Summary: In a trial in women with type 2 diabetes, combined training plus astaxanthin gave the best improvements in oxidative-stress, inflammatory, and molecular markers, but the glycaemic benefits (glucose, insulin resistance, HbA1c) came from exercise, not from the supplement, which alone did not change them.
PICO Summary
| Element | Detail |
|---|---|
| Population | 90 women with type 2 diabetes, randomised to six groups of 15; 8-week trial, Iran. |
| Intervention | Combined aerobic and resistance training plus astaxanthin 8 mg/day (CT+S). |
| Comparison | Control, placebo, astaxanthin alone, training alone, and training plus placebo. |
| Outcome | Both training and astaxanthin enhanced antioxidant defences and reduced inflammation, with CT+S best. Humanin rose in training groups; miR-126-3p and miR-146a were upregulated and miR-122 downregulated in CT+S. Crucially, fasting glucose, HOMA-IR, and HbA1c improved significantly in the training groups but remained unchanged with astaxanthin alone. |
Expert Commentary
This is a mechanistically rich trial whose factorial design usefully separates what the exercise does from what the supplement does, and that separation is the message to keep front and centre. The molecular story is interesting, with a carotenoid antioxidant and training together shifting redox-sensitive microRNAs and raising Humanin, a mitochondrial-derived peptide linked to insulin signalling, which offers a plausible pathway for the antioxidant and anti-inflammatory effects. But the clinically decisive finding is the dissociation: the glycaemic markers that matter to patients, fasting glucose, insulin resistance, and HbA1c, improved with training and did not move with astaxanthin alone. So astaxanthin should be read as a possible adjunct that augments oxidative and inflammatory markers, not as a glucose-lowering agent. The limitations are real, an eight-week study of 90 women split across six small arms, surrogate molecular endpoints, and a single setting. Can I use this with my patients? Mainly to reinforce exercise. The unambiguous practical lesson is that combined training improves glycaemia and the broader redox profile, while I would present astaxanthin as an unproven add-on for glucose control and not a substitute for activity or established therapy.
References
Basereh A, Khoramipour K, Hosseini N, et al. Redox-sensitive miRNAs and Humanin could mediate effects of exercise and astaxanthin on oxidative stress and inflammation in type 2 diabetes. Sci Rep. 2025;15(1):40113. doi:10.1038/s41598-025-23914-y