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Antidiabetic and hypolipidaemic properties of garlic (Allium sativum) in streptozotocin-induced diabetic rats

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In this study the hypoglycaemic, hypocholesterolaemic and hypotriglyceridaemic effects of garlic were studied in streptozotocin (STZ)-induced diabetic rats. Compared to normal (non-diabetic) rats, STZ-induced diabetic rats had approximately 200% higher serum glucose, 50% higher serum cholesterol and 30% higher serum triglyceride levels as well as 86% higher urinary protein levels. Daily treatment of STZ-induced diabetic rats with an extract of raw garlic (500mg/kg intraperitoneally) for seven weeks significantly lowered serum glucose, cholesterol and triglyceride levels. Compared to control diabetic rats, garlic-treated rats had 57% less serum glucose, 40% lower serum cholesterol levels and 35% lower triglyceride. In addition, urinary protein levels in garlic-treated diabetic animals were 50% lower compared to the diabetic controls. In contrast, the increased urine output and water intake of diabetic rats were not affected by garlic treatment. These results indicate that raw garlic possesses a beneficial potential in reversing proteinuria in addition to reducing blood sugar, cholesterol and triglycerides in diabetic rats. Therefore, garlic could be of great value in managing the effects and complications of diabetes in affected individuals.
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Int J Diabetes & Metabolism (2007) 15: 108-115
108
Anti-diabetic and hypolipidaemic properties of garlic (Allium sativum) in
streptozotocin-induced diabetic rats
Martha Thomson, Zainab M. Al-Amin, Khaled K. Al-Qattan, Lemia H. Shaban and Muslim Ali
Department of Biological Sciences, Faculty of Science, Kuwait University, , Kuwait.
____________________________________________________________________________________
Abstract
In this study the hypoglycaemic, hypocholesterolaemic and hypotriglyceridaemic effects of garlic were studied in
streptozotocin (STZ)-induced diabetic rats. Compared to normal (non-diabetic) rats, STZ-induced diabetic rats had
approximately 200% higher serum glucose, 50% higher serum cholesterol and 30% higher serum triglyceride levels as well
as 86% higher urinary protein levels. Daily treatment of STZ-induced diabetic rats with an extract of raw garlic (500mg/kg
intraperitoneally) for seven weeks significantly lowered serum glucose, cholesterol and triglyceride levels. Compared to
control diabetic rats, garlic-treated rats had 57% less serum glucose, 40% lower serum cholesterol levels and 35% lower
triglyceride. In addition, urinary protein levels in garlic-treated diabetic animals were 50% lower compared to the diabetic
controls. In contrast, the increased urine output and water intake of diabetic rats were not affected by garlic treatment. These
results indicate that raw garlic possesses a beneficial potential in reversing proteinuria in addition to reducing blood sugar,
cholesterol and triglycerides in diabetic rats. Therefore, garlic could be of great value in managing the effects and
complications of diabetes in affected individuals.
Key words: Diabetes, Garlic, hypoglycaemic activity, hypolipidaemic activity, proteinuria
Introduction
Garlic (Allium sativum) is one of the most popular herbs
used worldwide to reduce various risk factors associated
with cardiovascular diseases. Garlic, a member of the
Liliaceae family, is a common food for flavour and spice
and it is one of the herbs most commonly used in modern
folkloric medicine. Garlic was an important medicine to the
ancient Egyptians as listed in the medical text Codex Ebers
(ca. 1550 BC) especially for the working class involved in
heavy labour because it was an effective remedy for many
aliments such as heart problems, headache, bites, worms
and tumours.
Garlic is stated to possess many therapeutic benefits.
Garlic’s strong odour is largely due to sulphur-containing
compounds (e.g. S-allylcysteine sulphoxide), which are
believed to account for most of its medicinal properties.1
Actually, garlic contains a variety of effective compounds
that exhibit anticoagulant (anti-thrombotic),2,3,4,5,6
antioxidant,7,8 antibiotic,9,10,11 hypocholesterolaemic,12
hypoglycaemic,1 as well as hypotensive activities.12-13
As mentioned above, although a large number of sulphur-
____________________________________
Received on: 16/3/2007
Accepted on: 18/10/2007
Correspondence to: Prof. Muslim Ali, Dept of Biological
Sciences, Faculty of Science, Kuwait University, P.O. Box
5969, 13060-Safat, Kuwait. Tel.: +965-498 5706; Fax:
+965-484 7054; email: alimuslim@hotmail.com
thiosulphinates are present in sufficient quantities at normal
consumption levels (3-5 g per day). Allicin has been shown
to be important in many health effects of garlic.14 However,
the anti-cancer effect of garlic might be shared between
allicin and other unidentified compounds.15 Garlic contains
about 1% alliin, which is converted enzymatically by
allicinase to allicin, and other sulphur-containing
compounds.16
Garlic has been found to be effective in lowering serum
glucose levels in STZ-induced as well as alloxan-induced
diabetic rats and mice. Most of the studies showed that
garlic can reduce blood glucose levels in diabetic mice, rats
and rabbits.14 Augusti and Sheela consistently showed that
S-allyl cysteine sulphoxide, (allicin), a sulphur-containing
amino acid in garlic (200 mg/kg body weight), had a
potential to reduce the diabetic condition in rats almost to
the same extent as did glibenclamide and insulin.17-18 Aged
garlic extract was also effective in preventing adrenal
hypertrophy, hyperglycaemia and elevation of
corticosterone in mice made hyperglycaemic by
immobilization stress.19 In addition, Liu and co-workers
reported that both garlic oil and diallyl trisulphide improved
glycaemic control in STZ-induced diabetic rats.20 Ingestion
of garlic juice resulted in better utilization of glucose in
glucose tolerance tests performed in rabbits, while allicin at
a dose of 250 mg/kg was 60% as effective as tolbutamide in
alloxan-induced diabetic rabbits.21
In contrast, garlic powder intake (6.25% by weight in diet)
for 12 days reduced hyperphagia and polydipsia, but did not
Thomson et al
109
alter either hyperglycaemia or hypoinsulinaemia in STZ-
induced diabetic mice.22 Similarly, Baluchnejadmojarad and
Rohgani found no hypoglycaemic effect of an aqueous
extract of garlic in rats with STZ-induced diabetes although
they did observe a significant effect of garlic on vascular
reactivity.23-24 Liu and co-workers have speculated that
these inconsistent results are at least partly due to the use of
different preparations or derivatives of garlic in the different
studies.20 Staba and coworkers have established that the
chemicals present in a garlic product are largely dependent
on the processing conditions, such as temperature, duration
of preparation, and extraction solvents used.25
In humans, the hypoglycaemic effect of garlic is not well
documented. Most reports have shown a significant effect of
garlic on blood glucose of normal healthy individuals but
not in diabetic patients. Thus the role of garlic in diabetes
treatment/prevention in humans is yet to be confirmed.13
The aim of the present study was to investigate the efficacy
of an aqueous extract of raw garlic in controlling serum
glucose, cholesterol, triglyceride and urine protein levels in
STZ-induced diabetic rats treated daily intraperitoneally
(IP) for a period of 7 weeks. Since there have been variable
reports about the use of different preparations of garlic, as
discussed above, an aqueous extract of raw garlic was used
in the present study. Use of this preparation is also
consistent with our previous work with garlic.4-5, 26, 27,28
Materials and Methods
Extract preparation
Aqueous garlic extract was prepared from locally available
garlic bulbs. The garlic bulbs were peeled on crushed ice.
Then 50 g of the peeled garlic was cut into small pieces and
homogenized in 70 ml of cold, sterile 0.9% NaCl in the
presence of some crushed ice. The homogenization was
carried out in a blender at high speed using 30 second bursts
for a total of 10 minutes. The homogenized mixture was
filtered 3 times through cheesecloth, the filtrate was
centrifuged at 2000 RCF for 10 minutes and the clear
supernatant was diluted to 100 ml with normal saline. The
concentration of this garlic preparation was considered to be
500 mg/ml on the basis of the weight of the starting material
(50 g/100 ml). The aqueous extract of garlic was stored in
small aliquots at -20°C until use. The stability of the
preparation during storage has been previously established
in platelet aggregation studies (unpublished observations).
Treatment of Diabetic Rats
Male Sprague-Dawley rats weighing 250-280 g (parents
purchased from Laboratory Animals Inc., England) and
maintained on a normal diet and filtered tap water ad
libitum were used in the experiment. For baseline data,
blood was drawn from all animals by cardiac puncture
under ether anaesthesia and allowed to clot. Immediately,
the clotted blood was centrifuged at 3500 RPM for 30
minutes. The serum was separated and stored at –80oC for
later analysis.
The animals were randomly divided into a healthy group (8
rats) and a streptozotocin (STZ)-treated group (initially 20
rats). The STZ-treated rats were injected IP with 60 mg
streptozotocin/kg body weight in a volume of 0.5 ml saline
following an overnight fast.29 After a period of three days,
blood was drawn from the fasting STZ-treated animals and
serum was prepared and stored for later analysis as
described above. Serum glucose levels were determined
immediately and the STZ-treated rats determined to be
diabetic due to a high serum glucose level (>350 mg/dl)
were randomly divided into two groups containing 8
animals each: Group 1, the control diabetic group, was
injected IP daily with saline for the treatment period, and
Group 2, the garlic-treated group, was injected IP daily with
500 mg/kg of the garlic extract. After periods of two, five
and seven weeks, blood was drawn from the fasting rats by
cardiac puncture, and serum was prepared and stored for
later analysis as described above.
Rats were weighed before the start of the experiment and
then weekly during the experimental period. Animals were
monitored for general health during the treatment period.
Twenty-four hour water intake was measured daily.
Twenty-four hour urine output was measured in each
treatment group before STZ administration and at two, five
and seven weeks by housing the animals in metabolic cages
and collecting the urine in a calibrated 250 ml attached
container. The collected urine was centrifuged at 3000
RPM for 10 min to remove any particulate material. Urine
samples were then stored at -80°C for protein determination.
At the end of the experiment, the rats were sacrificed under
sodium pentobarbitone anaesthesia according to the
guidelines for euthanasia in the Guide for the Care and Use
of Laboratory Animals.30
Assays
Serum glucose, cholesterol and triglyceride were
determined spectrophotometrically using kits supplied by
CARO Co., Germany. Urinary protein was determined by
the Coomassie Blue dye binding method of Bradford.31
Statistical Analysis
The data are expressed as mean ± SEM. Readings within a
group were compared using the one-way ANOVA analysis
and readings between groups were compared using the
independent sample test. Statistical analysis was performed
using SPSS (Version 14). A level of p <0.05 was considered
to be significant.
Results
Figure 1 shows changes in the serum glucose levels in STZ-
induced diabetic rats in response to 500 mg/kg garlic extract
administration. It is clear from the data that the serum
glucose levels of the control diabetic animals continued to
increase during the 7 weeks of the experiment compared to
the post-STZ injection level. In contrast, the garlic-treated
diabetic rats showed significantly reduced serum glucose
levels during the treatment period when compared to the
control diabetic rats. At weeks 2, 5 and 7 of garlic extract
treatment, the serum glucose levels of the garlic-treated
diabetic rats were reduced by 29%, 68% and 57%,
respectively in comparison to control diabetic rats.
Anti-diabetic effects of garlic
110
0
100
200
300
400
500
600
700
800
blood glucose (mg/dl)
control diabetic garlic treated diabetic normal
a
post-STZ 2 wks 5 wks 7 wks
b
c
a
b
c
a
b
c
Figure 1: Serum glucose levels in STZ-induced diabetic rats treated with aqueous extract of garlic. Glucose levels were
measured in serum of normal rats, STZ-induced diabetic rats (control diabetic) and garlic-treated STZ-induced diabetic rats
(garlic-treated diabetic). Normal glucose levels were averaged over the experimental period and are depicted as a broken
line. Analysis was done after STZ injection (post-STZ), and after 2, 5 and 7 weeks of treatment.
a: Significantly increased compared to normal (p<0.05), b: Significantly decreased compared to control diabetic (p<0.05).
c: Significantly decreased compared to post-STZ (p<0.05).
0
20
40
60
80
100
120
140
160
180
weight % with weeks during the experiment
normal control diabe tic gar lic tr ea ted dia be tic
a
a
b
pre- STZ pos t-STZ 1 23456 7
Figure 2: Weights of normal and STZ-induced diabetic rats over the garlic treatment period. Weights were measured in
normal rats, STZ-induced diabetic rats (control diabetic) and garlic-treated STZ-induced diabetic rats (garlic treated
diabetic). The animals were weighed before STZ injection (pre-STZ), one week after STZ-injection (post-STZ), and then
weekly during the treatment period of 7 weeks. Weights are plotted as percentiles with the starting weights all standardized to
100%. a: Significantly decreased compared to normal at week 7 (p<0.05), b Significant difference between control diabetic
and garlic treated diabetic rats (p<0.05).
However, garlic treatment did not reduce serum glucose of
diabetic animals to normal levels.
Normal rats gained weight significantly throughout the
experimental period, while both the control diabetic and
garlic-treated diabetic animals had significantly lower body
weights when compared to normal animals (Figure 2).
However, garlic-treated diabetic rats maintained their initial
weights during the 7-week treatment period although at the
end of the experiment their body weights were significantly
less than those of normal rats. In contrast, the control
diabetic rats showed significant weight loss when compared
to both the normal rats and the garlic-treated diabetic rats at
the end of the 7-week experiment.
Thomson et al
111
0
20
40
60
80
100
120
140
160
180
Blood cholesterol (mg/dl)
control diabetic garlic treated diabetic normal
post-ST
Z
2 wks 5 wks 7 wks
a
aa
a
b
bb
Figure 3: Serum cholesterol levels in STZ-induced diabetic rats treated with aqueous extract of garlic. Cholesterol levels
were measured in serum of normal rats, STZ-induced diabetic rats (control diabetic) and garlic-treated STZ-induced diabetic
rats (garlic treated diabetic). Normal cholesterol levels were averaged over the experimental period and are depicted as a
broken line. Analysis was done after STZ injection (post STZ), and after 2, 5 and 7 weeks of treatment.
a Significantly increased compared to normal (p <0.05), b Significantly decreased compared to diabetic control (p <0.05).
0
10
20
30
40
50
60
70
80
90
100
blood triglycerides (mg/dl)
control diabetic garlic treated diabetic normal
post-STZ 2 wks 5 wks 7 wks
aa
a
a
bbb
Figure 4: Serum triglyceride levels in STZ-induced diabetic rats treated with aqueous extract of garlic. Triglyceride levels
were measured in serum of normal rats, STZ-induced diabetic rats (control diabetic) and garlic-treated STZ-induced diabetic
rats (garlic treated diabetic). Normal triglyceride levels were averaged over the experimental period and are depicted as a
broken line. Analysis was done after STZ injection (post STZ), and after 2, 5 and 7 weeks of treatment. a: Significantly
increased compared to normal (p< 0.05), b: Significantly decreased compared to diabetic control (p< 0.05).
In Figure 3, one week after STZ-injection (post-STZ), the
serum cholesterol levels of the diabetic rats were
significantly higher than the normal levels. After treatment,
the serum cholesterol levels of garlic-treated diabetic rats
were significantly lower in comparison with the control
diabetic rats. The serum cholesterol reduction elicited by
garlic was sustained throughout the course of treatment with
serum cholesterol levels below the normal level after 5 and
7 weeks of garlic treatment. Figure 4 shows a reduction in
serum triglyceride levels to normal levels in garlic-treated
diabetic rats through the 7 weeks of treatment. In contrast,
both cholesterol and triglyceride levels remained elevated in
the control diabetic animals throughout the experimental
period.
Anti-diabetic effects of garlic
112
0
2
4
6
8
10
12
14
16
18
20
urine protein (mg/24 hrs)
control diabetic garlic treated diabetic normal
post-STZ 2 wks 5 wks
7 wks
aa
aa
b
bb
Figure 5: Urinary protein levels in STZ-induced diabetic rats treated with aqueous extract of garlic. Protein levels were
measured in urine of normal rats, STZ-induced diabetic rats (control diabetic) and garlic-treated STZ-induced diabetic rats
(garlic treated diabetic). Normal urinary protein levels were averaged over the experimental period and are depicted as a
broken line. Analysis was done after STZ injection (post STZ), and after 2, 5 and 7 weeks of treatment.
a Significantly increased compared to normal (p<0.05). b Significantly decreased compared to control diabetic (p<0.05).
Figure 6: Urine output in STZ-induced diabetic rats treated with aqueous extract of garlic. Urine output was measured in rats
after STZ-injection (post STZ) and after 2, 5 and 7 weeks of garlic treatment of STZ-induced diabetic rats. Normal urine
output levels were averaged over the experimental period and are depicted as a broken line. Urine output levels in control
diabetic rats were averaged over the experimental period and are presented as an open bar.
a Significantly increased compared to normal (p<0.05).
The urinary protein levels of garlic-treated diabetic rats
were significantly lower than urinary protein levels in the
control diabetic rats (Figure 5). One week after STZ-
injection (post-STZ), the urinary protein level of the control
diabetic rats was double that of the normal rats and
remained elevated throughout the experimental period. In
contrast, at weeks 2, 5 and 7 of garlic treatment, urinary
protein levels in garlic-treated diabetic rats were lowered by
28%, 53% and 49%, respectively, with the urinary protein
levels at 5 and 7 weeks of garlic treatment reaching the
normal level. In the analysis of the data collected on urine
output, it was found that the effect of garlic treatment was
insignificant (Figure 6).
In fact, the urine output of the garlic-treated diabetic rats
remained elevated during the 7 weeks of treatment. In
contrast, the garlic-treated diabetic rats had decreased water
intake after 2 weeks of treatment, after which
0
50
100
150
200
250
300
urine output (ml/day)
control diabetic garlic treated diabetic normal
control diabetic post- 2 wks 5 wks 7 wks
a
a
a
a
a
Thomson et al
113
0
50
100
150
200
250
300
water intake (ml/day)
control diabetic garlic treated diabetic normal
control diabetic post-STZ 2 wks 5 wks 7 w ks
aa
a
a
a
b
Figure 7: Water intake in STZ-induced diabetic rats treated with aqueous extract of garlic. Water intake was measured in
rats after STZ-injection (post STZ) and after 2, 5 and 7 weeks of garlic treatment of STZ-induced diabetic rats. Normal
water intake levels were averaged over the experimental period and are depicted as a broken line. Water intake levels in
control diabetic rats were averaged over the experimental period and are presented as an open bar. a Significantly increased
compared to normal (p<0.05).b Significantly decreased compared to control diabetic (p<0.05).
there was no significant reduction in water intake in the
garlic-treated diabetic animals compared to the control
diabetic rats (Figure 7).
Discussion
Diabetes mellitus is the most common endocrine disorder
that affects more than 194 million people worldwide. If
nothing is done to control this disease, the number will
exceed 333 million by 2025 (6.3% of population). In 2003,
Kuwait was among the five countries of the world with the
highest diabetes prevalence in the adult population
(12.8%).32
In addition to the primary effects of diabetes, diabetes is
accompanied by increased risk factors such as
hyperglycaemia, dyslipidaemia, hypertension, decreased
fibrinolytic activity, increased platelet aggregation, and
severe atherosclerosis.33-34 Many synthetic drugs have been
developed for the treatment of diabetes. However, these
drugs have limits in terms of efficacy and side effects.35
Therefore, there is much interest in discovering natural
treatments without negative side effects that can reduce
these risk factors in diabetic patients.
Garlic has been reported to possess a variety of medicinal
properties including hypoglycaemic, hypocholesterolaemic
and hypolipidaemic activities.36 However, previous studies
on the hypoglycaemic activity of garlic preparations have
produced variable results.7,17-24 Since we are interested in
the beneficial effects of consumption of whole garlic, we
chose to study the complete aqueous extract. In addition, in
our previous studies, we have obtained consistent results
using an aqueous extract of garlic in both rats and
rabbits.4,5,6,7,8,9,10,11,12, 26, 27,28
In these experiments, the aqueous extract of garlic was
given IP since, in previous experiments, both oral and IP
administrations were found to be beneficial and IP
administration required less handling of the animals.6 The
dosage was chosen to be 500 mg/kg since it is a safe amount
of garlic to be given daily and does not cause toxicity.14, 36
In addition, we have previously administered this dose (500
mg/kg) via the IP route with no detrimental effects in terms
of toxicity and mode of administration.26, 28
The effects of the extracts of raw garlic were observed over
a period of seven weeks. STZ-induced diabetic rats showed
significant elevation of serum glucose, cholesterol and
triglyceride levels. Our results confirmed that raw garlic has
significant hypoglycaemic, hypocholesterolaemic and
hypolipidaemic effects. Therefore, the present study
reinforces the findings of previous papers that garlic had a
significant effect in reducing blood glucose,17,18,19,20,21, 37, 38
cholesterol12 and triglyceride levels8 in diabetic animal
models.
We also observed that the weight loss that occurred in STZ-
induced diabetic rats was attenuated by garlic treatment. In
addition, at 7 weeks, the garlic-treated diabetic group had a
lower mortality (one out of eight) compared to the control
diabetic group (three out of eight). These changes may be a
reflection of the improved health of the garlic-treated
diabetic animals.
Proteinuria is a major predictor of glomerular injury and
elevated rates of protein excretion are selective markers of
progressive nephropathy.39 STZ-induced diabetic rats are
characterized by the development of proteinuria.40
Furthermore, it has been shown that STZ has no long-term
Anti-diabetic effects of garlic
114
direct effects on the kidney, but STZ has secondary effects
on the kidney as a result of the development of diabetes
mellitus.41 Our results showed that raw garlic may alleviate
renal damage caused by STZ-induced diabetes, which was
manifested by the significant lowering of urinary protein
levels in the raw garlic-treated rats. Similar results were
observed in alloxan-induced diabetic rats by El-Demerdash
et al. who emphasized the alleviating effect of garlic on
renal damage.42 However, garlic treatment did not alleviate
the characteristic polydypsia or polyuria observed in the
STZ-induced diabetic rats. This is in agreement with the
results of Liu et al. who also observed no change in water
intake or urine output in STZ-induced diabetic rats treated
with garlic oil or diallyl trisulphide.20
It is not clear how garlic actually works in alleviating
hyperglycaemia. The hypoglycaemic action of garlic could
possibly be due to an increase in pancreatic secretion of
insulin from β-cells, release of bound insulin or
enhancement of insulin sensitivity. It has been previously
suggested that garlic (allicin) can enhance serum insulin by
effectively combining with compounds like cysteine, which
would spare insulin from SH group reactions which are a
common cause of insulin inactivation.21 Another mechanism
proposed by Augusti and Sheela states that the antioxidant
effect of S-allyl cysteine sulfoxide, an isolated product from
garlic, may contribute to its beneficial effect in diabetes.7
Jain and Vyas postulated that garlic may act as an anti-
diabetic agent by increasing either the pancreatic secretion
of insulin from the β-cells or release of bound insulin.43 This
explanation is supported by the results of Liu and coworkers
who reported that treatment of STZ-induced diabetic rats
with garlic oil or diallyl sulphide resulted in increased
serum insulin levels.20
The results of this study strongly suggest that garlic may be
very useful in the alleviation of diabetic complications as
well as in the prevention of the development of
atherosclerosis and nephropathy generally observed in
diabetic patients. In the future, further work is needed to
investigate the active ingredients in garlic. In addition, more
parameters should be studied such as insulin enhancement,
HbA1c level, free radical production, etc., to elucidate the
mechanism of action of the active constituents of garlic.
Acknowledgments
This work was supported by Kuwait University grant
number SB01/99 and the College of Graduate Studies,
Kuwait University for which the authors are grateful.
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... The most prevalent thiol-reactive organosulfur chemical produced by Allium sativum in reaction to tissue injury is allicin, also known as diallyl thiosulfinate 42 . In diabetic nerve cell models, allicin exhibits its renoprotective properties by reducing oxidative stress and renal inflammation while also improving the morphological changes of the kidney caused by diabetes 43,44 . Additionally, it inhibits the OS-hypoxiafibrosis pathway, HIF-1, and CTGF to slow down the progression of nephropathy. ...
... Additionally, it inhibits the OS-hypoxiafibrosis pathway, HIF-1, and CTGF to slow down the progression of nephropathy. physiologic changes to the kidney 45,44 and the suppression of renal inflammation and oxidative stress 43 . Additionally, it inhibits the OS-hypoxia fibrosis pathway, HIF-1, and CTGF to slow down the progression of nephropathy 46 . ...
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An extremely dangerous side effect of type I and type II diabetes is diabetic nephropathy (DN). From the early microproteinuria to end-stage renal failure, it progresses. About one in three diabetics in the US suffer from diabetic nephropathy. Chronic hyperglycemia is the primary cause of diabetic ketoacidosis. Hyperglycemia (HG) has the potential to cause humoral mediators and cytokines to be produced by both resident and non-resident renal cells. These substances may interfere with cell growth, alter renal cell and tissue phenotype and function, interact with proteins, produce advanced glycation end products (AGEs), damage tubules and glomeruli, and ultimately cause kidney disease. Poor blood glucose management is thus a significant risk factor for the onset of DN. An alternate course of treatment for DN may use extracts from herbal remedies. Medicinal plants' bioactive components stop DN from progressing. Attention has to be paid to the role that traditional herbs and medications play in the treatment of diabetic nephropathy, particularly in India where several fruits and herbs are believed to provide health benefits. Natural compounds influence the KEAP1/Nrf2/ARE and NFB pathways in addition to having antioxidant and anti-inflammatory properties. The efficacy of entire herbs, plants, or seeds, together with their active components, in treating diabetic nephropathy was investigated in preclinical research. Natural compounds are biologically active substances that come from natural sources and are beneficial for treating specific illnesses. Numerous natural substances, such as glycosides, polysaccharides, terpenoids, alkaloids, flavonoids, and polyphenols, have been shown to enhance DN. The exorbitant expenses associated with contemporary medications suggest that other approaches are necessary for improved DN treatment. Future research on herbal remedies may provide a natural key to open a pharmacy for diabetologists. Keywords: Diabetic nephropathy; nephroprotective plant; herbal compounds, bioactive compound
... The beneficial effects of garlic on diabetes mellitus are largely attributed to its rich content of volatile sulfur compounds, such as alliin, allicin, and ajoene (El et al., 2021). Specifically, S-allyl cysteine sulfoxide (SACS) has been shown to stimulate insulin secretion in the β-cells of healthy rats, while allicin exerts a therapeutic effect by reducing oxidative stress, which it accomplishes by increasing the levels of catalase and glutathione peroxidase (Liu et al., 2005;Thomson et al., 2007). This therapeutic effect is promising because oxidative stress plays a significant role in the progression of diabetes and its complications (Rösen et al., 2001). ...
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Ajoene, a bioactive sulfur-containing compound derived from garlic, exhibits a wide range of pharmacological properties that have garnered substantial scientific interest. This review presents a comprehensive analysis of its biological activities, including anticancer, antidiabetic, anti-inflammatory, antimicrobial, and neuroprotective effects. Several scientific research databases, including Google Scholar, Web of Science, PubMed, SciFinder, SpringerLink, Science Direct, Scopus, and, Wiley Online have been consulted. Ajoene has been shown to modulate key molecular pathways such as oxidative stress, inflammatory cytokine release, enzyme activity, and cellular apoptosis. These mechanisms contribute to its potential therapeutic applications across various diseases, including cancer, diabetes, cardiovascular disorders, neurodegenerative diseases , and infections. In vitro and in vivo studies consistently highlight ajoene's ability to inhibit tumor growth, reduce hyperglycemia, prevent neurodegeneration, and suppress inflammatory responses. Despite these promising results, the underlying mechanisms of ajoene's bioactivity remain incompletely understood, particularly in the context of complex human pathologies. This review emphasizes the need for more extensive clinical trials and toxicological evaluations to validate the efficacy and safety of ajoene in human populations. As such, ajoene is a promising candidate for developing novel therapeutic interventions, meriting further drug design and development investigation.
... Additionally, urinary protein levels were 50% lower. The study suggests that garlic could be beneficial in managing diabetes effects and complications in diabetic individuals [38] . ...
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Traditional foods are a good example of how food may have a purpose beyond just being a source of nutrients. Consuming these classic foods on regular basis offers a great way to prevent many illnesses. Rasam, a traditional dish popular in the southern region of India consumed usually along with rice on a regular basis is known for its unique blend of spices and a wide range of ingredients like tamarind, turmeric, tomato, sesame oil, chili pepper, garlic, black pepper, coriander and asafoetida all offering therapeutic and physiological advantage to human health. The findings of this review paper will contribute to the growing body of knowledge on traditional foods and their potential health implications. The goal is to bridge the gap between traditional culinary practices and modern nutritional sciences, shedding light on the potential of Rasam as a health-promoting element in southern cuisine.
... For example, several researches on diabetic animal models have been conducted on vivo treated with garlic extract. An agerelated study was done on STZ-induced diabetic rats treated with aged garlic extract, where the blood glucose levels, hemoglobin (HbA1c), decreased and renal functions improved also (Thomson et al. 2007). Another comparative study was focused on the effect of garlic extract and gliclazide, an antidiabetic drug, on diabetic rat models. ...
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Diabetes mellitus is a chronic metabolic disorder marked by hyperglycemia, resistance to insulin, and impaired function of the pancreatic β‐cells; it advances into more serious complications like nephropathy, neuropathy, cardiovascular disease, and retinopathy; herbal medicine has indicated promise in not just mitigating the symptoms but also in managing the complications. This review would aim to evaluate the pharmacological aspect of the botanical therapies Anacardium occidentale , Allium sativum , Urtica dioica , and Cinnamomum zeylanicum , as well as their bioactive phytochemicals, quercetin, resveratrol, berberine, and epigallocatechin gallate (EGCG). In this review, we discuss their mechanisms for secreting the insulin sensitizers, carbohydrate‐hydrolyzing enzymes, reduction in oxidative stress and effectiveness against diabetic complications‐all through sensitivity to insulin. Great emphasis is laid on the integration of multi‐omics technologies such as genomics, proteomics, metabolomics, and transcriptomics in the discovery of bioactive compounds. The nature of the technologies can evaluate the intrinsic complexities of herbal pharmacology and even identify therapeutic candidates. Finally, the review refers to the meagre clinical trials on the efficiency of these compounds in the metabolism of humans. High‐quality future research, such as human large‐scale trials, would be emphasized; improvement in the clinical validity of a drug might come from improved study design, better selection of potentially usable biomarkers, and enhanced safety profiles to guarantee efficacy with lessened risks.
... Garlic (Allium sativum) is a widely used herb for preventing and treating various diseases, as it has many bioactive components that can reduce risk factors [13]. Among these components are sulfurcontaining compounds that could contribute to garlic's benefits [14]. ...
... Theoretically, this impact is believed to be facilitated via many pathways, such as improving insulin sensitivity, boosting insulin secretion, and shielding pancreatic β-cells against cell death or malfunction. Furthermore, it has been noted that garlic may impact glucose metabolism via the inhibition of enzymes such as α-glucosidase and α-amylase, which play a role in carbohydrate digestion [185,186]. ...
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Garlic (Allium sativum L.) is a common culinary component because of its medicinal properties. However, the industry often discards garlic skin, which constitutes about 20–30 % of the total production. Garlic skin (GS) is a good source of phytochemicals and therapeutic compounds. Many cultures have recognized the health benefits of GS in preventing and treating illnesses. This review article highlights the main bioactive components of GS, including total flavonoids, total phenolics, and their derivatives, which may help regulate blood sugar, reduce cardiovascular disease risk, and offer anti-viral, anti-tumor, anti-inflammatory, antifungal, and antimicrobial properties. Based on current knowledge, GS is a valuable agricultural waste since it has a variety of biologically active ingredients. It can be used as a natural preservative in food products, particularly in the wheat flour (WF) industry, enhancing microbiological stability due to the antibacterial properties of garlic components like allicin. Incorporating GS into WF improves the nutritional value and flavor of the resulting flour-based food products, positively affecting the digestive system and antioxidant levels. This approach offers a unique blend of taste, nutrition, and health benefits.
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Abstract Garlic and its preparations have been widely recognized as agents for prevention and treatment of cardiovascular and other metabolic diseases, atherosclerosis, hyperlipidemia, thrombosis, hypertension and diabetes. Effectiveness of garlic in cardiovascular diseases was more encouraging in experimental studies, which prompted several clinical trials. Though many clinical trials showed a positive effect of garlic on almost all cardiovascular conditions mentioned above, however a number of negative studies have recently cast doubt on the efficary of garlic specially its cholesterol lowering effect of garlic. It is a great challenge for scientists all over the world to make a proper use of garlic and enjoy its maximum beneficial effect as it is the cheapest way to prevent cardiovascular disease. This review has attempted to make a bridge the gap between experimental and clinical study and to discuss the possible mechanisms of such therapeutic actions of garlic.
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E/Z-Ajoene (IIa)/(IIb), among other compounds isolated from garlic, is a potent inhibitor of platelet aggregation.
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This comprehensive resource uses evidence-based information to support the clinical use of natural herbs, supplements, and nutrients. It includes therapeutic protocols that can be used to manage or support other treatment regimes in promoting health, as well as preventing and treating disease. Key information on indications, doses, interactions, and side effects ensure safe, effective use of natural remedies.
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An aqueous extract of freeze-dried garlic (Allium sativum), when incorporated into growth media, inhibited many representative bacteria, yeasts, fungi and a virus. All microorganisms tested were susceptible to garlic. Quantitative assessment of the minimum inhibitory concentrations for bacteria and yeasts showed values ranging from 0.8 to 40.0 mg garlic ml-1. Fungal radial colony growth was inhibited by at least 25% at concentrations as low as 2.0 mg garlic ml-1. The 50% endpoint neutralization titre for rotavirus was 2.4 to 2.8 µg ml-1. Lactic acid bacteria were the least sensitive microorganisms to the inhibitory effects of garlic. In mixed culture studies of Lactobacillus acidophilus and Escherichia coli, garlic prevented the establishment of E. coli, although the final outcome of competition was not affected.
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Garlic (Allium sativum) extracts contain a compound termed ajoene, which, among other compounds from garlic, is a potent inhibitor of platelet aggregation. The structure of ajoene was determined by spectroscopic methods to be (E and Z)-4,5,9-trithiadodeca-1,6,11-triene 9-oxide. Ajoene can be readily synthesized by decomposing allicin in acetone-water. A detailed mechanism is presented for the thermal decomposition of allicin. Ajoene could be oxidized to its 9,9-dioxide, 4,9,9-trioxide, and 4,4,9,9-tetraoxide. An attempted synthesis of the ajoene isomer (E)-4,5,9-trithiadodeca-1,7,11-triene 9-oxide led instead to a sulfine (thial S-oxide) by way of the sulfoxide thio-Claisen rearrangement. Decomposition of the garlic component S-allyl methanethiosulfinate led to various homologues of ajoene. A variety of ajoene homologues in which the 6,7-double bond has been replaced by an o-phenylene group have been prepared from o-thiosalicylic acid. Data on the antithrombotic activity of a variety of structures related to ajoene have been used to explain the molecular basis for antithrombotic activity of ajoene, which is attributed to its ability to alter platelet membranes by capturing sulfhydryl groups.
Chapter
Neuro-arthropathy, or Charcot foot, is an important complication of long-standing diabetes and peripheral neuropathy and is generally acknowledged as a risk factor for foot ulceration and subsequent amputation. The natural history and pathogenesis are described, mainly on the basis of clinical observations and case studies since there have been few prospective observational studies. The clinical features are presented, as are radiographic studies and other diagnostic studies. The patterns of neuro-arthropathy are clearly illustrated. The recommended approach to management is based on the need to prevent further trauma and to promote eventual healing with stability and minimal deformity. The general goals and objectives are described for the acute and quiescent stages. Treatment options include reconstructive surgery, ways to prevent weight-bearing and selection of appropriate footwear.