世界范围内超过 4 仪 2 千 2 百万人患有糖尿病。大多数患者——90% 到 95%——患的是 2 型糖尿病，这类糖尿病主要是由生活方式导致，如饮食不良和体育活动不足。免疫系统错误攻击胰腺，从而阻止胰腺分泌胰岛素时，1 型糖尿病就发生了，而一旦发生，就无法阻止它。

美国期刊《心血管药物》(Cardiovascular Drugs) 中一项 2018 年的研究显示，使用NAC补充剂的糖尿病患者心脏得到了更好的保护。具体而言，研究者们评论说：”通过抵御氧化应激，NAC对糖尿病患者具有心肌梗塞风险的心脏提供了强有力的保护……“

《药理研究》(Pharmacological Research) 期刊中一篇 2019 年的评论文章进一步探讨了 NAC 有助益的证据，证据显示 NAC 可能有助于改善胰岛素耐受性患者、前驱糖尿病患者和糖尿病患者对胰岛素的敏感度。

虽然使用糖尿病补充剂可能对糖尿病患者有助益，但是健康的生活方式也是控制血糖水平的基础。咨询医生之前，糖尿病患者务必不要停药。

参考文献：

00001. Julius M, Lang CA, Gleiberman L, Harburg E, DiFranceisco W, Schork A. Glutathione and morbidity in a community-based sample of elderly.J Clin Epidemiol. 1994;47(9):1021–1026. doi:10.1016/0895-4356(94)90117-1Dröge W, Breitkreutz R. Glutathione and immune function.Proc Nutr Soc. 2000;59(4):595–600. doi:10.1017/s0029665100000847

00002. Ghezzi P. Role of glutathione in immunity and inflammation in the J Gen Med. 2011;4:105–113.Published 2011 Jan 25. doi:10.2147/IJGM.S15618Sadowska AM. N-Acetylcysteine mucolysis in the management of chronic obstructive pulmonary disease.Ther Adv Respir Dis. 2012;6(3):127–135. doi:10.1177/1753465812437563

00003. Tse HN, Raiteri L, Wong KY, et al.High-dose N-acetylcysteine in stable COPD: the 1-year, double-blind, randomized, placebo-controlled HIACE study.Chest. 2013;144(1):106–118. doi:10.1378/chest.12-2357

00004. Santus P, Corsico A, Solidoro P, Braido F, Di Marco F, Scichilone N. Oxidative stress and respiratory system: pharmacological and clinical reappraisal of N-acetylcysteine.COPD. 2014;11(6):705–717. doi:10.3109/15412555.2014.898040

00005. Matera MG, Calzetta L, Cazzola M. Oxidation pathway and exacerbations in COPD: the role of NAC.Expert Rev Respir Med. 2016;10(1):89–97. doi:10.1586/17476348.2016.1121105

00006. Ayfer Aytemur Z, Baysak A, Ozdemir O, Köse T, Sayiner A. N-acetylcysteine in patients with COPD exacerbations associated with increased sputum.Wien Klin Wochenschr. 2015;127(7-8):256–261. doi:10.1007/s00508-014-0692-4

00007. Kalyuzhin OV.Effect of N-acetylcysteine on mucosal immunity of respiratory tract.Ter Arkh. 2018;90(3):89–95. doi:10.26442/terarkh201890389-95

00008. Fundam Clin Pharmacol. 2018 Nov 24. doi: 10.1111/fcp.12437. (NAC and Acetaminophen)

00009. Fisher ES, Curry SC.Evaluation and treatment of acetaminophen toxicity.Adv Pharmacol. 2019;85:263–272. doi:10.1016/bs.apha.2018.12.004

00010. Su W, Zhang Y, Zhang Q, et al.N-acetylcysteine attenuates myocardial dysfunction and postischemic injury by restoring caveolin-3/eNOS signaling in diabetic rats.Cardiovasc Diabetol. 2016;15(1):146.Published 2016 Oct 12. doi:10.1186/s12933-016-0460-z

00011. Bartekova M, Barancik M, Ferenczyova K, Dhalla NS.Beneficial Effects of N-acetylcysteine and N-mercaptopropionylglycine on Ischemia Reperfusion Injury in the Heart.Curr Med Chem. 2018;25(3):355–366. doi:10.2174/0929867324666170608111917

00012. Zaki SM, Abdalla IL, Sadik AOE, Mohamed EA, Kaooh S. Protective Role of N-Acetylcysteine on Isoprenaline-Induced Myocardial Injury: Histological, Immunohistochemical and Morphometric Study.Cardiovasc Toxicol. 2018;18(1):9–23. doi:10.1007/s12012-017-9407-1

00013. Marian AJ, Tan Y, Li L, et al.Hypertrophy Regression With N-Acetylcysteine in Hypertrophic Cardiomyopathy (HALT-HCM): A Randomized, Placebo-Controlled, Double-Blind Pilot Study.Circ Res. 2018;122(8):1109–1118. doi:10.1161/CIRCRESAHA.117.312647

00014. Gunturk EE, Yucel B, Gunturk I, Yazici C, Yay A, Kose K. The effects of N-acetylcysteine on cisplatin induced cardiotoxicity.Bratisl Lek Listy. 2019;120(6):423–428. doi:10.4149/BLL_2019_068

00015. Bauer IE, Green C, Colpo GD, et al.A Double-Blind, Randomized, Placebo-Controlled Study of Aspirin and N-Acetylcysteine as Adjunctive Treatments for Bipolar Depression.J Clin Psychiatry. 2018;80(1):18m12200.Published 2018 Dec 4. doi:10.4088/JCP.18m12200

00016. Miyake N, Miyamoto S. Nihon Shinkei Seishin Yakurigaku Zasshi. 2016;36(2):29–35.

00017. Rapado-Castro M, Dodd S, Bush AI, et al.Cognitive effects of adjunctive N-acetyl cysteine in psychosis.Psychol Med. 2017;47(5):866–876. doi:10.1017/S0033291716002932

00018. Adeoye O, Olawumi J, Opeyemi A, Christiania O. Review on the role of glutathione on oxidative stress and infertility.JBRA Assist Reprod. 2018;22(1):61–66.Published 2018 Mar 1. doi:10.5935/1518-0557.20180003

00019. Nemati M, Nemati S, Taheri AM, Heidari B. Comparison of metformin and N-acetyl cysteine, as an adjuvant to clomiphene citrate, in clomiphene-resistant women with polycystic ovary syndrome.J Gynecol Obstet Hum Reprod. 2017;46(7):579–585. doi:10.1016/j.jogoh.2017.07.004

00020. Jannatifar R, Parivar K, Roodbari NH, Nasr-Esfahani MH.Effects of N-acetyl-cysteine supplementation on sperm quality, chromatin integrity and level of oxidative stress in infertile men.Reprod Biol Endocrinol. 2019;17(1):24.Published 2019 Feb 16. doi:10.1186/s12958-019-0468-9

00021. Dludla PV, Dias SC, Obonye N, Johnson R, Louw J, Nkambule BB.A Systematic Review on the Protective Effect of N-Acetyl Cysteine Against Diabetes-Associated CardiovascularJ Cardiovasc Drugs. 2018;18(4):283–298. doi:10.1007/s40256-018-0275-2

00022. Dludla PV, Mazibuko-Mbeje SE, Nyambuya TM, et al.The beneficial effects of N-acetyl cysteine (NAC) against obesity associated complications: A systematic review of pre-clinical studies.Pharmacol Res. 2019;146:104332. doi:10.1016/j.phrs.2019.104332