Effectiveness of polyherbal formulations for the treatment of type 2 Diabetes mellitus - A systematic review and meta-analysis

Investigation of the Cognitive Activity Between the Leaf Extracts of Eclipta alba and Ziziphus jujuba in Diabetic Animal Models

Diabetes mellitus (DM), a prevalent metabolic disorder, is associated with widespread damage to bodily systems, notably causing significant dysfunction within the peripheral and central nervous systems (CNS). The primary objective of this study is to explore the extent of DM's impact on cognitive and behavioral functions and to evaluate the therapeutic potential of ethanol leaf extracts from Ziziphus jujuba (ZJ) and Eclipta alba (EA) in mitigating these adverse effects. Utilizing an established animal model, we aimed to determine the effectiveness of these plant extracts in ameliorating the cognitive impairments commonly seen in diabetic states. In our experimental framework, we allocated Wistar rats (n=6 per group) into eight different groups, inducing DM through alloxan administration. The intervention groups were treated orally with either the standard antidiabetic drug glibenclamide or varying doses of ZJ and EA extracts over periods of seven and 21 days. Throughout the study, we carefully tracked fluctuations in blood glucose levels, noting considerable decreases, particularly following the 21-day treatment interval. Post-treatment, the rats' cognitive functions were assessed using the Morris water maze (MWM) test. This evaluation revealed significant cognitive enhancement in the diabetic rats administered with ZJ and EA extracts, with these groups displaying reduced latency in finding the submerged platform, indicative of improved learning and memory. These observations were statistically significant (p<0.01). The findings underscore the hypoglycemic effects of ZJ and EA extracts and suggest their viability as cognitive enhancers in the context of DM. The protective effects of these extracts against cognitive decline caused by DM are clear. They add important new information to the research on natural phytochemicals for managing chronic diseases. This study opens new avenues for the application of these substances in treating neurocognitive disorders associated with DM.

Polyherbal extract improves glycometabolic control in alloxan-induced diabetic rats via down-regulating the MAPK/JNK pathway, modulating Nrf-2/Keap-1 expression, and stimulating insulin signaling

Objectives

This study focused on the evaluation of antioxidant and antidiabetic activities of polyherbal extract (PHE), containing Cassia absus (L.), Gymnema sylvestre (R. Br.), Nigella sativa (L.), and Piper nigrum (L.), in alloxan-induced diabetes model.

Materials and Methods

In vitro, HPLC characterization, DPPH scavenging assay, and α-amylase inhibition test were conducted. In vivo, acute oral toxicity of PHE was assessed. Alloxan-induced diabetic Wistar rats (n=6) were orally treated with PHE (200, 400, and 600 mg/kg/day) and glibenclamide (GLB; 10 mg/kg/day) for six consecutive weeks. Then, biochemical biomarkers, oxidative stress parameters, histopathological examination, and mRNA expression levels (RT-qPCR) were determined.

Results

The presence of polyphenols in PHE was confirmed in correlation to marked DPPH scavenging (IC50: 1.60 mg/ml) and α-amylase inhibition (IC50: 0.82 mg/ml). PHE demonstrated no toxicity in rats up to a dose of 2000 mg/kg. In diabetic rats, PHE dose-dependently ameliorated the serum levels of glucose, insulin, glycated hemoglobin A1c (HbA1c), leptin, and glucokinase (GCK). Also, PHE substantially alleviated serum inflammatory markers (TNF-α and CRP) and oxidative stress indicators (MDA, SOD, and CAT) in pancreatic tissues. PHE, particularly at 600 mg/kg, attenuated cellular oxidative stress via modulating the mRNA expression levels of genes regulating MAPK/JNK (Mapk-8, Traf-4, and Traf-6) and Nrf-2/Keap-1 pathways and promoted insulin signaling through up-regulating insulin signaling cascade (Pdx-1, Ins-1, and Ins-2), as compared to GLB. Furthermore, histopathological findings supported the aforementioned results.

Conclusion

Our study suggests that polyherbal extract has promising antioxidant and antidiabetic activities by modulating the MAPK/JNK, Nrf-2/Keap-1, and insulin signaling pathways.

'Vidangadi Lauha' for obese type 2 diabetes mellitus patients - An open-label randomized controlled clinical trial

BACKGROUND

Type 2 diabetes mellitus in obese persons is becoming alarming due to the increasing prevalence of its microvascular and macrovascular complications. Multi-targeted treatment can be considered better than single-targeted treatment because of the multiple pathways involved in the pathogenesis of diabetes and its complications.

OBJECTIVE

The study aimed to evaluate the efficacy of 'Vidangadi Lauha' (VL) (an Ayurveda formulation) compared with Metformin for obese type II diabetes mellitus.

METHODOLOGY

This is an open-label randomized controlled clinical study.Participants were divided into two groups. The trial Group received VL 5 gm BID, and the control group received tablet metformin (MT) 500 mg BID for three months.

RESULTS

VL showed reduction in HbA1c from 8.048(0.95) to 7.14(0.73), (CI, 0.7810 to 1.035; p < 0.0001) while MT showed reduction in HbA1C from 8.3(0.99) to7.18(0.67), (CI, 0.9220 to 1.305; p < 0.0001). VL showed improvement in the Quality of life instrument for the Indian Diabetes questionnaire(QOLID) score from 113.87(11.36) to 136.47(8.703) (CI, -25.68 to -19.52; p < 0.0001) as compared to MT 128.57(7.9) to 102.32(7.9), (CI, 23.19 to 29.39; p < 0.0001) VL showed reduction in bowel symptom questionnaire 30.275(8.077) to 13.2(1.265), (CI, 14.60-19.51; p < 0.0001) as compared to MT from 23.85(7.530) to 38.25(6.332), (CI, -15.99 to -12.80; p < 0.0001).

CONCLUSION

Both treatments were equally effective in reducing blood sugar fasting (F), post-meal (PM) glycated hemoglobin (HbA1C), and body mass index (BMI). VL is more effective than MT in reducing Ayurvedic symptoms, waist-hip ratio, cholesterol, quality of life, and bowel symptom questionnaire score.

Amelioration of hyperglycemia and hyperlipidemia in a high-fat diet-fed mice by supplementation of a developed optimized polyherbal formulation

This study evaluated in vivo anti-diabetic and anti-obesity activity of a polyherbal formulation's methanolic extract containing an optimized ratio of edible seeds (Salvia hispanica, Chenopodium quinoa, Nelumbo nucifera). Diet-induced obese mice model (C57BL/6) was developed by feeding the mice a high-fat diet for 10 weeks resulting in hyperglycemia and obesity. Different doses (125, 250 and 500 mg/kg of body weight) of formulation were administered orally daily for 6 weeks. Fasting blood glucose and body weight were monitored throughout the study. At the end of the study, serum parameters were analyzed and histological examinations were performed. There was a significant reduction in fasting blood glucose levels and body weight in animal groups receiving polyherbal formulation. Lipid profile was improved as revealed by a reduction in serum triglycerides and total cholesterol. Histological study showed an improvement in liver, kidney and pancreatic sections of treated mice. High-performance thin layer chromatography was performed to identify the phytochemicals responsible for the above-mentioned bioactivities. The results revealed the presence of flavonoid (rutin) in seeds of N.nucifera and in the polyherbal formulation. For the first time, this study demonstrated the anti-diabetic and anti-obesity potential of the optimized formulation. The formulation can be used as a potential therapy for management of diabesity.

Therapeutic Applications of Curcumin in Diabetes: A Review and Perspective

Diabetes is a metabolic disease with multifactorial causes which requires lifelong drug therapy as well as lifestyle changes. There is now growing scientific evidence to support the effectiveness of the use of herbal supplements in the prevention and control of diabetes. Curcumin is one of the most studied bioactive components of traditional medicine, but its physicochemical characteristics are represented by low solubility, poor absorption, and low efficacy. Nanotechnology-based pharmaceutical formulations can help overcome the problems of reduced bioavailability of curcumin and increase its antidiabetic effects. The objectives of this review were to review the effects of nanocurcumin on DM and to search for databases such as PubMed/MEDLINE and ScienceDirect. The results showed that the antidiabetic activity of nanocurcumin is due to complex pharmacological mechanisms by reducing the characteristic hyperglycemia of DM. In light of these results, nanocurcumin may be considered as potential agent in the pharmacotherapeutic management of patients with diabetes.

Effects of Dietary Red Raspberry Consumption on Pre-Diabetes and Type 2 Diabetes Mellitus Parameters

Type 2 diabetes mellitus (T2DM) is a chronic metabolic condition characterized by glucose clearance abnormalities and insufficient insulin response. Left uncontrolled, T2DM can result in serious complications and death. With no cure available currently and the prevalence of major risk factors such as pre-diabetes and the metabolic syndrome continuously increasing, there is an urgent need for effective treatments with limited or no side effects. Red raspberries (RR) contain various phytonutrients with potential for modulating insulin function, glucose, and lipid metabolism. The objective of this literature review was to investigate the potential metabolic benefits of dietary RR in individuals with T2DM and pre-diabetes. A search of major scientific databases was employed to identify peer-reviewed, in vivo, or human studies that utilized whole RR or its functional constituents as treatment. The studies examined provide evidence that RR may offer clinically beneficial effects for the prevention and management of chronic diseases through improvements in glucose handling and insulin sensitivity, adiposity, lipid profiles, ectopic lipid accumulation, inflammation, oxidative stress, and cardiac health. More human trials and in vivo studies are needed to confirm the benefits of dietary RR in T2DM and pre-diabetes and to explore the dose-dependent relationships, optimal duration, and treatment modality.