Quercetin Intake and Absolute Telomere Length in Patients with Type 2 Diabetes Mellitus: Novel Findings from a Randomized Controlled Before-and-After Study.

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• Lifestyle choices may have an impact on the progression of T2DM.
• Telomere length, which can be short, very short, or very long, is an important sign of how bodies are aging. It is considered to reflect the health of cells and how well they are functioning.
• Shortening of telomeres is accelerated by oxidative stress and inflammation.
• Quercetin, a natural plant-derived dietary source, may play a role in protecting against cellular aging and telomere dysfunction in age-related diseases including type 2 diabetes.

Introduction

This study aimed to assess the relationship between the aging process and type 2 diabetes (T2DM) by investigating the impact of quercetin supplementation on absolute telomere length (aTL) in patients T2DM.

Methods

This was a prospective randomised controlled before-and-after study. It enrolled one hundred patients diagnosed with T2DM who were randomly assigned to the intervention (INT - standard care plus quercetin - 500 mg/day) or control group (CTR - standard care) for two 12-week periods with an 8-week washout period in between. The primary outcome measure was telomere length. Secondary outcomes included night-time sleep duration, health self-assessment, body mass index (BMI), blood pressure, total cholesterol and cholesterol ratio, and glycosylated haemoglobin (HbA1c).

Results

• 82 participants voluntarily consented to blood sampling for whole blood aTL measurements.
• Night-time sleep duration, assessed via self-reported health evaluations, improved in the INT (+0.8 h, p < 0.001), while the CTR experienced a decrease (−0.5 h, p < 0.001).
• Health self-assessment scores in the INT improved whereas those of the CTR decreased (1.5 vs. −0.6, p < 0.001).
• INT saw a decrease in the systolic blood pressure, while it increased in the CTR (−6.3 vs. 0.5 mmHg, p = 0.02).
• Blood sugar levels, indicated by HbA1C, decreased more in the INT compared to the CTR (−0.28 vs. 0.03%, p = 0.008).
• Over the eight-month supplementation period, there was an increase in the average TL per chromosome end in the INT (from 5.11 ± 1.35 to 5.63 ± 2.08 kb), whereas it decreased in the CTR (5.19 ± 1.76 to 4.88 ± 1.19 kb; 0.52 vs. −0.31 kb, p = 0.048).
• BMI, diastolic blood pressure and total cholesterol remained largely unchanged in both groups (p > 0.05).

Conclusion

The authors concluded that based on quercetin’s potential to increase average TL together with better sleep quality and improved wellbeing, blood pressure and blood sugar levels, it can be a complementary plant-based nutritional approach in addition to conventional pharmacological treatment to offer a more integrative care plan to diabetes care.

• Quercetin supplementation may be included as part of the primary health care interventions to support telomere length maintenance in patients with T2DM.
• Quercetin supplementation may also be beneficial for T2DM patients to improve their sleep quality, general well-being perception, blood pressure and blood sugar level regulation.
• TL measurements should be part of the clinical assessments of patients with T2DM for early detection of accelerated TL shortening.

• Larger-scale blinded placebo-controlled studies carried out in multiple research sites or hospitals are needed to assess different doses of the intervention treatment to see how the effect changes with the amount given. These would help to confirm the strengths and reliability of the findings.