Relationship of oxidative stress and fibrinolysis in diabetes Diabetics have an increased need for antioxidant nutrients like vitamins C and E due to increased oxidative stress. High dosages of vitamin E (e.g., 800 to 1200 UJ) and vitamin C (>1,000 mg) have been shown to improve not only antioxidant status, but also blood sugar control. Another mechanism by which vitamin E may be beneficial via reducing fibrinogen formation. Elevated fibrinogen levels are a major, primary risk factor for cardiovascular disease - the leading cause of death in diabetics and a major factor in the development of the complications of diabetes. Fibrinogen promotes atherosclerosis by acting as a cofactor for platelet aggregation; increasing the viscosity of blood; and stimulating the formation of the atherosclerotic plaque. A recent analysis verified the existence of a relationship between oxidative stress using malondialdehyde levels and the level of tissue plasminogen activator inhibitor (WAI). With increasing malondialdehyde levels, there was a parallel increase in tPAL These results indicate that oxidative stress is a major factor in the hypofibrinolytic state in diabetics. What needs to be determined is what effect antioxidant therapy has in offsetting the hypofibrinolytic state. In the meantime, based on other studies showing considerable benefit, diabetics should supplement their diet with high dosages of vitamins C and E. Reference: Skrha I et al: Relationship of oxidative stress and fibrinolysis in diabetes mellitus. Diabetic Medicine 13:800-5,1996