Efficacy, safety and phytochemistry of medicinal plants used for the management of diabetes mellitus in Ethiopia: a systematic review

Abstract Background Despite tremendous developments in synthetic medicine, medicinal plants are still commonly used for the management of diabetes mellitus. This study synthesized scientific evidence on commonly used medicinal plants for the management of diabetes mellitus (DM) in Ethiopia. Methods Databases (PubMed, Cochrane, CINAHL and Google Scholar) have been thoroughly sought and evidence was synthesized. Results Thirty studies conducted anti-diabetic activities studies on 19 medicinal plants in Ethiopia. Most of the studies were in vivo studies (25). Others include; clinical study (1), in vitro studies (2), and both in vivo and in vitro study (2). Trigonella foenum-graecum L., clinical study, showed an improved lipid profile in type II diabetic patients. Comparable blood sugar level (BSL) lowering effect to glibenclimide was observed with Persea Americana and Moringa stenopetala. Noteworthy in vitro half maximal inhibitory concentration (IC 50) of Aloe megalacantha B and Aloe monticola R were observed. Animal model studies demonstrated the relative safety of the plants extract and phytochemistry studies showed various components. Conclusion Medicinal plants used for management of diabetes mellitus in Ethiopia are worthy for further study for pharmacologically active ingredients and clinical evaluation.

Download Full-text

The Functionality of Endothelial-Colony-Forming Cells from Patients with Diabetes Mellitus

Cells ◽

10.3390/cells9071731 ◽

2020 ◽

Vol 9 (7) ◽

pp. 1731

Author(s):

Caomhán J. Lyons ◽

Timothy O'Brien

Keyword(s):

Diabetes Mellitus ◽

Cell Therapy ◽

Diabetic Patients ◽

Angiogenic Potential ◽

Endothelial Colony Forming Cells ◽

Allogeneic Cell Therapy ◽

Patients With Diabetes ◽

Pre Treatment

Endothelial-colony-forming cells (ECFCs) are a population of progenitor cells which have demonstrated promising angiogenic potential both in vitro and in vivo. However, ECFCs from diabetic patients have been shown to be dysfunctional compared to ECFCs from healthy donors. Diabetes mellitus itself presents with many vascular co-morbidities and it has been hypothesized that ECFCs may be a potential cell therapy option to promote revascularisation in these disorders. While an allogeneic cell therapy approach would offer the potential of an ‘off the shelf’ therapeutic product, to date little research has been carried out on umbilical cord-ECFCs in diabetic models. Alternatively, autologous cell therapy using peripheral blood-ECFCs allows the development of a personalised therapeutic approach to medicine; however, autologous diabetic ECFCs are dysfunctional and need to be repaired so they can effectively treat diabetic co-morbidities. Many different groups have modified autologous diabetic ECFCs to improve their function using a variety of methods including pre-treatment with different factors or with genetic modification. While the in vitro and in vivo data from the literature is promising, no ECFC therapy has proceeded to clinical trials to date, indicating that more research is needed for a potential ECFC therapy in the future to treat diabetic complications.

Download Full-text

Implications of Dietary Vegetables on Glycemic Control- A Mechanistic Review

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v11ispl4.4254 ◽

2020 ◽

Vol 11 (SPL4) ◽

pp. 1130-1139

Author(s):

Syed Sagheer Ahmed ◽

Rupesh Kumar M ◽

Rajesh Kowti ◽

Ramesh B

Keyword(s):

Diabetes Mellitus ◽

Glucose Transporter ◽

Antioxidant Properties ◽

Good Health ◽

Diabetic Patients ◽

Peroxisome Proliferator ◽

Dietary Fibres ◽

The People

The global prevalence of diabetes mellitus is increasing day by day. Despite using synthetic anti-diabetic agents, diabetic patients must modify their lifestyle, including routine diet. Vegetables are the adequate source of vitamins, dietary fibres, minerals and Phytoconstituents. Use of vegetables is growing among the people as a part of the diet. They, with their antioxidant properties, can maintain good health and reduce the risk of chronic diseases. Besides, they contain many dietary fibres that are anti-diabetic. The constituents present in these vegetables help to reduce blood glucose level through several mechanisms such as alpha-amylase and alpha-glucosidase enzyme inhibition, Dipeptidyl peptidase IV (DPP IV) inhibition, enhancing the expression of peroxisome proliferator activator receptor gamma (PPAR) γ and glucose transporter 4 (GLUT4). Therefore the people must consume such vegetables with the proper knowledge to control diabetes mellitus and its complications. Hence the present review focuses on summarizing in vitro and in vivo anti-diabetic activity of most common dietary vegetables.

Download Full-text

Change on Blood Coagulation, Platelet Function and Fibrinolysis in Diabetes Mellitus - Preliminary Report

10.1055/s-0039-1682387 ◽

1977 ◽

Author(s):

R. Giustolisi ◽

R. Musso ◽

T. Lombardo ◽

M. Russoand ◽

E. Cacciola

Keyword(s):

Diabetes Mellitus ◽

Degradation Products ◽

Vascular Wall ◽

Diabetic Patients ◽

Platelet Adhesiveness ◽

Platelet Factor ◽

Protamine Sulphate ◽

At Iii

Some coagulation aspects are studied in diabetes mellitus because this dismetabo-lic disease represents a “high risk factor” of predisposition leading to classical lesions of the vascular wall and thrombosis. Were studied 24 diabetic patients between 16 and 68 years old and 14 healthy subjects. Tests performed are followed: partial thromboplastyn time(PTT), plasma coagulation time RVV(RVV-T), antithrombin III(At-III), alpha2macroglobulin(a2M), fibrin/fibrinogen degradation products(FDP), ethanol gelation(EG) and protamine sulphate(PS), euglobulin lysis time(ELT), platelet adhesiveness to glass(PAG), platelet adhesiveness in vivo (PAV), platelet factor-3 availability(PF-3), platelet aggregation by ristocetin 1, 2-1, 5-1, 8 mg/ml(RIPA),Diabetics showed a fall in At-III, increase a2M, a significant decrease ELT and increase FDP with often positivity EG. We also noted a shortening of PTT, PF-3 rate and RVV-T. In vitro platelets adhesiveness rises more than it does in vivo. Besides the PPP from diabetics increased the control subjects PAG. The RIPA is increased. Our findings showed, therefore, in diabetic patients a thrombophilic pattern by blood hypercoagulability and fibrinolytic activity decreased.

Download Full-text

Phytomedicines Used for Diabetes Mellitus in Ghana: A Systematic Search and Review of Preclinical and Clinical Evidence

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2019/6021209 ◽

2019 ◽

Vol 2019 ◽

pp. 1-23 ◽

Cited By ~ 5

Author(s):

Michael Buenor Adinortey ◽

Rosemary Agbeko ◽

Daniel Boison ◽

William Ekloh ◽

Lydia Enyonam Kuatsienu ◽

...

Keyword(s):

Diabetes Mellitus ◽

Medicinal Plants ◽

Cell Function ◽

Glucose Absorption ◽

Mechanisms Of Action ◽

Future Research ◽

Secretion Inhibition ◽

Preclinical And Clinical Studies

Background. Available data indicate that diabetes mellitus leads to elevated cost of healthcare. This imposes a huge economic burden on households, societies, and nations. As a result many Ghanaians, especially rural folks, resort to the use of phytomedicine, which is relatively less expensive. This paper aims at obtaining information on plants used in Ghana to treat diabetes mellitus, gather and present evidence-based data available to support their uses and their mechanisms of action, and identify areas for future research.Method. A catalogue of published textbooks, monographs, theses, and peer-reviewed articles of plants used in Ghanaian traditional medicine between 1987 and July 2018 for managing diabetes mellitus was obtained and used.Results. The review identified 76 plant species belonging to 45 families that are used to manage diabetes mellitus. Leaves were the part of the plants frequently used for most preparation (63.8%) and were mostly used as decoctions. Majority of the plants belonged to the Euphorbiaceae, Lamiaceae, Asteraceae, and Apocynaceae families. Pharmacological data were available on 23 species that have undergonein vitrostudies. Forty species have been studied usingin vivoanimal models. Only twelve plants and their bioactive compounds were found with data on both preclinical and clinical studies. The records further indicate that medicinal plants showing antidiabetic effects did so via biochemical mechanisms such as restitution of pancreaticβ-cell function, improvement in insulin sensitivity by receptors, stimulating rate of insulin secretion, inhibition of liver gluconeogenesis, enhanced glucose absorption, and inhibition of G-6-Pase,α-amylase, andα-glucosidase activities.Conclusion. This review contains information on medicinal plants used to manage diabetes mellitus, including their pharmacological properties and mechanisms of action as well as models used to investigate them. It also provides gaps that can form the basis for further investigations and development into useful medications for effective treatment of diabetes mellitus.

Download Full-text

Abstract 460: Characterization of Glycated Albumin Isolated From Poorly Controlled Diabetic Patients and Its Role in Macrophage Cholesterol Efflux

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.34.suppl_1.460 ◽

2014 ◽

Vol 34 (suppl_1) ◽

Author(s):

Adriana Machado-Lima ◽

Erika R Oliveira ◽

Rodrigo T Iborra ◽

Gabriela Castilho ◽

Edna R Nakandakare ◽

...

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Cholesterol Efflux ◽

Glycated Albumin ◽

Maldi Mass Spectrometry ◽

Diabetic Patients ◽

Advanced Glycation ◽

Macrophage Cholesterol Efflux

Advanced glycation end products (AGE) are elevated in diabetes mellitus (DM) and predict the development of atherosclerosis. In vitro produced AGE-albumin induces oxidative stress that is linked to the reduction in ABCA-1 levels and cholesterol efflux mediated by apo A-I and HDL-subfractions, leading to macrophage cholesterol accumulation. We characterized the glycation level/profile of human serum albumin (HSA) isolated by fast protein liquid chromatography from poorly controlled type 1 (DM1) and type 2 (DM2) diabetes mellitus patients (HbA1c > 8%) in comparison to control (C) individuals, and how these AGE-albumin can interfere in macrophage lipid accumulation. The glycation level of HSA from C, DM1 and DM2 was analyzed by MALDI mass spectrometry and was similar between DM1 and DM2-HSA. An increased mean mass was observed in DM1-HSA (68,544 ± 192 Da; n=6) and DM2-HSA (68,547 ± 132 Da; n=6) compared to C-HSA (67,846 ± 301 Da; n=6), reflecting the condensation of at least 8 and 5 units of glucose, respectively. The tryptic digestion of C-HSA generated a number of peptide species higher than those originated from DM1 and DM2-HSA. Macrophages isolated from peritoneal wild-type mice were treated for 18 h with C, DM1 or DM2-HSA in order to measure the 14C-cholesterol efflux and the mRNA expression of NOX-4 (NADPHoxidase4), ABCA-1 (Abca1) and ABCG-1 (Abcg1). Data were compared by one-way ANOVA and Dunnet′s post test. In comparison to cells treated with C-HSA the expression of NADPHoxidase4 (p<0.05; n=3) mRNA was increased after cell treatment with DM1 (3.2x) and DM2-HSA (0.7x), confirming oxidative stress. Abcg1 mRNA was reduced by DM2-HSA (26%; p<0.05; n=3); Abca1 mRNA was unchanged but ABCA-1 protein content was greatly reduced (82 and 25%, respectively in DM1 and DM2-HAS; p<0.05; n=12). The % of apo A-I mediated cholesterol efflux was impaired in DM1 (1.3 ± 0.3) and DM2-HSA-treated cells (2.4 ± 0.5) as compared to C-HSA (4.4 ± 0.5; n= 5; p<0.05). The level of advanced glycation that takes place in vivo was similar between DM1 and DM2-HSA and induced macrophage oxidative stress and impairment in cholesterol efflux that may contribute to atherogenesis in DM. Funding: FAPESP, Brazil (2012/19112-0)

Download Full-text

The influence of natural dicarbonils on the antioxidant enzymes activity in vitro and in vivo

Biomeditsinskaya Khimiya ◽

10.18097/pbmc20125806727 ◽

2012 ◽

Vol 58 (6) ◽

pp. 727-736 ◽

Cited By ~ 1

Author(s):

V.Z. Lankin ◽

G.G. Konovalova ◽

A.K. Tikhaze ◽

L.V. Nedosugova

Keyword(s):

Oxidative Stress ◽

Diabetes Mellitus ◽

Antioxidant Enzymes ◽

Carbonyl Stress ◽

Diabetic Patients ◽

Glutathione S Transferase ◽

Liver Glutathione ◽

Bovine Erythrocytes

Natural dicarbonyls, which may be accumulated during oxidative stress in atherosclerosis (e.g. malondialdehyde) or carbonyl stress in diabetes mellitus (glyoxal and methylglyoxal) effectively inhibited the activities of commercial preparations of antioxidant enzymes: catalase, Cu,Zn-superoxide dismutase (Cu,Zn-SOD) and Se-contained glutathione peroxidase from human and bovine erythrocytes and also rat liver glutathione-S-transferase. After incubation of human erythrocytes with 10 mM of each investigated dicarbonyls the decrease of intracellular Cu,Zn-SOD was observed. The decreased activity of erythrocyte Cu,Zn-SOD was also detected in diabetic patients with carbohydrate metabolism disturbance but effective sugar-lowered therapy was accompanied by the increase of this enzyme activity. The increase of erythrocytes activity of Cu,Zn-SOD of diabetic patients theated with metformin (which may utilize methylglyoxal) was higher than in erythrocytase of diabetic patients subjected to traditional therapy.

Download Full-text

Natural Hydrogen Sulfide Donors from Allium sp. as a Nutraceutical Approach in Type 2 Diabetes Prevention and Therapy

Nutrients ◽

10.3390/nu11071581 ◽

2019 ◽

Vol 11 (7) ◽

pp. 1581 ◽

Cited By ~ 7

Author(s):

Melino ◽

Leo ◽

Papajani

Keyword(s):

Type 2 Diabetes ◽

Medicinal Plants ◽

Dietary Therapy ◽

Diabetic Patients ◽

Organosulfur Compounds ◽

Type 2 Dm ◽

Peripheral Arterial Diseases

Type 2 diabetes mellitus (DM) is a socially relevant chronic disease with high prevalence worldwide. DM may lead to several vascular, macrovascular, and microvascular complications (cerebrovascular, coronary artery, and peripheral arterial diseases, retinopathy, neuropathy, and nephropathy), often accelerating the progression of atherosclerosis. Dietary therapy is generally considered to be the first step in the treatment of diabetic patients. Among the current therapeutic options, such as insulin therapy and hypoglycemic drugs, in recent years, attention has been shifting to the effects and properties—that are still not completely known—of medicinal plants as valid and inexpensive therapeutic supports with limited side effects. In this review, we report the relevant effects of medicinal plants and nutraceuticals in diabetes. In particular, we paid attention to the organosulfur compounds (OSCs) present in plant extracts that due to their antioxidant, hypoglycemic, anti-inflammatory, and immunomodulatory effects, can contribute as cardioprotective agents in type 2 DM. OSCs derived from garlic (Allium sp.), due to their properties, can represent a valuable support to the diet in type 2 DM, as outlined in this manuscript based on both in vitro and in vivo studies. Moreover, a relevant characteristic of garlic OSCs is their ability to produce the gasotransmitter H2S, and many of their effects can be explained by this property. Indeed, in recent years, several studies have demonstrated the relevant effects of endogenous and exogenous H2S in human DM, including by in vitro and in vivo experiments and clinical trials; therefore, here, we summarize the effects and the underlying molecular mechanisms of H2S and natural H2S donors.

Download Full-text

Middle East Medicinal Plants in the Treatment of Diabetes: A Review

Molecules ◽

10.3390/molecules26030742 ◽

2021 ◽

Vol 26 (3) ◽

pp. 742

Author(s):

Alaa M. Abu-Odeh ◽

Wamidh H. Talib

Keyword(s):

Middle East ◽

Medicinal Plants ◽

Antidiabetic Activity ◽

Pharmacokinetic Parameters ◽

Diabetic Patients ◽

East Region ◽

History Of ◽

Middle East Region

Diabetes is a global health problem, and the number of diabetic patients is in continuous rise. Conventional antidiabetic therapies are associated with high costs and limited efficiency. The use of traditional medicine and plant extracts to treat diabetes is gaining high popularity in many countries. Countries in the Middle East region have a long history of using herbal medicine to treat different diseases, including diabetes. In this review, we compiled and summarized all the in vivo and in vitro studies conducted for plants with potential antidiabetic activity in the Middle East region. Plants of the Asteraceae and Lamiaceae families are the most investigated. It is hoped that this review will contribute scientifically to evidence the ethnobotanical use of medicinal plants as antidiabetic agents. Work has to be done to define tagetes, mechanism of action and the compound responsible for activity. In addition, safety and pharmacokinetic parameters should be investigated.

Download Full-text

Reliability of a Single β-Thromboglobulin Measurement in a Diabetic Population : Importance of PGE1 in Anticoagulant Mixture

Thrombosis and Haemostasis ◽

10.1055/s-0038-1651094 ◽

1987 ◽

Vol 57 (02) ◽

pp. 201-204 ◽

Cited By ~ 2

Author(s):

P Y Scarabin ◽

L Strain ◽

C A Ludlam ◽

J Jones ◽

E M Kohner

Keyword(s):

In Vitro Release ◽

Mean Value ◽

Reliable Estimate ◽

Diabetic Patients ◽

Single Measurement ◽

Diabetic Population ◽

The Difference ◽

Vitro Release

SummaryDuring the collection of samples for plasma β-thromboglobulin (β-TG) determination, it is well established that artificially high values can be observed due to in-vitro release. To estimate the reliability of a single β-TG measurement, blood samples were collected simultaneously from both arms on two separate occasions in 56 diabetic patients selected for a clinical trial. From each arm, blood was taken into two tubes containing an anticoagulant mixture with (tube A) and without (tube B) PGE!. The overall mean value of B-TG in tube B was 1.14 times higher than in tube A (p <0.01). The markedly large between-arms variation accounted for the most part of within-subject variation in both tubes and was significantly greater in tube B than in tube A. Based on the difference between B-TG values from both arms, the number of subjects with artifically high B-TG values was significantly higher in tube B than in tube A on each occasion (overall rate: 28% and 14% respectively). Estimate of between-occasions variation showed that B-TG levels were relatively stable for each subject between two occasions in each tube. It is concluded that the use of PGEi decreases falsely high B-TG levels, but a single measurement of B-TG does not provide a reliable estimate of the true B-TG value in vivo.

Download Full-text