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Farhadnejad H, Saber N, Neshatbini Tehrani A, Kazemi Jahromi M, Mokhtari E, Norouzzadeh M, Teymoori F, Asghari G, Mirmiran P, Azizi F. Herbal Products as Complementary or Alternative Medicine for the Management of Hyperglycemia and Dyslipidemia in Patients with Type 2 Diabetes: Current Evidence Based on Findings of Interventional Studies. J Nutr Metab 2024; 2024:8300428. [PMID: 39021815 PMCID: PMC11254466 DOI: 10.1155/2024/8300428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 05/18/2024] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
Type 2 diabetes (T2D) is known as a major public health problem with a noticeable adverse impact on quality of life and health expenditures worldwide. Despite using routine multiple pharmacological and nonpharmacological interventions, including diet therapy and increasing physical activity, controlling this chronic disease remains a challenging issue, and therapeutic goals are often not achieved. Therefore, recently, other therapeutic procedures, such as using herbal products and functional foods as complementary or alternative medicine (CAM), have received great attention as a new approach to managing T2D complications, according to the literature. We reviewed the existing evidence that supports using various fundamental medicinal herbs, including cinnamon, saffron, ginger, jujube, turmeric, and barberry, as CAM adjunctive therapeutic strategies for T2D patients. The current review addressed different aspects of the potential impact of the abovementioned herbal products in improving glycemic indices and lipid profiles, including the effect size reported in the studies, their effective dose, possible side effects, herbs-drug interactions, and their potential action mechanisms.
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Affiliation(s)
- Hossein Farhadnejad
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloufar Saber
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asal Neshatbini Tehrani
- Student Research CommitteeAhvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of NutritionSchool of Allied Medical SciencesAhvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mitra Kazemi Jahromi
- Endocrinology and Metabolism Research CenterHormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Ebrahim Mokhtari
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Norouzzadeh
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of NutritionSchool of Public HealthIran University of Medical Sciences, Tehran, Iran
| | - Farshad Teymoori
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of NutritionSchool of Public HealthIran University of Medical Sciences, Tehran, Iran
| | - Golaleh Asghari
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
- Department of Community NutritionFaculty of Nutrition Sciences and Food TechnologyNational Nutrition and Food Technology Research InstituteShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvin Mirmiran
- Nutrition and Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- Endocrine Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical Sciences, Tehran, Iran
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McBenedict B, Orfao AL, Goh KS, Yau RCC, Alphonse B, Machado Lima J, Ahmed HA, Ienaco GP, Cristina de Souza E, Lima Pessôa B, Hauwanga WN, Valentim G, de Souza Chagas M, Abrahão A. The Role of Alternative Medicine in Managing Type 2 Diabetes: A Comprehensive Review. Cureus 2024; 16:e61965. [PMID: 38978922 PMCID: PMC11229830 DOI: 10.7759/cureus.61965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2024] [Accepted: 06/08/2024] [Indexed: 07/10/2024] Open
Abstract
Diabetes, a chronic metabolic disorder marked by elevated blood glucose levels, is increasingly prevalent globally, significantly impacting health-related quality of life. Type 2 diabetes (T2DM), characterized by insulin resistance and inadequate insulin production, presents a substantial public health challenge, necessitating comprehensive management strategies. Conventional treatments, including lifestyle modifications and pharmacotherapy, are essential for glycemic control and preventing complications. However, adherence to these treatments is often limited, highlighting the need for alternative strategies. Complementary and alternative medicine (CAM) offers potential cost-effective and accessible approaches for managing T2DM. Key herbal remedies like cinnamon, fenugreek, and bitter melon, along with dietary supplements like chromium, magnesium, and vanadium, have shown promise in glycemic control. Mind-body therapies, including yoga, tai chi, and meditation, contribute to improved hemoglobin A1c and fasting blood glucose levels. Research supports the integration of CAM with conventional therapies, demonstrating enhanced clinical efficacy and reduced economic burden. However, challenges such as standardization, quality control, and potential risks of herbal medicines need careful consideration. Regulatory frameworks and ethical considerations are essential to ensure patient safety and informed decision-making. Patient education and effective communication between healthcare providers and patients are crucial for integrating CAM into diabetes management. Empowerment-based interventions and collaborative approaches can enhance self-management skills and clinical outcomes. Overall, integrating CAM with conventional treatments offers a holistic approach to managing T2DM, potentially improving patient outcomes and reducing healthcare costs.
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Affiliation(s)
| | - Andréa L Orfao
- Public Health, Federal Fluminense University, Niterói, BRA
| | - Kang S Goh
- Internal Medicine, Monash University Malaysia, Johor Bahru, MYS
| | - Ryan Chun C Yau
- Internal Medicine, Monash University Malaysia, Johor Bahru, MYS
| | | | | | - Hassan A Ahmed
- Neurosurgery, Fluminense Federal University, Niterói, BRA
| | | | | | | | - Wilhelmina N Hauwanga
- Family Medicine, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BRA
| | | | | | - Ana Abrahão
- Public Health, Federal Fluminense University, Niterói, BRA
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Ogugu EG, Bidwell JT, Ruark A, Butterfield RM, Weiser SD, Neilands TB, Mulauzi N, Rambiki E, Mkandawire J, Conroy AA. Barriers to accessing care for cardiometabolic disorders in Malawi: partners as a source of resilience for people living with HIV. Int J Equity Health 2024; 23:83. [PMID: 38678232 PMCID: PMC11055364 DOI: 10.1186/s12939-024-02181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
BACKGROUND People living with HIV (PLWH) are at increased risk of cardiometabolic disorders (CMD). Adequate access to care for both HIV and CMD is crucial to improving health outcomes; however, there is limited research that have examined couples' experiences accessing such care in resource-constrained settings. We aimed to identify barriers to accessing CMD care among PLWH in Malawi and the role of partners in mitigating these barriers. METHODS We conducted a qualitative investigation of barriers to CMD care among 25 couples in Malawi. Couples were eligible if at least one partner was living with HIV and had hypertension or diabetes (i.e., the index patient). Index patients were recruited from HIV care clinics in the Zomba district, and their partners were enrolled thereafter. Interviews were conducted separately with both partners to determine barriers to CMD care access and how partners were involved in care. RESULTS Participants framed their experiences with CMD care by making comparisons to HIV treatment, which was free and consistently available. The main barriers to accessing CMD care included shortage of medications, cost of tests and treatments, high cost of transportation to health facilities, lengthy wait times at health facilities, faulty or unavailable medical equipment and supplies, inadequate monitoring of patients' health conditions, some cultural beliefs about causes of illness, use of herbal therapies as an alternative to prescribed medicine, and inadequate knowledge about CMD treatments. Partners provided support through decision-making on accessing medical care, assisting partners in navigating the healthcare system, and providing financial assistance with transportation and treatment expenses. Partners also helped manage care for CMD, including communicating health information to their partners, providing appointment reminders, supporting medication adherence, and supporting recommended lifestyle behaviors. CONCLUSIONS Couples identified many barriers to CMD care access, which were perceived as greater challenges than HIV care. Partners provided critical forms of support in navigating these barriers. With the rise of CMD among PLWH, improving access to CMD care should be prioritized, using lessons learned from HIV and integrated care approaches. Partner involvement in CMD care may help mitigate most barriers to CMD care.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA, USA.
- Betty Irene Moore School of Nursing, University of California Davis, 2570 48th Street, Sacramento, CA, 95817, USA.
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California Davis, Davis, CA, USA
| | - Allison Ruark
- Wheaton College, Biological and Health Sciences, Wheaton, IL, USA
| | - Rita M Butterfield
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Sheri D Weiser
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Torsten B Neilands
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | | | | | | | - Amy A Conroy
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
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Demanou MCD, Njonnou SRS, Fouda AAB, Balti E, Lekpa FK, Ouankou CN, Etoga MCE, Bangbang CFGE, Essomba MJN, Boli AO, Lekeufack F, Adiogo DDM. Frequency and determinants of phytotherapy use in patients with type 2 diabetes in the Dschang Health District, Cameroon: a cross-sectional study. Pan Afr Med J 2024; 47:174. [PMID: 39036028 PMCID: PMC11260045 DOI: 10.11604/pamj.2024.47.174.41677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 02/25/2024] [Indexed: 07/23/2024] Open
Abstract
Introduction phytotherapy is widely used in Africa for the management of many diseases. Data on the use of phytotherapy in people with type 2 diabetes are scarce. We aimed to determine the frequency and factors associated with the consumption/use of phytotherapy products among patients with type 2 diabetes in the Dschang Health District. Methods we conducted a cross-sectional study from January to May 2022, including community-dwelling or hospitalized patients with type 2 diabetes who had lived in the Dschang Health District for at least one year. Informed consent was obtained from all patients. Data were collected using a pre-designed questionnaire. Variables collected included socio-demographic characteristics, diabetes knowledge and practices, and perceptions of care. Results we included 403 (249 women) patients with type 2 diabetes with a mean (SD) age of 63 (± 14.86) years). Among them, 240 (59.55%) used phytotherapy, either in combination with conventional treatment (168 (41.69%) participants) or not (72 (17.86%) participants), to treat diabetes. The most common reasons for using phytotherapy were easy accessibility and belief in its efficacy. Most patients used both treatments because they thought the combination was more effective. In univariable analysis, we observed a statistically significant association between level of education (p=0.003), socioeconomic level (p<0.001), place of residence (p=0.003), duration of diabetes (p=0.007), and use of phytotherapy. In multivariable analysis, only age between 51 and 60 years (OR: 0.50, 95% CI 0.298 - 0.8521; p=0.01) was associated with the use of phytotherapy. Conclusion people living with T2D in the Dschang Health District frequently use phytotherapy as an antidiabetic remedy, especially those aged between 51 and 60 years, those with low education level, low socioeconomic level and medium duration of diabetes. There is a need to evaluate its effectiveness in treating diabetes and its adverse effects.
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Affiliation(s)
| | - Sylvain Raoul Simeni Njonnou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Sciences Pharmaceutical of the University of Dschang, Dschang, Cameroon
- Dschang Regional Hospital Annex, Dschang, Cameroon
| | - André Arsène Bita Fouda
- Department of Public Health, Faculty of Medicine and Pharmaceutical Sciences, Douala University, Douala, Cameroon
| | - Eric Balti
- Department of Internal Medicine and Specialties, Faculty of Medicine and Sciences Pharmaceutical of the University of Dschang, Dschang, Cameroon
- Yaounde Central Hospital, Yaounde, Cameroon
- Diabetes Research Center and Department of Internal Medicine, Universiteit Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Fernando Kemta Lekpa
- Department of Internal Medicine and Specialties, Faculty of Medicine and Sciences Pharmaceutical of the University of Dschang, Dschang, Cameroon
- Douala General Hospital, Douala, Cameroon
| | - Christian Ngongang Ouankou
- Department of Internal Medicine and Specialties, Faculty of Medicine and Sciences Pharmaceutical of the University of Dschang, Dschang, Cameroon
- Yaounde Teaching Hospital, Yaounde, Cameroon
| | - Martine Claude Etoa Etoga
- Diabetes Research Center and Department of Internal Medicine, Universiteit Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | | | - Marie-Josiane Ntsama Essomba
- Diabetes Research Center and Department of Internal Medicine, Universiteit Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Anne Ongmeb Boli
- Yaounde Central Hospital, Yaounde, Cameroon
- Department of Clinical Sciences, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
| | - Fabrice Lekeufack
- Department of Public Health, Faculty of Health Sciences, University of Bamenda, Bamenda, Cameroon
| | - Dieudonné Désiré Michel Adiogo
- Department of Biological Sciences of the University of Douala, Faculty of Medicine and Pharmaceutical Sciences of the University of Douala, Douala, Cameroon
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Benson M, Hossain J, Darmaun D. Improved glycemic control either alone, or combined with antioxidant supplementation, fails to restore blood glutathione or markers of oxidative stress in adolescents with poorly controlled type 1 diabetes. Nutr Res 2023; 117:83-90. [PMID: 37515943 DOI: 10.1016/j.nutres.2023.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 05/22/2023] [Accepted: 05/22/2023] [Indexed: 07/31/2023]
Abstract
In earlier studies, we showed that adolescents with type 1 diabetes mellitus (T1DM) have significant glutathione (GSH) depletion and that GSH is reciprocally related to glycemic control. In both the general population and in those with diabetes, the use of over-the-counter antioxidant supplements is widespread. We hypothesized that improved glycemic control, alone or in combination with dietary antioxidants, would restore blood GSH pool. The study included 41 participants who were 15.8 ± 2.4 years of age (mean ± standard deviation) and with poorly controlled T1DM (hemoglobin A1c [HbA1c] 8.2 ± 0.6%). Erythrocyte GSH, and 3-nitrotyrosine, F2-isoprostane, and 8-hydroxy-2'-deoxy-guanosine (as markers of protein, lipid, and DNA oxidative stress, respectively) were determined in the postabsorptive state after blood glucose was maintained overnight near euglycemia. Participants were then randomized to a mix of antioxidants (vitamin C, selenium, zinc, vitamin E, β-carotene) or placebo for 3 to 6 months, and diabetes management was intensified using CSII (n = 30) or multiple daily injections (n = 11) coupled with CDE phone calls and visits with a Nutritionist. A second, identical study was performed when/if a drop in HbA1c ≥0.5% was achieved. HbA1c levels dropped similarly in both groups (from 8.9 ± 1.0% to 7.9 ± 0.9% and 8.5 ± 0.6% to 7.7 ± 0.7% in placebo and antioxidant group, respectively). Neither total nor reduced GSH was altered by improved metabolic control. Markers of protein, lipid, and DNA oxidation remained unaltered. We conclude that, in youngsters with T1DM, neither a significant improvement in diabetes control over a 3-month period nor the regimen of dietary antioxidant supplied in the current study can mitigate oxidative stress. These findings suggest that, in adolescents with T1DM, (1) more sustained improvement of diabetes control may be needed to alleviate oxidative stress and (2) the putative benefit of antioxidant supplements remains to be proven.
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Affiliation(s)
- Matthew Benson
- Division of Endocrinology & Metabolism, Nemours Children's Health, Jacksonville, FL, 32207
| | | | - Dominique Darmaun
- Division of Endocrinology & Metabolism, Nemours Children's Health, Jacksonville, FL, 32207; UMR 1280, INRAE and Nantes University, CRNH, Nantes, France.
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Azimian L, Weerasuriya NM, Munasinghe R, Song S, Lin CY, You L. Investigating the effects of Ceylon cinnamon water extract on HepG2 cells for Type 2 diabetes therapy. Cell Biochem Funct 2023; 41:254-267. [PMID: 36779418 DOI: 10.1002/cbf.3778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 01/17/2023] [Accepted: 01/17/2023] [Indexed: 02/14/2023]
Abstract
Cinnamon and its extracts have been used as herbal remedies for many ailments, including for reducing insulin resistance and diabetes complications. Type 2 diabetes mellitus (T2DM) is a rapidly growing health concern around the world. Although many drugs are available for T2DM treatment, side effects and costs can be considerable, and there is increasing interest in natural products for managing chronic health conditions. Cinnamon may decrease the expression of genes associated with T2DM risk. The purpose of this study was to evaluate the effects of cinnamon water extract (CWE) compared with metformin on T2DM-related gene expression. HepG2 human hepatoma cells, widely used in drug metabolism and hepatotoxicity studies, were treated with different concentrations of metformin or CWE for 24 or 48 h. Cell viability was assessed by MTT (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium) assay and glucose uptake was compared in untreated and CWE- or metformin-treated cells under high-glucose conditions. Finally, total RNA was extracted and analyzed by RNA sequencing (RNA-seq), and bioinformatics analyses were performed to compare the transcriptional effects of CWE and metformin. We found cell viability was better in cells treated with CWE than in metformin-treated cells, demonstrating that CWE was not toxic at tested doses. CWE significantly increased glucose uptake in HepG2 cells, to the same degree as metformin (1.4-fold). RNA-seq data revealed CWE and metformin both induced significantly increased (1.3- to 1.4-fold) glucose uptake gene expression compared with untreated controls. Transcriptional differences between CWE and metformin were not significant. The effects of 0.125 mg mL-1 CWE on gene expression were comparable to 1.5 mg mL-1 (9.5 mM) metformin. In addition, gene expression at 0.125 mg mL-1 CWE was comparable to 1.5 mg mL-1 (9.5 mM) metformin. Our results reveal that CWE's effects on cell viability, glucose uptake, and gene expression in HepG2 cells are comparable to those of metformin, suggesting CWE may be an effective dietary supplement for mitigating T2DM-related metabolic dysfunction.
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Affiliation(s)
- Leila Azimian
- Department of Mechanical and Industrial Engineering, The University of Toronto, Toronto, Ontario, Canada
| | | | | | - Suzie Song
- Department of Mechanical and Industrial Engineering, The University of Toronto, Toronto, Ontario, Canada
| | - Chun-Yu Lin
- Institute of Biomedical Engineering, The University of Toronto, Toronto, Ontario, Canada
| | - Lidan You
- Department of Mechanical and Industrial Engineering, The University of Toronto, Toronto, Ontario, Canada.,Institute of Biomedical Engineering, The University of Toronto, Toronto, Ontario, Canada
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YILDIRIM G, RASHİDİ M. The Effect of Herbal Product Use on BMI and HbA1c in Patients with Diabetes. İSTANBUL GELIŞIM ÜNIVERSITESI SAĞLIK BILIMLERI DERGISI 2022. [DOI: 10.38079/igusabder.1169051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
Aim: Patients with diabetes can use herbal products to better manage the disease. The aim of this study is to examine the rate of herbal product use and the effect of herbal product use on Body Mass Index (BMI) and hemoglobin A1c (HbA1c) values in patients with diabetes.Method: The descriptive and cross-sectional study was conducted in the diabetes outpatient clinic of a hospital in Istanbul with a total of 104 patients with diabetes. The data were collected using a data collection form, which questioned the patients' socio-demographic characteristics, disease information and herbal product use. Data analysis was performed using Chi-square, One-Sample Kolmogorov-Smirnov test and Mann Whitney U test in computer environment.Results: The mean age of patients with diabetes was 61,08±9,3 years, the mean BMI was 26,3±5,4kg/m², and the mean HbA1c value was 6,9%±1,8%. The BMI and HbA1c values of the patients using herbal products were lower than the patients not using herbal products (respectively; p=,002; p=,047). It was determined that the duration of herbal product use did not affect BMI and HbA1c values (p>,05).Conclusion: The use of herbal products was high in patients with diabetes. It was determined that olive leaf, cinnamon leaf, thyme juice, garlic, black sesame, blueberry, fenugreek seeds, French lavender and bitter almond were used as herbal products. Herbal product use decreased BMI and HbA1c values.
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Affiliation(s)
- Gülay YILDIRIM
- TRAKYA ÜNİVERSİTESİ, KEŞAN HAKKI YÖRÜK SAĞLIK YÜKSEKOKULU
| | - Mahruk RASHİDİ
- İSTANBUL GELİŞİM ÜNİVERSİTESİ, SAĞLIK BİLİMLERİ YÜKSEKOKULU, HEMŞİRELİK BÖLÜMÜ
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Setiyorini E, Qomaruddin MB, Wibisono S, Juwariah T, Setyowati A, Wulandari NA, Sari YK, Sari LT. Complementary and alternative medicine for glycemic control of diabetes mellitus: A systematic review. J Public Health Res 2022; 11:22799036221106582. [PMID: 35911428 PMCID: PMC9335474 DOI: 10.1177/22799036221106582] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/25/2022] Open
Abstract
The use of complementary and alternative medicine (CAM) is increasingly popular for the management of diabetes mellitus (DM). The aim of this study was to conduct systematic review of any types of complementary and alternative medicine for glycemic control of diabetes mellitus. Four databases was used in this study, the CINAHL, PUBMED, SCOPUS, and ProQUEST. The systematic review were reported according to the PRISMA guidelines. The keywords were used according to medical subject headings (MeSH) in this study were diabetes mellitus AND complementary and alternative medicine AND blood glucose levels or blood sugar or blood glucose. Articles were limited to 2015–2021 and only in English language. We obtained 231 articles from these databases: CINAHL six articles, PUBMED 85 articles, SCOPUS 66 articles, PROQUEST 74 articles. Then, the final results recorded 17 articles. The results of a systematic review showed the effectiveness of natural products as CAM for glycemic control of DM, namely Berberis aristata/Silybum marianum, fenugreek seed, bitter melon, cinnamon or whortleberry supplements, a combination of herbal plants (C. spinosa, R. canina, and S. securigera), Nigella sativa, Mulberry juice, chicory, chamomile tea, and bell pepper juice combined with an integrated approach of yoga therapy. Mind body practices such as auditory guided imagery (AGI), qigong and tai chi exercises, and relaxation. Whole system approach, such as acupressure. Health care providers consider CAM for DM management.
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Affiliation(s)
- Erni Setiyorini
- Public Health Faculty, Universitas Airlangga, Surabaya, Indonesia
| | | | - Sony Wibisono
- Department of Internal Medicine, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia
| | | | - Anggi Setyowati
- School of Nursing, Faculty of Medicine, Universitas Lambung Mangkurat, Banjarbaru, Indonesia
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Han B, Zhang L, Hou Y, Zhong J, Hettinga K, Zhou P. Phosphoproteomics reveals that camel and goat milk improve glucose homeostasis in HDF/STZ-induced diabetic rats through activation of hepatic AMPK and GSK3-GYS axis. Food Res Int 2022; 157:111254. [DOI: 10.1016/j.foodres.2022.111254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/11/2022] [Accepted: 04/14/2022] [Indexed: 12/22/2022]
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Crichton M, Davidson AR, Innerarity C, Marx W, Lohning A, Isenring E, Marshall S. Orally consumed ginger and human health: an umbrella review. Am J Clin Nutr 2022; 115:1511-1527. [PMID: 35147170 PMCID: PMC9170469 DOI: 10.1093/ajcn/nqac035] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/04/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Emerging evidence supports the health benefits of ginger for a range of conditions and symptoms; however, there is a lack of synthesis of literature to determine which health indications are supported by quality evidence. OBJECTIVES In this umbrella review of systematic reviews we aimed to determine the therapeutic effects and safety of any type of ginger from the Zingiber family administered in oral form compared with any comparator or baseline measures on any health and well-being outcome in humans. METHODS Five databases were searched from inception to April 2021. Review selection and quality were assessed in duplicate using the Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) checklist and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) method, with results presented in narrative form. RESULTS Twenty-four systematic reviews were included with 3% overlap of primary studies. The strongest evidence was found for the antiemetic effects of ginger in pregnant women (effect size: large; GRADE: high), analgesic effects for osteoarthritis (effect size: small; GRADE: high), and glycemic control (effect size: none to very large; GRADE: very low to moderate). Ginger also had a statistically significant positive effect on blood pressure, weight management, dysmenorrhea, postoperative nausea, and chemotherapy-induced vomiting (effect size: moderate to large; GRADE: low to moderate) as well as blood lipid profile (effect size: small; GRADE: very low) and anti-inflammatory and antioxidant biomarkers (effect size: unclear; GRADE: very low to moderate). There was substantial heterogeneity and poor reporting of interventions; however, dosage of 0.5-3 g/d in capsule form administered for up to 3 mo was consistently reported as effective. CONCLUSIONS Dietary consumption of ginger appears safe and may exert beneficial effects on human health and well-being, with greatest confidence in antiemetic effects in pregnant women, analgesic effects in osteoarthritis, and glycemic control. Future randomized controlled and dose-dependent trials with adequate sample sizes and standardized ginger products are warranted to better inform and standardize routine clinical prescription.
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Affiliation(s)
- Megan Crichton
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Alexandra R Davidson
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Celia Innerarity
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Wolfgang Marx
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Deakin University, Impact (the Institute for Mental and Physical Health and Clinical Translation), Food & Mood Centre, Geelong, Australia
| | - Anna Lohning
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Elizabeth Isenring
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
| | - Skye Marshall
- Nutrition and Dietetics Research Group, Faculty of Health Science & Medicine, Bond University, Robina, Queensland, Australia
- Department of Science, Nutrition Research Australia, Sydney, New South Wales, Australia
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Perception of Individuals with Diabetes about Efficacy and Safety of Complementary and Alternative Medicines (CAM) in the Jazan Region, Saudi Arabia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:2104056. [PMID: 35571737 PMCID: PMC9098292 DOI: 10.1155/2022/2104056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 04/16/2022] [Accepted: 04/25/2022] [Indexed: 11/18/2022]
Abstract
Background CAM is widely accepted for the management of diabetes, and CAM users from many countries showed positive perception towards its use. However, little is known about the perception of individuals with diabetes in Saudi Arabia. Objectives This study was aimed to assess the perception of the individuals with diabetes of Jazan region in Saudi Arabia towards CAM. Methods An online, anonymous cross-sectional survey was designed and conducted between September 5 and December 31, 2021. Data were collected using 19-item self-report survey from the individuals with diabetes of the Jazan region. Results A total of 359 validated responses were received. Approximately, 34% of the participants reported using CAM with modern medicine to control diabetes. Most of the participants reported that CAM is affordable, accessible, acceptable, and effective. Of the study sample, 28% reported using herbal medicine to control diabetes. Significantly, higher percentages of CAM users reported media (42% vs 27%) and friends/family (31% vs 27%) as the primary sources of information about CAM as compared to non-CAM users. Individuals who used CAM for diabetes showed significantly more positive perception (β = 2.386; p=0.001) than those who did not use CAM in the adjusted analysis. Similarly, students had a significantly higher positive perception towards CAM (β = 4.121; p=0.013) compared to employed individuals. Conclusion A quarter of the sample of individuals with diabetes used herbal medicine to control diabetes. Individuals who ever used CAM for diabetes showed positive perception towards CAM. However, there is a need of healthcare workers to be involved in educating the individuals with diabetes and the general public in order to use CAM more effectively and safely.
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12
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Shrimant Kumar S, Santhi Sree M, Manjusha M, Reddy MM, B R, Kishore B, G RS, Mohapatra JJ. Efficacy of Residential, Group-Based, Intensive Holistic Lifestyle Intervention Among Type-2 Diabetes Patients - A Single Group Pre- And Post-intervention Study. Cureus 2022; 14:e22253. [PMID: 35350487 PMCID: PMC8933147 DOI: 10.7759/cureus.22253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2022] [Indexed: 11/11/2022] Open
Abstract
Background The present study assessed the efficacy of the residential, group-based, intensive holistic lifestyle intervention on glycaemic control. Materials and methods A one-group pre and post-intervention study was conducted among 145 people with diabetes for a period of one year from February 2019 to January 2020. The study population underwent "Brahma Kumaris Raja Yoga lifestyle" intervention. Outcome variables were changes in HbA1c levels and anthropometric parameters (like weight, BMI, etc.). Paired t-test was used to compare normally distributed numeric variables. Results The mean age was 52.39±5.79 years, with a male-female ratio close to 1:1. Mean HbA1c at baseline was 9.06±2.1%. The mean weight and BMI were 71.03±12.84 kg and 28.28±4.83kg/m2, respectively. Mean HbA1c value had shown a reduction of 1.60% (95%CI 1.17 to 1.90, p <0.001) at three months and 1.58% (95% CI 1.13-1.87, p<0.001) reduction at a six-month follow-up. Between the third and sixth months, there was no significant change in the HbA1c value. Mean weight reduced by 0.79 kg (95% CI 0.08-1.08, p=0.023) at six-month follow-up and mean BMI decreased by 0.31 units from baseline to three months (95% CI 0.05-0.56, p=0.017). A statistically significant reduction was observed in waist circumference at the third month (MD=1.61 95% CI =0.95 to 2.28, P<0.001) and sixth month (MD=1.53, 95% CI 0.82-2.25, p<0.001) follow-up. Conclusion This residential, group-based, intensive holistic lifestyle intervention showed a significant decrease in HbA1c levels and anthropometric parameters at three- and six-months follow-up, thereby improving the overall health and wellbeing of people with diabetes.
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Affiliation(s)
- Sahu Shrimant Kumar
- Diabetology and Holistic Care, J. Watumull Global Hospital and Research Centre, Mount Abu, IND
| | - M Santhi Sree
- Community Medicine, Ananta Institute of Medical Sciences and Research Centre, Rajsamand, IND
| | - Mohandas Manjusha
- Clinical Psychology, National Institute of Mental Health and Neurosciences, Bangalore, IND
| | | | - Ramya B
- Diabetology, Dr. Mohan's Diabetes Specialities Centre, Chennai, IND
| | - Bala Kishore
- Vedic Sciences, MIT Art Design and Technology University, Pune, IND
| | - Rohini Sharma G
- Evidencian Science, Evidencian Research Associates, Bangalore, IND
| | - Jagat Jit Mohapatra
- Diabetology, J. Watumull Global Hospital and Research Centre, Mount Abu, IND
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Ali Kazem T, Zeylabi F, Filayih Hassan A, Paridar P, Pezeshki SP, Pezeshki SMS. Diabetes mellitus and COVID-19: review of a lethal interaction from the cellular and molecular level to the bedside. Expert Rev Endocrinol Metab 2022; 17:1-19. [PMID: 34781797 DOI: 10.1080/17446651.2022.2002145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/25/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION While the main mode of transmission of coronavirus disease 2019 (COVID-19) is close contact with other individuals, the presence of chronic underlying diseases such as Diabetes Mellitus (DM) increases the chance of hospitalization and mortality rate due to infection. AREAS COVERED To investigate the effects of COVID-19 infection in DM patients, we reviewed literature from Google Scholar search engine and PubMed database from '2013 to 2020' using the terms "COVID-19; SARS-CoV-2; Diabetes mellitus; obesity; Angiotensin-converting enzyme 2; ACE2; Insulin and Metformin. Evidence suggests that COVID-19 exacerbates the course of diabetes. Presence of pro-inflammatory conditions, increased expression of receptors, and more difficult control of glucose levels in diabetics COVID-19 patients are some of the problems that diabetic patients may face. Also, psychological problems caused by the COVID-19 epidemic in diabetic patients is one of the most important problems in these patients, which is less covered. EXPERT OPINION DM is a strong and independent risk factor with a poor prognosis, which increases the risk of COVID-19 infection, the need for emergency services, the rate of hospitalization in the intensive care unit and also increases the mortality rate of COVID-19 patients.
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Affiliation(s)
| | - Fatemeh Zeylabi
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Pouria Paridar
- Islamic Azad University, North-Tehran Branch, Tehran, Iran
| | - Seyedeh Pardis Pezeshki
- Department of Clinical Biochemistry, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Sadegh Pezeshki
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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14
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Joeliantina A, Norontoko DA, Anugrahini HN. Development of a nursing assessment form for patients with diabetes mellitus in a hospital: A research and development study. BELITUNG NURSING JOURNAL 2021; 7:431-437. [PMID: 37496505 PMCID: PMC10367994 DOI: 10.33546/bnj.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/14/2021] [Accepted: 09/06/2021] [Indexed: 07/28/2023] Open
Abstract
Background People with Diabetes Mellitus (DM) tend to seek herbal medicine or complementary drugs in their treatments. But, unfortunately, the existing nursing assessment forms have not prepared the format for the use of complementary medicine. Objective This study aimed to develop a nursing assessment form in patients with DM based on the Chronic Care Model (CCM) approach. Methods This study employed a Research and Development study design, which consists of ten stages. The nursing assessment form was developed based on CCM theory and integrated complementary medicines into the assessment form. A content validity test was done by four experts and calculated using Aiken's V formula. Face validity among 12 nurses through Focus Group Discussions (FGDs) was also employed to test the quality of the nursing assessment form based on three aspects: functionality, efficiency, and usability. In addition, nine nurses were included for pilot testing of the form. Data were analyzed using descriptive analysis. Results The nursing assessment form demonstrated a good content validity, with Aiken's V value of 0.94. The form was categorized based on four components of CCM: self-management support, decision support, social activities, and clinical information. Additionally, all nurses could fill the form properly. Conclusion The nursing assessment form is valid. It can be used for nurses to assess patients with DM based on the CCM with an additional component to evaluate the use of complementary medicine.
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Affiliation(s)
- Anita Joeliantina
- Department of Nursing, Politeknik Kesehatan Kemenkes Surabaya, Indonesia
| | - Dwi Adji Norontoko
- Department of Nursing, Politeknik Kesehatan Kemenkes Surabaya, Indonesia
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15
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Ng JY, Nayeni M, Gilotra K. Quality of complementary and alternative medicine information for type 2 diabetes: a cross-sectional survey and quality assessment of websites. BMC Complement Med Ther 2021; 21:233. [PMID: 34535126 PMCID: PMC8447516 DOI: 10.1186/s12906-021-03390-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The global prevalence of diabetes mellitus is projected to reach approximately 700 million by the year 2045, with roughly 90-95% of all diabetes cases being type 2 in nature. Patients with type 2 diabetes mellitus (T2DM) frequently seek information about complementary and alternative medicine (CAM) online. This study assessed the quality of publicly accessible websites providing consumer health information at the intersection of T2DM and CAM. METHODS An online search engine (Google) was searched to identify pertinent websites containing information specific to CAM for T2DM patients, and the relevant websites were then screened with an eligibility criteria. Consumer health information found on eligible websites were then assessed for quality using the DISCERN instrument, a 16-item standardized scoring system. RESULTS Across the 480 webpages identified, 94 unique webpages remained following deduplication, and 37 eligible webpages belonged to and were collapsed into 30 unique websites that were each assessed using the DISCERN instrument. The mean overall quality score (question 16) across all 30 assessed websites was 3.55 (SD = 0.86), and the mean summed DISCERN score was 52.40 (SD = 12.11). Eighty percent of websites presented a wide range of CAM treatment options with the associated benefits/risks of each treatment, but in 56.7% of the websites, the sources used to collect information were unreliable. CONCLUSION This study identified, assessed, and presents findings on the quality of online CAM information for T2DM. Although there were several high scoring websites, there was variability across most of the individual DISCERN items in the assessed websites. This study highlights the importance of awareness among healthcare providers regarding the reliability of online information about CAM treatment and management options for T2DM. Healthcare providers should be aware of patients' information seeking behaviour, guide them in navigating through the content they encounter online, and provide them with resources containing trustworthy and reliable information.
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Affiliation(s)
- Jeremy Y. Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, Ontario L8S 4K1 Canada
| | - Manav Nayeni
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, Ontario L8S 4K1 Canada
| | - Kevin Gilotra
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Michael G. DeGroote Centre for Learning and Discovery, McMaster University, Room 2112, 1280 Main Street West, Hamilton, Ontario L8S 4K1 Canada
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16
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Blahova J, Martiniakova M, Babikova M, Kovacova V, Mondockova V, Omelka R. Pharmaceutical Drugs and Natural Therapeutic Products for the Treatment of Type 2 Diabetes Mellitus. Pharmaceuticals (Basel) 2021; 14:806. [PMID: 34451903 PMCID: PMC8398612 DOI: 10.3390/ph14080806] [Citation(s) in RCA: 87] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 12/13/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is the most widespread form of diabetes, characterized by chronic hyperglycaemia, insulin resistance, and inefficient insulin secretion and action. Primary care in T2DM is pharmacological, using drugs of several groups that include insulin sensitisers (e.g., biguanides, thiazolidinediones), insulin secretagogues (e.g., sulphonylureas, meglinides), alpha-glucosidase inhibitors, and the newest incretin-based therapies and sodium-glucose co-transporter 2 inhibitors. However, their long-term application can cause many harmful side effects, emphasising the importance of the using natural therapeutic products. Natural health substances including non-flavonoid polyphenols (e.g., resveratrol, curcumin, tannins, and lignans), flavonoids (e.g., anthocyanins, epigallocatechin gallate, quercetin, naringin, rutin, and kaempferol), plant fruits, vegetables and other products (e.g., garlic, green tea, blackcurrant, rowanberry, bilberry, strawberry, cornelian cherry, olive oil, sesame oil, and carrot) may be a safer alternative to primary pharmacological therapy. They are recommended as food supplements to prevent and/or ameliorate T2DM-related complications. In the advanced stage of T2DM, the combination therapy of synthetic agents and natural compounds with synergistic interactions makes the treatment more efficient. In this review, both pharmaceutical drugs and selected natural products, as well as combination therapies, are characterized. Mechanisms of their action and possible negative side effects are also provided.
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Affiliation(s)
- Jana Blahova
- Department of Botany and Genetics, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (J.B.); (M.B.); (V.M.)
| | - Monika Martiniakova
- Department of Zoology and Anthropology, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia;
| | - Martina Babikova
- Department of Botany and Genetics, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (J.B.); (M.B.); (V.M.)
| | - Veronika Kovacova
- Department of Zoology and Anthropology, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia;
| | - Vladimira Mondockova
- Department of Botany and Genetics, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (J.B.); (M.B.); (V.M.)
| | - Radoslav Omelka
- Department of Botany and Genetics, Faculty of Natural Sciences, Constantine the Philosopher University in Nitra, 949 74 Nitra, Slovakia; (J.B.); (M.B.); (V.M.)
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17
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Oral Administration of Gongronema latifolium Leaf Extract Modulates Gut Microflora and Blood Glucose of Induced Diabetic Rats. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2021. [DOI: 10.22207/jpam.15.1.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Studies have suggested that modulation of gut microbiota is a viable therapeutic possibility for diabetes. This study evaluated the ability of an edible plant, Gongronema (G.) latifolium Benth (Asclepiadaceae), to modulate the gut microbiome and reduce blood glucose of alloxan-induced diabetic rats. Thirty (30) young, male, albino rats were divided into 6 groups of 5 rats each: Group 1 comprised normal rats; Groups 2 to 4, diabetic rats treated with 200, 400 and 800 mg/Kg body weight of hydro-alcoholic leaf extract, respectively; Group 5, diabetic rats treated with 0.2 mg/Kg glibenclamide (an anti-diabetic drug); and Group 6 comprised untreated diabetic rats. Following induction of diabetes with alloxan injections, the treatments were administered twice daily on a 12-hourly basis by orogastric intubation for 21 days. Thereafter, faecal samples were collected from the animals and subjected to metagenomic analysis, to ascertain the composition and relative abundance of the gut microbiota. There were five dominant bacterial phyla in the rat gut: Firmicutes, Bacteroidetes, Actinobacteria, Spirochaetea and Proteobacteria. Induction of diabetes resulted in observable dysbiosis in the rats. However, treatment of the diabetic rats with G. latifolium extract, ameliorated the state of dysbiosis and resulted in significant increase in species like Lactobacillus (L.) johnsonii, L. reuteri and Prevotella corpri, which are associated with improved glucose metabolism. The plant extract produced the best result at the dose of 400 mg/Kg. The results from this study show that G. latifolium may be used as a therapeutic option for restoration of the microbiome in diabetic patients.
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18
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Zurbau A, Smircic Duvnjak L, Magas S, Jovanovski E, Miocic J, Jenkins AL, Jenkins DJA, Josse RG, Leiter LA, Sievenpiper JL, Vuksan V. Co-administration of viscous fiber, Salba-chia and ginseng on glycemic management in type 2 diabetes: a double-blind randomized controlled trial. Eur J Nutr 2021; 60:3071-3083. [PMID: 33486572 DOI: 10.1007/s00394-020-02434-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/29/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE Viscous dietary fiber, functional seeds and ginseng roots have individually been proposed for the management of diabetes. We explored whether their co-administration would improve glycemic control in type 2 diabetes beyond conventional therapy. METHODS In a randomized, double-blind, controlled trial conducted at two academic centers (Toronto, Canada and Zagreb, Croatia), individuals with type 2 diabetes were assigned to either an active intervention (10 g viscous fiber, 60 g white chia seeds, 1.5 g American and 0.75 g Korean red ginseng extracts), or energy and fiber-matched control (53 g oat bran, 25 g inulin, 25 g maltodextrose and 2.25 g wheat bran) intervention for 24 weeks, while on conventional standard of care. The prespecified primary endpoint was end difference at week 24 in HbA1c, following an intent-to-treat analysis adjusted for center and baseline. RESULTS Between January 2016 and April 2018, 104 participants (60M:44F; mean ± SEM age 59 ± 0.8 years; BMI 29.0 ± 0.4 kg/m2; HbA1c 7.0 ± 0.6%) managed with antihyperglycemic agent(s) (n = 98) or lifestyle (n = 6), were randomized (n = 52 test; n = 52 control). At week 24, HbA1c levels were 0.27 ± 0.1% lower on test compared to control (p = 0.03). There was a tendency towards an interaction by baseline HbA1c (p = 0.07), in which a greater reduction was seen in participants with baseline HbA1c > 7% vs ≤ 7% (- 0.56 ± 0.2% vs 0.03 ± 0.2%). Diet and body weight remained unchanged. The interventions were well tolerated with no related adverse events and with high retention rate of 84%. CONCLUSIONS Co-administration of selected dietary and herbal therapies was well-tolerated and may provide greater glycemic control as add-on therapy in type 2 diabetes. Registration: Clinicaltrials.gov NCT02553382 (registered on September 17, 2015).
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Affiliation(s)
- Andreea Zurbau
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada
| | - Lea Smircic Duvnjak
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zagreb, Croatia.,School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Sasa Magas
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zagreb, Croatia
| | - Elena Jovanovski
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - Jelena Miocic
- Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zagreb, Croatia
| | - Alexandra L Jenkins
- Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada
| | - David J A Jenkins
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Robert G Josse
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Lawrence A Leiter
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - John L Sievenpiper
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada.,Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada.,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada.,Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Vladimir Vuksan
- Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. .,Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada. .,Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. .,Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada. .,Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
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Mahdinezhad MR, Hooshmand S, Soukhtanloo M, Jamshidi ST, Ehtiati S, Ghorbani A. Protective effects of a standardized extract of Iris germanica on pancreas and liver in streptozotocin-induced diabetic rats. Res Pharm Sci 2020; 16:71-78. [PMID: 33953776 PMCID: PMC8074805 DOI: 10.4103/1735-5362.305190] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 07/05/2020] [Accepted: 12/07/2020] [Indexed: 12/02/2022] Open
Abstract
Background and purpose: Previous studies have shown the antioxidant, anti-inflammatory, immunomodulatory, and hypolipidemic activities of Iris germanica. The aim of the present study was to evaluate the protective effects of hydroalcoholic extract of Iris germanica rhizomes on streptozotocin-induced diabetic rats. Experimental approach: Twenty-four male Wistar rats were randomly assigned into four groups including a normal control group, diabetic control group, diabetic groups treated for 4 weeks with 100 and 200 mg/kg/day of the Iris germanica extract (IGE). Findings/Results: Induction of diabetes significantly decreased the body weight gain and considerably increased the serum levels of glucose, triglyceride, blood urea nitrogen (BUN), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP). Diabetes also diminished the antioxidant capacity of the liver (decrease of thiol groups) and significantly degenerated pancreatic islands. The IGE at both doses of 100 and 200 mg/kg significantly reduced the levels of glucose, triglyceride, AST, ALT, and ALP. Moreover, IGE increased the total antioxidant capacity of the liver and ameliorated pancreatic island morphology. The extract had no significant effect on body weight and BUN level. Conclusion and implication: These findings suggest that Iris germanica rhizomes inhibits the progression of hyperglycemia and hypertriglyceridemia and has protective effects against diabetes-induced injury of the liver and pancreas. Therefore, this plant has the potential to be used as a natural product for controlling diabetes.
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Affiliation(s)
- Mohammad Reza Mahdinezhad
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Sara Hooshmand
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.,Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Mohammad Soukhtanloo
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Shirin Taraz Jamshidi
- Kidney Transplantation Complications Research Center, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Sajad Ehtiati
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
| | - Ahmad Ghorbani
- Pharmacological Research Center of Medicinal Plants, Mashhad University of Medical Sciences, Mashhad, I.R. Iran.,Department of Pharmacology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, I.R. Iran
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20
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Kilari BP, Mudgil P, Azimullah S, Bansal N, Ojha S, Maqsood S. Effect of camel milk protein hydrolysates against hyperglycemia, hyperlipidemia, and associated oxidative stress in streptozotocin (STZ)-induced diabetic rats. J Dairy Sci 2020; 104:1304-1317. [PMID: 33272578 DOI: 10.3168/jds.2020-19412] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 09/08/2020] [Indexed: 12/12/2022]
Abstract
This study investigated the effect of camel milk protein hydrolysates (CMPH) at 100, 500 and 1,000 mg/kg of body weight (BW) for 8 wk on hyperglycemia, hyperlipidemia, and associated oxidative stress in streptozotocin-induced diabetic rats. Body weights and fasting blood glucose levels were observed after every week until 8 wk, and oral glucose tolerance test (OGTT) levels and biochemical parameters were evaluated after 8 wk in blood and serum samples. Antioxidant enzyme activity and lipid peroxidation in the liver were estimated, and histological examination of the liver and pancreatic tissues was also conducted. Results showed that CMPH at 500 mg/kg of BW [camel milk protein hydrolysate, mid-level dosage (CMPH-M)] exhibited potent hypoglycemic activity, as shown in the reduction in fasting blood glucose and OGTT levels. The hypolipidemic effect of CMPH was indicated by normalization of serum lipid levels. Significant improvement in activity of superoxide dismutase and catalase, and reduced glutathione levels were observed, along with the attenuation of malondialdehyde content in groups fed CMPH, especially CMPH-M, was observed. Decreased levels of liver function enzymes (aspartate aminotransferase and alanine aminotransferase) in the CMPH-M group was also noted. Histology of liver and pancreatic tissue displayed absence of lipid accumulation in hepatocytes and preservation of β-cells in the CMPH-M group compared with the diabetic control group. This is the first study to report anti-hyperglycemic and anti-hyperlipidemic effect of CMPH in an animal model system. This study indicates that CMPH can be suggested for its therapeutic benefits for hyperglycemia and hyperlipidemia, thus validating its use for better management of diabetes and associated comorbidities.
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Affiliation(s)
- Bhanu Priya Kilari
- Department of Food Science, College of Food and Agriculture, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates
| | - Priti Mudgil
- Department of Food Science, College of Food and Agriculture, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates
| | - Sheikh Azimullah
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, 17666, United Arab Emirates
| | - Nidhi Bansal
- ARC Dairy Innovation Hub, School of Agriculture and Food Sciences, The University of Queensland, QLD 4072, Australia
| | - Shreesh Ojha
- Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, 17666, United Arab Emirates.
| | - Sajid Maqsood
- Department of Food Science, College of Food and Agriculture, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates.
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21
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Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, Makkawi S, Alhomoud F. Herbal medicine from the perspective of type II diabetic patients and physicians: what is the relationship? BMC Complement Med Ther 2020; 20:65. [PMID: 32111222 PMCID: PMC7076897 DOI: 10.1186/s12906-020-2854-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/12/2020] [Indexed: 12/24/2022] Open
Abstract
Background Diabetes mellitus (DM) is a major public health problem and one of the most challenging diseases worldwide. According to the World Health Organization (WHO), the Kingdom of Saudi Arabia (KSA) has the second highest rate of diabetes in the Middle East and seventh highest globally. Some diabetic patients may prefer to use alternative approaches such as herbal remedies to control their blood glucose level and this study aims to assess the prevalence of herbal usage and to evaluate users’ and doctors’ knowledge, attitudes and beliefs about herbal medicine as well as the patient/doctor relationship in this regard. Method A cross-sectional survey was conducted in several hospitals and medical centres in Makkah, KSA, between January and March 2019. Around 289 type II diabetic patients and 105 doctors were interviewed. Results We found that 68% of the participants were frequent consumers of herbal remedies, especially cinnamon, ginger and fenugreek. Patients’ knowledge of herbal usage was mainly gleaned from family and friends as well as social media, and we found that many (71.4%) did not bother to consult or inform their doctors about their choice to self-medicate with herbs. Patients had no concerns regarding the efficacy and safety of herbal usage use in diabetes, as around half of the participants believe that herbal medicine is effective (54%) and safe (46%) for treating symptoms of diabetes. Two-thirds of the doctors (66%) routinely ask patients whether they use herbs for their condition. Although 25% of the doctors took a positive view of herbal medicine in relation to diabetes, others expressed concerns with the rise in herb use and want to see more attention paid to safety aspects. Conclusion The study concludes that herbal remedies are commonly used by diabetic patients and that a gap exists in the relationship between patients and doctors concerning the disclosure of herbal remedy use and views on its safety.
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Affiliation(s)
- Aljawharah Alqathama
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.
| | - Ghadeer Alluhiabi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Halah Baghdadi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Lujain Aljahani
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Ola Khan
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Sara Jabal
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Shorooq Makkawi
- Department of Pharmacognosy, Pharmacy College, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Farah Alhomoud
- Department of Clinical Pharmacy and Pharmacy Practice, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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22
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Friedman J, Birstler J, Love G, Kiefer D. Diagnoses associated with dietary supplement use in a national dataset. Complement Ther Med 2019; 43:277-282. [PMID: 30935543 DOI: 10.1016/j.ctim.2019.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Revised: 02/22/2019] [Accepted: 02/22/2019] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The purpose of this study was to determine if participant diagnosis, as determined by a health care provider, is associated with dietary supplement (DS) use. DESIGN/SETTING Surveys from 1255 study participants aged 34-84, part of the Midlife in the US Study (MIDUS 2 Survey) Biomarker Project, were reviewed. Participant data included pharmaceutical use (prescription and over-the-counter medications (OTC)), clinical symptoms and diagnosis, and laboratory results. Associations were calculated between the above participant characteristics and DS use. MAIN OUTCOME MEASURES Frequency of DS use for physician-reported diagnoses. RESULTS Overall prevalence of DS use was 32.4%. Participants taking DS were more often female (p = .048), white (p < 0.001), and older (mean age 57 years, p < 0.001). Participants taking DS reported taking more OTC (p < .001) and prescription medications (p = .024), and had an increased number of chronic conditions (p = .004). Participants reporting physician-diagnosed diabetes were significantly less likely to be taking DS (p = .0066), while participants with eye disease (p = .001), high cholesterol (p = 0.041), cancer (p = 0.042), and arthritis (p = 0.044) were more likely to be taking DS than those without those conditions. No difference in DS use was found between patients with and without other identified medical conditions. After adjusting for age, race/ethnicity, and gender, only diabetes remained a significant predictor of decreased DS use (OR 0.588, CI 0.388-0.873, p = .01). CONCLUSIONS Some physician-reported participant diagnoses were associated, positively or negatively, with DS use.
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Affiliation(s)
- Julie Friedman
- University of Wisconsin School of Medicine and Public Health, United States
| | - Jen Birstler
- University of Wisconsin-Madison, Department of Biostatistics and Informatics, United States
| | - Gayle Love
- University of Wisconsin-Madison Institute on Aging, United States
| | - David Kiefer
- University of Wisconsin, Department of Family Medicine and Community Health, United States.
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