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Diabetes: Exploring the Intersection of Metabolic Disorders, Lifestyle Factors and Herbal Remedies: A Review
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The present study focuses the determination of the anti-diabetic activity of the extracted fractions of Allium sativum in rats with diabetes induced through STZ. The 20 mg/kg and 40 mg/kg doses of Allium sativum were given to the rats for 28 days. Using the accu-chek active test meter, blood glucose levels were measured to assess the anti-diabetic effects of the isolated fractions. Additionally, a comparison was made with the standard anti-diabetic medication, Pioglitazone, was given to another group of rats at a normal dose of 2.7 mg/kg. The results revealed that Allium sativum had significant anti-diabetic activity. Also, the Allium sativum remained safe till 300 mg/kg in acute toxic and 1000 mg/kg in sub-acute toxic studies and had photochemically. From these findings it can be inferred that Allium sativum has lowered FBG in experimentally induced diabetic rats.
Many Indian plants with tremendous medicinal value against various human ailments are still underutilized among which wood apple is one such edible fruit plant. The leaves, bark, roots, fruits and seeds are used extensively in Ayurvedic medicine for the treatment of chronic diarrhea, dysentery and peptic ulcers, as a laxative and to treat myriad ailments. Extensive scientific studies have also validated its ethno medicinal properties and presence of a variety of bioactive compounds which possess anti-hyperglycemic, antidiabetic, anticancer, antimicrobial, hepatoprotective and various other such activities. This review majorly provides information about the nutritional values, phytochemistry, traditional and modern pharmacological aspects of largely underutilized and neglected wood apple.
Diabetes mellitus (DM) is the most common chronic disease. Scientific research has turned to traditional herbal remedies as a potential adjunct therapy to maintain better glycemic control with minimal side effects. Garlic has been known since ancient times as an essential regulator either in diet or in medicine. Today the use of garlic is growing and widespread all over the world. This study is carried out to evaluate in vivo and in vitro antidiabetic effects of garlic extract compared to glibenclamide on biochemical parameters in alloxan induced diabetic mice. In-vitro antidiabetic effect of the A. sativum aqueous extract was conducted using α-amylase assay. Meanwhile in-vivo antidiabetic activity was conducted using alloxan induced diabetic mice with an intraperitoneal injection of 160 mg/kg body weight. The diabetic mice were divided into five groups, two of which were given garlic extract orally (200 mg/kg and 400 mg/kg) and a group composed of diabetic mice were given the standard drug, glibenclamide, orally at a dose of 2.5 mg/kg. The control mice (normal and diabetic) were fed normal saline once a day for 28 days. The preventive effect of garlic extract was proved to have the same result as the standard drug, glibenclamide when given at the dose indicated above. This result was shown when experiments dealt with blood glucose, glycosylated hemoglobin levels, total cholesterol, triglycerides, total lipids, alanine aminotransferase (ALAT), and aspartate aminotransferase (ASAT), with significant increases in plasma insulin. In addition, the plant extract exhibited a considerable inhibitory effect on α-amylase activity with IC50 value of 680.54± 0.58μg/ml. The present study shows that garlic extract possesses significant, potent anti-diabetic activity in vitro and in vivo, and that this activity is dose related. The garlic extract also recovers metabolic alterations and preserves insulin secretion capacity.
Background
In diabetic animals, there is a significant increase in plasma glucose, serum total cholesterol, triglyceride, and low-density lipoprotein levels, and decreased body weight, liver and muscle glycogen, and high-density lipoprotein. Effective treatment of diabetes mellitus is not yet known, even though the management of diabetes mellitus is considered a global concern. Plants and herbs have played an important role in the healthcare of many societies throughout history. Today’s researchers are investigating the potential for using these nonpharmaceutical approaches to treat and control diabetes, either in conjunction with standard treatments or as an alternative to them. Herbal formulations are favored because to lower cost and fewer side effects compared to other methods for alleviating diabetes and its consequences. In ethnomedicinal practices, different parts of Mangifera indica are used to treatment of diabetes. The present investigation was undertaken to evaluate the antidiabetic activity of an ethanolic extract of Mangifera indica and mangiferin in alloxan-induced diabetic rats. This experiment was conducted in a set of two with four groups of animals namely control (Tc), treatment alloxan (Ta), treatment extract (Tae), and treatment mangiferin (Tam). To develop diabetes, Wistar rats treated with 150 mg/kg b.w. of alloxan monohydrate were injected intraperitoneally. Tae and Tam’s groups received a freshly prepared single dose of extract and mangiferin in distilled water via the oral route. All experimental groups received laboratory pallet feed diet and drinking water ad libitum. Diabetic rats were treated for 21 days with an ethanolic extract of mango peel and pure mangiferin orally daily at rates of 200 mg/kg b.w. and 20 mg/kg b.w.
Results
An alloxan-induced diabetic rat treated with mango peel extract and mangiferin significantly improved the overhead impact due to diabetes. There was a significant ( p < 0.05) body weight loss in the alloxan-induced diabetic rats (Ta), whereas animals given mango peel extract and mangiferin showed a significant increase in body weight from 2 weeks onwards in comparison with control. Alloxan-induced rats (Ta) group have higher blood glucose levels and are significantly different ( p < 0.01) from the control group. Mango peel extract and mangiferin significantly reduced the levels of fasting glucose after 21 days of treatment in comparison with diabetic animals. Mango peel extract and mangiferin influence the glycogen synthesis pathway in diabetes groups by increasing glycogen levels in muscle and liver. mango peel extract and mangiferin were found to have a nonsignificant impact on plasma cholesterol and HDL levels compared with the control group. Mango peel extract was found to have a significant difference ( p < 0.05) in LDL levels compared with the control group. Mangiferin was found to have a significant difference ( p < 0.05) in triglyceride and VLDL levels when compared with the control group. Histopathological examination of the pancreas in rats with type I diabetes caused by alloxan found that therapy with an ethanolic extract of mango peel and mangiferin restored beta cell function as well as rejuvenation of Islets of Langerhans.
Conclusions
Mango peel extract and mangiferin have antidiabetic, glycogenesis, and hypolipidemic properties when administered to alloxan-induced diabetic rats.
Graphical abstract
In this review article, an attempt was made to present an overview of diabetes mellitus. Diabetes mellitus (DM) is a group of insulin resistance syndrome characterized by a high blood sugar level over a prolonged period of time. Diabetes is not a contagious disease. We can say Insulin dependent disorder. Nowadays, Diabetes Mellitus detect in many more peoples all over the World. In this report, we all know about Diabetes Mellitus. In that, we include its classification, sign & symptoms, etiology, pathogenesis, diagnosis, treatment etc. It’s had Four types, namely type 1, type 2, gestational Diabetes Mellitus & Other specific types such as, lada, mody. Fatigue Polyphagia, Polydipsia, polyuria, vomiting, dehydration etc., are common signs & symptoms are observed in Diabetes Mellitus. Diabetes Mellitus is mainly caused by the destruction of beta cells in the pancreas. Its cause’s autoimmune disorders such as Addison’s Disease, Hashimoto’s Thyroiditis & Graves’ disease. Some genetic factors, prior family history, environmental factors, autoimmune destruction, high insulin resistance these factors increase the risk of the development of diabetes mellitus. Most of the diabetic patients are older adults. Blood Glucose tests are used to detect diabetes mellitus. Insulin therapy is helpful to prevent or treat diabetes mellitus. For some patients, we used Islet replacement therapy and stem cell therapy used. In diabetes mellitus treatment, some drugs are used, such as miglitol, metformin, nateglinide, pioglitazone, glipizide, dapagliflozin, colestimide, bromocriptine etc. it's known as anti-diabetic drugs. Diabetics patients are more fastly rise in World.
The potential effects of anthocyanin-rich roselle, Hibiscus sabdariffa L. extract (ARRE) on
the growth, carcass traits, intestinal histomorphology, breast muscle composition, blood biochemical
parameters, antioxidant activity, and immune status of broiler chickens were evaluated. In the present
study, Hibiscus acidified ethanolic extract was reported to have a total anthocyanin content of about
359.3 mg cyanidin 3-glucoside/100 g DW, total polyphenol concentration (TPC) of about 598 mg gallic
acid equivalent (GAE)/100 g DW, and total flavonoids (TFs) of about 100 mg quercetin equivalent
(QE)/100 g DW. Two-hundred-fifty one-day-old chicks (Ross 308 broiler) (87.85 gm ± 0.32) were
randomly allotted to five experimental groups and fed on basal diets supplemented with five levels of
ARRE: 0, 50, 100, 200, and 400 mg Kg−1
for 35 days. Dietary ARRE addition did not improve the birds’
growth and carcass traits. Supplemental ARRE increased the n-3 polyunsaturated fatty acids (PUFA)
(ω-3) percentage in the breast muscle. Dietary ARRE increased the villous height, and the ARRE100
group raised the villus height to crypt depth ratio. Dietary ARRE increased the immunoexpression
of immunoglobulin G (IgG) in the spleen. The serum thyroxine hormone (T4) level was higher
in the ARRE200 group. The serum growth hormone level was increased by ARRE addition in a
level-dependent manner. According to the broken-line regression analysis, the optimum inclusion
level of ARRE was 280 mg Kg−1
. All levels of supplemental ARRE decreased the serum triglyceride
level. The serum total antioxidant capacity (TAC) was increased in the ARRE100-ARRE400 groups,
the serum superoxide dismutase (SOD) level was increased in the ARRE200 group, and the serum
malondialdehyde (MDA) level was decreased by increasing the ARRE level. Supplemental ARRE
significantly increased the serum levels of lysozymes and IL10. The serum complement 3 (C3) level
was increased in ARRE200 and ARRE400 groups. It can be concluded that dietary ARRE addition
had many beneficial effects represented by the improvements in the bird’s metabolic functions, blood
biochemistry, intestinal morphology, antioxidant activity, immune status, and higher ω-3 content in
the breast muscles. However, it had no improving effect on the birds’ growth.
Diabetes mellitus is a condition of metabolic imbalance, indicated by a high level of blood glucose (hyperglycemia) resulting from a reduction of insulin secretion, action, or both. People with diabetes suffer from a lack or deficiency of insulin or insulin resistance. The metabolic imbalances are often not satisfactorily corrected using conventional medicines and even cause some side effects, which can be detrimental. Research on herbal medicines for the treatment of diabetes is urged by the need to reduce unwanted side effects common with conventional medicines/treatments used in glucose regulation. This study aims to investigate the antidiabetic effect of Ginger ( Zingiber officinale ) aqueous extract in improving the glucose uptake in mouse tissues in vitro. This study is a true experimental research design with a posttest-only control group design. There were three groups of mice in this study: the control group, which were only given plain water; the second group of mice with 5% aqueous ginger extract and the last group were given 25% aqueous ginger extract. All groups were given treatment for four consecutive weeks, then dissected their cardiac muscle, skeletal muscle, pancreas, and liver tissues to analyze the glucose uptake. The result showed that both the ginger aqueous extract groups were able to increase the glucose uptake of the mice. In conclusion, this research has shown that aqueous ginger extract may have improved the glucose uptake in most tissues of the mice in the groups. Therefore, ginger could have great potential as an alternative way in the treatment of diabetes type 2.
Background: Recently with the changes in population lifestyle, prediabetes is constantly on the rise. Management of prediabetes currently is with lifestyle modifications like weight loss, exercise and diet control. Better drugs with acceptable safety profile are needed for better control of prediabetes. This study was thus designed to evaluate the antihyperglycaemic effect of one such potential compound Syzygium cumini (SC) (Jamun)in comparison to conventional antidiabetic drug Metformin. Methods: Rats were divided into four study groups (SC 100mg/kg and 200 mg/kg, metformin 90 mg/kg and SC 200 mg/kg with metformin 90 mg/kg). The glycaemic changes were followed up for a period of 8 weeks. Results: Streptozotocin (STZ) induced significant rise in blood glucose levels in the rats. SC100 mg/kg and 200 mg/kg caused a reduction in BSL (192.50 ± 6.189 & 175.00 ± 6.782 respectively). SC 200 mg/kg alone and in combination with metformin caused a significant reduction in HbA1C levels at the end of 8th week (8.84 ± 0.65 &6.86 ± 0.40 respectively) as compared to their baseline levels. Increase in dose had led to more significant reduction in BSL at the end of 8th week in groups A & B (p < 0.05). However, reduction of BSL was superior with Metforminalone (159.17 ± 13.060) compared to Syzygium cumini administered alone. Also antihyperglycemic effect of Syzygium cumini administered along with metformin was significant (p < 0.05) compared to either doses of Syzygium cumini given alone. Conclusions: Syzygium cumini demonstratedantihyperglycemic activity in diabetic rats but less significant when compared to metformin. Antihyperglycaemic effect of Syzygium cumini with metformin was significantly better than either drugsgiven alone. In prediabetic or diabeticindividuals Syzygium cumini seed powdercan be suggested as a potential add-on therapy with conventional antidiabetic drugs. However more non-clinical and clinical studies need to be conducted to confirm the findings.
Carica papaya has tremendous medicinal applications against diverse diseases since ancient period. Considering this, the present study was aimed to assess in vitro antioxidant and anti-diabetic activities of bioactive fractions of C. papaya seed extracts. Initially, the shade-dried ripen seeds of C. papaya were powdered and extracted via soxhlet protocol to obtain crude extracts. The crude extracts were then fractionated using different solvents viz. hexane, ethyl acetate, methanol, and water. Fractions obtained were assessed for α-glucosidase and amylase inhibitory activities using standard methodologyies. Results revealed that ethyl acetate fraction C (83.66 ± 0.10%) and D (84.56 ± 0.23%) showed maximum inhibition of α-amylase with an IC50 value of 36.84 and 36.86 mg/ml, respectively. Likewise, ethyl acetate fraction C (48.72 ± 0.10%) and D (51.81 ± 0.45%) exhibited α-glucosidase inhibition with an IC50 value of 83.54 and 82.33 mg/ml, respectively. The ethyl acetate fractions C and D were further purified to obtain sub-fraction K, L, M, and N and evaluated for in vitro antioxidant and anti-diabetic activities. The sub-fraction K demonstrated maximum antioxidant activity against DPPH and TBA radicals (IC50 = 41.37 and 53.98 mg/ml) respectively. However, the sub-fraction K elicited the most conspicuous anti-diabetic activity towards α-amylase (IC50 = 156.15 mg/ml) and intestinal α-glucosidase (IC50 = 70.89 mg/ml). The mode of inhibition was determined using the Lineweaver- Burk plot. Sub-fraction K exhibited a competitive mechanism of inhibition on both α-amylase and α-glucosidase. The GC-MS profile confirmed the presence of diverse metabolites in the sub-fraction and the major bioactive compounds detected were hexadecanoic acid, methyl ester, 11-octadecenoic acid, methyl ester, N, N-dimethyl, n-hexadecanoic acid, and oleic acid. Our findings suggested the folklore medicinal use of C. papaya seeds as an effective antioxidant and anti-diabetic agents.
Wood apple (Limonia acidissima) is a tropical fruit native to Southeast Asia. The main aim of the study was to find the awareness and therapeutic benefits of wood apple. To know the consumption of wood apple in their life style, the questionnaire was developed and data was recorded, by randomly selected diabetes subjects. Subjects were belonged to the age group of 50-60 years (66.6 percent) and 30-40 years (33.34 per cent). Among the selected subjects 66.7 percent were suffering from diabetes since past 1-5 years, 13.3 percent had from 5-10 years and remaining 20 percent had from more than 10 years. Among the selected subjects eight were non-vegetarians (53.3%), 2 are vegetarian and 5 are ova-vegetarians (33.3%). Majority of the subjects follows three meals per day (73.3%) and another 4 subjects followed four meals per day (26.7%). Among the selected subjects eight were non-vegetarians (53.3%), 2 are vegetarian and 5 are ova- vegetarians (33.3%). Majority of the subjects follows three meals per day (73.3%) and another 4 subjects followed four meals per day (26.7%). Along with their life style they also had the habit of consuming alcohol (26.7%), smoking (33.3), and chewing tobacco (26.7%). It is evident from the results that, majority of respondents (60 percent) consumed wood apple for the consumption for dysentery/ diarrhea followed by 20 percent for control of heat and 20 percent as a refreshing drink. The wood apple fruit pulp contains functional and bioactive compounds such as carotenoids, phenolics, alkaloids, flavonoids, terpenoids, and other antioxidants which may help to protect against degenarative diseases.
Diabetes mellitus (DM) is a metabolic disorder that occurs in the body because of decreased insulin activity and/or insulin secretion. Pathological changes such as nephropathy, retinopathy, and cardiovascular complications inevitably occur in the body with the progression of the disease. DM is mainly categorized into 2 sub-types, type I DM and type II DM. While type I DM is generally treated through insulin replacement therapy, type II DM is treated with oral hypoglycaemics. The major drug therapy for type II DM comprises of insulin secretagogues, biguanides, insulin sensitizers, alpha glucosidase inhibitors, incretin mimetics, amylin antagonists and sodium-glucose co-transporter-2 (SGLT2) inhibitors. Dual drug therapies are often recommended in patients who are unable to achieve therapeutic goals with first line oral hypoglycaemic agents as monotherapy. Inspite of the appreciable therapeutic benefits, the conventional dosage forms depicts differential bioavailability and short half-life, mandating frequent dosage and causing greater side effects leading to therapy ineffectiveness and patient non-compliance. Given the pathological complexity of the said disease, nanotechnology-based approaches are more enticing as it comes with added advantage of site-specific drug delivery with higher bioavailability and reduced dosage regimen.
In the present review article, we have made an attempt to explore the pathophysiology of type II DM, the conventional treatment approaches (mono and combination therapy) as well as the nano based drug delivery approaches for the treatment of type II DM.
Antidiabetic potential and related activity of Jamun (Syzygium cumini Linn.) and its utilization in Unani medicine: An overview
Diabetes, a rampant disease is now a big concern for the humanity. Syzygium cumini Linn., commonly known as "Jamun" or black plum is an important medicinal plant in Unani system of medicine (USM) used commonly for the treatment of diabetes mellitus and other ailments. In USM the pharmacological actions of Jamun are Nafe ziabetus (Antidiabetic), Qabiz wa habis Dam (Astringent and Haemostatic), Dafe salasal bawl (Helpful in urinary incontinence), Muquwie bah (Sexual tonic) etc. Different parts of the Jamun were reported for its antidiabetic, antioxidant, hypolipidemic, neuropsycho-pharmacological, anti-ulcerogenic, free radical scavenging, nitric oxide scavenging and radio-protective activities. Both in-vivo and in-vitro anti diabetic activity are reported from the drug. The chemical constituents responsible for the inhibition of glucose are terpenoids, glycosides, saponins, flavanoids, phenols etc. Jamun contains an important glycoside namely Jambolin which prevents the conversion of starch into sugar thereby helps in controlling the blood sugar. This review helps to overcome the gap between traditional therapeutic and modern contemporary medication for providing better understanding. Overview of photochemistry / constituents and pharmacological activities of both classical and reported can update the information regarding the drug for better utilization in therapeutics of diabetes mellitus.
Hyperglycaemia that develops during pregnancy and resolves after birth has been recognized for over 50 years, but uniform worldwide consensus is lacking about threshold hyperglycaemic levels that merit a diagnosis of ‘gestational diabetes mellitus’ (GDM) and thus treatment during pregnancy. GDM is currently the most common medical complication of pregnancy, and prevalence of undiagnosed hyperglycaemia and even overt diabetes in young women is increasing. Maternal overweight and obesity, later age at childbearing, previous history of GDM, family history of type 2 diabetes mellitus and ethnicity are major GDM risk factors. Diagnosis is usually performed using an oral glucose tolerance test (OGTT), although a non-fasting, glucose challenge test (GCT) is used in some parts of the world to screen women for those requiring a full OGTT. Dietary modification and increased physical activity are the primary treatments for GDM, but pharmacotherapy, usually insulin, is used when normoglycaemia is not achieved. Oral hypoglycaemic agents, principally metformin and glibenclamide (glyburide), are also used in some countries. Treatment improves immediate pregnancy outcomes, reducing excess fetal growth and adiposity and pregnancy-related hypertensive disorders. GDM increases the risk of long-term complications, including obesity, impaired glucose metabolism and cardiovascular disease, in both the mother and infant. Optimal management of mother and infant during long-term follow-up remains challenging, with very limited implementation of preventive strategies in most parts of the world. Gestational diabetes mellitus (GDM) is the most common complication in pregnancy and has short-term and long-term effects in both mother and offspring. This Primer discusses the definitions of GDM, diagnosis and management of the disease and areas requiring further research.
The potential roles of Zingiber officinale Roscoe (ginger) for treating and preventing diabetes have been investigated in both humans and experimental animals. However, the mode of its action has not yet been elucidated. This study aimed to investigate the effects of ginger extract on glucose uptake activity and its activation pathway in L6 myotubes. Cells were co-cultured for 24 h with a variable concentration of either ginger extract or 2 mM metformin or 200 nM insulin or 20 µM Troglitazone (TGZ), followed by a 10-min 2-[ ³ H]-deoxy-D-glucose (2-DG) uptake. The levels of glucose transporters 1 (GLUT1) and GLUT4 protein and mRNA expression were determined. Ginger extract at 400 µg/ml significantly enhanced glucose uptake in L6 myotubes (208.03 ± 10.65% above basal value, p<0.05) after co-culture for 24 h. The ginger-enhancement of glucose uptake was inhibited by 3.5 µM cycloheximide, a protein synthesis inhibitor, 1 µM wortmannin (Phosphatidylinositol 3-Kinase (PI3 kinase) inhibitor) and 15 nM rapamycin (mammalian target of rapamycin (mTOR) inhibitor). The enhancement of glucose transport by ginger extract at 400 µg/ml was accompanied with the increased expression of GLUT1 protein (1.60 ± 0.20, 2.03 ± 0.19, and 2.25 ± 0.35 folds of basal at 4, 8, and 24 h, respectively p<0.05) and mRNA (1.22 ± 0.96, 1.45 ± 0.93, 1.91 ± 0.75, 2.32±0.92, and 2.20 ± 0.64 folds of basal at 1, 2, 4, 8, and 24 h, respectively p<0.05) in a time-dependent manner. Z. officinale Roscoe rhizome extract increase glucose transport activity of L6 myotubes by enhancing GLUT1 expression, the results of PI3-Kinase and 5’-AMP-activated kinase (AMPK) stimulation.
Acromegaly is a rare disease due to chronic GH excess and to the consequent increase in IGF-1 levels. Both GH and IGF-1 play a role in intermediate metabolism affecting glucose homeostasis. Indeed, chronic GH excess impairs insulin sensitivity, increases gluconeogenesis, reduces the glucose uptake in adipose tissue and muscle and alters pancreatic β cells function. As a consequence, glucose metabolism alterations are a very frequent complication in acromegaly patients, further contributing to the increased cardiovascular risk and mortality. Treatment modalities of acromegaly differently impact on glucose tolerance. Successful surgical treatment of acromegaly ameliorates glucose metabolism abnormalities. Drugs used to treat acromegaly patients may per se affect glucose homeostasis, therefore influencing patients' management. Indeed pegvisomant has been shown to positively impact on glucose metabolism, while somatostatin analogs, especially pasireotide, can cause hyperglycaemia. On the other hand, robust data on the effect of dopamine agonists on glycaemic profile are still lacking. This review summarizes the available data on diabetes mellitus in acromegaly patients, with a focus on the potential effects of the medical treatment of the disease on glucose homeostasis, providing an overview of the current state of the art.
Associated with important comorbidities that significantly reduce patients’ overall wellbeing and life expectancy, Cushing’s disease (CD) is the most common cause of endogenous hypercortisolism. Glucocorticoid excess can lead to diabetes, and although its prevalence is probably underestimated, up to 50% of patients with CD have varying degrees of altered glucose metabolism. Fasting glycemia may nevertheless be normal in some patients in whom glucocorticoid excess leads primarily to higher postprandial glucose levels. An oral glucose tolerance test should thus be performed in all CD patients to identify glucose metabolism abnormalities. Since diabetes mellitus (DM) is a consequence of cortisol excess, treating CD also serves to alleviate impaired glucose metabolism. Although transsphenoidal pituitary surgery remains the first-line treatment for CD, it is not always effective and other treatment strategies may be necessary. This work examines the main features of DM secondary to CD and focuses on antidiabetic drugs and how cortisol-lowering medication affects glucose metabolism.
Pancreatic Cancer is the fourth cause of cancer-related deaths in the United States. Up to 80% of pancreatic cancer patients present with either new-onset type 2 diabetes or impaired glucose tolerance at the time of diagnosis. Recent literature suggests that diabetes mellitus type 2 is a risk factor, a manifestation and a prognostic factor for pancreatic cancer. This article is intended to clarify the evidence about diabetes as a risk factor for pancreatic cancer.
Cystic fibrosis (CF) is the most common autosomal recessive disorder in Caucasian populations. Individuals with CF have seen significant increases in life expectancy in the last 60 years. As a result, previously rare complications are now coming to light. The most common of these is cystic fibrosis-related diabetes (CFRD), which affects 40–50% of CF adults. CFRD significantly impacts the pulmonary function and longevity of CF patients, yet a lack of consensus on the best methods to diagnose and treat CFRD remains. We begin by reviewing our understanding of the pathogenesis of CFRD, as emerging evidence shows the cystic fibrosis transmembrane conductance regulator (CFTR) also has important roles in the release of insulin and glucagon and in the protection of β cells from oxidative stress. We then discuss how current recommended methods of CFRD diagnosis are not appropriate, as continuous glucose monitoring becomes more effective, practical, and cost-effective. Finally, we evaluate emerging treatments which have narrowed the mortality gap within the CF patient group. In the future, pharmacological potentiators and correctors directly targeting CFTR show huge promise for both CFRD and the wider CF patient groups.
Diabetes in whites of European descent with hemochromatosis was first attributed to pancreatic siderosis. Later observations revealed that the pathogenesis of diabetes in HFE hemochromatosis is multifactorial and its clinical manifestations are heterogeneous. Increased type 2 diabetes risk in HFE hemochromatosis is associated with one or more factors, including abnormal iron homeostasis and iron overload, decreased insulin secretion, cirrhosis, diabetes in first-degree relatives, increased body mass index, insulin resistance, and metabolic syndrome. In p.C282Y homozygotes, serum ferritin, usually elevated at hemochromatosis diagnosis, largely reflects body iron stores but not diabetes risk. In persons with diabetes type 2 without hemochromatosis diagnoses, serum ferritin levels are higher than those of persons without diabetes, but most values are within the reference range. Phlebotomy therapy to achieve iron depletion does not improve diabetes control in all persons with HFE hemochromatosis. The prevalence of type 2 diabetes diagnosed today in whites of European descent with and without HFE hemochromatosis is similar. Routine iron phenotyping or HFE genotyping of patients with type 2 diabetes is not recommended. Herein, we review diabetes in HFE hemochromatosis and the role of iron in diabetes pathogenesis in whites of European descent with and without HFE hemochromatosis.
Context: Momordica charantia Linn (Cucurbitaceae) (MC) is used in folk medicine to treat various diseases including diabetes mellitus.
Objective: This study investigates the antidiabetic activities of Momordica charantia (bitter gourd) on streptozotocin-induced type 2 diabetes mellitus in rats.
Materials and methods: Male Wister rats were randomly assigned to 4 groups. Group I, Normal control; Group II, STZ diabetic; Group III and IV, Momordica charantia fruit juice was orally administered to diabetic rats (10 mL/kg/day either as prophylaxis for 14 days before induction of diabetes then 21 days treatment, or as treatment given for 21 days after induction of diabetes). The effects of MC juice were studied both in vivo and in vitro by studying the glucose uptake of isolated rat diaphragm muscles in the presence and absence of insulin. Histopathological examination of pancreas was also performed.
Results: This study showed that MC caused a significant reduction of serum glucose (135.99 ± 6.27 and 149.79 ± 1.90 vs. 253.40* ± 8.18) for prophylaxis and treatment respectively, fructosamine (0.99 ± 0.01 and 1.01 ± 0.04 vs. 3.04 ± 0.07), total cholesterol, triglycerides levels, insulin resistance index (1.13 ± 0.08 and 1.19 ± 0.05 vs. 1.48 ± 1.47) and pancreatic malondialdehyde content (p < 0.05). While it induced a significant increase of serum insulin (3.41 ± 0.08 and 3.28 ± 0.08 vs. 2.39 ± 0.27), HDL-cholesterol, total antioxidant capacity levels, β cell function percent, and pancreatic reduced glutathione (GSH) content (p < 0.05) and improved histopathological changes of the pancreas. It also increased glucose uptake by diaphragms of normal (12.17 ± 0.60 vs. 9.07 ± 0.66) and diabetic rats (8.37 ± 0.28 vs. 4.29 ± 0.51) in the absence and presence of insulin (p < 0.05).
Conclusions: Momordica charantia presents excellent antidiabetic and antioxidant activities and thus has great potential as a new source for diabetes treatment whether it is used for prophylaxis or treatment.
tree belongs to the Myrtaceae family. This also called as jamun, jambul and jambol in india and malaya. The bark of jamun is acrid, sweet, digestive, astringent to the bowels, anthelmintic and used for the treatment of sore throat, bronchitis, asthma, thirst,biliousness, dysentery and ulcers. It is also a good blood purifier.[9] [Muniappan and Panddurangan, 2012]. In Union medicine various parts of Jambolan acts as liver tonic, enrich blood, strengthen teeth and gums and form good lotion for removing ringworm infection of the head. E. jambolana leaf extract showed hypoglycemic action in diabetic rats [5]. Eugenia jambolana Lam., commonly known as black plum or " jamun " is an important medicinal plant in various traditional systems of medicine. It is effective in the treatment of diabetes mellitus, inflammation, ulcers and diarrhea and preclinical studies have also shown it to possess chemopreventive, radioprotective and antineoplastic properties [11]. The study revealed that Syzygium cumini extracts contains rich availability of carbohydrates, phenols, flavonoids and tannins as their secondary metabolites. Further the ethanolic extracts ofleaves and aqueous extracts of seeds were found to have very high anti microbial propertyfor wide range of gram positive and gram negative bacterial strains. Various extracts of fruit and seeds of Syzygium cumini were found to have antidiabetic, antiinflammatory, hepatoprotective, antihyperlipidemic, diuretic and antibacterial ABSTRACT : Jamun (syzygium cumini) is an important medicinal plant of india. The present study was carried out to identify antihyperglycemic activity and the putative antidiabetic compound from the S. cumini [SC] seed .The 50% methanolic extract of syzygium cumini seeds have the anti-hyperglycemic properties and give positive result on alloxan-induced diabetic mice. Phytochemical analysis was investigated. Flavonoids are strongly present in extract, biologically active phytochemical alkaloids, terpenoids and tannins are also present. syzygium cumini, anti-hyperglycemic, alloxan-induced diabetes.
: Ginger (
: A double-blind, placebo-controlled, randomized clinical trial was conducted on 20–60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting.
: Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (–19.41±18.83 vs. 1.63±4.28 mg/dL, p
With rapidly increasing prevalence, diabetes has become one of the major causes of mortality worldwide. According to the latest studies, genetic information makes substantial contributions towards the prediction of diabetes risk and individualized antidiabetic treatment. To date, approximately 70 susceptibility genes have been identified as being associated with type 2 diabetes (T2D) at a genome-wide significant level (P < 5 × 10(-8)). However, all the genetic loci identified so far account for only about 10% of the overall heritability of T2D. In addition, how these novel susceptibility loci correlate with the pathophysiology of the disease remains largely unknown. This review covers the major genetic studies on the risk of T2D based on ethnicity and briefly discusses the potential mechanisms and clinical utility of the genetic information underlying T2D.
The aim of the present study was to evaluate the effects of garlic on fasting blood sugar and HbA1c in patients with type 2 diabetes mellitus. This was a 24 week, single-blind placebo controlled study. The patients (n = 210) with fasting blood sugar above 126 mg/dl were recruited and divided into 7 groups (A, B, C, D, E, F and G), each comprised of 30 patients. Group A, B, C, D, and E were given garlic tablets at doses of 300, 600, 900, 1200, and 1500 mg per day respectively. Group F received metformin while group G received placebo. FBS and HbA1c were measured at week 0, 12 and 24. Present study showed significant decrease in fasting blood sugar and HbA1c in both dose and duration dependent manner. In each garlic treated group, significant reduction in FBS (p <0.005) and HbA1c (p <0.005) were observed when compared with placebo. Highly significant reduction in FBS and improvement in HbA1 C were observed at higher doses of garlic and with increase in the duration of study. Garlic is more effective than placebo and comparable to metformin in reducing fasting blood glucose and may be a valuable addition in the management of diabetic patients.
Trigonella foenum-graecum L. is directly related to the traditional use. Trigonella foenum-graecum L, have been reported to be beneficial for treating type 2 diabetes (T2D). The study was conducted to investigate the postprandial hypoglycemic effect of fenugreek seeds on patients with T2D. Pretest - posttest control group design was used to test the hypothesis that fenugreek may have a hypoglycemic effect on blood sugar. One hundred sixty-six D2T patients were assigned into three groups: FG0 (control group: placebo drink), FG2.5 (2.5g of fenugreek), and FG5 (5g of fenugreek). Participants were instructed to drink the extract and chew the seeds. Postprandial plasma glucose level was measured before and 2-hours after the administration of the treatment. Accounting for gender, age, education, physical activity, body mass index, glycemic control, and medication, patients in FG5 group showed the greatest decrease in postprandial glucose with a pretest-posttest difference (D) of - 41 ± 6.1 mg/dl. Two-hour plasma glucose dropped for patients in FG2.5, however, the drop was not statistically different from that noticed in the placebo group (D = - 24.8 ± 4.9 mg/dl vs. - 9.8 ± 2.2 mg/dl respectively). Fenugreek seeds appear to have a significant hypoglycemic activity in T2D patients.
Diabetes mellitus (DM), both insulin-dependent DM (IDDM) and non-insulin dependent DM (NIDDM) is a common and serious metabolic disorder throughout the world. Several oral hypoglycemic agents and insulin therapy are the primary forms of treatment for diabetes. However, prominent side effects of such drugs are the main reason for an increasing number of people seeking alternative therapies that may have less severe or no side effects. Several medicinal plants have been used to control diabetes in the traditional medicinal systems of many cultures worldwide. Many more medicinal plants have found potential use as hypoglycemic in the Indian system of medicines. In this review, there are 39 plants described. It clearly shows the importance of herbal plants in the treatment of diabetes mellitus. The present review profile-gives information about scientific name, common name, family and theparts of the plant used to treat diabetes.
Type 2 diabetes mellitus (T2DM) has an intersecting underlying pathology with thyroid dysfunction. The literature is punctuated with evidence indicating a contribution of abnormalities of thyroid hormones to type 2 DM. The most probable mechanism leading to T2DM in thyroid dysfunction could be attributed to perturbed genetic expression of a constellation of genes along with physiological aberrations leading to impaired glucose utilization and disposal in muscles, overproduction of hepatic glucose output, and enhanced absorption of splanchnic glucose. These factors contribute to insulin resistance. Insulin resistance is also associated with thyroid dysfunction. Hyper- and hypothyroidism have been associated with insulin resistance which has been reported to be the major cause of impaired glucose metabolism in T2DM. The state-of-art evidence suggests a pivotal role of insulin resistance in underlining the relation between T2DM and thyroid dysfunction. A plethora of preclinical, molecular, and clinical studies have evidenced an undeniable role of thyroid malfunctioning as a comorbid disorder of T2DM. It has been investigated that specifically designed thyroid hormone analogues can be looked upon as the potential therapeutic strategies to alleviate diabetes, obesity, and atherosclerosis. These molecules are in final stages of preclinical and clinical evaluation and may pave the way to unveil a distinct class of drugs to treat metabolic disorders.
Diabetes affects a substantial part of the world’s population and, possibly, is the world’s fastest-growing metabolic disease. Garlic, Allium sativum L., Liliaceae, a popular cooking spice with a long history as traditional medicine, has been demonstrated to exhibit antidiabetic properties. Garlic is a rich natural source of bioactive sulfur-containing compounds with potential antidiabetic properties. This review aimed to present a summary of the most recent and relevant literature pertaining to the use of garlic for the prevention and treatment of diabetes, and the potential use of this natural food as complementary or alternative medicine. This review also focuses on the essential biological roles of the bioactive compounds present in garlic in the treatment of diabetes along with identifying and addressing the related pathways related to diabetes regulation. This review further emphasizes the relevance of evidence on garlic’s antidiabetic efficacy in experimentally induced or inherited animal models, as well as human cell line studies, and discusses the mechanisms of action of garlic as both an insulin sensitizer and secretagogue. Conclusions of this review on the therapeutic aspects of garlic and its bioactive compounds highlight the medicinal and folk values of this spice and its active compounds against diabetes.
Objective:
We aim to provide a critical review focused on the various pharmacological activities of Azadirachta indica A. Juss related to diabetes management. We also emphasise on phytochemistry and toxicology of A. indica, which could provide a comprehensive approach for plant-based drug development in future.
Key findings:
From 2784 identified studies, only 83 were considered after double screening based on the inclusion criteria. Further, 63 pharmacological investigations were considered for review. Resultant studies deliberated on using different extracts and phytochemicals of A. indica on blood glucose level, lipid profile, oxidative stress, carbohydrate digestion enzymes, diabetic complications, glucose tolerance, and uptake of glucose.
Summary:
In the end, one can know the efficacy of A. indica as a potent antidiabetic herbal medicine. However, based on gaps in research, recommendations have been provided to evaluate A. indica. in a systematic manner to develop plant-based drugs, nutraceuticals, and to evaluate their clinical efficiency and safety against diabetes mellitus.
Hibiscus sabdariffa (HS) is a woody-based subshrub of the Malvaceae family which has various uses in traditional medicine. This review systematically evaluates the evidence from clinical trials on the antidiabetic activity of HS. A random-effects model was used to obtain summary estimates. Five outcome measure, including fasting plasma glucose (FPG), total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoproteins (LDL), and triglyceride (TG) were assessed in the study. The results of the overall pooled statics for the FPG level showed that there was a significant reduction in FPG (WMD = -3.964 mg/dL; 95% CI: -6.227 to -1.702 and P-value was 0.001) and in the level of LDL (WMD = -7.843 mg/dL; 95% CI: -14.337 to -1.350 and P-value was 0.018). However, the pooled estimate showed that there was no statistically significant change on the TC (WMD = -30.382 mg/dL; 95% CI: -66.752 to 5.989 and P value was 0.102), the HDL (WMD = 0.074 mg/dL; 95% CI: -1.986 to 2.135 and P value was 0.944) and the TG (WMD= -9.050 mg/dL; 95% CI, -30.819 to 12.719 and P value was 0.102) compared to the placebo. Egger’s weighted regression P values suggested that there was no potential publication bias in the FPG (P =0.664), HDL (P = 0.065), LDL (P = 0.677) and TG (P = 0.232) but there was a publication bias in the TC (0.056). Therefore, the result of this meta-analysis clearly shows that HS has antidiabetic activity, whereas its lipid-lowering effect needs further study.
The present study was designed to evaluate the antidiabetic and antioxidant effect of Hibiscus rosasinensis against streptozotocin induced diabetic rats. Streptozotocin (STZ) was administered as a single dose (40 mg/kg) to induce diabetes. The hypoglycemic activity of Hibiscus rosasinensis extract (HRSEt) was investigated in a dose dependent manner such as (125, 250 and 500 mg/kg bwt) by evaluating various biochemical parameters. The levels of blood glucose, carbohydrate metabolizing enzymes, TBARS, enzymatic and non-enzymatic antioxidants and lipid profiles were found to be significantly increased in diabetic rats when compared to control groups. Administration of extract in the treated groups showed altered changes in the above mentioned parameters and found that among the three doseses, 250 mg/kg showed best result when compared to other two doses. HRSEt possess antioxidant, hypoglycemic and hypolipidemic activity against streptozotocin induced diabetic rats. However the detailed mechanism(s) of action will require elucidating in further studies.
Diabetes mellitus is one of the most common endocrine metabolic disorders. Adverse effects of the conventional antidiabetic therapy are increasing. Many herbs have strong antidiabetic properties, and fenugreek is one among them. Although fenugreek is one of the most common herbs used for diabetes, its antidiabetic effects are not well-documented. The aim of this review was to report the evidence-based antidiabetic effects of fenugreek. We performed PubMed/Medline search to review relevant articles in English literature using keywords 'trigonella foenum graecum for the management of diabetes.' Out of 26 articles found, 18 articles were reported in this review. Based on the available literature, this review suggests that the fenugreek has the evidence-based antidiabetic effect, such as stimulating and/or regenerating effect on β cells along with the extrapancreatic effect, that is effective in reducing blood glucose levels in diabetic patients.
Fruit phenolics are important dietary antioxidant and antidiabetic constituents. The fruit parts (pulp, seed, seed coat, kernel) of underutilized indigenous six black jamun landraces (Syzygium cumini L.), found in Gir forest region of India and differed in their fruit size, shape and weight, are evaluated and correlated with antidiabetic, DPPH radical scavenging and phenolic constituents. The α-amylase inhibitors propose an efficient antidiabetic strategy and the levels of postprandial hyperglycemia were lowered by restraining starch breakdown. The sequential solvent systems with ascending polarity-petroleum ether, ethyl acetate, methanol and water were performed for soxhlet extraction by hot percolation method and extractive yield was found maximum with methanolic fruit part extracts of six landraces. The methanolic extracts of fruit parts also evidenced higher antidiabetic activity and hence utilized for further characterization. Among the six landraces, pulp and kernel of BJLR-6 (very small, oblong fruits) evidenced maximum 53.8 and 98.2% inhibition of α-amylase activity, respectively. The seed attained inhibitory activity mostly contributed by the kernel fraction. The inhibition of DPPH radical scavenging activity was positively correlated with phenol constituents. An HPLC-PDA technique was used to quantify the seven individual phenolics. The seed and kernel of BJLR-6 exhibited higher individual phenolics-gallic, catechin, ellagic, ferulic acids and quercetin, whereas pulp evidenced higher with gallic acid and catechin as α-amylase inhibitors. The IC50 value indicates concentration of fruit extracts exhibiting ≥50% inhibition on porcine pancreatic α-amylase (PPA) activity. The kernel fraction of BJLR6 evidenced lowest (8.3 µg ml(-1)) IC50 value followed by seed (12.9 µg ml(-1)), seed coat (50.8 µg ml(-1)) and pulp (270 µg ml(-1)). The seed and kernel of BJLR-6 inhibited PPA at much lower concentrations than standard acarbose (24.7 µg ml(-1)) considering good candidates for antidiabetic herbal formulations.
Graphical abstract:
This study aimed to determine the nutraceutical composition of mango by-product (BP) and to evaluate the mechanisms related to its antidiabetic properties. Mango BP reduced (p < 0.05) serum glucose in streptozotocin-induced diabetic rats, which was not associated with a decreased glucose intestinal absorption or to the protection of Langerhans islets. Mango BP showed insulin mimetic effects in 3T3-L1 adipocyte cells, increasing Glut4, Irs1 and Pi3k expression. Mango BP reduced (p < 0.05) serum triacylglycerides in diabetic rats, which was associated to a decreased lipid intestinal absorption, and ameliorated diabetic nephropathy due to its renal antioxidant activity. The anti-diabetic effect of mango BP was associated to its high content of soluble fiber, as well as several polyphenols and carotenoids, like ellagic acid, gallic acid, quercetin, epicatechin gallate, and β-carotene. Therefore, these results suggest that mango BP could be used as a functional supplement for diabetes treatment.
Background: Most of the parts of neem tree were studied in details by many researchers but neem root bark was not screened for antidiabetic effect. To evaluate antidiabetic effect of neem root bark this study was conducted. Aims & Objective: The present study was undertaken to evaluate the 70% alcoholic neem root bark extract (NRE) in diabetes. Materials and Methods: Basal blood sugar levels were estimated in overnight fasted wistar albino rats of either sex. To evaluate antihyperglycemic action of Neem root bark extract (NRE) OGTT was done by giving glucose orally 60 minutes after giving standard drug (Glibenclamide),Test drug (NRE) in the dose of 200,400 and 800 mg/kg and blood sugar levels were estimated every half hourly up to 4 hours. To evaluate hypoglycemic activity in alloxan induced diabetic rats similar doses once daily for 15 days. Blood sugar levels were estimated by using glucometer. Results: For glucose tolerance test Glibenclamide significant (p< 0.01) reduction in blood sugar levels. The NRE showed statistically significant results in only 800 mg/kg dose. In comparison to glibenclamide it did not show. In alloxan induced diabetes Glibenclamide showed significant (p<0.01) reduction in blood sugar levels. The NRE showed statistically significant results in only 800 mg/kg dose. Conclusion: Neem root has antihyperglycemic and hypoglycemic activity. It is not as significant as glibenclmide.
The aim of present study was to evaluate antidiabetic activity of methanolic extract of Hibiscus cannabinus; family Malvaceae leaves in streptozotocin induced diabetic rats. The alcoholic extract of Hibiscus cannabinus was studied for antidiabetic activity in streptozotocin induced diabetic rats by oral administration of extract 400mg/kg body weight for 15 days. The effect was compared with oral dose of 0.5mg/kg Glibenclamide. The determination of blood glucose level by GOD-POD kit method. The result shows the alcoholic extract of Hibiscus cannabinus leaves significantly lowered the blood glucose of hyperglycemic rats. From the toxicity study it was observed that methanolic extract of Hibiscus cannabinus was nontoxic up to 5g/kg body weight and phytochemical study showed the presence of phytosterols, flavonoids and glycosides. It is concluded that Hibiscus cannabinus leaf extract has significant antidiabetic activity, which lowered the fasting blood glucose level in Streptozotocin induced diabetic rats.
Peel is a major by-product during processing of mango fruit into pulp. Recent report indicates that the whole peel powder ameliorated diabetes. In the present study, ethanolic extract of mango peel was analysed for its bioactive compounds, evaluated for α-amylase and α-glucosidase inhibitory properties, oral glucose tolerance test, antioxidant properties, plasma insulin level and biochemical parameters related to diabetes. In addition to gallic and protocatechuic acids, the extract also had chlorogenic and ferulic acids, which were not reported earlier in mango peel extracts. The peel extract inhibited α-amylase and α-glucosidase activities, with IC50 values of 4.0 and 3.5 μg/ml. Ethanolic extract of peel showed better glucose utilization in oral glucose tolerance test. Treatment of streptozotocin-induced diabetic rats with the extract decreased fasting blood glucose, fructosamine and glycated hemoglobin levels, and increased plasma insulin level. Peel extract treatment decreased malondialdehyde level, but increased the activities of antioxidant enzymes significantly in liver and kidney compared to diabetic rats. These beneficial effects were comparable to metformin, but better than gallic acid treated diabetic rats. The beneficial effects of peel extract may be through different mechanism like increased plasma insulin levels, decreased oxidative stress and inhibition of carbohydrate hydrolyzing enzyme activities by its bioactive compounds. Thus, results suggest that the peel extract can be a potential source of nutraceutical or can be used in functional foods and this is the first report on antidiabetic properties of mango peel extract.
To investigate the hypoglycemic activity of an aqueous extract of the flower of Hibiscus rosa sinensis on blood glucose in normal and streptozotocin (STZ) -induced diabetic rats, serum triglyceride and cholesterol levels and the effect of the flower extract on insulin secretion. Effect of H. rosa sinensis flower extract on blood glucose was studied with fed, fasted and glucose-loaded diabetic and nondiabetic rats. Glycosylated hemoglobin, serum insulin levels and lipid profile were also determined. Student's t test was used for statistical analysis. In normal rats, the aqueous extract of the flower of H. rosa sinensis (250 and 500 mg/kg body weight) significantly (P < 0.001) reduced the blood glucose levels after an oral glucose load from 127.9 +/- 5.6 to 80.6 +/- 3.9 mg/dl 2 h after oral administration of the flower extract. It also significantly lowered the blood glucose in STZ diabetic rats from 241.0 +/- 6.6 to 90.8 +/- 5.7 mg/dl after 21 days of oral administration of the extract (P < 0.001). Serum insulin levels were not stimulated in the animals treated with the extract. Glycosylated hemoglobin and serum lipid profiles were significantly lowered by the administration of the extract. From the studies, it can be concluded that the aqueous extract of the flowers of H. rosa sinensis at a dosage of 500 mg/kg/day exhibits significant hypoglycemic and hypolipidemic activities. A marked reduction in glycosylated hemoglobin was also observed while insulin levels did not show any significant change.
Diabetes mellitus is a complex metabolic disorder resulting from either insulin deficiency or insulin dysfunction. Based on the recent advances and involvement of oxidative stress in complicating diabetes mellitus, efforts are on to find suitable antidiabetic and antioxidant therapy. Medicinal plants are being looked upon once again for the treatment of diabetes. Neem, Azadirachta Indica is a widely grown plant in the Indian subcontinent. It has been found to have various medicinal properties, so this study was carried out. Rats were used as animal models to study the antidiabetic effects of neem. Diabetes was induced in rats by alloxan monohydrate. The assessment was done by fasting blood glucose levels and oral glucose tolerance test. The results of the study indicate that neem oil has got the potential to reduce blood glucose levels within a short period of time and also it has potential to improve the glucose tolerance after a treatment period of 4 weeks. Azadirachta Indica may have beneficial effects in diabetes mellitus and holds the scope of new generation of antidiabetic drug.
The incidence of type 1 diabetes (T1D) in young children (age <6 years) is rising. Diabetes management guidelines offered by the American Diabetes Association and health care teams understandably place a high burden of responsibility on caregivers to check young children's blood glucose levels, administer insulin, and monitor diet and physical activity with the ultimate goal of maintaining tight glycemic control. Unfortunately, this tight control is needed during a vulnerable developmental period when behavior is unpredictable, T1D can be physiologically difficult to control, parenting stress can be elevated, and caregivers are strained by normal child caretaking routines. Despite the potentially different management needs, specific education and clinical services for managing diabetes in young children are rarely offered, and behavioral research with this young child age group has been limited in scope and quantity. Research findings pertinent to young children with T1D are reviewed, and potential clinical implications, as well as areas for future research, are discussed.
Type 2 diabetes mellitus is one of the fastest growing diseases; the number of people affected by diabetes will soon reach 552 million worldwide, with associated increases in complications and healthcare expenditure. Lifestyle and medical nutrition therapy are considered the keystones of type 2 diabetes prevention and treatment, but there is no definite consensus on how to treat this disease with these therapies.
The American Diabetes Association has made several recommendations regarding the medical nutrition therapy of diabetes; these emphasize the importance of minimizing macrovascular and microvascular complications in people with diabetes. Four types of diets were reviewed for their effects on diabetes: the Mediterranean diet, a low‐carbohydrate/high‐protein diet, a vegan diet and a vegetarian diet.
Each of the four types of diet has been shown to improve metabolic conditions, but the degree of improvement varies from patient to patient. Therefore, it is necessary to evaluate a patient's pathophysiological characteristics in order to determine the diet that will achieve metabolic improvement in each individual.
Many dietary regimens are available for patients with type 2 diabetes to choose from, according to personal taste and cultural tradition. It is important to provide a tailor‐made diet wherever possible in order to maximize the efficacy of the diet on reducing diabetes symptoms and to encourage patient adherence. Additional randomized studies, both short term (to analyse physiological responses) and long term, could help reduce the multitude of diets currently recommended and focus on a shorter list of useful regimens. Copyright © 2013 John Wiley & Sons, Ltd.
Glucose metabolism is normally regulated by a feedback loop including islet β cells and insulin-sensitive tissues, in which tissue sensitivity to insulin affects magnitude of β-cell response. If insulin resistance is present, β cells maintain normal glucose tolerance by increasing insulin output. Only when β cells cannot release sufficient insulin in the presence of insulin resistance do glucose concentrations rise. Although β-cell dysfunction has a clear genetic component, environmental changes play an essential part. Modern research approaches have helped to establish the important role that hexoses, aminoacids, and fatty acids have in insulin resistance and β-cell dysfunction, and the potential role of changes in the microbiome. Several new approaches for treatment have been developed, but more effective therapies to slow progressive loss of β-cell function are needed. Recent findings from clinical trials provide important information about methods to prevent and treat type 2 diabetes and some of the adverse effects of these interventions. However, additional long-term studies of drugs and bariatric surgery are needed to identify new ways to prevent and treat type 2 diabetes and thereby reduce the harmful effects of this disease.