Mushrooms as a functional food mediator in Preventing and ameliorating diabetes

Abstract

Diabetes is a major health problem predisposing to markedly increased complications. Despite the numerous preventative strategies and armories of medication, the management of diabetes remains grossly unsatisfactory. Diabetes is emerging as a pandemic. Therefore it is important to identify novel nutraceuticals or drugs for curing or preventing diabetes, which have fewer side effects. The present paper reviewed scientific information on mushrooms with regards to its anti-diabetic active compounds and/or pharmacological test results, which are commonly used as functional foods and ingredients used in the traditional medical system and which have demonstrated experimental or/and clinical anti-diabetic effectiveness. These functional foods might have a big potential for the prevention or cure of diabetes more than in other plant species. However, still scientific or clinical studies are not sufficient for hypoglycemic effect for mushrooms use as ‘official’ drug. Therefore, it is proposed that a close attention be paid to carry out further research of functional mushrooms for preventive and curative measures for diabetes and its complications.

Full text

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Review Open Access
Mushrooms as a functional food mediator in
Preventing and ameliorating diabetes
Pathirage Kamal Perera1, Yunman Li2*
1Department of Materia medica and Pharmacology, Institute of Indigenous Medicine, University
of Colombo, Rajagiriya, Sri Lanka.
2Department of Physiology, China Pharmaceutical University, Mailbox 207 Tongjiaxiang 24,
Nanjing, Jiangsu, 210009, P. R. China.
Correspondence Yunman Li, Department of Physiology and Pharmacology, China Pharmaceutical
University, Mailbox 207 Tongjiaxiang 24, Nanjing, Jiangsu, 210009, P. R. China
Submission date: March 23, 2011; Acceptance date: April 23, 2011; Publication date: April 25,
2011
Abstract
Diabetes is a major health problem predisposing to markedly increased complications. Despite
the numerous preventative strategies and armories of medication, the management of diabetes
remains grossly unsatisfactory. Diabetes is emerging as a pandemic. Therefore it is important to
identify novel nutraceuticals or drugs for curing or preventing diabetes, which have fewer side
effects. The present paper reviewed scientific information on mushrooms with regards to its
anti-diabetic active compounds and/or pharmacological test results, which are commonly used as
functional foods and ingredients used in the traditional medical system and which have
demonstrated experimental or/and clinical anti-diabetic effectiveness. These functional foods
might have a big potential for the prevention or cure of diabetes more than in other plant species.
However, still scientific or clinical studies are not sufficient for hypoglycemic effect for
mushrooms use as ‗official‘ drug. Therefore, it is proposed that a close attention be paid to carry
out further research of functional mushrooms for preventive and curative measures for diabetes
and its complications.
Keywords: Diabetes, Mushrooms, Functional foods, Hypoglycemic, and Nutraceuticals
Introduction
As of 2000 at least 171 million people worldwide suffer from diabetes, or 2.8% of the population
[1]. Diabetes is a major health problem predisposing to markedly increased cardiovascular
mortality and serious morbidity and mortality related to development of nephropathy, neuropathy
and retinopathy [2]. Although chemical and biochemical hypoglycemic agents, e.g., insulin,

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tolbutamide, phenformin, troglitazone, rosigitazone and repaglinide, are the mainstay of
treatment of diabetes and are effective in controlling hyperglycemia, they have harmful side-
effects and fail to significantly alter the course of diabetic complications [3].
Some mushrooms appear to be effective for both the control of blood glucose and the
modification of the course of diabetic complications without side-effects. This review
particularly explores the promising mushrooms that have demonstrated clinical or/and
experimental anti-diabetic properties by preventing or lowering down the development of
diabetes mellitus. But still scientific or clinical studies are not sufficient enough to show the
hypoglycemic effects of mushrooms to be use as ‗official‘ drugs or nutraceuticals. Therefore, we
suggest a closer attention be paid to the mushrooms that have preventive and curative functions
of diabetes mellitus and its complications.
Diabetes mellitus (DM)
There are two main types of Diabetes mellitus (DM); type I diabetes and type II diabetes. Type I
diabetes occurs as a result of deficiency of insulin due to destructive lesions of pancreatic β-cells,
and usually progresses to the stage of absolute insulin deficiency [4]. Typically, type I diabetes
occurs in young subjects with acute onset, but may occur at any age, sometimes with slow
progression [5]. Type I diabetes may be further divided into subtypes according to the mode of
onset (i.e. acute or slowly-progressive), HLA antigens, or epitopes of autoantigens [5, 6].
Most patients previously called non insulin-dependent diabetes mellitus (NIDDM) belong to
Type II diabetes category. In this type, the mass of pancreatic β cells and their function are
preserved to some extent, and insulin injection is seldom needed to sustain life. Ketoacidosis
may occur in the presence of severe infection or other stress. Both decreased insulin secretion
and decreased insulin sensitivity (insulin resistance) are involved in its pathogenesis. Insulin
resistance may not always be present. The relative role of these two factors varies between
patients. With regard to insulin secretion, the acute insulin response to a glucose load is
characteristically defective. The majority of patients are obese or have been obese in the past.
The prevalence of type II DM among adults varies from less than 5% to over 40% depending on
the population in question [2]. With the increase of obesity, sedentariness and dietary habits in
both developed and developing countries, the prevalence of type II DM is growing at an
exponential rate [2, 7]. Typically, type II DM develops after middle age, but may occur in
younger people. Screening by urine analysis of large numbers of school children has revealed
that type II diabetes has been steadily increasing since the 1970s [8, 9].
Mushrooms as a functional food
Chang et al. defined the mushrooms as "a macro fungus with distinctive fruiting bodies that
could be hypogeous or epigeous, large enough to be seen by naked eyes and to be picked by
hands [10]. From taxonomic point of view, basidiomycetes and some species of ascomycetes
mainly belong to category of mushrooms. Mushrooms constitute 22,000 known species. They

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are widely available on earth and about 10% of them are explored. Among the unexplored and
unexamined mushrooms, if the proportion of useful mushroom is 5%, it suggests that 7000
undiscovered species would possibly provide benefit to mankind [11].
Numerous species of mushrooms exist in nature; however, only a few are used as edibles.
Many Asian countries use traditionally wild edible mushrooms as delicious and nutritional foods
and medicine [12]. Wild edible mushrooms are appreciated not only for their texture and flavor
but also for the chemical and nutritional characteristics [13, 14]. Edible mushrooms have higher
protein contents and minerals and contain less fat but are rich in B vitamins, vitamin D, vitamin
K and sometimes vitamins A and C [15-18]. Mushrooms are not only sources of nutrients but
also have been reported as therapeutic foods, useful in preventing diseases such as hypertension,
diabetes, hypercholesterolemia and cancer [19, 20]. These functional characteristics are mainly
due to the presence of dietary fiber and in particular chitin and beta glucans [16]. Studies have
also shown that certain mushrooms species have antitumor, antiviral, antithrombotic and
immunomodulating properties. [21]. Research has shown that some mushrooms may have
potential to lower elevated blood sugar levels. But the explanation for this effect is limited, with
the exception of some mushrooms. Therefore it is useful to carry out more research on
mushrooms with a view to identify active principles in them for the treatment of diabetes
mellitus and its complications.
Medicinal mushrooms and diabetes
Tremella fuciformis (berk)
Tremella fuciformis has been given the common names snow fungus or silver ear fungus. In
Chinese cuisine, Tremella fuciformis is traditionally used in sweet dishes. Despite its tasteless
nature, T. fuciformis is valued for its gelatinous texture as well as its supposed medicinal benefits
[22]. Glucuronoxylomannan (AC) from the fruiting bodies of T. fuciformis exhibited a significant
dose-dependent hypoglycemic activity in normal mice and also showed a significant activity in
streptozotocin-induced diabetic mice, by intraperitoneal administration [23]. The anti-diabetic
activities of the exopolysaccharides (EPS) produced by submerged mycelial culture of T.
fuciformis in ob/ob mice were investigated [24]. The results suggested that EPS exhibited
considerable hypoglycemic effect and improved insulin sensitivity possibly through regulating
PPAR-gamma-mediated lipid metabolism [24]. These results indicated that Tremella fuciformis
has potential oral hypoglycemic effect as a functional food for the management of DM.
Wolfiporia extensa (Peck) Ginns (formerly known as Poria cocos F.A. Wolf)
Poria cocos, a rotten pine-tree fungus is a wood decay fungus but has a terrestrial growth habit. It
has long been used as traditional Chinese medicine and food [25-27]. Poria cocos, alone or in
combination with other herbs is often used to treat diabetes as well as other disorders [28-30].
Mechanistic study on streptozocin (STZ) treated mice showed that the crude extract,

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dehydrotumulosic acid, dehydrotrametenolic acid, and pachymic acid of Poria cocos exhibited
different levels of insulin sensitizer activity [31]. The data suggested that the Poria cocos extract
and its triterpenes reduce postprandial blood glucose levels in db/db mice via enhanced insulin
sensitivity irrespective of PPAR-γ [31].
Ganoderma lucidum (Curtis) P.Karst
Ganoderma lucidum has been use since the 4th century A.D. and is well known in China as the
herb of longevity. Ganoderma is to be famous tonic and found an important place in Chinese
medicine due to its beneficial effects to all viscera and nontoxic nature [32]. Research workers
have found that Ganoderma lucidum polysaccharides (Gl-PS) dose-dependently lowered the
serum glucose levels after administration in mice. Ganoderma lucidum polysaccharides (Gl-PS)
possess the hypoglycemic effect on normal mice; one mechanism is through its insulin releasing
activity due to a facilitation of Ca2+ inflow to the pancreatic beta cells [33].
Ganoderma applanatum (Pers.) Pat. and Collybia confluens (Pers.: Fr.) Kummer
The hypoglycemic effects of Ganoderma applanatum exo-polymer (GAE) and Collybia
confluens exo-polymer (CCE) produced by submerged mycelial cultures in streptozotocin (STZ)-
induced diabetic rats were shown hypoglycemic effects. The results strongly demonstrated the
potential of GAE and CCE in combating diabetes in experimental animals [34].
Auricularia auricula-judae (Bull.)
Auricularia auricula-judae, known as the Jew‘s Ear, Jelly Ear is a species of edible
Auriculariales mushroom found worldwide. Distinguished by its noticeably ear-like shape and
brown coloration, it grows upon wood. It is popular in China, where the medicinal use of food is
common; a soup containing A. auricula-judae, chicken, pak choi and ginger is used medicinally
for dealing with colds and fevers by reducing the heat of the body [35]. The hypoglycemic effect
of water-soluble polysaccharide (FA) from fruiting bodies of A. auricula-judae was investigated
on genetically diabetic mice (KK-Ay). This study showed that FA had a hypoglycemic effect on
KK-Ay mice, and the reduced food consumption was not a major factor which contributed to the
hypoglycemic action of FA [36].
Agaricus campestris (L.)
Agaricus campestris has fast maturing and short shelf-life [37]. A. campestris (mushroom) has
been documented as a traditional treatment for diabetes. The administration of mushroom in the
diet and drinking water countered the hyperglycaemia of streptozotocin-diabetic mice [38].
Agaricus subrufescens (Peck)
Agaricus subrufescens is a choice edible, with a somewhat sweet taste and fragrance of almonds
[39].In Japan, A. subrufescens is also the most popular complementary and alternative medicine

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used by cancer patients [40]. A. brasiliensis fruit body is useful as a health promoting food.
Performed studies on murine models and human volunteers to examine the immune-enhancing
effects of the naturally outdoor-cultivated fruit body of Agaricus brasiliensis KA21 (i.e.
Agaricus blazei) has shown antitumor, leukocyte-enhancing, hepatopathy-alleviating and
endotoxin shock-alleviating effects in mice [41]. In the human study, percentage body fat,
percentage visceral fat, blood cholesterol level and blood glucose level were decreased and
natural killer cell activity was increased [41]. Beta-glucans and oligosaccharides (AO) of
Agaricus blazei Murill showed anti-hyperglycemic, anti-hypertriglyceridemic, anti-
hypercholesterolemic, and anti-arteriosclerotic activity indicating overall anti-diabetic activity in
diabetic rats, AO had about twice the activity of beta-glucans with respect to anti-diabetic
activity [42]. Further supplement of Agaricus blazei Murill extract has improved insulin
resistance among subjects with type 2 DM. The increase in adiponectin concentration after
taking Agaricus blazei Murill extract might be the mechanism that brings the beneficial effect
[43].
Inonotus obliquus (L.)
Chaga mushroom (Inonotus obliquus), a white rot fungus, belongs to the hymenochaetaceae
family of Basidomycetes. Chaga mushroom grows on birch trees in colder northern climates
[44]. Since the sixteenth century, Chaga has been used as a folk medicine in Russia and western
Siberia [45]. Researches exposed that the dry matter of culture broth of Inonotus obliquus
possesses significant anti-hyperglycemic, anti-lipid peroxidative and antioxidant effects in
alloxan-induced diabetic mice [46].
Hericium erinaceus (Bull.)
Hericium erinaceus is named for its shape, and is literally interpreted as ―Monkey Head
Mushroom‖ in China. Recent studies have determined that many types of mushroom (eg
Hericium spp), may have important physiological functions in humans, including antioxidant
activities, the regulation of blood lipid levels and reduction of blood glucose levels [47].
Researchers have found that the hypoglycemic effects of feeding the methanol extract of H
erinaceus to streptozotocin-induced diabetic rats were significantly lower elevation rates of
blood glucose levels [47].
Agrocybe aegerita
It is an important valuable source possessing varieties of bioactive secondary metabolites such as
indole derivatives with free radical scavenging activity, cylindan with anticancer activity, and
also agrocybenine with antifungal activity [48]. A glucan and a heteroglycan were isolated from
a hot-water extract of the fruiting bodies of Agrocybe cylindracea. A glucan showed a
remarkable hypoglycemic activity in both normal and streptozotocin-induced diabetic mice by
intraperitoneal administration, and its activity was higher than that of heteroglycan [49].

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Coprinus comatus (O.F.Mull)
The young mushrooms of Coprinus comatus, before the gills start to turn black, are edible. It can
sometimes be used in mushroom soup with parasol mushroom [50].This species is cultivated in
China as food. When young it is an excellent edible mushroom provided that it is eaten soon
after being collected. It can be used as a hypoglycemic food or medicine for hyperglycemic
people [51].The hypoglycemic activity of fermented mushroom, Coprinus comatus tested on
Alloxan and adrenalin-induced hyperglycemic mice. It confirmed that Coprinus comatus rich in
vanadium has significant anti-hyperglycemic effect [51].
Cordyceps sinensis
Cordyceps sinensis, known in English commonly as caterpillar fungus is considered a medicinal
mushroom in traditional Chinese medicine [52]. Crude polysaccharides of Cordyceps sinensis
were tested in normal mice and streptozotocin-induced diabetic mice. It significantly lowered the
glucose level by oral administration in mice [53]. A polysaccharide obtained from the cultural
mycelium of Cordyceps sinensis showed potent hypoglycemic activity in genetic diabetic mice
after intraperitoneal administration, and the plasma glucose level was quickly reduced in normal
and streptozotocin-induced diabetic mice after intravenous administration [54].Further
Cordyceps, a Chinese herbal medicine with fruiting body and carcass, has been proposed to have
multiple medicinal activities. The diabetic rats had significantly lower weight gain and higher
blood glucose response in oral glucose tolerance test than the control rats; and these changes
were significantly reduced by administrating the fruiting body of Cordyceps and these
improvements suggested that fruiting body of Cordyceps has a potential to be the functional food
for diabetes[55]. Another research revealed that isolated polysaccharide from Cordyceps
sinensis, named CSP-1 produced a significant drop in blood glucose level in both STZ-induced
diabetic rats and alloxan-induced diabetic mice. It suggested that CSP-1 may stimulate
pancreatic release of insulin and/or reduce insulin metabolism [56].
Grifola frondosa (Dicks.)
Grifola frondosa is also very popular in Korea, China and Japan, where it is cultivated as
maitake, the dancing mushroom. Controlled experiments have found many beneficial activities
attributable to Grifola frondosa and/or its extracts. The reason Maitake lowers blood sugar is due
to the fact that the mushroom naturally contains an alpha-glucosidase inhibitor. Alpha-
glucosidase inhibitory activities were found in aqueous methanol extracts of the seeds of
Momordica charantia and the fruit bodies of Grifola frondosa [57]. Researchers evaluated the
anti-diabetic effect of an alpha-glucan (MT-alpha-glucan) from the fruit body of maitake
mushrooms (Grifola frondosa) on KK-Ay mice. These data suggest that MT-alpha-glucan has an
anti-diabetic effect on KK-Ay mice, which might be related to its effect on insulin receptors (i.e.,

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increasing insulin sensitivity and ameliorating insulin resistance of peripheral target tissues) [58].
Further animal and human experiments also proven that anti-diabetic activity present in the fruit
body of Grifola frondosa [59-63].
Table 1. Medicinal mushrooms and major effective compounds
Plant name
Major effective compounds
Tremella fuciformis (berk)
Glucuronoxylomannan[23]
Wolfiporia extensa (Peck)
Dehydrotumulosic acid, Dehydrotrametenolic
acid and Pachymic acid [31]
Ganoderma lucidum (Curtis)
Polysaccharides (Gl-PS) [33]
Ganoderma applanatum (Pers.) Pat.
Exo-polymer (GAE) [34]
Collybia confluens (Pers.: Fr.)
Exo-polymer (CCE) [34]
Auricularia auricula-judae (Bull.)
Polysaccharide (FA) [36]
Agaricus subrufescens (Peck)
Beta-glucans and Oligosaccharides (AO) [42]
Coprinus comatus (O.F.Mull)
Vanadium[51]
Cordyceps sinensis
Polysaccharide CSP-1 [56]
Grifola frondosa (Dicks.)
Alpha-glucan (MT-alpha-glucan) [59-63]
Conclusion
Mushrooms with immune-modulating polysaccharides are used as delicious food or as health-
promoting food supplement (nutraceutical) or as drug in limited geographic regions. But
scientific or clinical studies are not sufficient for use as ‗official‘ drug/nutraceutical worldwide
till now. These functional mushrooms might have a particularly high impact for prevention or
curative of diabetes more than in other species. Therefore further research needs to identify their
active compounds to develop drug/nutraceutical use in diabetes.
Competing interests
No competing interests.
Authors' Contributions
Authors contributed equally to this work.

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References
1. Wild S, Roglic G, Green A, Sicree R, King H. "Global prevalence of diabetes: estimates
for 2000 and projections for 2030". Diabetes Care 2004; 27: 1047–53.
2. Zimmet PZ, McCarty DJ, de Courten MP. The global epidemiology of non-insulin-
dependent diabetes mellitus and the metabolic syndrome. J Diabetes Complications 1997;
11: 60-68.
3. Li WL, Zheng HC, Bukuru J, De Kimpe N. Natural medicines used in the traditional
Chinese medical system for therapy of diabetes mellitus. J Ethnopharmacol 2004; 92:1–
21.
4. Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, et al. Report of
the Committee on the classification and diagnostic criteria of diabetes mellitus. Diabetes
Res Clin Pract 2002; 55: 65–85.
5. Kobayashi T. Subtype of insulin-dependent diabetes mellitus (IDDM) in Japan: Slowly
progressive IDDM—the clinical characteristics and pathogenesis of the syndrome,
Diabetes Res Clin Pract 1994; 24: S95–S99.
6. Imagawa A, Hanafusa TA, Miyagawa J, Matsuzawa Y. A novel subtype of type 1
diabetes melllitus characterized by a rapid onset and an absence of diabetes-related
antibodies, New Engl J Med 2000; 342: 301–307.
7. Zimmet P, Lefebvre P. The global NIDDM epidemic. Treating the disease and ignoring
thesymptom. Diabetologia 1996; 39:1247-1248.
8. Kitagawa T, Owada M, Urakami T, Tajima N. Epidemiology of type 1 (insulin-
dependent) and type 2 (non insulin-dependent) diabetes mellitus in Japanese children.
Diabetes Res Clin Pract 1994; 24: S7–S13.
9. Kitagawa T, Owada M, Urakami T, Yamauchi K. Increased incidence of non-insulin-
dependent diabetes mellitus among Japanese schoolchildren correlates with an increased
intake of animal protein and fat. Clin Pediatr 1998; 37:111–116.
10. Chang ST, Miles PG. Mushrooms biology-a new discipline. Mycologist 1992; 6: 64-5.
11. Hawksworth DL. Mushrooms: The extent of the unexplored potential. Int J Med
Mushrooms 2001; 3:333-7.
12. Saiqa S, Haq NB, Muhammad AH Studies on Chemical Composition and Nutritive
Evaluation of Wild Edible Mushrooms Iran J Chem Chem Eng 2008; 27:151-154.
13. Manzi P, Gambelli L, Marcon S, Vivanti V, Pizzofrrato L, Nutrients in Edible
Mushrooms: An Inter-Species Comparative Study. Food Chem 1999; 65:477-477.
14. Sanmee R, Dell B, Lumyong P, Izumori K, Lumyong S. Nutritive Value of Popular Wild
Edible Mushrooms from North Thailand. Food Chem 2003; 84: 527-527.
15. Alector VA. Compositional Studies on Edible Tropical Species of Mushrooms. Food
Chem 1995; 54:265-265.
16. Manzi P, Aguzzi A, Pizzoferrato L. Nutritional Value of Mushrooms Widely Consumed
in Italy. Food Chem. 2001; 73: 321-321.

Functional Foods in Health and Disease 2011; 4:161-171 Page 169 of 171
17. Mattila P, Könkö K, Eurola M, Pihlava JM, Astola J, Vahteristo L, et al. Contents of
Vitamins, Mineral Elements and Some Phenolic Compounds in Cultivated Mushrooms. J
Agric Food Chem 2001; 49:2343-2348.
18. Yildiz A, Karakaplan M, Aydin F, Studies on Pleurotus ostreatus (Jacq. ex Fr.) Kum. var.
salignus (Pers. ex Fr.) Konr. et Maubl: Cultivation, Proximate Composition, Organic and
Mineral Composition of Carpophores. Food Chem 1998; 61:127-127.
19. Bobek P, Galbavy S. Hypocholesterolemic and Antiatherogenic Effect of Oyster
Mushroom (Pleurotus ostreatus) in Rabbit. Nahrung 1999; 43: 339-342.
20. Bobek P, Ozdyn L, Kuniak L. The Effect of Oyster (Pleurotus ostreatus) Ethanolic
Extracts and Extraction Residues on Cholesterol Levels in Serum Lipoproteins and Liver
of Rat 1995; Nahrung 39: 98-99.
21. Mau LL, Lim HC, Chen CC.Antioxidant Properties of Several Medicinal Mushrooms, J.
Agric. Food Chem 2002 50: 6072 6077.
22. Shu-Ting C, Philip G.M. Tremella - Increased Production by a Mixed Culture Technique.
Mushrooms: Cultivation, Nutritional Value, Medicinal Effect, and Environmental Impact
(2nd ed.). Boca Raton, Florida: CRC Press 2004.
23. Kiho T, Tsujimura Y, Sakushima M, Usui S, Ukai S.Polysaccharides in fungi. XXXIII.
Hypoglycemic activity of an acidic polysaccharide (AC) from Tremella fuciformis.
Yakugaku zasshi 1994; 114: 308–15.
24. Cho EJ, Hwang HJ, Kim SW, Oh JY, Baek YM, Choi JW, et al.Hypoglycemic effects of
exopolysaccharides produced by mycelial cultures of two different mushrooms Tremella
fuciformis and Phellinus baumii in ob/ob mice. Appl Microbiol Biotechnol 2007;
75:1257-65.
25. Bi Zhishu GZ , Taihui L. The Macrofungus Flora of China's Guangdong Province, The
Chinese University Press, Hong Kong, 1997.
26. Boa E. Wild Edible Fungi: A Global Overview of Their Use and Importance to People.
Food & Agriculture Organization of the UN, 2004.
27. Kirk PM, Cannon PF, Minter DW, Stalpers JA. Dictionary of the Fungi, CABI
Publishing, Wallingford, UK, 2008.
28. Jia W, Gaoz W, Tang L. Antidiabetic herbal drugs officially approved in China.
Phytother Res 2003; 17:1127–1134.
29. Lindequist U, Niedermeyer THJ, Jülich WD.The pharmacological potential of
mushrooms. eCAM Journal 2005; 2: 285–299.
30. Li WL, Zheng HC, Bukuru J, Kimpe N. Natural medicines used in the traditional Chinese
medical system for therapy of diabetes mellitus. J Ethnopharmacol 2004; 92: 1–21.
31. Sato T, Tai Y, Nunoura Y, Yajima Y, Kawashima S, Tanaka K. Dehydrotrametenolic
acid induces preadipocyte differentiation and sensitizes animal models of noninsulin-
dependent diabetes mellitus to insulin. Biol Pharm Bull 2002; 25: 81–86.
32. Liu GT. Recent advances in research of pharmacology and Clinical application of

Functional Foods in Health and Disease 2011; 4:161-171 Page 170 of 171
Ganoderma (P. Karst) species (Aphyllophoromycetideae) in China. Int J Med Mushrooms
1999; 1:63-7.
33. Zhang HN, Lin ZB. Hypoglycemic effect of Ganoderma lucidum polysaccharides. Acta
Pharmacol Sin 2004; 25: 191–5.
34. Yang BK, Jung YS, Song CH. Hypoglycemic effects of Ganoderma applanatum and
Collybia confluens exo-polymers in streptozotocin-induced diabetic rats. Phytother Res
2007; 21: 1066–9.
35. Johnny A, Nick S. Mushroom. Kyle Cathie, U.K.2001.
36. Yuan Z, He P, Cui J, Takeuchi H. Hypoglycemic effect of water-soluble polysaccharide
from Auricularia auricula-judae Quel. on genetically diabetic KK-Ay mice. Biosci
Biotechnol Biochem 1998; 62:1898–903.
37. Jane G.The Mushroom Feast. London: Penguin, 1975.
38. Gray AM, Flatt PR. Insulin-releasing and insulin-like activity of Agaricus campestris
(mushroom). J. Endocrinol 1998; 157: 259–66.
39. Chuchin CC, Wu CM. Volatile Components of Mushroom (Agaricus subrufecens). J
Food Sci 1984; 49: 1208.
40. Hyodo I, Amano N, Eguchi K, Narabayashi M, Imanishi J, Hirai M, et al. Nationwide
survey on complementary and alternative medicine in cancer patients in Japan. J Clin
Oncol 2005; 23: 2645–54.
41. Liu Y, Fukuwatari Y, Okumura K, Okumura K, Takeda K, Ishibashi K, et al.
Immunomodulating Activity of Agaricus brasiliensis KA21 in Mice and in Human
Volunteers. Evid Based Complement Alternat Med 2008; 5: 205–219.
42. Kim YW, Kim KH, Choi HJ, Lee DS. Anti-diabetic activity of beta-glucans and their
enzymatically hydrolyzed oligosaccharides from Agaricus blazei. Biotechnol Lett 2005;
27: 483–7.
43. Hsu CH, Liao YL, Lin SC, Hwang KC, Chou P. The mushroom Agaricus Blazei Murill
in combination with metformin and gliclazide improves insulin resistance in type 2
diabetes: a randomized, double-blinded, and placebo-controlled clinical trial. J Altern
Complement Med 2007; 13: 97–102.
44. Park YK, Lee HB, Jeon EJ, Jung HS, Kang MH. Chaga mushroom extract inhibits
oxidative DNA damage in human lymphocytes as assessed by comet assay. Biofactors
2004; 21:109–112.
45. Saar M. Fungi in Khanty folk medicine. J Ethnopharmacol 1991; 31:175–179.
46. Sun JE, Ao ZH, Lu ZM, Xu HY, Zhang XM, Dou WF, et al. Antihyperglycemic and
antilipidperoxidative effects of dry matter of culture broth of Inonotus obliquus in
submerged culture on normal and alloxan-diabetes mice. J Ethnopharmacol 2008; 118:7-
13.
47. Wang JC, Hu SH, Wang JT, Chen KS, Chia YC. Hypoglycemic effect of extract of
Hericium erinaceus. J Sci Food Agric 2005; 4 641-646.

Functional Foods in Health and Disease 2011; 4:161-171 Page 171 of 171
48. Zhong JJ, Bai FW, Zhang W, Biotechnology in China I: From Bioreaction to
Bioseparation and Bioremediation, Springer 2009.
49. Kiho T, Sobue S, Ukai S. Structural features and hypoglycemic activities of two
polysaccharides from a hot-water extract of Agrocybe cylindracea. Carbohydr Res 1994;
251: 81–7.
50. Benjamin DR. Mushrooms: poisons and panaceas — a handbook for naturalists,
mycologists and physicians. New York: WH Freeman and Company, 1995.
51. Han C, Liu T. A comparison of hypoglycemic activity of three species of basidiomycetes
rich in vanadium. Biol Trace Elem Res 2009; 127: 177–82.
52. Georges MH. Healing Mushrooms. Square one publisher. New York, USA, 2007.
53. Kiho T, Hui J, Yamane A, Ukai S.Polysaccharides in fungi. XXXII. Hypoglycemic
activity and chemical properties of a polysaccharide from the cultural mycelium of
Cordyceps sinensis. Biol Pharm Bull 1993; 16: 1291–3.
54. Kiho T, Yamane A, Hui J, Usui S, Ukai S. Polysaccharides in fungi. XXXVI.
Hypoglycemic activity of a polysaccharide (CS-F30) from the cultural mycelium of
Cordyceps sinensis and its effect on glucose metabolism in mouse liver. Biol Pharm Bull
1996; 19: 294–6.
55. Lo HC, Tu ST, Lin KC, Lin SC. The anti-hyperglycemic activity of the fruiting body of
Cordyceps in diabetic rats induced by nicotinamide and streptozotocin". Life Sciences
2004; 74: 2897–908.
56. Li SP, Zhang GH, Zeng Q. Hypoglycemic activity of polysaccharide, with antioxidation,
isolated from cultured Cordyceps mycelia. Phytomed 2006; 13: 428–33.
57. Matsuur H, Asakawa C, Kurimoto M, Mizutani J. Alpha-glucosidase inhibitor from the
seeds of balsam pear (Momordica charantia) and the fruit bodies of Grifola frondosa".
Biosci Biotechnol Biochem 2002; 66: 1576–8.
58. Hong L, Xun M, Wutong W. Anti-diabetic effect of an alpha-glucan from fruit body of
maitake (Grifola frondosa) on KK-Ay mice. J. Pharm. Pharmacol 2007; 59: 575–82.
59. Kubo K, Aoki H, Nanba H. Anti-diabetic activity present in the fruit body of Grifola
frondosa (Maitake). I. Biol Pharm Bull 1994; 17: 1106–10.
60. Lo HC, Hsu TH, Chen CY. Submerged culture mycelium and broth of Grifola frondosa
improve glycemic responses in diabetic rats. Am J Chin Med 2008; 36: 265–85.
61. Manohar V, Talpur NA, Echard BW, Lieberman S, Preuss HG. Effects of a water-soluble
extract of maitake mushroom on circulating glucose/insulin concentrations in KK mice.
Diabetes Obes Meta 2002; 4: 43–8.
62. Horio H, Ohtsuru M. Maitake (Grifola frondosa) improve glucose tolerance of
experimental diabetic rats. J Nutr Sci Vitaminol 2001; 47: 57–63.
63. Konno S, Tortorelis DG, Fullerton SA, Samadi AA, Hettiarachchi J, Tazaki H. A
possible hypoglycaemic effect of maitake mushroom on Type 2 diabetic patients.
Diabetic Medic 2001; 18: 1010-1010.