My nine year old son, who has type 1 diabetes, had pulmonary stenosis which required surgery at birth, and he is still followed by his cardiologist. We are concerned about the development of additional cardiovascular disease due to his diabetes. We have asked his endocrinologist, as well as the cardiologist, about the value of Vitamin E in the prevention of cardiovascular disease in people with diabetes, and neither one felt there was any. What’s your opinion about the value of Vitamin E in the prevention of cardiovascular disease in people with diabetes? What studies support your opinion?

Despite early optimism based on animal and some human studies, antioxidants like vitamin E and nicotinamide have been of little value in the management of type 1A (autoimmune) diabetes, either in delaying insulin dependence or preventing microvascular complications. The disappointing results of ENDIT, the Europaean trial of nicotinamide to delay the need for insulin, and in a smaller trial in our own Center of a mix of antioxidants on early microvascular disease, confirm this.

In your son’s case his early pulmonary stenosis would not have any effect on the incidence of subsequent renal and retinal vascular problems and so far as is known at the moment the best prevention is optimal control of blood glucose at this stage, and later on, regular testing of sleeping blood pressure and for microalbumin as well as eye testing with the newer technologies like retinal blood flow measurement. Appropriate treatments at this stage can reverse early changes.

DOB