The effect of Aqueous, Ethanolic extracts of Rheum ribeson insulin sensitivity, inflammation, oxidative stress in patients with type 2 diabetes mellitus: A Randomized, Double-Blind, Placebo-Controlled Trial

Meta-analysis of the anti-oxidative and anti-inflammatory effects of hypoglycaemic plant-derived medicines

BACKGROUND

The pivotal role of oxidative stress and inflammation in the pathophysiology of type 2 diabetes mellitus (T2DM) has been firmly established. However, the evidence concerning hypoglycaemic medicinal plants' antioxidant and anti-inflammatory effects remains inconclusive due to inconsistencies in prior studies. To address this gap, our study aims to perform a comprehensive systematic review and meta-analysis of randomized controlled trials (RCTs) to consolidate previous research findings in this field.

METHODS

We conducted a comprehensive search in the PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases to identify relevant English randomized controlled trials (RCTs). Our study adhered to the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines. All eligible studies that evaluated concurrently the antioxidative and anti-inflammatory effects of hypoglycaemic plant-derived supplements on type 2 diabetes mellitus (T2DM) were included in the meta-analysis. The meta-analysis itself was carried out using both fixed and random effects models to synthesize the findings from the selected studies.

RESULTS

Our study included 47 trials with a total of 2636 participants, both male and female, aged between 20 and 79 years, diagnosed with prediabetes, type 2 diabetes mellitus (T2DM), or metabolic syndrome. The meta-analysis revealed that plant-derived treatments, compared to placebos or other medicines, significantly improved oxidative stress (SMD = - 0.36, 95% CI - 0.64 to - 0.09), inflammation (SMD = - 0.47, 95% CI - 0.63 to - 0.31), total antioxidant capacity (SMD = 0.46, 95% CI 0.16-0.75), and antioxidant enzyme activity (SMD = 1.80, 95% CI 1.26-2.33). The meta-regression analysis showed that treatment duration exceeding 8 weeks significantly impacted the heterogeneity of the oxidative stress data.

CONCLUSIONS

Several hypoglycaemic plant-based treatments appear to positively affect T2DM patients by concurrently lowering oxidative stress and inflammatory indicators and boosting antioxidant enzyme activity.

CLINICAL TRAIL REGISTRY

PROSPERO ID: CRD42021226147.

Wonderful Natural Drugs with Surprising Nutritional Values, Rheum Species, Gifts of the Nature

Abstract:

Nutrition therapy on the basis of traditional medicinal plants and herbs is common in many Asian countries, especially Iran and China. Rheum species, especially rhubarbs, belong to plant medicines recognized in 2500 BC. An online search of the literature was carried out at Pubmed/Medline, Scopus, and Google scholar, covering all years until April 2021. The following key terms were used, usually in combinations: Rheum species, rhubarb, natural products, pharmaceutical benefits, anthraquinones and anthranone. After performing the literature search, the bibliographies of all articles were checked for cross-references that were not found in the search databases. Articles were selected if they reported any biological effects, ethnomedicinal uses, phytochemical compounds and botanical description of Rheum species. The most important components of rhubarb are anthraquinones, anthranone, stilbenes, tannins and butyrophenones. Anthraquinones consist of rhein, emodin, aloe-emodin and chrysophanl, and anthranone includes sennosides and rheinosides. The most important health benefits of rhubarb are antioxidant and anticancer activities, antimicrobial activity, wound healing action, hepatoprotective and anti-diabetic effects, and nephroprotective effect, as well as anti-inflammatory, analgesic and antibacterial activities. Integration of both traditional pharmaceutical science and modern medicines may promote sustainability, lead to organic life and promote the cultivation of medicinal plants.

Lactobacillus rhamnosus LRa05 Ameliorate Hyperglycemia through a Regulating Glucagon-Mediated Signaling Pathway and Gut Microbiota in Type 2 Diabetic Mice

In this study, we aimed to explore the antidiabetic effects of Lactobacillus rhamnosus LRa05 on glucose metabolism and gut microbiota in type 2 diabetes mellitus (T2DM) mice. Our data indicated that the fasting blood glucose levels were reduced by 53.5% after treatment with LRa05 at a dose of 10⁹ CFU·day^-1. Meanwhile, LRa05 attenuated insulin resistance, relieved hepatic oxidative stress, and alleviated metabolic lipopolysaccharide-related inflammation in T2DM mice. LRa05 promoted the expression of glucose transporter 2, while it inhibited the expression of glucagon receptor, glucose-6-phosphatase, cellular adenosine-3'-5'-cyclic monophosphate-dependent protein kinase, and phosphoenolpyruvate carboxykinase in diabetic mice. Meanwhile, LRa05 reshaped gut microbiota, resulting in increased short-chain fatty acid bacteria (Alloprevotella and Bacteroides) and decreased proinflammatory bacteria (Odoribacter and Mucispirillum). Thus, LRa05 may be used as a functional food supplement for modulating the disorder glucose metabolism and gut microbiota in T2DM.