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82 Iraqi J. Comm. Med., Jan. 2012 (1)
Study of Dried Apricot Effect on Type 2 Diabetic Patients as a Hypoglycemic Material
Bilal J.M. Al Rawi
1
Louwy M.A. Al Ani
2
Ali K Alywee
3
PhD PhD MSc
Abstract:
Background & objectives: apricot has constituents with antioxidant activity and some of them had been studied and showed
good results against diabetes. Dried apricot is available during the year and its constituents are concentrated as well
as apricot is desirable fruit and very safe. Therefore the aim of this work is to study the ability of apricot (Prunus
armeniaca L.) in decreasing glucose concentration in patients with type 2 diabetes.
Methods: this study was undertaken on 67 patients with type 2 diabetes mellitus, (39-67 years old) with mean ± SE (49.313
± 1.2968). The healthy control group consisted of 75 individuals which did not suffer from any problem, (19-69
years old) with mean ± SE (48.65 ± 2.15). The patients did not have other interfering health problems. Blood
glucose concentrations were determined using enzymatic colorimetric method ENDPOINT for all subjects at
beginning and the concentration labeled as (time 0). Directly after blood withdrawing, all subjects had 18 grams of
dried apricot. The second time labeled as (time 30) which mean the concentration of glucose after 30 minutes of
eating the apricot. After eating the apricot, another sample of blood was collected from every subject to determine
the glucose concentration and this time the concentration called (time 60).
Results: the results showed that the apricot decrease glucose in blood of patients of type2 diabetes not healthy control and
there is significant differences (p< 0.01). There are three expectation equations to estimate glucose level in
experiment conditions.
Interpretation & conclusions: apricot is good food for diabetic patients. It is safe, desirable, it decrease glucose
concentration, and it reduce the risk of diabetes complications. Apricots do all this activities because it has
constituents with antioxidant activity and other compounds with hypoglycemic activity like anthocyanin,
procyanidin, cartenoids, and others.
Keywords: apricot, type 2 diabetes, Prunus armeniaca L.
Introduction
iabetes mellitus, according to the classical
definition, is a disorder resulting from both genetic
predisposition and favoring environmental factors,
and is characterized by alterations in the metabolism
of carbohydrate, fat and protein, which are caused
by a relative or absolute deficiency of insulin
secretion and different levels of insulin resistance 1.
There are two types of diabetes, type-1 (insulin-
dependent diabetes) and type-2 diabetes.
Type-1 diabetes results from autoimmune
destruction of pancreatic β-cells, the cells that
secrete insulin, which leads into insulin
insufficiency2.
Type 2 diabetes (previously also named non-
insulin-dependent diabetes mellitus – NIDDM – or
adult-onset diabetes) is more prevalent and occurs in
approximately 90–95% of diabetic people in the
Western world, resulting from insulin resistance and
insufficient compensatory insulin secretion 2,3. The
undiagnosed diabetes is a serious problem. Early
detection and treatment are indispensable to reduce
the late complications of type 2 diabetes 4. Oral
hypoglycemic agents that directly stimulate insulin
release from β-cells (e.g., sulfonylurea-based drugs),
however, have shown that insulin secretion from
islets of type-2 diabetic patients can be elevated
sufficiently to overcome peripheral insulin resistance
and normalize blood glucose levels 5.
One of the disadvantages of using sulfonylurea-
based drugs is that it fails to control normal blood
glucose levels 6. These drugs also adversely affect
the ability of β-cells to secrete insulin and cause
weight gain 6. Hence, there is a role for dietary
constituents that can regulate blood glucose levels or
induce insulin production by pancreatic β-cells. In
the treatment of diabetes mellitus, changes in
lifestyle play a major role, in addition to treatment
with insulin or oral glucose-lowering drugs. For
most patients with type 2 diabetes, the changes in
lifestyle (concerning diet and exercise) are the
cornerstone of treatment whereas the pharmacologic
intervention represents a supplementary treatment
for those patients who do not respond adequately to
lifestyle changes.
Apricot (Prunus armeniaca L.) is one of the most
important fruits. It has a high nutritional value. This
fruit is rich in most of the essential nutrients,
especially, vitamin A, vitamin C, beta carotene,
calcium, potassium, flavonoids, Kaempferol, etc. as
well as high levels of lycopene 8-14. Apricots are
available in both fresh and dried forms. While, dried
apricots are available throughout the year, fresh ones
are seasonal. Both are nutritious and offer various
health benefits. Dried apricots health benefits are
said to be higher as compared to the fresh form 15.
The previous studies showed that some of apricot
constituents are anthocyanin, procyanidin,
hydroxycinnamic acid derivatives, β- carotene, and
others which had been proved that play roles in
decreasing glucose by different mechanisms 2,17-20.
Because apricot has constituents having
antioxidant activities and some hypoglycemic agents
like anthocynin, we think apricot can reduce the
glucose concentration in blood of type 2 diabetic
patients and reduce the risk of diabetes
complications. So the aim of this work is to study
the effect of dried apricot on glucose concentration
D
Study of Dried Apricot Effect on Type 2 Diabetic Patients as a Hypoglycemic Material Bilal J.M. Al Rawi, et. al.
83 Iraqi J. Comm. Med., Jan. 2012 (1)
in patients with type 2 and comparing the results
with healthy individuals as a control group.
Materials & Methods
Dried apricot which has been used in this study is
Malatya type with 24% moisture, Turkey.
Instruments: UV-VIS double beam
spectrophotometer from Bio Tech management
Co.LTD. UK. was used to determine glucose
concentration photometrically using glucose
laboratory kit from cramatest linear chemicals;
Spain.
Subjects: this study was undertaken on 67 patients
with type 2 diabetes mellitus, (39-67 years old) with
mean ± SE (49.313 ± 1.2968). The healthy control
group consisted of 75 individuals which did not
suffer from any problem, (19-69 years old) with
mean ± SE (48.65 ± 2.15). The patients did not have
other interfering health problems.
Method: Blood glucose concentrations were
determined using Enzymatic colorimetric method
ENDPOINT 21 for all subjects at beginning and the
concentration labeled as (time 0). It is important to
note the period after medication for patients and it
should be at least 3 hours. Directly after blood
withdrawing, all subjects had 18 grams of dried
apricot. The second time labeled as (time 30) which
mean the concentration of glucose after 30 minutes
of eating the apricot. After eating the apricot,
another sample of blood was collected from every
subjects to determine the glucose concentration and
this time the concentration called (time 60).
Statistics: data were subjected to (ANOVA) using
analysis of covariance. Also multiple regressions
was used to get the equation of variables
dependence.
Differences were considered significant at P<0.05.
Statistical analyses were performed using MedCalc
statistical software (1993-2009 copyright © Frank
Schoonjans., Norway.)
Results
The results showed that there is significant
differences between groups (diabetic and healthy
control) (p< 0.001) in different intervals (figure 1).
There are significant differences according to sex
(p< 0.01) in both groups (figure 2). We investigated
the age effect and the subjects (diabetic and control)
were divided into six subgroups; G1 represents the
subjects under 20 yr old, G2 represents (21-30 yr
old), G3 represents (31-40 yr old), G4 represents
(41-50 yr old), G5 represents (51-60 yr old), and G6
represents above 60 yr old. The results showed that
there is significant differences ( p= 0.003). figure 3
shows the differences according to age subgroups in
different intervals.
Using of multiple regression enable us to expect
the concentration of glucose in any of experimental
times (before eating apricot, after 30 minutes of
eating, and after an hour) by applying the concluded
equations. There are three variable in each equation,
sex, age, and afflicting by diabetes. The general
formula of equation is:
Y = b0 + b1 X1 + b2 X2 + b3 X3
Where the b0,b1,b2, and b3 are constants. While
X1,X2, and X3 are variables represent afflicting, sex,
and age respectively. The letter Y in equation is
glucose concentration in (mg/dl).
Depending on symbols used in statistical analysis,
afflicting would be 1 for diabetic patients and 2 for
healthy control individuals. In the same way, 1 for
male and 2 for female to substitute X2. To substitute
X3, age should be represented in years.
The equations of time 0, time 30, and time 60 are
as followed:
Glucose conc. (mg/dl) at time 0 = 85.2295 + (-37.7158 *afflicting) + (34.8289*Sex) + (1.6853*age)
Glucose conc. (mg/dl) at time 30 = 88.5282+ (-31.1596* afflicting) + (33.1428*Sex) + (1.57*age)
Glucose conc. (mg/dl) at time 60 = 72.3834+ (-22.4497* afflicting) + (22.6608*Sex) + (1.6603*age)
Figure 1: The effect of dried apricot on glucose concentration at different times.
Study of Dried Apricot Effect on Type 2 Diabetic Patients as a Hypoglycemic Material Bilal J.M. Al Rawi, et. al.
84 Iraqi J. Comm. Med., Jan. 2012 (1)
Figure 2: The effect of dried apricot on glucose concentration in different sex.
Figure 3: The difference of dried apricot effect on glucose concentration in different age subgroups.
Discussion:
Glucose concentration is maintained by a
mechanism controlled mainly by insulin which
secreted from islets of Langerhans. The first signal
which stimulates insulin secretion is increasing of
glucose concentration 22. Figure 4 demonstrates the
mechanism.
There are a defect in the control mechanism in
patients with type 2 diabetes mellitus, which is,
either a problem in insulin secretion 23 or a defect in
insulin receptors 24. The increase in cell volume
with fixed number of receptors may be, sometimes,
the reason of the defect in insulin mechanism 25.
The apricot, from the results, improves the
whole mechanism and then decreases the elevated
glucose concentration in patients with type 2
diabetes. But in healthy control individuals the
glucose did not decrease under the normal fasting
level 26 (90-120 mg/dl).
This phenomenon confirms that the apricot is
working on the whole mechanism.
The differences of apricot effect on different sex
can be explained that the distribution and the
quantity of fat are different between the two sexes
27 and that would reflect to the cell volumes. The
increasing in fat layer affects on cell volume and
may make (down regulation) which means the level
of hormone is high but all the receptors are
saturated which give a signal as a local negative
feedback28 which affect the control insulin
mechanism.
Figure (4): Example of how the direct control of
hormone secretion by the plasma concentration of a
substance, either organic nutrient or mineral ion,
results in the negative-feedback control of the
substance’s plasma concentration.
Study of Dried Apricot Effect on Type 2 Diabetic Patients as a Hypoglycemic Material Bilal J.M. Al Rawi, et. al.
85 Iraqi J. Comm. Med., Jan. 2012 (1)
The elevation of glucose at 30 minutes after
eating apricot is probably because glucose of
apricot absorbed directly but after that the other
constituents worked on stimulating the β cells to
secret insulin.
There is a significant difference depending on
the age that may be while age progressed the
concentration of growth hormone decreased which
has a direct effect on the concentration of insulin
and consequently the whole mechanism of glucose
regulation 22. Eating food with low fat and rich in
antioxidant compounds may reduce the risk of
obesity and insulin resistance2,29,30.
Previous studies indicated that eating of
vegetable and fruits, especially those with high
polyphenols, could decrease the probability of
incidence of type 2 diabetes mellitus in case of
insulin resistace 31-33.
Insulin resistance is a defect when insulin is
insufficient to stimulate glucose transport in
skeletal muscles and adipose tissues as well as
insufficient stopping glucose production in the
liver.
Apricot is rich with fibers and antioxidant
compounds and these compounds may be the
reason of apricot role in decreasing the glucose
concentration. Four phenolic compound groups,
procyanidins, hydroxycinnamic acid derivatives,
flavonols, and anthocyanins, were identified by
HPLC MS/MS and individually quantified using
HPLC DAD in apricots 13.
All of these compounds participate in ability of
apricot to decrease glucose concentration in patients
with type 2 diabetes. Anthocyanin prevent
oxidative stress in β-cell in pancreas which affected
by glucose 30. Jayaprakasam et al 2 showed that
anthocyanin triggered insulin secretion and it has
direct role in preventing type 2 diabetes and
probably useful in treating type 2 diabetes.
On the other hand, it is proved recently that
hydroxycinnamic acid derivatives stimulate insulin
secretion 18. Procyanidin is a group of polymeric
flavonoids having the ability to diminish the
concentration of glucose and enhancing the diabetic
symptoms in mice with streptozotocin induced
diabetes 19.
There are many indicators about cartenoids that
have antioxidant properties which prevent and treat
some chronic disease, especially, atherosclerosis,
diabetes mellitus, and asthma 34-37.
Cartenoids are exist in numerous quantity in
apricot and extractable compounds13. Also there is
disproportion between β- carotene and glucose in
blood 21.
The presence of the different compounds like
anthocyanin, procyanidin, hydroxycinnamic acid
derivatives, cartenoids, which can decrease glucose
in blood in diabetic patients make them work
together in case of synergistic effect and
consequently apricot become good source of
preventing diabetes and good food for diabetic
patients with type 2 diabetes.
Now we can conclude expected glucose level
for everyone in circumstances like ours in the
experiment depending on 3 parameters.
The parameters which have significant
differences can be variables in equation of glucose
dependence, age in years, afflicting of people with
diabetes, and sex. The concluded equations can
calculate glucose in any one before eating, after 30
minutes of eating 18 gram of dried apricot, and
finally after 60 minutes of eating 18 gram of dried
apricot.
Apricot has good ability to decrease glucose
concentration in patients with type 2diabetes and
the good thing is eating apricot did not decrease
glucose under normal value. We think that the
constituents of apricot work together in way of
synergistic effect and treat the whole insulin
mechanism which controls the level of glucose in
the blood. Apricot has a lot of constituents can
reduce the risk of diabetes, so we advice patients
with type 2 diabetes to eat dried apricot (available
in all the year and has concentrated constituents)
daily in quantity about 18 gram. We can estimate
glucose level for everybody if we know his or her
sex, diabetic or no, and age. Estimating glucose
normally and approximately and expectation the
glucose level after eating dried apricot in condition
of our experiment.
Acknowledgments
We wish to express our deepest appreciation
and sincere gratitude to Mr. Abdulsattar A. H.
Alassafi for his advising and suggestion some
thought of this work. Aspecial thanks go to the
students; Ibtisam H Taref, Marwa H Atallah, and
Nibras M Fayadh for their assisting in blood
collection in the laboratory.
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1 Dept. of Chemistry- Education College for Women- Al
Anbar University.
2 Biology Dept.-College of Science –Al Anbar University.
3 Dept. of Chemistry- Education College for Women Al
Anbar University.
