scholarly journals Herbal Therapies for Type 2 Diabetes Mellitus: Chemistry, Biology, and Potential Application of Selected Plants and Compounds

2013 ◽  
Vol 2013 ◽  
pp. 1-33 ◽  
Author(s):  
Cicero L. T. Chang ◽  
Yenshou Lin ◽  
Arlene P. Bartolome ◽  
Yi-Ching Chen ◽  
Shao-Chih Chiu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cell Function ◽  
Therapeutic Potential ◽  
Glucose Lowering ◽  
Limited Efficacy ◽  
National Economic ◽  
Herbal Therapies ◽  
Made In

Diabetes mellitus has been recognized since antiquity. It currently affects as many as 285 million people worldwide and results in heavy personal and national economic burdens. Considerable progress has been made in orthodox antidiabetic drugs. However, new remedies are still in great demand because of the limited efficacy and undesirable side effects of current orthodox drugs. Nature is an extraordinary source of antidiabetic medicines. To date, more than 1200 flowering plants have been claimed to have antidiabetic properties. Among them, one-third have been scientifically studied and documented in around 460 publications. In this review, we select and discuss blood glucose-lowering medicinal herbs that have the ability to modulate one or more of the pathways that regulate insulin resistance,β-cell function, GLP-1 homeostasis, and glucose (re)absorption. Emphasis is placed on phytochemistry, anti-diabetic bioactivities, and likely mechanism(s). Recent progress in the understanding of the biological actions, mechanisms, and therapeutic potential of compounds and extracts of plant origin in type 2 diabetes is summarized. This review provides a source of up-to-date information for further basic and clinical research into herbal therapy for type 2 diabetes. Emerging views on therapeutic strategies for type 2 diabetes are also discussed.

scholarly journals Ten-year follow-up of sitagliptin treatment in patients with type 2 diabetes mellitus

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Sachiko Hattori
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Cell Function ◽  
Urinary Albumin ◽  
Control Group ◽  
Β Cell ◽  
Glucose Lowering ◽  
Β Cell Function ◽  
History Of

Abstract Background Early and effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in not only microvascular disease, but also CVD. Method This study aimed to investigate whether sitagliptin is effective and tolerated for glycemic control and whether renoprotective effects and β-cell function are preserved for as long as ten years in Japanese patients with T2DM without a history of CVD. Results The situation is equivalent to improving glycemic control as assessed by hemoglobin A1c both in a sitagliptin group [sitagliptin 50 mg as either monotherapy or combination therapy with other oral glucose-lowering drugs (n = 17)] or a control group [placebo as either monotherapy or combination therapy with other glucose-lowering drugs (n = 9)], while anti-inflammatory effects as assessed by high-sensitivity C-reactive peptide in the sitagliptin group were superior to those in the control group. In the sitagliptin group, mean urinary albumin excretion (measured as urinary albumin-to-creatinine ratio) was markedly decreased, but no changes in estimated glomerular filtration rate were seen throughout the study. Beta-cell function as evaluated by homeostatic model assessment of β-cell function values was reduced at baseline in both groups, improved significantly in the sitagliptin group, and continued unchanged in the control group during the study. Conclusion These observations suggest that early intervention with sitagliptin in patients with T2DM may have long-lasting renoprotective and islet-protective effects. Trial registration: UMIN Clinical Registry (UMIN000038459). Registered 01 November (retrospectively registered): https://upload.umin.ac.jp/UMIN000038459

scholarly journals Ten-year Follow-up of Sitagliptin Treatment in Type 2 Diabetes Mellitus Patients

2021 ◽  
Author(s):  
Sachiko Hattori
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Cell Function ◽  
Urinary Albumin ◽  
Control Group ◽  
Glucose Lowering ◽  
B Cell Function ◽  
History Of

Abstract Background: Early and effective intervention with a dipeptidyl peptidase 4 inhibitor (DPP4i) before the development of advanced atherosclerosis in type 2 diabetes mellitus (T2DM) patients without a history of cardiovascular disease (CVD) is reported to increase the chance of significant reductions in not only microvascular disease, but also CVD. Method: This study aimed to investigate whether sitagliptin is effective and tolerated for glycemic control and whether renoprotective effects and b-cell function are preserved for as long as ten years in Japanese patients with T2DM without a history of CVD. Results: The situation is equivalent to improving glycemic control as assessed by hemoglobin A1c both in a sitagliptin group (sitagliptin 50 mg as either monotherapy or combination therapy with other oral glucose-lowering drugs (n=17)) or a control group (placebo as either monotherapy or combination therapy with other glucose-lowering drugs (n=9)), while anti-inflammatory effects as assessed by high-sensitivity C-reactive peptide in the sitagliptin group were superior to those in the control group. In the sitagliptin group, the mean values of urinary albumin excretion measured as urinary albumin-to-creatinine ratio (ACR) were markedly decreased, but no changes in estimated glomerular filtration rate (eGFR) were seen throughout the study. Beta-cell function as evaluated by homeostatic model assessment of b-cell function (HOMA-β) values was reduced at baseline in both groups, improved significantly in the sitagliptin group, and continued unchanged in the control group during the study. Conclusion: This observation suggests that early intervention with sitagliptin in patients with T2DM may have long-lasting renoprotective and islet-protective effects. Trial registration: UMIN Clinical Registry (UMIN000038459). Registered 01November (Retrospectively registered), https://upload.umin.ac.jp/UMIN000038459

The Cardiovascular Events in Metabolic Surgery Compared to the New Classes of Glucose-Lowering Agents in Patients with T2DM

2021 ◽  
Author(s):  
Najla Shamsi
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Metabolic Surgery ◽  
Cardiovascular Events ◽  
Controlled Trials ◽  
Glucose Lowering ◽  
Randomized Controlled ◽  
History Of

Type 2 Diabetes Mellitus is a prevalent chronic disease with several macrovascular and microvascular complications. Cardiovascular diseases including coronary artery disease and stroke are common macrovascular complication that reduces the quality of life and lead to early mortality. Additionally, they pose enormous socioeconomic burden on the societies and the governments. Therefore, any intervention that reduces the cardiovascular events in patients with diabetes will have positive impact of the patients and the society. Thus, this systematic review aimed to evaluate the cardiovascular events after metabolic surgery in comparison with the new classes of glucose lowering agents in patients with type 2 diabetes mellitus. The review included 11 randomized controlled trials to both GLP-1 RA and SGLT-2 i groups. It also included 7 metabolic surgery studies, 2 of these are randomized controlled trials and the other 5 are observational studies. These studies were the most relevant studies to the research question. The results revealed different baseline demographic and clinical characteristics between the medication trials and metabolic surgery studies. Moreover, it revealed significant reduction in cardiovascular events in metabolic surgery studies when compared to medication trials. It also showed significant HbA1c and weight reduction in the metabolic surgery group. The remission of diabetes was very high in the metabolic surgery group while none of medication trials accomplished diabetes recovery. However, both medication and surgery groups had adverse events. In conclusion, the review is consistent with previous literature. It suggests that metabolic surgery is more effective than medical therapy in reducing cardiovascular events. Although this conclusion should be interpreted with caution due to the differences in baseline characteristics between studies. In general, the review recommends younger adult diabetic patients with obesity and history of established cardiovascular diseases to undergo metabolic surgery. Whereas, older patients with history of cardiovascular disease should be advised to take one of the medications that has been proved to reduce cardiovascular events. Future studies that compare metabolic surgery and the new classes of the glucose lowering agents is recommended to confirm the findings in this review.

scholarly journals Renoprotective opportunities of Lespedeza capitata in patients with chronic kidney disease and type 2 diabetes mellitus

KIDNEYS ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 162-168
Author(s):  
S.V. Kushnirenko ◽  
D.D. Ivanov ◽  
S.A. Rotova ◽  
О.V. Kushnirenko
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Antihypertensive Therapy ◽  
Glucose Lowering ◽  
Type 2 Dm ◽  
Group I ◽  
Ckd Stage ◽  
Lespedeza Capitata ◽  
Group Ii

Background. Today, issues of renoprotection have gone beyond the use of antihypertensive therapy alone. Stable glucose-lowering and urate-lowering therapy are integral parts of modern renoprotection, which improve the functional state of the kidneys by increasing the glomerular filtration rate (GFR) and reducing the albumin excretion rate (AER) and the albumin-to-creatinine ratio (ACR). Nevertheless, hypoazotemic therapy aimed at reducing the content of nitrogenous wastes remains the leading component of the treatment of patients with chronic kidney disease (CKD). The aim of the study is the assessment of the renoprotective potential of the drug Libera (Lespedeza capitata) in patients with CKD stages 2–3 on the background of type 2 diabetes mellitus (DM). Materials and methods. The study included 107 patients with type 2 DM, aged 19 to 75 years (female — 41.1 %, male — 58.9 %), CKD stages 2–3, micro- and macroalbuminuria (category A2 and A3). The patients were divided into two groups: group I — traditional stable glucose-lowering and antihypertensive therapy (n = 50) and group II — traditional stable glucose-lowering and antihypertensive therapy in combination with Libera (Lespedeza capitata) (n = 57), which was prescribed 1 capsule t.i.d. regardless of food intake for 3 months. The criteria for the effectiveness of treatment were dynamics of GFR, AER/ACR in daily urine. The observation period for the patients was 3 months. Results. The renoprotective potential of Lespedeza capitata (Libera) was demonstrated after 3 months of treatment in the form of a significant increase in GFR in patients with CKD stage 2 in group II up to 79.0 ± 1.4 ml/min/1.73 m2 in comparison with the initial data (p < 0.01) and the results obtained in group I after 3 months of using only traditional stable glucose-lowering and antihypertensive therapy (p < 0.05). The use of Libera in the complex treatment of patients of the II group with CKD stage 3 against the background of type 2 DM for 3 months had a positive effect on nitrogen and water excretory kidney function, which manifested itself in an improvement in GFR to 56.6 ± 2.1 ml/min/1.73 m2 in comparison with the initial data (p < 0.05) and the results obtained in group I — 50.8 ± 1.9 ml/min/1.73 m2 (p < 0.05). In group I with traditional stable glucose-lowering and antihypertensive therapy, only 3 patients (9.1 %) transferred from category A2 to category A1 (normoalbuminuria) after 3 months and 2 patients (11.8 %) from category A3 to category A2. In group II, the appointment of Lespedeza capitata (Libera) in combination with stable glucose-lowering and antihypertensive therapy facilitated the transfer of 10 patients (27.8 %) from category A2 to A1 and 7 patients (33.3 %) from category A3 to A2 (p < 0.001). Conclusions. Lespedeza capitata (Libera) in combination with traditional stable glucose-lowering and antihypertensive therapy contributes to the preservation and improvement of the filtration function of the kidneys, a decrease in AER/ACR in patients with CKD stage 2–3 (3a і 3b) against the background of type 2 DM and proves renoprotective efficiency and safety.

scholarly journals Inflammation of adipose tissue. Part 2. Pathogenetic role in type 2 diabetes mellitus

2009 ◽  
Vol 55 (5) ◽  
pp. 43-48 ◽  
Author(s):  
V Shvarts
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Adipose Tissue ◽  
Cell Function ◽  
Signal Pathway ◽  
Insulin Signal ◽  
Kinase Cascade

This review deals with the role of adipose tissue inflammation (ATI) in the development of type 2 diabetes mellitus (DM2). ATI is regarded as a link between obesity and DM2. The review illustrates the involvement of main adipokines in pathogenesis of DM2 and provides a detailed description of such factors as impaired adiponectin and stimulation of cytokine production responsible for metabolic disorders, activation of lipolysis, in adipocytes, increased fatty acid and triglyceride levels, suppression of insulin activity at the receptor and intracellular levels. Adipokines, in the first place cytokines, act on the insulin signal pathway and affect the intracellular inflammatory kinase cascade. At the intercellular level, ATI stimulates JNK and IKK-beta/kB responsible for the development of insulin resistance via such mechanisms as activation of cytokine secretion in the adipose tissue, oxidative stress, and induction of endoplasmic reticulum enzymes. The key role of JNK and IKK-beta/kB in the inhibition of the insulin signal pathway is mediated through inactivation of insulin receptor substrate 1. Also, it is shown that ATI modulates B-cell function and promotes progressive reduction of insulin secretion.

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