Rational therapy for diabetes: early recognition of adverse effects and avoidance of disruptive false alarms

Neo-clerodane Diterpenoids with Hypoglycemic Effects in Vivo from the Aerial Parts of Salvia hispanica L

A new neo-clerodane diterpenoid, salvihispin H (1), and six known ones (2-7) were identified from the aerial parts of Salvia hispanica L. The structure and absolute configuration of 1 were elucidated by extensive analysis of spectroscopic (¹ H, ¹³ C, and 2D NMR, and HR-ESI-MS) and single-crystal X-ray diffraction data. The anti-diabetic effects of salvihispin H (1) and salvifaricin (2) were evaluated in diabetic db/db mice. The data showed that 1 and 2 could significantly reduce fasting blood glucose level and improve insulin resistance, and compound 1 exerted glucose-lowering effect more quickly than metformin. In addition, 1 and 2 could also reduce serum TG level in db/db mice. These results demonstrated that compounds 1 and 2 could be considered as potent candidates for the therapy of type 2 diabetes mellitus (T2DM).

Characterization of Anoectochilus roxburghii polysaccharide and its therapeutic effect on type 2 diabetic mice

Anoectochilus roxburghii is a traditional herb in China that can be potentially used to treat diabetes. A novel polysaccharide ARLP-W was isolated from Anoectochilus roxburghii by chromatography on DEAE-52 cellulose. Chemical analysis indicated that ARLP-W (8.1 × 10⁴ Da) was mainly composed of mannose and glucose. The main linkages of glycosidic bonds of ARLP-W were β-1, 4-Manp and α-1, 4-Glcp. The terminal Glcp was connected to Manp-via O-3. RT-qPCR and western blotting analysis showed that ARLP-W caused a significant reduction in the levels of the key gluconeogenesis enzymes phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase) in the liver. The results of the insulin resistance tests indicated that ARLP-W increased glucose absorption. These results indicate that ARLP-W has a good therapeutic effect on type 2 diabetes and can assist with further development and application treatment of diabetes.

Plant leaves for wrapping zongzi in China: an ethnobotanical study

BACKGROUND

Zongzi, a common Chinese rice-pudding and one of the most symbolic foods in traditional Chinese festivals, is integral to both Chinese traditional culture and daily meals. Traditionally, the leaves of different plant species have been used to wrap zongzi. The variety of zongzi leaves (ZLs) can contribute to the zongzi-based cultural diversity. Given the cultural and dietary significance of zongzi, the ethnobotanical surveys were carried out, aiming to investigate the diversity of plant species and associated traditional botanical knowledge of ZLs, which could attract particular attention for their further studies.

METHOD

Both literature studies and field surveys were conducted in the study. The field investigations were carried out from May 2006 to June 2018 throughout China. Ethnobotanical information about ZLs was obtained by direct observation, semi-structured interviews, and key informant interviews.

RESULTS

In total, ZLs from 57 plant species were identified and recorded, belonging to 38 genera and 18 families. Several folk legends have been formed to explain the origin of using plant leaves to pack zongzi. Over time, Chinese people have developed diverse traditional botanical knowledge surrounding ZLs, especially regarding the zongzi flavor, antiseptic functions, and medicinal values. Based on the literature review, some species of ZLs such as the leaves of Corchorus capsularis and Vernicia fordii may even pose a potential threat to human health. Presently, in some regions of China, the traditional ZLs, such as Cocos nucifera, Tilia tuan, and Zizania latifolia, are being substituted by commercialized ZLs such as Phragmites australis and Indocalamus tessellatus.

CONCLUSION

A variety of traditional ZLs have been discovered in China. Although diverse traditional knowledge exists in China surrounding the usage of ZLs, some species may have the potential of threatening human health. Therefore, further explorations are necessary to comprehensively evaluate traditional ZLs, the results of which could help to conserve the cultural diversity of zongzi, to guarantee food safety, and to encourage the uses of plant leaves in food, medicine, and environmental management, for our human health.

DIBc, a nanochelating-based nano metal-organic framework, shows anti-diabetic effects in high-fat diet and streptozotocin-induced diabetic rats

Aims

Despite daily increase in diabetic patients in the world, currently approved medications for this disease, at best, only reduce its progression speed. Using novel technologies is a solution for synthetizing more efficient medicines. In the present study, we evaluated anti-diabetic effects of DIBc, a nano metal–organic framework, which is synthetized based on nanochelating technology.

Methods

High-fat diet and streptozotocin-induced diabetic rats were treated by DIBc or metformin for 6 weeks.

Results

DIBc decreased plasma glucose, triglyceride, cholesterol, high-density lipoprotein, and low-density lipoprotein compared with diabetic and metformin groups. In DIBc-treated rats, significant homeostasis model assessment of insulin resistance index, malondialdehyde, and tumor necrosis factor-α decrease was observed. H&E staining showed increased islet number and area in DIBc-treated rats compared with diabetic controls.

Conclusion

The results showed anti-diabetic effects of nanochelating-based framework. So DIBc, as a nano structure, has the capacity to be evaluated in future studies as a novel anti-diabetic agent.

The safety of dipeptidyl peptidase-4 (DPP-4) inhibitors or sodium-glucose cotransporter 2 (SGLT-2) inhibitors added to metformin background therapy in patients with type 2 diabetes mellitus: a systematic review and meta-analysis

The aim of the present meta-analysis was to assess the safety profile of dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium-glucose cotransporter 2 (SGLT-2) inhibitors in comparison with placebo as add-on to metformin therapy in patients with type 2 diabetes. Randomized controlled trials and controlled clinical trials were identified by searching Pubmed, Embase and the Cochrane Central Register of Controlled Trials database until 15 July 2013. All included studies were critically appraised and analysed with the use of Review Manager 5.1.0 software according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement protocol. Twenty randomized and double-blinded studies published in 22 articles fulfilled the inclusion criteria for meta-analysis. The overall results demonstrated that the use of oral antidiabetic agents (analysed separately and together) was not associated with any significantly increased risk of any serious adverse events including hypoglycaemia and gastrointestinal disorders. Moreover, the use of DPP-4 or SGLT-2 inhibitors significantly decreased risk of diarrhoea compared with placebo, when given concomitantly with metformin. However, we found that the SGLT-2 inhibitors were more likely to cause a genital infection. Despite some limitations, the findings of this meta-analysis indicate that DPP-4 or SGLT-2 inhibitors have favourable safety profile, and such therapy, when combined with metformin is well tolerated.

Exenatide once weekly: opportunities in the primary care setting

Type 2 diabetes mellitus is a pandemic, with millions of new diagnoses made each year. In the United States, > 90% of patients with type 2 diabetes mellitus are cared for by primary care physicians who bear the primary responsibility of diagnosing and treating this disease. Building an optimal treatment regimen for a patient from the many choices available depends on many factors, including the ability of a given therapy to safely and effectively lower blood glucose levels, and potential benefits on body weight, cardiovascular risk factors, and hypoglycemia risk. With these considerations at the forefront, this article provides an overview of exenatide once weekly (EQW), a recently available antidiabetes therapy in the glucagon-like peptide-1 receptor agonist class designed to provide continuous glycemic control with once-weekly dosing. We discuss the clinical trials that have demonstrated the ability of EQW to effectively lower blood glucose levels and body weight with a minimal risk of hypoglycemia. In addition, we examine other issues likely to be relevant in a primary care setting, including safety and tolerability profiles, pharmacology and dosing, ease of use, recommended place in treatment, and patient perceptions of EQW.