Plant-Derived Supplementary Carbohydrates, Polysaccharides and Oligosaccharides in Management of Diabetes Mellitus: A Comprehensive Review

Fructooligosaccharides from Cynoglossum tubiflorus: Effect of the molecular size on their antidiabetic activity in high-fat diet and alloxan induced diabetic rats

The use of acetylation followed by silica gel column purification allowed the isolation of eight fructooligosaccharides (FOS) from the ethanol extract of Cynoglossum tubiflorus roots. Each FOS was identified by analyzing its FT-IR, HRMS/MS and NMR data, including 1H, 13C and 2D NMR HH COSY, HMBC and NOESY. In diabetic rats treated with a series of FOS from Glc-(Fru)3 to Glc-(Fru)7, a significant inhibition of intestinal α-amylase was observed. This activity increases proportionally with the FOS molecular size. It was found that they delay the absorption of total cholesterol (TC), ldl-cholesterol (LDL-C) and increase HDL-cholesterol (HDL-C) in a molecular size-dependent manner. This inhibitory effect on the activity of the digestive enzyme causes a significant (p < 0.05) reduction in the level of glucose in the blood as an anti-diabetic action. The ethanolic extract (E.E) exerts a significant effect against α-amylase as well as antihyperglycemic and antihyperlipidemic actions, while its acetylation suppresses these effects. Therefore, this study demonstrates for the first time that pure FOS act as an efficient agent in preventing hyperglycemia and hyperlipidemia and that this action evolves in the same manner with their molecular size.

A review on the hypoglycemic effect, mechanism and application development of natural dietary polysaccharides

Diabetes mellitus (DM) as one chronic metabolic disease was greatly increased over recent decades. The major agents treating diabetes have noticeable side effects as well as the tolerability problems. The bioactive dietary polysaccharides from abundant natural resources exhibit good hypoglycemic effect with rare adverse effects, which might serve as a candidate to prevent and treat diabetes. However, the correlations between the hypoglycemic mechanism of polysaccharides and their structure were not mentioned in several studies, what's more, most of the current hypoglycemic studies on polysaccharides were based on in vitro and in vivo experiments, and there was a lack of knowledge about the effects in human clinical trials. The aim of this review is to discuss recent literature about the variety of dietary polysaccharides with hypoglycemic activity, as well the mechanism of action and the structure-function relationship are highlighted. Meanwhile, the application of dietary polysaccharides in functional foods and clinical medicine are realized with an in-depth understanding. So as to promote the exploration of dietary polysaccharides in low glycemic healthy foods or clinical medicine to prevent and treat diabetes.

Pectin from Citrus unshiu Marc. Alleviates Glucose and Lipid Metabolism by Regulating the Gut Microbiota and Metabolites

The effects of pectin from Citrus unshiu Marc. on glycolipid metabolism, the morphologies of the pancreas and epididymal fat, the gut microbiota, and the metabolites of short-chain fatty acids (SCFAs) in db/db mice were investigated in this study. The results indicated that pectin reduced the levels of fasting blood glucose, glycated serum protein, triglycerides, total cholesterol, and low-density lipoprotein cholesterol while increasing the levels of high-density lipoprotein cholesterol. Meanwhile, pectin could improve the morphology of islet cells and inhibit the hypertrophy of adipocytes. Additionally, pectin not only regulated the intestinal flora dysbiosis in db/db mice, as shown by the increasing proportion of Firmicutes/Bacteroidetes and the relative abundance of Ligilactobacillus, Lactobacillus, and Limosilactobacillus, but also remedied the metabolic disorder of SCFAs in db/db mice. These results suggest that pectin could promote glucose and lipid metabolism by regulating the intestinal flora with changes in SCFA profile. This study proves that pectin might serve as a new prebiotic agent to prevent the disorder of glycolipid metabolism.

Marine algal polysaccharides as future potential constituents against non-alcoholic steatohepatitis

Non-alcoholic steatohepatitis (NASH) is one of the most chronic and incurable liver diseases triggered mainly by an inappropriate diet and hereditary factors which burden liver metabolic stress, and may result in liver fibrosis or even cancer. While the available drugs show adverse side effects. The non-toxic bioactive molecules derived from natural resources, particularly marine algal polysaccharides (MAPs), present significant potential for treating NASH. In this review, we summarized the protective effects of MAPs on NASH from multiple perspectives, including reducing oxidative stress, regulating lipid metabolism, enhancing immune function, preventing fibrosis, and providing cell protection. Furthermore, the mechanisms of MAPs in treating NASH were comprehensively described. Additionally, we highlight the influences of the special structures of MAPs on their bioactive differences. Through this comprehensive review, we aim to further elucidate the molecular mechanisms of MAPs in NASH and inspire insights for deeper research on the functional food and clinical applications of MAPs.

Antidiabetic Properties of Plant Secondary Metabolites

The prevalence of diabetes mellitus is one of the major medical problems that the modern world is currently facing. Type 1 and Type 2 diabetes mellitus both result in early disability and death, as well as serious social and financial problems. In some cases, synthetic drugs can be quite effective in the treatment of diabetes, though they have side effects. Plant-derived pharmacological substances are of particular interest. This review aims to study the antidiabetic properties of secondary plant metabolites. Existing review and research articles on the investigation of the antidiabetic properties of secondary plant metabolites, the methods of their isolation, and their use in diabetes mellitus, as well as separate articles that confirm the relevance of the topic and expand the understanding of the properties and mechanisms of action of plant metabolites, were analyzed for this review. The structure and properties of plants used for the treatment of diabetes mellitus, including plant antioxidants, polysaccharides, alkaloids, and insulin-like plant substances, as well as their antidiabetic properties and mechanisms for lowering blood sugar, are presented. The main advantages and disadvantages of using phytocomponents to treat diabetes are outlined. The types of complications of diabetes mellitus and the effects of medicinal plants and their phytocomponents on them are described. The effects of phytopreparations used to treat diabetes mellitus on the human gut microbiota are discussed. Plants with a general tonic effect, plants containing insulin-like substances, plants-purifiers, and plants rich in vitamins, organic acids, etc. have been shown to play an important role in the treatment of type 2 diabetes mellitus and the prevention of its complications.

Onchidium struma polysaccharides exhibit hypoglycemic activity and modulate the gut microbiota in mice with type 2 diabetes mellitus

Onchidium struma polysaccharides (OsPs) are natural biologically active compounds, and our previous work showed that they can inhibit the activity of α-glucosidase in vitro, showing potential hypoglycemic activity. However, the effects of OsPs on type 2 diabetes mellitus (T2DM) in vivo remain unknown. Thus, the anti-diabetic activity of OsPs was evaluated in the present study in diabetic mice. The results showed that OsPs can significantly ameliorate the features of T2DM in mice by improving the levels of fasting blood glucose (FBG), oral glucose tolerance test (OGTT), and pro-inflammatory factors, and ameliorating insulin resistance. Furthermore, OsPs can significantly improve biochemical indicators, decrease the contents of total cholesterol (TC) and triglyceride (TG), and reduce lipid accumulation in the liver. The possible mechanism of the prevention and treatment of T2DM by OsPs may involve the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT-1) signaling pathway. OsPs can regulate the dysbiosis of gut microbiota and reverse the abundance of Lactobacillus in mice with T2DM. Moreover, OsPs significantly increased the concentration of short-chain fatty acids (SCFAs) in mice with T2DM. Our results indicate that OsPs can be used as a novel food supplement for the prevention and treatment of T2DM.

Fucoidan from Laminaria japonica Ameliorates Type 2 Diabetes Mellitus in Association with Modulation of Gut Microbiota and Metabolites in Streptozocin-Treated Mice

Chronic diseases have been a leading cause of death worldwide, and polysaccharide supplementation is an effective therapeutic strategy for chronic diseases without adverse effects. In this study, the beneficial effect of Laminaria japonica fucoidan (LJF) on type 2 diabetes mellitus (T2DM) was evaluated in streptozocin-treated mice. LJF ameliorated the symptoms of T2DM in a dose-dependent manner, involving reduction in weight loss, water intake, triglyceride, blood glucose, cholesterol and free fatty acids, and increases in high-density lipoprotein cholesterol, catalase, glucagon-like peptide-1, and superoxide dismutase. In addition, LJF regulated the balance between insulin resistance and insulin sensitivity, reduced islet necrosis and β-cell damage, and inhibited fat accumulation in T2DM mice. The protective effect of LJF on T2DM can be associated with modulation of the gut microbiota and metabolites, e.g., increases in Lactobacillus and Allobaculum. Untargeted and targeted metabolomics analysis showed that the microbiota metabolite profile was changed with LJF-induced microbiota alterations, mainly involving amino acids, glutathione, and glyoxylate and dicarboxylate metabolism pathways. This study indicates that LJF can be used as a prebiotic agent for the prevention and treatment of diabetes and microbiota-related diseases.

Effect of chitooligosaccharides with a specific degree of polymerization on multiple targets in T2DM mice

Chitooligosaccharides (COS) are found naturally in the ocean and present a variety of physiological activities, of which hypoglycemic action has attracted considerable research attention. This study aimed to assess the therapeutic effect of COS on mice suffering from type 2 diabetes mellitus (T2DM). COS effectively reduced blood glucose and blood lipid levels and improved glucose tolerance. Furthermore, COS revealed strong inhibitory activity against α-glucosidase, reducing postprandial blood glucose levels. Molecular docking data showed that COS might interact with surrounding amino acids to form a complex and decrease α-glucosidase activity. Additionally, COS enhanced insulin signal transduction and glycogen synthesis while restricting gluconeogenesis in the liver and muscles, reducing insulin resistance (IR) as a result. Moreover, COS effectively protected and restored islet cell function to increase insulin secretion. These results indicated that COS exhibited a significant hypoglycemic effect with multi-target participation. Therefore, COS may serve as a new preventive or therapeutic drug for diabetes to alleviate metabolic syndrome.

Providing evidence from practice: Evaluating 4.5 years of implementing diabetes education support program in carbohydrate management

OBJECTIVE

To evaluate personal and economical outcomes of CarbSmart, a 3-hour person-centered, theory-based program implemented throughout Australia, targeting optimal dietary carbohydrate management.

METHODS

More than 500 CarbSmart programs were implemented over 4.5 years. Pre-, post-, (N = 4656) and 3-month follow-up assessments (N = 188) of knowledge, empowerment, confidence, and patient activation were collected from people with diabetes. Participant satisfaction and potential annual cost-savings were calculated.

FINDINGS

Repeated measures ANCOVAs showed large improvements pre- to post-program in all outcome variables (d = 0.80-1.68), which were maintained at 3-month follow-up in a sub-sample. Participant satisfaction was high (Net Promoter Score = 72.3). Potential annual cost-savings nation-wide were estimated at US$512million.

CONCLUSION

This paper provides evidence that CarbSmart is effective in improving behavioral indicators of self-management outcomes in Australians living with diabetes.

PRACTICE IMPLICATIONS

CarbSmart has the potential to prevent diabetes-related complications. However, not engaging people living with diabetes with lower levels of patient activation at baseline was recognized as a future opportunity to improve the impact of our service. Strategies are needed to engage people with lower activation levels to improve outcomes in vulnerable and at-risk populations.

FUNDING

The development of CarbSmart was funded by Diabetes WA, the national implementation of CarbSmart by the National Diabetes Services Scheme, an initiative of the Australian Government.

Phytotherapeutics Against Alzheimer's Disease: Mechanism, Molecular Targets and Challenges for Drug Development

Alzheimer's disease is inflating worldwide and is combatted by only a few approved drugs. At best, these drugs treat symptomatic conditions by targeting cholinesterase and N-methyl-D-aspartate receptors. Most of the clinical trials in progress are focused to develop disease-modifying agents that aim single targets. The 'one drug-one target' approach is failing in the case of Alzheimer's disease due to its labyrinth etiopathogenesis. Traditional medicinal systems like ayurveda uses a holistic approach encompassing legion of medicinal plants exhibiting multimodal activity. Recent advances in high-throughput technologies have catapulted the research in the arena of ayurveda, specifically in identifying plants with potent anti-Alzheimer's disease properties and their phytochemical characterization. Nonetheless, clinical trials of very few herbal medicines are in progress. This review is a compendium of Indian plants and ayurvedic medicines against Alzheimer's disease and their paraphernalia. A record of 230 plants that are found in India with anti-Alzheimer's disease potential and about 500 phytochemicals from medicinal plants has been solicited with the hope of exploring the unexplored. Further, the molecular targets of phytochemicals isolated from commonly used medicinal plants such as Acorus calamus, Bacopa monnieri, Convolvulus pluricaulis, Tinospora cordifolia and Withania somnifera have been reviewed with respect to their multidimensional property such as antioxidant, anti-inflammation, anti-aggregation, synaptic plasticity modulation, cognition and memory enhancing activity. In addition, the strengths, and challenges in ayurvedic medicine that limit its use as mainstream therapy is discussed and a framework for the development of herbal medicine has been proposed.

Recent Advances in Chiral Analysis of Proteins and Peptides

Like many biological compounds, proteins are found primarily in their homochiral form. However, homochirality is not guaranteed throughout life. Determining their chiral proteinogenic sequence is a complex analytical challenge. This is because certain d-amino acids contained in proteins play a role in human health and disease. This is the case, for example, with d-Asp in elastin, β-amyloid and α-crystallin which, respectively, have an action on arteriosclerosis, Alzheimer’s disease and cataracts. Sequence-dependent and sequence-independent are the two strategies for detecting the presence and position of d-amino acids in proteins. These methods rely on enzymatic digestion by a site-specific enzyme and acid hydrolysis in a deuterium or tritium environment to limit the natural racemization of amino acids. In this review, chromatographic and electrophoretic techniques, such as LC, SFC, GC and CE, will be recently developed (2018–2020) for the enantioseparation of amino acids and peptides. For future work, the discovery and development of new chiral stationary phases and derivatization reagents could increase the resolution of chiral separations.

Oat-Based Foods: Chemical Constituents, Glycemic Index, and the Effect of Processing

The desire for foods with lower glycemic indices has led to the exploration of functional ingredients and novel food processing techniques. The glycemic index (GI) is a well-recognized tool to assess the capacity of foods to raise blood glucose levels. Among cereal crops, oats have shown the greatest promise for mitigating glycemic response. This review evaluated decades of research on the effects of oat components on the GI level of oat-based foods with specific emphasis on oat starch, β-glucans, proteins, and phenolics. The effects of commonly used processing techniques in oats on GI level, including heating, cooling, and germination were also discussed. In addition, the GI of oat-based foods in various physical formats such as whole grain, flakes, and flour was systematically summarized. The aim of this review was to synthesize knowledge of the field and to provide a deeper understanding of how the chemical composition and processing of oats affect GI, thereby further benefiting the development of low-GI oat foods.

Plants of the Spontaneous Flora with Beneficial Action in the Management of Diabetes, Hepatic Disorders, and Cardiovascular Disease

The current pharmacological agents advised for the management of diabetes as well as cardiovascular and hepatic diseases are subject to numerous studies for safety and efficacy. Therefore, it is worth looking into alternative therapeutic aids such as natural products of medicinal plants. By a broad review of in vitro and in vivo studies on the various dandelion, chicory, and mulberry extracts, this work highlights their bioactive compounds and therapeutic action when used as a prevention and management aid in public health such as diabetes, cardiovascular disease, and hepatic disorders like non-alcoholic steatohepatitis. Natural products of dandelion leaves and root extracts can suppress the development of liver cancer, decrease insulin resistance, and suppress total triglyceride and cholesterol levels. Recent studies on mulberry leaves extracts indicated that they could decrease palmitic acid-induced lipotoxicity, increase total cholesterol and bile acid excretion, improve superoxide dismutase expression, and improve insulin resistance. Chicory root extracts boost satiety, reverse insulin resistance, and augment lipid metabolism thanks to their contents in chicoric acid, chlorogenic acid, and polysaccharides. Taraxacum officinale L., Morus nigra L., and Cichorium intybus L. present hepatoprotective, anti-inflammatory, antioxidant, hypolipidemic, and hypoglycemic activities and are shown to be advantageous in the management of obesity, dyslipidemia, Type 2 diabetes, and non-alcoholic fatty liver diseases. These plants are commonly available in the European spontaneous flora and more attention could be paid to their natural products.

Hypoglycemic and antioxidant properties of konjac (Amorphophallus konjac) in vitro and in vivo

The aim of this study was to evaluate the hypoglycemic and antioxidant potential of konjac in vitro and in vivo. Glucose diffusion and enzymatic starch digestion of konjac were assayed using α-amylase and α-glucosidase. Oral glucose tolerance test (OGTT) and oral starch tolerance test (OSTT) were performed at dose of 102 mg/Kg of body weight (equivalent to 1 g/meal in humans). Additionally, the antioxidant activity of konjac was evaluated through inhibition of lipid peroxidation. The konjac decreased glucose diffusion by 36% and 19% compared with the negative and positive controls, respectively. Additionally, konjac inhibited α-amylase and α-glucosidase activities by 14% and 90%, respectively. After OSTT, group treated with konjac showed significant lower glucose levels compared with control group (p = .03). Finally, konjac reduced lipid peroxidation in human plasma (93%) compared with the negative control. Our results suggest that konjac exhibits hypoglycemic and antioxidant activities in vitro and in vivo. PRACTICAL APPLICATIONS: Because the use of herbal products have emerged as an attractive therapeutic option for chronic diseases, konjac administration may be an adjuvant for the treatment of type 2 diabetes.

Homogenate Extraction of Polysaccharides from Pine Nut Meal: Optimization and Comparison with Other Extraction Methods by Characterizing Their Extracts

Homogenate extraction technology was applied to extract polysaccharides from pine nut (Pinus koraiensis) meal, a food waste from its oil processing. The first objective was to study the effects of liquid-solid ratio, homogenate extraction time, and temperature on the yield of pine nut meal polysaccharides (PNMP) using single-factor and Box–Behnken design. The optimal processing conditions were liquid-solid ratio of 43.23 mL/g at 35°C for 2 min 50 sec that produced PNMP yield of 11.7%. Extraction factors interacted with each other significantly (p<0.01). The second objective was to compare the homogenate extract with those produced using other methods including ultrasonic, microwave, and hot water extraction. Polysaccharides were separated using HPLC based on molecular weight (MW) and characterized with the polysaccharide and protein contents of each fraction. The homogenate PNMP had the most of small size (<100 kDa) polysaccharides, and its glycoprotein fractions generally contained higher level of protein, as well as a high ABTS+ scavenging activity observed by HPLC-UV-ABTS+ assay. FTIR analysis was used to characterize the functional groups. Homogenate extraction is superior in producing PNMP compared with other common methods, and its PNMP extract has potential antioxidant benefit.

Production of Oligosaccharides from Agrofood Wastes

The development of biorefinery processes to platform chemicals for most lignocellulosic substrates, results in side processes to intermediates such as oligosaccharides. Agrofood wastes are most amenable to produce such intermediates, in particular, cellooligo-saccharides (COS), pectooligosaccharides (POS), xylooligosaccharides (XOS) and other less abundant oligomers containing mannose, arabinose, galactose and several sugar acids. These compounds show a remarkable bioactivity as prebiotics, elicitors in plants, food complements, healthy coadyuvants in certain therapies and more. They are medium to high added-value compounds with an increasing impact in the pharmaceutical, nutraceutical, cosmetic and food industries. This review is focused on the main production processes: autohydrolysis, acid and basic catalysis and enzymatic saccharification. Autohydrolysis of food residues at 160–190 °C leads to oligomer yields in the 0.06–0.3 g/g dry solid range, while acid hydrolysis of pectin (80–120 °C) or cellulose (45–180 °C) yields up to 0.7 g/g dry polymer. Enzymatic hydrolysis at 40–50 °C of pure polysaccharides results in 0.06–0.35 g/g dry solid (DS), with values in the range 0.08–0.2 g/g DS for original food residues.