pressure cardiovascular disease, abnormalities related to blood flow, such as plaque buildup in the carotid arteries and brain dysfunction and concomitant maladies such as diabetic foot ulcers and associated neuropathies.
There has been a proven relationship between Nitric Oxide (NO) levels and both type I and II diabetes.
- Type 2 diabetes: People with type 2 diabetes often have lower levels of NO in their urine. This can be due to a number of factors, including hyperinsulinemia. Nitric oxide (NO) is a key metabolic and vascular regulator. Its production is stimulated by insulin. A reduced urinary excretion of NO products (NOx) is frequently found in type 2 diabetes, particularly in association with nephropathy.
- Type 1 diabetes: People with type 1 diabetes can have impaired NO metabolism, which can be related to a lack of available nitric oxide or the imability to effectively process it at an adequate level. 8
NITRIC OXIDE SUPPLEMENTATION
Maintaining or introducing a bioavailability of NO on an “as needed” basis could prove to not only reduce insulin resistance but also affect the associated issues that could be both causal, or the result of the presence of either Type I or Type II diabetes.
Some supplements contain ingredients that the body converts to NO. These supplements may help improve insulin sensitivity and lower blood pressure, which are problems associated with diabetes. However, the inability for current supplementation to attain bioavailability for more than minutes limits any measurable efficacy.
Attempts have been made in studies to introduce NO repeatedly to overcome the rapid dissipation of externally introduced NO but have met with limited results.
Numerous studies associated with a Korean company that has introduced NO with various delivery systems, including intravenous, oral, inhaled and topical has proven to increase the presence of available NO throughout the day on an as needed basis. Current supplementation only allows for a few hours of available NO and only minutes at a therapeutic level.
Additionally, while it may have a significant effect on insulin sensitivity:
- NO helps with carbohydrate metabolism.
- NO donors may help improve glucose homeostasis and insulin signaling in people with type 2 diabetes.
CONCLUSION
Numerous studies have ascertained that a bioavailable form of nitric oxide has numerous health benefits and could be a valuable tool to combat both the causal elements of diabetes, while also mitigating the symptoms and damage wrought by the onset of both Type I and Type II diabetes.
1. Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract. 2022;183:109119.
2. Einarson TR, Acs A, Ludwig C, Panton UH. Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017. Cardiovascular Diabetol. 2018;17:83.
3. Aikaeli F, Njim T, Gissing S, Moyo F, Alam U, Mfinanga SG, et al. Prevalence of microvascular and macrovascular complications of diabetes in newly diagnosed type 2 diabetes in low-and-middle-income countries: A systematic review and meta-analysis. PLOS Glob Public Health. 2022;2:e0000599.
4. Hadi HA, Suwaidi JA. Endothelial dysfunction in diabetes mellitus. Vasc Health Risk Manag. 2007;3:853–76.
5. Montero D, Walther G, Pérez-Martin A, Vicente-Salar N, Roche E, Vinet A. Vascular smooth muscle function in type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetologia. 2013;56:2122–33.
6. Forbes JM, Fotheringham AK. Vascular complications in diabetes: old messages, new thoughts. Diabetologia. 2017;60:2129–38.
7. Katherine McDermott, Michael Fang, Andrew J.M. Boulton, Elizabeth Selvin, Caitlin W. Hicks; Etiology, Epidemiology, and Disparities in the Burden of Diabetic Foot Ulcers. Diabetes Care 2 January 2023; 46 (1): 209–221. https://doi.org/10.2337/dci22-0043
8. Tessari P, Cecchet D, Cosma A, Vettore M, Coracina A, Millioni R, Iori E, Puricelli L, Avogaro A, Vedovato M. Nitric oxide synthesis is reduced in subjects with type 2 diabetes and nephropathy. Diabetes. 2010 Sep;59(9):2152-9. doi: 10.2337/db09-1772. Epub 2010 May 18. PMID: 20484137; PMCID: PMC2927936.