The Role of Natural Products on Diabetes Mellitus Treatment: A Systematic Review of Randomized Controlled Trials

The present study was carried out to relate the role of natural products in the metabolism of an increasingly prevalent disease, type 2 diabetes mellitus. At present, in addition to the pharmacological resources, an attempt is being made to treat diabetes mellitus with natural products. We carried out a systematic review of studies focusing on the role of natural products on diabetes mellitus treatment. The bibliographic search was done through Medline (Pubmed) and Web of Science. From 193 records, the title and summary of each were examined according to the criteria and whether they met the selection criteria. A total of 15 articles were included; after reviewing the literature, it is apparent that the concept of natural products is ambiguous as no clear boundary has been established between what is natural and what is synthetic, therefore we feel that a more explicit definition of the concept of “natural product” is needed. Gut microbiota is a promising therapeutic target in the treatment of diabetes. Therefore, it would be necessary to work on the relationship between the microbiome and the benefits in the treatment of diabetes mellitus. Treatment based solely on these natural products is not currently recommended as more studies are needed.

ДОСВІД ТА ПЕРСПЕКТИВИ ЗАСТОСУВАННЯ КАРБОКСІТЕРАПІЇ ПРИ ЦУКРОВОМУ ДІАБЕТІ

Цукровий діабет (ЦД) є глобальною актуальною соціальною проблемою XXI століття. Метою даного огляду літератури: є аналіз фізіологічних властивостей та фармакотерапевтичних можливостей карбоксітерапії, а також досвіду застосування даного методу для лікування ЦД. Матеріали і методи дослідження. Наукові публікації в зарубіжних та вітчизняних журналах переважно за останні 5 років, інтернет ресурси по карбоксітерапії як методу лікування ЦД. Результати досліджувати і їх обговорення. В результаті аналізу літератури були зіставленні механізми реалізації фармакологічних ефектів карбоксітерапії з окремими ланками патогенезу ЦД. Проаналізовані механізми і ефекти карбоксітерапії як ефективного альтернативного методу лікування ЦД та його ускладнень. Представлені дані свідчать про раціональність застосування карбоксітерапії як альтернативного методу лікування ЦД та його ускладнень. Висновки. З огляду на сучасні можливості фармакотерапії ЦД та більш ніж п’ятдесятирічний досвід застосування карбоксітерапії в практичній медицині дозволяє рекомендувати цей інноваційний метод як альтернативну off-label терапію ЦД. Ключові слова: цукровий діабет, лікування, карбоксітерапія. EXPERIENCE AND PROSPECTS OF CARBOXYTHERAPY IN DIABETES MELLITUS Drogovoz S. M.1, Belik G. V.1, Kalko К. О.1, Bondariev Ye. V.1, Derymedvid L. V.1, Orlenko І. V.1, Shtroblya А. L.2 National University of Pharmacy, Kharkiv, Ukraine Uzhgorod National University, Uzhgorod, Ukraine Diabetes mellitus (DM) is a global topical social problem of the XXI century. The aim of this literature review is to analyze the physiological properties and pharmacotherapeutic possibilities of carboxytherapy, as well as the experience of this method for the treatment of diabetes. Materials and methods. Scientific publications in foreign and domestic journals mainly for the last 5 years, online resources on carboxytherapy as a method of DM treating. Results and discussions. As a result of the literature analysis, the mechanisms of implementation of the pharmacological effects with separate links of the pathogenesis of diabetes were compared. The mechanisms and effects of carboxytherapy as an effective alternative method for treating diabetes mellitus and its complications have been analyzed. The presented data indicate the rational use of carboxytherapy as an alternative method for treating diabetes and its complications. Conclusions. Given the current possibilities of pharmacotherapy of diabetes and more than fifty years of experience in the use of carboxytherapy in practical medicine allows us to recommend this innovative method as an alternative to off-label therapy of diabetes. Key words: diabetes mellitus, treatment, carboxytherapy.

Exosome-Mediated Insulin Delivery for the Potential Treatment of Diabetes Mellitus

Exosomes are extracellular nanovesicles between 30 and 150 nm that serve as essential messengers for different biological signaling and pathological processes. After their discovery, a wide range of applications have been developed, especially in therapeutic drug delivery. In this context, the aim of this work was to test the efficiency of exosome-mediated human insulin delivery using exosomes extracted from three different cell lines: hepatocellular carcinoma (HepG2); primary dermal fibroblasts (HDFa) and pancreatic β cells (RIN-m); all are related to the production and/or the ability to sense insulin and to consequently regulate glucose levels in the extracellular medium. The obtained results revealed that the optimal insulin loading efficiency was achieved by a 200 V electroporation, in comparison with incubation at room temperature. Moreover, the maximum in vitro exosome uptake was reached after incubation for 6 h, which slightly decreased 24 h after adding the exosomes. Glucose quantification assays revealed that exosome-mediated incorporation of insulin presented significant differences in HDFa and HepG2 cells, enhancing the transport in HDFa, in comparison with free human insulin effects in the regulation of extracellular glucose levels. No significant differences were found between the treatments in RIN-m cells. Hence, the results suggest that exosomes could potentially become a valuable tool for stable and biocompatible insulin delivery in diabetes mellitus treatment alternatives.

Does Personality and Anxiety Symptomatology Matter in the Diabetes Mellitus Treatment Adherence? A Cross-Sectional Study Among Women with Diabetes Mellitus.

Purpose: Anxiety is prevalent among women with diabetes mellitus. Women also tend to have higher levels of neuroticism and anxiety. These symptoms can have an impact on social functioning and diabetes care. The main aim of the present study was to determine the relationship between neuroticism and anxiety symptoms, and other clinical and psychosocial variables, among women with diabetes mellitus (DM). Patients and methods: This was a cross-sectional study conducted on women with diabetes mellitus. Sociodemographic and clinical variables were acquired, including perceptions on religious practice, social support, and diabetic self-care. Study subjects completed the Generalized Anxiety Disorder 7-item (GAD-7) and the Big-Five Inventory (BFI). The neuroticism subscale of the BFI was used for analysis. Results: The study included 141 subjects (Median age: 64.0 years, IQR: 52.5–71.0 years) with a median duration of diabetes of 12.0 years (IQR: 6.0–20.0 years). Neuroticism scores correlated positively with the GAD-7 scores (Spearman’s rho: 0.406; p<0.001). In the bivariate analysis, neuroticism also had significant association with employment status (p=0.023), religious practice (p=0.006), perceived social support (p=0.001), and perceived ability of diabetic self-management (p<0.001). In the regression analysis, after controlling for employment, religious practice, and social support, neuroticism remained associated with anxiety (p<0.001) and diabetic self-management (p=0.001). Conclusions: Neuroticism was related to poorer subjective sense of diabetic management and a greater level of anxiety among women with DM. Improving self-efficacy in managing diabetes may help patients coping up with anxiety symptoms among those with neuroticism traits. This may also contribute to a better understanding of features and effective treatment of women with DM.

Pharmacokinetics and Pharmacological Activities of Berberine in Diabetes Mellitus Treatment

Traditional Chinese medicine (TCM) has good clinical application prospects in diabetes treatment. In addition, TCM is less toxic and/or has fewer side effects and provides various therapeutic effects. Berberine (BBR) is isolated as the main component in many TCM kinds (e.g., Rhizoma Coptidis and Berberidis Cortex). Furthermore, BBR can reduce blood sugar and blood fat, alleviate inflammation, and improve the state of patients. Based on the recent study results of BBR in diabetes treatment, the BBR pharmacokinetics and mechanism on diabetes are mainly studied, and the specific molecular mechanism of related experimental BBR is systematically summarized and analyzed. Clinical studies have proved that BBR has a good therapeutic effect on diabetes, suggesting that BBR may be a promising drug candidate for diabetes. More detailed BBR mechanisms and pathways of BBR need to be studied further in depth, which will help understand the BBR pharmacology in diabetes treatment.

Possibilities of application a fixed combination of alogliptin and pioglitazone for type 2 diabetes mellitus treatment

Hyperglycemia in T2DM is based on three main mechanisms: insulin resistance, progressive β-cell dysfunction, and excess glucose production by the liver.The onset of T2DM is usually preceded by a long period of insulin resistance. Prescribing sugar drugs that affect different links of pathogenesis, reducing a steady decrease in glycemia. To date, in clinical practice, various combinations of hypoglycemic drugs are used, the choice of which is determined by the characteristics of the course of diabetes in the patient, the presence of concomitant diseases and complications of diabetes, as well as the dominant clinical problem. This resolution provides an expert council opinion on the feasibility of using a combination of alogliptin and pioglitazone in patients with type 2 diabetes.

Role of glucometry in outpatient care, and managing patients with impaired carbohydrate metabolism

The patient should become a full-fledged partner of the physician in the question of diabetes mellitus treatment. Patient’s compliance and ability to perform structured self-monitoring have a direct impact on the treatment outcome. Patient education is a potential resource of treatment compliance. According to modern algorithms of care for patients with DM, patient training on blood glucose and blood pressure self-monitoring is a prerequisite for prevention and successful treatment of DM complications. Modern glucose meters, simple to use and comfortable, help to monitor blood glucose levels.