Diabetes Research
Molecular Changes in Diabetic Wound Healing following Administration of Vitamin D and Ginger Supplements: Biochemical and Molecular Experimental Study
Hadeel A. Al-Rawaf,1,2 Sami A. Gabr,1 and Ahmad H. Alghadir
Abstract
Background. Circulating micro-RNAs are differentially expressed in various tissues and could be considered as potential regulatory biomarkers for T2DM and related complications, such as chronic wounds. Aim. In the current study, we investigated whether ginger extract enriched with [6]-gingerol-fractions either alone or in combination with vitamin D accelerates diabetic wound healing and explores underlying molecular changes in the expression of miRNA and their predicted role in diabetic wound healing.
Methods. Diabetic wounded mice were treated with [6]-gingerol-fractions (GF) (25 mg/kg of body weight) either alone or in combination with vitamin D (100 ng/kg per day) for two weeks. Circulating miRNA profile, fibrogenesis markers, hydroxyproline (HPX), fibronectin (FN), and collagen deposition, diabetic control variables, FBS, HbA1c, C-peptide, and insulin, and wound closure rate and histomorphometric analyses were, respectively, measured at days 3, 6, 9, and 15 by RT–PCR and immunoassay analysis.
Results. Treatment of diabetic wounds with GF and vitamin D showed significant improvement in wound healing as measured by higher expression levels of HPX, FN, collagen, accelerated wound closure, complete epithelialization, and scar formation in short periods (11-13 days, (P<0.01). On a molecular level, three circulating miRNAs, miR-155, miR-146a, and miR-15a, were identified in diabetic and nondiabetic skin wounds by PCR analysis. Lower expression in miR-155 levels and higher expression of miR-146a and miR-15a levels were observed in diabetic skin wounds following treatment with gingerols fractions and vitamin D for 15 days. The data showed that miRNAs, miR-146a, miR-155, and miR-15a, correlated positively with the expression levels of HPX, FN, and collagen and negatively with FBS, HbA1c, C-peptide, and insulin in diabetic wounds following treatment with GF and /or vitamin D, respectively.
Conclusion. Treatment with gingerols fractions (GF) and vitamin D for two weeks significantly improves delayed diabetic wound healing. The data showed that vitamin D and gingerol activate vascularization, fibrin deposition (HPX, FN, and collagen), and myofibroblasts in such manner to synthesize new tissues and help in the scar formation. Accordingly, three miRNAs, miR-155, miR-146a, and miR-15, as molecular targets, were identified and significantly evaluated in wound healing process. It showed significant association with fibrin deposition, vascularization, and reepithelialization process following treatment with GF and vitamin D. It proposed having anti-inflammatory action and promoting new tissue formation via vascularization process during the wound healing. Therefore, it is very interesting to consider miRNAs as molecular targets for evaluating the efficiency of nondrug therapy in the regulation of wound healing process
Source Journal Evidence Based Complementary and Alternative Medicine
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Diabetes mellitus and nature’s pharmacy of putative antidiabetic plants
Kazhila C.
Abstract
Globally, diabetes causes about 1.5 million deaths per year. Data predicts that the current global epidemiological burden of diabetes is increasing alongside its long-term life threatening sequelae and side-effects from synthetic antidiabetic drugs. Challenges in the public healthcare delivery system, inadequate human and financial resources, expensive antidiabetic drugs coupled with their limited availability, efficacy and tolerability, and a higher priority for subventions to the control of communicable diseases such as HIV/AIDS than to drugs for non-communicable conditions especially diabetes have opened new vistas for diabetics to seek complementary and alternative medicines. As a corollary, there is a renewed momentum backed by the World Health Organization to discover newer, cheaper and better antidiabetic agents from medicinal plants. As data on putative antidiabetic properties of plants remain scattered, this review provides a new synthesis of antidiabetic plants from Africa, Central America, Mexico, South Asia, and Iran. In the countries mentioned in this review, numerous plant species decrease blood sugar levels by inhibiting the enzymes α-amylase and α-glucosidase. Other antidiabetic plants restore pancreatic cells, improve insulin secretion and sensitivity, decrease metabolic syndrome in type 2 diabetes patients in addition to exerting antioxidant and hepatoprotective functions. Mechanisms of action are mediated by phytochemical agents including saponins, polyphenols, ellagitannins, triterpenes, and elements such as Mg, P, Ca, K, Mn, Cu, Zn, S, Cr, Co, Ni and V. These plant compounds and elements may be included into new and more efficacious herbal drugs and nutraceuticals to lessen the global burden of diabetes.
Source : Journal of Herbal Medicine
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Apple and pear consumption and type 2 diabetes mellitus risk: a meta-analysis of prospective cohort studies
Abstract
The conclusions from epidemiological studies are controversial between apple and pear consumption and type 2 diabetes mellitus (T2DM) risk. The present study aimed to investigate whether apple and pear consumption was inversely associated with T2DM risk, and to evaluate the potential dose–response relationship. The Cochrane library, Embase and PubMed databases were searched up to Nov 2016. Prospective cohort studies, which reported the association of apple and pear consumption with incidence of T2DM, were included. Multivariate-adjusted relative risks (RRs) for the highest versuslowest category were combined by using a random-effects model. A restricted cubic spline regression model was performed to examine the dose–response relationship. A total of 5 independent prospective cohort studies were included (14 120 T2DM incident cases and 228 315 participants). The summary estimate showed that consumption of apples and pears was associated with 18% reduction in T2DM risk (95% confidence interval (CI): 0.75, 0.88; I2 = 0.00%). Dose–response analysis showed that one serving per week increment of apple and pear consumption was associated with a 3% (95% CI: 0.96, 0.98; p for trend <0.001) reduction in T2DM risk. The present meta-analysis provides significant evidence of an inverse association between apple and pear consumption and T2DM risk.
Source : Journal Food and Nutrition
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Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Aurélie Ballon, Manuela Neuenschwander, and Sabrina Schlesinge
Abstract
Background: Epidemiologic studies have indicated that breakfast skipping is associated with risk of type 2 diabetes. However, the shape of the dose-response relation and the influence of adiposity on this association have not been reported.
Objective: We investigated the association between breakfast skipping and risk of type 2 diabetes by considering the influence of the body mass index (BMI).
Methods: In this systematic review and meta-analysis, PubMed and Web of Science were searched up to August 2017. Prospective cohort studies on breakfast skipping and risk of type 2 diabetes in adults were included. Summary RRs and 95% CIs, without and with adjustment for BMI, were estimated with the use of a random-effects model in pairwise and dose-response meta-analyses.
Results: In total 6 studies, based on 96,175 participants and 4935 cases, were included. The summary RR for type 2 diabetes comparing ever with never skipping breakfast was 1.33 (95% CI: 1.22, 1.46, n = 6 studies) without adjustment for BMI, and 1.22 (95% CI: 1.12, 1.34, n = 4 studies) after adjustment for BMI. Nonlinear dose-response meta-analysis indicated that risk of type 2 diabetes increased with every additional day of breakfast skipping, but the curve reached a plateau at 4–5 d/wk, showing an increased risk of 55% (summary RR: 1.55; 95% CI: 1.41, 1.71). No further increase in risk of type 2 diabetes was observed after 5 d of breakfast skipping/wk (P for nonlinearity = 0.08).
Conclusions: This meta-analysis provides evidence that breakfast skipping is associated with an increased risk of type 2 diabetes, and the association is partly mediated by BMI.
Source : The Journal of Nutrition
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Baduanjin exerts anti-diabetic and anti-depression effects by regulating the expression of mRNA, lncRNA, and circRNA
Tian An†,Zhong-Chen He†, Xin-Qing Zhang, Jun Li, Ai-Ling Chen, Fang Tan, Hong-Dong Chen, Bo-Han Lv, Juan Lian, Si-Hua Gao and Guang-Jian Jiang
Abstract
Background
Baduanjin, a traditional Chinese exercise therapy, has been widely used in China to treat type 2 diabetes (T2DM) with depression (DD). However, the underlying mechanism of Baduanjin in anti-DD is unclear. This study was focused on investigating the effects of Baduanjin on symptoms of depression and blood glucose in patients with DD and the underlying mechanism.
Methods
We performed a 12-week Baduanjin intervention on patients with DD and longitudinally compared the differential expressions of lncRNAs, circRNAs, and mRNAs between pre- (BDD) and post- (ADD) Baduanjin intervention in the same group. Subsequently, Gene Ontology (GO) and pathway analysis was performed to investigate the function of differentially expressed mRNAs. Finally, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was used to verify the sequencing result and the mRNA-lncRNA regulatory network was constructed.
Results
The blood glucose level, depression index scores, and PHQ9 scores of the patients with DD were significantly decreased (P < 0.05) after Baduanjin intervention. Compared to BDD, 207 lncRNAs, 266 circRNAs, and 610 differentially expressed mRNAs were identified in ADD. Kyoto Encyclopedia of Genes and Genomes (KEGG) and GO showed that the significantly dysregulated mRNAs were mainly involved in immune function and inflammatory response pathways, and various signaling pathways including IL-17 and TNF. In addition, we selected five differentially expressed lncRNAs to construct an lncRNA-mRNA regulatory network, and found a total of 1045 mRNAs associated with them.
Conclusions
Our research is the first systematic profiling of mRNA, lncRNA, and circRNA in patients of ADD and BDD, and provides valuable insights in the potential mechanism of Baduanjin in anti-DD. Further, it was confirmed that Baduanjin is a safe and effective intervention for patients with DD because it can effectively ameliorate the symptoms of depression and blood glucose levels in patients with DD by regulating the dysregulated expression of lncRNA, mRNA, and circRNA.
Source Journal Chinese Medicine
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Circulating Hypoxia Responsive microRNAs (HRMs) and Wound Healing Potentials of Green Tea in Diabetic and Nondiabetic Rat Models
Hadeel A. Al-Rawaf,1,2 Sami A. Gabr,1 and Ahmad H. Alghadir
Abstract
Green tea (Camellia sinensis) has many biological activities and may promote diabetic wound healing by regulation of circulating hypoxia responsive microRNAs (HRMs) which triggers the wound repairing process in diabetic and nondiabetic wounds. Thus, in this study, the potential effects of green tea extract (GTE) on the expression of miRNAs; miR-424, miR-199a, miR-210, miR-21, and fibrogenitic markers; hydroxyproline (HPX), fibronectin (FN), and nitric oxide (NO) were evaluated in wounds of diabetic and nondiabetic rats. The animals were topically treated with vaseline, 0.6% GTE, and 5%w/w povidone iodine (standard control). HPX, FN, and NO levels and microRNAs, miR-424, miR-210, miR-199a, and miR-21, were estimated in wound tissues using colorimetric, immunoassay, and molecular PCR analysis. In vitro analysis was performed to estimate active constituents and their antioxidant activities in methanolic green teat extract (GTE). Wounds treated with green tea, a dose of 0.6, healed significantly earlier than those treated with standard vehicle and vaseline treated diabetic wounds. Higher expressions of HRMs, miR-199a, and miR-21, and lower expression of HRMs, miR-424 and miR-210, were significantly reported in tissues following treatment with green tea extract compared to standard control vehicle. The tissues also contained more collagen expressed as measures of HPX, FN, and NO and more angiogenesis, compared to wounds treated with standard control vehicle. Diabetic and nondiabetic wounds treated with green tea (0.6%) for three weeks had lesser scar width and greater re-epithelialization in shorter periods when compared to standard control vehicle. Expression of HRMs, miR-199a, miR-21, and HRMs and miR-424 and miR-210 correlated positively with HPX, fibronectin, NO, better scar formation, and tensile strength and negatively with diabetes. In addition to antidiabetic and antioxidant activities of green tea components, GTE showed angiogenesis promoting activity in diabetic wound healing. In conclusion, Camellia sinensis extracts in a dose of 0.6% significantly promote more collagen and fibronectin deposition with higher expression of NO, promoting angiogenesis process via molecular controlling of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 in diabetic and nondiabetic wounds. Our results support a functional role of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 as potential therapeutic targets in angiogenesis and vascular remodeling in diabetic wound healing.
Source : Journal Evidence Based Complementary and Alternative Medicine
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Quercetin protects rat dorsal root ganglion neurons against high glucose-induced injury in vitro through Nrf-2/HO-1 activation and NF-κB inhibition
Yue Shi,1 Xiao-chun Liang,1,* Hong Zhang,2 Qun-li Wu,1 Ling Qu,1 and Qing Sun1
Abstract
Aim:To examine the effects of quercetin, a natural antioxidant, on high glucose (HG)-induced apoptosis of cultured dorsal root ganglion (DRG) neurons of rats.
Methods:DRG neurons exposed to HG (45 mmol/L) for 24 h were employed as an in vitro model of diabetic neuropathy. Cell viability, reactive oxygen species (ROS) level and apoptosis were determined. The expression of NF-кB, IкBα, phosphorylated IкBα and Nrf2 was examined using RT PCR and Western blot assay. The expression of hemeoxygenase-1 (HO-1), IL-6, TNF-α, iNOS, COX-2, and caspase-3 were also examined.
Results:HG treatment markedly increased DRG neuron apoptosis via increasing intracellular ROS level and activating the NF-κB signaling pathway. Co-treatment with quercetin (2.5, 5, and 10 mmol/L) dose-dependently decreased HG-induced caspase-3 activation and apoptosis. Quercetin could directly scavenge ROS and significantly increased the expression of Nrf-2 and HO-1 in DRG neurons. Quercetin also dose-dependently inhibited the NF-κB signaling pathway and suppressed the expression of iNOS, COX-2, and proinflammatory cytokines IL-6 and TNF-α.
Conclusion:Quercetin protects rat DRG neurons against HG-induced injury in vitro through Nrf-2/HO-1 activation and NF-κB inhibition, thus may be beneficial for the treatment of diabetic neuropathy.
Source : Acta Pharacologica Sinica
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Antidiabetic Activity of Picris japonica Thunb Aqueous Extract in Diabetic KK-Ay Mice
Yanmei Jia and Lirong Chen
Abstract
Objective. To evaluate the hypoglycemic effect of Picris japonica Thunb (Asteraceae) on KK-Ay mice. Methods. The hypoglycemic effect of Picris japonica aqueous extract (PJE) in a spontaneous type 2 diabetic model (KK-Ay mice) was studied in the present research. PJE was administrated at doses of 700 mg/kg and 350 mg/kg (calculated as crude herb) for 14 days and blood glucose, oral glucose tolerance test, plasma insulin level, and blood lipid were evaluated. Meanwhile, Rosiglitazone was used for the positive control. Results. It was found the PJE treatment significantly reduced blood glucose level and improved oral glucose tolerance ability (p < 0.01 orp < 0.05) in a dose-dependent manner compared to the control diabetic mice. The blood insulin levels were significantly reduced in PJE-treated mice (700 mg/kg) and Rosiglitazone compared with the diabetic control (p< 0.01). Compared with the control diabetic group, the serum total cholesterol, triglyceride, and low density lipoprotein cholesterol were reduced by PJE (700 mg/kg) and Rosiglitazone (p < 0.05), and the serum high density lipoprotein cholesterol was significantly increased only by Rosiglitazone (p < 0.01). Conclusions. The findings demonstrate that Picris japonica has remarkable antidiabetic effect in diabetic KK-Ay mice, which suggests that Picris japonica may be beneficial to the treatment of type 2 diabetes mellitus.
Source : Journal Evidence Based Complementary and Alternative Medicine
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The Microalga Spirulina platensis Presents Anti-inflammatory Action as well as Hypoglycemic and Hypolipidemic Properties in Diabetic Rats
Ivan P. Joventino, Henrique G.R. Alves, Lia C. Neves, Francisca Pinheiro-Joventino, Luzia Kalyne A.M. Leal, Samya A. Neves Francisco Valdeci Ferreira, Gerly Anne C. Brito, Glauce B. Viana
Abstract
Spirulina platensis (Spi) is a microalga presenting high contents of proteins, γ-linolenic acid, vitamins and minerals, and showing many biological activities. It is a promising drug for the treatment of diseases including diabetes. The objectives of this work were to study Spi effects on alloxan-induced diabetic rats, and associate this to its anti-inflammatory activity. The treatment with Spi (25, 50 or 100 mg/kg, p.o.) started 48 h after the alloxan injection, continuing for 5 or 10 days. Biochemical parameters were measured in sera of treated and untreated animals. The anti-inflammatory activity of Spi was assessed by the formalin test and carrageenan-induced paw edema in mice. Immunostainings for TNF-alpha were carried out in the carrageenan-induced paw edema in rats, before and after the Spi treatment, and its effect on the release of myeloperoxidase from human neutrophils was also determined. Spi decreased glycemia as well as triglyceride and total cholesterol levels of diabetic rats. Levels of urea and creatinine were also reduced, while liver transaminases were unaltered. Spi also decreased dose-dependently the 1st (neurogenic) and mainly the 2nd phase (inflammatory) of the formalin test, as well as the carrageenan-induced paw edema in mice. The anti-inflammatory effect of Spi was further confirmed by decreases in TNF-alpha immunostaining in the inflamed paw and in the myeloperoxidase release from human neutrophils. The results showed that the anti-diabetic effect of S. platensis is already manifested after a 5-day treatment. Additionally, considering the relationship between diabetes and inflammation, the microalga anti-inflammatory action may also be involved.
Source : Journal of Complementary and Integrative Medicine
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The effect of ginger (Zingiber Officinale) as an ancient medicinal plant on improving blood lipids
TaherehArablouaNaheedAryaeianb
Abstract
Ginger (Zingiber Officinale Roscoe) is a plant that is used as a popular spice in foods, desserts and drinks all around the world. This plant is native to Asia and has been used since ancient times in the prevention and treatment of many diseases. To date, several properties of ginger such as antioxidant, anti-inflammatory and anticoagulation activities have been studied and the effect of the plant to reduce pain and improve nausea and vomiting has been established. Among human and animal studies that have been carried out in recent years on the properties of ginger, some literature aimed to investigate the effect of this plant on blood lipids. In this review, we consider those studies and their possible enzymatic and molecular mechanisms regarding the effect of ginger on lipid profiles.
Conclusion
This paper aimed to address the question of whether ginger has a reducing effect on blood lipids. Therefore, we discussed relevant human studies on this effect and the possible explanatory mechanisms. In the cited clinical trials, different doses of ginger powder (range 13 g) in different time periods (range 45 days–12 weeks) were used. According to our literature findings regarding the effect of ginger consumption on lipid profile, it seems that ginger can be considered as a valuable ingredient for modifying blood lipids, especially in diabetic patients. This probable property might be due to its effective antioxidants, including gingerols and shogaols. However, because of the lack of clinical trials in this field, it is necessary to conduct further human studies that examine the use of various amounts of ginger during a longer period of time. Also, other experimental human studies to characterize the possible mechanisms of the effect of ginger on blood lipids are recommended.
Source : Journal Herbal Medicine
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Mulberry leaf extract displays antidiabetic activity in db/db mice via Akt and AMP-activated protein kinase phosphorylation
Ui-Jin Bae 1, 2 †, Eun-Soo Jung 2† , Su-Jin Jung 2 , Soo-Wan Chae 2 , 3* and Byung-Hyun Park 1
Abstract
Background:
Augmenting glucose utilization in skeletal muscle via the phosphatidylinositol-3 kinase (PI3 kinase)/protein kinase B (Akt) pathway or the adenosine monophosphate (AMP)-activated protein kinase (AMPK) pathway is necessary to regulate hyperglycemia in patients with type 2 diabetes mellitus.
Objective:
We investigated the effect of mulberry leaf extract (MLE) on glucose uptake in skeletal muscle cells and explored its in vivo
antidiabetic potential.
Design:
Male db/db mice were treated with either MLE (50 mg/kg, 100 mg/kg, and 250 mg/kg) or metformin (100 mg/kg) for 8 weeks.
Results:
MLE treatment stimulated glucose uptake, driven by enhanced translocation of glucose transporter 4 to cell membranes in L6 myotubes. These effects of MLE were synergistic with those of insulin and were abolished in the presence of PI3K inhibitor or AMPK inhibitor. In db/db mice, supplementation with MLE decreased fasting blood glucose and insulin levels and enhanced insulin sensitivity, with increases of p-Akt and p-AMPK in skeletal muscle. Moreover, MLE improved blood lipid parameters and attenuated hepatic steatosis in diabetic db/db mice.
Discussion:
These findings suggest that MLE exerts antidiabetic activity through stimulating glucose disposal in skeletal muscle cells
via the PI3K/Akt and AMPK pathways.
Conclusions:
MLE can potentially improve hyperglycemia and hepatic steatosis in patients with type 2 diabetes.
Source : Food and Nutrition Research
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Effect of garlic supplement in the management of type 2 diabetes mellitus (T2DM): a meta-analysis of randomized controlled trials
Juan Wang, Xiuming Zhang, Haili Lan & Weijia Wang
Abstract
The present study was designed to systematically evaluate the clinical efficacy and safety of garlic supplement in the management of type 2 diabetes mellitus (T2DM). PubMed, EMBASE, the Cochrane Library, and China National Knowledge Internet (CNKI) were searched for relevant randomized controlled trials (RCTs) by using the terms garlic and T2DM up to April 2017. The quality of included RCTs was assessed by the Cochrane tool of risk of bias, and data of outcomes were pooled by REVMAN 5.3. Clinical factors were handled by meta-regression and subgroup analysis, and risk of publication bias was explored by inverted funnel plots. Nine RCTs involving 768 T2DM patients were included in the meta-analysis, and the dose of daily garlic (allicin) supplement ranged from 0.05g to 1.5g. A significant reduction in the level of fasting blood glucose in 1–2 weeks [SMD = −1.61, 95%CI (−2.89, −0.32)], 3–4 weeks [SMD = −2.87, 95%CI (−4.74, −1.00)], 12 weeks [SMD = −9.57, 95%CI (−12.39, −6.75)], and 24 weeks [SMD = −21.02, 95% CI (−32.47, −9.57)] was achieved in favour of the garlic group rather than the control group. Significantly decreased fructosamine and glycated hemoglobin (both in 12 and 24 weeks) were also found in garlic group. Meanwhile, significantly improved blood liquids of total cholesterol [SMD = −1.93, 95%CI (−2.98, −0.87), 3–4 weeks], high density lipoprotein [SMD = −0.41, 95%CI (−0.83, −0.00), 3–4 weeks] and low density lipoprotein [SMD = −3.47, 95%CI (−5.76, −1.18), 12 weeks] were confirmed after garlic administration. There was no significant difference in complications. Current data confirms that garlic supplement plays positive and sustained roles in blood glucose, total cholesterol, and high/low density lipoprotein regulation in the management of T2DM.
Source : Food and Nutrition Research
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Effect of dark sweet cherry powder consumption on the gut microbiota, short-chain fatty acids, and biomarkers of gut health in obese db/db mice
Jose F. Garcia-Mazcorro,1,2 Nara N. Lage,3,4 Susanne Mertens-Talcott,4 Stephen Talcott,4 Boon Chew,4Scot E. Dowd,5 Jorge R. Kawas,6 and Giuliana D. Noratto4
Abstract
Cherries are fruits containing fiber and bioactive compounds (e.g., polyphenolics) with the potential of helping patients with diabetes and weight disorders, a phenomenon likely related to changes in the complex host-microbiota milieu. The objective of this study was to investigate the effect of cherry supplementation on the gut bacterial composition, concentrations of caecal short-chain fatty acids (SCFAs) and biomarkers of gut health using an in vivo model of obesity. Obese diabetic (db/db) mice received a supplemented diet with 10% cherry powder (supplemented mice, n = 12) for 12 weeks; obese (n = 10) and lean (n = 10) mice served as controls and received a standard diet without cherry. High-throughput sequencing of the 16S rRNA gene and quantitative real-time PCR (qPCR) were used to analyze the gut microbiota; SCFAs and biomarkers of gut health were also measured using standard techniques. According to 16S sequencing, supplemented mice harbored a distinct colonic microbiota characterized by a higher abundance of mucin-degraders (i.e., Akkermansia) and fiber-degraders (the S24-7 family) as well as lower abundances of Lactobacillus and Enterobacteriaceae. Overall this particular cherry-associated colonic microbiota did not resemble the microbiota in obese or lean controls based on the analysis of weighted and unweighted UniFrac distance metrics. qPCR confirmed some of the results observed in sequencing, thus supporting the notion that cherry supplementation can change the colonic microbiota. Moreover, the SCFAs detected in supplemented mice (caproate, methyl butyrate, propionate, acetate and valerate) exceeded those concentrations detected in obese and lean controls except for butyrate. Despite the changes in microbial composition and SCFAs, most of the assessed biomarkers of inflammation, oxidative stress, and intestinal health in colon tissues and mucosal cells were similar in all obese mice with and without supplementation. This paper shows that dietary supplementation with cherry powder for 12 weeks affects the microbiota and the concentrations of SCFAs in the lower intestinal tract of obese db/db diabetic mice. These effects occurred in absence of differences in most biomarkers of inflammation and other parameters of gut health. Our study prompts more research into the potential clinical implications of cherry consumption as a dietary supplement in diabetic and obese human patients.
Source : PeerJ
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Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women’s Health
Moniek Looman1 *, Danielle A. J. M. Schoenaker2 , Sabita S. Soedamah-Muthu3,4, Anouk Geelen1 , Edith J. M. Feskens1 and Gita D. Mishra5
1 Division of Human Nutrition, Wageningen University & Research, PO Box 17, 6700 AA Wageningen, The Netherlands
2 Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia
3 Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
4 Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, UK
5 School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia
Abstract
Carbohydrate quantity and quality affect postprandial glucose response, glucose metabolism and risk of type 2 diabetes. The aim of this study was to examine the association of pre-pregnancy dietary carbohydrate quantity and quality with the risk of developing gestational diabetes mellitus (GDM). We used data from the Australian Longitudinal Study on Women’s Health that included 3607 women aged 25–30 years without diabetes who were followed up between 2003 and 2015. We examined carbohydrate quantity (total carbohydrate intake and a low-carbohydrate diet (LCD) score) and carbohydrate subtypes indicating quality (fibre, total sugar intake, glycaemic index, glycaemic load and intake of carbohydrate-rich food groups). Relative risks (RR) for development of GDM were estimated using multivariable regression models with generalised estimating equations. During 12 years of follow-up, 285 cases of GDM were documented in 6263 pregnancies (4·6 %). The LCD score, reflecting relatively high fat and protein intake and low carbohydrate intake, was positively associated with GDM risk (RR 1·54; 95 % CI 1·10, 2·15), highest quartile v. lowest quartile). Women in the quartile with highest fibre intake had a 33 % lower risk of GDM (RR 0·67; 95 % CI 0·45, 0·96)). Higher intakes of fruit (0·95 per 50 g/d; 95 % CI 0·90, 0·99) and fruit juice (0·89 per 100 g/d; 95 % CI 0·80, 1·00)) were inversely associated with GDM, whereas cereal intake was associated with a higher risk of GDM (RR 1·05 per 20 g/d; 95 % CI 1·01, 1·07)). Thus, a relatively low carbohydrate and high fat and protein intake may increase the risk of GDM, whereas higher fibre intake could decrease the risk of GDM. It is especially important to take the source of carbohydrates into account
Source : The British Journal of Nutrition via Sci-Hub
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Aloe Vera Shows Promise in Lowering Blood Glucose and Reducing Other Symptoms of Prediabetes
Zhang Y, Liu W, Liu D, Zhao T, Tian H. Efficacy of aloe vera supplementation on prediabetes and early non-treated diabetic patients: a systematic review and meta-analysis of randomized controlled trials. Nutrients. June 23, 2016;8(7). pii: E388. doi: 10.3390/nu8070388.
Diabetes is characterized partly by elevated blood glucose and is a serious disease that may lead to potentially devastating health complications. Standard medications for diabetes often cause adverse side effects; thus, botanicals may be an effective and less expensive option for lowering blood glucose. Aloe vera (Aloe vera, Xanthorrhoeaceae) is used to treat many health concerns, but the research on its potential use for diabetes is conflicted. This systematic review and meta-analysis focused on randomized clinical trials (RCTs) investigating potential hypoglycemic activity of aloe vera.
The authors searched PubMed, Embase, and Cochrane Central Register of Controlled Trials, from each database's origin to January 28, 2016. The search terms used were extensive, including "hyperglycemia," "impaired glucose tolerance," "diabetes mellitus," and "aloe vera," among others. Publications in any language were considered. The American Diabetes Association and World Health Organization criteria for prediabetes and type 2 diabetes mellitus were used. Studies included were RCTs, with or without lifestyle interventions, used aloe vera alone, included patients that were not using hypoglycemic medication and did not have heart disease or other serious health problems, and had glucose and/or lipid status as primary outcomes. The studies were evaluated on quality, with the terms "adequate, inadequate, and unclear," to describe randomization, allocation concealment, blinding, and intention-to-treat (ITT) analysis.
The search yielded 282 publications and was narrowed down to five RCTs, published from 1996 to 2016, with 415 patients. It was found that of the five studies, two reported randomization methodology, and no RCTs had adequate blinding. Three RCTs had adequate patient withdrawal and dropout data, and ITT analysis occurred in one study. Patients were overweight or obese as reported in four RCTs, and study length was six to 12 weeks.
There was significant heterogeneity for fasting blood glucose in patients across the five RCTs (P<0.00001). Aloe vera performed better than placebo in reducing fasting blood glucose concentrations (P=0.02). No effect was noted on insulin concentrations, but heterogeneity was reported in the two RCTs with this outcome (P<0.00001). Glycated hemoglobin (HbA1c, a long-term glucose metric) was measured in two RCTs and was significantly decreased by aloe vera usage (P<0.00001) with no significant heterogeneity.
Of the RCTs, four investigated aloe vera in comparison to placebo for triglyceride and total cholesterol (TC) concentrations. It was found that aloe vera was more effective than placebo in decreasing triglyceride (P=0.0001) and TC concentrations (P<0.00001); however, heterogeneity in both metrics was observed (P<0.00001 for both). Also, aloe vera was found to better increase high-density lipoprotein (HDL) cholesterol (P=0.04) and decrease low-density lipoprotein (LDL) cholesterol (P<0.00001) as compared with placebo. Both outcomes had significant heterogeneity (P=0.0008 and P<0.00001, respectively).
In summary, the authors conclude that aloe vera treatment impacted fasting blood glucose concentrations, HbA1c, and triglyceride, TC, and LDL and HDL cholesterol concentrations, despite heterogeneity across RCTs. Discussed possible mechanisms include potentiation of glucose transport, attenuation of cholesterol gut absorption, and modulation of gene expression. Stated limitations include the finite RCT sample size, discrepancy of patient background, publication bias, variation in form and dose of aloe vera (studies included used capsules, powder, or juice), and lack of available data for certain outcomes. Additionally, some methodology was not reported. Larger and more rigorous trials to establish the efficacy and safety of aloe vera in this population are recommended.
--Amy C. Keller, PhD
Source : American Botanical Council - Herb Cllip
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Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose
AbstractCinnamon (肉桂 ròu guì) has in vitro insulin potentiating activity, and proanthocyanidins from cinnamon prevent in vitro formation of advanced glycation end products. Some human studies were equivocal, but several have shown beneficial effects of cinnamon supplementation on circulating glucose, lipids, and/or insulin. This placebo-controlled double-blind trial tested the effects of a dried water extract of cinnamon (Cinnamomum cassia) on circulating glucose, lipids, insulin, and insulin resistance. Men and women from Beijing and Dalian, China, were invited to participate if they had fasting serum glucose >6.1 mmol/L or 2-h glucose >7.8 mmol/L. Participants, (173 were enrolled and 137 completed the study) were randomly assigned to receive either a spray-dried, water extract of cinnamon (CinSulin®), 250 mg/capsule, or a placebo, twice a day for two months. Mean ± SEM age of participants was 61.3 ± 0.8 years, BMI was 25.3 ± 0.3 and M/F ratio was 65/72. After 2 mo, fasting glucose decreased (p < 0.001) in the cinnamon extract-supplemented group (8.85 ± 0.36 to 8.19 ± 0.29 mmol/L) compared with the placebo group (8.57 ± 0.32 to 8.44 ± 0.34 mmol/L, p = 0.45). Glucose 2 h after a 75 g carbohydrate load, fasting insulin, and HOMA-IR also decreased with cinnamon extract compared with placebo. Total and LDL-cholesterol decreased with cinnamon extract and HDL-cholesterol decreased in both the cinnamon-extract and placebo groups. In conclusion, supplementation with 500 mg of water-extract of cinnamon for two months reduced fasting insulin, glucose, total cholesterol, and LDL cholesterol and enhanced insulin sensitivity of subjects with elevated blood glucose.
Source : Journal of Traditional and Complementary Medicine
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Chemical analysis of Punica granatum fruit peel and its in vitro and in vivo biological properties
Abstract
BackgroundThe medical application of pomegranate fruits and its peel is attracted human beings. The aim of the present study was to evaluate the in vitro α-Glucosidase inhibition, antimicrobial, antioxidant property and in vivo anti-hyperglycemic activity of Punica granatum (pomegranate) fruit peel extract using Caenorhabditis elegans.
Methods Various invitro antioxidant activity of fruit peel extracts was determined by standard protocol. Antibacterial and antifungal activities were determined using disc diffusion and microdilution method respectively. Anti-hyperglycemic activity of fruit peel was observed using fluorescence microscope for in vivo study.
Results The ethyl acetate extract of P. granatum fruit peel (PGPEa) showed α-Glucosidase inhibition upto 50 % at the concentration of IC50 285.21 ± 1.9 μg/ml compared to hexane and methanol extracts. The total phenolic content was highest (218.152 ± 1.73 mg of catechol equivalents/g) in ethyl acetate extract. PGPEa showed more scavenging activity on 2,2-diphenyl-picrylhydrazyl (DPPH) with IC50 value 302.43 ± 1.9 μg/ml and total antioxidant activity with IC50 294.35 ± 1.68 μg/ml. PGPEa also showed a significant effecton lipid peroxidation IC50 208.62 ± 1.68 μg/ml, as well as high reducing power. Among the solvents extracts tested, ethyl acetate extract of fruit peel showed broad spectrum of antimicrobial activity. Ethyl acetate extract supplementedC.elegans worms showed inhibition of lipid accumulation similar to acarbose indicating good hypoglycemic activity. The normal worms compared to test (ethyl acetate extract supplemented) showed the highest hypoglycaemic activity by increasing the lifespan of the worms. GC-MS analysis of PGPEa showed maximum amount of 5-hydroxymethylfurfural and 4-fluorobenzyl alcohol (48.59 %).
Conclusion In the present investigation we observed various biological properties of pomegranate fruit peel. The results clearly indicated that pomegranate peel extract could be used in preventing the incidence of long term complication of diabetics.
Source : BMC Complementary and Alternative Medicine
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Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis
Dick William R., Fletcher Emily A., and Shah Sachin A..
Abstract
Purpose: Diabetes mellitus is a global epidemic and one of the leading causes of morbidity and mortality. Additional medications that are novel, affordable, and efficacious are needed to treat this rampant disease. This meta-analysis was performed to ascertain the effectiveness of oral aloe vera consumption on the reduction of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c).
Methods: PubMed, CINAHL, Natural Medicines Comprehensive Database, and Natural Standard databases were searched. Studies of aloe vera's effect on FBG, HbA1c, homeostasis model assessment-estimated insulin resistance (HOMA-IR), fasting serum insulin, fructosamine, and oral glucose tolerance test (OGTT) in prediabetic and diabetic populations were examined. After data extraction, the parameters of FBG and HbA1c had appropriate data for meta-analyses. Extracted data were verified and then analyzed by StatsDirect Statistical Software. Reductions of FBG and HbA1c were reported as the weighted mean differences from baseline, calculated by a random-effects model with 95% confidence intervals. Subgroup analyses to determine clinical and statistical heterogeneity were also performed. Publication bias was assessed by using the Egger bias statistic.
Results: Nine studies were included in the FBG parameter (n = 283); 5 of these studies included HbA1c data (n = 89). Aloe vera decreased FBG by 46.6 mg/dL (p < 0.0001) and HbA1c by 1.05% (p = 0.004). Significant reductions of both endpoints were maintained in all subgroup analyses. Additionally, the data suggest that patients with an FBG ≥200 mg/dL may see a greater benefit. A mean FBG reduction of 109.9 mg/dL was observed in this population (p ≤ 0.0001). The Egger statistic showed publication bias with FBG but not with HbA1c (p = 0.010 and p = 0.602, respectively).
Conclusion: These results support the use of oral aloe vera for significantly reducing FBG (46.6 mg/dL) and HbA1c (1.05%). Further clinical studies that are more robust and better controlled are warranted to further explore these findings.
Source : Journal Alternative and Complementary Medicine
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Chinese medicines in the treatment of experimental diabetic nephropathy
Diabetic nephropathy (DN) is a severe micro vascular complication accompanying diabetes mellitus that affects millions of people worldwide. End-stage renal disease occurs in nearly half of all DN patients, resulting in large medical costs and lost productivity. The course of DN progression is complicated, and effective and safe therapeutic strategies are desired. While the complex nature of DN renders medicines with a single therapeutic target less efficacious, Chinese medicine, with its holistic view targeting the whole system of the patient, has exhibited efficacy for DN management. This review aims to describe the experimental evidence for Chinese medicines in DN management, with an emphasis on the underlying mechanisms, and to discuss the combined use of herbs and drugs in DN treatment.
Conclusion
CMs provides an alternative for DN management in all stages of experimental DN models, especially in the early and incipient stages of DN, and the synergistic administration of CM herbs with conventional drugs exhibited better efficacy than drugs alone in DN treatment.
Source : Journal Chinese Medicine
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Ethanolic Ginkgo biloba leaf extract prevents renal fibrosis through Akt/mTOR signaling in diabetic nephropathy
Abstract
Background
Recently, extract of Ginkgo biloba leaves (GbE) have become widely known phytomedicines and have shown various pharmacological activities, including improvement of blood circulation, protection of oxidative cell damage, prevention of Alzheimer's disease, treatment of cardiovascular disease and diabetes complications. This study was designed to investigate the effects of an ethanolic GbE on renal fibrosis in diabetic nephropathy (DN) and to clarify the possible mechanism by which GbE prevents renal fibrosis.
Study design
We investigated the protective effects of GbE on renal fibrosis in STZ-induced diabetic rats. Rats were randomized into six groups termed normal control, diabetes mellitus, low dose of GbE (50 mg/kg/d), intermediate dose of GbE (100 mg/kg/d), high dose of GbE (200 mg/kg/d) and rapamycin (1 mg/kg/d).
Methods
After 12 weeks, the rats were sacrificed and then fasting blood glucose (FBG), creatinine (Cr), blood urea nitrogen (BUN), urine protein, relative kidney weight, glycogen and collagen accumulation, and collagen IV and laminin expression were measured by different methods. The amounts of E-cadherin, α-SMA and snail, as well as the phosphorylation of Akt, mTOR and p70S6K in the renal cortex of rats, were examined by western blotting.
Results
Compared with diabetic rats, the levels of Cr, BUN, urine protein, relative kidney weight, accumulation of glycogen and collagen, and expression of collagen IV and laminin in the renal cortex were all decreased in GbE treated rats. In addition, GbE reduced the expression of E-cadherin, α-SMA, snail and the phosphorylation of Akt, mTOR and p70S6K in diabetic renal cortex.
Conclusion
GbE can prevent renal fibrosis in rats with diabetic nephropathy, which is most likely to be associated with its abilities to inhibit the Akt/mTOR signaling pathway.
Source : Journal Phytomedicine
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Everyday mindfulness linked to healthy glucose levels
Brown University researchers investigating how mindfulness may affect cardiovascular health have measured a significant association between a high degree of ‘everyday’ mindfulness and a higher likelihood of having normal, healthy glucose levels. Their analysis showed that a lower risk of obesity and greater sense of control among more mindful people may play mediating roles.
PROVIDENCE, R.I. [Brown University] —Dispositional, or “everyday” mindfulness is the inherent trait of being aware of one’s present thoughts and feelings. In a new study of 399 people that measured health indicators including dispositional mindfulness and blood glucose, researchers found that those with higher scores for mindfulness were significantly more likely than people with low scores to have healthy glucose levels.
The results show an association and do not prove a cause, but they are part of a program led by Brown University where researchers are studying whether interventions that increase mindfulness can improve cardiovascular health. Their overarching hypotheses are that people practicing higher degrees of mindfulness may be better able to motivate themselves to exercise, to resist cravings for high-fat, high-sugar treats, and to stick with diet and exercise regimens recommended by their doctors.
The researchers therefore sought to identify factors that might explain the connection they saw between higher mindfulness and healthier glucose levels. Their analysis of the data showed that obesity risk (mindful people are less likely to be obese) and sense of control (mindful people are more likely to believe they can change many of the important things in their life) both contribute to the link.
“This study demonstrated a significant association of dispositional mindfulness with glucose regulation, and provided novel evidence that obesity and sense of control may serve as potential mediators of this association,” wrote the authors led by Eric Loucks, assistant professor of epidemiology in the Brown University School of Public Health. “As mindfulness is likely a modifiable trait, this study provides preliminary evidence for a fairly novel and modifiable potential determinant of diabetes risk.”
The study, published in the American Journal of Health Behavior, did not show a direct, statistically significant link between mindfulness and type 2 diabetes risk, which is the medical concern related to elevated blood glucose. Participants with high levels of mindfulness were about 20 percent less likely to have type 2 diabetes, but the total number of people in the study with the condition may have been too small to allow for definitive findings, Loucks said.
Measuring mindfulness, gauging glucose
To gather their data, Loucks and his team enrolled 399 volunteers who’ve been participating in the New England Family Study. The subjects participated in several psychological and physiological tests including glucose tests and the Mindful Attention Awareness Scale (MAAS), a 15-item questionnaire to assess dispositional mindfulness on a 1 to 7 scale. The researchers also collected data on a host of other potentially relevant demographic and health traits including body-mass index, smoking, education, depression, blood pressure, perceived stress, and sense of control.
After adjusting their data to account for such confounding factors as age, sex, race or ethnicity, family history of diabetes, and childhood socioeconomic status, the researchers found that people with high MAAS scores of 6 or 7 were 35 percent more likely to have healthy glucose levels under 100 milligrams per deciliter than people with low MAAS scores below 4.
The analysis found that obesity made about a 3-percentage point difference of the total 35-percent point risk difference. Sense of control accounted for another 8 percentage points of the effect. The rest may derive from factors the study didn’t measure, but at least now researchers have begun to elucidate the possible mechanisms that link mindfulness to glucose regulation.
“There’s been almost no epidemiological observational study investigations on the relationship of mindfulness with diabetes or any cardiovascular risk factor,” Loucks said. “This is one of the first. We’re getting a signal. I’d love to see it replicated in larger sample sizes and prospective studies as well.”
Source : Brown University
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Protective effects of Egyptian cloudy apple juice and apple peel extract on lipid peroxidation, antioxidant enzymes and inflammatory status in diabetic rat pancreas
Abstract
Background
Apples possess rich content of varied polyphenolic compounds showing a variety of biological activities that may ascribe to worthy effects against some chronic diseases. The present study was designed to assess the protective effects of the cloudy apple juice (CAJ) and apple peel extract (APE) of Egyptian Anna apple on the complications in experimental diabetes.
Materials and methods
Four groups were studied. Diabetes was induced by a single dose of streptozotocin (STZ) to only three groups of albino Wistar rats. Two of the diabetic groups received either CAJ or APE for 21 days. At the end of the study, lipid profile parameters were measured in serum while lipid peroxidation (LPO) level, antioxidant enzyme activities and inflammatory markers were evaluated in pancreas tissue samples. The gas chromatography–mass spectrometry (GC-MS) analysis of phenolic compounds found in CAJ and APE was carried out. Moreover, total phenolic content of CAJ and APE were measured.
Results
The significant increase of blood glucose level, serum total cholesterol (TC), triglycerides (TG), low- density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein (VLDL) levels, in addition to tissue malondialdehyde (MDA), nuclear factor kappa B (NF-kB), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8) levels, but a significant decrease in high-density lipoprotein cholesterol (HDL-C), and the activity of pancreatic antioxidant enzymes were the remarkably parameters observed in diabetic control rats. Dissimilarly, oral supplementation of 15 ml/kg CAJ and 1 g/kg APE for 21 days resulted in a significant decrease in fasting blood glucose, serum TC, TG, LDL-C, VLDL-C and tissue MDA, NF-kB, TNF-α, IL-6, IL-8 levels coupled with a significant elevation of HDL-C and antioxidant enzymes’ activity when compared with diabetic control animals.
Conclusions
The results indicate that Egyptian CAJ and APE supplementation may have protective effects against deleterious complications of diabetes mellitus.
Source : BMC Complementary and Alternative Medicine
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Triphala improves glucose homeostasis by alleviating atherogenic lipids and oxidative stress in human Type 2 diabetes mellitus
Nita Singh1 , Sunil Mahajan1, Senthil K Subramani1,Dhananjay Yadav2, Lokendra Singh3, Prasad GBKS1
Abstract
Aims: ‘Triphala’ constituting equal parts of three medicinal dried plant fruits Emblica Officinalis Gaertn., Terminalia chebula Retz. and Terminalia bellerica Gaertn. is an antioxidant rich Ayurvedic formulation. The present study assessed therapeutic as well as protective effects of Triphala on human subjects with Type 2 diabetes mellitus (T2DM) and Impaired glucose tolerance (IGT).
Materials and methods: Triphala at a dose of 5 gms BD was administered to two cohorts viz., IGT, N= 20 and T2DM, N=30 consecutively for a period of 12 months. The therapeutic efficacy was assessed quarterly by monitoring blood glucose and lipid levels; the protective effect by monitoring antioxidants level quarterly and DNA damage annually. Toxicity if any, to liver and kidney due to long term administration was assessed quarterly in both cohorts.
Results: Continuous ‘Triphala’ therapy for 12 months significantly reduced blood glucose (p≤0.001) and lipid levels (p≤0.05) in both the cohorts. Triphala resisted oxidative stress generated during the course of hyperglycemia by significantly increasing the activity of super oxide dismutase and Catalase (p≤0.001) and the level of reduced glutathione (p≤0.001). Protective effect on DNA was accessed through significant reduction in the comet tail length (p≤0.001).
Conclusions: ‘Triphala’ ameliorated not only the oxidative stress but also normalized glucose and lipid homeostasis in subjects with impaired glucose and T2DM.
Source : International Journal Ayurvedic Medicine
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In-vitro antioxidant and antidiabetic potentials of Dianthus basuticus Burtt Davy whole plant extracts
Abstract
Dianthus basuticus is a popular South African medicinal plant used in the management of diabetes mellitus. This study evaluated the antioxidant and antidiabetic potential of D. basuticus using an in-vitro model. The antioxidant activity was determined using iron chelation, 1,1-diphenyl-2-picrylhydrazyl (DPPH), hydroxyl and superoxide anion radical scavenging abilities of the aqueous, ethanol and hydro-ethanol extracts of D. basuticuswhile the antidiabetic potential was assessed by evaluating the inhibitory effects of the extracts on the activities of α-amylase, α-glucosidase, maltase and sucrase. The aqueous extract displayed significantly higher (p < 0.05) DPPH (2.56 μg/mL) and superoxide radical (7.22 μg/mL) scavenging abilities while ethanol (10.56 μg/mL) and hydro-ethanol (6.95 μg/mL) extracts exhibited strongest hydroxyl radical scavenging and iron chelation activities respectively. The ethanol extract displayed significantly higher (p < 0.05) inhibition of α-amylase (34.02 μg/mL) while aqueous extract exhibited strongest inhibition of α-glucosidase (6.59 μg/mL), maltase (31.21 μg/mL) and sucrase (20.98 μg/mL). Hydro-ethanol and aqueous extract inhibited α-amylase and α-glucosidase in a mixed non-competitive and pure non-competitive manner respectively while the aqueous extract competitively inhibited both maltase and sucrase activities. It can be concluded that D. basuticus extracts possessed antioxidant and antidiabetic activities, and one of its mechanism of antidiabetic action is through the inhibition of diabetes-related enzymes.
Source : Journal of Herbal Medicine
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Topical Hypericum perforatum Improves Tissue Regeneration in Full-Thickness Excisional Wounds in Diabetic Rat Model
Soheila Yadollah-Damavandi,1 Mehdi Chavoshi-Nejad,2 Ehsan Jangholi,1 Noushin Nekouyian,3 Sahar Hosseini,3 Amin Seifaee,3 Shima Rafiee,3 Hossein Karimi,3 Soheil Ashkani-Esfahani,3 Yekta Parsa,1 and Maryam Mohsenikia4
1Young Researchers and Elite Club, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
2Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4Dezful University of Medical Sciences, Dezful, Iran
Abstract
Delayed wound healing process is one of the most important concerns in diabetes. Healing of wounds has four phases, namely, hemostasis, inflammation, proliferation, and remodeling. For a successful repair, all four factors must occur properly. Hence, we aimed to evaluate the healing effects of Hypericum perforatum (HP) on full-thickness diabetic skin wounds by using stereological methods. Forty-eight female diabetic rats were randomly divided into four groups (n = 12): gel base treated group, HP 5% gel treated group, HP 10% gel treated group, and the control group which received no treatment. A circular 1 cm2 full-thickness wound was created on the animal’s neck and wound area was measured every three days. After sacrificing the animals, skin samples were fixed and prepared for stereological evaluations. Based on the results, HP treated group showed faster wound closure rate in comparison with control and vehicle groups (P<0.05). In addition, numerical density of fibroblasts, volume density of collagen bundles, and mean diameter and volume densities of the vessels in HP group were significantly higher than control and vehicle groups. The results of this study showed that HP has the ability to improve tissue regeneration by enhancing fibroblast proliferation, collagen bundle synthesis, and revascularization.
Source : Evidence Based Complementaryand Alternative Medicine
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Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction
Abstract
Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom.
Design Systematic review and meta-analysis.
Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million).
Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages.
Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%).
Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
Source : BMJ
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The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance
P Mitrou1, E Petsiou2, E Papakonstantinou2, E Maratou1, V Lambadiari2, P Dimitriadis3, F Spanoudi2, S A Raptis1,2 and G Dimitriadis2
Abstract
Background/Objectives: Previous studies support the glucose-lowering effect of vinegar. However, the effect of vinegar on muscle glucose metabolism and endothelial function has not been studied in humans. This open, randomized, crossover, placebo-controlled study aims to investigate the effects of vinegar on muscle glucose metabolism, endothelial function and circulating lipid levels in subjects with impaired glucose tolerance (IGT) using the arteriovenous difference technique.
Subjects/Methods: Eight subjects with IGT (4 males, age 46±10 years, body mass index 30±5) were randomised to consume 0.50 mmol vinegar (6% acetic acid) or placebo before a mixed meal. Plasma samples were taken for 300 min from the radial artery and the forearm vein for measurements of glucose, insulin, triglycerides, non-esterified fatty acids (NEFAs) and glycerol. Muscle blood flow was measured with strain gauge plethysmography. Glucose flux was calculated as the arteriovenous difference of glucose multiplied by the blood flow rates.
Results: Vinegar compared with placebo: (1) decreased arterial plasma insulin (Poverall<0.001; P75 min=0.014, β=−42), (2) increased forearm blood flow (Poverall<0.001; P240 min=0.011, β=1.53; P300 min=0.023, β=1.37), (3) increased muscle glucose uptake (Poverall<0.001; P60 min=0.029, β=2.78) and (4) decreased arterial plasma triglycerides (Poverall=0.005;P240 min<0.001, β=−344; P300 min<0.001, β=−373), without changing NEFA and glycerol.
Conclusions: In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.
Source : European Journal of Clinical Nutrition
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Vitamin D and type 2 diabetes: a systematic review
J Mitri1, M D Muraru2 and A G Pittas1
Abstract
Background/Objectives: Vitamin D may modify the risk of type 2 diabetes mellitus. The aim of this review was to examine the association between vitamin D status and incident type 2 diabetes, and the effect of vitamin D supplementation on glycemic outcomes.
Methods: We performed a systematic review of English-language studies using MEDLINE through February 2011. Longitudinal cohort studies reporting associations between vitamin D status and incident type 2 diabetes, and randomized controlled trials (RCTs) of vitamin D supplementation, were included. Study characteristics and results were extracted, and study quality was assessed.
Results: A total of 8 observational cohort studies and 11 RCTs were included. In meta-analyses of observational studies, vitamin D intake >500 international units (IU)/day decreased the risk of type 2 diabetes by 13%compared with vitamin D intake <200 IU/day. Individuals with the highest vitamin D status (>25 ng/ml) had a 43% lower risk of developing type 2 diabetes (95% confidence interval 24, 57%) compared with those in the lowest group (<14 ng/ml). In post hoc analyses from eight trials among participants with normal glucose tolerance at baseline and in three small underpowered (n=32–62) trials of patients with established type 2 diabetes, there was no effect of vitamin D supplementation on glycemic outcomes. In two trials among patients with baseline glucose intolerance, vitamin D supplementation improved insulin resistance.
Conclusions: Vitamin D may play a role in type 2 diabetes; however, to better define the role of vitamin D in the development and progression of type 2 diabetes, high-quality observational studies and RCTs that measure blood 25-hydroxyvitamin D concentration and clinically relevant glycemic outcomes are needed.
Source : European Journal of Clinical Nutrition
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Dietary modulation of the gut microbiota – a randomised controlled trial in obese postmenopausal women
Lena K. Brahea1 †, Emmanuelle Le Chateliera2 †, Edi Priftia2, Nicolas Ponsa2, Sean Kennedya2, Trine Blædela1, Janet Håkanssona3, Trine Kastrup Dalsgaarda4, Torben Hansena5, Oluf Pedersena5, Arne Astrupa1, S. Dusko Ehrlicha2 and Lesli H. Larsena1 c1
a1 Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
a2 INRA, Institut National de la Recherche Agronomique, US 1367 Metagenopolis, Jouy-en-Josas, France
a3 Arla Strategic Innovation Centre, Stockholm, Sweden
a4 Department of Food Science, Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
a5 Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
Abstract
The gut microbiota has been implicated in obesity and its progression towards metabolic disease. Dietary interventions that target the gut microbiota have been suggested to improve metabolic health. The aim of the present study was to investigate the effect of interventions with Lactobacillus paracasei F19 or flaxseed mucilage on the gut microbiota and metabolic risk markers in obesity. A total of fifty-eight obese postmenopausal women were randomised to a single-blinded, parallel-group intervention of 6-week duration, with a daily intake of either L. paracasei F19 (9·4 × 1010 colony-forming units), flaxseed mucilage (10 g) or placebo. Quantitative metagenomic analysis of faecal DNA was performed to identify the changes in the gut microbiota. Diet-induced changes in metabolic markers were explored using adjusted linear regression models. The intake of flaxseed mucilage over 6 weeks led to a reduction in serum C-peptide and insulin release during an oral glucose tolerance test (P< 0·05) and improved insulin sensitivity measured by Matsuda index (P< 0·05). Comparison of gut microbiota composition at baseline and after 6 weeks of intervention with flaxseed mucilage showed alterations in abundance of thirty-three metagenomic species (P< 0·01), including decreased relative abundance of eight Faecalibacterium species. These changes in the microbiota could not explain the effect of flaxseed mucilage on insulin sensitivity. The intake of L. paracasei F19 did not modulate metabolic markers compared with placebo. In conclusion, flaxseed mucilage improves insulin sensitivity and alters the gut microbiota; however, the improvement in insulin sensitivity was not mediated by the observed changes in relative abundance of bacterial species.
Source : British Journal of Nutrition
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Cinnamon Extract Reduces Postprandial Blood Sugar Levels in Humans and Rats
by Amy C. Keller
Reviewed: Beejmohun V, Peytavy-Izard M, Mignon C, et al. Acute effect of Ceylon cinnamon extract on postprandial glycemia: alpha-amylase inhibition, starch tolerance test in rats, and randomized crossover clinical trial in healthy volunteers.BMC Complement Altern Med. 2014;14(1):351. doi: 10.1186/1472-6882-14-351.
Hyperglycemia, or high blood sugar, is central to the etiology of type 2 diabetes. Controlling postprandial (after-meal) hyperglycemia is important to maintaining overall health and reducing the risk of both type 2 diabetes and cardiovascular diseases. “Ceylon” or “true” cinnamon (Cinnamomum verum syn. C. zeylanicum, Lauraceae) has been used traditionally for gastrointestinal problems and continues to be used for respiratory infections. Although clinical trials have addressed the potential hypoglycemic activity of various types and preparations of cinnamon, studies conflict as to its efficacy. This in vitro, in vivo, and randomized, placebo-controlled, crossover human clinical trial investigated the starch tolerance of rats and healthy humans supplemented with Ceylon cinnamon bark extract.
Ceylon cinnamon bark extract (CCE; MealShape™; Dialpha; Montferrier sur Lez, France) is a 10:1 concentrate extracted with water and ethanol (50:50), which is then filtered and dried. [Note: Four of the seven study authors are Dialpha employees.] The resultant powder is standardized to contain at least 40% polyphenols, primarily oligomeric procyanidins composed of catechin and epicatechin. As a comparison for using the alcoholic solvent, an aqueous extract also was made. An enzymatic plate assay was used to gauge the inhibition of α-amylase (an enzyme that breaks down starches into sugars) activity, with acarbose (an anti-diabetic drug sold as Precose® in North America; Bayer; Whippany, New Jersey) as a positive control.
Animal studies
The authors used male Wistar rats for the in vivo experiments. Various groups comprising eight to 20 animals were tested to determine effects of CCE on glucose and insulin at 50 mg/kg body weight; dose-effects of CCE on glucose response at 6.25, 12.5, 25, 50, or 100 mg/kg body weight; and comparative responses between CCE and aqueous extracts at 50 mg/kg body weight. Fasted rats underwent a starch tolerance test (STT) and were fed wheat (Triticum aestivum, Poaceae) starch alone at 1.5 g/kg body weight as a control, or wheat starch with cinnamon extract at 20 mL/kg body weight. Blood glucose levels were measured at baseline, 15, 30, 60, 90, and 120 minutes.
During the STT, rats administered CCE and starch at 50 mg/kg body weight experienced a significant 20.4% decrease in glucose area under the curve (AUC; a calculation used to estimate a compound’s bioavailability and clearance from the body) from 0-120 minutes, as compared to the control group (P<0.05). At the same dose, insulin AUC was significantly less after 60 minutes compared to control (P<0.05), with an insulin peak reduction of 40.6%. Glucose AUC from 0-120 minutes also was significantly less in rats given CCE at 12.5, 25, 50, and 100 mg/kg body weight (P<0.05 for all). Compared to the aqueous cinnamon extract, CCE consumption in rats resulted in a significantly greater reduction in glucose AUC from 0-15 (P<0.05), 0-30 (P<0.01), and 0-60 minutes (P<0.05).
In vitro analysis
In the pancreatic α-amylase activity assay, CCE had an inhibitory concentration of 50% (IC50; a measure of how much a substance inhibits a biological process) of 25 µg/mL, while the acarbose control had an IC50 of 18 µg/mL. When comparing the aqueous and alcoholic cinnamon extracts, the CCE had an IC50 of 30 µg/mL while the water extract had an IC50 of 40µg/mL.
Human study
The clinical trial took place at the Clinic Nutrition Center at Hôpital Saint Vincent de Paul in Lille, France, and was administered by Naturalpha, a contract research company based in Lille, France. The study’s primary endpoint was glucose AUC from 0-120 minutes following consumption of a standard white bread meal. Secondary endpoints included glucose AUC from 0-60 minutes, insulin AUC from 0-60 and 0-120 minutes, maximum concentrations of glucose and insulin, and concentrations of both at each time point. Adverse side effects (ASEs) were recorded and classified as mild, moderate, or severe.
Included subjects (aged 18 to 45 years) had a body mass index between 18.5 and 25 kg/m2 and less than a 5% variation in body weight for the three months prior to the study. Those with fasting glucose concentrations greater than 110 mg/dL, a history of diabetes, a smoking habit, or who took any supplements or pharmaceuticals that could impact glucose or insulin were excluded. Subjects who had two-hour postprandial capillary blood glucose concentrations greater than 140 mg/dl were excluded as well.
Subjects were instructed to maintain their current lifestyle and were randomly assigned to receive either CCE followed by placebo or placebo followed by CCE. Treatment consisted of two capsules of CCE (500 mg each) or placebo (500 mg; containing 20% microcrystalline cellulose and 80% dicalcium phosphate). After an overnight fast, participants had blood drawn 35 minutes prior to the test and were given CCE or placebo five minutes later with 125 mL water. At baseline, a standardized meal was consumed with 250 mL water within eight minutes (103 g of white bread containing 52.2% carbohydrates [3.6% of which were sugars], 7.4% protein, 0.1% lipids, and 3.3% fiber). Fasting glucose concentrations were calculated as an average of measurements taken five and 10 minutes before the meal; fasting insulin was determined five minutes before the meal; and glucose and insulin were measured at 15, 30, 45, 60, 90, and 120 minutes following the meal.
Of the 22 subjects initially screened, 18 were randomly assigned to CCE (n=9) or placebo (n=9). Two subjects were not included in the per-protocol analysis due to protocol deviations, leaving 16 subjects in the final analysis. Upon supplementation with CCE, there was a significantly lower glucose AUC from 0-60 minutes compared to placebo (P<0.05). No other significant effects were noted, and no ASEs were observed.
Conclusions
In summary, CCE consumption in rats decreased both glucose and insulin concentrations during a starch tolerance test, and doses of 12.5 mg/kg body weight and above resulted in decreased glucose concentrations. Comparable IC50 levels for CCE and acarbose in the α-amylase activity assay suggest that enzyme inhibition is a likely mechanism of action for the alcoholic cinnamon extract. Although CCE significantly lowered glucose concentrations in healthy subjects, no effects were seen on insulin concentrations, which points to mechanisms independent of increased insulin in humans.
The authors mention that Ceylon cinnamon contains much less coumarin (a potentially toxic compound) than cassia (Cinnamomum aromaticum syn. C. cassia), although alcohol extraction can increase an extract’s coumarin content due to its solubility. The CCE used in the study exposed participants to less than 0.2 mg coumarin per day (per one gram dose), well below the European Food Safety Authority’s tolerable daily intake guideline of seven mg/day for a 70-kg (154-lb) person. This study reports more robust bioactivity with the alcoholic extract than the aqueous extract, which deserves further investigation. Future clinical trials of hyperglycemic individuals should continue to examine the use of Ceylon cinnamon extract in managing this condition.
Source : HerbalGram
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Curcumin Pharmacokinetic and Pharmacodynamic Evidences in Streptozotocin-Diabetic Rats Support the Antidiabetic Activity to Be via Metabolite(s)
Vânia Ortega Gutierres,1 Michel Leandro Campos,2 Carlos Alberto Arcaro,1 Renata Pires Assis,1 Helen Mariana Baldan-Cimatti,2 Rosângela Gonçalves Peccinini,2 Silvia Paula-Gomes,3 Isis Carmo Kettelhut,3 Amanda Martins Baviera,1 and Iguatemy Lourenço Brunetti1
1Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú Km 01, 14801-902 Araraquara, SP, Brazil
2Department of Natural Active Principles and Toxicology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú Km 01, 14801-902 Araraquara, SP, Brazil
3Department of Biochemistry and Immunology, School of Medicine, University of São Paulo (USP), Avenida Bandeirantes 3900, 14040-900 Ribeirão Preto, SP, Brazil
Abstract
This study measures the curcumin concentration in rat plasma by liquid chromatography and investigates the changes in the glucose tolerance and insulin sensitivity of streptozotocin-diabetic rats treated with curcumin-enriched yoghurt. The analytical method for curcumin detection was linear from 10 to 500 ng/mL. The Cmax and the time to reach Cmax (Tmax) of curcumin in plasma were 3.14 ± 0.9 μg/mL and 5 minutes (10 mg/kg, i.v.) and 0.06 ± 0.01 μg/mL and 14 minutes (500 mg/kg, p.o.). The elimination half-time was 8.64 ± 2.31 (i.v.) and 32.70 ± 12.92 (p.o.) minutes. The oral bioavailability was about 0.47%. Changes in the glucose tolerance and insulin sensitivity were investigated in four groups: normal and diabetic rats treated with yoghurt (NYOG and DYOG, resp.) and treated with 90 mg/kg/day curcumin incorporated in yoghurt (NC90 and DC90, resp.). After 15 days of treatment, the glucose tolerance and the insulin sensitivity were significantly improved in DC90 rats in comparison with DYOG, which can be associated with an increase in the AKT phosphorylation levels and GLUT4 translocation in skeletal muscles. These findings can explain, at least in part, the benefits of curcumin-enriched yoghurt to diabetes and substantiate evidences for the curcumin metabolite(s) as being responsible for the antidiabetic activity.
Source : eCAM
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Dietary functional benefits of Bartlett and Starkrimson pears for potential management of hyperglycemia, hypertension and ulcer bacteria Helicobacter pylori while supporting beneficial probiotic bacterial response
Dipayan Sarkar, Chandrakant Ankolekar, Marcia Pinto, Kalidas Shetty
Highlights
Pear has potential for phenolic-linked management of type 2 diabetes associated hyperglycemia and hypertension.
Fermented pear juices also possess inhibitory activity of stomach ulcer relevant bacteriumHelicobacter pylori.
Pear cultivars have relevance to be included in dietary strategies for better management of early stage hyperglycemia.
This in vitro study provides conceptual foundation for animal and clinical studies involving pear to combat type 2 diabetes.
Abstract
Phenolic-linked health benefits of Bartlett and Starkrimson pear cultivars were investigated for the potential relevance in managing type 2 diabetes and hypertension using in vitro enzyme models. Further effects of fermented (0, 24, 48, and 72-h with Lactobacillus helveticus) pear juice on inhibition of Helicobacter pyloriand proliferation of probiotic Bifidobacterium longum were also evaluated. High total phenolic content along with high 2,2 diphenyl-1-picrylhydrazyl-linked free radical scavenging antioxidant activities were observed in peel extracts of both cultivars. In vitro enzyme assays with peel and pulp extracts also indicated high inhibitory activity of α-glucosidase and α-amylase used as models for anti-hyperglycemia benefits. Only the aqueous pulp extract of Bartlett pear had angiotensin I-converting enzyme inhibitory activity used as model for anti-hypertension benefits. Fermented acidic pH samples of both cultivars showed H. pylori inhibition at 48 and 72 h, while fermented sample of Starkrimson even showed inhibition at 24 h. Both cultivar extracts did not inhibit growth of probiotic B. longum
Source : Food Research International
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American Ginseng Reported to Be Safe When Used as Adjunctive Therapy in Patients with Type 2 Diabetes Mellitus
by Shari Henson
Reviewed: Mucalo I, Jovanovski E, Vuksan V, Božikov V, Romić Ž, Rahelić D. American ginseng extract (Panax quinquefolius L.) is safe in long-term use in type 2 diabetic patients [published online May 7, 2014]. Evid Based Complement Alternat Med. doi: 10.1155/2014/969168.
For patients with type 2 diabetes mellitus (T2DM), managing the condition is complicated by a growing number of hypoglycemic pharmaceutical agents used in various combinations and by concerns about the agents’ potential interactions and associated adverse effects. Common among patients with T2DM is an interest in so-called complementary and alternative medicine, particularly the use of American ginseng (AG; Panax quinquefolius, Araliaceae), which reportedly is well tolerated by most users. Because of a lack of randomized clinical studies on the long-term use of ginseng in patients with T2DM, the authors conducted a double-blind, randomized, placebo-controlled, parallel study to determine the safety of 12 weeks of supplementation with AG when used as adjunctive therapy in patients with T2DM.
Seventy-four patients (mean age: 63 ± 9.5 years) with T2DM recruited from a diabetes outpatient clinic completed the study. From the original group of patients screened, five participants dropped out because of changes in medication therapy, and two were unwilling to continue the study. Included participants had well-controlled T2DM for more than six months without complications, metabolic stability (average glycated hemoglobin A1c [HbA1c] between 6.5% and 8.1%), and were on diet modifications and/or conventional diabetes medications. Nine of the patients used diet only to treat T2DM; others used diet plus oral agents such as metformin (n=48), sulfonylurea (n=43), dipeptidyl peptidase-4 inhibitors (n=11), glucagon-like peptide-1 agonists (n=1), acarbose (n=4), and metformin with pioglitazone (n=1).
The patients were randomly assigned to receive either two 500 mg capsules of AG root extract (containing 10% ginsenosides) before meals three times daily (n=35) — a daily dosage recommended in traditional Chinese medicine1 — or two 500 mg identical-appearing placebo capsules containing corn (Zea mays, Poaceae) starch (n=39). AG root was supplied by Ontario Ginseng Growers (Simcoe, Ontario, Canada) and extracted with ethanol. Treatment or placebo was taken along with any antihypertensive or hypoglycemic medications used by the patients. At baseline, body mass index and fasting plasma glucose levels were significantly higher in the AG group compared with the placebo group; all other demographic and clinical parameters were similar.
The patients visited the clinic at baseline and at weeks six and 12 to have biochemical and anthropometric measurements taken. During these visits, participants also completed the International Quality of Life Assessment SF-36v2 questionnaire, received a new supply of capsules, returned unused capsules, and were interviewed by a dietitian. Patients were instructed to maintain body weight, follow their usual dietary and physical activity habits throughout the study, and refrain from all medications, including AG or placebo, for 12 hours before each study visit.
Safety was assessed by measuring markers of hepatic (aspartate aminotransferase and alanine aminotransferase), renal (serum urates and serum creatinine), and hemostatic (prothrombin time and international normalized ratio) functions.
The authors report that AG had no significant dependent or independent effects on any of the safety parameters. All hepatic, renal, and hemostatic function values were within normal limits. Regarding adverse events, stomach heaviness was reported in one patient in the AG group during the first six weeks, but the patient continued the treatment.
Safety concerns surrounding the use of ginseng followed a now widely discredited, uncontrolled, observational study by Siegel2 in 1979, in which 12 weeks of ginseng supplementation was associated with elevated blood pressure and several other adverse effects (e.g., gastrointestinal disturbances, insomnia, and nervousness).* The ginseng dose assigned in the Siegel trial was much higher than the usually recommended dose, and “the validity of these side effects is questionable due to a lack of a control group in the study and the fact that subjects were not controlled for dose, duration, route of administration, type of ginseng, or other concurrent bioactive substances intake,” write the authors of the study reported here, who previously found that three grams of AG taken daily for 12 weeks compared with placebo was associated with decreased blood pressure in persons with hypertension and T2DM.3
The authors point out that the results of this current study may not be generalizable to other AG ingredients, including the unprocessed root or other ginseng extracts, but they conclude that the AG treatment in this study demonstrated “rather convincing long-term clinical safety when administered as an adjunct to conventional antihypertensive and antidiabetic therapy.”
--Shari Henson
Source American Botanical Council - Herbalgram
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Effect of Hypericum perforatum L. Extract on Insulin Resistance and Lipid Metabolic Disorder in High-Fat-Diet Induced Obese Mice
Jin-ying Tian, Rong-ya Tao, Xiao-lin Zhang, Qian Liu, Yi-bo He, Ya-lun Su, Teng-fei Ji, Fei Ye
Abstract
Natural product Hypericum perforatum L. has been used in folk medicine to improve mental performance. However, the effect of H. perforatum L. on metabolism is still unknown. In order to test whether H. perforatum L. extract (EHP) has an effect on metabolic syndrome, we treated diet induced obese (DIO) C57BL/6J mice with the extract. The chemical characters of EHP were investigated with thin-layer chromatography, ultraviolet, high-performance liquid chromatography (HPLC), and HPLC-mass spectrometry fingerprint analysis. Oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and the glucose infusion rate (GIR) in hyperinsulinemic–euglycemic clamp test were performed to evaluate the glucose metabolism and insulin sensitivity. Skeletal muscle was examined for lipid metabolism. The results suggest that EHP can significantly improve the glucose and lipid metabolism in DIO mice. In vitro, EHP inhibited the catalytic activity of recombinant human protein tyrosine phosphatase 1B (PTP1B) and reduced the protein and mRNA levels of PTP1B in the skeletal muscle. Moreover, expressions of genes related to fatty acid uptake and oxidation were changed by EHP in the skeletal muscle. These results suggest that EHP may improve insulin resistance and lipid metabolism in DIO mice
Source : Journal Phtotherapy Research
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THE PROTECTIVE EFFECT OF MUSHROOMS IN EXPERIMENTALLY INDUCED DIABETES IN MICE
CORNELIA MIRCEA1, VERONICA BILD2, DANIELA ZAVASTIN3, OANA CIOANCĂ4*
1 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of General and Applied Biochemistry, 16 Universitatii Street, Romania, Iasi, 700115
2 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Pharmacodynamics and Clinical Pharmacy, 16 Universitatii Street, Romania, Iasi, 700115
3 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Physical Chemistry, 16 Universitatii Street, Romania, Iasi, 700115
4 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Pharmacognosy, 16 Universitatii Street, Romania, Iasi, 700115
Abstract
Mushrooms represent an important food source and are recommended for diabetics because of their low glycemic index due to content nutrients. The beneficial effect of products from mushrooms was evaluated under experimental diabetes in mice. The study
was performed on extracts and powder respectively from three species of fungi, two of which are edible and cultivated (Pleurotus ostreatus - powder and extract, Agaricus bisporus brown - powder and extract) and one is parasite (Fomes fomentarius - extract).
Among the extracts a positive effect on blood glucose was recorded in the group treated with Fomes fomentarius extract (31.35% reduction) and from the group treated with Pleurotus ostreatus powder (20.24% reduction). Cholesterol reduction level was between
5.23% (Fomes fomentarius) and 15.46% (Agaricus bisporus brown extract). For A.bisporus brown the extract registered better results, while for P. ostreatus the powder was more active. Extracts administration did not result in a return to the control group registered values for liver function tests (ALT, AST, alkaline phosphatase), but determined evident beneficial effects compared with diabetic group and could counteract hepatocellular damage in diabetes.
Source : Revista Farmacia
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Impact of Beverage Content on Health and the Kidneys
Johnson, Richard J. MD; Thomas, Jeffrey MD; Lanaspa, Miguel A. PhD
Abstract
The last 50 years have witnessed an epidemic rise in obesity, diabetes, high blood pressure, and chronic kidney disease. Some animal research suggests the epidemic may in part be triggered by sugar. Sugar contains glucose and fructose, and studies suggest it is the fructose component that may have a role in chronic disease development. Animal studies indicate that fructose is distinct from other sugars by its ability to cause transient adenosine triphosphate (ATP) depletion in the cell with uric acid generation. The administration of fructose, or the raising of uric acid, can induce kidney disease and accelerate established kidney disease in animals. Therefore, we believe that the greatest risk from sugar is when it is given as a soft drink, as the rapidity of ingestion relates directly to the concentration of fructose that the cells are exposed to and hence govern the degree of ATP depletion and uric acid generation. Restricting sugar-sweetened beverages may be one strategy to combat obesity, diabetes, high blood pressure, and kidney disease, but human intervention studies are needed to support the theory.
Source : Journal Nutrition Today
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Green tea and type 2 diabetes
Jae-Hyung Park, , Jae-Hoon Bae, Sung-Soon Im, Dae-Kyu Song
Department of Physiology, Keimyung University School of Medicine, Daegu, Korea
Abstract
Green tea and coffee consumption have been widely popular worldwide. These beverages contain caffeine to activate the central nervous system by adenosine receptor blockade, and due to the caffeine, addiction or tolerance may occur. In addition to this caffeine effect, green tea and coffee consumption have always been at the center of discussions about human health, disease, and longevity. In particular, green tea catechins are involved in many biological activities such as antioxidation and modulation of various cellular lipid and proteins. Thus, they are beneficial against degenerative diseases, including obesity, cancer, cardiovascular diseases, and various inflammatory diseases. Some reports also suggest that daily consumption of tea catechins may help in controlling type 2 diabetes. However, other studies have reported that chronic consumption of green tea may result in hepatic failure, neuronal damage, and exacerbation of diabetes, suggesting that interindividual variations in the green tea effect are large. This review will focus on the effect of green tea catechins extracted from the Camellia sinensis plant on type 2 diabetes and obesity, and the possible mechanistic explanation for the experimental results mainly from our laboratory. It is hoped that green tea can be consumed in a suitable manner as a supplement to prevent the development of type 2 diabetes and obesity.
Source : Intergrative Medicine Journal
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Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds
Fahmida Alam,1 Md. Asiful Islam,1 Siew Hua Gan,1 and Md. Ibrahim Khalil2
1Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
2Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh
Abstract
Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey’s antibacterial activity on diabetic wound-related microorganisms and honey’s clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.
Source : Evidence Based Complementary and Alternative Medicine
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Artificial Sweeteners May Raise Diabetes Risk
By Salynn Boyles, Contributing Writer, MedPage TodayReviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Consumption of noncaloric artificial sweeteners appeared to induce glucose intolerance in both mice and humans by altering gut microbiota in a series of experiments conducted by researchers in Israel.
Rather than helping to prevent obesity and metabolic disease, use of noncalorie sweeteners may have contributed to the epidemic rise of these conditions, wrote Eran Elinav, MD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues, online in the journal Nature.
Their research is among the first to examine the impact of a specific food additive on gut microbiota and the findings are compelling, said microbiome researcher Suzanne Devkota, PhD, of Joslin Diabetes Center and Harvard Medical School. Devkota was not involved with the research.
"This was a very well done study, and the fact that they had a human component was a big plus," she told MedPage Today.
Artificial Sweetener Research Mixed
Five no-calorie or low-calorie artificial sweeteners -- saccharin, sucralose, aspartame, neotame and acesulfame K -- are approved for use in the U.S. by the FDA and sweeteners derived from the Stevia plant extract Reb-A have been designated "generally recognized as safe."
While some studies have linked noncaloric sweetener use to an increased risk for obesity and diabetes, others suggest a protective effect or no effect at all. Interpretation of these studies has been complicated by the fact that noncaloric artificial sweeteners are often consumed by people who have some manifestations of metabolic syndrome, the researchers wrote.
They further noted that most noncaloric artificial sweeteners (NAS) pass through the human gastrointestinal tract without being digested, so they directly encounter intestinal microbiota.
"Microbiota compositions and function are modulated by diet in the healthy lean state as well as in obesity and diabetes mellitus, and in turn microbiota alterations have been associated with propensity to metabolic syndrome," Elinav and colleagues wrote.
Their studies in animals and humans examined NAS-mediated modulation of microbiota composition and function and their effects on host glucose metabolism.
NAS Fed Mice Developed Glucose Intolerance
In an effort to better understand the effects of NAS on glucose homeostasis, the researchers added commercial formulations of saccharin, sucralose, or aspartame to the drinking water of 10-week-old C57/BI/6 mice. Control mice were fed only water or water supplemented with either glucose or sucralose.
At week 11, the three groups that consumed water alone, glucose and sucrose had comparable glucose tolerance curves, while the three NAS-fed mouse groups developed marked glucose intolerance (P<0.001). Saccharin exerted the most pronounced effect, and the researchers further studied this sweetener by feeding the mice a high-fat (60% calories from fat) diet while they consumed either commercial saccharine or pure glucose. As in the earlier experiment, the saccharin-fed mice developed glucose intolerance and the control mice did not.
"Taken together, these results suggest that NAS promote metabolic derangements in a range of formulations, doses, mouse strains, and diets paralleling human conditions, in both the lean and the obese state," the researchers wrote.
To test whether the observed NAS effect was regulated in the gut microbiota, the researchers treated mouse groups consuming commercial or pure NAS in the lean and high-fat diet states with a Gram-negative-targeting broad-spectrum antibiotic regimen (ciprofloxacin and metronidazole) while maintaining the mice on their diet and sweetener regimens.
After 4 weeks of antibiotic treatment, differences in glucose intolerance between NAS-consuming mice and controls were abolished in both the lean and obese states. Similar effects were seen with the Gram-positive-targeting antibiotic vancomycin.
"These results suggest that NAS-induced glucose intolerance is mediated through alterations to the commensal microbiota, with contributions from diverse bacterial taxa," the researchers wrote.
Fecal Experiments Studied Causal Link
In an effort to determine if the microbiota role was causal, the researchers performed fecal transplantation experiments, by transferring the microbiota configuration from mice on normal-chow diet drinking commercial saccharin or glucose (control) into normal-chow-consuming germ-free mice. Recipients of microbiota from mice consuming commercial saccharin exhibited impaired glucose tolerance compared with control microbiota recipients 6 days after transfer (P<0.03)
The researchers also examined the fecal microbiota composition of the various mouse groups by sequencing their 16S ribosomal RNA gene. In this series of experiments, they demonstrated that saccharin directly modulated the composition and function of the microbiome to induce a harmful imbalance of intestinal microbes (dysbiosis), accounting for the downstream glucose intolerance phenotype in the mammalian host.
NAS Raised Metabolic Risk in Humans
To study the effects of NAS in humans, the researchers examined the relationship between long-term NAS consumption (determined through food frequency questionnaires) and dysbiosis and various parameters of metabolic risk using data collected from 381 people who did not have diabetes (44% male; mean age 43.3, SD 13.2) participating in an ongoing clinical nutritional study.
"We found significant positive correlations between NAS consumption and several metabolic-syndrome-related clinical parameters, including increased weight and waist-to-hip ratio, higher fasting blood glucose, glycosylated HbA1c [percentage] and glucose tolerance test (GTT, measures of impaired glucose tolerance), and elevated serum alanine aminotransferase," the researchers wrote.
Levels of HbA1c, indicative of glucose concentration over the previous 3 months, were significantly increased when comparing a subgroup of high NAS consumers (40 people) to non-NAS consumers (236 people, rank sum P<0.002). The increase remained significant when adjusted for body mass index (rank sum P<0.015).
When Elinav and colleagues characterized 16S rRNA in 172 randomly selected members of the cohort, they found statistically significant positive correlations between multiple taxonomic entities and NAS consumption, including the Enterobacteriaceae family and the Actinobacteria phylum.
"Importantly, we did not detect statistically significant correlations between operational taxonomic unit abundances and BMI, suggesting that the correlations are not due to the distinct BMI of NAS consumers," they wrote.
In an effort to determine if the relationship between human NAS consumption and blood glucose control is causative, the researchers followed seven healthy volunteers (five males and two females, ages 28-36) who did not normally consume NAS or foods containing NAS for 1 week (days two-seven). During this week, participants consumed the FDA's maximal acceptable daily intake of commercial saccharin (5 mg per kg body weight as three divided daily doses equivalent to 120 mg). The participants were monitored by continuous glucose measurements and daily GTT.
"Notably, even in this short-term, 7-day exposure period, most individuals (four of seven) developed significantly poorer glycemic response 5-7 days after NAS consumption, compared with their individual glycemic response on days one-four," the researchers wrote.
Personalized Response to NAS Found
The microbiome configurations of theses NAS responders, assessed using 16S rRNA analysis, also clustered differently from the three nonresponders. Microbiomes from nonresponders showed little changes in composition during the study week, wheres pronounced compositional changes were seen in NAS responders.
To further examine whether this NAS-induced dysbiosis had a causal role in glucose intolerance, the researchers transferred stool from before day one or after day seven NAS exposure from two NAS responders and two nonresponders into groups of normal chow-fed germ-free mice.
Transfer of day seven stool from NAS responders was found to induce significant glucose intolerance in the mice, compared with day one stool from the same people. In contrast, D7 stools transferred from two NAS nonresponders induced normal glucose tolerance which was similar to that of mice transferred with day one stool.
"Our results from short- and long-term human NAS consumer cohorts suggest that human individuals feature a personalized response to NAS, possibly stemming from differences in their microbiota composition and function," the researchers wrote.
The researchers further suggested that these individualized nutritional responses may be driven by personalized functional differences in the microbiome.
Expert: All Things in Moderation
Diabetes researcher Robert Rizza, MD, of the Mayo Clinic in Rochester, Minn., who was not involved with the research, called the findings "fascinating."
He noted that earlier research suggests people who eat large amounts of artificial sweeteners have higher incidences of obesity and diabetes. The new research, he said, suggests there may be a causal link.
"This was a very thorough and carefully done study, and I think the message to people who use artificial sweeteners is they need to use them in moderation," he said. "Drinking 17 diet sodas a day is probably a bad idea, but one or two may be OK."
Source : MedPage Today
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Assesment of Antidiabetic Activity of Mangifera Indica Seed Kernel Extracts in Streptozotocin Induced Diabetic Rats
M. S. Rajesh, J. Rajshekar
Abstract
The objective of the study was to screen the extracts of Mangifera indica seed kernel for its antidiabetic activity so that tons of mango seed kernels going waste during the mango season can be utilized as house hold remedy in treating diabetes so that the dose and cost of the actual treatment can be brought down. Extracts were evaluated for their glucose reducing effect in both normal and diabetic rats at the dose of 200 mg/kg body weight. Diabetes was induced by administering streptozotocin at 65 mg/kg body weight in citrate buffer intraperitonially. Blood samples were collected through tip of tail vein and the fasting blood glucose levels were estimated by using reactive strips of glucose oxidase and peroxidase. Serum lipid profiles were carried out by using ready kits by colorimetric method. The results indicate aqueous and methanolic extract of Mangifera indica seed kernel possesses significant antidiabetic activity.
Source : Journal of Natural Remedies
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Acute effects of raisin consumption on glucose and insulin reponses in healthy individuals
Amin Esfahani1,2,3, Joanne Lam1and Cyril W. C. Kendall2,3,4*
1School of Medicine, New York Medical College, Valhalla, NY, USA
2Clinical Nutrition and Risk Factor Modification Center, St Michael’s Hospital, Toronto, ON, Canada
3Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
4College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
Abstract
Raisins are popular snacks with a favourable nutrient profile, being high in dietary fibre, polyphenols and a number of vitamins and minerals, in addition to being rich in fructose. In light of evidence demonstrating improvements in glycaemic control with moderate fructose intake and low-glycaemic index(GI)fruits, our aim was to determine the GI, insulin index (II) and postprandial responses to raisins in an acute feeding setting. A total of ten healthy participants(four male and six female) consumed breakfast study meals on four occasions over a 2- to 8-week period: meal 1: white bread (WB) (108 g WB; 50 gavailable carbohydrate) served as the control and was consumed on two separate occasions; meal 2: raisins (R50) (69 g raisins; 50 g available carbohydrate);and meal 3: raisins (R20) (one serving, 28 g raisins; 20 g available carbohydrate). Postprandial glucose and insulin were measured over a 2 h period for the determination of GI, glycaemic load (GL) and II. The raisin meals, R50 and R20, resulted in significantly reduced postprandial glucose and insulin responses when compared with WB (P<0·05). Furthermore, raisins were determined to be low-GI, -GL and -II foods. The favourable effect of raisins on postprandial glycaemic response, their insulin-sparing effect and low GI combined with their other metabolic benefits may indicate that raisins are a healthy choice not only for the general population but also for individuals with diabetes or insulin resistance.
Source : Journal of Nutritional Science
Link to Full Article.
Interaction of Some Commercial Teas with Some Carbohydrate Metabolizing Enzymes Linked with Type-2 Diabetes: A Dietary Intervention in the Prevention of Type-2 Diabetes
Ganiyu Oboh,1 Omodesola O. Ogunruku,1,2 Funke O. Ogidiolu,1 Adedayo O. Ademiluyi,1 Bukola C. Adedayo,1 and Ayokunle O. Ademosun1
1Functional Foods and Nutraceuticals Unit, Biochemistry Department, Federal University of Technology, PMB 704, Akure, Nigeria
2Biochemistry Department, Obafemi Awolowo University, Ile-Ife, Nigeria
Abstract
This study is aimed at assessing the inhibitory effect of teas on key enzymes (alpha-amylase and alpha-glucosidase) linked with type-2 diabetes and their antioxidant properties. Four samples of three brands were used; infusions of green tea (GT), 2 brands of black tea (BT), and a formulated herbal preparation for diabetes (ADT) (white tea, Radix Puerariae, Radix ophiopogonis, hawthorn berry, Chinese yam, and fragrant Solomon seal rhizome) were prepared and subsequently analyzed for their total phenol, ascorbic acid contents, antioxidant properties (2,2-Azizobis (3-Ethylbenzo-Thiazoline~6-sulfonate) “ABTS” scavenging ability and ferric reducing antioxidant property), and inhibition of pancreatic-alpha-amylase and intestinal-alpha-glucosidase in vitro. The study revealed that GT had the highest total phenol content, ascorbic acid content, ABTS* scavenging ability, and ferric reducing ability. Furthermore, all the teas inhibited Fe2+ and sodium nitroprusside induced lipid peroxidation in pancreas, with GT having the highest inhibitory effect. Conversely, there was no significant difference ( P>0.05) in the inhibitory effects of the teas on alpha-amylase and alpha-glucosidase. The antidiabetic property of the teas could be attributed to their inhibitory effect on carbohydrate hydrolyzing enzymes implicated in diabetes and their antioxidant activities.
Source : Evidence Based Complementary and Alternative Medicine
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Effects of a beetroot juice with high neobetanin content on the early-phase insulin response in healthy volunteers
Peter C. Wootton-Bearda1, Kirsten Brandta2, David Fella3, Sarah Warnera1a2 and Lisa Ryana1a4 c1
a1 Functional Food Centre, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, UK
a2 Human Nutrition Research Centre, School of Agriculture and Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
a3 Cell Systems Modelling Group, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, UK
a4 Department of Nutrition and Dietetics, Monash University, Faculty of Medicine, Nursing and Health Sciences, 264 Ferntree Gully Road, Vic 3168, Australia
Abstract
Produce rich in phytochemicals may alter postprandial glucose and insulin responses by interacting with the pathways that regulate glucose uptake and insulin secretion in humans. The aims of the present study were to assess the phytochemical constituents of red beetroot juice and to measure the postprandial glucose and insulin responses elicited by either 225 ml beetroot juice (BEET), a control beverage matched for macronutrient content (MCON) or a glucose beverage in healthy adults. Beetroot juice was a particularly rich source of betalain degradation compounds. The orange/yellow pigment neobetanin was measured in particularly high quantities (providing 1·3 g in the 225 ml). A total of sixteen healthy individuals were recruited, and consumed the test meals in a controlled single-blind cross-over design. Results revealed a significant lowering of the postprandial insulin response in the early phase (0–60 min) (P < 0·05) and a significantly lower glucose response in the 0–30 min phase (P < 0·05) in the BEET treatment compared with MCON. Betalains, polyphenols and dietary nitrate found in the beetroot juice may each contribute to the observed differences in the postprandial insulin concentration.
Source : Journal of Nutritional Science
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Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study1,2,3,4
Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.
Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.
Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal fat; and a vegetable LCD score on the basis of intakes of carbohydrate, vegetable protein, and vegetable fat. A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models.
Results: We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons of highest with lowest quartiles were 1.27 (1.06, 1.51) for the overall LCD score (P-trend = 0.03), 1.36 (1.13, 1.64) for the animal LCD score (P-trend = 0.003), and 0.84 (0.69, 1.03) for the vegetable LCD score (P-trend = 0.08). Associations between LCD scores and GDM risk were not significantly modified by age, parity, family history of diabetes, physical activity, or overweight status.
Conclusions: A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high protein and fat from vegetable food sources is not associated with the risk. Women of reproductive age who follow a low-carbohydrate dietary pattern may consider consuming vegetable rather than animal sources of protein and fat to minimize their risk of GDM.
Source : The American Journal of Clinical Nutrition
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Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis1,2,3,4
Abstract
Background: Epidemiologic studies have shown inverse associations between nut consumption and diabetes, cardiovascular disease (CVD), and all-cause mortality, but results have not been consistent.
Objective: We assessed the relation between nut intake and incidence of type 2 diabetes, CVD, and all-cause mortality.
Design: We searched PubMed and EMBASE for all prospective cohort studies published up to March 2013 with RRs and 95% CIs for outcomes of interest. A random-effects model was used to pool risk estimates across studies.
Results: In 31 reports from 18 prospective studies, there were 12,655 type 2 diabetes, 8862 CVD, 6623 ischemic heart disease (IHD), 6487 stroke, and 48,818 mortality cases. The RR for each incremental serving per day of nut intake was 0.80 (95% CI: 0.69, 0.94) for type 2 diabetes without adjustment for body mass index; with adjustment, the association was attenuated [RR: 1.03; 95% CI: 0.91, 1.16; NS]. In the multivariable-adjusted model, pooled RRs (95% CIs) for each serving per day of nut consumption were 0.72 (0.64, 0.81) for IHD, 0.71 (0.59, 0.85) for CVD, and 0.83 (0.76, 0.91) for all-cause mortality. Pooled RRs (95% CIs) for the comparison of extreme quantiles of nut intake were 1.00 (0.84, 1.19; NS) for type 2 diabetes, 0.66 (0.55, 0.78) for IHD, 0.70 (0.60, 0.81) for CVD, 0.91 (0.81, 1.02; NS) for stroke, and 0.85 (0.79, 0.91) for all-cause mortality.
Conclusions: Our meta-analysis indicates that nut intake is inversely associated with IHD, overall CVD, and all-cause mortality but not significantly associated with diabetes and stroke. The inverse association between the consumption of nuts and diabetes was attenuated after adjustment for body mass index. These findings support recommendations to include nuts as part of a healthy dietary pattern for the prevention of chronic diseases
Source : The American Journal of Clinical Nutrition
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Amelioration of Diabetes and Painful Diabetic Neuropathy by Punica granatum L. Extract and Its Spray Dried Biopolymeric Dispersions
K. Raafat1 and W. Samy2,3
1Department of Pharmaceutical Sciences, Faculty of Pharmacy, Beirut Arab University, Beirut 115020, Lebanon
2Department of Pharmaceutical Technology, Faculty of Pharmacy, Beirut Arab University, Beirut 115020, Lebanon
3Department of Industrial Pharmacy, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
Abstract
Aims. To evaluate the effect of Punica granatum (universally known as pomegranate) (Pg) rind extract and its spray dried biopolymeric dispersions with casein (F1) or chitosan (F2) against Diabetes mellitus (DM) and diabetic neuropathy (DN).
Methods. We measured the acute (6 h) and subacute (8 days) effect of various doses of Pg, F1, and F2 and the active compounds on alloxan-induced DM mouse model. We evaluated DN utilizing latency tests for longer period of time (8 weeks). In addition, the in vivo antioxidant activity was assessed utilizing serum catalase level.
Results. The results proved that the highest dose levels of Pg extract, F1, F2 exerted remarkable hypoglycemic activity with 48, 52, and 40% drop in the mice glucose levels after 6 hours, respectively. The tested compounds also improved peripheral nerve function as observed from the latency tests. Bioguided fractionation suggested that gallic acid (GA) was Pg main active ingredient responsible for its actions.
Conclusion. Pg extract, F1, F2, and GA could be considered as a new therapeutic potential for the amelioration of diabetic neuropathic pain and the observed in vivo antioxidant potential may be involved in its antinociceptive effect. It is highly significant to pay attention to Pg and GA for amelioration and control of DM and its complications.
Source : Journal Complementary and Alternative Medicine
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Effects of Chinese Medicine Tong xinluo on Diabetic Nephropathy via Inhibiting TGF-β1-Induced Epithelial-to-Mesenchymal Transition
Na Zhang,1 Yanbin Gao,1 Dawei Zou,1 Jinyang Wang,1 Jiaoyang Li,1 Shengnan Zhou,1 Zhiyao Zhu,1 Xuan Zhao,1 Liping Xu,1 and Haiyan Zhang2
1School of Traditional Chinese Medicine, Capital Medical University, No. 10, Youanmenwai, Xitoutiao, Fengtai District, Beijing 100069, China
2Department of Cell Biology, School of Basic Medical Science, Capital Medical University, No. 10, Youanmenwai, Xitoutiao, Fengtai District, Beijing 100069, China
Abstract
Diabetic nephropathy (DN) is a major cause of chronic kidney failure and characterized by interstitial and glomeruli fibrosis. Epithelial-to-mesenchymal transition (EMT) plays an important role in the pathogenesis of DN. Tong xinluo (TXL), a Chinese herbal compound, has been used in China with established therapeutic efficacy in patients with DN. To investigate the molecular mechanism of TXL improving DN, KK-Ay mice were selected as models for the evaluation of pathogenesis and treatment in DN. In vitro, TGF-β1 was used to induce EMT. Western blot (WB), immunofluorescence staining, and real-time polymerase chain reaction (RT-PCR) were applied to detect the changes of EMT markers in vivo and in vitro, respectively. Results showed the expressions of TGF-β1 and its downstream proteins smad3/p-smad3 were greatly reduced in TXL group; meantime, TXL restored the expression of smad7. As a result, the expressions of collagen IV (Col IV) and fibronectin (FN) were significantly decreased in TXL group. In vivo, 24 h-UAER (24-hour urine albumin excretion ratio) and BUN (blood urea nitrogen) were decreased and Ccr (creatinine clearance ratio) was increased in TXL group compared with DN group. In summary, the present study demonstrates that TXL successfully inhibits TGF-β1-induced epithelial-to-mesenchymal transition in DN, which may account for the therapeutic efficacy in TXL-mediated renoprotection.
Source : Evidence Based Complementary and Alternative Medicine
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Meat Consumption as a Risk Factor for Type 2 Diabetes
Neal Barnard,1 Susan Levin,2,* and Caroline Trapp2
Abstract
Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption), as a scalar variable (i.e., gradations of meat consumption), or as part of a broader dietary pattern.
Source : Journal Nutrients
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Acute effects of pistachio consumption on glucose and insulin, satiety hormones and endothelial function in the metabolic syndrome
C W C Kendall1,2,3, S G West4,5, L S Augustin1,2, A Esfahani6, E Vidgen1,2, B Bashyam1,2, K A Sauder4, J Campbell7, L Chiavaroli1,2, A L Jenkins1,7 and D J Jenkins1,2,8
Background/Objective:
Nut consumption has been found to decrease risk of coronary heart disease and diabetes and to promote healthy body weights possibly related to their favorable macronutrient profile. We therefore assessed the effect of pistachios on postprandial glucose and insulin levels, gut hormones related to satiety and endothelial function.
Subjects/Methods:
In this randomized crossover study, 20 subjects with metabolic syndrome consumed five study meals over 5–10 weeks. The meals differed in fat type and quantity, but were matched according to available carbohydrates (CHOs). Three meals had 50 g available CHO: white bread (WB50g), white bread, butter and cheese (WB+B+Ch) and white bread and pistachios (WB+P). Two meals had 12 g available CHO: white bread (WB12g) and pistachios (P).
Results:
Within each group of available CHO meals, postprandial glucose levels were the highest following the white bread-only meals, and glucose response was significantly attenuated when butter and cheese or pistachios were consumed (P<0.05). Postprandial insulin levels were highest after the WB+B+Ch meal (P<0.05), but did not differ between the white bread-only and pistachio meals. Both endothelial function (reactive hyperemia index) and arterial stiffness (augmentation index) significantly increased after the white bread-only meals compared with the WB+B+Ch meal (all P<0.05). Insulin secretagogue levels were higher when butter and cheese or pistachios were consumed than when white bread only was consumed (P<0.05).
Conclusions:
Compared with white bread, pistachio consumption reduced postprandial glycemia, increased glucagon-like-peptide levels and may have insulin-sparing properties. These effects could be beneficial for individuals with diabetes and metabolic syndrome.
Source : EU Journal of Clinical Nutrition
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Updated Meta-Analysis Shows Beneficial Effect of Cinnamon Supplements on Type 2 Diabetes
by Cheryl McCutchan, PhD
Reviewed: Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med. 2013;11(5):452-459.
Type 2 diabetes results in impaired glycemic control and potential complications from cardiovascular disease. The main forms of treatment for type 2 diabetes include medication, lifestyle adjustments, and dietary modifications. Dietary supplements are not generally recommended as a treatment by the American Diabetes Association because the organization believes that the clinical efficacy of supplements has not been sufficiently established and because there is a lack of “standardized formulations.” (Presumably, this refers to the fact that there are various types of cinnamon formulations, for example, that have shown some degree of clinical efficacy, and — unlike single chemical entity pharmaceutical medications — cinnamon dietary supplements contain numerous naturally occurring phytochemicals, more than one of which may contribute to the formulation’s physiological effect.)
Cinnamon (Cinnamomum spp., Lauraceae) has been demonstrated in basic research studies to lower serum lipids and blood glucose, promote insulin release, enhance insulin sensitivity, increase insulin disposal, and regulate protein-tyrosine phosphatase 1β and insulin receptor kinase. In studies with diabetic rats, cinnamon extracts were shown to increase the expression of peroxisome proliferator-activated receptors (PPARs). PPARs are targeted in therapies for diabetes and hyperlipidemia (high levels of blood lipids, e.g., cholesterol) and have been shown to increase insulin sensitivity and high-density lipoprotein cholesterol (HDL-C) levels in addition to decreasing triglyceride levels.
Evidence from previous human clinical trials has shown conflicting effects of cinnamon on blood glucose and lipids. The authors of the this review found no significant relationship between cinnamon and measures of type 2 diabetes in a previous meta-analysis published in 2008.1 For their current paper, they repeated the meta-analysis with the addition of five new randomized, controlled studies.
The databases MEDLINE®, Embase™, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2012 using the keywords cinnamon and diabetes. Studies were considered for inclusion in the analysis if they were randomized, controlled trials that investigated type 2 diabetes using cinnamon supplements in any dose or form. The studies had to have one of the following dependent variables measured to be considered for analysis: glycosylated hemoglobin (hemoglobin A1c), fasting plasma glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), HDL-C, or triglycerides (TGs). All of the potentially relevant articles were reviewed by two of the investigators. Author identification, year of publication, study design, source of study funding, study duration and follow-up, study population, sample size, time since diagnosis, cinnamon dose, product name and brand, formulation used, and cinnamon species were recorded. Baseline data for hemoglobin A1c level, fasting plasma glucose level, body weight, body mass index, TC, LDL-C, HDL-C, and TGs were recorded. The studies were checked for bias with the Cochrane Risk of Bias Tool. The mean change from baseline for levels of hemoglobin A1c, fasting plasma glucose, TC, LDL-C, HDL-C, and TGs were analyzed with Comprehensive Meta-Analysis software, version 2 (Biostat). Both heterogeneity among studies and publication bias were calculated. The effects of cinnamon dosage and form were calculated with subgroup analysis.
Ten studies met the criteria imposed by the authors (n=543 subjects). Of these, eight trials had measures of hemoglobin A1c, LDL-C, and HDL-C, and eight trials had measures of fasting plasma glucose, TC, and TGs. Eight of the studies used formulations of C. aromaticum (syn. C. cassia) and two did not state the species of cinnamon. The dosage of cinnamon ranged from 120 mg per day to six grams per day. There was variation among the studies as to when the cinnamon supplements were administered relative to meals. In seven studies, participants took the cinnamon supplements with a meal. In the remaining studies, participants took supplements either before (one study) or after a meal (two studies).
Cinnamon supplements significantly reduced fasting plasma glucose by a weighted average of 24.59 mg/dL. This is a slightly greater reduction than that seen with the antihyperglycemic drug sitagliptin (-16 to -21 mg/dL), but considerably lower than that found with metformin monotherapy (-58 mg/dL). LDL-C and TGs also were reduced in patients who took cinnamon supplements when compared to control patients (-9.4 mg/dL and -29.6 mg/dL, respectively). Again, these reductions are considerably less than in patients on conventional medications; pravastatin and gemfibrozil have been shown to decrease both LDL-C and TGs by -50 mg/dL. HDL-C was significantly increased (1.66 mg/dL) in patients who took cinnamon supplements. There was no effect of cinnamon on hemoglobin A1c levels; however, when only capsule formulations of cinnamon were considered, hemoglobin A1c was significantly decreased (-0.27%).
There was a high level of heterogeneity among the studies for hemoglobin A1c, fasting plasma glucose, TC, LDL-C, and TGs. This may be the result of variation among the studies in the patients’ age and health and in the dosage and form of cinnamon supplements used. There was also potential publication bias for fasting plasma glucose. No difference was seen in glycemic or lipid measures with cinnamon dosage.
These trends are similar to the authors’ findings from their 2008 meta-analysis, but the five additional randomized, controlled trials have allowed the authors to conclude that cinnamon does, indeed, have a positive, significant effect on some measures of glycemic and lipid metabolism in patients with type 2 diabetes. This publication is consistent with another previous meta-analysis by other researchers of eight randomized, controlled trials on cinnamon preparations, which showed that cinnamon supplementation resulted in a statistically significant reduction of fasting blood glucose in people with type 2 diabetes and prediabetes.2
—Cheryl McCutchan, PhD
References
1. Baker WL, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care. 2008;31(1):41-43.
2. Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food. April 2011; [epub ahead of print]. doi:10.1089/jmf.2010.0180.
Source : American Botanical Council - HerbalGram
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Effects of Brown Seaweed (Sargassum polycystum) Extracts on Kidney, Liver, and Pancreas of Type 2 Diabetic Rat Model
Mahsa Motshakeri, 1, Mahdi Ebrahimi, 2 Yong Meng Goh, 2,3, Hemn Hassan Othman, 2, Mohd Hair-Bejo, 2 and Suhaila Mohamed 4
1 Faculty of Food Science & Technology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
2 Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
3 Institute of Tropical Agriculture, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
4 Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
Abstract
The edible seaweed Sargassum polycystum (SP) is traditionally used against several human diseases. This investigation evaluated
the effects of two dietary doses of SP ethanolic and aqueous extracts on the pancreatic, hepatic, and renal morphology of type 2
diabetic rats (T2DM). T2DM was induced by feeding rats on high calorie diet followed by a low dose streptozotocin. Changes in
the diabetic rat organs in SP treated groups with different doses of extracts were compared with normal rats, diabetic control rats,
and metformin treated rats. After 22 days of treatment, the pathological lesions of the livers and kidneys in the diabetic rats were
quantitatively and qualitatively alleviated ( 푃<0.05) by both the SP extracts at 150mg/kg body weight and by metformin. All the
treated diabetic groups revealed marked improvement in the histopathology of the pancreas compared with the control diabetic
group. Oral administration of 300mg/kg body weight of aqueous and ethanolic extracts of SP and metformin revealed pancreas
protective or restorative effects.The seaweed extracts a t150mg/kg body weight reduced the liver and kidney damages in the diabetic rats and may exert tissue repair or restoration of the pancreatic islets in experimentally induced diabetes to produce the beneficial homeostatic effects.
Source : Evidence Based Complementary and Alternative Medicine Journal
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Chinese Herbal Medicine Tianqi Reduces Progression From Impaired Glucose Tolerance to Diabetes: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial
Fengmei Lian, Guangwei Li, Xinyan Chen, Xiuzhi Wang, Chunli Piao, Jingfei Wang, Yuzhi Hong, Zhuoma Ba, Shentao Wu, Xiaoyan Zhou, Jiangming Lang, Yajun Liu, Rongfang Zhang, Jianjun Hao, Zhangzhi Zhu, Huilin Li, Hong Fang Liu, Aimei Cao, Zhu Yan, Yali An, Yujing Bai, Qiang Wang, Zhong Zhen, Chunhao Yu, Chong-Zhi Wang, Chun-Su Yuan* and Xiaolin Tong*
Abstract
Context: Living in a prediabetes state significantly increases a patient's risk for both diabetes and cardiovascular disease. Tianqi capsule, containing 10 Chinese herbal medicines, is used in China for the treatment of type 2 diabetes mellitus (T2DM).
Objective: The purpose of this study was to assess whether Tianqi prevented T2DM in subjects with impaired glucose tolerance (IGT) over the course of a 12-month treatment.
Methods: Individuals with IGT were randomly allocated in a double-blind manner to receive Tianqi (n = 210) or a placebo (n = 210) for 12 months. Oral glucose tolerance tests were conducted every 3 months to assess the development of diabetes or restoration to normal glucose tolerance. All subjects received the same lifestyle education. The primary endpoint was the conversion of IGT to T2DM. Body weight and body mass index were observed. Adverse effects were monitored.
Results: Of the 420 enrolled subjects with IGT, 389 completed the trial (198 in the Tianqi group and 191 in the placebo group). At the end of the 12-month trial, 36 subjects in the Tianqi group (18.18%) and 56 in the placebo group (29.32%) had developed diabetes (P = .01). There was a significant difference in the number of subjects who had normal glucose tolerance at the end of the study between the Tianqi and placebo groups (n = 125, 63.13%, and n = 89, 46.60%, respectively; P = .001). Cox's proportional hazards model analysis showed that Tianqi reduced the risk of diabetes by 32.1% compared with the placebo. No severe adverse events occurred in the trial. There were no statistical differences in body weight and body mass index changes between the Tianqi group and the placebo group during the 12-month trial.
Conclusions: Treatment with a Tianqi capsule for 12 months significantly decreased the incidence of T2DM in subjects with IGT, and this herbal drug was safe to use.
Source : The Journal of Clinical Endocrinology & Metabolism
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Curcumin and Diabetes: A Systematic Review
Dong-wei Zhang,1 Min Fu,2 Si-Hua Gao,1 and Jun-Li Liu2
1Diabetes Research Center, Beijing University of Chinese Medicine, Beijing 100029, China
2Fraser Lab for Diabetes Research, McGill University Health Center, Montreal, Canada H3A 1A1
Abstract
Turmeric (Curcuma longa), a rhizomatous herbaceous perennial plant of the ginger family, has been used for the treatment of diabetes in Ayurvedic and traditional Chinese medicine. The active component of turmeric, curcumin, has caught attention as a potential treatment for diabetes and its complications primarily because it is a relatively safe and inexpensive drug that reduces glycemia and hyperlipidemia in rodent models of diabetes. Here, we review the recent literature on the applications of curcumin for glycemia and diabetes-related liver disorders, adipocyte dysfunction, neuropathy, nephropathy, vascular diseases, pancreatic disorders, and other complications, and we also discuss its antioxidant and anti-inflammatory properties. The applications of additional curcuminoid compounds for diabetes prevention and treatment are also included in this paper. Finally, we mention the approaches that are currently being sought to generate a “super curcumin” through improvement of the bioavailability to bring this promising natural product to the forefront of diabetes therapeutics.
Conclusion
Recent research has provided the scientific basis for “traditional” curcumin and confirmed the important role of curcumin in the prevention and treatment of diabetes and its associated disorders. Curcumin could favorably affect most of the leading aspects of diabetes, including insulin resistance, hyperglycemia, hyperlipidemia, and islet apoptosis and necrosis (Figure 2). In addition, curcumin could prevent the deleterious complications of diabetes. Despite the potential tremendous benefits of this multifaceted nature product, results from clinical trials of curcumin are only available in using curcumin to treat diabetic nephropathy, microangiopathy and retinopathy so far. Studies are badly needed to be done in humans to confirm the potential of curcumin in limitation of diabetes and other associated disorders. Further, multiple approaches are also needed to overcome limited solubility and poor bioavailability of curcumin. These include synthesis of curcuminoids and development of novel formulations of curcumin, such as nanoparticles, liposomal encapsulation, emulsions, and sustained released tablets. Enhanced bioavailability and convinced clinical trial results of curcumin are likely to bring this promising natural product to the forefront of therapeutic agents for diabetes by generating a “super curcumin” in the near future.
Source : Journal Evidence Based Complementary and Alternative Medicine
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Efficacy of Purple Passion Fruit Peel Extract in Lowering Cardiovascular Risk Factors in Type 2 Diabetic Subjects
The clinical efficacy of purple passion fruit peel extract (a flavonoid-rich dietary supplement) in reducing cardiovascular risk factors in adult type 2 diabetic subjects was investigated in a randomized, double-blind, placebo-controlled trial. Forty-one subjects were randomly assigned to receive a daily dose of purple passion fruit (220 mg) or a matched placebo for 16 weeks. Body mass index, blood pressure, fasting and postprandial blood glucose, glycated hemoglobin, and lipid profile were determined at baseline and at monthly intervals. A significant reduction in systolic blood pressure and fasting blood glucose was observed following administration of purple passion fruit (P < .05). Purple passion fruit was well tolerated, and no adverse events were reported. These data suggest that purple passion fruit supplementation for 16 weeks in type 2 diabetics results in a significant reduction in systolic blood pressure and fasting blood glucose, indicating that purple passion fruit is safe and well tolerated by diabetics.
Source : Journal Evidence Based Complementary and Alternative Medicine
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BPA, phthalates tied to kids' weight, diabetes risk
Children exposed to two chemicals commonly used in food packaging are more likely to be obese or show signs of diabetes precursors than those with lower exposure, new research suggests.
Researchers found urine levels of one type of phthalate, used to soften plastic, were tied to a higher risk of insulin resistance among teenagers. Based on data from the same large nutrition survey, another study group linked bisphenol A, or BPA - used to line aluminum cans - to obesity and larger waists in youth.
According to the Centers for Disease Control and Prevention, about one in six U.S. children and teenagers is now obese.
"Clearly unhealthy diet and lack of physical activity are the drivers of this epidemic … but increasingly environmental chemicals are being identified as possible contributors," Dr. Leonardo Trasande, a pediatrician from New York University, said.
He and his colleagues analyzed data from a nationally-representative health and nutrition survey conducted in 2003 to 2008, which included urine and blood tests for 766 adolescents aged 12 to 19.
They found urinary levels of one particular type of phthalate, known as Di-2-ethylhexylphthalate (DEHP), were closely tied to a teenager's chance of having insulin resistance, a precursor to diabetes.
Just under 15 percent of study participants with the lowest one-third of DEHP levels were insulin resistant, compared to almost 22 percent of those with the highest levels.
DEHP, Trasande said, is often used to soften plastic bottles. It's used in plastic that is printed with the number 3 for recycling.
The researchers said their findings don't prove that eating food packaged with phthalates causes insulin resistance. For example, it's possible children who are already insulin-resistant have unhealthier eating habits and eat and drink more packaged products - thus the higher phthalate levels in their urine.
But Trasande told Reuters Health the chemical may influence how the body secretes insulin in response to sugar.
Because of that, he tells parents to avoid buying plastics made with DEHP.
"I advise them not to wash plastic containers in the dishwasher," he said. And, "When the plastic is clearly etched or damaged, it's time to throw it away."
MORE EVIDENCE ON BPA
For a separate study published concurrently in Pediatrics, Dr. Joyce Lee from the University of Michigan in Ann Arbor and her colleagues used nutrition survey data through 2010 to compare BPA levels in the urine of six- to 18-year-olds with other health measures.
In their analysis of 3,370 kids, BPA - an industrial chemical that may mimic estrogen in the body - was not linked to insulin resistance or blood sugar.
But children with higher BPA levels were more likely to be obese, and tended to have a higher waist circumference-to-height ratio, than those with the lowest levels.
A total of 18 percent of kids in the study were obese, based on CDC growth charts. Compared to children with the lowest BPA levels, the 25 percent with the highest levels were twice as likely to meet the cutoff for obesity.
The average child had 2.6 nanograms, or 2.6 billionths of a gram, of BPA in every milliliter of urine.
The findings are in line with a 2012 study that used some of the same data and also linked BPA in kids' urine to their chance of being overweight or obese, without proving a cause-and-effect relationship (see Reuters Health story of September 18, 2012 here: reut.rs/PDrxzL).
"That study adds further concerns to the ongoing use of BPA in food," Trasande said.
"There are a variety of chemicals used in children's products including BPA as well as other chemicals of less notoriety that our kids are exposed to on a daily basis, for which there are unknown health effects," Lee told Reuters Health in an email.
"Although the evidence about BPA and adverse health effects are not definitive, as a clinician, I do recommend that parents try to avoid BPA-containing plastics when possible to minimize their family's exposure. I also tell them to avoid microwaving food in plastic containers, as this can lead to chemicals leaking into the food," Lee said.
Still, one researcher cautioned that urinary levels of BPA and other chemicals may not say a lot about how much actually gets into children's blood and tissues.
"Everybody who does BPA studies uses the urine for a surrogate of exposure. It's erroneous, because the urine is purely what the person took in that day in BPA," Dr. Robert Brent from Alfred I. DuPont Hospital for Children in Wilmington, Delaware, who wrote an editorial accompanying the new studies, said.
"In order to know what exposure is you have to have the blood level of the chemical," he told Reuters Health - as well as how quickly it breaks down in the blood.
Last year the U.S. Food and Drug Administration banned BPA from baby bottles, but said there was not enough evidence for a more widespread ban. The FDA has not placed regulations on phthalates in food products, Trasande's team noted.
Source : Reuters
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Antidiabetic and antioxidant properties of Ficus deltoidea fruit extracts and fractions
Hasni Misbah1, Azlina A Aziz2 and Norhaniza Aminudin3*
1. Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
2 University Malaya Centre for Proteomics Research (UMCPR), Medical Biotechnology Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
3 Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
Abstract
Background
Diabetes is a serious metabolic disorder affecting the metabolism of carbohydrate, protein and fat. A number of studies have shown that diabetes mellitus is associated with oxidative stress, leading to an increased production of reactive oxygen species. Ficus deltoidea is traditionally used in Malaysia for regulating blood sugar, blood pressure and cholesterol levels. The use of F. deltoidea as an alternative medicinal herb is increasingly gaining popularity with the sale of F. deltoidea tea bags and capsules in the local market. The present study was undertaken to investigate the antidiabetic and antioxidant activities of the fruits from different varieties of F. deltoidea, employing in vitro methods.
Method
Two fruit varieties of F. deltoidea (var. angustifolia (SF) and var. kunstleri (BF)) were extracted separately using double-distilled water. The resulting aqueous extracts were partitioned using ethyl acetate to obtain the ethyl acetate and water fractions. The crude aqueous extracts and the corresponding fractions were evaluated for their phenolic, flavonoid, sugar and protein contents. Protein profiling of the extracts and fractions were also carried out by means of SDS-PAGE and SELDI-TOF MS. Antidiabetic activities were assessed based on the ability of the samples to inhibit yeast and mammalian α-glucosidase as well as α-amylase. Antioxidant capacities were examined by measuring the ability of the samples to reduce ferric ions and to scavenge DPPH, superoxide anion, ABTS and nitric oxide radicals.
Results
The crude extracts and fractions of SF and BF inhibited both yeast and rat intestinal α-glucosidases in a dose-dependent manner, but did not inhibit porcine pancreatic α-amylase. The water fraction of BF showed the highest percentage of α-glucosidase inhibition while having the highest amount of protein (73.33 ± 4.99 μg/mg fraction). All the extracts and fractions exhibited antioxidant activities, with SF crude extract showing the highest antioxidant activity and phenolic content (121.62 ± 4.86 mg/g extract). Fractionation of the crude extracts resulted in loss of antioxidant activities. There was no positive correlation between phenolic and flavonoid content with α-glucosidase inhibitory activities. However, phenolic content correlated well with antioxidant activities of the crude extracts but not with the fractions.
Conclusions
The antioxidant activities of the fruits of F. deltoidea might be asserted by the phenolic content but other polar plant components were possibly involved in the antidiabetic properties. The study of these compounds having both antihyperglycemic and antioxidant activities may provide a new approach in the treatment of diabetes mellitus.
Source : BMC Complementary and Alternative Medicine
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Treating Type 2 Diabetes Mellitus with Traditional Chinese and Indian Medicinal Herbs
Zhijun Wang,1 Jeffrey Wang,1,2 and Patrick Chan3
1Center for Advancement of Drug Research and Evaluation, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
2Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
3Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
Abstract
Type II diabetes mellitus (T2DM) is a fast-growing epidemic affecting people globally. Furthermore, multiple complications and comorbidities are associated with T2DM. Lifestyle modifications along with pharmacotherapy and patient education are the mainstay of therapy for patients afflicted with T2DM. Western medications are frequently associated with severe adverse drug reactions and high costs of treatment. Herbal medications have long been used in the treatment and prevention of T2DM in both traditional Chinese medicine (TCM) and traditional Indian medicine (TIM). This review examines in vivo, in vitro, and clinical evidence supporting the use of various herbs used in TCM and TIM. The problems, challenges, and opportunities for the incorporation of herbal frequently used in TCM and TIM into Western therapy are presented and discussed.
Conclusion
It is evident that many TCM/TIM herbs possess anti-DM activities by interacting with various proven drug targets where Western drugs interact. Because of their empirically known oral efficacy and safety profiles, nutritional supplement status, multiple components for multiple drug targets, low cost, and easy access, TCM/TIM herbs such as ginseng, mulberry, and Radix coptidis are excellent candidates for long-term use for the prevention and treatment of T2DM. During the development stage, product standardization, quality control and assurance, placebo-controlled and randomized clinical trials are essential components that need to be perfected in order to translate their potential into a reality that millions of people could benefit upon.
Source : Evidence Based Complementary and Alternative Medicine
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Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III
Tripathi B Rajavashisth1,2, Magda Shaheen3, Keith C Norris3, Deyu Pan3, Satyesh K Sinha1, Juan Ortega1, Theodore C Friedman1
1Division of Endocrinology, Metabolism, and Molecular Medicine, Los Angeles, California, USA
2Omics Biotechnology, Inc, Lawndale, California, USA
3Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
Abstract
Objective
To determine the association between diabetes mellitus (DM) and marijuana use.
Design
Cross-sectional study.
Setting
Data from the National Health and Nutrition Examination Survey (NHANES III, 1988–1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.
Participants
The study included participants of the NHANES III, a nationally representative sample of the US population. The total analytic sample was 10 896 adults. The study included four groups (n=10 896): non-marijuana users (61.0%), past marijuana users (30.7%), light (one to four times/month) (5.0%) and heavy (more than five times/month) current marijuana users (3.3%). DM was defined based on self-report or abnormal glycaemic parameters. We analysed data related to demographics, body mass index, smoking status, alcohol use, total serum cholesterol, high-density lipoprotein, triglyceride, serum 25-hydroxy vitamin D, plasma haemoglobin A1c, fasting plasma glucose level and the serum levels of C reactive protein and four additional inflammatory markers as related to marijuana use.
Main outcome measures
OR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).
Results
Marijuana users had a lower age-adjusted prevalence of DM compared to non-marijuana users (OR 0.42, 95% CI 0.33 to 0.55; p<0.0001). The prevalence of elevated C reactive protein (>0.5 mg/dl) was significantly higher (p<0.0001) among non-marijuana users (18.9%) than among past (12.7%) or current light (15.8%) or heavy (9.2%) users. In a robust multivariate model controlling for socio-demographic factors, laboratory values and comorbidity, the lower odds of DM among marijuana users was significant (adjusted OR 0.36, 95% CI 0.24 to 0.55; p<0.0001).
Conclusions
Marijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.
Source : BMJ
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The Impact of Marijuana Use on Glucose, Insulin, and Insulin Resistance among US Adults
Elizabeth A. Penner, BS Hannah Buettner, BA Murray A. Mittleman, MD, DrPH
Department of Epidemiology, Harvard School of Public Health, Boston, Mass
Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
Requests for reprints should be addressed to Murray A. Mittleman, MD, DrPH, 375 Longwood Ave, Boston, MA 02215.
Abstract
Background
There are limited data regarding the relationship between cannabinoids and metabolic processes. Epidemiologic studies have found lower prevalence rates of obesity and diabetes mellitus in marijuana users compared with people who have never used marijuana, suggesting a relationship between cannabinoids and peripheral metabolic processes. To date, no study has investigated the relationship between marijuana use and fasting insulin, glucose, and insulin resistance.
Methods
We included 4657 adult men and women from the National Health and Nutrition Examination Survey from 2005 to 2010. Marijuana use was assessed by self-report in a private room. Fasting insulin and glucose were measured via blood samples after a 9-hour fast, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated to evaluate insulin resistance. Associations were estimated using multiple linear regression, accounting for survey design and adjusting for potential confounders.
Results
Of the participants in our study sample, 579 were current marijuana users and 1975 were past users. In multivariable adjusted models, current marijuana use was associated with 16% lower fasting insulin levels (95% confidence interval [CI], −26, −6) and 17% lower HOMA-IR (95% CI, −27, −6). We found significant associations between marijuana use and smaller waist circumferences. Among current users, we found no significant dose-response.
Conclusions
We found that marijuana use was associated with lower levels of fasting insulin and HOMA-IR, and smaller waist circumference.
Source : The American Journal of Medicine
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Olive (Olea europaea L.) Leaf Polyphenols Improve Insulin Sensitivity in Middle-Aged Overweight Men: A Randomized, Placebo-Controlled, Crossover Trial
Martin de Bock, José G. B. Derraik, Christine M. Brennan, Janene B. Biggs, Philip E. Morgan, Steven C. Hodgkinson, Paul L. Hofman, Wayne S. Cutfield
Abstract
Background
Olive plant leaves (Olea europaea L.) have been used for centuries in folk medicine to treat diabetes, but there are very limited data examining the effects of olive polyphenols on glucose homeostasis in humans.
Objective
To assess the effects of supplementation with olive leaf polyphenols (51.1 mg oleuropein, 9.7 mg hydroxytyrosol per day) on insulin action and cardiovascular risk factors in middle-aged overweight men.
Design
Randomized, double-blinded, placebo-controlled, crossover trial in New Zealand. 46 participants (aged 46.4±5.5 years and BMI 28.0±2.0 kg/m2) were randomized to receive capsules with olive leaf extract (OLE) or placebo for 12 weeks, crossing over to other treatment after a 6-week washout. Primary outcome was insulin sensitivity (Matsuda method). Secondary outcomes included glucose and insulin profiles, cytokines, lipid profile, body composition, 24-hour ambulatory blood pressure, and carotid intima-media thickness.
Results
Treatment evaluations were based on the intention-to-treat principle. All participants took >96% of prescribed capsules. OLE supplementation was associated with a 15% improvement in insulin sensitivity (p = 0.024) compared to placebo. There was also a 28% improvement in pancreatic β-cell responsiveness (p = 0.013). OLE supplementation also led to increased fasting interleukin-6 (p = 0.014), IGFBP-1 (p = 0.024), and IGFBP-2 (p = 0.015) concentrations. There were however, no effects on interleukin-8, TNF-α, ultra-sensitive CRP, lipid profile, ambulatory blood pressure, body composition, carotid intima-media thickness, or liver function.
Conclusions
Supplementation with olive leaf polyphenols for 12 weeks significantly improved insulin sensitivity and pancreatic β-cell secretory capacity in overweight middle-aged men at risk of developing the metabolic syndrome.
Source : Plos One
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Efficacy and Safety of Traditional Chinese Medicine for Diabetes: A Double-Blind, Randomised, Controlled Trial
Linong Ji,1,* Xiaolin Tong,2 Hongyuan Wang,3 Haoming Tian,4 Huimin Zhou,5 Lili Zhang,6 Qifu Li,7 Yizhong Wang,8 Hongmei Li,9 Min Liu,10 Hongjie Yang,11 Yanbin Gao,12 Yan Li,13 Quanmin Li,14 Xiaohui Guo,15 Gangyi Yang,16 Zhongai Zhang,17 Zhiguang Zhou,18 Guang Ning,19 Yingli Chen,1 Sanjoy Paul,20,*,
for the Evidence-Based Medical Research of Xiaoke Pill Study Group and the Evidence-Based Medical Research of Xiaoke Pill Study Group¶Jianping Ye, Editor
Abstract
BackgroundTreatment of diabetes mellitus with Traditional Chinese Medicine has a long history. The aim of this study is to establish the safety and efficacy of traditional Chinese medicine combined with glibenclamide to treat type 2 diabetes mellitus.
Methods
In a controlled, double blind, multicentre non-inferiority trial, 800 patients with unsatisfactory glycemic control (fasting glucose 7–13 mmol/L and HbA1c 7–11%) were randomly assigned to receive Xiaoke Pill, a compound of Chinese herbs combined with glibenclamide, or Glibenclamide in two study groups – drug naive group, and patients previously treated with metformin monotherapy (metformin group). Outcome measures at 48 weeks were the incidence and rate of hypoglycemia, mean difference in HbA1c, and proportion of patients with HbA1c<6.5%.
Findings
In drug naïve group, the total hypoglycemia rate and the mild hypoglycemic episode in the Xiaoke Pill arm were 38% (p=0.024) and 41% (p=0.002) less compared to Glibenclamide arm; in Metformin group, the average annual rate of hypoglycemia was 62% lower in Xiaoke Pill arm (p=0.003). Respective mean changes in HbA1c from baseline were −0.70% and −0.66% for Xiaoke Pill and Glibenclamide, with a between-group difference (95% CI) of −0.04% (−0.20, 0.12) in the drug naïve group, and those in metformin group were −0.45% and −0.59%, 0.14% (−0.12, 0.39) respectively. The respective proportions of patients with a HbA1c level <6.5% were 26.6% and 23.4% in the drug naïve group and 20.1% and 18.9% in the metformin group.
Interpretation
In patients with type 2 diabetes and inadequate glycaemic control, treatment with Xiaoke Pill led to significant reduction in risk of hypoglycemia and similar improvements in glycemic control after 48 weeks compared to Glibenclamide.
Source : PLoS One. 2013; 8(2): e56703.
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Mangos Help Regulate Blood Sugar Levels Among Obese People
The positive health effects of Mangos have been recently explored and presented by researchers at the Federation of American Societies for Experimental Biology (FASEB). They found that mangos have properties that can help regulate blood sugar levels among people suffering from obesity.
*The study, which was led by Edralin Lucas, Ph.D., evaluated what effect eating mangos everyday would have on a total of twenty obese adult people. The participants ate 10 grams of freeze-dried mango everyday for 12 weeks.
At the end of the study period they found that the blood sugar levels of the participants were much lower than at the start of the study.
Among both genders there wasn't any substantial change in body composition, however, BMIs (body mass indexes) went up among the female participants.
The authors noted that these results are only from a single study and that more research is necessary to fully understand the health effects of mango consumption among obese people.
Obesity is a serious public health issue in the U.S., where a total of twelve states have 30+% obesity rates today, compared to just one in 2007. Since 1995, obesity rates have risen by 90+% in 10 states and have doubled in another 7.
According to the Centers for Disease Control and Prevention (CDC), obesity is a main cause of: type 2 diabetes, breast and colon cancer, coronary heart disease, stroke, hypertension, liver and gallbladder disease and high cholesterol.
Researchers have long been looking for factors that can help prevent the health effects of obesity. This study, along with others, shows promise for those suffering from the condition.
According to Dr. Lucas:
"The results of this study support what we learned in our recent animal model, which found that mango improved blood glucose in mice fed a high fat diet. Although the mechanism by which mango exerts its effects warrants further investigation, we do know that mangos contain a complex mixture of polyphenolic compounds.
Research has shown that several other plants and their polyphenolic compounds, such as isoflavone from soy, epigallocatechin gallate from green tea , and proanthocyanidin from grape seed , have a positive effect on adipose tissue."
An average mango has an energy value per 100g of approximately 60 kcal, they have numerous health benefits and nutrients, they are naturally high in prebiotic dietary fiber (substances that encourage the growth of beneficial bacteria, not to be confused with probiotics), vitamin C, and antioxidant vitamins A and C, as well as vitamin B6. Mango contains triterpene and lupeol, which have been found to be an effective inhibitor in laboratory models of prostate and skin cancer.
The health benefits of mango consumption have been explored in previous studies,. Texas AgriLife Research food scientists found that mango able to prevent or stop certain colon and breast cancer cells in the lab.
Written by Joseph Nordqvist
Source : Medical News Today
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More Proof Soft Drinks Tied to Diabetes
By Cole Petrochko
One can -- or one more can -- of soda daily significantly increased the risk of diabetes in a European population, researchers found.
Consuming an additional 12 ounces of sugar-sweetened beverages -- a standard size can of soda -- daily was associated with a 22% (95% CI 1.09 to 1.38) increased risk for diabetes, and an extra can of artificially-sweetened beverage put the risk 52% higher (95% CI 1.26 to 1.83), according to Dora Romaguera-Bosch, PhD, MSc, of Imperial College London in England, and colleagues at the InterAct consortium.
However, only the association between sugar-sweetened beverages and diabetes risk remained significant after adjustment for body mass index and energy intake (HR 1.18, 95% CI 1.06 to 1.32), they wrote online in the journal Diabetologia.
Soda and other artificially- and sugar-sweetened beverages may contribute to diabetes due to their effect on body weight and blood glucose, the researchers wrote. A link between sugary drink consumption and diabetes has also been seen in prior research in American populations.
The authors studied associations between consumption of juices, nectars, sugar-sweetened soft drinks, and artificially-sweetened soft drinks with diabetes incidence in a case-cohort study of 15,374 participants from eight European countries, and including 11,684 incident cases of diabetes.
Cohorts from eight countries were involved in the EPIC (European Prospective Investigation into Cancer and Nutrition)-InterAct study. InterAct specifically looked at incidence of diabetes.
Participants answered dietary questionnaires that measured:
Covariates included smoking status, alcohol intake, education, physical activity, BMI, and, "in most participating centers," baseline chronic conditions, including hypertension, hyperlipidemia, and cardiovascular disease.
Raw scores were also calculated with adjustment for age, sex, BMI category, and physical activity levels.
Compared with those who consumed lower levels of sugary soft drinks, high-level consumers were more likely to be male, physically active, less educated, smokers, and have a higher waist circumference. Juice and nectar high consumers were mostly younger, female, physically active, former smokers, and better educated than those with lower juice and nectar consumption.
Although soft drink consumption was linked with diabetes incidence, there was no association between diabetes and consumption of juices and nectars. One or more glasses daily of soft drink was associated with a 58% increased risk of diabetes compared with those who consumed the lowest levels of soft drinks (P<0.0001).
When this comparison was adjusted for BMI, this trend remained significant, though the association was not as strong (P=0.0005).
Artificially-sweetened soft drink consumption was associated with diabetes risk prior to adjustment for BMI (P<0.0001), but this association lost significance after adjustment (P=0.24).
Consumption of sugar-sweetened soft drinks remained significantly associated with diabetes both before (P<0.0001) and after (P=0.013) adjustment for BMI.
"The observed association between sugar-sweetened soft drinks and diabetes in the present analysis is of similar magnitude as the association reported in a meta-analysis of eight prospective studies, which was based on 15,043 diabetes cases mostly from the U.S.A.," they concluded.
They also noted that future studies should examine whether BMI acts as a mediator or confounder with the association.
The authors said the study was limited by the clinical definition of type 2 diabetes, lack of follow-up dietary data, a definition of juices and nectars that included those with and without added sugar, and possible measurement errors. The study was also limited by center-specific factors, possible residual confounding, and possible reverse causality.
Source : MedPage Today
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Study finds a spoonful of cinnamon improves health
Sprinkling a spoonful of cinnamon on breakfast foods not only adds a burst of flavor but also dramatically lowers an individual's blood sugar levels, potentially reducing the chance of developing diabetes, says a new study from Ball State University.
Ball State researcher Jo Carol Chezem found when healthy weight and obese adults ate a cooked breakfast cereal with 6 grams of cinnamon, blood sugar levels declined by 25 percent for the next two hours compared to participants who did not ingest the spice. The study was reported in the November issue of the Journal of the Academy of Nutrition and Dietetics. Chezem's study involved 37 participants and confirms that in both healthy-weight and obese adults, cinnamon reduces blood glucose concentration and enhances insulin sensitivity, strengthening the body's ability to ward off diabetes. "Nearly 80 million American adults have prediabetes, a condition characterized by high blood glucose that often leads to diabetes," said Chezem, who teaches nutrition in Ball State's Department of Family and Consumer Sciences. "We are very encouraged by the study's results and are planning similar studies in individuals with prediabetes and diabetes." "Although the amount used in the study – 6 grams or about 2 1/2 teaspoons – was much more than a sprinkle, our subjects found the taste acceptable," she said. "Cinnamon can be added to a wide variety of foods. Some ideas include yogurt, iced coffees and teas, fruit smoothies and muffins." These research findings could play a major role in helping millions of Americans stay healthy by simply adding a flavorful ingredient to start their day, she said. Burden of Diabetes Among Adults in Indiana, released by the university's Global Health Institute (GHI) in 2011, found that another 5.6 percent of the adult population in Indiana report having prediabetes or borderline diabetes. The average annual health care cost for a person with diabetes in this country is $11,744 as compared to $2,935 for a person without diabetes "As health care in the United States becomes more expensive, cinnamon may offer a low cost approach to modifying blood glucose," Chezem said. Journal reference: Journal of the Academy of Nutrition and Dietetics
Source : Medicalxpress
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The ancient Tibetan goji berry could help fight blindness caused by long-term diabetes
Faculty of Pharmacy researchers have conducted in vitro tests investigating the potential power of the berry which is now a popular natural remedy.
According to lead researcher, University of Sydney Professor of Pharmaceutical Chemistry Basil Roufogalis, the goji berry is abundant in taurine, an ingredient credited with anti-oxidative, anti-inflammatory and immuno-modulating properties which could protect the retina.
"Diabetic retinopathy is a leading cause of blindness for people with diabetes, with up to 60 per cent of people living with either type 1 or type 2 diabetes developing chronic hyperglycaemia, a condition which can damage retina cells," explains Professor Roufogalis.
"Typically what happens is proteins in the eye become oxidated and high glucose levels force retinal cells to die.
"What's more, blood vessels build up in the retina and grow over the vision spot, which can result in vision loss."
The pharmacy researchers initially undertook work showing the goji berry and its taurine component activated a nuclear receptor protein called PPAR-gamma. This protein plays a crucial role in regulating the retinal cells. This paved the way for further investigation of Lycium barbarum (goji) and its potential to activate the PPAR-gamma receptor.
"First we looked at the protective effect of pure taurine, and an extract of goji berry rich in taurine, in retinal barrier epithelial cells exposed to high glucose - a cell line that can serve as a model to emulate diabetic retinopathy."
"We found that goji berry protected against the death of cells caused by high concentrations of glucose in the retina. This protection occurred in parallel with the activation by the extract of the receptor protein (PPAR-gamma). The pure taurine found in the extract mimicked the effects of the goji berry extract.
"We then wanted to see whether the same extracts of goji berry and its pure taurine and had an effect on protecting the retinal barrier against toxin invasion when the barrier is typically damaged by high glucose in diabetes patients," said Professor Roufogalis.
"What we found is that both the pure taurine and the taurine-laden goji berry extract protected the retina against increased permeability of the protective barrier through its actions on the PPAR-gamma receptor, thereby helping the epithelial cells that provide the protective barrier to the retina."
"We are hopeful that these promising results for treating or preventing diabetic retinopathy will lead to human clinical trials," said Professor Roufogalis.
Ms Min Song, from the Faculty of Pharmacy, received a National Institute of Complementary Medicine (NICM) PhD scholarship to assist in the groundbreaking research. NICM, hosted by the University of Western Sydney, was launched in 2007 to facilitate strategic research in complementary medicine in Australia.
Professor Alan Bensoussan, director of NICM, hailed the novel research.
"This is pioneering scientific research in the field of herbal medicine, and is to be applauded for investigating novel ways to address the debilitating effects of diabetes, which is such a pressing global health problem," he said.
Source : NICM
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Intensive Program May Reverse Diabetes
Intense lifestyle-based weight-loss interventions were associated with a partial remission of diabetes, researchers found.
Compared with an education and support intervention for diabetes patients, those engaged in an intense weight-loss and lifestyle intervention were more likely to experience any remission at year 1 (11.5% versus 7.3%, P<0.001), and were more likely to see that remission continuously sustained over 3 years of measurements (9.2%, 6.4%, and 3.5% versus 1.7%, 1.3%, and 0.5%, respectively), according to Edward Gregg, PhD, of the Centers for Disease Control and Prevention, and colleagues.
Participants in the intervention group also lost significantly more weight at two follow-up periods (a difference of 7.9% at year one and 3.9% at year four, P<0.001 for both), and significantly fewer participants in the weight-loss intervention who experienced remission returned to clinical diabetes status at each point of follow-up, they wrote online in the Journal of the American Medical Association.
The researchers also noted that the weight-loss intervention was particularly effective in "those whose diabetes is of short duration, who have lower hemoglobin A levels, and who do not yet require insulin therapy."
Patients diagnosed as having type 2 diabetes frequently ask if their condition is reversible, and "some physicians may provide hopeful advice that lifestyle change can normalize glucose levels," they wrote in the introduction to their findings. "However, the rate of remission of type 2 diabetes that may be achieved using nonsurgical approaches has not been reported."
To help clarify the issue, the researchers investigated the outcomes of a long-term (4 years) intensive weight-loss intervention on frequency of remission from diabetes to prediabetes or normoglycemia in 2,241 participants and compared them with a sample of 2,262 diabetes patients participating in a diabetes and support education intervention.
The intensive weight-loss intervention included weekly group and individual counseling for the first 6 months focused on reducing caloric intake, decreasing consumption of total and saturated fats, and increasing physical activities; this was followed by three sessions per month for the second 6 months and twice-monthly sessions over years 2 to 4. Participants also were offered liquid meal replacements to help with dietary goals.
In the support education intervention participants were given three group sessions annually that offered information on diet, physical activity, and social support.
Participants in each group were evaluated at baseline and once at each year of the 4 years of follow-up for health status, including body mass index and glycemic status. Participant fitness also was assessed at baseline through a maximal graded exercise test and at years one and four through a submaximal exercise test.
The participants were 45 to 75 years old with a mean age of 59 years, had a median time since diabetes diagnosis of 5 years, and were "notably obese at baseline."
In addition to losing more weight, the weight-loss intervention group had greater increases in fitness in years one and four (20.6% versus 4.9% and 5.3% versus 1.5%, respectively, P<0.001 for both) than those in the education group.
Complete remission -- defined as glucose normalization without medication -- was more common among the lifestyle weight-loss participants than the education group (prevalence ratio 6.6, 95% CI 3.3 to 13.3, P<0.001). Absolute prevalence of complete remission was low overall, the authors noted.
Participants were significantly more likely to experience either partial or complete remission in the lifestyle intervention than in the education intervention at years 1 and 4 (P<0.001 for both).
Return to clinical diabetes status occurred in roughly one-third of the lifestyle intervention group each year (33.1% at year two, 33.8% at year three, and 31.6% at year four) versus around half among participants in the education group (52.4% at year two, 45.9% at year three, and 43.8% at year four).
In addition, continuous, sustained remission was significantly more common among weight-loss intervention participants than in the education group at years two to four (P<0.001 for all).
In an accompanying editorial, David Arterburn, MD, of the Group Health Research Institute in Seattle Wash., and Patrick O'Connor, MD, of the Institute for Education and Research in Minneapolis, Minn., noted that neither intervention translated to "lower rates of nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, or death compared with conventional diabetes treatment."
They editorialists speculated that this was due to overall lower-than-expected rates of cardiovascular events due to improved risk factor control in each group, improved critical care after acute cardiovascular events, a healthier-than-expected cohort, and exclusion of participants with high cardiovascular risk at baseline.
They also noted that bariatric surgery achieves an effective reduction in cardiovascular events and mortality rates.
The study was limited by a lack of pure intention-to-treat approach, a non-ideal study population that likely underestimated frequency of remission, lack of evaluation of each intervention's impact on insulin resistance, and greater likelihood of healthcare professionals modifying medications in the education group.
Source : MedPage Today
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Drinking Green Tea With Starchy Food May Help Lower Blood Sugar Spikes
An ingredient in green tea that helps reduce blood sugar spikes in mice may lead to new diet strategies for people, according to Penn State food scientists.
Mice fed an antioxidant found in green tea -- epigallocatechin-3-gallate, or EGCG -- and corn starch had a significant reduction in increase in their blood sugar -- blood glucose -- levels compared to mice that were not fed the compound, according to Joshua Lambert, assistant professor of food science in agricultural sciences.
"The spike in blood glucose level is about 50 percent lower than the increase in the blood glucose level of mice that were not fed EGCG," Lambert said.
The dose of EGCG fed to the mice was equivalent to about one and a half cups of green tea for a human.
Lambert, who worked with Sarah C. Forester, postdoctoral fellow, and Yeyi Gu, graduate student, both in food science, said EGCG was most effective when the compound was fed to the mice simultaneously with corn starch. For humans, this may mean that green tea could help them control the typical blood sugar increases that are brought on when they eat starchy foods, like breads and bagels that are often a part of typical breakfasts.
"If what you are eating with your tea has starch in it then you might see that beneficial effect," Lambert said. "So, for example, if you have green tea with your bagel for breakfast, it may reduce the spike in blood glucose levels that you would normally get from that food."
The EGCG had no significant effect on blood sugar spikes in mice that were fed glucose or maltose, according to the researchers who released their findings in the online version of Molecular Nutrition and Food Research. Lambert said that the reason blood sugar spikes are reduced when the mice ate starch, but not these sugars, may be related to the way the body converts starch into sugar.
An enzyme called alpha-amylase that is produced in both the mouth and by the pancreas helps break down starch into maltose and glucose. EGCG may inhibit the enzymes ability to break down the starch, the researchers indicated, since they also found that EGCG reduced the activity of alpha amylase in the pancreas by 34 percent.
If the mechanism holds in humans, this may mean that people who want to limit the blood sugar spike should skip adding sugar to their cup of green tea.
"That may mean that if you add sugar into your green tea, that might negate the effect that the green tea will have on limiting the rise in blood glucose level," Lambert said.
Lambert added that the green tea and the starch would need to be consumed simultaneously. For example, drinking a cup of tea well after eating a piece of toast would probably not change the blood sugar spike.
For the study, researchers separated mice into several groups based on body weight. After a fasting period, the mice were given common corn starch, maltose, or sucrose. One group of mice received EGCG along with the feed, while a control group was not fed the compound.
The researchers then tested the blood sugar levels of both groups.
Lambert said the researchers next step is to test the compound on people.
"The relatively low effective dose of EGCG makes a compelling case for studies in human subjects," the researchers said.
Source : Science Daily
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Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis
A J Cooper1, N G Forouhi1, Z Ye1, B Buijsse2, L Arriola3,4,5, B Balkau6,7, A Barricarte5,8, J W J Beulens9, H Boeing2, F L Büchner10, C C Dahm11,12, B de Lauzon-Guillain7,13, G Fagherazzi13, P W Franks14,15, C Gonzalez16, S Grioni17, R Kaaks18, T J Key19, G Masala20, C Navarro5,21,22, P Nilsson23, K Overvad11,12, S Panico24, J Ramón Quirós25, O Rolandsson15, N Roswall26, C Sacerdote27,28, M-J Sánchez5,29, N Slimani30, I Sluijs9, A M W Spijkerman10, B Teucher18, A Tjonneland31, R Tumino32,33, S J Sharp1, C Langenberg1, E J M Feskens34, E Riboli35, N J Wareham1 and The InterAct Consortium
Abstract
Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case–cohort study nested within eight European countries, a representative sample of 16 154 participants and 12 403 incident cases of T2D were identified from 340 234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80–1.01) for FVI; 0.89 (0.76–1.04) for fruit and 0.94 (0.84–1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77–0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87–1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74–0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.
Source : European Journal of Clinical Nutrition (2012) 66, 1082–1092; doi:10.1038/ejcn.2012.85
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Curcuminoid Extract Lowered the Risk for Type 2 Diabetes Mellitus Development in Prediabetic Subjects
Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C, Jirawatnotai S. Curcumin extract for prevention of type 2 diabetes. Diabetes Care. July 6, 2012;[epub ahead of print]. doi: 10.2337/dc12-0116.
More than 300 million people worldwide have type 2 diabetes mellitus (T2DM), and its prevalence continues to increase. Persons with prediabetes (having blood glucose levels higher than normal but not high enough to be diagnosed as diabetes) can often prevent the development of the disease by making lifestyle changes, but those changes are often challenging. Effective therapeutic agents, with relatively low cost and low toxicity, are needed to control the progression of the disease. Curcumin, the principal curcuminoid in turmeric (Curcuma longa), has been shown to possess anti-inflammatory and antidiabetic properties. These authors conducted a randomized, double-blind, placebo-controlled trial to determine the effectiveness of a curcuminoid extract in preventing the development of T2DM.
The 12-month trial was conducted at the HRH Princess Maha Chakri Sirindhorn Medical Center of Srinakharinwirot University in Nakornnayok, Thailand. Eligible subjects were instructed to follow the same protocols for diet and exercise for 3 months after enrollment while awaiting randomization. Standard lifestyle recommendations were provided, and all subjects were counseled one-on-one on the importance of a healthy lifestyle.
Persons aged 35 years and older with prediabetes, as defined by the American Diabetes Association (ADA) guidelines, were included. Eligible subjects had at least 1 of these 3 criteria: fasting plasma glucose (FPG) between 100 mg/dL and 124 mg/dL; an oral glucose tolerance test (OGTT) at 2 hours post-glucose load between 140 mg/dL and 199 mg/dL; and a glycated hemoglobin (HbA1c) range from 5.7% to 6.4%.
The 237 subjects (with 3 dropouts after randomization) were randomly assigned to either the curcumin-treated group (n=118) or the placebo-treated group (n=116). Baseline characteristics were similar between the 2 groups.
All subjects were instructed to take 3 capsules twice daily for 9 months. The curcuminoid extract was prepared by extracting dried, powdered turmeric with ethanol and removing the oleoresin. Each curcumin capsule contained 250 mg curcuminoids (curcumin, demethoxycurcumin, and bisdemethoxycurcumin in a peak ratio of 1:≤0.6:≤0.4, respectively). Compliance rates were determined by the number of capsules the subjects returned at their follow-up visits at 3, 6, and 9 months.
The primary outcome was the number of subjects in the 2 groups diagnosed with T2DM according to ADA guidelines. Secondary outcomes were changes in β-cell functions (homeostasis model assessment [HOMA]-β, C-peptide, and proinsulin/insulin ratio); insulin resistance (IR) by HOMA-IR; obesity; abdominal obesity; and anti-inflammatory cytokine (adiponectin). β-cells store and release insulin, which controls the level of glucose in the blood.
The authors report that at all visits (months 3, 6, and 9), the diabetes-related blood chemistries (FPG, OGTT at 2 h, and HbA1c) used to measure the progression of the disease were all significantly lower in the curcumin-treated group compared with the placebo-treated group (P<0.01). For example, at month 9, FPG in the curcumin-treated group was 86.47 mg/dL (range=73-122 mg/dL) compared with 108.21 mg/dL (range=80-138 mg/dL) in the placebo-treated group. Mean baseline FPG values were 103.65 mg/dL in the curcumin-treated group and 103.24 mg/dL in the placebo-treated group.
In their assessments of β-cell function, the authors discovered that HOMA-β in the curcumin-treated group was increasingly elevated at all follow-up visits and became statistically significant at month 9 (P<0.01). C-peptide levels were significantly lower in the curcumin-treated group compared with the placebo-treated group at 9 months (P<0.05). The proinsulin/insulin ratio showed a nonsignificant, lower trend in the curcumin-treated group.
The mean levels of HOMA-IR were lower in the curcumin-treated group than in the placebo-treated group at all visits. The differences were significant at months 6 (P<0.05) and 9 (P<0.001). Adiponectin levels, unchanged in the placebo-treated group, gradually increased at months 3 and 6 in the curcumin-treated group and became significantly different than the placebo-treated group at month 9 (P<0.05).
None of the subjects in either group showed any change in kidney or liver functions. A few subjects in the curcumin-treated group reported minor adverse side effects such as itching, constipation, or vertigo.
The authors report that none of the subjects in the curcumin-treated group developed T2DM in regard to the primary outcome; however, the following numbers of subjects in the placebo-treated group developed T2DM: 11 (9.5%) at month 6; 18 (15.5%) at month 9; and 19 (16.4%) at month 12.
The authors note that the conversion rate of the placebo group was significantly higher than that published in a "well-known" American study.1 They reasoned that the ethnicity of the subjects in their study may account for the high conversion rate. They compared their results with those of a diabetes study of a large Thai cohort2 that identified a set of strong risk factors that accelerate the development of T2DM among the Thai population: old age, high body mass index, high waist circumference, hypertension, and a family history of diabetes. They found that the same factors influenced their study and that their reported rate of development of T2DM was within the estimation of the earlier study.2 "Therefore, we believe that the high conversion rates found in the present study are a common characteristic of Thai prediabetes," they write.
These authors report that the ethanol-extracted curcuminoids used in this study substantially and significantly prevented T2DM development in subjects with prediabetes. They also found that the curcuminoid extract improved β-cell functions.
"Because of its benefits and safety, we propose that curcumin extract may be used for an intervention therapy for the prediabetes population," they write.
―Shari Henson
References
1Knowler WC, Barrett-Connor E, Fowler SE, et al.; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
2Aekplakorn W, Bunnag P, Woodward M, et al. A risk score for predicting incident diabetes in the Thai population. Diabetes Care. 2006;29(8):1872-1877.
Source : American Botanical Council
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Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year
Ryan Bradley1, Karen J Sherman2, Sheryl Catz2, Carlo Calabrese1, Erica B Oberg1, Luesa Jordan2, Lou Grothaus2 and Dan Cherkin2*
1 Bastyr University Research Institute (BURI), Kenmore, WA, 98028, USA
2 Group Health Research Institute (GHRI), Seattle, WA, 98101, USA
Abstract
Background Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC) in primary care patients with inadequately controlled type 2 diabetes.
Methods Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c) values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight). Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment.
Results Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003). Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005). For clinical outcomes, mean HbA1c decreased by −0.90 % (P = 0.02) in the ANC cohort at 6-months, a −0.51 % mean difference compared to usual care (P = 0.07). Reductions at 12-months were not statistically significant (−0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12).
Conclusions Improvements were noted in self-monitoring of glucose, diet, self-efficacy, motivation and mood following initiation of ANC for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits.
Source : BMC - Complementary and Alternative Medicine
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Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes
Abstract
For thousands of years, cinnamon has been used as a traditional treatment in China. However, there are no studies to date that investigate whether cinnamon supplements are able to aid in the treatment of type 2 diabetes in Chinese subjects. We hypothesized cinnamon should be effective in improving blood glucose control in Chinese patients with type 2 diabetes. To address this hypothesis, we performed a randomized, double-blinded clinical study to analyze the effect of cinnamon extract on glycosylated hemoglobin A1c and fasting blood glucose levels in Chinese patients with type 2 diabetes. A total of 66 patients with type 2 diabetes were recruited and randomly divided into 3 groups: placebo and low-dose and high-dose supplementation with cinnamon extract at 120 and 360 mg/d, respectively. Patients in all 3 groups took gliclazide during the entire 3 months of the study. Both hemoglobin A1c and fasting blood glucose levels were significantly reduced in patients in the low- and high-dose groups, whereas they were not changed in the placebo group. The blood triglyceride levels were also significantly reduced in the low-dose group. The blood levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and liver transaminase remained unchanged in the 3 groups. In conclusion, our study indicates that cinnamon supplementation is able to significantly improve blood glucose control in Chinese patients with type 2 diabetes.
Source : Nutrition Research
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INTEGRATING BOTANICALS INTO DIABETES TREATMENT PROTOCOLS
Diabetes is a complex disease that exists in two major forms: insulin- dependent diabetes (IDDM) and non- insulin- dependent or type 2 diabetes mellitus (NIDDM). The vast majority of people with diabetes have NIDDM and presently almost 20% of Americans over the age of 65 suffer from this disorder. It is a growing epidemic and by the year 2010, this percentage is expected to rise to 30%.1 In addition, it is increasingly affecting younger people and can no longer accurately be referred by its old common name of age- onset diabetes. NIDDM is a progressive disease that shows a consistent deterioration in glycemic control over time, and it is estimated that at least a third of patients with NIDDM will ultimately require insulin therapy. This chapter primarily focuses on herbs that are useful in NIDDM. These are used to help patients with this diagnosed disease reduce, delay, or avoid entirely oral hypoglycemic drugs and to avoid developing a need for insulin therapy. They can also be used to help individuals with impaired glucose tolerance (IGT) from manifesting NIDDM.2 While the pathophysiology and pathogenesis of the NIDDM is not fully understood, it is clear that IGT often develops into NIDDM. Moreover, about 11% of American adults (18% of those over 65) suffer
from IGT so interventions that may delay or prevent the progression are desperately needed in our society.
Most of the herbs we discuss are established traditional treatments for diabetic patients, and many are being confi rmed effective in modern clinical trials. However, some very promising treatments are covered that have slight to no investigation. It must be noted that there are other well-established treatments, such as Trigonella foenum- graecum (fenugreek), Panax quinquefolius
(American ginseng), Oplopanax horridum (dev il’s club), and many others that we do not discuss in this chapter. Thus, this chapter is meant to open the door to treatment possibilities, not to be an exhaustive description of any and all possible botanical treatments for diabetes. It should also be noted that the precise mechanisms of action, major active constituents, optimal dose and dose form, and safety for the medicinal plants discussed have not been worked out in a rigorous fashion. Finally, we do not suggest that the herbs in this chapter should be relied upon as the sole treatment for anyone with diabetes. Obviously, lifestyle interventions
such as changes in diet and exercise patterns are a critical component of both treatment and prevention but these are beyond the scope of this book. And in many cases, antidiabetic medications are necessary. For patients with IDDM, of course, insulin can never be discontinued. However, there are certainly cases of IDDM and NIDDM where botanicals can be used to reduce doses of insulin or other prescription medication. There are also cases of NIDDM where botanicals may be able to supplant entirely these medications, at least for a while. However, combining these, or any other herbs, with antidiabetic medication will require close
monitoring of serum glucose levels to maintain appropriate glycemic control, something that should be done regularly in these patients in any event. It is only with close monitoring that the success or failure of a chosen botanical treatment be evaluated. Thus, any practitioner working with these therapies must be able to monitor and address the medical issues and tests associated with treating diabetes.
Source : Clinical Botanical Medicine
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Secondhand Smoke is Linked to Type 2 Diabetes and Obesity
Adults who are exposed to secondhand smoke have higher rates of obesity and Type 2 diabetes than do nonsmokers without environmental exposure to tobacco smoke, a new study shows. The results will be presented Sunday at The Endocrine Society’s 94th Annual Meeting in Houston.“More effort needs to be made to reduce exposure of individuals to secondhand smoke,” said study co-author Theodore C. Friedman, MD, PhD, chairman of the Department of Internal Medicine at Charles R. Drew University, Los Angeles.
Studies have shown an association between cigarette smoking and an increased rate of Type 2 diabetes despite the fact that most smokers are leaner than nonsmokers and obesity is a risk factor for Type 2 diabetes. Although some studies have suggested a relationship between Type 2 diabetes and passive, or secondhand, smoking, Friedman said these studies have not verified exposure to secondhand smoke through serum (blood) levels of cotinine. Cotinine is a metabolite of nicotine, and serum cotinine measures a person’s exposure to tobacco smoke.
In their current study, Friedman and his fellow researchers used serum cotinine levels to verify passive smoking. They examined data from more than 6,300 adults who participated from 2001 to 2006 in the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population.
The investigators defined current smokers, which made up 25 percent of the sample, as survey participants who reported that they smoke cigarettes and who had a measured serum cotinine level greater than 3 nanograms per milliliter (ng/mL). Nonsmokers (41 percent of the sample) were those who answered “no” to the question “Do you smoke cigarettes?” and who had a cotinine level below 0.05 ng/mL. Participants who answered “no” to this question but whose cotinine level was above 0.05 ng/mL were defined as secondhand “smokers” (34 percent).
In analyzing these groups, the researchers controlled for age, sex, race, alcohol consumption and physical activity. They found that, compared with nonsmokers, secondhand smokers had a higher measure of insulin resistance, a condition that can lead to Type 2 diabetes; higher levels of fasting blood glucose, or blood sugar; and a higher hemoglobin A1c, a measure of blood sugar control over the past three months.
Secondhand smokers also had a higher rate of Type 2 diabetes, as defined by a hemoglobin A1c greater than 6.5 percent. Secondhand smokers had a similar rate of diabetes to that of current smokers, according to Friedman.
Secondhand smokers also had a higher body mass index (BMI), a measure of body fat, compared with nonsmokers, Friedman reported. Current smokers had a lower BMI than nonsmokers but a higher hemoglobin A1c. When the researchers controlled for BMI, they found that secondhand smokers and current smokers still had a higher hemoglobin A1c than did nonsmokers.
“This finding shows that the association between secondhand smoke and Type 2 diabetes was not due to obesity,” Friedman said. “More studies are needed to show whether secondhand smoke is a cause of diabetes.”
Source : Newswise
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Low Vitamin D Level Is Linked to Greater Chance of Risk Factors For Type 2 Diabetes
A new study presents more evidence of a possible link between low vitamin D levels and a higher risk of Type 2 diabetes and heart disease. The results will be presented Saturday at The Endocrine Society’s 94th Annual Meeting in Houston.The study found an inverse relationship between the level of vitamin D in the blood and the presence of the metabolic syndrome, which is a group of risk factors that increases the risk of heart disease and Type 2 diabetes. People with the highest blood levels of vitamin D had a 48 percent lower risk of having the metabolic syndrome than did those with the lowest vitamin D levels, the authors reported.
“This association has been documented before, but our study expands the association to people of diverse racial and ethnic backgrounds,” said the lead author, Joanna Mitri, MD, a research fellow at Tufts Medical Center in Boston. “These include minority groups that are already at higher risk of diabetes.”
Furthermore, all study participants were at risk of developing diabetes because they had prediabetes, abnormally high blood sugar levels that are not yet high enough to be classified as diabetes. Prediabetes affects an estimated 79 million Americans ages 20 or older, according to 2010 statistics from the Centers for Disease Control and Prevention.
Mitri and her co-investigators conducted the study using data from participants of the Diabetes Prevention Program, a large, now-completed study funded by the National Institutes of Health. They divided study subjects into three groups based on plasma 25-hydroxyvitamin D level, which is the most common way used to measure vitamin D status in the body, according to Mitri. The Institute of Medicine recommends a 25-hydroxyvitamin D level of 20 to 30 ng/mL as adequate for healthy people.
In the new study, the group with the highest levels of vitamin D had a median vitamin D concentration of 30.6 nanograms per milliliter, or ng/mL, and those in the lowest group had a median vitamin D concentration of 12.1 ng/mL. The risk of having the metabolic syndrome with a high vitamin D level was about one half the risk with a low vitamin D level, Mitri said.
The researchers also found an association between vitamin D status and some of the individual components of the metabolic syndrome, which includes a large waist size, low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood glucose (sugar). Study participants with the best vitamin D status had a smaller waist circumference, higher HDL cholesterol and lower blood sugar.
Mitri cautioned that their research does not prove that vitamin D deficiency causes Type 2 diabetes, or even that there is a link between the two conditions.
“However, the metabolic syndrome is common, and progression to Type 2 diabetes is high,” she said. “If a causal relationship can be established in ongoing and planned studies of vitamin D, this link will be of public health importance, because vitamin D supplementation is easy and inexpensive.”
Source : Newswise
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Fungicide Used on Farm Crops Linked to Insulin Resistance
A fungicide used on farm crops can induce insulin resistance, a new tissue-culture study finds, providing another piece of evidence linking environmental pollutants to diabetes. The results will be presented Saturday at The Endocrine Society’s 94th Annual Meeting in Houston.“For the first time, we’ve ascribed a molecular mechanism by which an environmental pollutant can induce insulin resistance, lending credence to the hypothesis that some synthetic chemicals might be contributors to the diabetes epidemic,” said investigator Robert Sargis, M.D., Ph.D., instructor in the endocrinology division at the University of Chicago.
The chemical, tolylfluanid, is used on farm crops in several countries outside of the United States to prevent fungal infestation, and sometimes is used in paint on ships to prevent organisms from sticking to their hulls. Animal studies have indicated that the chemical may adversely affect the thyroid gland, as well as other organs, and that it may increase the risk of cancer in humans.
Within the last decade, research attention has increasingly focused on the link between environmental contaminants and the rising rates of obesity and diabetes throughout many parts of the world. In the United States alone, nearly 26 million adults and children have some form of diabetes, according to the American Diabetes Association. A serious disease by itself, diabetes also increases the risk of other medical complications, including heart and blood-vessel diseases.
Normally, the pancreas secretes the hormone insulin, which acts to regulate blood-sugar levels. Among diabetic patients, insulin secretion either decreases or stops altogether, or cells become resistant to the hormone’s activity. These conditions then disrupt the process that transports sugar, or glucose, from the blood to the body’s other cells, which can lead to the dangerously high blood-sugar levels associated with diabetes.
In this project, Sargis and his co-investigators used mouse fat to examine the effects of tolylfluanid on insulin resistance at the cellular level. They found that exposure to tolylfluanid induced insulin resistance in fat cells, which play a critical role in regulating the body’s blood glucose and fat levels. When exposed to tolylfluanid in culture the ability of insulin to trigger action inside the fat cell, or adipocyte, was reduced, which is an early indication of diabetes.
“The fungicide and antifouling agent tolylfluanid may pose a threat to public health through the induction of adipocytic-insulin resistance, an early step in the pathogenesis of type 2 diabetes,” Sargis said. “Based on these studies, further efforts should be undertaken to clarify human exposure to tolylfluanid and the possible metabolic consequences of that exposure.”
At the same time, tolylfluanid-exposed cells stored more fat, or lipids, in a similar action to a steroid called corticosterone. Like this steroid, tolylfluanid bound receptors in fat cells, called glucocorticoid receptors, which help regulate blood-sugar levels, as well as many other important body processes.
“For the public, this raises the specter of environmental pollutants as potential contributors to the metabolic disease epidemic,” said Sargis, adding that, “hopefully, it will put further pressure on public policy makers to reassess the contribution of environmental pollution as a contributor to human disease in order to encourage the development of strategies for reversing those effects.”
The National Institute of Environmental Health Sciences and the University of Chicago Diabetes Research and Training Center funded this research.
Source : Newswise
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Pharmacognostic and antidiabetic study of Clitoria ternatea
Manish Gunjan1*, Ravindran M1, Sengamalam R1, Goutam K Jana1, A.K Jha1
Abstract
Aparajita means "The Undefeated". This plant is a trailing creeper with the usual Indigo Blue colour flowers and the rare white ones which is more of a pale cream with a hint of green at the edges. In Kerala it is called the Sankhu Pushpam or Conch Shell flower although it hardly resembles a Conch shell. It actually resembles a quaint Snapdragon flower with it's front open. Graphically it represents the cutout of an inverted womb. May be that explains their close affinity to Indian Midwives, particularly the White variety. Aparajita grows throughout India. It is a beautiful-looking plant, hence cultivated in gardens. It is a perennial twining herb having 7 leaflets, which are elliptic and obtuse. There are few varieties with white, violet and blue flowers. The pods are 5-7 cm long, flat with 6 to 10 seed, in each pod. The flowers resemble in shape to cows ear, hence the synonym- gokarnika. Chronic administration of plant extracts (100mg/kg) for 14 days reduces the blood glucose level of the diabetes induced animals as compared to diabetic control group. There was significant decrease in the blood glucose level in the 7th [p<0.01] and 14th [p<0.001] days of the diabetes induction, showing antidiabetic effect. The effect was comparable to that of standard antidiabetic drug Glibenclamide. The aim of this research is to explore the antidiabetic activity of this plant which will be helpful in the future investigations.
Source : International Journal of Phytomedicine
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Ficus deltoidea: A Potential Alternative Medicine for Diabetes Mellitus
Zainah Adam,1 Shafii Khamis,1 Amin Ismail,2 and Muhajir Hamid3
Ficus deltoidea from the Moraceae family has been scientifically proven to reduce hyperglycemia at different prandial states. In this study, we evaluate the mechanisms that underlie antihyperglycemic action of Ficus deltoidea. The results had shown that hot aqueous extract of Ficus deltoidea stimulated insulin secretion significantly with the highest magnitude of stimulation was 7.31-fold (𝑃< 0 001). The insulin secretory actions of the hot aqueous extract involved K+ ATP channel-dependent and K + ATP -channel-independent pathway. The extract also has the ability to induce the usage of intracellular Ca2+ to trigger insulin release. The ethanolic and methanolic extracts enhanced basal and insulin-mediated glucose uptake into adipocytes cells. The extracts possess either insulin-mimetic or insulin-sensitizing property or combination of both properties during enhancing glucose uptake into such cells. Meanwhile, the hot aqueous and methanolic extracts augmented basal and insulin-stimulated adiponectin secretion from adipocytes cells. From this study, it is suggested that Ficus deltoidea has the potential to be developed as future oral antidiabetic agent.
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 632763, 12 pages doi:10.1155/2012/632763
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Liquorice Root Found to Contain Anti-Diabetic Substance
Researchers have discovered a promising anti-diabetic substance in the amorfrutin class of natural substances.
It provides the raw material for liquorice candy, calms the stomach and alleviates diseases of the airways: liquorice root. Chosen as the "Medicinal plant 2012," the root has been treasured in traditional healing since ancient times. Researchers at the Max Planck Institute for Molecular Genetics in Berlin have now discovered that liquorice root also contains substances with an anti-diabetic effect. These amorfrutins not only reduce blood sugar, they are also anti-inflammatory and are very well tolerated. Thus, they may be suitable for use in the treatment of complex metabolic disorders.
Natural substances have a surprising and often largely unexploited potential in the prevention and treatment of common diseases. For example, liquorice root Glycyrrhiza contains different substances that help to alleviate disorders of the airways and digestive system. It has been used for millennia in traditional healing and is mainly administered in the form of tea. A team of researchers working with Sascha Sauer from the Max Planck Institute for Molecular Genetics in Berlin has now discovered that the plant from the papilionaceae or leguminous family might also be effective in the treatment of adult (type 2) diabetes. The scientists identified a group of natural substances with an anti-diabetic effect, the amorfrutins, in the plant's edible root.
The substances, which have a simple chemical structure, are not only found in liquorice root, but are also in the fruit of the Amorpha fruticosa bush. The new anti-diabetic agents were named after this plant, which is native to the US, Canada and Mexico. As the researchers demonstrated using diabetic mice, the amorfrutins not only have characteristics that reduce blood sugar, they are also anti-inflammatory in their effect. Moreover, they also prevent fatty liver -- a common disease caused by excessively fat-rich nutrition.
"The health-beneficial effects are based on the fact that the amorfrutin molecules dock directly onto a receptor in the nucleus called PPARγ," explains Sascha Sauer. PPARγ plays an important role in the cell's fat and glucose metabolism. The binding of the amorfrutin molecules activates various genes that reduce the plasma concentration of certain fatty acids and glucose. The reduced glucose level prevents the development of insulin resistance -- the main cause of adult diabetes.
"Although there are already drugs on the market that affect the PPARγ receptor, they are not selective enough in their effect and cause side effects like weight gain and cardio-vascular problems," says Sascha Sauer. In contrast, as demonstrated by the studies carried out to date, the amorfrutins are very well tolerated. "However, drinking liquorice tea or eating liquorice will not help to treat diabetes," explains the scientist. "The concentration of the substances in the tea and liquorice is far too low to be effective." The researchers therefore developed special extraction processes to obtain the amorfrutins from the plant in sufficient concentrations. This could be used to produce amorfrutin extracts on an industrial scale.
The newly discovered active substances not only seem to hold great promise for the treatment of complex metabolic disorders, they may also be suitable for prophylactic use. "The amorfrutins can be used as functional nutritional supplements or as mild remedies that are individually tailored to the patient," says Sascha Sauer. "In view of the rapid spread of metabolic diseases like diabetes, it is intended to develop these substances further so that they can be used on humans in the future." To do this, the researchers must now test the effect of the substances and the plant amorfrutin extracts in clinical studies on diabetes patients
Source : Science Daily
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Protective Effect of Proanthocyanidin against Diabetic Oxidative Stress
Takako Yokozawa,1 Eun Ju Cho,2 Chan Hum Park,1 and Ji Hyun Kim1
1Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
2Department of Food Science and Nutrition, Pusan National University, Busan 609-735, Republic of Korea
Abstract
We investigated the antidiabetic potential of proanthocyanidin and its oligomeric form in STZ-induced diabetic model rats and db/db type 2 diabetic mice. Proanthocyanidin ameliorated the diabetic condition by significant decreases of serum glucose, glycosylated protein, and serum urea nitrogen as well as decreases of urinary protein and renal-AGE in STZ-induced diabetic rats and decrease of serum glucose as well as significant decrease of glycosylated protein in db/db type 2 diabetic mice. The suppression of ROS generation and elevation of the GSH/GSSG ratio were also observed in the groups administered proanthocyanidin. Moreover, proanthocyanidin, especially its oligomeric form, affected the inflammatory process with the regulation of related protein expression, iNOS, COX-2 and upstream regulators, NF-κB, and the IκB-α. In addition, it had a marked effect on hyperlipidemia through lowering significant levels of triglycerides, total cholesterol, and NEFA. Moreover, expressions in the liver of SREBP-1 and SREBP-2 were downregulated by the administration of proanthocyanidins. The protective effect against hyperglycemia and hyperlipidemia in type 1 and 2 diabetic models was significantly strong in the groups administered the oligomeric rather than polymeric form. This suggests that oligomers act as a regulator in inflammatory reactions caused by oxidative stress in diabetes.
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 623879, 11 pages
doi:10.1155/2012/623879
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The Effects of Green Tea Consumption on Cardiometabolic Alterations Induced by Experimental Diabetes
Patricia Fiorino,1 Fabiana Sant'Anna Evangelista,2 Fernando Santos,1 Fátima Maria Motter Magri,1 Jan Carlo Morais O. B. Delorenzi,1 Milton Ginoza,1 and Vera Farah1
1Renal, Cardiovascular and Metabolic Physiopharmacology Laboratory, Health and Biological Science Center, Mackenzie University, 01302-907 São Paulo, Brazil
2School of Arts, Science and Humanities, University of Sao Paulo, Sao Paulo, BrazilReceived 8 September 2011;
Abstract
We evaluated cardiac autonomic modulation by heart rate (HRV), and arterial pressure variability (APV), and metabolic response in streptozotocin diabetic rats treated with green tea. Male Wistar rats were separated in groups: control, drinking tap water (C), green tea-treated (GT) group, diabetic, drinking tap water (D), and diabetic, treated with green tea (DGT). Kidney mass was greater in D and DGT than in C and GT, but reduced in DGT compared to D. Green tea prevented the increase in creatinine clearance and reduced hyperglycemia in DGT compared to D. Arterial pressure was increased in GT and decreased in D compared to C. HRV was reduced in D compared with all groups. APV was decreased in D compared to C and recovery in DGT. Sympathetic modulation of APV was decreased in D compared with all groups. Green tea reduced hyperglycemia, prevented renal injury and autonomic dysfunction, suggesting reduced cardiovascular risk and target organ damage in diabetes.
Source : Experimental Diabetes Research Volume 2012 (2012), Article ID 309231, 7 pages
doi:10.1155/2012/309231
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Vitamin D and incidence of diabetes: A prospective cohort study Vitamin D and diabetes incidence.
González-Molero I, Rojo-Martínez G, Morcillo S, Gutiérrez-Repiso C, Rubio-Martín E, Almaraz MC, Olveira G, Soriguer F.Source
Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain; Ciber de Diabetes y Metabolismo (CIBERDEM), Spain.
Abstract
BACKGROUND & AIMS: To investigate the relationship between levels of 25-hydroxyvitamin D and the incidence of type 2 diabetes in a Spanish population.
METHODS: We undertook a population-based prospective study in a population from southern Spain. The first phase of the study (1996-1998) included 1226 individuals. Of this original cohort, 988 persons were reassessed in 2002-2004 and 961 in 2005-2007. Measurements were made of 25-hydroxyvitamin D and intact parathyroid hormone in 2002-2004 and an oral glucose tolerance test was done in three time points.
RESULTS: The incidence of diabetes in subjects with 25-hydroxyvitamin D levels ≤18.5 ng/mL (percentile 25) was 12.4% vs 4.7% in subjects with levels >18.5 ng/mL. The likelihood of having diabetes during the four years of follow-up was significantly lower in the subjects with higher levels of 25-hydroxyvitamin D [OR = 0.17 (0.05-0.61)]. None of the subjects with levels higher than 30 ng/mL developed diabetes.
CONCLUSION: In this prospective study, we found a significant inverse association between serum 25-hydroxyvitamin D levels and the risk for type 2 diabetes in a population from the south of Spain.
Source : Clinical Nutrition
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Cinnamon extract regulates glucose transporter and insulin-signaling gene expression in mouse adipocytes
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Green Tea Review Suggests Ability to Control Obesity and Diabetes among Many Other Health Benefits
Tea catechins, especially EGCG, appear to have antiobesity and antidiabetic effects. Recent data from human studies indicate that the consumption of green tea or green tea extracts may help reduce body weight, mainly body fat, by increasing postprandial thermogenesis and fat oxidation. One cited study of 6 overweight men given 300 mg EGCG daily for 2 days suggests that EGCG alone has the potential to increase fat oxidation in men and may thereby contribute to the antiobesity effects of green tea.
Cited studies in animal models of diabetes reported reductions in serum glucose levels with the administration of green tea polyphenols. In normal rats, green tea catechins reduced plasma triglyceride levels in an oral glucose-tolerance test. Green tea and green tea extracts have been demonstrated to modify glucose metabolism beneficially in experimental models of type 2 diabetes mellitus. A human study reported that green tea promoted glucose metabolism in healthy human volunteers as shown in oral glucose-tolerance tests.
The authors point out that the effects of green tea and its constituents may be beneficial up to a certain dose and may cause some as yet unrecognized adverse effects at higher doses (this is the authors’ conjecture; potentially adverse higher dose levels were not specified). Also, the effects of green tea catechins may vary from person to person. The harmful effects of too much tea are mainly due to its caffeine content, the possible presence of aluminum in some teas (which is problematic for patients with renal failure), and the effects of tea polyphenols on iron bioavailability.
The authors conclude that long-term consumption of tea catechins could be beneficial to high-fat diet-induced obesity and type 2 diabetes and could reduce the risk for coronary disease. Further research should focus on the pharmacological and clinical effects of green tea and its mechanisms of action.
—Shari Henson
Reference
1. Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea: a review. J Am Coll Nutr. 2006;25:79-99.
Source : HerbalGram
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Hadeel A. Al-Rawaf,1,2 Sami A. Gabr,1 and Ahmad H. Alghadir
Abstract
Background. Circulating micro-RNAs are differentially expressed in various tissues and could be considered as potential regulatory biomarkers for T2DM and related complications, such as chronic wounds. Aim. In the current study, we investigated whether ginger extract enriched with [6]-gingerol-fractions either alone or in combination with vitamin D accelerates diabetic wound healing and explores underlying molecular changes in the expression of miRNA and their predicted role in diabetic wound healing.
Methods. Diabetic wounded mice were treated with [6]-gingerol-fractions (GF) (25 mg/kg of body weight) either alone or in combination with vitamin D (100 ng/kg per day) for two weeks. Circulating miRNA profile, fibrogenesis markers, hydroxyproline (HPX), fibronectin (FN), and collagen deposition, diabetic control variables, FBS, HbA1c, C-peptide, and insulin, and wound closure rate and histomorphometric analyses were, respectively, measured at days 3, 6, 9, and 15 by RT–PCR and immunoassay analysis.
Results. Treatment of diabetic wounds with GF and vitamin D showed significant improvement in wound healing as measured by higher expression levels of HPX, FN, collagen, accelerated wound closure, complete epithelialization, and scar formation in short periods (11-13 days, (P<0.01). On a molecular level, three circulating miRNAs, miR-155, miR-146a, and miR-15a, were identified in diabetic and nondiabetic skin wounds by PCR analysis. Lower expression in miR-155 levels and higher expression of miR-146a and miR-15a levels were observed in diabetic skin wounds following treatment with gingerols fractions and vitamin D for 15 days. The data showed that miRNAs, miR-146a, miR-155, and miR-15a, correlated positively with the expression levels of HPX, FN, and collagen and negatively with FBS, HbA1c, C-peptide, and insulin in diabetic wounds following treatment with GF and /or vitamin D, respectively.
Conclusion. Treatment with gingerols fractions (GF) and vitamin D for two weeks significantly improves delayed diabetic wound healing. The data showed that vitamin D and gingerol activate vascularization, fibrin deposition (HPX, FN, and collagen), and myofibroblasts in such manner to synthesize new tissues and help in the scar formation. Accordingly, three miRNAs, miR-155, miR-146a, and miR-15, as molecular targets, were identified and significantly evaluated in wound healing process. It showed significant association with fibrin deposition, vascularization, and reepithelialization process following treatment with GF and vitamin D. It proposed having anti-inflammatory action and promoting new tissue formation via vascularization process during the wound healing. Therefore, it is very interesting to consider miRNAs as molecular targets for evaluating the efficiency of nondrug therapy in the regulation of wound healing process
Source Journal Evidence Based Complementary and Alternative Medicine
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Diabetes mellitus and nature’s pharmacy of putative antidiabetic plants
Kazhila C.
Abstract
Globally, diabetes causes about 1.5 million deaths per year. Data predicts that the current global epidemiological burden of diabetes is increasing alongside its long-term life threatening sequelae and side-effects from synthetic antidiabetic drugs. Challenges in the public healthcare delivery system, inadequate human and financial resources, expensive antidiabetic drugs coupled with their limited availability, efficacy and tolerability, and a higher priority for subventions to the control of communicable diseases such as HIV/AIDS than to drugs for non-communicable conditions especially diabetes have opened new vistas for diabetics to seek complementary and alternative medicines. As a corollary, there is a renewed momentum backed by the World Health Organization to discover newer, cheaper and better antidiabetic agents from medicinal plants. As data on putative antidiabetic properties of plants remain scattered, this review provides a new synthesis of antidiabetic plants from Africa, Central America, Mexico, South Asia, and Iran. In the countries mentioned in this review, numerous plant species decrease blood sugar levels by inhibiting the enzymes α-amylase and α-glucosidase. Other antidiabetic plants restore pancreatic cells, improve insulin secretion and sensitivity, decrease metabolic syndrome in type 2 diabetes patients in addition to exerting antioxidant and hepatoprotective functions. Mechanisms of action are mediated by phytochemical agents including saponins, polyphenols, ellagitannins, triterpenes, and elements such as Mg, P, Ca, K, Mn, Cu, Zn, S, Cr, Co, Ni and V. These plant compounds and elements may be included into new and more efficacious herbal drugs and nutraceuticals to lessen the global burden of diabetes.
Source : Journal of Herbal Medicine
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Apple and pear consumption and type 2 diabetes mellitus risk: a meta-analysis of prospective cohort studies
Abstract
The conclusions from epidemiological studies are controversial between apple and pear consumption and type 2 diabetes mellitus (T2DM) risk. The present study aimed to investigate whether apple and pear consumption was inversely associated with T2DM risk, and to evaluate the potential dose–response relationship. The Cochrane library, Embase and PubMed databases were searched up to Nov 2016. Prospective cohort studies, which reported the association of apple and pear consumption with incidence of T2DM, were included. Multivariate-adjusted relative risks (RRs) for the highest versuslowest category were combined by using a random-effects model. A restricted cubic spline regression model was performed to examine the dose–response relationship. A total of 5 independent prospective cohort studies were included (14 120 T2DM incident cases and 228 315 participants). The summary estimate showed that consumption of apples and pears was associated with 18% reduction in T2DM risk (95% confidence interval (CI): 0.75, 0.88; I2 = 0.00%). Dose–response analysis showed that one serving per week increment of apple and pear consumption was associated with a 3% (95% CI: 0.96, 0.98; p for trend <0.001) reduction in T2DM risk. The present meta-analysis provides significant evidence of an inverse association between apple and pear consumption and T2DM risk.
Source : Journal Food and Nutrition
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Breakfast Skipping Is Associated with Increased Risk of Type 2 Diabetes among Adults: A Systematic Review and Meta-Analysis of Prospective Cohort Studies
Aurélie Ballon, Manuela Neuenschwander, and Sabrina Schlesinge
Abstract
Background: Epidemiologic studies have indicated that breakfast skipping is associated with risk of type 2 diabetes. However, the shape of the dose-response relation and the influence of adiposity on this association have not been reported.
Objective: We investigated the association between breakfast skipping and risk of type 2 diabetes by considering the influence of the body mass index (BMI).
Methods: In this systematic review and meta-analysis, PubMed and Web of Science were searched up to August 2017. Prospective cohort studies on breakfast skipping and risk of type 2 diabetes in adults were included. Summary RRs and 95% CIs, without and with adjustment for BMI, were estimated with the use of a random-effects model in pairwise and dose-response meta-analyses.
Results: In total 6 studies, based on 96,175 participants and 4935 cases, were included. The summary RR for type 2 diabetes comparing ever with never skipping breakfast was 1.33 (95% CI: 1.22, 1.46, n = 6 studies) without adjustment for BMI, and 1.22 (95% CI: 1.12, 1.34, n = 4 studies) after adjustment for BMI. Nonlinear dose-response meta-analysis indicated that risk of type 2 diabetes increased with every additional day of breakfast skipping, but the curve reached a plateau at 4–5 d/wk, showing an increased risk of 55% (summary RR: 1.55; 95% CI: 1.41, 1.71). No further increase in risk of type 2 diabetes was observed after 5 d of breakfast skipping/wk (P for nonlinearity = 0.08).
Conclusions: This meta-analysis provides evidence that breakfast skipping is associated with an increased risk of type 2 diabetes, and the association is partly mediated by BMI.
Source : The Journal of Nutrition
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Baduanjin exerts anti-diabetic and anti-depression effects by regulating the expression of mRNA, lncRNA, and circRNA
Tian An†,Zhong-Chen He†, Xin-Qing Zhang, Jun Li, Ai-Ling Chen, Fang Tan, Hong-Dong Chen, Bo-Han Lv, Juan Lian, Si-Hua Gao and Guang-Jian Jiang
Abstract
Background
Baduanjin, a traditional Chinese exercise therapy, has been widely used in China to treat type 2 diabetes (T2DM) with depression (DD). However, the underlying mechanism of Baduanjin in anti-DD is unclear. This study was focused on investigating the effects of Baduanjin on symptoms of depression and blood glucose in patients with DD and the underlying mechanism.
Methods
We performed a 12-week Baduanjin intervention on patients with DD and longitudinally compared the differential expressions of lncRNAs, circRNAs, and mRNAs between pre- (BDD) and post- (ADD) Baduanjin intervention in the same group. Subsequently, Gene Ontology (GO) and pathway analysis was performed to investigate the function of differentially expressed mRNAs. Finally, Reverse Transcription-Polymerase Chain Reaction (RT-PCR) was used to verify the sequencing result and the mRNA-lncRNA regulatory network was constructed.
Results
The blood glucose level, depression index scores, and PHQ9 scores of the patients with DD were significantly decreased (P < 0.05) after Baduanjin intervention. Compared to BDD, 207 lncRNAs, 266 circRNAs, and 610 differentially expressed mRNAs were identified in ADD. Kyoto Encyclopedia of Genes and Genomes (KEGG) and GO showed that the significantly dysregulated mRNAs were mainly involved in immune function and inflammatory response pathways, and various signaling pathways including IL-17 and TNF. In addition, we selected five differentially expressed lncRNAs to construct an lncRNA-mRNA regulatory network, and found a total of 1045 mRNAs associated with them.
Conclusions
Our research is the first systematic profiling of mRNA, lncRNA, and circRNA in patients of ADD and BDD, and provides valuable insights in the potential mechanism of Baduanjin in anti-DD. Further, it was confirmed that Baduanjin is a safe and effective intervention for patients with DD because it can effectively ameliorate the symptoms of depression and blood glucose levels in patients with DD by regulating the dysregulated expression of lncRNA, mRNA, and circRNA.
Source Journal Chinese Medicine
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Circulating Hypoxia Responsive microRNAs (HRMs) and Wound Healing Potentials of Green Tea in Diabetic and Nondiabetic Rat Models
Hadeel A. Al-Rawaf,1,2 Sami A. Gabr,1 and Ahmad H. Alghadir
Abstract
Green tea (Camellia sinensis) has many biological activities and may promote diabetic wound healing by regulation of circulating hypoxia responsive microRNAs (HRMs) which triggers the wound repairing process in diabetic and nondiabetic wounds. Thus, in this study, the potential effects of green tea extract (GTE) on the expression of miRNAs; miR-424, miR-199a, miR-210, miR-21, and fibrogenitic markers; hydroxyproline (HPX), fibronectin (FN), and nitric oxide (NO) were evaluated in wounds of diabetic and nondiabetic rats. The animals were topically treated with vaseline, 0.6% GTE, and 5%w/w povidone iodine (standard control). HPX, FN, and NO levels and microRNAs, miR-424, miR-210, miR-199a, and miR-21, were estimated in wound tissues using colorimetric, immunoassay, and molecular PCR analysis. In vitro analysis was performed to estimate active constituents and their antioxidant activities in methanolic green teat extract (GTE). Wounds treated with green tea, a dose of 0.6, healed significantly earlier than those treated with standard vehicle and vaseline treated diabetic wounds. Higher expressions of HRMs, miR-199a, and miR-21, and lower expression of HRMs, miR-424 and miR-210, were significantly reported in tissues following treatment with green tea extract compared to standard control vehicle. The tissues also contained more collagen expressed as measures of HPX, FN, and NO and more angiogenesis, compared to wounds treated with standard control vehicle. Diabetic and nondiabetic wounds treated with green tea (0.6%) for three weeks had lesser scar width and greater re-epithelialization in shorter periods when compared to standard control vehicle. Expression of HRMs, miR-199a, miR-21, and HRMs and miR-424 and miR-210 correlated positively with HPX, fibronectin, NO, better scar formation, and tensile strength and negatively with diabetes. In addition to antidiabetic and antioxidant activities of green tea components, GTE showed angiogenesis promoting activity in diabetic wound healing. In conclusion, Camellia sinensis extracts in a dose of 0.6% significantly promote more collagen and fibronectin deposition with higher expression of NO, promoting angiogenesis process via molecular controlling of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 in diabetic and nondiabetic wounds. Our results support a functional role of circulating hypoxia responsive microRNAs: miR-424, miR-210, miR-199a, and miR-21 as potential therapeutic targets in angiogenesis and vascular remodeling in diabetic wound healing.
Source : Journal Evidence Based Complementary and Alternative Medicine
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Quercetin protects rat dorsal root ganglion neurons against high glucose-induced injury in vitro through Nrf-2/HO-1 activation and NF-κB inhibition
Yue Shi,1 Xiao-chun Liang,1,* Hong Zhang,2 Qun-li Wu,1 Ling Qu,1 and Qing Sun1
Abstract
Aim:To examine the effects of quercetin, a natural antioxidant, on high glucose (HG)-induced apoptosis of cultured dorsal root ganglion (DRG) neurons of rats.
Methods:DRG neurons exposed to HG (45 mmol/L) for 24 h were employed as an in vitro model of diabetic neuropathy. Cell viability, reactive oxygen species (ROS) level and apoptosis were determined. The expression of NF-кB, IкBα, phosphorylated IкBα and Nrf2 was examined using RT PCR and Western blot assay. The expression of hemeoxygenase-1 (HO-1), IL-6, TNF-α, iNOS, COX-2, and caspase-3 were also examined.
Results:HG treatment markedly increased DRG neuron apoptosis via increasing intracellular ROS level and activating the NF-κB signaling pathway. Co-treatment with quercetin (2.5, 5, and 10 mmol/L) dose-dependently decreased HG-induced caspase-3 activation and apoptosis. Quercetin could directly scavenge ROS and significantly increased the expression of Nrf-2 and HO-1 in DRG neurons. Quercetin also dose-dependently inhibited the NF-κB signaling pathway and suppressed the expression of iNOS, COX-2, and proinflammatory cytokines IL-6 and TNF-α.
Conclusion:Quercetin protects rat DRG neurons against HG-induced injury in vitro through Nrf-2/HO-1 activation and NF-κB inhibition, thus may be beneficial for the treatment of diabetic neuropathy.
Source : Acta Pharacologica Sinica
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Antidiabetic Activity of Picris japonica Thunb Aqueous Extract in Diabetic KK-Ay Mice
Yanmei Jia and Lirong Chen
Abstract
Objective. To evaluate the hypoglycemic effect of Picris japonica Thunb (Asteraceae) on KK-Ay mice. Methods. The hypoglycemic effect of Picris japonica aqueous extract (PJE) in a spontaneous type 2 diabetic model (KK-Ay mice) was studied in the present research. PJE was administrated at doses of 700 mg/kg and 350 mg/kg (calculated as crude herb) for 14 days and blood glucose, oral glucose tolerance test, plasma insulin level, and blood lipid were evaluated. Meanwhile, Rosiglitazone was used for the positive control. Results. It was found the PJE treatment significantly reduced blood glucose level and improved oral glucose tolerance ability (p < 0.01 orp < 0.05) in a dose-dependent manner compared to the control diabetic mice. The blood insulin levels were significantly reduced in PJE-treated mice (700 mg/kg) and Rosiglitazone compared with the diabetic control (p< 0.01). Compared with the control diabetic group, the serum total cholesterol, triglyceride, and low density lipoprotein cholesterol were reduced by PJE (700 mg/kg) and Rosiglitazone (p < 0.05), and the serum high density lipoprotein cholesterol was significantly increased only by Rosiglitazone (p < 0.01). Conclusions. The findings demonstrate that Picris japonica has remarkable antidiabetic effect in diabetic KK-Ay mice, which suggests that Picris japonica may be beneficial to the treatment of type 2 diabetes mellitus.
Source : Journal Evidence Based Complementary and Alternative Medicine
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The Microalga Spirulina platensis Presents Anti-inflammatory Action as well as Hypoglycemic and Hypolipidemic Properties in Diabetic Rats
Ivan P. Joventino, Henrique G.R. Alves, Lia C. Neves, Francisca Pinheiro-Joventino, Luzia Kalyne A.M. Leal, Samya A. Neves Francisco Valdeci Ferreira, Gerly Anne C. Brito, Glauce B. Viana
Abstract
Spirulina platensis (Spi) is a microalga presenting high contents of proteins, γ-linolenic acid, vitamins and minerals, and showing many biological activities. It is a promising drug for the treatment of diseases including diabetes. The objectives of this work were to study Spi effects on alloxan-induced diabetic rats, and associate this to its anti-inflammatory activity. The treatment with Spi (25, 50 or 100 mg/kg, p.o.) started 48 h after the alloxan injection, continuing for 5 or 10 days. Biochemical parameters were measured in sera of treated and untreated animals. The anti-inflammatory activity of Spi was assessed by the formalin test and carrageenan-induced paw edema in mice. Immunostainings for TNF-alpha were carried out in the carrageenan-induced paw edema in rats, before and after the Spi treatment, and its effect on the release of myeloperoxidase from human neutrophils was also determined. Spi decreased glycemia as well as triglyceride and total cholesterol levels of diabetic rats. Levels of urea and creatinine were also reduced, while liver transaminases were unaltered. Spi also decreased dose-dependently the 1st (neurogenic) and mainly the 2nd phase (inflammatory) of the formalin test, as well as the carrageenan-induced paw edema in mice. The anti-inflammatory effect of Spi was further confirmed by decreases in TNF-alpha immunostaining in the inflamed paw and in the myeloperoxidase release from human neutrophils. The results showed that the anti-diabetic effect of S. platensis is already manifested after a 5-day treatment. Additionally, considering the relationship between diabetes and inflammation, the microalga anti-inflammatory action may also be involved.
Source : Journal of Complementary and Integrative Medicine
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The effect of ginger (Zingiber Officinale) as an ancient medicinal plant on improving blood lipids
TaherehArablouaNaheedAryaeianb
Abstract
Ginger (Zingiber Officinale Roscoe) is a plant that is used as a popular spice in foods, desserts and drinks all around the world. This plant is native to Asia and has been used since ancient times in the prevention and treatment of many diseases. To date, several properties of ginger such as antioxidant, anti-inflammatory and anticoagulation activities have been studied and the effect of the plant to reduce pain and improve nausea and vomiting has been established. Among human and animal studies that have been carried out in recent years on the properties of ginger, some literature aimed to investigate the effect of this plant on blood lipids. In this review, we consider those studies and their possible enzymatic and molecular mechanisms regarding the effect of ginger on lipid profiles.
Conclusion
This paper aimed to address the question of whether ginger has a reducing effect on blood lipids. Therefore, we discussed relevant human studies on this effect and the possible explanatory mechanisms. In the cited clinical trials, different doses of ginger powder (range 13 g) in different time periods (range 45 days–12 weeks) were used. According to our literature findings regarding the effect of ginger consumption on lipid profile, it seems that ginger can be considered as a valuable ingredient for modifying blood lipids, especially in diabetic patients. This probable property might be due to its effective antioxidants, including gingerols and shogaols. However, because of the lack of clinical trials in this field, it is necessary to conduct further human studies that examine the use of various amounts of ginger during a longer period of time. Also, other experimental human studies to characterize the possible mechanisms of the effect of ginger on blood lipids are recommended.
Source : Journal Herbal Medicine
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Mulberry leaf extract displays antidiabetic activity in db/db mice via Akt and AMP-activated protein kinase phosphorylation
Ui-Jin Bae 1, 2 †, Eun-Soo Jung 2† , Su-Jin Jung 2 , Soo-Wan Chae 2 , 3* and Byung-Hyun Park 1
Abstract
Background:
Augmenting glucose utilization in skeletal muscle via the phosphatidylinositol-3 kinase (PI3 kinase)/protein kinase B (Akt) pathway or the adenosine monophosphate (AMP)-activated protein kinase (AMPK) pathway is necessary to regulate hyperglycemia in patients with type 2 diabetes mellitus.
Objective:
We investigated the effect of mulberry leaf extract (MLE) on glucose uptake in skeletal muscle cells and explored its in vivo
antidiabetic potential.
Design:
Male db/db mice were treated with either MLE (50 mg/kg, 100 mg/kg, and 250 mg/kg) or metformin (100 mg/kg) for 8 weeks.
Results:
MLE treatment stimulated glucose uptake, driven by enhanced translocation of glucose transporter 4 to cell membranes in L6 myotubes. These effects of MLE were synergistic with those of insulin and were abolished in the presence of PI3K inhibitor or AMPK inhibitor. In db/db mice, supplementation with MLE decreased fasting blood glucose and insulin levels and enhanced insulin sensitivity, with increases of p-Akt and p-AMPK in skeletal muscle. Moreover, MLE improved blood lipid parameters and attenuated hepatic steatosis in diabetic db/db mice.
Discussion:
These findings suggest that MLE exerts antidiabetic activity through stimulating glucose disposal in skeletal muscle cells
via the PI3K/Akt and AMPK pathways.
Conclusions:
MLE can potentially improve hyperglycemia and hepatic steatosis in patients with type 2 diabetes.
Source : Food and Nutrition Research
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Effect of garlic supplement in the management of type 2 diabetes mellitus (T2DM): a meta-analysis of randomized controlled trials
Juan Wang, Xiuming Zhang, Haili Lan & Weijia Wang
Abstract
The present study was designed to systematically evaluate the clinical efficacy and safety of garlic supplement in the management of type 2 diabetes mellitus (T2DM). PubMed, EMBASE, the Cochrane Library, and China National Knowledge Internet (CNKI) were searched for relevant randomized controlled trials (RCTs) by using the terms garlic and T2DM up to April 2017. The quality of included RCTs was assessed by the Cochrane tool of risk of bias, and data of outcomes were pooled by REVMAN 5.3. Clinical factors were handled by meta-regression and subgroup analysis, and risk of publication bias was explored by inverted funnel plots. Nine RCTs involving 768 T2DM patients were included in the meta-analysis, and the dose of daily garlic (allicin) supplement ranged from 0.05g to 1.5g. A significant reduction in the level of fasting blood glucose in 1–2 weeks [SMD = −1.61, 95%CI (−2.89, −0.32)], 3–4 weeks [SMD = −2.87, 95%CI (−4.74, −1.00)], 12 weeks [SMD = −9.57, 95%CI (−12.39, −6.75)], and 24 weeks [SMD = −21.02, 95% CI (−32.47, −9.57)] was achieved in favour of the garlic group rather than the control group. Significantly decreased fructosamine and glycated hemoglobin (both in 12 and 24 weeks) were also found in garlic group. Meanwhile, significantly improved blood liquids of total cholesterol [SMD = −1.93, 95%CI (−2.98, −0.87), 3–4 weeks], high density lipoprotein [SMD = −0.41, 95%CI (−0.83, −0.00), 3–4 weeks] and low density lipoprotein [SMD = −3.47, 95%CI (−5.76, −1.18), 12 weeks] were confirmed after garlic administration. There was no significant difference in complications. Current data confirms that garlic supplement plays positive and sustained roles in blood glucose, total cholesterol, and high/low density lipoprotein regulation in the management of T2DM.
Source : Food and Nutrition Research
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Effect of dark sweet cherry powder consumption on the gut microbiota, short-chain fatty acids, and biomarkers of gut health in obese db/db mice
Jose F. Garcia-Mazcorro,1,2 Nara N. Lage,3,4 Susanne Mertens-Talcott,4 Stephen Talcott,4 Boon Chew,4Scot E. Dowd,5 Jorge R. Kawas,6 and Giuliana D. Noratto4
Abstract
Cherries are fruits containing fiber and bioactive compounds (e.g., polyphenolics) with the potential of helping patients with diabetes and weight disorders, a phenomenon likely related to changes in the complex host-microbiota milieu. The objective of this study was to investigate the effect of cherry supplementation on the gut bacterial composition, concentrations of caecal short-chain fatty acids (SCFAs) and biomarkers of gut health using an in vivo model of obesity. Obese diabetic (db/db) mice received a supplemented diet with 10% cherry powder (supplemented mice, n = 12) for 12 weeks; obese (n = 10) and lean (n = 10) mice served as controls and received a standard diet without cherry. High-throughput sequencing of the 16S rRNA gene and quantitative real-time PCR (qPCR) were used to analyze the gut microbiota; SCFAs and biomarkers of gut health were also measured using standard techniques. According to 16S sequencing, supplemented mice harbored a distinct colonic microbiota characterized by a higher abundance of mucin-degraders (i.e., Akkermansia) and fiber-degraders (the S24-7 family) as well as lower abundances of Lactobacillus and Enterobacteriaceae. Overall this particular cherry-associated colonic microbiota did not resemble the microbiota in obese or lean controls based on the analysis of weighted and unweighted UniFrac distance metrics. qPCR confirmed some of the results observed in sequencing, thus supporting the notion that cherry supplementation can change the colonic microbiota. Moreover, the SCFAs detected in supplemented mice (caproate, methyl butyrate, propionate, acetate and valerate) exceeded those concentrations detected in obese and lean controls except for butyrate. Despite the changes in microbial composition and SCFAs, most of the assessed biomarkers of inflammation, oxidative stress, and intestinal health in colon tissues and mucosal cells were similar in all obese mice with and without supplementation. This paper shows that dietary supplementation with cherry powder for 12 weeks affects the microbiota and the concentrations of SCFAs in the lower intestinal tract of obese db/db diabetic mice. These effects occurred in absence of differences in most biomarkers of inflammation and other parameters of gut health. Our study prompts more research into the potential clinical implications of cherry consumption as a dietary supplement in diabetic and obese human patients.
Source : PeerJ
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Pre-pregnancy dietary carbohydrate quantity and quality, and risk of developing gestational diabetes: the Australian Longitudinal Study on Women’s Health
Moniek Looman1 *, Danielle A. J. M. Schoenaker2 , Sabita S. Soedamah-Muthu3,4, Anouk Geelen1 , Edith J. M. Feskens1 and Gita D. Mishra5
1 Division of Human Nutrition, Wageningen University & Research, PO Box 17, 6700 AA Wageningen, The Netherlands
2 Centre for Behavioural Research in Cancer, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC 3004, Australia
3 Department of Medical and Clinical Psychology, Center of Research on Psychology in Somatic Diseases (CoRPS), Tilburg University, PO Box 90153, 5000 LE Tilburg, The Netherlands
4 Institute for Food, Nutrition and Health, University of Reading, Reading RG6 6AR, UK
5 School of Public Health, University of Queensland, 288 Herston Road, Herston, QLD 4006, Australia
Abstract
Carbohydrate quantity and quality affect postprandial glucose response, glucose metabolism and risk of type 2 diabetes. The aim of this study was to examine the association of pre-pregnancy dietary carbohydrate quantity and quality with the risk of developing gestational diabetes mellitus (GDM). We used data from the Australian Longitudinal Study on Women’s Health that included 3607 women aged 25–30 years without diabetes who were followed up between 2003 and 2015. We examined carbohydrate quantity (total carbohydrate intake and a low-carbohydrate diet (LCD) score) and carbohydrate subtypes indicating quality (fibre, total sugar intake, glycaemic index, glycaemic load and intake of carbohydrate-rich food groups). Relative risks (RR) for development of GDM were estimated using multivariable regression models with generalised estimating equations. During 12 years of follow-up, 285 cases of GDM were documented in 6263 pregnancies (4·6 %). The LCD score, reflecting relatively high fat and protein intake and low carbohydrate intake, was positively associated with GDM risk (RR 1·54; 95 % CI 1·10, 2·15), highest quartile v. lowest quartile). Women in the quartile with highest fibre intake had a 33 % lower risk of GDM (RR 0·67; 95 % CI 0·45, 0·96)). Higher intakes of fruit (0·95 per 50 g/d; 95 % CI 0·90, 0·99) and fruit juice (0·89 per 100 g/d; 95 % CI 0·80, 1·00)) were inversely associated with GDM, whereas cereal intake was associated with a higher risk of GDM (RR 1·05 per 20 g/d; 95 % CI 1·01, 1·07)). Thus, a relatively low carbohydrate and high fat and protein intake may increase the risk of GDM, whereas higher fibre intake could decrease the risk of GDM. It is especially important to take the source of carbohydrates into account
Source : The British Journal of Nutrition via Sci-Hub
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Aloe Vera Shows Promise in Lowering Blood Glucose and Reducing Other Symptoms of Prediabetes
Zhang Y, Liu W, Liu D, Zhao T, Tian H. Efficacy of aloe vera supplementation on prediabetes and early non-treated diabetic patients: a systematic review and meta-analysis of randomized controlled trials. Nutrients. June 23, 2016;8(7). pii: E388. doi: 10.3390/nu8070388.
Diabetes is characterized partly by elevated blood glucose and is a serious disease that may lead to potentially devastating health complications. Standard medications for diabetes often cause adverse side effects; thus, botanicals may be an effective and less expensive option for lowering blood glucose. Aloe vera (Aloe vera, Xanthorrhoeaceae) is used to treat many health concerns, but the research on its potential use for diabetes is conflicted. This systematic review and meta-analysis focused on randomized clinical trials (RCTs) investigating potential hypoglycemic activity of aloe vera.
The authors searched PubMed, Embase, and Cochrane Central Register of Controlled Trials, from each database's origin to January 28, 2016. The search terms used were extensive, including "hyperglycemia," "impaired glucose tolerance," "diabetes mellitus," and "aloe vera," among others. Publications in any language were considered. The American Diabetes Association and World Health Organization criteria for prediabetes and type 2 diabetes mellitus were used. Studies included were RCTs, with or without lifestyle interventions, used aloe vera alone, included patients that were not using hypoglycemic medication and did not have heart disease or other serious health problems, and had glucose and/or lipid status as primary outcomes. The studies were evaluated on quality, with the terms "adequate, inadequate, and unclear," to describe randomization, allocation concealment, blinding, and intention-to-treat (ITT) analysis.
The search yielded 282 publications and was narrowed down to five RCTs, published from 1996 to 2016, with 415 patients. It was found that of the five studies, two reported randomization methodology, and no RCTs had adequate blinding. Three RCTs had adequate patient withdrawal and dropout data, and ITT analysis occurred in one study. Patients were overweight or obese as reported in four RCTs, and study length was six to 12 weeks.
There was significant heterogeneity for fasting blood glucose in patients across the five RCTs (P<0.00001). Aloe vera performed better than placebo in reducing fasting blood glucose concentrations (P=0.02). No effect was noted on insulin concentrations, but heterogeneity was reported in the two RCTs with this outcome (P<0.00001). Glycated hemoglobin (HbA1c, a long-term glucose metric) was measured in two RCTs and was significantly decreased by aloe vera usage (P<0.00001) with no significant heterogeneity.
Of the RCTs, four investigated aloe vera in comparison to placebo for triglyceride and total cholesterol (TC) concentrations. It was found that aloe vera was more effective than placebo in decreasing triglyceride (P=0.0001) and TC concentrations (P<0.00001); however, heterogeneity in both metrics was observed (P<0.00001 for both). Also, aloe vera was found to better increase high-density lipoprotein (HDL) cholesterol (P=0.04) and decrease low-density lipoprotein (LDL) cholesterol (P<0.00001) as compared with placebo. Both outcomes had significant heterogeneity (P=0.0008 and P<0.00001, respectively).
In summary, the authors conclude that aloe vera treatment impacted fasting blood glucose concentrations, HbA1c, and triglyceride, TC, and LDL and HDL cholesterol concentrations, despite heterogeneity across RCTs. Discussed possible mechanisms include potentiation of glucose transport, attenuation of cholesterol gut absorption, and modulation of gene expression. Stated limitations include the finite RCT sample size, discrepancy of patient background, publication bias, variation in form and dose of aloe vera (studies included used capsules, powder, or juice), and lack of available data for certain outcomes. Additionally, some methodology was not reported. Larger and more rigorous trials to establish the efficacy and safety of aloe vera in this population are recommended.
--Amy C. Keller, PhD
Source : American Botanical Council - Herb Cllip
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Cinnamon extract lowers glucose, insulin and cholesterol in people with elevated serum glucose
- Richard A. Andersona, , ,
- Zhiwei Zhanb,
- Rencai Luoc,
- Xiuhua Guod,
- Qingqing Guod,
- Jin Zhoue,
- Jiang Kongf,
- Paul A. Davisg,
- Barbara J. Stoeckerh
AbstractCinnamon (肉桂 ròu guì) has in vitro insulin potentiating activity, and proanthocyanidins from cinnamon prevent in vitro formation of advanced glycation end products. Some human studies were equivocal, but several have shown beneficial effects of cinnamon supplementation on circulating glucose, lipids, and/or insulin. This placebo-controlled double-blind trial tested the effects of a dried water extract of cinnamon (Cinnamomum cassia) on circulating glucose, lipids, insulin, and insulin resistance. Men and women from Beijing and Dalian, China, were invited to participate if they had fasting serum glucose >6.1 mmol/L or 2-h glucose >7.8 mmol/L. Participants, (173 were enrolled and 137 completed the study) were randomly assigned to receive either a spray-dried, water extract of cinnamon (CinSulin®), 250 mg/capsule, or a placebo, twice a day for two months. Mean ± SEM age of participants was 61.3 ± 0.8 years, BMI was 25.3 ± 0.3 and M/F ratio was 65/72. After 2 mo, fasting glucose decreased (p < 0.001) in the cinnamon extract-supplemented group (8.85 ± 0.36 to 8.19 ± 0.29 mmol/L) compared with the placebo group (8.57 ± 0.32 to 8.44 ± 0.34 mmol/L, p = 0.45). Glucose 2 h after a 75 g carbohydrate load, fasting insulin, and HOMA-IR also decreased with cinnamon extract compared with placebo. Total and LDL-cholesterol decreased with cinnamon extract and HDL-cholesterol decreased in both the cinnamon-extract and placebo groups. In conclusion, supplementation with 500 mg of water-extract of cinnamon for two months reduced fasting insulin, glucose, total cholesterol, and LDL cholesterol and enhanced insulin sensitivity of subjects with elevated blood glucose.
Source : Journal of Traditional and Complementary Medicine
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Chemical analysis of Punica granatum fruit peel and its in vitro and in vivo biological properties
- Kaliyan Barathikannan,
- Babu Venkatadri,
- Ameer Khusro,
- Naif Abdullah Al-Dhabi,
- Paul Agastian,
- Mariadhas Valan Arasu,
- Han Sung Choi and
- Young Ock Kim
Abstract
BackgroundThe medical application of pomegranate fruits and its peel is attracted human beings. The aim of the present study was to evaluate the in vitro α-Glucosidase inhibition, antimicrobial, antioxidant property and in vivo anti-hyperglycemic activity of Punica granatum (pomegranate) fruit peel extract using Caenorhabditis elegans.
Methods Various invitro antioxidant activity of fruit peel extracts was determined by standard protocol. Antibacterial and antifungal activities were determined using disc diffusion and microdilution method respectively. Anti-hyperglycemic activity of fruit peel was observed using fluorescence microscope for in vivo study.
Results The ethyl acetate extract of P. granatum fruit peel (PGPEa) showed α-Glucosidase inhibition upto 50 % at the concentration of IC50 285.21 ± 1.9 μg/ml compared to hexane and methanol extracts. The total phenolic content was highest (218.152 ± 1.73 mg of catechol equivalents/g) in ethyl acetate extract. PGPEa showed more scavenging activity on 2,2-diphenyl-picrylhydrazyl (DPPH) with IC50 value 302.43 ± 1.9 μg/ml and total antioxidant activity with IC50 294.35 ± 1.68 μg/ml. PGPEa also showed a significant effecton lipid peroxidation IC50 208.62 ± 1.68 μg/ml, as well as high reducing power. Among the solvents extracts tested, ethyl acetate extract of fruit peel showed broad spectrum of antimicrobial activity. Ethyl acetate extract supplementedC.elegans worms showed inhibition of lipid accumulation similar to acarbose indicating good hypoglycemic activity. The normal worms compared to test (ethyl acetate extract supplemented) showed the highest hypoglycaemic activity by increasing the lifespan of the worms. GC-MS analysis of PGPEa showed maximum amount of 5-hydroxymethylfurfural and 4-fluorobenzyl alcohol (48.59 %).
Conclusion In the present investigation we observed various biological properties of pomegranate fruit peel. The results clearly indicated that pomegranate peel extract could be used in preventing the incidence of long term complication of diabetics.
Source : BMC Complementary and Alternative Medicine
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Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis
Dick William R., Fletcher Emily A., and Shah Sachin A..
Abstract
Purpose: Diabetes mellitus is a global epidemic and one of the leading causes of morbidity and mortality. Additional medications that are novel, affordable, and efficacious are needed to treat this rampant disease. This meta-analysis was performed to ascertain the effectiveness of oral aloe vera consumption on the reduction of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c).
Methods: PubMed, CINAHL, Natural Medicines Comprehensive Database, and Natural Standard databases were searched. Studies of aloe vera's effect on FBG, HbA1c, homeostasis model assessment-estimated insulin resistance (HOMA-IR), fasting serum insulin, fructosamine, and oral glucose tolerance test (OGTT) in prediabetic and diabetic populations were examined. After data extraction, the parameters of FBG and HbA1c had appropriate data for meta-analyses. Extracted data were verified and then analyzed by StatsDirect Statistical Software. Reductions of FBG and HbA1c were reported as the weighted mean differences from baseline, calculated by a random-effects model with 95% confidence intervals. Subgroup analyses to determine clinical and statistical heterogeneity were also performed. Publication bias was assessed by using the Egger bias statistic.
Results: Nine studies were included in the FBG parameter (n = 283); 5 of these studies included HbA1c data (n = 89). Aloe vera decreased FBG by 46.6 mg/dL (p < 0.0001) and HbA1c by 1.05% (p = 0.004). Significant reductions of both endpoints were maintained in all subgroup analyses. Additionally, the data suggest that patients with an FBG ≥200 mg/dL may see a greater benefit. A mean FBG reduction of 109.9 mg/dL was observed in this population (p ≤ 0.0001). The Egger statistic showed publication bias with FBG but not with HbA1c (p = 0.010 and p = 0.602, respectively).
Conclusion: These results support the use of oral aloe vera for significantly reducing FBG (46.6 mg/dL) and HbA1c (1.05%). Further clinical studies that are more robust and better controlled are warranted to further explore these findings.
Source : Journal Alternative and Complementary Medicine
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Chinese medicines in the treatment of experimental diabetic nephropathy
- Jing-Yi Liu,
- Xiao-Xin Chen,
- Sydney Chi-Wai TangEmail author,
- Stephen Cho-Wing Sze,
- Yi-Bin Feng,
- Kai-Fai Lee and
- Kalin Yan-Bo Zhang
Diabetic nephropathy (DN) is a severe micro vascular complication accompanying diabetes mellitus that affects millions of people worldwide. End-stage renal disease occurs in nearly half of all DN patients, resulting in large medical costs and lost productivity. The course of DN progression is complicated, and effective and safe therapeutic strategies are desired. While the complex nature of DN renders medicines with a single therapeutic target less efficacious, Chinese medicine, with its holistic view targeting the whole system of the patient, has exhibited efficacy for DN management. This review aims to describe the experimental evidence for Chinese medicines in DN management, with an emphasis on the underlying mechanisms, and to discuss the combined use of herbs and drugs in DN treatment.
Conclusion
CMs provides an alternative for DN management in all stages of experimental DN models, especially in the early and incipient stages of DN, and the synergistic administration of CM herbs with conventional drugs exhibited better efficacy than drugs alone in DN treatment.
Source : Journal Chinese Medicine
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Ethanolic Ginkgo biloba leaf extract prevents renal fibrosis through Akt/mTOR signaling in diabetic nephropathy
- Qian Lu1,
- Wen-Zi Zuo1,
- Xiao-Jun Ji,
- Yue-Xian Zhou,
- Yu-Qing Liu,
- Xiao-Qin Yao,
- Xue-Yan Zhou,
- Yao-Wu Liu,
- Fan Zhang,
- Xiao-Xing Yin
Abstract
Background
Recently, extract of Ginkgo biloba leaves (GbE) have become widely known phytomedicines and have shown various pharmacological activities, including improvement of blood circulation, protection of oxidative cell damage, prevention of Alzheimer's disease, treatment of cardiovascular disease and diabetes complications. This study was designed to investigate the effects of an ethanolic GbE on renal fibrosis in diabetic nephropathy (DN) and to clarify the possible mechanism by which GbE prevents renal fibrosis.
Study design
We investigated the protective effects of GbE on renal fibrosis in STZ-induced diabetic rats. Rats were randomized into six groups termed normal control, diabetes mellitus, low dose of GbE (50 mg/kg/d), intermediate dose of GbE (100 mg/kg/d), high dose of GbE (200 mg/kg/d) and rapamycin (1 mg/kg/d).
Methods
After 12 weeks, the rats were sacrificed and then fasting blood glucose (FBG), creatinine (Cr), blood urea nitrogen (BUN), urine protein, relative kidney weight, glycogen and collagen accumulation, and collagen IV and laminin expression were measured by different methods. The amounts of E-cadherin, α-SMA and snail, as well as the phosphorylation of Akt, mTOR and p70S6K in the renal cortex of rats, were examined by western blotting.
Results
Compared with diabetic rats, the levels of Cr, BUN, urine protein, relative kidney weight, accumulation of glycogen and collagen, and expression of collagen IV and laminin in the renal cortex were all decreased in GbE treated rats. In addition, GbE reduced the expression of E-cadherin, α-SMA, snail and the phosphorylation of Akt, mTOR and p70S6K in diabetic renal cortex.
Conclusion
GbE can prevent renal fibrosis in rats with diabetic nephropathy, which is most likely to be associated with its abilities to inhibit the Akt/mTOR signaling pathway.
Source : Journal Phytomedicine
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Everyday mindfulness linked to healthy glucose levels
Brown University researchers investigating how mindfulness may affect cardiovascular health have measured a significant association between a high degree of ‘everyday’ mindfulness and a higher likelihood of having normal, healthy glucose levels. Their analysis showed that a lower risk of obesity and greater sense of control among more mindful people may play mediating roles.
PROVIDENCE, R.I. [Brown University] —Dispositional, or “everyday” mindfulness is the inherent trait of being aware of one’s present thoughts and feelings. In a new study of 399 people that measured health indicators including dispositional mindfulness and blood glucose, researchers found that those with higher scores for mindfulness were significantly more likely than people with low scores to have healthy glucose levels.
The results show an association and do not prove a cause, but they are part of a program led by Brown University where researchers are studying whether interventions that increase mindfulness can improve cardiovascular health. Their overarching hypotheses are that people practicing higher degrees of mindfulness may be better able to motivate themselves to exercise, to resist cravings for high-fat, high-sugar treats, and to stick with diet and exercise regimens recommended by their doctors.
The researchers therefore sought to identify factors that might explain the connection they saw between higher mindfulness and healthier glucose levels. Their analysis of the data showed that obesity risk (mindful people are less likely to be obese) and sense of control (mindful people are more likely to believe they can change many of the important things in their life) both contribute to the link.
“This study demonstrated a significant association of dispositional mindfulness with glucose regulation, and provided novel evidence that obesity and sense of control may serve as potential mediators of this association,” wrote the authors led by Eric Loucks, assistant professor of epidemiology in the Brown University School of Public Health. “As mindfulness is likely a modifiable trait, this study provides preliminary evidence for a fairly novel and modifiable potential determinant of diabetes risk.”
The study, published in the American Journal of Health Behavior, did not show a direct, statistically significant link between mindfulness and type 2 diabetes risk, which is the medical concern related to elevated blood glucose. Participants with high levels of mindfulness were about 20 percent less likely to have type 2 diabetes, but the total number of people in the study with the condition may have been too small to allow for definitive findings, Loucks said.
Measuring mindfulness, gauging glucose
To gather their data, Loucks and his team enrolled 399 volunteers who’ve been participating in the New England Family Study. The subjects participated in several psychological and physiological tests including glucose tests and the Mindful Attention Awareness Scale (MAAS), a 15-item questionnaire to assess dispositional mindfulness on a 1 to 7 scale. The researchers also collected data on a host of other potentially relevant demographic and health traits including body-mass index, smoking, education, depression, blood pressure, perceived stress, and sense of control.
After adjusting their data to account for such confounding factors as age, sex, race or ethnicity, family history of diabetes, and childhood socioeconomic status, the researchers found that people with high MAAS scores of 6 or 7 were 35 percent more likely to have healthy glucose levels under 100 milligrams per deciliter than people with low MAAS scores below 4.
The analysis found that obesity made about a 3-percentage point difference of the total 35-percent point risk difference. Sense of control accounted for another 8 percentage points of the effect. The rest may derive from factors the study didn’t measure, but at least now researchers have begun to elucidate the possible mechanisms that link mindfulness to glucose regulation.
“There’s been almost no epidemiological observational study investigations on the relationship of mindfulness with diabetes or any cardiovascular risk factor,” Loucks said. “This is one of the first. We’re getting a signal. I’d love to see it replicated in larger sample sizes and prospective studies as well.”
Source : Brown University
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Protective effects of Egyptian cloudy apple juice and apple peel extract on lipid peroxidation, antioxidant enzymes and inflammatory status in diabetic rat pancreas
- Samah M. FathyEmail author and
- Ehab A. Drees
Abstract
Background
Apples possess rich content of varied polyphenolic compounds showing a variety of biological activities that may ascribe to worthy effects against some chronic diseases. The present study was designed to assess the protective effects of the cloudy apple juice (CAJ) and apple peel extract (APE) of Egyptian Anna apple on the complications in experimental diabetes.
Materials and methods
Four groups were studied. Diabetes was induced by a single dose of streptozotocin (STZ) to only three groups of albino Wistar rats. Two of the diabetic groups received either CAJ or APE for 21 days. At the end of the study, lipid profile parameters were measured in serum while lipid peroxidation (LPO) level, antioxidant enzyme activities and inflammatory markers were evaluated in pancreas tissue samples. The gas chromatography–mass spectrometry (GC-MS) analysis of phenolic compounds found in CAJ and APE was carried out. Moreover, total phenolic content of CAJ and APE were measured.
Results
The significant increase of blood glucose level, serum total cholesterol (TC), triglycerides (TG), low- density lipoprotein cholesterol (LDL-C), and very low-density lipoprotein (VLDL) levels, in addition to tissue malondialdehyde (MDA), nuclear factor kappa B (NF-kB), tumor necrosis factor α (TNF-α), interleukin 6 (IL-6), interleukin 8 (IL-8) levels, but a significant decrease in high-density lipoprotein cholesterol (HDL-C), and the activity of pancreatic antioxidant enzymes were the remarkably parameters observed in diabetic control rats. Dissimilarly, oral supplementation of 15 ml/kg CAJ and 1 g/kg APE for 21 days resulted in a significant decrease in fasting blood glucose, serum TC, TG, LDL-C, VLDL-C and tissue MDA, NF-kB, TNF-α, IL-6, IL-8 levels coupled with a significant elevation of HDL-C and antioxidant enzymes’ activity when compared with diabetic control animals.
Conclusions
The results indicate that Egyptian CAJ and APE supplementation may have protective effects against deleterious complications of diabetes mellitus.
Source : BMC Complementary and Alternative Medicine
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Triphala improves glucose homeostasis by alleviating atherogenic lipids and oxidative stress in human Type 2 diabetes mellitus
Nita Singh1 , Sunil Mahajan1, Senthil K Subramani1,Dhananjay Yadav2, Lokendra Singh3, Prasad GBKS1
Abstract
Aims: ‘Triphala’ constituting equal parts of three medicinal dried plant fruits Emblica Officinalis Gaertn., Terminalia chebula Retz. and Terminalia bellerica Gaertn. is an antioxidant rich Ayurvedic formulation. The present study assessed therapeutic as well as protective effects of Triphala on human subjects with Type 2 diabetes mellitus (T2DM) and Impaired glucose tolerance (IGT).
Materials and methods: Triphala at a dose of 5 gms BD was administered to two cohorts viz., IGT, N= 20 and T2DM, N=30 consecutively for a period of 12 months. The therapeutic efficacy was assessed quarterly by monitoring blood glucose and lipid levels; the protective effect by monitoring antioxidants level quarterly and DNA damage annually. Toxicity if any, to liver and kidney due to long term administration was assessed quarterly in both cohorts.
Results: Continuous ‘Triphala’ therapy for 12 months significantly reduced blood glucose (p≤0.001) and lipid levels (p≤0.05) in both the cohorts. Triphala resisted oxidative stress generated during the course of hyperglycemia by significantly increasing the activity of super oxide dismutase and Catalase (p≤0.001) and the level of reduced glutathione (p≤0.001). Protective effect on DNA was accessed through significant reduction in the comet tail length (p≤0.001).
Conclusions: ‘Triphala’ ameliorated not only the oxidative stress but also normalized glucose and lipid homeostasis in subjects with impaired glucose and T2DM.
Source : International Journal Ayurvedic Medicine
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In-vitro antioxidant and antidiabetic potentials of Dianthus basuticus Burtt Davy whole plant extracts
Abstract
Dianthus basuticus is a popular South African medicinal plant used in the management of diabetes mellitus. This study evaluated the antioxidant and antidiabetic potential of D. basuticus using an in-vitro model. The antioxidant activity was determined using iron chelation, 1,1-diphenyl-2-picrylhydrazyl (DPPH), hydroxyl and superoxide anion radical scavenging abilities of the aqueous, ethanol and hydro-ethanol extracts of D. basuticuswhile the antidiabetic potential was assessed by evaluating the inhibitory effects of the extracts on the activities of α-amylase, α-glucosidase, maltase and sucrase. The aqueous extract displayed significantly higher (p < 0.05) DPPH (2.56 μg/mL) and superoxide radical (7.22 μg/mL) scavenging abilities while ethanol (10.56 μg/mL) and hydro-ethanol (6.95 μg/mL) extracts exhibited strongest hydroxyl radical scavenging and iron chelation activities respectively. The ethanol extract displayed significantly higher (p < 0.05) inhibition of α-amylase (34.02 μg/mL) while aqueous extract exhibited strongest inhibition of α-glucosidase (6.59 μg/mL), maltase (31.21 μg/mL) and sucrase (20.98 μg/mL). Hydro-ethanol and aqueous extract inhibited α-amylase and α-glucosidase in a mixed non-competitive and pure non-competitive manner respectively while the aqueous extract competitively inhibited both maltase and sucrase activities. It can be concluded that D. basuticus extracts possessed antioxidant and antidiabetic activities, and one of its mechanism of antidiabetic action is through the inhibition of diabetes-related enzymes.
Source : Journal of Herbal Medicine
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Topical Hypericum perforatum Improves Tissue Regeneration in Full-Thickness Excisional Wounds in Diabetic Rat Model
Soheila Yadollah-Damavandi,1 Mehdi Chavoshi-Nejad,2 Ehsan Jangholi,1 Noushin Nekouyian,3 Sahar Hosseini,3 Amin Seifaee,3 Shima Rafiee,3 Hossein Karimi,3 Soheil Ashkani-Esfahani,3 Yekta Parsa,1 and Maryam Mohsenikia4
1Young Researchers and Elite Club, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran
2Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
4Dezful University of Medical Sciences, Dezful, Iran
Abstract
Delayed wound healing process is one of the most important concerns in diabetes. Healing of wounds has four phases, namely, hemostasis, inflammation, proliferation, and remodeling. For a successful repair, all four factors must occur properly. Hence, we aimed to evaluate the healing effects of Hypericum perforatum (HP) on full-thickness diabetic skin wounds by using stereological methods. Forty-eight female diabetic rats were randomly divided into four groups (n = 12): gel base treated group, HP 5% gel treated group, HP 10% gel treated group, and the control group which received no treatment. A circular 1 cm2 full-thickness wound was created on the animal’s neck and wound area was measured every three days. After sacrificing the animals, skin samples were fixed and prepared for stereological evaluations. Based on the results, HP treated group showed faster wound closure rate in comparison with control and vehicle groups (P<0.05). In addition, numerical density of fibroblasts, volume density of collagen bundles, and mean diameter and volume densities of the vessels in HP group were significantly higher than control and vehicle groups. The results of this study showed that HP has the ability to improve tissue regeneration by enhancing fibroblast proliferation, collagen bundle synthesis, and revascularization.
Source : Evidence Based Complementaryand Alternative Medicine
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Consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice and incidence of type 2 diabetes: systematic review, meta-analysis, and estimation of population attributable fraction
Abstract
Objectives To examine the prospective associations between consumption of sugar sweetened beverages, artificially sweetened beverages, and fruit juice with type 2 diabetes before and after adjustment for adiposity, and to estimate the population attributable fraction for type 2 diabetes from consumption of sugar sweetened beverages in the United States and United Kingdom.
Design Systematic review and meta-analysis.
Data sources and eligibility PubMed, Embase, Ovid, and Web of Knowledge for prospective studies of adults without diabetes, published until February 2014. The population attributable fraction was estimated in national surveys in the USA, 2009-10 (n=4729 representing 189.1 million adults without diabetes) and the UK, 2008-12 (n=1932 representing 44.7 million).
Synthesis methods Random effects meta-analysis and survey analysis for population attributable fraction associated with consumption of sugar sweetened beverages.
Results Prespecified information was extracted from 17 cohorts (38 253 cases/10 126 754 person years). Higher consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, by 18% per one serving/day (95% confidence interval 9% to 28%, I2 for heterogeneity=89%) and 13% (6% to 21%, I2=79%) before and after adjustment for adiposity; for artificially sweetened beverages, 25% (18% to 33%, I2=70%) and 8% (2% to 15%, I2=64%); and for fruit juice, 5% (−1% to 11%, I2=58%) and 7% (1% to 14%, I2=51%). Potential sources of heterogeneity or bias were not evident for sugar sweetened beverages. For artificially sweetened beverages, publication bias and residual confounding were indicated. For fruit juice the finding was non-significant in studies ascertaining type 2 diabetes objectively (P for heterogeneity=0.008). Under specified assumptions for population attributable fraction, of 20.9 million events of type 2 diabetes predicted to occur over 10 years in the USA (absolute event rate 11.0%), 1.8 million would be attributable to consumption of sugar sweetened beverages (population attributable fraction 8.7%, 95% confidence interval 3.9% to 12.9%); and of 2.6 million events in the UK (absolute event rate 5.8%), 79 000 would be attributable to consumption of sugar sweetened beverages (population attributable fraction 3.6%, 1.7% to 5.6%).
Conclusions Habitual consumption of sugar sweetened beverages was associated with a greater incidence of type 2 diabetes, independently of adiposity. Although artificially sweetened beverages and fruit juice also showd positive associations with incidence of type 2 diabetes, the findings were likely to involve bias. None the less, both artificially sweetened beverages and fruit juice were unlikely to be healthy alternatives to sugar sweetened beverages for the prevention of type 2 diabetes. Under assumption of causality, consumption of sugar sweetened beverages over years may be related to a substantial number of cases of new onset diabetes.
Source : BMJ
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The role of acetic acid on glucose uptake and blood flow rates in the skeletal muscle in humans with impaired glucose tolerance
P Mitrou1, E Petsiou2, E Papakonstantinou2, E Maratou1, V Lambadiari2, P Dimitriadis3, F Spanoudi2, S A Raptis1,2 and G Dimitriadis2
- 1Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and its Complications (H.N.D.C.), Athens, Greece
- 2Second Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, Haidari, Greece
- 3Department of Water Resources and Environmental Engineering, School of Civil Engineering, NTUA, Athens, Greece
Abstract
Background/Objectives: Previous studies support the glucose-lowering effect of vinegar. However, the effect of vinegar on muscle glucose metabolism and endothelial function has not been studied in humans. This open, randomized, crossover, placebo-controlled study aims to investigate the effects of vinegar on muscle glucose metabolism, endothelial function and circulating lipid levels in subjects with impaired glucose tolerance (IGT) using the arteriovenous difference technique.
Subjects/Methods: Eight subjects with IGT (4 males, age 46±10 years, body mass index 30±5) were randomised to consume 0.50 mmol vinegar (6% acetic acid) or placebo before a mixed meal. Plasma samples were taken for 300 min from the radial artery and the forearm vein for measurements of glucose, insulin, triglycerides, non-esterified fatty acids (NEFAs) and glycerol. Muscle blood flow was measured with strain gauge plethysmography. Glucose flux was calculated as the arteriovenous difference of glucose multiplied by the blood flow rates.
Results: Vinegar compared with placebo: (1) decreased arterial plasma insulin (Poverall<0.001; P75 min=0.014, β=−42), (2) increased forearm blood flow (Poverall<0.001; P240 min=0.011, β=1.53; P300 min=0.023, β=1.37), (3) increased muscle glucose uptake (Poverall<0.001; P60 min=0.029, β=2.78) and (4) decreased arterial plasma triglycerides (Poverall=0.005;P240 min<0.001, β=−344; P300 min<0.001, β=−373), without changing NEFA and glycerol.
Conclusions: In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.
Source : European Journal of Clinical Nutrition
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Vitamin D and type 2 diabetes: a systematic review
J Mitri1, M D Muraru2 and A G Pittas1
- 1Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, Boston, MA, USA
- 2Department of Internal Medicine, Carney Hospital, Dorchester, MA, USA
Abstract
Background/Objectives: Vitamin D may modify the risk of type 2 diabetes mellitus. The aim of this review was to examine the association between vitamin D status and incident type 2 diabetes, and the effect of vitamin D supplementation on glycemic outcomes.
Methods: We performed a systematic review of English-language studies using MEDLINE through February 2011. Longitudinal cohort studies reporting associations between vitamin D status and incident type 2 diabetes, and randomized controlled trials (RCTs) of vitamin D supplementation, were included. Study characteristics and results were extracted, and study quality was assessed.
Results: A total of 8 observational cohort studies and 11 RCTs were included. In meta-analyses of observational studies, vitamin D intake >500 international units (IU)/day decreased the risk of type 2 diabetes by 13%compared with vitamin D intake <200 IU/day. Individuals with the highest vitamin D status (>25 ng/ml) had a 43% lower risk of developing type 2 diabetes (95% confidence interval 24, 57%) compared with those in the lowest group (<14 ng/ml). In post hoc analyses from eight trials among participants with normal glucose tolerance at baseline and in three small underpowered (n=32–62) trials of patients with established type 2 diabetes, there was no effect of vitamin D supplementation on glycemic outcomes. In two trials among patients with baseline glucose intolerance, vitamin D supplementation improved insulin resistance.
Conclusions: Vitamin D may play a role in type 2 diabetes; however, to better define the role of vitamin D in the development and progression of type 2 diabetes, high-quality observational studies and RCTs that measure blood 25-hydroxyvitamin D concentration and clinically relevant glycemic outcomes are needed.
Source : European Journal of Clinical Nutrition
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Dietary modulation of the gut microbiota – a randomised controlled trial in obese postmenopausal women
Lena K. Brahea1 †, Emmanuelle Le Chateliera2 †, Edi Priftia2, Nicolas Ponsa2, Sean Kennedya2, Trine Blædela1, Janet Håkanssona3, Trine Kastrup Dalsgaarda4, Torben Hansena5, Oluf Pedersena5, Arne Astrupa1, S. Dusko Ehrlicha2 and Lesli H. Larsena1 c1
a1 Department of Nutrition, Exercise and Sports, Faculty of Science, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark
a2 INRA, Institut National de la Recherche Agronomique, US 1367 Metagenopolis, Jouy-en-Josas, France
a3 Arla Strategic Innovation Centre, Stockholm, Sweden
a4 Department of Food Science, Faculty of Science and Technology, Aarhus University, Aarhus, Denmark
a5 Novo Nordisk Foundation Centre for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
Abstract
The gut microbiota has been implicated in obesity and its progression towards metabolic disease. Dietary interventions that target the gut microbiota have been suggested to improve metabolic health. The aim of the present study was to investigate the effect of interventions with Lactobacillus paracasei F19 or flaxseed mucilage on the gut microbiota and metabolic risk markers in obesity. A total of fifty-eight obese postmenopausal women were randomised to a single-blinded, parallel-group intervention of 6-week duration, with a daily intake of either L. paracasei F19 (9·4 × 1010 colony-forming units), flaxseed mucilage (10 g) or placebo. Quantitative metagenomic analysis of faecal DNA was performed to identify the changes in the gut microbiota. Diet-induced changes in metabolic markers were explored using adjusted linear regression models. The intake of flaxseed mucilage over 6 weeks led to a reduction in serum C-peptide and insulin release during an oral glucose tolerance test (P< 0·05) and improved insulin sensitivity measured by Matsuda index (P< 0·05). Comparison of gut microbiota composition at baseline and after 6 weeks of intervention with flaxseed mucilage showed alterations in abundance of thirty-three metagenomic species (P< 0·01), including decreased relative abundance of eight Faecalibacterium species. These changes in the microbiota could not explain the effect of flaxseed mucilage on insulin sensitivity. The intake of L. paracasei F19 did not modulate metabolic markers compared with placebo. In conclusion, flaxseed mucilage improves insulin sensitivity and alters the gut microbiota; however, the improvement in insulin sensitivity was not mediated by the observed changes in relative abundance of bacterial species.
Source : British Journal of Nutrition
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Cinnamon Extract Reduces Postprandial Blood Sugar Levels in Humans and Rats
by Amy C. Keller
Reviewed: Beejmohun V, Peytavy-Izard M, Mignon C, et al. Acute effect of Ceylon cinnamon extract on postprandial glycemia: alpha-amylase inhibition, starch tolerance test in rats, and randomized crossover clinical trial in healthy volunteers.BMC Complement Altern Med. 2014;14(1):351. doi: 10.1186/1472-6882-14-351.
Hyperglycemia, or high blood sugar, is central to the etiology of type 2 diabetes. Controlling postprandial (after-meal) hyperglycemia is important to maintaining overall health and reducing the risk of both type 2 diabetes and cardiovascular diseases. “Ceylon” or “true” cinnamon (Cinnamomum verum syn. C. zeylanicum, Lauraceae) has been used traditionally for gastrointestinal problems and continues to be used for respiratory infections. Although clinical trials have addressed the potential hypoglycemic activity of various types and preparations of cinnamon, studies conflict as to its efficacy. This in vitro, in vivo, and randomized, placebo-controlled, crossover human clinical trial investigated the starch tolerance of rats and healthy humans supplemented with Ceylon cinnamon bark extract.
Ceylon cinnamon bark extract (CCE; MealShape™; Dialpha; Montferrier sur Lez, France) is a 10:1 concentrate extracted with water and ethanol (50:50), which is then filtered and dried. [Note: Four of the seven study authors are Dialpha employees.] The resultant powder is standardized to contain at least 40% polyphenols, primarily oligomeric procyanidins composed of catechin and epicatechin. As a comparison for using the alcoholic solvent, an aqueous extract also was made. An enzymatic plate assay was used to gauge the inhibition of α-amylase (an enzyme that breaks down starches into sugars) activity, with acarbose (an anti-diabetic drug sold as Precose® in North America; Bayer; Whippany, New Jersey) as a positive control.
Animal studies
The authors used male Wistar rats for the in vivo experiments. Various groups comprising eight to 20 animals were tested to determine effects of CCE on glucose and insulin at 50 mg/kg body weight; dose-effects of CCE on glucose response at 6.25, 12.5, 25, 50, or 100 mg/kg body weight; and comparative responses between CCE and aqueous extracts at 50 mg/kg body weight. Fasted rats underwent a starch tolerance test (STT) and were fed wheat (Triticum aestivum, Poaceae) starch alone at 1.5 g/kg body weight as a control, or wheat starch with cinnamon extract at 20 mL/kg body weight. Blood glucose levels were measured at baseline, 15, 30, 60, 90, and 120 minutes.
During the STT, rats administered CCE and starch at 50 mg/kg body weight experienced a significant 20.4% decrease in glucose area under the curve (AUC; a calculation used to estimate a compound’s bioavailability and clearance from the body) from 0-120 minutes, as compared to the control group (P<0.05). At the same dose, insulin AUC was significantly less after 60 minutes compared to control (P<0.05), with an insulin peak reduction of 40.6%. Glucose AUC from 0-120 minutes also was significantly less in rats given CCE at 12.5, 25, 50, and 100 mg/kg body weight (P<0.05 for all). Compared to the aqueous cinnamon extract, CCE consumption in rats resulted in a significantly greater reduction in glucose AUC from 0-15 (P<0.05), 0-30 (P<0.01), and 0-60 minutes (P<0.05).
In vitro analysis
In the pancreatic α-amylase activity assay, CCE had an inhibitory concentration of 50% (IC50; a measure of how much a substance inhibits a biological process) of 25 µg/mL, while the acarbose control had an IC50 of 18 µg/mL. When comparing the aqueous and alcoholic cinnamon extracts, the CCE had an IC50 of 30 µg/mL while the water extract had an IC50 of 40µg/mL.
Human study
The clinical trial took place at the Clinic Nutrition Center at Hôpital Saint Vincent de Paul in Lille, France, and was administered by Naturalpha, a contract research company based in Lille, France. The study’s primary endpoint was glucose AUC from 0-120 minutes following consumption of a standard white bread meal. Secondary endpoints included glucose AUC from 0-60 minutes, insulin AUC from 0-60 and 0-120 minutes, maximum concentrations of glucose and insulin, and concentrations of both at each time point. Adverse side effects (ASEs) were recorded and classified as mild, moderate, or severe.
Included subjects (aged 18 to 45 years) had a body mass index between 18.5 and 25 kg/m2 and less than a 5% variation in body weight for the three months prior to the study. Those with fasting glucose concentrations greater than 110 mg/dL, a history of diabetes, a smoking habit, or who took any supplements or pharmaceuticals that could impact glucose or insulin were excluded. Subjects who had two-hour postprandial capillary blood glucose concentrations greater than 140 mg/dl were excluded as well.
Subjects were instructed to maintain their current lifestyle and were randomly assigned to receive either CCE followed by placebo or placebo followed by CCE. Treatment consisted of two capsules of CCE (500 mg each) or placebo (500 mg; containing 20% microcrystalline cellulose and 80% dicalcium phosphate). After an overnight fast, participants had blood drawn 35 minutes prior to the test and were given CCE or placebo five minutes later with 125 mL water. At baseline, a standardized meal was consumed with 250 mL water within eight minutes (103 g of white bread containing 52.2% carbohydrates [3.6% of which were sugars], 7.4% protein, 0.1% lipids, and 3.3% fiber). Fasting glucose concentrations were calculated as an average of measurements taken five and 10 minutes before the meal; fasting insulin was determined five minutes before the meal; and glucose and insulin were measured at 15, 30, 45, 60, 90, and 120 minutes following the meal.
Of the 22 subjects initially screened, 18 were randomly assigned to CCE (n=9) or placebo (n=9). Two subjects were not included in the per-protocol analysis due to protocol deviations, leaving 16 subjects in the final analysis. Upon supplementation with CCE, there was a significantly lower glucose AUC from 0-60 minutes compared to placebo (P<0.05). No other significant effects were noted, and no ASEs were observed.
Conclusions
In summary, CCE consumption in rats decreased both glucose and insulin concentrations during a starch tolerance test, and doses of 12.5 mg/kg body weight and above resulted in decreased glucose concentrations. Comparable IC50 levels for CCE and acarbose in the α-amylase activity assay suggest that enzyme inhibition is a likely mechanism of action for the alcoholic cinnamon extract. Although CCE significantly lowered glucose concentrations in healthy subjects, no effects were seen on insulin concentrations, which points to mechanisms independent of increased insulin in humans.
The authors mention that Ceylon cinnamon contains much less coumarin (a potentially toxic compound) than cassia (Cinnamomum aromaticum syn. C. cassia), although alcohol extraction can increase an extract’s coumarin content due to its solubility. The CCE used in the study exposed participants to less than 0.2 mg coumarin per day (per one gram dose), well below the European Food Safety Authority’s tolerable daily intake guideline of seven mg/day for a 70-kg (154-lb) person. This study reports more robust bioactivity with the alcoholic extract than the aqueous extract, which deserves further investigation. Future clinical trials of hyperglycemic individuals should continue to examine the use of Ceylon cinnamon extract in managing this condition.
Source : HerbalGram
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Curcumin Pharmacokinetic and Pharmacodynamic Evidences in Streptozotocin-Diabetic Rats Support the Antidiabetic Activity to Be via Metabolite(s)
Vânia Ortega Gutierres,1 Michel Leandro Campos,2 Carlos Alberto Arcaro,1 Renata Pires Assis,1 Helen Mariana Baldan-Cimatti,2 Rosângela Gonçalves Peccinini,2 Silvia Paula-Gomes,3 Isis Carmo Kettelhut,3 Amanda Martins Baviera,1 and Iguatemy Lourenço Brunetti1
1Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú Km 01, 14801-902 Araraquara, SP, Brazil
2Department of Natural Active Principles and Toxicology, School of Pharmaceutical Sciences, São Paulo State University (UNESP), Rodovia Araraquara-Jaú Km 01, 14801-902 Araraquara, SP, Brazil
3Department of Biochemistry and Immunology, School of Medicine, University of São Paulo (USP), Avenida Bandeirantes 3900, 14040-900 Ribeirão Preto, SP, Brazil
Abstract
This study measures the curcumin concentration in rat plasma by liquid chromatography and investigates the changes in the glucose tolerance and insulin sensitivity of streptozotocin-diabetic rats treated with curcumin-enriched yoghurt. The analytical method for curcumin detection was linear from 10 to 500 ng/mL. The Cmax and the time to reach Cmax (Tmax) of curcumin in plasma were 3.14 ± 0.9 μg/mL and 5 minutes (10 mg/kg, i.v.) and 0.06 ± 0.01 μg/mL and 14 minutes (500 mg/kg, p.o.). The elimination half-time was 8.64 ± 2.31 (i.v.) and 32.70 ± 12.92 (p.o.) minutes. The oral bioavailability was about 0.47%. Changes in the glucose tolerance and insulin sensitivity were investigated in four groups: normal and diabetic rats treated with yoghurt (NYOG and DYOG, resp.) and treated with 90 mg/kg/day curcumin incorporated in yoghurt (NC90 and DC90, resp.). After 15 days of treatment, the glucose tolerance and the insulin sensitivity were significantly improved in DC90 rats in comparison with DYOG, which can be associated with an increase in the AKT phosphorylation levels and GLUT4 translocation in skeletal muscles. These findings can explain, at least in part, the benefits of curcumin-enriched yoghurt to diabetes and substantiate evidences for the curcumin metabolite(s) as being responsible for the antidiabetic activity.
Source : eCAM
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Dietary functional benefits of Bartlett and Starkrimson pears for potential management of hyperglycemia, hypertension and ulcer bacteria Helicobacter pylori while supporting beneficial probiotic bacterial response
Dipayan Sarkar, Chandrakant Ankolekar, Marcia Pinto, Kalidas Shetty
Highlights
Pear has potential for phenolic-linked management of type 2 diabetes associated hyperglycemia and hypertension.
Fermented pear juices also possess inhibitory activity of stomach ulcer relevant bacteriumHelicobacter pylori.
Pear cultivars have relevance to be included in dietary strategies for better management of early stage hyperglycemia.
This in vitro study provides conceptual foundation for animal and clinical studies involving pear to combat type 2 diabetes.
Abstract
Phenolic-linked health benefits of Bartlett and Starkrimson pear cultivars were investigated for the potential relevance in managing type 2 diabetes and hypertension using in vitro enzyme models. Further effects of fermented (0, 24, 48, and 72-h with Lactobacillus helveticus) pear juice on inhibition of Helicobacter pyloriand proliferation of probiotic Bifidobacterium longum were also evaluated. High total phenolic content along with high 2,2 diphenyl-1-picrylhydrazyl-linked free radical scavenging antioxidant activities were observed in peel extracts of both cultivars. In vitro enzyme assays with peel and pulp extracts also indicated high inhibitory activity of α-glucosidase and α-amylase used as models for anti-hyperglycemia benefits. Only the aqueous pulp extract of Bartlett pear had angiotensin I-converting enzyme inhibitory activity used as model for anti-hypertension benefits. Fermented acidic pH samples of both cultivars showed H. pylori inhibition at 48 and 72 h, while fermented sample of Starkrimson even showed inhibition at 24 h. Both cultivar extracts did not inhibit growth of probiotic B. longum
Source : Food Research International
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American Ginseng Reported to Be Safe When Used as Adjunctive Therapy in Patients with Type 2 Diabetes Mellitus
by Shari Henson
Reviewed: Mucalo I, Jovanovski E, Vuksan V, Božikov V, Romić Ž, Rahelić D. American ginseng extract (Panax quinquefolius L.) is safe in long-term use in type 2 diabetic patients [published online May 7, 2014]. Evid Based Complement Alternat Med. doi: 10.1155/2014/969168.
For patients with type 2 diabetes mellitus (T2DM), managing the condition is complicated by a growing number of hypoglycemic pharmaceutical agents used in various combinations and by concerns about the agents’ potential interactions and associated adverse effects. Common among patients with T2DM is an interest in so-called complementary and alternative medicine, particularly the use of American ginseng (AG; Panax quinquefolius, Araliaceae), which reportedly is well tolerated by most users. Because of a lack of randomized clinical studies on the long-term use of ginseng in patients with T2DM, the authors conducted a double-blind, randomized, placebo-controlled, parallel study to determine the safety of 12 weeks of supplementation with AG when used as adjunctive therapy in patients with T2DM.
Seventy-four patients (mean age: 63 ± 9.5 years) with T2DM recruited from a diabetes outpatient clinic completed the study. From the original group of patients screened, five participants dropped out because of changes in medication therapy, and two were unwilling to continue the study. Included participants had well-controlled T2DM for more than six months without complications, metabolic stability (average glycated hemoglobin A1c [HbA1c] between 6.5% and 8.1%), and were on diet modifications and/or conventional diabetes medications. Nine of the patients used diet only to treat T2DM; others used diet plus oral agents such as metformin (n=48), sulfonylurea (n=43), dipeptidyl peptidase-4 inhibitors (n=11), glucagon-like peptide-1 agonists (n=1), acarbose (n=4), and metformin with pioglitazone (n=1).
The patients were randomly assigned to receive either two 500 mg capsules of AG root extract (containing 10% ginsenosides) before meals three times daily (n=35) — a daily dosage recommended in traditional Chinese medicine1 — or two 500 mg identical-appearing placebo capsules containing corn (Zea mays, Poaceae) starch (n=39). AG root was supplied by Ontario Ginseng Growers (Simcoe, Ontario, Canada) and extracted with ethanol. Treatment or placebo was taken along with any antihypertensive or hypoglycemic medications used by the patients. At baseline, body mass index and fasting plasma glucose levels were significantly higher in the AG group compared with the placebo group; all other demographic and clinical parameters were similar.
The patients visited the clinic at baseline and at weeks six and 12 to have biochemical and anthropometric measurements taken. During these visits, participants also completed the International Quality of Life Assessment SF-36v2 questionnaire, received a new supply of capsules, returned unused capsules, and were interviewed by a dietitian. Patients were instructed to maintain body weight, follow their usual dietary and physical activity habits throughout the study, and refrain from all medications, including AG or placebo, for 12 hours before each study visit.
Safety was assessed by measuring markers of hepatic (aspartate aminotransferase and alanine aminotransferase), renal (serum urates and serum creatinine), and hemostatic (prothrombin time and international normalized ratio) functions.
The authors report that AG had no significant dependent or independent effects on any of the safety parameters. All hepatic, renal, and hemostatic function values were within normal limits. Regarding adverse events, stomach heaviness was reported in one patient in the AG group during the first six weeks, but the patient continued the treatment.
Safety concerns surrounding the use of ginseng followed a now widely discredited, uncontrolled, observational study by Siegel2 in 1979, in which 12 weeks of ginseng supplementation was associated with elevated blood pressure and several other adverse effects (e.g., gastrointestinal disturbances, insomnia, and nervousness).* The ginseng dose assigned in the Siegel trial was much higher than the usually recommended dose, and “the validity of these side effects is questionable due to a lack of a control group in the study and the fact that subjects were not controlled for dose, duration, route of administration, type of ginseng, or other concurrent bioactive substances intake,” write the authors of the study reported here, who previously found that three grams of AG taken daily for 12 weeks compared with placebo was associated with decreased blood pressure in persons with hypertension and T2DM.3
The authors point out that the results of this current study may not be generalizable to other AG ingredients, including the unprocessed root or other ginseng extracts, but they conclude that the AG treatment in this study demonstrated “rather convincing long-term clinical safety when administered as an adjunct to conventional antihypertensive and antidiabetic therapy.”
--Shari Henson
Source American Botanical Council - Herbalgram
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Effect of Hypericum perforatum L. Extract on Insulin Resistance and Lipid Metabolic Disorder in High-Fat-Diet Induced Obese Mice
Jin-ying Tian, Rong-ya Tao, Xiao-lin Zhang, Qian Liu, Yi-bo He, Ya-lun Su, Teng-fei Ji, Fei Ye
Abstract
Natural product Hypericum perforatum L. has been used in folk medicine to improve mental performance. However, the effect of H. perforatum L. on metabolism is still unknown. In order to test whether H. perforatum L. extract (EHP) has an effect on metabolic syndrome, we treated diet induced obese (DIO) C57BL/6J mice with the extract. The chemical characters of EHP were investigated with thin-layer chromatography, ultraviolet, high-performance liquid chromatography (HPLC), and HPLC-mass spectrometry fingerprint analysis. Oral glucose tolerance test (OGTT), insulin tolerance test (ITT), and the glucose infusion rate (GIR) in hyperinsulinemic–euglycemic clamp test were performed to evaluate the glucose metabolism and insulin sensitivity. Skeletal muscle was examined for lipid metabolism. The results suggest that EHP can significantly improve the glucose and lipid metabolism in DIO mice. In vitro, EHP inhibited the catalytic activity of recombinant human protein tyrosine phosphatase 1B (PTP1B) and reduced the protein and mRNA levels of PTP1B in the skeletal muscle. Moreover, expressions of genes related to fatty acid uptake and oxidation were changed by EHP in the skeletal muscle. These results suggest that EHP may improve insulin resistance and lipid metabolism in DIO mice
Source : Journal Phtotherapy Research
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THE PROTECTIVE EFFECT OF MUSHROOMS IN EXPERIMENTALLY INDUCED DIABETES IN MICE
CORNELIA MIRCEA1, VERONICA BILD2, DANIELA ZAVASTIN3, OANA CIOANCĂ4*
1 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of General and Applied Biochemistry, 16 Universitatii Street, Romania, Iasi, 700115
2 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Pharmacodynamics and Clinical Pharmacy, 16 Universitatii Street, Romania, Iasi, 700115
3 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Physical Chemistry, 16 Universitatii Street, Romania, Iasi, 700115
4 University of Medicine and Pharmacy „Grigore T. Popa” Iaşi, Faculty of Pharmacy, Department of Pharmacognosy, 16 Universitatii Street, Romania, Iasi, 700115
Abstract
Mushrooms represent an important food source and are recommended for diabetics because of their low glycemic index due to content nutrients. The beneficial effect of products from mushrooms was evaluated under experimental diabetes in mice. The study
was performed on extracts and powder respectively from three species of fungi, two of which are edible and cultivated (Pleurotus ostreatus - powder and extract, Agaricus bisporus brown - powder and extract) and one is parasite (Fomes fomentarius - extract).
Among the extracts a positive effect on blood glucose was recorded in the group treated with Fomes fomentarius extract (31.35% reduction) and from the group treated with Pleurotus ostreatus powder (20.24% reduction). Cholesterol reduction level was between
5.23% (Fomes fomentarius) and 15.46% (Agaricus bisporus brown extract). For A.bisporus brown the extract registered better results, while for P. ostreatus the powder was more active. Extracts administration did not result in a return to the control group registered values for liver function tests (ALT, AST, alkaline phosphatase), but determined evident beneficial effects compared with diabetic group and could counteract hepatocellular damage in diabetes.
Source : Revista Farmacia
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Impact of Beverage Content on Health and the Kidneys
Johnson, Richard J. MD; Thomas, Jeffrey MD; Lanaspa, Miguel A. PhD
Abstract
The last 50 years have witnessed an epidemic rise in obesity, diabetes, high blood pressure, and chronic kidney disease. Some animal research suggests the epidemic may in part be triggered by sugar. Sugar contains glucose and fructose, and studies suggest it is the fructose component that may have a role in chronic disease development. Animal studies indicate that fructose is distinct from other sugars by its ability to cause transient adenosine triphosphate (ATP) depletion in the cell with uric acid generation. The administration of fructose, or the raising of uric acid, can induce kidney disease and accelerate established kidney disease in animals. Therefore, we believe that the greatest risk from sugar is when it is given as a soft drink, as the rapidity of ingestion relates directly to the concentration of fructose that the cells are exposed to and hence govern the degree of ATP depletion and uric acid generation. Restricting sugar-sweetened beverages may be one strategy to combat obesity, diabetes, high blood pressure, and kidney disease, but human intervention studies are needed to support the theory.
Source : Journal Nutrition Today
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Green tea and type 2 diabetes
Jae-Hyung Park, , Jae-Hoon Bae, Sung-Soon Im, Dae-Kyu Song
Department of Physiology, Keimyung University School of Medicine, Daegu, Korea
Abstract
Green tea and coffee consumption have been widely popular worldwide. These beverages contain caffeine to activate the central nervous system by adenosine receptor blockade, and due to the caffeine, addiction or tolerance may occur. In addition to this caffeine effect, green tea and coffee consumption have always been at the center of discussions about human health, disease, and longevity. In particular, green tea catechins are involved in many biological activities such as antioxidation and modulation of various cellular lipid and proteins. Thus, they are beneficial against degenerative diseases, including obesity, cancer, cardiovascular diseases, and various inflammatory diseases. Some reports also suggest that daily consumption of tea catechins may help in controlling type 2 diabetes. However, other studies have reported that chronic consumption of green tea may result in hepatic failure, neuronal damage, and exacerbation of diabetes, suggesting that interindividual variations in the green tea effect are large. This review will focus on the effect of green tea catechins extracted from the Camellia sinensis plant on type 2 diabetes and obesity, and the possible mechanistic explanation for the experimental results mainly from our laboratory. It is hoped that green tea can be consumed in a suitable manner as a supplement to prevent the development of type 2 diabetes and obesity.
Source : Intergrative Medicine Journal
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Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds
Fahmida Alam,1 Md. Asiful Islam,1 Siew Hua Gan,1 and Md. Ibrahim Khalil2
1Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
2Department of Biochemistry and Molecular Biology, Jahangirnagar University, Savar, Dhaka-1342, Bangladesh
Abstract
Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey’s antibacterial activity on diabetic wound-related microorganisms and honey’s clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims.
Source : Evidence Based Complementary and Alternative Medicine
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Artificial Sweeteners May Raise Diabetes Risk
By Salynn Boyles, Contributing Writer, MedPage TodayReviewed by Zalman S. Agus, MD; Emeritus Professor, Perelman School of Medicine at the University of Pennsylvania and Dorothy Caputo, MA, BSN, RN, Nurse Planner
Consumption of noncaloric artificial sweeteners appeared to induce glucose intolerance in both mice and humans by altering gut microbiota in a series of experiments conducted by researchers in Israel.
Rather than helping to prevent obesity and metabolic disease, use of noncalorie sweeteners may have contributed to the epidemic rise of these conditions, wrote Eran Elinav, MD, of the Weizmann Institute of Science in Rehovot, Israel, and colleagues, online in the journal Nature.
Their research is among the first to examine the impact of a specific food additive on gut microbiota and the findings are compelling, said microbiome researcher Suzanne Devkota, PhD, of Joslin Diabetes Center and Harvard Medical School. Devkota was not involved with the research.
"This was a very well done study, and the fact that they had a human component was a big plus," she told MedPage Today.
Artificial Sweetener Research Mixed
Five no-calorie or low-calorie artificial sweeteners -- saccharin, sucralose, aspartame, neotame and acesulfame K -- are approved for use in the U.S. by the FDA and sweeteners derived from the Stevia plant extract Reb-A have been designated "generally recognized as safe."
While some studies have linked noncaloric sweetener use to an increased risk for obesity and diabetes, others suggest a protective effect or no effect at all. Interpretation of these studies has been complicated by the fact that noncaloric artificial sweeteners are often consumed by people who have some manifestations of metabolic syndrome, the researchers wrote.
They further noted that most noncaloric artificial sweeteners (NAS) pass through the human gastrointestinal tract without being digested, so they directly encounter intestinal microbiota.
"Microbiota compositions and function are modulated by diet in the healthy lean state as well as in obesity and diabetes mellitus, and in turn microbiota alterations have been associated with propensity to metabolic syndrome," Elinav and colleagues wrote.
Their studies in animals and humans examined NAS-mediated modulation of microbiota composition and function and their effects on host glucose metabolism.
NAS Fed Mice Developed Glucose Intolerance
In an effort to better understand the effects of NAS on glucose homeostasis, the researchers added commercial formulations of saccharin, sucralose, or aspartame to the drinking water of 10-week-old C57/BI/6 mice. Control mice were fed only water or water supplemented with either glucose or sucralose.
At week 11, the three groups that consumed water alone, glucose and sucrose had comparable glucose tolerance curves, while the three NAS-fed mouse groups developed marked glucose intolerance (P<0.001). Saccharin exerted the most pronounced effect, and the researchers further studied this sweetener by feeding the mice a high-fat (60% calories from fat) diet while they consumed either commercial saccharine or pure glucose. As in the earlier experiment, the saccharin-fed mice developed glucose intolerance and the control mice did not.
"Taken together, these results suggest that NAS promote metabolic derangements in a range of formulations, doses, mouse strains, and diets paralleling human conditions, in both the lean and the obese state," the researchers wrote.
To test whether the observed NAS effect was regulated in the gut microbiota, the researchers treated mouse groups consuming commercial or pure NAS in the lean and high-fat diet states with a Gram-negative-targeting broad-spectrum antibiotic regimen (ciprofloxacin and metronidazole) while maintaining the mice on their diet and sweetener regimens.
After 4 weeks of antibiotic treatment, differences in glucose intolerance between NAS-consuming mice and controls were abolished in both the lean and obese states. Similar effects were seen with the Gram-positive-targeting antibiotic vancomycin.
"These results suggest that NAS-induced glucose intolerance is mediated through alterations to the commensal microbiota, with contributions from diverse bacterial taxa," the researchers wrote.
Fecal Experiments Studied Causal Link
In an effort to determine if the microbiota role was causal, the researchers performed fecal transplantation experiments, by transferring the microbiota configuration from mice on normal-chow diet drinking commercial saccharin or glucose (control) into normal-chow-consuming germ-free mice. Recipients of microbiota from mice consuming commercial saccharin exhibited impaired glucose tolerance compared with control microbiota recipients 6 days after transfer (P<0.03)
The researchers also examined the fecal microbiota composition of the various mouse groups by sequencing their 16S ribosomal RNA gene. In this series of experiments, they demonstrated that saccharin directly modulated the composition and function of the microbiome to induce a harmful imbalance of intestinal microbes (dysbiosis), accounting for the downstream glucose intolerance phenotype in the mammalian host.
NAS Raised Metabolic Risk in Humans
To study the effects of NAS in humans, the researchers examined the relationship between long-term NAS consumption (determined through food frequency questionnaires) and dysbiosis and various parameters of metabolic risk using data collected from 381 people who did not have diabetes (44% male; mean age 43.3, SD 13.2) participating in an ongoing clinical nutritional study.
"We found significant positive correlations between NAS consumption and several metabolic-syndrome-related clinical parameters, including increased weight and waist-to-hip ratio, higher fasting blood glucose, glycosylated HbA1c [percentage] and glucose tolerance test (GTT, measures of impaired glucose tolerance), and elevated serum alanine aminotransferase," the researchers wrote.
Levels of HbA1c, indicative of glucose concentration over the previous 3 months, were significantly increased when comparing a subgroup of high NAS consumers (40 people) to non-NAS consumers (236 people, rank sum P<0.002). The increase remained significant when adjusted for body mass index (rank sum P<0.015).
When Elinav and colleagues characterized 16S rRNA in 172 randomly selected members of the cohort, they found statistically significant positive correlations between multiple taxonomic entities and NAS consumption, including the Enterobacteriaceae family and the Actinobacteria phylum.
"Importantly, we did not detect statistically significant correlations between operational taxonomic unit abundances and BMI, suggesting that the correlations are not due to the distinct BMI of NAS consumers," they wrote.
In an effort to determine if the relationship between human NAS consumption and blood glucose control is causative, the researchers followed seven healthy volunteers (five males and two females, ages 28-36) who did not normally consume NAS or foods containing NAS for 1 week (days two-seven). During this week, participants consumed the FDA's maximal acceptable daily intake of commercial saccharin (5 mg per kg body weight as three divided daily doses equivalent to 120 mg). The participants were monitored by continuous glucose measurements and daily GTT.
"Notably, even in this short-term, 7-day exposure period, most individuals (four of seven) developed significantly poorer glycemic response 5-7 days after NAS consumption, compared with their individual glycemic response on days one-four," the researchers wrote.
Personalized Response to NAS Found
The microbiome configurations of theses NAS responders, assessed using 16S rRNA analysis, also clustered differently from the three nonresponders. Microbiomes from nonresponders showed little changes in composition during the study week, wheres pronounced compositional changes were seen in NAS responders.
To further examine whether this NAS-induced dysbiosis had a causal role in glucose intolerance, the researchers transferred stool from before day one or after day seven NAS exposure from two NAS responders and two nonresponders into groups of normal chow-fed germ-free mice.
Transfer of day seven stool from NAS responders was found to induce significant glucose intolerance in the mice, compared with day one stool from the same people. In contrast, D7 stools transferred from two NAS nonresponders induced normal glucose tolerance which was similar to that of mice transferred with day one stool.
"Our results from short- and long-term human NAS consumer cohorts suggest that human individuals feature a personalized response to NAS, possibly stemming from differences in their microbiota composition and function," the researchers wrote.
The researchers further suggested that these individualized nutritional responses may be driven by personalized functional differences in the microbiome.
Expert: All Things in Moderation
Diabetes researcher Robert Rizza, MD, of the Mayo Clinic in Rochester, Minn., who was not involved with the research, called the findings "fascinating."
He noted that earlier research suggests people who eat large amounts of artificial sweeteners have higher incidences of obesity and diabetes. The new research, he said, suggests there may be a causal link.
"This was a very thorough and carefully done study, and I think the message to people who use artificial sweeteners is they need to use them in moderation," he said. "Drinking 17 diet sodas a day is probably a bad idea, but one or two may be OK."
Source : MedPage Today
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Assesment of Antidiabetic Activity of Mangifera Indica Seed Kernel Extracts in Streptozotocin Induced Diabetic Rats
M. S. Rajesh, J. Rajshekar
Abstract
The objective of the study was to screen the extracts of Mangifera indica seed kernel for its antidiabetic activity so that tons of mango seed kernels going waste during the mango season can be utilized as house hold remedy in treating diabetes so that the dose and cost of the actual treatment can be brought down. Extracts were evaluated for their glucose reducing effect in both normal and diabetic rats at the dose of 200 mg/kg body weight. Diabetes was induced by administering streptozotocin at 65 mg/kg body weight in citrate buffer intraperitonially. Blood samples were collected through tip of tail vein and the fasting blood glucose levels were estimated by using reactive strips of glucose oxidase and peroxidase. Serum lipid profiles were carried out by using ready kits by colorimetric method. The results indicate aqueous and methanolic extract of Mangifera indica seed kernel possesses significant antidiabetic activity.
Source : Journal of Natural Remedies
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Acute effects of raisin consumption on glucose and insulin reponses in healthy individuals
Amin Esfahani1,2,3, Joanne Lam1and Cyril W. C. Kendall2,3,4*
1School of Medicine, New York Medical College, Valhalla, NY, USA
2Clinical Nutrition and Risk Factor Modification Center, St Michael’s Hospital, Toronto, ON, Canada
3Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
4College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
Abstract
Raisins are popular snacks with a favourable nutrient profile, being high in dietary fibre, polyphenols and a number of vitamins and minerals, in addition to being rich in fructose. In light of evidence demonstrating improvements in glycaemic control with moderate fructose intake and low-glycaemic index(GI)fruits, our aim was to determine the GI, insulin index (II) and postprandial responses to raisins in an acute feeding setting. A total of ten healthy participants(four male and six female) consumed breakfast study meals on four occasions over a 2- to 8-week period: meal 1: white bread (WB) (108 g WB; 50 gavailable carbohydrate) served as the control and was consumed on two separate occasions; meal 2: raisins (R50) (69 g raisins; 50 g available carbohydrate);and meal 3: raisins (R20) (one serving, 28 g raisins; 20 g available carbohydrate). Postprandial glucose and insulin were measured over a 2 h period for the determination of GI, glycaemic load (GL) and II. The raisin meals, R50 and R20, resulted in significantly reduced postprandial glucose and insulin responses when compared with WB (P<0·05). Furthermore, raisins were determined to be low-GI, -GL and -II foods. The favourable effect of raisins on postprandial glycaemic response, their insulin-sparing effect and low GI combined with their other metabolic benefits may indicate that raisins are a healthy choice not only for the general population but also for individuals with diabetes or insulin resistance.
Source : Journal of Nutritional Science
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Interaction of Some Commercial Teas with Some Carbohydrate Metabolizing Enzymes Linked with Type-2 Diabetes: A Dietary Intervention in the Prevention of Type-2 Diabetes
Ganiyu Oboh,1 Omodesola O. Ogunruku,1,2 Funke O. Ogidiolu,1 Adedayo O. Ademiluyi,1 Bukola C. Adedayo,1 and Ayokunle O. Ademosun1
1Functional Foods and Nutraceuticals Unit, Biochemistry Department, Federal University of Technology, PMB 704, Akure, Nigeria
2Biochemistry Department, Obafemi Awolowo University, Ile-Ife, Nigeria
Abstract
This study is aimed at assessing the inhibitory effect of teas on key enzymes (alpha-amylase and alpha-glucosidase) linked with type-2 diabetes and their antioxidant properties. Four samples of three brands were used; infusions of green tea (GT), 2 brands of black tea (BT), and a formulated herbal preparation for diabetes (ADT) (white tea, Radix Puerariae, Radix ophiopogonis, hawthorn berry, Chinese yam, and fragrant Solomon seal rhizome) were prepared and subsequently analyzed for their total phenol, ascorbic acid contents, antioxidant properties (2,2-Azizobis (3-Ethylbenzo-Thiazoline~6-sulfonate) “ABTS” scavenging ability and ferric reducing antioxidant property), and inhibition of pancreatic-alpha-amylase and intestinal-alpha-glucosidase in vitro. The study revealed that GT had the highest total phenol content, ascorbic acid content, ABTS* scavenging ability, and ferric reducing ability. Furthermore, all the teas inhibited Fe2+ and sodium nitroprusside induced lipid peroxidation in pancreas, with GT having the highest inhibitory effect. Conversely, there was no significant difference ( P>0.05) in the inhibitory effects of the teas on alpha-amylase and alpha-glucosidase. The antidiabetic property of the teas could be attributed to their inhibitory effect on carbohydrate hydrolyzing enzymes implicated in diabetes and their antioxidant activities.
Source : Evidence Based Complementary and Alternative Medicine
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Effects of a beetroot juice with high neobetanin content on the early-phase insulin response in healthy volunteers
Peter C. Wootton-Bearda1, Kirsten Brandta2, David Fella3, Sarah Warnera1a2 and Lisa Ryana1a4 c1
a1 Functional Food Centre, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, UK
a2 Human Nutrition Research Centre, School of Agriculture and Rural Development, Newcastle University, Newcastle upon Tyne NE1 7RU, UK
a3 Cell Systems Modelling Group, Oxford Brookes University, Gipsy Lane, Oxford OX3 0BP, UK
a4 Department of Nutrition and Dietetics, Monash University, Faculty of Medicine, Nursing and Health Sciences, 264 Ferntree Gully Road, Vic 3168, Australia
Abstract
Produce rich in phytochemicals may alter postprandial glucose and insulin responses by interacting with the pathways that regulate glucose uptake and insulin secretion in humans. The aims of the present study were to assess the phytochemical constituents of red beetroot juice and to measure the postprandial glucose and insulin responses elicited by either 225 ml beetroot juice (BEET), a control beverage matched for macronutrient content (MCON) or a glucose beverage in healthy adults. Beetroot juice was a particularly rich source of betalain degradation compounds. The orange/yellow pigment neobetanin was measured in particularly high quantities (providing 1·3 g in the 225 ml). A total of sixteen healthy individuals were recruited, and consumed the test meals in a controlled single-blind cross-over design. Results revealed a significant lowering of the postprandial insulin response in the early phase (0–60 min) (P < 0·05) and a significantly lower glucose response in the 0–30 min phase (P < 0·05) in the BEET treatment compared with MCON. Betalains, polyphenols and dietary nitrate found in the beetroot juice may each contribute to the observed differences in the postprandial insulin concentration.
Source : Journal of Nutritional Science
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Prepregnancy low-carbohydrate dietary pattern and risk of gestational diabetes mellitus: a prospective cohort study1,2,3,4
- Wei Bao,
- Katherine Bowers,
- Deirdre K Tobias,
- Sjurdur F Olsen,
- Jorge Chavarro,
- Allan Vaag,
- Michele Kiely, and
- Cuilin Zhang
Background: Low-carbohydrate diets (LCDs) have been vastly popular for weight loss. The association between a low-carbohydrate dietary pattern and risk of gestational diabetes mellitus (GDM) remains unknown.
Objective: We aimed to prospectively examine the association of 3 prepregnancy low-carbohydrate dietary patterns with risk of GDM.
Design: We included 21,411 singleton pregnancies in the Nurses’ Health Study II. Prepregnancy LCD scores were calculated from validated food-frequency questionnaires, including an overall LCD score on the basis of intakes of carbohydrate, total protein, and total fat; an animal LCD score on the basis of intakes of carbohydrate, animal protein, and animal fat; and a vegetable LCD score on the basis of intakes of carbohydrate, vegetable protein, and vegetable fat. A higher score reflected a higher intake of fat and protein and a lower intake of carbohydrate, and it indicated closer adherence to a low-carbohydrate dietary pattern. RRs and 95% CIs were estimated by using generalized estimating equations with log-binomial models.
Results: We documented 867 incident GDM pregnancies during 10 y follow-up. Multivariable-adjusted RRs (95% CIs) of GDM for comparisons of highest with lowest quartiles were 1.27 (1.06, 1.51) for the overall LCD score (P-trend = 0.03), 1.36 (1.13, 1.64) for the animal LCD score (P-trend = 0.003), and 0.84 (0.69, 1.03) for the vegetable LCD score (P-trend = 0.08). Associations between LCD scores and GDM risk were not significantly modified by age, parity, family history of diabetes, physical activity, or overweight status.
Conclusions: A prepregnancy low-carbohydrate dietary pattern with high protein and fat from animal-food sources is positively associated with GDM risk, whereas a prepregnancy low-carbohydrate dietary pattern with high protein and fat from vegetable food sources is not associated with the risk. Women of reproductive age who follow a low-carbohydrate dietary pattern may consider consuming vegetable rather than animal sources of protein and fat to minimize their risk of GDM.
Source : The American Journal of Clinical Nutrition
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Nut consumption and risk of type 2 diabetes, cardiovascular disease, and all-cause mortality: a systematic review and meta-analysis1,2,3,4
Abstract
Background: Epidemiologic studies have shown inverse associations between nut consumption and diabetes, cardiovascular disease (CVD), and all-cause mortality, but results have not been consistent.
Objective: We assessed the relation between nut intake and incidence of type 2 diabetes, CVD, and all-cause mortality.
Design: We searched PubMed and EMBASE for all prospective cohort studies published up to March 2013 with RRs and 95% CIs for outcomes of interest. A random-effects model was used to pool risk estimates across studies.
Results: In 31 reports from 18 prospective studies, there were 12,655 type 2 diabetes, 8862 CVD, 6623 ischemic heart disease (IHD), 6487 stroke, and 48,818 mortality cases. The RR for each incremental serving per day of nut intake was 0.80 (95% CI: 0.69, 0.94) for type 2 diabetes without adjustment for body mass index; with adjustment, the association was attenuated [RR: 1.03; 95% CI: 0.91, 1.16; NS]. In the multivariable-adjusted model, pooled RRs (95% CIs) for each serving per day of nut consumption were 0.72 (0.64, 0.81) for IHD, 0.71 (0.59, 0.85) for CVD, and 0.83 (0.76, 0.91) for all-cause mortality. Pooled RRs (95% CIs) for the comparison of extreme quantiles of nut intake were 1.00 (0.84, 1.19; NS) for type 2 diabetes, 0.66 (0.55, 0.78) for IHD, 0.70 (0.60, 0.81) for CVD, 0.91 (0.81, 1.02; NS) for stroke, and 0.85 (0.79, 0.91) for all-cause mortality.
Conclusions: Our meta-analysis indicates that nut intake is inversely associated with IHD, overall CVD, and all-cause mortality but not significantly associated with diabetes and stroke. The inverse association between the consumption of nuts and diabetes was attenuated after adjustment for body mass index. These findings support recommendations to include nuts as part of a healthy dietary pattern for the prevention of chronic diseases
Source : The American Journal of Clinical Nutrition
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Amelioration of Diabetes and Painful Diabetic Neuropathy by Punica granatum L. Extract and Its Spray Dried Biopolymeric Dispersions
K. Raafat1 and W. Samy2,3
1Department of Pharmaceutical Sciences, Faculty of Pharmacy, Beirut Arab University, Beirut 115020, Lebanon
2Department of Pharmaceutical Technology, Faculty of Pharmacy, Beirut Arab University, Beirut 115020, Lebanon
3Department of Industrial Pharmacy, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
Abstract
Aims. To evaluate the effect of Punica granatum (universally known as pomegranate) (Pg) rind extract and its spray dried biopolymeric dispersions with casein (F1) or chitosan (F2) against Diabetes mellitus (DM) and diabetic neuropathy (DN).
Methods. We measured the acute (6 h) and subacute (8 days) effect of various doses of Pg, F1, and F2 and the active compounds on alloxan-induced DM mouse model. We evaluated DN utilizing latency tests for longer period of time (8 weeks). In addition, the in vivo antioxidant activity was assessed utilizing serum catalase level.
Results. The results proved that the highest dose levels of Pg extract, F1, F2 exerted remarkable hypoglycemic activity with 48, 52, and 40% drop in the mice glucose levels after 6 hours, respectively. The tested compounds also improved peripheral nerve function as observed from the latency tests. Bioguided fractionation suggested that gallic acid (GA) was Pg main active ingredient responsible for its actions.
Conclusion. Pg extract, F1, F2, and GA could be considered as a new therapeutic potential for the amelioration of diabetic neuropathic pain and the observed in vivo antioxidant potential may be involved in its antinociceptive effect. It is highly significant to pay attention to Pg and GA for amelioration and control of DM and its complications.
Source : Journal Complementary and Alternative Medicine
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Effects of Chinese Medicine Tong xinluo on Diabetic Nephropathy via Inhibiting TGF-β1-Induced Epithelial-to-Mesenchymal Transition
Na Zhang,1 Yanbin Gao,1 Dawei Zou,1 Jinyang Wang,1 Jiaoyang Li,1 Shengnan Zhou,1 Zhiyao Zhu,1 Xuan Zhao,1 Liping Xu,1 and Haiyan Zhang2
1School of Traditional Chinese Medicine, Capital Medical University, No. 10, Youanmenwai, Xitoutiao, Fengtai District, Beijing 100069, China
2Department of Cell Biology, School of Basic Medical Science, Capital Medical University, No. 10, Youanmenwai, Xitoutiao, Fengtai District, Beijing 100069, China
Abstract
Diabetic nephropathy (DN) is a major cause of chronic kidney failure and characterized by interstitial and glomeruli fibrosis. Epithelial-to-mesenchymal transition (EMT) plays an important role in the pathogenesis of DN. Tong xinluo (TXL), a Chinese herbal compound, has been used in China with established therapeutic efficacy in patients with DN. To investigate the molecular mechanism of TXL improving DN, KK-Ay mice were selected as models for the evaluation of pathogenesis and treatment in DN. In vitro, TGF-β1 was used to induce EMT. Western blot (WB), immunofluorescence staining, and real-time polymerase chain reaction (RT-PCR) were applied to detect the changes of EMT markers in vivo and in vitro, respectively. Results showed the expressions of TGF-β1 and its downstream proteins smad3/p-smad3 were greatly reduced in TXL group; meantime, TXL restored the expression of smad7. As a result, the expressions of collagen IV (Col IV) and fibronectin (FN) were significantly decreased in TXL group. In vivo, 24 h-UAER (24-hour urine albumin excretion ratio) and BUN (blood urea nitrogen) were decreased and Ccr (creatinine clearance ratio) was increased in TXL group compared with DN group. In summary, the present study demonstrates that TXL successfully inhibits TGF-β1-induced epithelial-to-mesenchymal transition in DN, which may account for the therapeutic efficacy in TXL-mediated renoprotection.
Source : Evidence Based Complementary and Alternative Medicine
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Meat Consumption as a Risk Factor for Type 2 Diabetes
Neal Barnard,1 Susan Levin,2,* and Caroline Trapp2
Abstract
Disease risk factors identified in epidemiological studies serve as important public health tools, helping clinicians identify individuals who may benefit from more aggressive screening or risk-modification procedures, allowing policymakers to prioritize intervention programs, and encouraging at-risk individuals to modify behavior and improve their health. These factors have been based primarily on evidence from cross-sectional and prospective studies, as most do not lend themselves to randomized trials. While some risk factors are not modifiable, eating habits are subject to change through both individual action and broader policy initiatives. Meat consumption has been frequently investigated as a variable associated with diabetes risk, but it has not yet been described as a diabetes risk factor. In this article, we evaluate the evidence supporting the use of meat consumption as a clinically useful risk factor for type 2 diabetes, based on studies evaluating the risks associated with meat consumption as a categorical dietary characteristic (i.e., meat consumption versus no meat consumption), as a scalar variable (i.e., gradations of meat consumption), or as part of a broader dietary pattern.
Source : Journal Nutrients
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Acute effects of pistachio consumption on glucose and insulin, satiety hormones and endothelial function in the metabolic syndrome
C W C Kendall1,2,3, S G West4,5, L S Augustin1,2, A Esfahani6, E Vidgen1,2, B Bashyam1,2, K A Sauder4, J Campbell7, L Chiavaroli1,2, A L Jenkins1,7 and D J Jenkins1,2,8
- 1Clinical Nutrition and Risk Factor Modification Center, St Michael’s Hospital, Toronto, ON, Canada
- 2Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- 3College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK, Canada
- 4Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
- 5Nutritional Sciences, Pennsylvania State University, University Park, PA, USA
- 6School of Medicine, New York Medical College, Valhalla, NY, USA
- 7Glycemic Index Laboratories, Toronto, ON, Canada
- 8Department of Medicine, Division of Endocrinology and Metabolism, St Michael’s Hospital, Toronto, ON, Canada
Background/Objective:
Nut consumption has been found to decrease risk of coronary heart disease and diabetes and to promote healthy body weights possibly related to their favorable macronutrient profile. We therefore assessed the effect of pistachios on postprandial glucose and insulin levels, gut hormones related to satiety and endothelial function.
Subjects/Methods:
In this randomized crossover study, 20 subjects with metabolic syndrome consumed five study meals over 5–10 weeks. The meals differed in fat type and quantity, but were matched according to available carbohydrates (CHOs). Three meals had 50 g available CHO: white bread (WB50g), white bread, butter and cheese (WB+B+Ch) and white bread and pistachios (WB+P). Two meals had 12 g available CHO: white bread (WB12g) and pistachios (P).
Results:
Within each group of available CHO meals, postprandial glucose levels were the highest following the white bread-only meals, and glucose response was significantly attenuated when butter and cheese or pistachios were consumed (P<0.05). Postprandial insulin levels were highest after the WB+B+Ch meal (P<0.05), but did not differ between the white bread-only and pistachio meals. Both endothelial function (reactive hyperemia index) and arterial stiffness (augmentation index) significantly increased after the white bread-only meals compared with the WB+B+Ch meal (all P<0.05). Insulin secretagogue levels were higher when butter and cheese or pistachios were consumed than when white bread only was consumed (P<0.05).
Conclusions:
Compared with white bread, pistachio consumption reduced postprandial glycemia, increased glucagon-like-peptide levels and may have insulin-sparing properties. These effects could be beneficial for individuals with diabetes and metabolic syndrome.
Source : EU Journal of Clinical Nutrition
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Updated Meta-Analysis Shows Beneficial Effect of Cinnamon Supplements on Type 2 Diabetes
by Cheryl McCutchan, PhD
Reviewed: Allen RW, Schwartzman E, Baker WL, Coleman CI, Phung OJ. Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Ann Fam Med. 2013;11(5):452-459.
Type 2 diabetes results in impaired glycemic control and potential complications from cardiovascular disease. The main forms of treatment for type 2 diabetes include medication, lifestyle adjustments, and dietary modifications. Dietary supplements are not generally recommended as a treatment by the American Diabetes Association because the organization believes that the clinical efficacy of supplements has not been sufficiently established and because there is a lack of “standardized formulations.” (Presumably, this refers to the fact that there are various types of cinnamon formulations, for example, that have shown some degree of clinical efficacy, and — unlike single chemical entity pharmaceutical medications — cinnamon dietary supplements contain numerous naturally occurring phytochemicals, more than one of which may contribute to the formulation’s physiological effect.)
Cinnamon (Cinnamomum spp., Lauraceae) has been demonstrated in basic research studies to lower serum lipids and blood glucose, promote insulin release, enhance insulin sensitivity, increase insulin disposal, and regulate protein-tyrosine phosphatase 1β and insulin receptor kinase. In studies with diabetic rats, cinnamon extracts were shown to increase the expression of peroxisome proliferator-activated receptors (PPARs). PPARs are targeted in therapies for diabetes and hyperlipidemia (high levels of blood lipids, e.g., cholesterol) and have been shown to increase insulin sensitivity and high-density lipoprotein cholesterol (HDL-C) levels in addition to decreasing triglyceride levels.
Evidence from previous human clinical trials has shown conflicting effects of cinnamon on blood glucose and lipids. The authors of the this review found no significant relationship between cinnamon and measures of type 2 diabetes in a previous meta-analysis published in 2008.1 For their current paper, they repeated the meta-analysis with the addition of five new randomized, controlled studies.
The databases MEDLINE®, Embase™, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched through February 2012 using the keywords cinnamon and diabetes. Studies were considered for inclusion in the analysis if they were randomized, controlled trials that investigated type 2 diabetes using cinnamon supplements in any dose or form. The studies had to have one of the following dependent variables measured to be considered for analysis: glycosylated hemoglobin (hemoglobin A1c), fasting plasma glucose, total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), HDL-C, or triglycerides (TGs). All of the potentially relevant articles were reviewed by two of the investigators. Author identification, year of publication, study design, source of study funding, study duration and follow-up, study population, sample size, time since diagnosis, cinnamon dose, product name and brand, formulation used, and cinnamon species were recorded. Baseline data for hemoglobin A1c level, fasting plasma glucose level, body weight, body mass index, TC, LDL-C, HDL-C, and TGs were recorded. The studies were checked for bias with the Cochrane Risk of Bias Tool. The mean change from baseline for levels of hemoglobin A1c, fasting plasma glucose, TC, LDL-C, HDL-C, and TGs were analyzed with Comprehensive Meta-Analysis software, version 2 (Biostat). Both heterogeneity among studies and publication bias were calculated. The effects of cinnamon dosage and form were calculated with subgroup analysis.
Ten studies met the criteria imposed by the authors (n=543 subjects). Of these, eight trials had measures of hemoglobin A1c, LDL-C, and HDL-C, and eight trials had measures of fasting plasma glucose, TC, and TGs. Eight of the studies used formulations of C. aromaticum (syn. C. cassia) and two did not state the species of cinnamon. The dosage of cinnamon ranged from 120 mg per day to six grams per day. There was variation among the studies as to when the cinnamon supplements were administered relative to meals. In seven studies, participants took the cinnamon supplements with a meal. In the remaining studies, participants took supplements either before (one study) or after a meal (two studies).
Cinnamon supplements significantly reduced fasting plasma glucose by a weighted average of 24.59 mg/dL. This is a slightly greater reduction than that seen with the antihyperglycemic drug sitagliptin (-16 to -21 mg/dL), but considerably lower than that found with metformin monotherapy (-58 mg/dL). LDL-C and TGs also were reduced in patients who took cinnamon supplements when compared to control patients (-9.4 mg/dL and -29.6 mg/dL, respectively). Again, these reductions are considerably less than in patients on conventional medications; pravastatin and gemfibrozil have been shown to decrease both LDL-C and TGs by -50 mg/dL. HDL-C was significantly increased (1.66 mg/dL) in patients who took cinnamon supplements. There was no effect of cinnamon on hemoglobin A1c levels; however, when only capsule formulations of cinnamon were considered, hemoglobin A1c was significantly decreased (-0.27%).
There was a high level of heterogeneity among the studies for hemoglobin A1c, fasting plasma glucose, TC, LDL-C, and TGs. This may be the result of variation among the studies in the patients’ age and health and in the dosage and form of cinnamon supplements used. There was also potential publication bias for fasting plasma glucose. No difference was seen in glycemic or lipid measures with cinnamon dosage.
These trends are similar to the authors’ findings from their 2008 meta-analysis, but the five additional randomized, controlled trials have allowed the authors to conclude that cinnamon does, indeed, have a positive, significant effect on some measures of glycemic and lipid metabolism in patients with type 2 diabetes. This publication is consistent with another previous meta-analysis by other researchers of eight randomized, controlled trials on cinnamon preparations, which showed that cinnamon supplementation resulted in a statistically significant reduction of fasting blood glucose in people with type 2 diabetes and prediabetes.2
—Cheryl McCutchan, PhD
References
1. Baker WL, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes Care. 2008;31(1):41-43.
2. Davis PA, Yokoyama W. Cinnamon intake lowers fasting blood glucose: meta-analysis. J Med Food. April 2011; [epub ahead of print]. doi:10.1089/jmf.2010.0180.
Source : American Botanical Council - HerbalGram
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Effects of Brown Seaweed (Sargassum polycystum) Extracts on Kidney, Liver, and Pancreas of Type 2 Diabetic Rat Model
Mahsa Motshakeri, 1, Mahdi Ebrahimi, 2 Yong Meng Goh, 2,3, Hemn Hassan Othman, 2, Mohd Hair-Bejo, 2 and Suhaila Mohamed 4
1 Faculty of Food Science & Technology, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
2 Faculty of Veterinary Medicine, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
3 Institute of Tropical Agriculture, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
4 Institute of Bioscience, Universiti Putra Malaysia, 43400 Serdang, Selangor, Malaysia
Abstract
The edible seaweed Sargassum polycystum (SP) is traditionally used against several human diseases. This investigation evaluated
the effects of two dietary doses of SP ethanolic and aqueous extracts on the pancreatic, hepatic, and renal morphology of type 2
diabetic rats (T2DM). T2DM was induced by feeding rats on high calorie diet followed by a low dose streptozotocin. Changes in
the diabetic rat organs in SP treated groups with different doses of extracts were compared with normal rats, diabetic control rats,
and metformin treated rats. After 22 days of treatment, the pathological lesions of the livers and kidneys in the diabetic rats were
quantitatively and qualitatively alleviated ( 푃<0.05) by both the SP extracts at 150mg/kg body weight and by metformin. All the
treated diabetic groups revealed marked improvement in the histopathology of the pancreas compared with the control diabetic
group. Oral administration of 300mg/kg body weight of aqueous and ethanolic extracts of SP and metformin revealed pancreas
protective or restorative effects.The seaweed extracts a t150mg/kg body weight reduced the liver and kidney damages in the diabetic rats and may exert tissue repair or restoration of the pancreatic islets in experimentally induced diabetes to produce the beneficial homeostatic effects.
Source : Evidence Based Complementary and Alternative Medicine Journal
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Chinese Herbal Medicine Tianqi Reduces Progression From Impaired Glucose Tolerance to Diabetes: A Double-Blind, Randomized, Placebo-Controlled, Multicenter Trial
Fengmei Lian, Guangwei Li, Xinyan Chen, Xiuzhi Wang, Chunli Piao, Jingfei Wang, Yuzhi Hong, Zhuoma Ba, Shentao Wu, Xiaoyan Zhou, Jiangming Lang, Yajun Liu, Rongfang Zhang, Jianjun Hao, Zhangzhi Zhu, Huilin Li, Hong Fang Liu, Aimei Cao, Zhu Yan, Yali An, Yujing Bai, Qiang Wang, Zhong Zhen, Chunhao Yu, Chong-Zhi Wang, Chun-Su Yuan* and Xiaolin Tong*
Abstract
Context: Living in a prediabetes state significantly increases a patient's risk for both diabetes and cardiovascular disease. Tianqi capsule, containing 10 Chinese herbal medicines, is used in China for the treatment of type 2 diabetes mellitus (T2DM).
Objective: The purpose of this study was to assess whether Tianqi prevented T2DM in subjects with impaired glucose tolerance (IGT) over the course of a 12-month treatment.
Methods: Individuals with IGT were randomly allocated in a double-blind manner to receive Tianqi (n = 210) or a placebo (n = 210) for 12 months. Oral glucose tolerance tests were conducted every 3 months to assess the development of diabetes or restoration to normal glucose tolerance. All subjects received the same lifestyle education. The primary endpoint was the conversion of IGT to T2DM. Body weight and body mass index were observed. Adverse effects were monitored.
Results: Of the 420 enrolled subjects with IGT, 389 completed the trial (198 in the Tianqi group and 191 in the placebo group). At the end of the 12-month trial, 36 subjects in the Tianqi group (18.18%) and 56 in the placebo group (29.32%) had developed diabetes (P = .01). There was a significant difference in the number of subjects who had normal glucose tolerance at the end of the study between the Tianqi and placebo groups (n = 125, 63.13%, and n = 89, 46.60%, respectively; P = .001). Cox's proportional hazards model analysis showed that Tianqi reduced the risk of diabetes by 32.1% compared with the placebo. No severe adverse events occurred in the trial. There were no statistical differences in body weight and body mass index changes between the Tianqi group and the placebo group during the 12-month trial.
Conclusions: Treatment with a Tianqi capsule for 12 months significantly decreased the incidence of T2DM in subjects with IGT, and this herbal drug was safe to use.
Source : The Journal of Clinical Endocrinology & Metabolism
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Curcumin and Diabetes: A Systematic Review
Dong-wei Zhang,1 Min Fu,2 Si-Hua Gao,1 and Jun-Li Liu2
1Diabetes Research Center, Beijing University of Chinese Medicine, Beijing 100029, China
2Fraser Lab for Diabetes Research, McGill University Health Center, Montreal, Canada H3A 1A1
Abstract
Turmeric (Curcuma longa), a rhizomatous herbaceous perennial plant of the ginger family, has been used for the treatment of diabetes in Ayurvedic and traditional Chinese medicine. The active component of turmeric, curcumin, has caught attention as a potential treatment for diabetes and its complications primarily because it is a relatively safe and inexpensive drug that reduces glycemia and hyperlipidemia in rodent models of diabetes. Here, we review the recent literature on the applications of curcumin for glycemia and diabetes-related liver disorders, adipocyte dysfunction, neuropathy, nephropathy, vascular diseases, pancreatic disorders, and other complications, and we also discuss its antioxidant and anti-inflammatory properties. The applications of additional curcuminoid compounds for diabetes prevention and treatment are also included in this paper. Finally, we mention the approaches that are currently being sought to generate a “super curcumin” through improvement of the bioavailability to bring this promising natural product to the forefront of diabetes therapeutics.
Conclusion
Recent research has provided the scientific basis for “traditional” curcumin and confirmed the important role of curcumin in the prevention and treatment of diabetes and its associated disorders. Curcumin could favorably affect most of the leading aspects of diabetes, including insulin resistance, hyperglycemia, hyperlipidemia, and islet apoptosis and necrosis (Figure 2). In addition, curcumin could prevent the deleterious complications of diabetes. Despite the potential tremendous benefits of this multifaceted nature product, results from clinical trials of curcumin are only available in using curcumin to treat diabetic nephropathy, microangiopathy and retinopathy so far. Studies are badly needed to be done in humans to confirm the potential of curcumin in limitation of diabetes and other associated disorders. Further, multiple approaches are also needed to overcome limited solubility and poor bioavailability of curcumin. These include synthesis of curcuminoids and development of novel formulations of curcumin, such as nanoparticles, liposomal encapsulation, emulsions, and sustained released tablets. Enhanced bioavailability and convinced clinical trial results of curcumin are likely to bring this promising natural product to the forefront of therapeutic agents for diabetes by generating a “super curcumin” in the near future.
Source : Journal Evidence Based Complementary and Alternative Medicine
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Efficacy of Purple Passion Fruit Peel Extract in Lowering Cardiovascular Risk Factors in Type 2 Diabetic Subjects
- I. Naga Raju, MSc1
- K. Kodandarami Reddy, PhD2
- C. Krishna Kumari, MSc1
- E. Bhaskar Reddy, MSc1
- S. Dattatreya Rao, PhD3
- C. Damodar Reddy, PhD1
- Ronald Ross Watson, PhD4,5⇑
- 1Sugen Life Sciences Pvt Ltd, Tirupati, Andhra Pradesh, India
- 2Sri Venkateswara University, Tirupati, Andhra Pradesh, India
- 3Sri Venkateswara Ayurvedic College, Tirupati, Andhra Pradesh, India
- 4South West Scientific Editing and Consulting, Tucson, AZ, USA
- 5University of Arizona, Tucson, AZ, USA
The clinical efficacy of purple passion fruit peel extract (a flavonoid-rich dietary supplement) in reducing cardiovascular risk factors in adult type 2 diabetic subjects was investigated in a randomized, double-blind, placebo-controlled trial. Forty-one subjects were randomly assigned to receive a daily dose of purple passion fruit (220 mg) or a matched placebo for 16 weeks. Body mass index, blood pressure, fasting and postprandial blood glucose, glycated hemoglobin, and lipid profile were determined at baseline and at monthly intervals. A significant reduction in systolic blood pressure and fasting blood glucose was observed following administration of purple passion fruit (P < .05). Purple passion fruit was well tolerated, and no adverse events were reported. These data suggest that purple passion fruit supplementation for 16 weeks in type 2 diabetics results in a significant reduction in systolic blood pressure and fasting blood glucose, indicating that purple passion fruit is safe and well tolerated by diabetics.
Source : Journal Evidence Based Complementary and Alternative Medicine
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BPA, phthalates tied to kids' weight, diabetes risk
Children exposed to two chemicals commonly used in food packaging are more likely to be obese or show signs of diabetes precursors than those with lower exposure, new research suggests.
Researchers found urine levels of one type of phthalate, used to soften plastic, were tied to a higher risk of insulin resistance among teenagers. Based on data from the same large nutrition survey, another study group linked bisphenol A, or BPA - used to line aluminum cans - to obesity and larger waists in youth.
According to the Centers for Disease Control and Prevention, about one in six U.S. children and teenagers is now obese.
"Clearly unhealthy diet and lack of physical activity are the drivers of this epidemic … but increasingly environmental chemicals are being identified as possible contributors," Dr. Leonardo Trasande, a pediatrician from New York University, said.
He and his colleagues analyzed data from a nationally-representative health and nutrition survey conducted in 2003 to 2008, which included urine and blood tests for 766 adolescents aged 12 to 19.
They found urinary levels of one particular type of phthalate, known as Di-2-ethylhexylphthalate (DEHP), were closely tied to a teenager's chance of having insulin resistance, a precursor to diabetes.
Just under 15 percent of study participants with the lowest one-third of DEHP levels were insulin resistant, compared to almost 22 percent of those with the highest levels.
DEHP, Trasande said, is often used to soften plastic bottles. It's used in plastic that is printed with the number 3 for recycling.
The researchers said their findings don't prove that eating food packaged with phthalates causes insulin resistance. For example, it's possible children who are already insulin-resistant have unhealthier eating habits and eat and drink more packaged products - thus the higher phthalate levels in their urine.
But Trasande told Reuters Health the chemical may influence how the body secretes insulin in response to sugar.
Because of that, he tells parents to avoid buying plastics made with DEHP.
"I advise them not to wash plastic containers in the dishwasher," he said. And, "When the plastic is clearly etched or damaged, it's time to throw it away."
MORE EVIDENCE ON BPA
For a separate study published concurrently in Pediatrics, Dr. Joyce Lee from the University of Michigan in Ann Arbor and her colleagues used nutrition survey data through 2010 to compare BPA levels in the urine of six- to 18-year-olds with other health measures.
In their analysis of 3,370 kids, BPA - an industrial chemical that may mimic estrogen in the body - was not linked to insulin resistance or blood sugar.
But children with higher BPA levels were more likely to be obese, and tended to have a higher waist circumference-to-height ratio, than those with the lowest levels.
A total of 18 percent of kids in the study were obese, based on CDC growth charts. Compared to children with the lowest BPA levels, the 25 percent with the highest levels were twice as likely to meet the cutoff for obesity.
The average child had 2.6 nanograms, or 2.6 billionths of a gram, of BPA in every milliliter of urine.
The findings are in line with a 2012 study that used some of the same data and also linked BPA in kids' urine to their chance of being overweight or obese, without proving a cause-and-effect relationship (see Reuters Health story of September 18, 2012 here: reut.rs/PDrxzL).
"That study adds further concerns to the ongoing use of BPA in food," Trasande said.
"There are a variety of chemicals used in children's products including BPA as well as other chemicals of less notoriety that our kids are exposed to on a daily basis, for which there are unknown health effects," Lee told Reuters Health in an email.
"Although the evidence about BPA and adverse health effects are not definitive, as a clinician, I do recommend that parents try to avoid BPA-containing plastics when possible to minimize their family's exposure. I also tell them to avoid microwaving food in plastic containers, as this can lead to chemicals leaking into the food," Lee said.
Still, one researcher cautioned that urinary levels of BPA and other chemicals may not say a lot about how much actually gets into children's blood and tissues.
"Everybody who does BPA studies uses the urine for a surrogate of exposure. It's erroneous, because the urine is purely what the person took in that day in BPA," Dr. Robert Brent from Alfred I. DuPont Hospital for Children in Wilmington, Delaware, who wrote an editorial accompanying the new studies, said.
"In order to know what exposure is you have to have the blood level of the chemical," he told Reuters Health - as well as how quickly it breaks down in the blood.
Last year the U.S. Food and Drug Administration banned BPA from baby bottles, but said there was not enough evidence for a more widespread ban. The FDA has not placed regulations on phthalates in food products, Trasande's team noted.
Source : Reuters
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Antidiabetic and antioxidant properties of Ficus deltoidea fruit extracts and fractions
Hasni Misbah1, Azlina A Aziz2 and Norhaniza Aminudin3*
1. Department of Molecular Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
2 University Malaya Centre for Proteomics Research (UMCPR), Medical Biotechnology Laboratory, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
3 Institute of Biological Sciences, Faculty of Science, University of Malaya, 50603, Kuala Lumpur, Malaysia
Abstract
Background
Diabetes is a serious metabolic disorder affecting the metabolism of carbohydrate, protein and fat. A number of studies have shown that diabetes mellitus is associated with oxidative stress, leading to an increased production of reactive oxygen species. Ficus deltoidea is traditionally used in Malaysia for regulating blood sugar, blood pressure and cholesterol levels. The use of F. deltoidea as an alternative medicinal herb is increasingly gaining popularity with the sale of F. deltoidea tea bags and capsules in the local market. The present study was undertaken to investigate the antidiabetic and antioxidant activities of the fruits from different varieties of F. deltoidea, employing in vitro methods.
Method
Two fruit varieties of F. deltoidea (var. angustifolia (SF) and var. kunstleri (BF)) were extracted separately using double-distilled water. The resulting aqueous extracts were partitioned using ethyl acetate to obtain the ethyl acetate and water fractions. The crude aqueous extracts and the corresponding fractions were evaluated for their phenolic, flavonoid, sugar and protein contents. Protein profiling of the extracts and fractions were also carried out by means of SDS-PAGE and SELDI-TOF MS. Antidiabetic activities were assessed based on the ability of the samples to inhibit yeast and mammalian α-glucosidase as well as α-amylase. Antioxidant capacities were examined by measuring the ability of the samples to reduce ferric ions and to scavenge DPPH, superoxide anion, ABTS and nitric oxide radicals.
Results
The crude extracts and fractions of SF and BF inhibited both yeast and rat intestinal α-glucosidases in a dose-dependent manner, but did not inhibit porcine pancreatic α-amylase. The water fraction of BF showed the highest percentage of α-glucosidase inhibition while having the highest amount of protein (73.33 ± 4.99 μg/mg fraction). All the extracts and fractions exhibited antioxidant activities, with SF crude extract showing the highest antioxidant activity and phenolic content (121.62 ± 4.86 mg/g extract). Fractionation of the crude extracts resulted in loss of antioxidant activities. There was no positive correlation between phenolic and flavonoid content with α-glucosidase inhibitory activities. However, phenolic content correlated well with antioxidant activities of the crude extracts but not with the fractions.
Conclusions
The antioxidant activities of the fruits of F. deltoidea might be asserted by the phenolic content but other polar plant components were possibly involved in the antidiabetic properties. The study of these compounds having both antihyperglycemic and antioxidant activities may provide a new approach in the treatment of diabetes mellitus.
Source : BMC Complementary and Alternative Medicine
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Treating Type 2 Diabetes Mellitus with Traditional Chinese and Indian Medicinal Herbs
Zhijun Wang,1 Jeffrey Wang,1,2 and Patrick Chan3
1Center for Advancement of Drug Research and Evaluation, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
2Department of Pharmaceutical Sciences, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
3Department of Pharmacy Practice and Administration, College of Pharmacy, Western University of Health Sciences, 309 E. Second Street, Pomona, CA 91766, USA
Abstract
Type II diabetes mellitus (T2DM) is a fast-growing epidemic affecting people globally. Furthermore, multiple complications and comorbidities are associated with T2DM. Lifestyle modifications along with pharmacotherapy and patient education are the mainstay of therapy for patients afflicted with T2DM. Western medications are frequently associated with severe adverse drug reactions and high costs of treatment. Herbal medications have long been used in the treatment and prevention of T2DM in both traditional Chinese medicine (TCM) and traditional Indian medicine (TIM). This review examines in vivo, in vitro, and clinical evidence supporting the use of various herbs used in TCM and TIM. The problems, challenges, and opportunities for the incorporation of herbal frequently used in TCM and TIM into Western therapy are presented and discussed.
Conclusion
It is evident that many TCM/TIM herbs possess anti-DM activities by interacting with various proven drug targets where Western drugs interact. Because of their empirically known oral efficacy and safety profiles, nutritional supplement status, multiple components for multiple drug targets, low cost, and easy access, TCM/TIM herbs such as ginseng, mulberry, and Radix coptidis are excellent candidates for long-term use for the prevention and treatment of T2DM. During the development stage, product standardization, quality control and assurance, placebo-controlled and randomized clinical trials are essential components that need to be perfected in order to translate their potential into a reality that millions of people could benefit upon.
Source : Evidence Based Complementary and Alternative Medicine
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Decreased prevalence of diabetes in marijuana users: cross-sectional data from the National Health and Nutrition Examination Survey (NHANES) III
Tripathi B Rajavashisth1,2, Magda Shaheen3, Keith C Norris3, Deyu Pan3, Satyesh K Sinha1, Juan Ortega1, Theodore C Friedman1
1Division of Endocrinology, Metabolism, and Molecular Medicine, Los Angeles, California, USA
2Omics Biotechnology, Inc, Lawndale, California, USA
3Office of Research, Charles R. Drew University of Medicine and Science, Los Angeles, California, USA
Abstract
Objective
To determine the association between diabetes mellitus (DM) and marijuana use.
Design
Cross-sectional study.
Setting
Data from the National Health and Nutrition Examination Survey (NHANES III, 1988–1994) conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.
Participants
The study included participants of the NHANES III, a nationally representative sample of the US population. The total analytic sample was 10 896 adults. The study included four groups (n=10 896): non-marijuana users (61.0%), past marijuana users (30.7%), light (one to four times/month) (5.0%) and heavy (more than five times/month) current marijuana users (3.3%). DM was defined based on self-report or abnormal glycaemic parameters. We analysed data related to demographics, body mass index, smoking status, alcohol use, total serum cholesterol, high-density lipoprotein, triglyceride, serum 25-hydroxy vitamin D, plasma haemoglobin A1c, fasting plasma glucose level and the serum levels of C reactive protein and four additional inflammatory markers as related to marijuana use.
Main outcome measures
OR for DM associated with marijuana use adjusted for potential confounding variables (ie, odds of DM in marijuana users compared with non-marijuana users).
Results
Marijuana users had a lower age-adjusted prevalence of DM compared to non-marijuana users (OR 0.42, 95% CI 0.33 to 0.55; p<0.0001). The prevalence of elevated C reactive protein (>0.5 mg/dl) was significantly higher (p<0.0001) among non-marijuana users (18.9%) than among past (12.7%) or current light (15.8%) or heavy (9.2%) users. In a robust multivariate model controlling for socio-demographic factors, laboratory values and comorbidity, the lower odds of DM among marijuana users was significant (adjusted OR 0.36, 95% CI 0.24 to 0.55; p<0.0001).
Conclusions
Marijuana use was independently associated with a lower prevalence of DM. Further studies are needed to show a direct effect of marijuana on DM.
Source : BMJ
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The Impact of Marijuana Use on Glucose, Insulin, and Insulin Resistance among US Adults
Elizabeth A. Penner, BS Hannah Buettner, BA Murray A. Mittleman, MD, DrPH
Department of Epidemiology, Harvard School of Public Health, Boston, Mass
Cardiovascular Epidemiology Research Unit, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Mass
Requests for reprints should be addressed to Murray A. Mittleman, MD, DrPH, 375 Longwood Ave, Boston, MA 02215.
Abstract
Background
There are limited data regarding the relationship between cannabinoids and metabolic processes. Epidemiologic studies have found lower prevalence rates of obesity and diabetes mellitus in marijuana users compared with people who have never used marijuana, suggesting a relationship between cannabinoids and peripheral metabolic processes. To date, no study has investigated the relationship between marijuana use and fasting insulin, glucose, and insulin resistance.
Methods
We included 4657 adult men and women from the National Health and Nutrition Examination Survey from 2005 to 2010. Marijuana use was assessed by self-report in a private room. Fasting insulin and glucose were measured via blood samples after a 9-hour fast, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated to evaluate insulin resistance. Associations were estimated using multiple linear regression, accounting for survey design and adjusting for potential confounders.
Results
Of the participants in our study sample, 579 were current marijuana users and 1975 were past users. In multivariable adjusted models, current marijuana use was associated with 16% lower fasting insulin levels (95% confidence interval [CI], −26, −6) and 17% lower HOMA-IR (95% CI, −27, −6). We found significant associations between marijuana use and smaller waist circumferences. Among current users, we found no significant dose-response.
Conclusions
We found that marijuana use was associated with lower levels of fasting insulin and HOMA-IR, and smaller waist circumference.
Source : The American Journal of Medicine
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Olive (Olea europaea L.) Leaf Polyphenols Improve Insulin Sensitivity in Middle-Aged Overweight Men: A Randomized, Placebo-Controlled, Crossover Trial
Martin de Bock, José G. B. Derraik, Christine M. Brennan, Janene B. Biggs, Philip E. Morgan, Steven C. Hodgkinson, Paul L. Hofman, Wayne S. Cutfield
Abstract
Background
Olive plant leaves (Olea europaea L.) have been used for centuries in folk medicine to treat diabetes, but there are very limited data examining the effects of olive polyphenols on glucose homeostasis in humans.
Objective
To assess the effects of supplementation with olive leaf polyphenols (51.1 mg oleuropein, 9.7 mg hydroxytyrosol per day) on insulin action and cardiovascular risk factors in middle-aged overweight men.
Design
Randomized, double-blinded, placebo-controlled, crossover trial in New Zealand. 46 participants (aged 46.4±5.5 years and BMI 28.0±2.0 kg/m2) were randomized to receive capsules with olive leaf extract (OLE) or placebo for 12 weeks, crossing over to other treatment after a 6-week washout. Primary outcome was insulin sensitivity (Matsuda method). Secondary outcomes included glucose and insulin profiles, cytokines, lipid profile, body composition, 24-hour ambulatory blood pressure, and carotid intima-media thickness.
Results
Treatment evaluations were based on the intention-to-treat principle. All participants took >96% of prescribed capsules. OLE supplementation was associated with a 15% improvement in insulin sensitivity (p = 0.024) compared to placebo. There was also a 28% improvement in pancreatic β-cell responsiveness (p = 0.013). OLE supplementation also led to increased fasting interleukin-6 (p = 0.014), IGFBP-1 (p = 0.024), and IGFBP-2 (p = 0.015) concentrations. There were however, no effects on interleukin-8, TNF-α, ultra-sensitive CRP, lipid profile, ambulatory blood pressure, body composition, carotid intima-media thickness, or liver function.
Conclusions
Supplementation with olive leaf polyphenols for 12 weeks significantly improved insulin sensitivity and pancreatic β-cell secretory capacity in overweight middle-aged men at risk of developing the metabolic syndrome.
Source : Plos One
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Efficacy and Safety of Traditional Chinese Medicine for Diabetes: A Double-Blind, Randomised, Controlled Trial
Linong Ji,1,* Xiaolin Tong,2 Hongyuan Wang,3 Haoming Tian,4 Huimin Zhou,5 Lili Zhang,6 Qifu Li,7 Yizhong Wang,8 Hongmei Li,9 Min Liu,10 Hongjie Yang,11 Yanbin Gao,12 Yan Li,13 Quanmin Li,14 Xiaohui Guo,15 Gangyi Yang,16 Zhongai Zhang,17 Zhiguang Zhou,18 Guang Ning,19 Yingli Chen,1 Sanjoy Paul,20,*,
for the Evidence-Based Medical Research of Xiaoke Pill Study Group and the Evidence-Based Medical Research of Xiaoke Pill Study Group¶Jianping Ye, Editor
Abstract
BackgroundTreatment of diabetes mellitus with Traditional Chinese Medicine has a long history. The aim of this study is to establish the safety and efficacy of traditional Chinese medicine combined with glibenclamide to treat type 2 diabetes mellitus.
Methods
In a controlled, double blind, multicentre non-inferiority trial, 800 patients with unsatisfactory glycemic control (fasting glucose 7–13 mmol/L and HbA1c 7–11%) were randomly assigned to receive Xiaoke Pill, a compound of Chinese herbs combined with glibenclamide, or Glibenclamide in two study groups – drug naive group, and patients previously treated with metformin monotherapy (metformin group). Outcome measures at 48 weeks were the incidence and rate of hypoglycemia, mean difference in HbA1c, and proportion of patients with HbA1c<6.5%.
Findings
In drug naïve group, the total hypoglycemia rate and the mild hypoglycemic episode in the Xiaoke Pill arm were 38% (p=0.024) and 41% (p=0.002) less compared to Glibenclamide arm; in Metformin group, the average annual rate of hypoglycemia was 62% lower in Xiaoke Pill arm (p=0.003). Respective mean changes in HbA1c from baseline were −0.70% and −0.66% for Xiaoke Pill and Glibenclamide, with a between-group difference (95% CI) of −0.04% (−0.20, 0.12) in the drug naïve group, and those in metformin group were −0.45% and −0.59%, 0.14% (−0.12, 0.39) respectively. The respective proportions of patients with a HbA1c level <6.5% were 26.6% and 23.4% in the drug naïve group and 20.1% and 18.9% in the metformin group.
Interpretation
In patients with type 2 diabetes and inadequate glycaemic control, treatment with Xiaoke Pill led to significant reduction in risk of hypoglycemia and similar improvements in glycemic control after 48 weeks compared to Glibenclamide.
Source : PLoS One. 2013; 8(2): e56703.
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Mangos Help Regulate Blood Sugar Levels Among Obese People
The positive health effects of Mangos have been recently explored and presented by researchers at the Federation of American Societies for Experimental Biology (FASEB). They found that mangos have properties that can help regulate blood sugar levels among people suffering from obesity.
*The study, which was led by Edralin Lucas, Ph.D., evaluated what effect eating mangos everyday would have on a total of twenty obese adult people. The participants ate 10 grams of freeze-dried mango everyday for 12 weeks.
At the end of the study period they found that the blood sugar levels of the participants were much lower than at the start of the study.
Among both genders there wasn't any substantial change in body composition, however, BMIs (body mass indexes) went up among the female participants.
The authors noted that these results are only from a single study and that more research is necessary to fully understand the health effects of mango consumption among obese people.
Obesity is a serious public health issue in the U.S., where a total of twelve states have 30+% obesity rates today, compared to just one in 2007. Since 1995, obesity rates have risen by 90+% in 10 states and have doubled in another 7.
According to the Centers for Disease Control and Prevention (CDC), obesity is a main cause of: type 2 diabetes, breast and colon cancer, coronary heart disease, stroke, hypertension, liver and gallbladder disease and high cholesterol.
Researchers have long been looking for factors that can help prevent the health effects of obesity. This study, along with others, shows promise for those suffering from the condition.
According to Dr. Lucas:
"The results of this study support what we learned in our recent animal model, which found that mango improved blood glucose in mice fed a high fat diet. Although the mechanism by which mango exerts its effects warrants further investigation, we do know that mangos contain a complex mixture of polyphenolic compounds.
Research has shown that several other plants and their polyphenolic compounds, such as isoflavone from soy, epigallocatechin gallate from green tea , and proanthocyanidin from grape seed , have a positive effect on adipose tissue."
An average mango has an energy value per 100g of approximately 60 kcal, they have numerous health benefits and nutrients, they are naturally high in prebiotic dietary fiber (substances that encourage the growth of beneficial bacteria, not to be confused with probiotics), vitamin C, and antioxidant vitamins A and C, as well as vitamin B6. Mango contains triterpene and lupeol, which have been found to be an effective inhibitor in laboratory models of prostate and skin cancer.
The health benefits of mango consumption have been explored in previous studies,. Texas AgriLife Research food scientists found that mango able to prevent or stop certain colon and breast cancer cells in the lab.
Written by Joseph Nordqvist
Source : Medical News Today
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More Proof Soft Drinks Tied to Diabetes
By Cole Petrochko
One can -- or one more can -- of soda daily significantly increased the risk of diabetes in a European population, researchers found.
Consuming an additional 12 ounces of sugar-sweetened beverages -- a standard size can of soda -- daily was associated with a 22% (95% CI 1.09 to 1.38) increased risk for diabetes, and an extra can of artificially-sweetened beverage put the risk 52% higher (95% CI 1.26 to 1.83), according to Dora Romaguera-Bosch, PhD, MSc, of Imperial College London in England, and colleagues at the InterAct consortium.
However, only the association between sugar-sweetened beverages and diabetes risk remained significant after adjustment for body mass index and energy intake (HR 1.18, 95% CI 1.06 to 1.32), they wrote online in the journal Diabetologia.
Soda and other artificially- and sugar-sweetened beverages may contribute to diabetes due to their effect on body weight and blood glucose, the researchers wrote. A link between sugary drink consumption and diabetes has also been seen in prior research in American populations.
The authors studied associations between consumption of juices, nectars, sugar-sweetened soft drinks, and artificially-sweetened soft drinks with diabetes incidence in a case-cohort study of 15,374 participants from eight European countries, and including 11,684 incident cases of diabetes.
Cohorts from eight countries were involved in the EPIC (European Prospective Investigation into Cancer and Nutrition)-InterAct study. InterAct specifically looked at incidence of diabetes.
Participants answered dietary questionnaires that measured:
- Food intake over the year prior to the survey
- Individual energy intake
- Consumption of juices, nectars, and soft drinks
Covariates included smoking status, alcohol intake, education, physical activity, BMI, and, "in most participating centers," baseline chronic conditions, including hypertension, hyperlipidemia, and cardiovascular disease.
Raw scores were also calculated with adjustment for age, sex, BMI category, and physical activity levels.
Compared with those who consumed lower levels of sugary soft drinks, high-level consumers were more likely to be male, physically active, less educated, smokers, and have a higher waist circumference. Juice and nectar high consumers were mostly younger, female, physically active, former smokers, and better educated than those with lower juice and nectar consumption.
Although soft drink consumption was linked with diabetes incidence, there was no association between diabetes and consumption of juices and nectars. One or more glasses daily of soft drink was associated with a 58% increased risk of diabetes compared with those who consumed the lowest levels of soft drinks (P<0.0001).
When this comparison was adjusted for BMI, this trend remained significant, though the association was not as strong (P=0.0005).
Artificially-sweetened soft drink consumption was associated with diabetes risk prior to adjustment for BMI (P<0.0001), but this association lost significance after adjustment (P=0.24).
Consumption of sugar-sweetened soft drinks remained significantly associated with diabetes both before (P<0.0001) and after (P=0.013) adjustment for BMI.
"The observed association between sugar-sweetened soft drinks and diabetes in the present analysis is of similar magnitude as the association reported in a meta-analysis of eight prospective studies, which was based on 15,043 diabetes cases mostly from the U.S.A.," they concluded.
They also noted that future studies should examine whether BMI acts as a mediator or confounder with the association.
The authors said the study was limited by the clinical definition of type 2 diabetes, lack of follow-up dietary data, a definition of juices and nectars that included those with and without added sugar, and possible measurement errors. The study was also limited by center-specific factors, possible residual confounding, and possible reverse causality.
Source : MedPage Today
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Study finds a spoonful of cinnamon improves health
Sprinkling a spoonful of cinnamon on breakfast foods not only adds a burst of flavor but also dramatically lowers an individual's blood sugar levels, potentially reducing the chance of developing diabetes, says a new study from Ball State University.
Ball State researcher Jo Carol Chezem found when healthy weight and obese adults ate a cooked breakfast cereal with 6 grams of cinnamon, blood sugar levels declined by 25 percent for the next two hours compared to participants who did not ingest the spice. The study was reported in the November issue of the Journal of the Academy of Nutrition and Dietetics. Chezem's study involved 37 participants and confirms that in both healthy-weight and obese adults, cinnamon reduces blood glucose concentration and enhances insulin sensitivity, strengthening the body's ability to ward off diabetes. "Nearly 80 million American adults have prediabetes, a condition characterized by high blood glucose that often leads to diabetes," said Chezem, who teaches nutrition in Ball State's Department of Family and Consumer Sciences. "We are very encouraged by the study's results and are planning similar studies in individuals with prediabetes and diabetes." "Although the amount used in the study – 6 grams or about 2 1/2 teaspoons – was much more than a sprinkle, our subjects found the taste acceptable," she said. "Cinnamon can be added to a wide variety of foods. Some ideas include yogurt, iced coffees and teas, fruit smoothies and muffins." These research findings could play a major role in helping millions of Americans stay healthy by simply adding a flavorful ingredient to start their day, she said. Burden of Diabetes Among Adults in Indiana, released by the university's Global Health Institute (GHI) in 2011, found that another 5.6 percent of the adult population in Indiana report having prediabetes or borderline diabetes. The average annual health care cost for a person with diabetes in this country is $11,744 as compared to $2,935 for a person without diabetes "As health care in the United States becomes more expensive, cinnamon may offer a low cost approach to modifying blood glucose," Chezem said. Journal reference: Journal of the Academy of Nutrition and Dietetics
Source : Medicalxpress
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The ancient Tibetan goji berry could help fight blindness caused by long-term diabetes
Faculty of Pharmacy researchers have conducted in vitro tests investigating the potential power of the berry which is now a popular natural remedy.
According to lead researcher, University of Sydney Professor of Pharmaceutical Chemistry Basil Roufogalis, the goji berry is abundant in taurine, an ingredient credited with anti-oxidative, anti-inflammatory and immuno-modulating properties which could protect the retina.
"Diabetic retinopathy is a leading cause of blindness for people with diabetes, with up to 60 per cent of people living with either type 1 or type 2 diabetes developing chronic hyperglycaemia, a condition which can damage retina cells," explains Professor Roufogalis.
"Typically what happens is proteins in the eye become oxidated and high glucose levels force retinal cells to die.
"What's more, blood vessels build up in the retina and grow over the vision spot, which can result in vision loss."
The pharmacy researchers initially undertook work showing the goji berry and its taurine component activated a nuclear receptor protein called PPAR-gamma. This protein plays a crucial role in regulating the retinal cells. This paved the way for further investigation of Lycium barbarum (goji) and its potential to activate the PPAR-gamma receptor.
"First we looked at the protective effect of pure taurine, and an extract of goji berry rich in taurine, in retinal barrier epithelial cells exposed to high glucose - a cell line that can serve as a model to emulate diabetic retinopathy."
"We found that goji berry protected against the death of cells caused by high concentrations of glucose in the retina. This protection occurred in parallel with the activation by the extract of the receptor protein (PPAR-gamma). The pure taurine found in the extract mimicked the effects of the goji berry extract.
"We then wanted to see whether the same extracts of goji berry and its pure taurine and had an effect on protecting the retinal barrier against toxin invasion when the barrier is typically damaged by high glucose in diabetes patients," said Professor Roufogalis.
"What we found is that both the pure taurine and the taurine-laden goji berry extract protected the retina against increased permeability of the protective barrier through its actions on the PPAR-gamma receptor, thereby helping the epithelial cells that provide the protective barrier to the retina."
"We are hopeful that these promising results for treating or preventing diabetic retinopathy will lead to human clinical trials," said Professor Roufogalis.
Ms Min Song, from the Faculty of Pharmacy, received a National Institute of Complementary Medicine (NICM) PhD scholarship to assist in the groundbreaking research. NICM, hosted by the University of Western Sydney, was launched in 2007 to facilitate strategic research in complementary medicine in Australia.
Professor Alan Bensoussan, director of NICM, hailed the novel research.
"This is pioneering scientific research in the field of herbal medicine, and is to be applauded for investigating novel ways to address the debilitating effects of diabetes, which is such a pressing global health problem," he said.
Source : NICM
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Intensive Program May Reverse Diabetes
Intense lifestyle-based weight-loss interventions were associated with a partial remission of diabetes, researchers found.
Compared with an education and support intervention for diabetes patients, those engaged in an intense weight-loss and lifestyle intervention were more likely to experience any remission at year 1 (11.5% versus 7.3%, P<0.001), and were more likely to see that remission continuously sustained over 3 years of measurements (9.2%, 6.4%, and 3.5% versus 1.7%, 1.3%, and 0.5%, respectively), according to Edward Gregg, PhD, of the Centers for Disease Control and Prevention, and colleagues.
Participants in the intervention group also lost significantly more weight at two follow-up periods (a difference of 7.9% at year one and 3.9% at year four, P<0.001 for both), and significantly fewer participants in the weight-loss intervention who experienced remission returned to clinical diabetes status at each point of follow-up, they wrote online in the Journal of the American Medical Association.
The researchers also noted that the weight-loss intervention was particularly effective in "those whose diabetes is of short duration, who have lower hemoglobin A levels, and who do not yet require insulin therapy."
Patients diagnosed as having type 2 diabetes frequently ask if their condition is reversible, and "some physicians may provide hopeful advice that lifestyle change can normalize glucose levels," they wrote in the introduction to their findings. "However, the rate of remission of type 2 diabetes that may be achieved using nonsurgical approaches has not been reported."
To help clarify the issue, the researchers investigated the outcomes of a long-term (4 years) intensive weight-loss intervention on frequency of remission from diabetes to prediabetes or normoglycemia in 2,241 participants and compared them with a sample of 2,262 diabetes patients participating in a diabetes and support education intervention.
The intensive weight-loss intervention included weekly group and individual counseling for the first 6 months focused on reducing caloric intake, decreasing consumption of total and saturated fats, and increasing physical activities; this was followed by three sessions per month for the second 6 months and twice-monthly sessions over years 2 to 4. Participants also were offered liquid meal replacements to help with dietary goals.
In the support education intervention participants were given three group sessions annually that offered information on diet, physical activity, and social support.
Participants in each group were evaluated at baseline and once at each year of the 4 years of follow-up for health status, including body mass index and glycemic status. Participant fitness also was assessed at baseline through a maximal graded exercise test and at years one and four through a submaximal exercise test.
The participants were 45 to 75 years old with a mean age of 59 years, had a median time since diabetes diagnosis of 5 years, and were "notably obese at baseline."
In addition to losing more weight, the weight-loss intervention group had greater increases in fitness in years one and four (20.6% versus 4.9% and 5.3% versus 1.5%, respectively, P<0.001 for both) than those in the education group.
Complete remission -- defined as glucose normalization without medication -- was more common among the lifestyle weight-loss participants than the education group (prevalence ratio 6.6, 95% CI 3.3 to 13.3, P<0.001). Absolute prevalence of complete remission was low overall, the authors noted.
Participants were significantly more likely to experience either partial or complete remission in the lifestyle intervention than in the education intervention at years 1 and 4 (P<0.001 for both).
Return to clinical diabetes status occurred in roughly one-third of the lifestyle intervention group each year (33.1% at year two, 33.8% at year three, and 31.6% at year four) versus around half among participants in the education group (52.4% at year two, 45.9% at year three, and 43.8% at year four).
In addition, continuous, sustained remission was significantly more common among weight-loss intervention participants than in the education group at years two to four (P<0.001 for all).
In an accompanying editorial, David Arterburn, MD, of the Group Health Research Institute in Seattle Wash., and Patrick O'Connor, MD, of the Institute for Education and Research in Minneapolis, Minn., noted that neither intervention translated to "lower rates of nonfatal myocardial infarction, nonfatal stroke, hospitalization for angina, or death compared with conventional diabetes treatment."
They editorialists speculated that this was due to overall lower-than-expected rates of cardiovascular events due to improved risk factor control in each group, improved critical care after acute cardiovascular events, a healthier-than-expected cohort, and exclusion of participants with high cardiovascular risk at baseline.
They also noted that bariatric surgery achieves an effective reduction in cardiovascular events and mortality rates.
The study was limited by a lack of pure intention-to-treat approach, a non-ideal study population that likely underestimated frequency of remission, lack of evaluation of each intervention's impact on insulin resistance, and greater likelihood of healthcare professionals modifying medications in the education group.
Source : MedPage Today
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Drinking Green Tea With Starchy Food May Help Lower Blood Sugar Spikes
An ingredient in green tea that helps reduce blood sugar spikes in mice may lead to new diet strategies for people, according to Penn State food scientists.
Mice fed an antioxidant found in green tea -- epigallocatechin-3-gallate, or EGCG -- and corn starch had a significant reduction in increase in their blood sugar -- blood glucose -- levels compared to mice that were not fed the compound, according to Joshua Lambert, assistant professor of food science in agricultural sciences.
"The spike in blood glucose level is about 50 percent lower than the increase in the blood glucose level of mice that were not fed EGCG," Lambert said.
The dose of EGCG fed to the mice was equivalent to about one and a half cups of green tea for a human.
Lambert, who worked with Sarah C. Forester, postdoctoral fellow, and Yeyi Gu, graduate student, both in food science, said EGCG was most effective when the compound was fed to the mice simultaneously with corn starch. For humans, this may mean that green tea could help them control the typical blood sugar increases that are brought on when they eat starchy foods, like breads and bagels that are often a part of typical breakfasts.
"If what you are eating with your tea has starch in it then you might see that beneficial effect," Lambert said. "So, for example, if you have green tea with your bagel for breakfast, it may reduce the spike in blood glucose levels that you would normally get from that food."
The EGCG had no significant effect on blood sugar spikes in mice that were fed glucose or maltose, according to the researchers who released their findings in the online version of Molecular Nutrition and Food Research. Lambert said that the reason blood sugar spikes are reduced when the mice ate starch, but not these sugars, may be related to the way the body converts starch into sugar.
An enzyme called alpha-amylase that is produced in both the mouth and by the pancreas helps break down starch into maltose and glucose. EGCG may inhibit the enzymes ability to break down the starch, the researchers indicated, since they also found that EGCG reduced the activity of alpha amylase in the pancreas by 34 percent.
If the mechanism holds in humans, this may mean that people who want to limit the blood sugar spike should skip adding sugar to their cup of green tea.
"That may mean that if you add sugar into your green tea, that might negate the effect that the green tea will have on limiting the rise in blood glucose level," Lambert said.
Lambert added that the green tea and the starch would need to be consumed simultaneously. For example, drinking a cup of tea well after eating a piece of toast would probably not change the blood sugar spike.
For the study, researchers separated mice into several groups based on body weight. After a fasting period, the mice were given common corn starch, maltose, or sucrose. One group of mice received EGCG along with the feed, while a control group was not fed the compound.
The researchers then tested the blood sugar levels of both groups.
Lambert said the researchers next step is to test the compound on people.
"The relatively low effective dose of EGCG makes a compelling case for studies in human subjects," the researchers said.
Source : Science Daily
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Fruit and vegetable intake and type 2 diabetes: EPIC-InterAct prospective study and meta-analysis
A J Cooper1, N G Forouhi1, Z Ye1, B Buijsse2, L Arriola3,4,5, B Balkau6,7, A Barricarte5,8, J W J Beulens9, H Boeing2, F L Büchner10, C C Dahm11,12, B de Lauzon-Guillain7,13, G Fagherazzi13, P W Franks14,15, C Gonzalez16, S Grioni17, R Kaaks18, T J Key19, G Masala20, C Navarro5,21,22, P Nilsson23, K Overvad11,12, S Panico24, J Ramón Quirós25, O Rolandsson15, N Roswall26, C Sacerdote27,28, M-J Sánchez5,29, N Slimani30, I Sluijs9, A M W Spijkerman10, B Teucher18, A Tjonneland31, R Tumino32,33, S J Sharp1, C Langenberg1, E J M Feskens34, E Riboli35, N J Wareham1 and The InterAct Consortium
Abstract
Fruit and vegetable intake (FVI) may reduce the risk of type 2 diabetes (T2D), but the epidemiological evidence is inconclusive. The aim of this study is to examine the prospective association of FVI with T2D and conduct an updated meta-analysis. In the European Prospective Investigation into Cancer-InterAct (EPIC-InterAct) prospective case–cohort study nested within eight European countries, a representative sample of 16 154 participants and 12 403 incident cases of T2D were identified from 340 234 individuals with 3.99 million person-years of follow-up. For the meta-analysis we identified prospective studies on FVI and T2D risk by systematic searches of MEDLINE and EMBASE until April 2011. In EPIC-InterAct, estimated FVI by dietary questionnaires varied more than twofold between countries. In adjusted analyses the hazard ratio (95% confidence interval) comparing the highest with lowest quartile of reported intake was 0.90 (0.80–1.01) for FVI; 0.89 (0.76–1.04) for fruit and 0.94 (0.84–1.05) for vegetables. Among FV subtypes, only root vegetables were inversely associated with diabetes 0.87 (0.77–0.99). In meta-analysis using pooled data from five studies including EPIC-InterAct, comparing the highest with lowest category for FVI was associated with a lower relative risk of diabetes (0.93 (0.87–1.00)). Fruit or vegetables separately were not associated with diabetes. Among FV subtypes, only green leafy vegetable (GLV) intake (relative risk: 0.84 (0.74–0.94)) was inversely associated with diabetes. Subtypes of vegetables, such as root vegetables or GLVs may be beneficial for the prevention of diabetes, while total FVI may exert a weaker overall effect.
Source : European Journal of Clinical Nutrition (2012) 66, 1082–1092; doi:10.1038/ejcn.2012.85
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Curcuminoid Extract Lowered the Risk for Type 2 Diabetes Mellitus Development in Prediabetic Subjects
Chuengsamarn S, Rattanamongkolgul S, Luechapudiporn R, Phisalaphong C, Jirawatnotai S. Curcumin extract for prevention of type 2 diabetes. Diabetes Care. July 6, 2012;[epub ahead of print]. doi: 10.2337/dc12-0116.
More than 300 million people worldwide have type 2 diabetes mellitus (T2DM), and its prevalence continues to increase. Persons with prediabetes (having blood glucose levels higher than normal but not high enough to be diagnosed as diabetes) can often prevent the development of the disease by making lifestyle changes, but those changes are often challenging. Effective therapeutic agents, with relatively low cost and low toxicity, are needed to control the progression of the disease. Curcumin, the principal curcuminoid in turmeric (Curcuma longa), has been shown to possess anti-inflammatory and antidiabetic properties. These authors conducted a randomized, double-blind, placebo-controlled trial to determine the effectiveness of a curcuminoid extract in preventing the development of T2DM.
The 12-month trial was conducted at the HRH Princess Maha Chakri Sirindhorn Medical Center of Srinakharinwirot University in Nakornnayok, Thailand. Eligible subjects were instructed to follow the same protocols for diet and exercise for 3 months after enrollment while awaiting randomization. Standard lifestyle recommendations were provided, and all subjects were counseled one-on-one on the importance of a healthy lifestyle.
Persons aged 35 years and older with prediabetes, as defined by the American Diabetes Association (ADA) guidelines, were included. Eligible subjects had at least 1 of these 3 criteria: fasting plasma glucose (FPG) between 100 mg/dL and 124 mg/dL; an oral glucose tolerance test (OGTT) at 2 hours post-glucose load between 140 mg/dL and 199 mg/dL; and a glycated hemoglobin (HbA1c) range from 5.7% to 6.4%.
The 237 subjects (with 3 dropouts after randomization) were randomly assigned to either the curcumin-treated group (n=118) or the placebo-treated group (n=116). Baseline characteristics were similar between the 2 groups.
All subjects were instructed to take 3 capsules twice daily for 9 months. The curcuminoid extract was prepared by extracting dried, powdered turmeric with ethanol and removing the oleoresin. Each curcumin capsule contained 250 mg curcuminoids (curcumin, demethoxycurcumin, and bisdemethoxycurcumin in a peak ratio of 1:≤0.6:≤0.4, respectively). Compliance rates were determined by the number of capsules the subjects returned at their follow-up visits at 3, 6, and 9 months.
The primary outcome was the number of subjects in the 2 groups diagnosed with T2DM according to ADA guidelines. Secondary outcomes were changes in β-cell functions (homeostasis model assessment [HOMA]-β, C-peptide, and proinsulin/insulin ratio); insulin resistance (IR) by HOMA-IR; obesity; abdominal obesity; and anti-inflammatory cytokine (adiponectin). β-cells store and release insulin, which controls the level of glucose in the blood.
The authors report that at all visits (months 3, 6, and 9), the diabetes-related blood chemistries (FPG, OGTT at 2 h, and HbA1c) used to measure the progression of the disease were all significantly lower in the curcumin-treated group compared with the placebo-treated group (P<0.01). For example, at month 9, FPG in the curcumin-treated group was 86.47 mg/dL (range=73-122 mg/dL) compared with 108.21 mg/dL (range=80-138 mg/dL) in the placebo-treated group. Mean baseline FPG values were 103.65 mg/dL in the curcumin-treated group and 103.24 mg/dL in the placebo-treated group.
In their assessments of β-cell function, the authors discovered that HOMA-β in the curcumin-treated group was increasingly elevated at all follow-up visits and became statistically significant at month 9 (P<0.01). C-peptide levels were significantly lower in the curcumin-treated group compared with the placebo-treated group at 9 months (P<0.05). The proinsulin/insulin ratio showed a nonsignificant, lower trend in the curcumin-treated group.
The mean levels of HOMA-IR were lower in the curcumin-treated group than in the placebo-treated group at all visits. The differences were significant at months 6 (P<0.05) and 9 (P<0.001). Adiponectin levels, unchanged in the placebo-treated group, gradually increased at months 3 and 6 in the curcumin-treated group and became significantly different than the placebo-treated group at month 9 (P<0.05).
None of the subjects in either group showed any change in kidney or liver functions. A few subjects in the curcumin-treated group reported minor adverse side effects such as itching, constipation, or vertigo.
The authors report that none of the subjects in the curcumin-treated group developed T2DM in regard to the primary outcome; however, the following numbers of subjects in the placebo-treated group developed T2DM: 11 (9.5%) at month 6; 18 (15.5%) at month 9; and 19 (16.4%) at month 12.
The authors note that the conversion rate of the placebo group was significantly higher than that published in a "well-known" American study.1 They reasoned that the ethnicity of the subjects in their study may account for the high conversion rate. They compared their results with those of a diabetes study of a large Thai cohort2 that identified a set of strong risk factors that accelerate the development of T2DM among the Thai population: old age, high body mass index, high waist circumference, hypertension, and a family history of diabetes. They found that the same factors influenced their study and that their reported rate of development of T2DM was within the estimation of the earlier study.2 "Therefore, we believe that the high conversion rates found in the present study are a common characteristic of Thai prediabetes," they write.
These authors report that the ethanol-extracted curcuminoids used in this study substantially and significantly prevented T2DM development in subjects with prediabetes. They also found that the curcuminoid extract improved β-cell functions.
"Because of its benefits and safety, we propose that curcumin extract may be used for an intervention therapy for the prediabetes population," they write.
―Shari Henson
References
1Knowler WC, Barrett-Connor E, Fowler SE, et al.; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346(6):393-403.
2Aekplakorn W, Bunnag P, Woodward M, et al. A risk score for predicting incident diabetes in the Thai population. Diabetes Care. 2006;29(8):1872-1877.
Source : American Botanical Council
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Adjunctive naturopathic care for type 2 diabetes: patient-reported and clinical outcomes after one year
Ryan Bradley1, Karen J Sherman2, Sheryl Catz2, Carlo Calabrese1, Erica B Oberg1, Luesa Jordan2, Lou Grothaus2 and Dan Cherkin2*
1 Bastyr University Research Institute (BURI), Kenmore, WA, 98028, USA
2 Group Health Research Institute (GHRI), Seattle, WA, 98101, USA
Abstract
Background Several small, uncontrolled studies have found improvements in self-care behaviors and reductions in clinical risk in persons with type 2 diabetes who received care from licensed naturopathic physicians. To extend these findings and determine the feasibility and promise of a randomized clinical trial, we conducted a prospective study to measure the effects of adjunctive naturopathic care (ANC) in primary care patients with inadequately controlled type 2 diabetes.
Methods Forty patients with type 2 diabetes were invited from a large integrated health care system to receive up to eight ANC visits for up to one year. Participants were required to have hemoglobin A1c (HbA1c) values between 7.5-9.5 % and at least one additional cardiovascular risk factor (i.e., hypertension, hyperlipidemia or overweight). Standardized instruments were administered by telephone to collect outcome data on self-care, self-efficacy, diabetes problem areas, perceived stress, motivation, and mood. Changes from baseline scores were calculated at 6- and 12-months after entry into the study. Six and 12-month changes in clinical risk factors (i.e., HbA1c, lipid and blood pressure) were calculated for the ANC cohort, and compared to changes in a cohort of 329 eligible, non-participating patients constructed using electronic medical records data. Between-cohort comparisons were adjusted for age, gender, baseline HbA1c, and diabetes medications. Six months was pre-specified as the primary endpoint for outcome assessment.
Results Participants made 3.9 ANC visits on average during the year, 78 % of which occurred within six months of entry into the study. At 6-months, significant improvements were found in most patient-reported measures, including glucose testing (P = 0.001), diet (P = 0.001), physical activity (P = 0.02), mood (P = 0.001), self-efficacy (P = 0.0001) and motivation to change lifestyle (P = 0.003). Improvements in glucose testing, mood, self-efficacy and motivation to change lifestyle persisted at 12-months (all P < 0.005). For clinical outcomes, mean HbA1c decreased by −0.90 % (P = 0.02) in the ANC cohort at 6-months, a −0.51 % mean difference compared to usual care (P = 0.07). Reductions at 12-months were not statistically significant (−0.34 % in the ANC cohort, P = 0.14; -0.37 % difference compared to the usual care cohort, P = 0.12).
Conclusions Improvements were noted in self-monitoring of glucose, diet, self-efficacy, motivation and mood following initiation of ANC for patients with inadequately controlled type 2 diabetes. Study participants also experienced reductions in blood glucose that exceeded those for similar patients who did not receive ANC. Randomized clinical trials will be necessary to determine if ANC was responsible for these benefits.
Source : BMC - Complementary and Alternative Medicine
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Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes
Abstract
For thousands of years, cinnamon has been used as a traditional treatment in China. However, there are no studies to date that investigate whether cinnamon supplements are able to aid in the treatment of type 2 diabetes in Chinese subjects. We hypothesized cinnamon should be effective in improving blood glucose control in Chinese patients with type 2 diabetes. To address this hypothesis, we performed a randomized, double-blinded clinical study to analyze the effect of cinnamon extract on glycosylated hemoglobin A1c and fasting blood glucose levels in Chinese patients with type 2 diabetes. A total of 66 patients with type 2 diabetes were recruited and randomly divided into 3 groups: placebo and low-dose and high-dose supplementation with cinnamon extract at 120 and 360 mg/d, respectively. Patients in all 3 groups took gliclazide during the entire 3 months of the study. Both hemoglobin A1c and fasting blood glucose levels were significantly reduced in patients in the low- and high-dose groups, whereas they were not changed in the placebo group. The blood triglyceride levels were also significantly reduced in the low-dose group. The blood levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and liver transaminase remained unchanged in the 3 groups. In conclusion, our study indicates that cinnamon supplementation is able to significantly improve blood glucose control in Chinese patients with type 2 diabetes.
Source : Nutrition Research
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INTEGRATING BOTANICALS INTO DIABETES TREATMENT PROTOCOLS
Diabetes is a complex disease that exists in two major forms: insulin- dependent diabetes (IDDM) and non- insulin- dependent or type 2 diabetes mellitus (NIDDM). The vast majority of people with diabetes have NIDDM and presently almost 20% of Americans over the age of 65 suffer from this disorder. It is a growing epidemic and by the year 2010, this percentage is expected to rise to 30%.1 In addition, it is increasingly affecting younger people and can no longer accurately be referred by its old common name of age- onset diabetes. NIDDM is a progressive disease that shows a consistent deterioration in glycemic control over time, and it is estimated that at least a third of patients with NIDDM will ultimately require insulin therapy. This chapter primarily focuses on herbs that are useful in NIDDM. These are used to help patients with this diagnosed disease reduce, delay, or avoid entirely oral hypoglycemic drugs and to avoid developing a need for insulin therapy. They can also be used to help individuals with impaired glucose tolerance (IGT) from manifesting NIDDM.2 While the pathophysiology and pathogenesis of the NIDDM is not fully understood, it is clear that IGT often develops into NIDDM. Moreover, about 11% of American adults (18% of those over 65) suffer
from IGT so interventions that may delay or prevent the progression are desperately needed in our society.
Most of the herbs we discuss are established traditional treatments for diabetic patients, and many are being confi rmed effective in modern clinical trials. However, some very promising treatments are covered that have slight to no investigation. It must be noted that there are other well-established treatments, such as Trigonella foenum- graecum (fenugreek), Panax quinquefolius
(American ginseng), Oplopanax horridum (dev il’s club), and many others that we do not discuss in this chapter. Thus, this chapter is meant to open the door to treatment possibilities, not to be an exhaustive description of any and all possible botanical treatments for diabetes. It should also be noted that the precise mechanisms of action, major active constituents, optimal dose and dose form, and safety for the medicinal plants discussed have not been worked out in a rigorous fashion. Finally, we do not suggest that the herbs in this chapter should be relied upon as the sole treatment for anyone with diabetes. Obviously, lifestyle interventions
such as changes in diet and exercise patterns are a critical component of both treatment and prevention but these are beyond the scope of this book. And in many cases, antidiabetic medications are necessary. For patients with IDDM, of course, insulin can never be discontinued. However, there are certainly cases of IDDM and NIDDM where botanicals can be used to reduce doses of insulin or other prescription medication. There are also cases of NIDDM where botanicals may be able to supplant entirely these medications, at least for a while. However, combining these, or any other herbs, with antidiabetic medication will require close
monitoring of serum glucose levels to maintain appropriate glycemic control, something that should be done regularly in these patients in any event. It is only with close monitoring that the success or failure of a chosen botanical treatment be evaluated. Thus, any practitioner working with these therapies must be able to monitor and address the medical issues and tests associated with treating diabetes.
Source : Clinical Botanical Medicine
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Secondhand Smoke is Linked to Type 2 Diabetes and Obesity
Adults who are exposed to secondhand smoke have higher rates of obesity and Type 2 diabetes than do nonsmokers without environmental exposure to tobacco smoke, a new study shows. The results will be presented Sunday at The Endocrine Society’s 94th Annual Meeting in Houston.“More effort needs to be made to reduce exposure of individuals to secondhand smoke,” said study co-author Theodore C. Friedman, MD, PhD, chairman of the Department of Internal Medicine at Charles R. Drew University, Los Angeles.
Studies have shown an association between cigarette smoking and an increased rate of Type 2 diabetes despite the fact that most smokers are leaner than nonsmokers and obesity is a risk factor for Type 2 diabetes. Although some studies have suggested a relationship between Type 2 diabetes and passive, or secondhand, smoking, Friedman said these studies have not verified exposure to secondhand smoke through serum (blood) levels of cotinine. Cotinine is a metabolite of nicotine, and serum cotinine measures a person’s exposure to tobacco smoke.
In their current study, Friedman and his fellow researchers used serum cotinine levels to verify passive smoking. They examined data from more than 6,300 adults who participated from 2001 to 2006 in the National Health and Nutrition Examination Survey (NHANES), a nationally representative sample of the U.S. population.
The investigators defined current smokers, which made up 25 percent of the sample, as survey participants who reported that they smoke cigarettes and who had a measured serum cotinine level greater than 3 nanograms per milliliter (ng/mL). Nonsmokers (41 percent of the sample) were those who answered “no” to the question “Do you smoke cigarettes?” and who had a cotinine level below 0.05 ng/mL. Participants who answered “no” to this question but whose cotinine level was above 0.05 ng/mL were defined as secondhand “smokers” (34 percent).
In analyzing these groups, the researchers controlled for age, sex, race, alcohol consumption and physical activity. They found that, compared with nonsmokers, secondhand smokers had a higher measure of insulin resistance, a condition that can lead to Type 2 diabetes; higher levels of fasting blood glucose, or blood sugar; and a higher hemoglobin A1c, a measure of blood sugar control over the past three months.
Secondhand smokers also had a higher rate of Type 2 diabetes, as defined by a hemoglobin A1c greater than 6.5 percent. Secondhand smokers had a similar rate of diabetes to that of current smokers, according to Friedman.
Secondhand smokers also had a higher body mass index (BMI), a measure of body fat, compared with nonsmokers, Friedman reported. Current smokers had a lower BMI than nonsmokers but a higher hemoglobin A1c. When the researchers controlled for BMI, they found that secondhand smokers and current smokers still had a higher hemoglobin A1c than did nonsmokers.
“This finding shows that the association between secondhand smoke and Type 2 diabetes was not due to obesity,” Friedman said. “More studies are needed to show whether secondhand smoke is a cause of diabetes.”
Source : Newswise
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Low Vitamin D Level Is Linked to Greater Chance of Risk Factors For Type 2 Diabetes
A new study presents more evidence of a possible link between low vitamin D levels and a higher risk of Type 2 diabetes and heart disease. The results will be presented Saturday at The Endocrine Society’s 94th Annual Meeting in Houston.The study found an inverse relationship between the level of vitamin D in the blood and the presence of the metabolic syndrome, which is a group of risk factors that increases the risk of heart disease and Type 2 diabetes. People with the highest blood levels of vitamin D had a 48 percent lower risk of having the metabolic syndrome than did those with the lowest vitamin D levels, the authors reported.
“This association has been documented before, but our study expands the association to people of diverse racial and ethnic backgrounds,” said the lead author, Joanna Mitri, MD, a research fellow at Tufts Medical Center in Boston. “These include minority groups that are already at higher risk of diabetes.”
Furthermore, all study participants were at risk of developing diabetes because they had prediabetes, abnormally high blood sugar levels that are not yet high enough to be classified as diabetes. Prediabetes affects an estimated 79 million Americans ages 20 or older, according to 2010 statistics from the Centers for Disease Control and Prevention.
Mitri and her co-investigators conducted the study using data from participants of the Diabetes Prevention Program, a large, now-completed study funded by the National Institutes of Health. They divided study subjects into three groups based on plasma 25-hydroxyvitamin D level, which is the most common way used to measure vitamin D status in the body, according to Mitri. The Institute of Medicine recommends a 25-hydroxyvitamin D level of 20 to 30 ng/mL as adequate for healthy people.
In the new study, the group with the highest levels of vitamin D had a median vitamin D concentration of 30.6 nanograms per milliliter, or ng/mL, and those in the lowest group had a median vitamin D concentration of 12.1 ng/mL. The risk of having the metabolic syndrome with a high vitamin D level was about one half the risk with a low vitamin D level, Mitri said.
The researchers also found an association between vitamin D status and some of the individual components of the metabolic syndrome, which includes a large waist size, low HDL (“good”) cholesterol, high triglycerides (fats in the blood), high blood pressure and high blood glucose (sugar). Study participants with the best vitamin D status had a smaller waist circumference, higher HDL cholesterol and lower blood sugar.
Mitri cautioned that their research does not prove that vitamin D deficiency causes Type 2 diabetes, or even that there is a link between the two conditions.
“However, the metabolic syndrome is common, and progression to Type 2 diabetes is high,” she said. “If a causal relationship can be established in ongoing and planned studies of vitamin D, this link will be of public health importance, because vitamin D supplementation is easy and inexpensive.”
Source : Newswise
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Fungicide Used on Farm Crops Linked to Insulin Resistance
A fungicide used on farm crops can induce insulin resistance, a new tissue-culture study finds, providing another piece of evidence linking environmental pollutants to diabetes. The results will be presented Saturday at The Endocrine Society’s 94th Annual Meeting in Houston.“For the first time, we’ve ascribed a molecular mechanism by which an environmental pollutant can induce insulin resistance, lending credence to the hypothesis that some synthetic chemicals might be contributors to the diabetes epidemic,” said investigator Robert Sargis, M.D., Ph.D., instructor in the endocrinology division at the University of Chicago.
The chemical, tolylfluanid, is used on farm crops in several countries outside of the United States to prevent fungal infestation, and sometimes is used in paint on ships to prevent organisms from sticking to their hulls. Animal studies have indicated that the chemical may adversely affect the thyroid gland, as well as other organs, and that it may increase the risk of cancer in humans.
Within the last decade, research attention has increasingly focused on the link between environmental contaminants and the rising rates of obesity and diabetes throughout many parts of the world. In the United States alone, nearly 26 million adults and children have some form of diabetes, according to the American Diabetes Association. A serious disease by itself, diabetes also increases the risk of other medical complications, including heart and blood-vessel diseases.
Normally, the pancreas secretes the hormone insulin, which acts to regulate blood-sugar levels. Among diabetic patients, insulin secretion either decreases or stops altogether, or cells become resistant to the hormone’s activity. These conditions then disrupt the process that transports sugar, or glucose, from the blood to the body’s other cells, which can lead to the dangerously high blood-sugar levels associated with diabetes.
In this project, Sargis and his co-investigators used mouse fat to examine the effects of tolylfluanid on insulin resistance at the cellular level. They found that exposure to tolylfluanid induced insulin resistance in fat cells, which play a critical role in regulating the body’s blood glucose and fat levels. When exposed to tolylfluanid in culture the ability of insulin to trigger action inside the fat cell, or adipocyte, was reduced, which is an early indication of diabetes.
“The fungicide and antifouling agent tolylfluanid may pose a threat to public health through the induction of adipocytic-insulin resistance, an early step in the pathogenesis of type 2 diabetes,” Sargis said. “Based on these studies, further efforts should be undertaken to clarify human exposure to tolylfluanid and the possible metabolic consequences of that exposure.”
At the same time, tolylfluanid-exposed cells stored more fat, or lipids, in a similar action to a steroid called corticosterone. Like this steroid, tolylfluanid bound receptors in fat cells, called glucocorticoid receptors, which help regulate blood-sugar levels, as well as many other important body processes.
“For the public, this raises the specter of environmental pollutants as potential contributors to the metabolic disease epidemic,” said Sargis, adding that, “hopefully, it will put further pressure on public policy makers to reassess the contribution of environmental pollution as a contributor to human disease in order to encourage the development of strategies for reversing those effects.”
The National Institute of Environmental Health Sciences and the University of Chicago Diabetes Research and Training Center funded this research.
Source : Newswise
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Pharmacognostic and antidiabetic study of Clitoria ternatea
Manish Gunjan1*, Ravindran M1, Sengamalam R1, Goutam K Jana1, A.K Jha1
Abstract
Aparajita means "The Undefeated". This plant is a trailing creeper with the usual Indigo Blue colour flowers and the rare white ones which is more of a pale cream with a hint of green at the edges. In Kerala it is called the Sankhu Pushpam or Conch Shell flower although it hardly resembles a Conch shell. It actually resembles a quaint Snapdragon flower with it's front open. Graphically it represents the cutout of an inverted womb. May be that explains their close affinity to Indian Midwives, particularly the White variety. Aparajita grows throughout India. It is a beautiful-looking plant, hence cultivated in gardens. It is a perennial twining herb having 7 leaflets, which are elliptic and obtuse. There are few varieties with white, violet and blue flowers. The pods are 5-7 cm long, flat with 6 to 10 seed, in each pod. The flowers resemble in shape to cows ear, hence the synonym- gokarnika. Chronic administration of plant extracts (100mg/kg) for 14 days reduces the blood glucose level of the diabetes induced animals as compared to diabetic control group. There was significant decrease in the blood glucose level in the 7th [p<0.01] and 14th [p<0.001] days of the diabetes induction, showing antidiabetic effect. The effect was comparable to that of standard antidiabetic drug Glibenclamide. The aim of this research is to explore the antidiabetic activity of this plant which will be helpful in the future investigations.
Source : International Journal of Phytomedicine
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Ficus deltoidea: A Potential Alternative Medicine for Diabetes Mellitus
Zainah Adam,1 Shafii Khamis,1 Amin Ismail,2 and Muhajir Hamid3
Ficus deltoidea from the Moraceae family has been scientifically proven to reduce hyperglycemia at different prandial states. In this study, we evaluate the mechanisms that underlie antihyperglycemic action of Ficus deltoidea. The results had shown that hot aqueous extract of Ficus deltoidea stimulated insulin secretion significantly with the highest magnitude of stimulation was 7.31-fold (𝑃< 0 001). The insulin secretory actions of the hot aqueous extract involved K+ ATP channel-dependent and K + ATP -channel-independent pathway. The extract also has the ability to induce the usage of intracellular Ca2+ to trigger insulin release. The ethanolic and methanolic extracts enhanced basal and insulin-mediated glucose uptake into adipocytes cells. The extracts possess either insulin-mimetic or insulin-sensitizing property or combination of both properties during enhancing glucose uptake into such cells. Meanwhile, the hot aqueous and methanolic extracts augmented basal and insulin-stimulated adiponectin secretion from adipocytes cells. From this study, it is suggested that Ficus deltoidea has the potential to be developed as future oral antidiabetic agent.
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 632763, 12 pages doi:10.1155/2012/632763
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Liquorice Root Found to Contain Anti-Diabetic Substance
Researchers have discovered a promising anti-diabetic substance in the amorfrutin class of natural substances.
It provides the raw material for liquorice candy, calms the stomach and alleviates diseases of the airways: liquorice root. Chosen as the "Medicinal plant 2012," the root has been treasured in traditional healing since ancient times. Researchers at the Max Planck Institute for Molecular Genetics in Berlin have now discovered that liquorice root also contains substances with an anti-diabetic effect. These amorfrutins not only reduce blood sugar, they are also anti-inflammatory and are very well tolerated. Thus, they may be suitable for use in the treatment of complex metabolic disorders.
Natural substances have a surprising and often largely unexploited potential in the prevention and treatment of common diseases. For example, liquorice root Glycyrrhiza contains different substances that help to alleviate disorders of the airways and digestive system. It has been used for millennia in traditional healing and is mainly administered in the form of tea. A team of researchers working with Sascha Sauer from the Max Planck Institute for Molecular Genetics in Berlin has now discovered that the plant from the papilionaceae or leguminous family might also be effective in the treatment of adult (type 2) diabetes. The scientists identified a group of natural substances with an anti-diabetic effect, the amorfrutins, in the plant's edible root.
The substances, which have a simple chemical structure, are not only found in liquorice root, but are also in the fruit of the Amorpha fruticosa bush. The new anti-diabetic agents were named after this plant, which is native to the US, Canada and Mexico. As the researchers demonstrated using diabetic mice, the amorfrutins not only have characteristics that reduce blood sugar, they are also anti-inflammatory in their effect. Moreover, they also prevent fatty liver -- a common disease caused by excessively fat-rich nutrition.
"The health-beneficial effects are based on the fact that the amorfrutin molecules dock directly onto a receptor in the nucleus called PPARγ," explains Sascha Sauer. PPARγ plays an important role in the cell's fat and glucose metabolism. The binding of the amorfrutin molecules activates various genes that reduce the plasma concentration of certain fatty acids and glucose. The reduced glucose level prevents the development of insulin resistance -- the main cause of adult diabetes.
"Although there are already drugs on the market that affect the PPARγ receptor, they are not selective enough in their effect and cause side effects like weight gain and cardio-vascular problems," says Sascha Sauer. In contrast, as demonstrated by the studies carried out to date, the amorfrutins are very well tolerated. "However, drinking liquorice tea or eating liquorice will not help to treat diabetes," explains the scientist. "The concentration of the substances in the tea and liquorice is far too low to be effective." The researchers therefore developed special extraction processes to obtain the amorfrutins from the plant in sufficient concentrations. This could be used to produce amorfrutin extracts on an industrial scale.
The newly discovered active substances not only seem to hold great promise for the treatment of complex metabolic disorders, they may also be suitable for prophylactic use. "The amorfrutins can be used as functional nutritional supplements or as mild remedies that are individually tailored to the patient," says Sascha Sauer. "In view of the rapid spread of metabolic diseases like diabetes, it is intended to develop these substances further so that they can be used on humans in the future." To do this, the researchers must now test the effect of the substances and the plant amorfrutin extracts in clinical studies on diabetes patients
Source : Science Daily
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Protective Effect of Proanthocyanidin against Diabetic Oxidative Stress
Takako Yokozawa,1 Eun Ju Cho,2 Chan Hum Park,1 and Ji Hyun Kim1
1Institute of Natural Medicine, University of Toyama, Toyama 930-0194, Japan
2Department of Food Science and Nutrition, Pusan National University, Busan 609-735, Republic of Korea
Abstract
We investigated the antidiabetic potential of proanthocyanidin and its oligomeric form in STZ-induced diabetic model rats and db/db type 2 diabetic mice. Proanthocyanidin ameliorated the diabetic condition by significant decreases of serum glucose, glycosylated protein, and serum urea nitrogen as well as decreases of urinary protein and renal-AGE in STZ-induced diabetic rats and decrease of serum glucose as well as significant decrease of glycosylated protein in db/db type 2 diabetic mice. The suppression of ROS generation and elevation of the GSH/GSSG ratio were also observed in the groups administered proanthocyanidin. Moreover, proanthocyanidin, especially its oligomeric form, affected the inflammatory process with the regulation of related protein expression, iNOS, COX-2 and upstream regulators, NF-κB, and the IκB-α. In addition, it had a marked effect on hyperlipidemia through lowering significant levels of triglycerides, total cholesterol, and NEFA. Moreover, expressions in the liver of SREBP-1 and SREBP-2 were downregulated by the administration of proanthocyanidins. The protective effect against hyperglycemia and hyperlipidemia in type 1 and 2 diabetic models was significantly strong in the groups administered the oligomeric rather than polymeric form. This suggests that oligomers act as a regulator in inflammatory reactions caused by oxidative stress in diabetes.
Source : Evidence-Based Complementary and Alternative Medicine Volume 2012 (2012), Article ID 623879, 11 pages
doi:10.1155/2012/623879
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The Effects of Green Tea Consumption on Cardiometabolic Alterations Induced by Experimental Diabetes
Patricia Fiorino,1 Fabiana Sant'Anna Evangelista,2 Fernando Santos,1 Fátima Maria Motter Magri,1 Jan Carlo Morais O. B. Delorenzi,1 Milton Ginoza,1 and Vera Farah1
1Renal, Cardiovascular and Metabolic Physiopharmacology Laboratory, Health and Biological Science Center, Mackenzie University, 01302-907 São Paulo, Brazil
2School of Arts, Science and Humanities, University of Sao Paulo, Sao Paulo, BrazilReceived 8 September 2011;
Abstract
We evaluated cardiac autonomic modulation by heart rate (HRV), and arterial pressure variability (APV), and metabolic response in streptozotocin diabetic rats treated with green tea. Male Wistar rats were separated in groups: control, drinking tap water (C), green tea-treated (GT) group, diabetic, drinking tap water (D), and diabetic, treated with green tea (DGT). Kidney mass was greater in D and DGT than in C and GT, but reduced in DGT compared to D. Green tea prevented the increase in creatinine clearance and reduced hyperglycemia in DGT compared to D. Arterial pressure was increased in GT and decreased in D compared to C. HRV was reduced in D compared with all groups. APV was decreased in D compared to C and recovery in DGT. Sympathetic modulation of APV was decreased in D compared with all groups. Green tea reduced hyperglycemia, prevented renal injury and autonomic dysfunction, suggesting reduced cardiovascular risk and target organ damage in diabetes.
Source : Experimental Diabetes Research Volume 2012 (2012), Article ID 309231, 7 pages
doi:10.1155/2012/309231
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Vitamin D and incidence of diabetes: A prospective cohort study Vitamin D and diabetes incidence.
González-Molero I, Rojo-Martínez G, Morcillo S, Gutiérrez-Repiso C, Rubio-Martín E, Almaraz MC, Olveira G, Soriguer F.Source
Servicio de Endocrinología y Nutrición, Hospital Universitario Carlos Haya, Málaga, Spain; Ciber de Diabetes y Metabolismo (CIBERDEM), Spain.
Abstract
BACKGROUND & AIMS: To investigate the relationship between levels of 25-hydroxyvitamin D and the incidence of type 2 diabetes in a Spanish population.
METHODS: We undertook a population-based prospective study in a population from southern Spain. The first phase of the study (1996-1998) included 1226 individuals. Of this original cohort, 988 persons were reassessed in 2002-2004 and 961 in 2005-2007. Measurements were made of 25-hydroxyvitamin D and intact parathyroid hormone in 2002-2004 and an oral glucose tolerance test was done in three time points.
RESULTS: The incidence of diabetes in subjects with 25-hydroxyvitamin D levels ≤18.5 ng/mL (percentile 25) was 12.4% vs 4.7% in subjects with levels >18.5 ng/mL. The likelihood of having diabetes during the four years of follow-up was significantly lower in the subjects with higher levels of 25-hydroxyvitamin D [OR = 0.17 (0.05-0.61)]. None of the subjects with levels higher than 30 ng/mL developed diabetes.
CONCLUSION: In this prospective study, we found a significant inverse association between serum 25-hydroxyvitamin D levels and the risk for type 2 diabetes in a population from the south of Spain.
Source : Clinical Nutrition
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Cinnamon extract regulates glucose transporter and insulin-signaling gene expression in mouse adipocytes
- Cinnamon extracts (CE) are reported to have beneficial effects on people with normal and impaired glucose tolerance, the metabolic syndrome, type 2 diabetes, and insulin resistance.
- The clinical results are controversial. Molecular characterization of CE effects is limited.
- This study investigated the effects of CE on gene expression in cultured mouse adipocytes.
- The results presented support the hypothesis that cinnamon polyphenol extract has insulin-like and insulin-independent effects on the regulation of gene expression in mouse adipocytes.
- The results indicated that Cinnamon extract regulates the expression of multiple genes in adipocytes. Therefore, the health benefits of cinnamon are likely due to its multiple effects on expression of various genes.
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Green Tea Review Suggests Ability to Control Obesity and Diabetes among Many Other Health Benefits
Tea catechins, especially EGCG, appear to have antiobesity and antidiabetic effects. Recent data from human studies indicate that the consumption of green tea or green tea extracts may help reduce body weight, mainly body fat, by increasing postprandial thermogenesis and fat oxidation. One cited study of 6 overweight men given 300 mg EGCG daily for 2 days suggests that EGCG alone has the potential to increase fat oxidation in men and may thereby contribute to the antiobesity effects of green tea.
Cited studies in animal models of diabetes reported reductions in serum glucose levels with the administration of green tea polyphenols. In normal rats, green tea catechins reduced plasma triglyceride levels in an oral glucose-tolerance test. Green tea and green tea extracts have been demonstrated to modify glucose metabolism beneficially in experimental models of type 2 diabetes mellitus. A human study reported that green tea promoted glucose metabolism in healthy human volunteers as shown in oral glucose-tolerance tests.
The authors point out that the effects of green tea and its constituents may be beneficial up to a certain dose and may cause some as yet unrecognized adverse effects at higher doses (this is the authors’ conjecture; potentially adverse higher dose levels were not specified). Also, the effects of green tea catechins may vary from person to person. The harmful effects of too much tea are mainly due to its caffeine content, the possible presence of aluminum in some teas (which is problematic for patients with renal failure), and the effects of tea polyphenols on iron bioavailability.
The authors conclude that long-term consumption of tea catechins could be beneficial to high-fat diet-induced obesity and type 2 diabetes and could reduce the risk for coronary disease. Further research should focus on the pharmacological and clinical effects of green tea and its mechanisms of action.
—Shari Henson
Reference
1. Cabrera C, Artacho R, Gimenez R. Beneficial effects of green tea: a review. J Am Coll Nutr. 2006;25:79-99.
Source : HerbalGram
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