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Oezer K, Kolibabka M, Gassenhuber J, Dietrich N, Fleming T, Schlotterer A, Morcos M, Wohlfart P, Hammes HP. The effect of GLP-1 receptor agonist lixisenatide on experimental diabetic retinopathy. Acta Diabetol 2023; 60:1551-1565. [PMID: 37423944 PMCID: PMC10520173 DOI: 10.1007/s00592-023-02135-7] [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: 01/27/2023] [Accepted: 06/10/2023] [Indexed: 07/11/2023]
Abstract
AIMS Glucagon-like peptide-1 receptor agonists are effective treatments for type 2 diabetes, effectively lowering glucose without weight gain and with low risk for hypoglycemia. However, their influence on the retinal neurovascular unit remains unclear. In this study, we analyzed the effects of the GLP-1 RA lixisenatide on diabetic retinopathy. METHODS Vasculo- and neuroprotective effects were assessed in experimental diabetic retinopathy and high glucose-cultivated C. elegans, respectively. In STZ-diabetic Wistar rats, acellular capillaries and pericytes (quantitative retinal morphometry), neuroretinal function (mfERG), macroglia (GFAP western blot) and microglia (immunohistochemistry) quantification, methylglyoxal (LC-MS/MS) and retinal gene expressions (RNA-sequencing) were determined. The antioxidant properties of lixisenatide were tested in C. elegans. RESULTS Lixisenatide had no effect on glucose metabolism. Lixisenatide preserved the retinal vasculature and neuroretinal function. The macro- and microglial activation was mitigated. Lixisenatide normalized some gene expression changes in diabetic animals to control levels. Ets2 was identified as a regulator of inflammatory genes. In C. elegans, lixisenatide showed the antioxidative property. CONCLUSIONS Our data suggest that lixisenatide has a protective effect on the diabetic retina, most likely due to a combination of neuroprotective, anti-inflammatory and antioxidative effects of lixisenatide on the neurovascular unit.
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Affiliation(s)
- Kuebra Oezer
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
| | - Matthias Kolibabka
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Nadine Dietrich
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Thomas Fleming
- Department of Medicine I and Clinical Chemistry, Heidelberg University, Heidelberg, Germany
- German Center for Diabetes Research (DZD), Neuherberg, Germany
| | - Andrea Schlotterer
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Morcos
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Stoffwechselzentrum Rhein-Pfalz, Belchenstraße 1-5, 68163, Mannheim, Germany
| | - Paulus Wohlfart
- Sanofi, MSAT M&I Bioassays and Compliance, Frankfurt, Germany
| | - Hans-Peter Hammes
- 5th Medical Department, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Rabizadeh S, Heidari F, Karimi R, Rajab A, Rahimi‐Dehgolan S, Yadegar A, Mohammadi F, Mirmiranpour H, Esteghamati A, Nakhjavani M. Vitamin C supplementation lowers advanced glycation end products (AGEs) and malondialdehyde (MDA) in patients with type 2 diabetes: A randomized, double-blind, placebo-controlled clinical trial. Food Sci Nutr 2023; 11:5967-5977. [PMID: 37823170 PMCID: PMC10563761 DOI: 10.1002/fsn3.3530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/22/2023] [Accepted: 06/15/2023] [Indexed: 10/13/2023] Open
Abstract
This study evaluated how daily vitamin C administration impacts systemic oxidative stress and inflammation and its safety in T2D patients. This randomized, double-blinded, placebo-controlled, parallel-arm clinical trial included 70 patients with T2D. They were allocated to receive either 500 mg/day of vitamin C or a matching placebo for 8 weeks. Of the 70 subjects assigned to the trial, 57 were included in the statistical analysis (vitamin C: n = 32, placebo: n = 25). Inflammatory and oxidative markers, including advanced glycation end products (AGEs), malondialdehyde (MDA), advanced oxidation protein products (AOPP), oxidized low-density lipoprotein (ox-LDL), highly sensitive C-reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), and ferric reducing ability of plasma (FRAP) were measured at baseline and the end of the trial. In addition, vitamin C tolerance was evaluated. A nutritionist visited all participants for a standard diabetic regimen. Following vitamin C supplementation, the serum levels of MDA (p-value < .001) and AGEs (p-value = .002) demonstrated a significant decrease after controlling for multiple confounders, including age, blood pressure, waist circumference, HbA1C, TG, and LDL-C, while no significant changes were observed for AOPP (p-value = .234) and ox-LDL (p-value = .480). The FRAP showed an increasing trend as an antioxidant marker but was not statistically significant (p-value = .312). The hs-CRP and TNF-α had no significant changes (p-value: .899 and .454, respectively). Also, no major adverse events were observed. Vitamin C supplementation may be beneficial in reducing AGEs and MDA in patients with T2D.
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Affiliation(s)
- Soghra Rabizadeh
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Firouzeh Heidari
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Reza Karimi
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Armin Rajab
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Shahram Rahimi‐Dehgolan
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Amirhossein Yadegar
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Fatemeh Mohammadi
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Hossein Mirmiranpour
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Alireza Esteghamati
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
| | - Manouchehr Nakhjavani
- Endocrinology and Metabolism Research Center (EMRC)Vali‐Asr Hospital, Tehran University of Medical SciencesTehranIran
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Attia JR, Holliday E, Weaver N, Peel R, Fleming KC, Hure A, Wiggers J, McEvoy M, Searles A, Reeves P, Ranasinghe P, Jayawardena R, Samman S, Luu J, Rissel C, Acharya S. The effect of zinc supplementation on glucose homeostasis: a randomised double-blind placebo-controlled trial. Acta Diabetol 2022; 59:965-975. [PMID: 35451678 PMCID: PMC9026040 DOI: 10.1007/s00592-022-01888-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 03/30/2022] [Indexed: 11/29/2022]
Abstract
AIMS The burden and health costs of Type 2 Diabetes Mellitus continue to increase globally and prevention strategies in at-risk people need to be explored. Previous work, in both animal models and humans, supports the role of zinc in improving glucose homeostasis. We, therefore, aimed to test the effectiveness of zinc supplementation on glycaemic control in pre-diabetic adults. METHODS We conducted a randomized, double-blind, placebo-controlled trial across 10 General Practitioner (GP) practices in NSW, Australia. The trial is known as Zinc in Preventing the Progression of pre-Diabetes (ZIPPeD)Study. Pre-diabetic (haemoglobin A1c [HbA1c] 5.7-6.4%, 39-46 mmol/mol) men and women (N = 98) were all assigned to a free state government telephone health coaching service (New South Wales Get Healthy Information and Coaching Service) and then randomised to either daily 30 mg zinc gluconate or placebo. Blood tests were collected at baseline, 1, 6 and 12 months for the primary outcomes (HbA1c, fasting blood glucose (FBG)); secondary outcomes included Homeostasis Model Assessment 2 (HOMA 2) parameters, lipids, body weight, height, waist circumference, blood pressure and pulse. RESULTS The baseline-adjusted mean group difference at 6 months, expressed as treatment-placebo, (95% CI) was -0.02 (-0.14, 0.11, p = 0.78) for HbA1c and 0.17 (-0.07, 0.42; p = 0.17) for FBG, neither of which were statistically significant. There were also no significant differences between groups in any of the secondary outcomes. Zinc was well tolerated, and compliance was high (88%). CONCLUSION We believe our results are consistent with other Western clinical trial studies and do not support the use of supplemental zinc in populations with a Western diet. There may still be a role for supplemental zinc in the developing world where diets may be zinc deficient. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry, ACTRN12618001120268. Registered on 6 July 2018.
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Affiliation(s)
- John R Attia
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia.
- Division of Medicine, Hunter New England Local Health District, New Lambton Heights, Australia.
| | - Elizabeth Holliday
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Natasha Weaver
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Roseanne Peel
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Kerry C Fleming
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
| | - Alexis Hure
- Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
| | - John Wiggers
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- Hunter New England Local Health District, New Lambton Heights, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, New Lambton Heights, Australia
- La Trobe Rural Health School, College of Science, Health and Engineering, La Trobe University, Bendigo, VIC, Australia
| | - Andrew Searles
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | - Penny Reeves
- Hunter Medical Research Institute, New Lambton Heights, Australia
| | | | | | - Samir Samman
- School of Life and Environmental Sciences, University of Sydney, New Lambton Heights, Australia
| | - Judy Luu
- Diabetes Stream, Diabetes Alliance HNELHD, New Lambton Heights, Australia
| | - Chris Rissel
- The University of Sydney, Camperdown, 2050, Australia
| | - Shamasunder Acharya
- Endocrinology and Diabetes Service and Diabetes Alliance Hunter New England Local Health District, New Lambton Heights, Australia
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4
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Kim Y, Oh YK, Lee J, Kim E. Could nutrient supplements provide additional glycemic control in diabetes management? A systematic review and meta-analysis of randomized controlled trials of as an add-on nutritional supplementation therapy. Arch Pharm Res 2022; 45:185-204. [PMID: 35304727 DOI: 10.1007/s12272-022-01374-6] [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: 11/22/2021] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
Abstract
This systematic review and meta-analysis assessed the antidiabetic effect of pharmaconutrients as an add-on in type 2 diabetes mellitus patients by pooling data from currently available randomized controlled trials (RCTs). Data sources included the PubMed and EMBASE, Cochrane Central Register of Controlled Trials. RCTs reporting changes in glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), or homeostasis model assessment of insulin resistance (HOMA-IR) levels following add-on pharmaconutritional therapies for T2DM patients consuming antidiabetic drugs were targeted. Using random-effects meta-analyses, we identified pharmaconutrients with effects on glycemic outcomes. Heterogeneity among studies was presented using I2 values. Among 9537 articles, 119 RCTs with nine pharmaconutrients (chromium; coenzyme Q10; omega-3 fatty acids; vitamins C, D, and E; alpha-lipoic acid; selenium; and zinc) were included. Chromium (HbA1c, FBG, and HOMA-IR), coenzyme Q10 (HbA1c and FBG), vitamin C (HbA1c and FBG), and vitamin E (HbA1c and HOMA-IR) significantly improved glycemic control. Baseline HbA1c level and study duration influenced the effects of chromium and vitamin E on HbA1c level. Sensitivity analyses did not modify the pooled effects of pharmaconutrients on glycemic control. Administration of chromium, coenzyme Q10, and vitamins C and E for T2DM significantly improved glycemic control. This study has been registered in PROSPERO (CRD42018115229).
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Affiliation(s)
- Yoonhye Kim
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Yun Kyoung Oh
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea
| | - Junhee Lee
- The Graduate School for Pharmaceutical Industry Management, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea
| | - Eunyoung Kim
- Evidence-Based and Clinical Research Laboratory, Department of Health, Social and Clinical Pharmacy, College of Pharmacy, Chung-Ang University, Seoul, Republic of Korea. .,The Graduate School for Pharmaceutical Industry Management, Chung-Ang University, 84 Heukseok-ro, Dongjak-gu, Seoul, 06974, Republic of Korea.
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Riaz N, Yousaf Z, Yasmin Z, Munawar M, Younas A, Rashid M, Aftab A, Shamsheer B, Yasin H, Najeebullah M, Simon PW. Development of Carrot Nutraceutical Products as an Alternative Supplement for the Prevention of Nutritional Diseases. Front Nutr 2022; 8:787351. [PMID: 35047545 PMCID: PMC8761950 DOI: 10.3389/fnut.2021.787351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022] Open
Abstract
Nutraceuticals can serve as an alternative supplement to overcome nutritional deficiency for a healthy lifestyle. They can also play a key role in disease management. To develop carrot nutraceutical products, 64 genotypes from four different continents were evaluated for a range of morpho-nutrition variables. Genetic variability, heritability, strength and direction of association among variables, and direct and indirect relationships among physiochemical and nutritional traits with β-carotene content were evaluated. Core diameter, foliage weight, root weight and shoulder weight showed significant association with β-carotene accumulation. Principal component analysis for physiochemical and nutritional assessment divided these genotypes into two distinctive groups, Eastern carrots and Western carrots. Caloric and moisture content had high positive associations with β-carotene content while carbohydrate content was negatively associated. Five genotypes (T-29, PI 634658, PI 288765, PI 164798, and Ames 25043) with the highest β-carotene contents were selected for making three nutraceutical supplements (carrot-orange juice, carrot jam and carrot candies). These nutraceutical supplements retained high β-carotene content coupled with antioxidant properties. Carrot jam (6.5 mg/100 g) and carrot candies (4.8 mg/100 g) had greater concentrations of β-carotene than carrot-orange juice (1.017 mg/100 g). Carrot jam presented high antioxidant activity with the highest values in T-29 (39% inhibition of oxidation) followed by PI 634658 (37%), PI 164798 (36.5%), Ames 25043 (36%) and PI 288765 (35.5%). These nutraceutical products, with 4–6.5 mg/100 g β-carotene content, had higher values than the USDA recommended dietary intake of 3–6 mg β-carotene/day can be recommended for daily use to lower the risk of chronic disease.
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Affiliation(s)
- Nadia Riaz
- Department of Botany, Lahore College for Women University, Lahore, Pakistan.,Department of Horticulture, University of Wisconsin-Madison, Madison, WI, United States
| | - Zubaida Yousaf
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Zarina Yasmin
- Post-Harvest Research Centre, Ayub Agricultural Research Institute, Faisalabad, Pakistan
| | - Muneeb Munawar
- Vegetable Research Institute, Ayub Agricultural Research Institute, Faisalabad, Pakistan
| | - Afifa Younas
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Madiha Rashid
- Department of Botany, Lahore College for Women University, Lahore, Pakistan.,Department of Botany, Division of Science and Technology, University of Education Lahore, Lahore, Pakistan
| | - Arusa Aftab
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Bushra Shamsheer
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Hamna Yasin
- Department of Botany, Lahore College for Women University, Lahore, Pakistan
| | - Muhammad Najeebullah
- Department of Botany, Division of Science and Technology, University of Education Lahore, Lahore, Pakistan
| | - Philipp W Simon
- Department of Horticulture, University of Wisconsin-Madison, Madison, WI, United States.,Vegetable Crops Research Unit, US Department of Agriculture-Agricultural Research Service, Madison, WI, United States
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6
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Opuntia genus in Human Health: A Comprehensive Summary on Its Pharmacological, Therapeutic and Preventive Properties. Part 1. HORTICULTURAE 2022. [DOI: 10.3390/horticulturae8020088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Opuntia spp. is a diverse and widely distributed genus in Africa, Asia, Australia, and America. Mexico has the largest number of wild species; mainly O. streptacantha, O. hyptiacantha, O. albicarpa, O. megacantha and O. ficus-indica. The latter being the most cultivated and domesticated species. Throughout history, plants and their phytochemicals have played an important role in health care and Opuntia spp. has shown a high nutritional, medicinal, pharmaceutical, and economic impacts. Its main bioactive compounds include pigments (carotenoids, betalains and betacyanins), vitamins, flavonoids (isorhamnetin, kaempferol, quercetin) and phenolic compounds. Together, they favor the different plant parts and are considered phytochemically important and associated with control, progression and prevention of some chronic and infectious diseases. This first review (Part 1), compiles information from published research (in vitro, in vivo, and clinical studies) on its preventive effects against atherosclerotic cardiovascular diseases, diabetes and obesity, hepatoprotection, effects on human infertility and chemopreventive and/or antigenotoxic capacity. The aim is to provide scientific evidences of its beneficial properties and to encourage health professionals and researchers to expand studies on the pharmacological and therapeutic effects of Opuntia spp.
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Robertson NU, Schoonees A, Brand A, Visser J. Pine bark (Pinus spp.) extract for treating chronic disorders. Cochrane Database Syst Rev 2020; 9:CD008294. [PMID: 32990945 PMCID: PMC8094515 DOI: 10.1002/14651858.cd008294.pub5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Pine bark (Pinus spp.) extract is rich in bioflavonoids, predominantly proanthocyanidins, which are antioxidants. Commercially-available extract supplements are marketed for preventing or treating various chronic conditions associated with oxidative stress. This is an update of a previously published review. OBJECTIVES To assess the efficacy and safety of pine bark extract supplements for treating chronic disorders. SEARCH METHODS We searched three databases and three trial registries; latest search: 30 September 2019. We contacted the manufacturers of pine bark extracts to identify additional studies and hand-searched bibliographies of included studies. SELECTION CRITERIA Randomised controlled trials (RCTs) evaluating pine bark extract supplements in adults or children with any chronic disorder. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted data and assessed risk of bias. Where possible, we pooled data in meta-analyses. We used GRADE to evaluate the certainty of evidence. Primary outcomes were participant- and investigator-reported clinical outcomes directly related to each disorder and all-cause mortality. We also assessed adverse events and biomarkers of oxidative stress. MAIN RESULTS This review included 27 RCTs (22 parallel and five cross-over designs; 1641 participants) evaluating pine bark extract supplements across 10 chronic disorders: asthma (two studies; 86 participants); attention deficit hyperactivity disorder (ADHD) (one study; 61 participants), cardiovascular disease (CVD) and risk factors (seven studies; 338 participants), chronic venous insufficiency (CVI) (two studies; 60 participants), diabetes mellitus (DM) (six studies; 339 participants), erectile dysfunction (three studies; 277 participants), female sexual dysfunction (one study; 83 participants), osteoarthritis (three studies; 293 participants), osteopenia (one study; 44 participants) and traumatic brain injury (one study; 60 participants). Two studies exclusively recruited children; the remainder recruited adults. Trials lasted between four weeks and six months. Placebo was the control in 24 studies. Overall risk of bias was low for four, high for one and unclear for 22 studies. In adults with asthma, we do not know whether pine bark extract increases change in forced expiratory volume in one second (FEV1) % predicted/forced vital capacity (FVC) (mean difference (MD) 7.70, 95% confidence interval (CI) 3.19 to 12.21; one study; 44 participants; very low-certainty evidence), increases change in FEV1 % predicted (MD 7.00, 95% CI 0.10 to 13.90; one study; 44 participants; very low-certainty evidence), improves asthma symptoms (risk ratio (RR) 1.85, 95% CI 1.32 to 2.58; one study; 60 participants; very low-certainty evidence) or increases the number of people able to stop using albuterol inhalers (RR 6.00, 95% CI 1.97 to 18.25; one study; 60 participants; very low-certainty evidence). In children with ADHD, we do not know whether pine bark extract decreases inattention and hyperactivity assessed by parent- and teacher-rating scales (narrative synthesis; one study; 57 participants; very low-certainty evidence) or increases the change in visual-motoric coordination and concentration (MD 3.37, 95% CI 2.41 to 4.33; one study; 57 participants; very low-certainty evidence). In participants with CVD, we do not know whether pine bark extract decreases diastolic blood pressure (MD -3.00 mm Hg, 95% CI -4.51 to -1.49; one study; 61 participants; very low-certainty evidence); increases HDL cholesterol (MD 0.05 mmol/L, 95% CI -0.01 to 0.11; one study; 61 participants; very low-certainty evidence) or decreases LDL cholesterol (MD -0.03 mmol/L, 95% CI -0.05 to 0.00; one study; 61 participants; very low-certainty evidence). In participants with CVI, we do not know whether pine bark extract decreases pain scores (MD -0.59, 95% CI -1.02 to -0.16; one study; 40 participants; very low-certainty evidence), increases the disappearance of pain (RR 25.0, 95% CI 1.58 to 395.48; one study; 40 participants; very low-certainty evidence) or increases physician-judged treatment efficacy (RR 4.75, 95% CI 1.97 to 11.48; 1 study; 40 participants; very low-certainty evidence). In type 2 DM, we do not know whether pine bark extract leads to a greater reduction in fasting blood glucose (MD 1.0 mmol/L, 95% CI 0.91 to 1.09; one study; 48 participants;very low-certainty evidence) or decreases HbA1c (MD -0.90 %, 95% CI -1.78 to -0.02; 1 study; 48 participants; very low-certainty evidence). In a mixed group of participants with type 1 and type 2 DM we do not know whether pine bark extract decreases HbA1c (MD -0.20 %, 95% CI -1.83 to 1.43; one study; 67 participants; very low-certainty evidence). In men with erectile dysfunction, we do not know whether pine bark extract supplements increase International Index of Erectile Function-5 scores (not pooled; two studies; 147 participants; very low-certainty evidence). In women with sexual dysfunction, we do not know whether pine bark extract increases satisfaction as measured by the Female Sexual Function Index (MD 5.10, 95% CI 3.49 to 6.71; one study; 75 participants; very low-certainty evidence) or leads to a greater reduction of pain scores (MD 4.30, 95% CI 2.69 to 5.91; one study; 75 participants; very low-certainty evidence). In adults with osteoarthritis of the knee, we do not know whether pine bark extract decreases composite Western Ontario and McMaster Universities Osteoarthritis Index scores (MD -730.00, 95% CI -1011.95 to -448.05; one study; 37 participants; very low-certainty evidence) or the use of non-steroidal anti-inflammatory medication (MD -18.30, 95% CI -25.14 to -11.46; one study; 35 participants; very low-certainty evidence). We do not know whether pine bark extract increases bone alkaline phosphatase in post-menopausal women with osteopenia (MD 1.16 ug/L, 95% CI -2.37 to 4.69; one study; 40 participants; very low-certainty evidence). In individuals with traumatic brain injury, we do not know whether pine bark extract decreases cognitive failure scores (MD -2.24, 95% CI -11.17 to 6.69; one study; 56 participants; very low-certainty evidence) or post-concussion symptoms (MD -0.76, 95% CI -5.39 to 3.87; one study; 56 participants; very low-certainty evidence). For most comparisons, studies did not report outcomes of hospital admissions or serious adverse events. AUTHORS' CONCLUSIONS Small sample sizes, limited numbers of RCTs per condition, variation in outcome measures, and poor reporting of the included RCTs mean no definitive conclusions regarding the efficacy or safety of pine bark extract supplements are possible.
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Affiliation(s)
- Nina U Robertson
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
| | - Anel Schoonees
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Amanda Brand
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Janicke Visser
- Division of Human Nutrition, Stellenbosch University, Cape Town, South Africa
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8
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Hannon BA, Fairfield WD, Adams B, Kyle T, Crow M, Thomas DM. Use and abuse of dietary supplements in persons with diabetes. Nutr Diabetes 2020; 10:14. [PMID: 32341338 PMCID: PMC7186221 DOI: 10.1038/s41387-020-0117-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/02/2020] [Accepted: 03/05/2020] [Indexed: 12/12/2022] Open
Abstract
The dietary supplement industry has estimated sales of over $30 billion in the US and over $100 billion globally. Many consumers believe that dietary supplements are safer and possibly more effective than drugs to treat diabetes. The sheer volume of the literature in this space makes compiling them into one review challenging, so much so that primarily narrative reviews currently exist. By applying the interactive database supplied by the Office of Dietary Supplements at the National Institutes of Health, we identified the top 100 ingredients that appeared most often in dietary supplement products. One-hundred different keyword searches using the ingredient name and the word diabetes were performed using a program developed to automatically scrape PubMed. Each search was retained in a separate Excel spreadsheet, which was then reviewed for inclusion or exclusion. The studies that met the inclusion criteria were evaluated for effect of reducing and controlling diabetes. The PubMed scrape resulted in 6217 studies. For each keyword search only the most recent 100 were retained, which refined the total to 1823 studies. Of these 425 met the screening criteria. The ingredients, fiber, selenium and zinc had the most studies associated with improvement in diabetes. Several popular supplement ingredients (phosphorus, pantothenic acid, calcium, magnesium, glutamine, isoleucine, tyrosine, choline, and creatine monohydrate) did not result in any studies meeting our screening criteria. Our study demonstrates how to automate reviews to filter and collapse literature in content areas that have an enormous volume of studies. The aggregated set of studies suggest there is little clinical evidence for the use of dietary supplements to reduce or control diabetes.
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Affiliation(s)
- Bridget A Hannon
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - William D Fairfield
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Bryan Adams
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Theodore Kyle
- ConscienHealth, Country Club Dr, Pittsburgh, PA, USA
| | - Mason Crow
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA
| | - Diana M Thomas
- Department of Mathematical Sciences, United States Military Academy, West Point, NY, USA.
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9
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Dietary antioxidative supplements and diabetic retinopathy; a systematic review. J Diabetes Metab Disord 2019; 18:705-716. [PMID: 31890694 DOI: 10.1007/s40200-019-00434-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022]
Abstract
Purpose There is controversial data regarding the effects of dietary antioxidative supplements on diabetic retinopathy (DR). We conducted a systematic review of both observational and randomized controlled clinical trials (RCTs) to clarify whether they are effective or not. Methods All observational and RCTs conducted by antioxidative supplements on DR published up to 1 January 2018 in PubMed, Web of Sciences, Scopus and Cochrane Library databases were included. Exclusion criteria were animal studies, and studies conducted in Type 1 diabetes mellitus (T1DM), children or pregnant women. Main outcome measures were reporting the incidence or progression of DR in T2DM by assessment of visual fields, and measurements of oxidative and antioxidative biomarkers. The quality of reporting of included articles and risk of bias were assessed. Results Finally, we reached 14 observational studies and 7 RCTs that conducted on 256,259 subjects. Due to severe methodological heterogeneity, only qualitative synthesis was carried. All studies were reported a significantly lower level of antioxidants and higher level of oxidative stress biomarkers in DR compared with others. There was an inverse significant correlation between vitamin C and malondialdehyde (MDA) (r = -0.81) or DNA damage (r = -0.41). These figures were statistically significant between vitamin E and MDA (r = 0.77) or superoxide dismutase (r = 0.44). Coefficient of correlation between MDA and zinc (-0.82), coenzyme Q10 (0.56), and magnesium (-0.73) was significant. Multi-oxidants trials were shown non-significant beneficial effects on DR. Conclusions Although our study supports the positive effects of antioxidative supplements on DR, more high quality studies are needed to confirm.
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Stróżyk A, Osica Z, Przybylak JD, Kołodziej M, Zalewski BM, Mrozikiewicz-Rakowska B, Szajewska H. Effectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials. J Hum Nutr Diet 2019; 32:635-645. [PMID: 31148299 DOI: 10.1111/jhn.12670] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The role of selenium (Se) in the management of type 2 diabetes mellitus (T2DM) remains unclear. We systematically assessed the effectiveness and safety of Se supplementation in adults with T2DM. METHODS MEDLINE, EMBASE and the Cochrane Library were searched up to April 2018 for randomised controlled trials (RCTs) evaluating the effectiveness of Se against a comparator on DM-related outcomes. RESULTS Four RCTs (241 participants) were included. In individual RCTs, Se supplementation significantly reduced fasting insulin levels [mean difference (MD) = -3.6 μIU mL-1 ; 95% confidence interval (CI) = -6.36 to -0.84; MD = -5.8 μIU mL-1 ; 95% CI = -9.23 to -2.37], homeostasis model of assessment-estimated insulin resistance (HOMA-IR) (MD = -1; 95% CI = -1.79 to -0.21; MD = -1.6; 95% CI, -2.58 to -0.62) and homeostasis model of assessment-estimated B cell function (HOMA-B) (MD = -13.6; 95% CI = -23.4 to -3.8; MD = -22.6; 95% CI = -36.39 to -8.81). No effects of Se were noted on most of the other outcomes of interest. None of the RCTs assessed the mortality, diabetes-related complications, non-high-density lipoprotein (non-HDL), blood pressure and health-related quality of life. The impact on HDL and fasting plasma glucose (FPG) was ambiguous. Only one adverse event (nausea) was reported as a reason for discontinuing the intervention; however, among the studies, the reporting was not accurate. Furthermore, only one RCT reported increase in FPG level in the Se group (MD = 36.38 mg dL-1 ; 95% CI = 15.39-57.37). CONCLUSIONS Currently, there is no evidence to support the effectiveness of Se supplementation in the T2DM population.
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Affiliation(s)
- A Stróżyk
- Medical University of Warsaw, Warsaw, Poland
| | - Z Osica
- Medical University of Warsaw, Warsaw, Poland
| | | | - M Kołodziej
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - B M Zalewski
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
| | - B Mrozikiewicz-Rakowska
- Department of Diabetology and Internal Diseases, Medical University of Warsaw, Warsaw, Poland
| | - H Szajewska
- Department of Paediatrics, Medical University of Warsaw, Warsaw, Poland
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12
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Amiri Siavashani M, Zadeh Modarres S, Mirhosseini N, Aghadavod E, Salehpour S, Asemi Z. The Effects of Chromium Supplementation on Gene Expression of Insulin, Lipid, and Inflammatory Markers in Infertile Women With Polycystic Ovary Syndrome Candidate for in vitro Fertilization: A Randomized, Double-Blinded, Placebo-Controlled Trial. Front Endocrinol (Lausanne) 2018; 9:726. [PMID: 30546347 PMCID: PMC6279845 DOI: 10.3389/fendo.2018.00726] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 11/15/2018] [Indexed: 12/04/2022] Open
Abstract
Purpose: This study was performed to determine the effects of chromium supplementation on the gene expression of insulin, lipid, and inflammatory markers in infertile women with polycystic ovary syndrome (PCOS) who were candidate for in vitro fertilization (IVF). Methods: Forty women, aged 18-40 years, who had been selected for IVF were recruited in this randomized double-blinded, placebo-controlled trial. They (n = 20/group) were randomly assigned into intervention groups to take either 200 μg/day of chromium or placebo for 8 weeks. Inflammatory markers were measured at baseline and end of the trial. Genes related to insulin, lipid, and inflammation were expressed in peripheral blood mononuclear cells (PBMCs), using RT-PCR method. Results: Chromium supplementation led to a significant reduction in serum high sensitivity C-reactive protein (hs-CRP) (-1.4 ± 1.5 vs. + 0.2 ± 2.2 mg/L, p = 0.01) compared with the placebo. RT-PCR findings indicated that chromium supplementation upregulated gene expression of peroxisome proliferator-activated receptor gamma (PPAR-γ) (p = 0.01), glucose transporter 1 (GLUT-1) (p = 0.001) and low-density lipoprotein receptor (LDLR) (p = 0.01), as well as downregulated gene expression of interleukin-1 (IL-1) (p = 0.004) in PBMCs of patients with PCOS compared with the placebo. Chromium supplementation had no significant effect on gene expression of IL-8, tumor necrosis factor alpha (TNF-α), transforming growth factor beta (TGF-β) and vascular endothelial growth factor (VEGF). Conclusion: Overall, our findings demonstrated that infertile women with PCOS, who were candidate for IVF benefited from chromium supplementation for 8 weeks in terms of lowering hs-CRP and improving gene expression of PPAR-γ, GLUT-1, LDLR, and IL-1, though chromium had no effect on the gene expression of IL-8, TNF-α, TGF-β, and VEGF. Clinical Trial Registration Number: http://www.irct.ir:IRCT20170513033941N32.
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Affiliation(s)
- Mehrnush Amiri Siavashani
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahrzad Zadeh Modarres
- Laser Application in Medical Science Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- *Correspondence: Shahrzad Zadeh Modarres
| | | | - Esmat Aghadavod
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Saghar Salehpour
- Preventative Gynecology Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zatollah Asemi
- Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
- Zatollah Asemi
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van Ommen B, van den Broek T, de Hoogh I, van Erk M, van Someren E, Rouhani-Rankouhi T, Anthony JC, Hogenelst K, Pasman W, Boorsma A, Wopereis S. Systems biology of personalized nutrition. Nutr Rev 2017; 75:579-599. [PMID: 28969366 PMCID: PMC5914356 DOI: 10.1093/nutrit/nux029] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Personalized nutrition is fast becoming a reality due to a number of technological, scientific, and societal developments that complement and extend current public health nutrition recommendations. Personalized nutrition tailors dietary recommendations to specific biological requirements on the basis of a person's health status and goals. The biology underpinning these recommendations is complex, and thus any recommendations must account for multiple biological processes and subprocesses occurring in various tissues and must be formed with an appreciation for how these processes interact with dietary nutrients and environmental factors. Therefore, a systems biology-based approach that considers the most relevant interacting biological mechanisms is necessary to formulate the best recommendations to help people meet their wellness goals. Here, the concept of "systems flexibility" is introduced to personalized nutrition biology. Systems flexibility allows the real-time evaluation of metabolism and other processes that maintain homeostasis following an environmental challenge, thereby enabling the formulation of personalized recommendations. Examples in the area of macro- and micronutrients are reviewed. Genetic variations and performance goals are integrated into this systems approach to provide a strategy for a balanced evaluation and an introduction to personalized nutrition. Finally, modeling approaches that combine personalized diagnosis and nutritional intervention into practice are reviewed.
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Affiliation(s)
- Ben van Ommen
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Tim van den Broek
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Iris de Hoogh
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Marjan van Erk
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Eugene van Someren
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Tanja Rouhani-Rankouhi
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | | | - Koen Hogenelst
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Wilrike Pasman
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - André Boorsma
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
| | - Suzan Wopereis
- TNO (The Netherlands Organization for Applied Scientific Research), Zeist, the Netherlands
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Fan W, Wang W, Zhang L, Qi L, Liu A. Study on changes and mechanisms of cytokines for alloxan-induced hepatic injury by Cr3+-treatment in mice. Mol Cell Toxicol 2016. [DOI: 10.1007/s13273-016-0025-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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15
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Lee YM, Wolf P, Hauner H, Skurk T. Effect of a fermented dietary supplement containing chromium and zinc on metabolic control in patients with type 2 diabetes: a randomized, placebo-controlled, double-blind cross-over study. Food Nutr Res 2016; 60:30298. [PMID: 27343205 PMCID: PMC4920940 DOI: 10.3402/fnr.v60.30298] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 05/23/2016] [Accepted: 05/23/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND For the increasing development of type 2 diabetes dietary habits play an important role. In this regard, dietary supplements are of growing interest to influence the progression of this disease. OBJECTIVE The aim of this study was to investigate the effect of a cascade-fermented dietary supplement based on fruits, nuts, and vegetables fortified with chromium and zinc on metabolic control in patients with type 2 diabetes mellitus. METHODS This was a randomized, placebo-controlled, double-blind, intervention study under free-living conditions using a cross-over design. Thirty-six patients with type 2 diabetes mellitus were enrolled and randomized either to receive a cascade-fermented dietary supplement enriched with chromium (100 µg/d) and zinc (15 mg/d) or a placebo similar in taste but without supplements, over a period of 12 weeks. After a wash-out period of 12 weeks, the patients received the other test product. The main outcome variable was the levels of glycated hemoglobin (HbA1c). Other outcome variables were fasting blood glucose, fructosamine, and lipid parameters. RESULTS Thirty-one patients completed the study. HbA1c showed no relevant changes during both treatment periods, nor was there a relevant difference between the two treatments (HbA1c: p=0.48). The same results were found for fructosamine and fasting glucose (fructosamine: p=0.9; fasting glucose: p=0.31). In addition, there was no effect on lipid metabolism. CONCLUSION This intervention study does not provide evidence that a cascade-fermented plant-based dietary supplement enriched with a combination of chromium and zinc improves glucose metabolism in patients with type 2 diabetes mellitus under free-living conditions.
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Affiliation(s)
- Yu-Mi Lee
- ZIEL Institute for Food and Health, Clinical Nutritional Medicine, Technical University of Munich, Munich, Germany;
| | - Petra Wolf
- Institute for Medical Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Hans Hauner
- ZIEL Institute for Food and Health, Clinical Nutritional Medicine, Technical University of Munich, Munich, Germany.,Institute of Nutritional Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Skurk
- ZIEL Institute for Food and Health, Clinical Nutritional Medicine, Technical University of Munich, Munich, Germany.,ZIEL Institute for Food and Health, Core Facility Human Studies, Technical University of Munich, Munich, Germany
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Rodríguez-Carrizalez AD, Castellanos-González JA, Martínez-Romero EC, Miller-Arrevillaga G, Román-Pintos LM, Pacheco-Moisés FP, Miranda-Díaz AG. The antioxidant effect of ubiquinone and combined therapy on mitochondrial function in blood cells in non-proliferative diabetic retinopathy: A randomized, double-blind, phase IIa, placebo-controlled study. Redox Rep 2016. [PMID: 26207797 PMCID: PMC8900708 DOI: 10.1179/1351000215y.0000000032] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Objectives: To evaluate the effect of ubiquinone and combined antioxidant therapy on mitochondrial function in non-proliferative diabetic retinopathy (NPDR) in a randomized, double-blind, phase IIa, placebo-controlled, clinical trial. Three groups of 20 patients were formed: Group 1, ubiquinone; Group 2, combined therapy; and Group 3, placebo (one daily dose for 6 months). Methods: Fluidity of the submitochondrial membrane in platelets was determined by examining intensity of fluorescence between the monomer (Im) and excimer (Ie). Hydrolytic activity of the mitochondrial F0F1-ATPase was evaluated with the spectrophotometric method. Results: Normal, baseline submitochondrial membrane fluidity, 0.24 ± 0.01 Ie/Im, was significantly diminished in the three study groups vs. normal values (P < 0.0001); placebo, 0.14 ± 0.01 Ie/Im; ubiquinone, 0.14 ± 0.01 Ie/Im; and combined therapy, 0.13 ± 0.00 Ie/Im. Afterward, it increased significantly (P < 0.0001), the ubiquinone group 0.22 ± 0.01 Ie/Im, combined therapy group, 0.19 ± 0.01 Ie/Im; with no changes the placebo group. Baseline hydrolytic activity of the F0F1-ATPase enzyme increased in the three study groups vs. normal values (184.50 ± 7.84 nmol PO4), placebo, 304.12 ± 22.83 nmol PO4 (P < 0.002); ubiquinone, 312.41 ± 25.63 nmol PO4 (P < 0.009); and combined therapy, 371.28 ± 33.50 nmol PO4 (P < 0.002). Afterward, a significant decrease the enzymatic activity: ubiquinone, 213.25 ± 14.19 nmol PO4 (P < 0.001); and combined therapy, 225.55 ± 14.48 nmol PO4 (P < 0.0001). Discussion: Mitochondrial dysfunction significantly improved in groups of NPDR patients treated with antioxidants.
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Affiliation(s)
- Adolfo Daniel Rodríguez-Carrizalez
- University Health Sciences Center, University of Guadalajara (Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara), Guadalajara, Jalisco, México
| | - José Alberto Castellanos-González
- Specialties Hospital of the National Occidental Medical Centre, Mexican Social Security Institute (Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social), Guadalajara, Jalisco, México
| | - Esaú César Martínez-Romero
- Specialties Hospital of the National Occidental Medical Centre, Mexican Social Security Institute (Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social), Guadalajara, Jalisco, México
| | - Guillermo Miller-Arrevillaga
- Specialties Hospital of the National Occidental Medical Centre, Mexican Social Security Institute (Hospital de Especialidades del Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social), Guadalajara, Jalisco, México
| | - Luis Miguel Román-Pintos
- University Health Sciences Center, University of Guadalajara (Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara), Guadalajara, Jalisco, México
| | - Fermín Paul Pacheco-Moisés
- University Centre for Exact and Engineering Sciences, University of Guadalajara (Centro Universitario de Ciencias Exactas e Ingeniería, Universidad de Guadalajara), Guadalajara, Jalisco, México
| | - Alejandra Guillermina Miranda-Díaz
- University Health Sciences Center, University of Guadalajara (Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara), Guadalajara, Jalisco, México
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Lugo-Radillo A, Amezcua-Portillo A, Valdovinos-Ruiz DE, Perez-Chavira CJ. The consumption of a diet abundant in vegetables and fruits or the performance of non-exhaustive exercise do not protect against diabetic retinopathy: a study in a Mexican population. Int J Diabetes Dev Ctries 2015. [DOI: 10.1007/s13410-015-0360-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Khodaeian M, Tabatabaei-Malazy O, Qorbani M, Farzadfar F, Amini P, Larijani B. Effect of vitamins C and E on insulin resistance in diabetes: a meta-analysis study. Eur J Clin Invest 2015; 45:1161-74. [PMID: 26313310 DOI: 10.1111/eci.12534] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2015] [Accepted: 08/24/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Data regarding the effect of vitamin C (VC) and vitamin E (VE) supplementation on insulin resistance in type 2 diabetes mellitus (T2DM) are controversial. We aimed to systematically review the current data on this topic. MATERIALS AND METHODS All randomized controlled trials (RCTs) conducted to assess the effect of VC and/or VE on insulin resistance in diabetes published in Google Scholar and PubMed web databases until January 2014 were included. Exclusion criteria were studies conducted in animal, type 1 DM, children or pregnant women. Main outcome measure was insulin resistance by homoeostasis model assessment (HOMA) index. According to degree of heterogeneity, fixed- or random-effect model was employed by stata software (11.0). RESULTS We selected 14 RCTs involving 735 patients with T2DM. VE or mixture-mode supplementation did not have any significant effect on HOMA with a standardized mean difference (SMD): 0·017, 95% CI: -0·376 to 0·411 (P = 0·932); and SMD: -0·035, 95% CI: -0·634 to 0·025 (P = 0·070), respectively, by random-effect model. VC supplement alone did not improve insulin resistance with a SMD: -0·150, 95% CI: -0·494 to 0·194 (P = 0·391), by fixed-effect model. Meta-regression test demonstrated that HOMA index may have not been influenced by the year of publication, dosage or duration of treatment. CONCLUSIONS The sole intake of VC, VE or their combination with other antioxidants could not improve insulin resistance in diabetes.
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Affiliation(s)
- Mehrnoosh Khodaeian
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ozra Tabatabaei-Malazy
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Qorbani
- Department of Community Medicine, School of Medicine, Alborz University of Medical Sciences, Karaj, Iran.,Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran university of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran university of Medical Sciences, Tehran, Iran
| | - Peyvand Amini
- Department of Physiology and Biophysics, Case Western Reserve University, Cleveland, OH, USA
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Smith JD, Clinard VB. Natural products for the management of type 2 diabetes mellitus and comorbid conditions. J Am Pharm Assoc (2003) 2015; 54:e304-18; quiz e319-21. [PMID: 25107389 DOI: 10.1331/japha.2014.14537] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To provide pharmacists with practical information to guide consumers in their choices of herbal products and dietary supplements for the management of type 2 diabetes mellitus (T2DM) and its comorbid disease states. SUMMARY The herbal and dietary supplement market has grown exponentially over the past decade as Americans increasingly use such agents for generalized health and the prevention and treatment of chronic disease states.1 Pharmacist advice is often requested on the use of these agents for the management of T2DM; however, this is an area that has insufficient evidence to support confident recommendations. Many published studies involving herbal agents and dietary supplements are small and poorly designed, with heterogeneous results. Pharmacists should be aware of the safety and efficacy data available for these agents, recognize potential drug interactions, and identify acceptable manufactured products. CONCLUSION The strongest scientific evidence for blood glucose lowering effect is associated with alpha-lipoic acid and fenugreek. There is also good evidence supporting the use of ivy gourd, gymnema, and vitamin E for management of hyperglycemia; however, caution should be used when recommending vitamin E. Pharmacists should advise consumers to disclose use of any of these products to all of their health care providers.
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Abstract
One of the major complications in patients with diabetes is diabetic retinopathy (DR), a leading cause of blindness worldwide. It causes visual impairment and finally blindness, a result of long-term accumulated damage to the small blood vessels in the retina. It takes several years before any clinical symptoms of retinopathy appear in diabetic patients. Consequently, glycemic control, blood pressure and lipid-lowering therapy have all shown benefits in reducing the incidence and progression of DR. A number of hyperglycemia-induced metabolic stresses have been implicated in the pathophysiology of DR. The microvasculature of the retina responds to hyperglycemia through a number of biochemical changes, including the activation of protein kinase C (PKC), increased advanced glycation end-products (AGEs) formation, polyol pathway and oxidative stress. There is an accumulating body of evidence indicating that inflammation and neurodegeneration play an important role in the pathogenesis of DR.
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Affiliation(s)
- Haseeb Ahsan
- Department of Biochemistry, Faculty of Dentistry, Jamia Millia Islamia, Okhla, New Delhi 110025, India.
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Soare A, Del Toro R, Roncella E, Khazrai YM, Angeletti S, Dugo L, Fallucca S, Fontana L, Altomare M, Formisano V, Capata F, Gesuita R, Manfrini S, Fallucca F, Pianesi M, Pozzilli P. The effect of macrobiotic Ma-Pi 2 diet on systemic inflammation in patients with type 2 diabetes: a post hoc analysis of the MADIAB trial. BMJ Open Diabetes Res Care 2015; 3:e000079. [PMID: 25852946 PMCID: PMC4379741 DOI: 10.1136/bmjdrc-2014-000079] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/08/2015] [Accepted: 03/11/2015] [Indexed: 01/30/2023] Open
Abstract
INTRODUCTION Current guidelines for the management of type 2 diabetes (T2D) emphasize diet as essential therapy. However, the effect of diet on systemic inflammation remains unclear. We investigated the effects of consuming a macrobiotic Ma-Pi 2 diet versus a standard recommended diet (control diet) on markers of inflammation in patients with T2D. METHODS This was a post hoc analysis of the MADIAB trial, a 21-day randomized controlled trial conducted in 51 patients (25 males and 26 females) with T2D. Patients were randomized 1:1 to the Ma-Pi 2 macrobiotic diet or a control diet based on dietary guidelines for T2D. Biological antioxidant potential of plasma and circulating levels of high-sensitivity C reactive protein, interleukin-6, tumor necrosis factor-α, and insulin-like growth factor-1 were assessed. RESULTS After 21 days on the Ma-Pi 2 or control diet, markers of inflammation were reduced in both groups. The antioxidant potential of plasma improved significantly in the Ma-Pi group. A significant reduction in insulin growth factor-1 was observed in the Ma-Pi group versus control group (p<0.001). CONCLUSIONS Findings of this post hoc analysis demonstrated that the Ma-Pi 2 diet is a safe dietary strategy to reduce levels of the markers of insulin resistance and inflammation, compared with baseline values, in the short term. Furthermore, the Ma-Pi 2 diet was superior to the control diet in reducing insulin growth factor-1 and may be beneficial for patients with T2D. TRIAL REGISTRATION NUMBER Current Controlled Trials ISRCTN10467793.
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Affiliation(s)
- Andreea Soare
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Rossella Del Toro
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Elena Roncella
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Yeganeh Manon Khazrai
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Silvia Angeletti
- Laboratory Medicine, University Campus Bio-Medico of Rome, Rome, Italy
| | - Laura Dugo
- Center of Integrated Research, University Campus Bio-Medico of Rome, Rome, Italy
| | - Sara Fallucca
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Lucia Fontana
- Unit of Dietology and Diabetology, Sandro Pertini Hospital, Rome, Italy
| | - Maria Altomare
- Unit of Dietology and Diabetology, Sandro Pertini Hospital, Rome, Italy
| | - Valeria Formisano
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Francesca Capata
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | - Rosaria Gesuita
- Center of Epidemiology, Biostatistics and Medical Information Technology, Polytechnic Marche University, Ancona, Italy
| | - Silvia Manfrini
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| | | | - Mario Pianesi
- International Study Center for Environment, Agriculture, Food, Health and Economics, Tolentino, Italy
| | - Paolo Pozzilli
- Area of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
- Centre of Diabetes, St. Bartholomew's and The London School of Medicine, Queen Mary University of London, London, UK
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A Randomized, Placebo-Controlled Trial of Selenium Supplementation in Patients With Type 2 Diabetes. Am J Ther 2014; 21:491-5. [DOI: 10.1097/mjt.0b013e318269175f] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Lou J, Hu W, Tian R, Zhang H, Jia Y, Zhang J, Zhang L. Optimization and evaluation of a thermoresponsive ophthalmic in situ gel containing curcumin-loaded albumin nanoparticles. Int J Nanomedicine 2014; 9:2517-25. [PMID: 24904211 PMCID: PMC4039420 DOI: 10.2147/ijn.s60270] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
This study aimed to optimize and evaluate a thermoresponsive ophthalmic in situ gel containing curcumin-loaded albumin nanoparticles (Cur-BSA-NPs-Gel). Albumin nanoparticles were prepared via a desolvation method, and the gels were prepared via a cold method. The central composite design and response surface method was used to evaluate the effects of varying Pluronic® F127 and Pluronic® F68 concentrations on the sol–gel transition temperature, which is an indicator of optimum formulations. The optimized formulation was a free-flowing liquid below 30.9°C that transformed into a semi-solid gel above 34.2°C after dilution with simulated tear fluid. Results of the in vitro release and erosion behavior study indicated that Cur-BSA-NPs-Gel achieved superior sustained-release effects and that incorporation of albumin nanoparticles exerted minimal effects on the gel structure. In addition, in vivo ophthalmic experiments employing Cur-BSA-NPs-Gel were subsequently performed in rabbits. In vivo eye irritation results showed that Cur-BSA-NPs-Gel might be considered safe for ophthalmic drug delivery. The in vivo study also revealed that the formulation could significantly increase curcumin bioavailability in the aqueous humor. In conclusion, the optimized in situ gel formulation developed in this work has significant potential for ocular application.
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Affiliation(s)
- Jie Lou
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing, People's Republic of China
| | - Wenjing Hu
- Chongqing Xijiao Hospital, Chongqing, People's Republic of China
| | - Rui Tian
- The Experimental Teaching Centre, Chongqing Medical University, Chongqing, People's Republic of China
| | - Hua Zhang
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing, People's Republic of China
| | - Yuntao Jia
- Department of Pharmacy, Children's Hospital of Chongqing Medical University, Chongqing, People's Republic of China
| | - Jingqing Zhang
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing, People's Republic of China
| | - Liangke Zhang
- Chongqing Key Laboratory of Biochemistry and Molecular Pharmacology, School of Pharmacy, Chongqing Medical University, Chongqing, People's Republic of China
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Bang CY, Choung SY. Enzogenol improves diabetes-related metabolic change in C57BL/KsJ-db/db mice, a model of type 2 diabetes mellitus. J Pharm Pharmacol 2014; 66:875-85. [DOI: 10.1111/jphp.12211] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 12/07/2013] [Indexed: 01/09/2023]
Abstract
Abstract
Objectives
Dietary use of pine bark extract has been associated with reduced risk of inflammation and diabetes. In this study, we investigated the antidiabetic effects of enzogenol, proanthocyanidins-rich bioflavonoid extract derived from the pine bark of New Zealand Pinus radiata trees, using C57BL/KsJ-db/db mice.
Methods
After 1-week acclimation period, the db/db mice were divided into vehicle-treated, Enzogenol-treated (12.5, 25 and 50 mg/kg; EZ) and positive control (tea polyphenol 50 mg/kg; TPP) groups.
Key findings
The administration of EZ improved the glucose tolerance and lowered the glycosylated haemoglobin (HbA1C), insulin and glucagon levels in blood. Interestingly, EZ and TPP treatments resulted in reduced hepatic free fatty acid, cholesterol and triglyceride levels in db/db mice. EZ and TPP treatments significantly elevated hepatic AMPK activity, and the expression of proteins related to glucose homeostasis and lipid metabolism, such as glucokinase, peroxisome proliferator-activated receptor (PPAR)α and long-chain acyl-CoA dehydrogenase protein level with a simultaneous reduction of glucose-6-phosphatase and phosphoenolpyruvate carboxykinase protein expression. In addition, the EZ administration groups had an increased hepatic glycogen synthase expression in db/db mice.
Conclusions
These results suggest that EZ may be beneficial in improving insulin resistance and hyperglycaemia in type 2 diabetic mice by enhancing the glucose and lipids metabolism.
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Affiliation(s)
- Chae-Young Bang
- Department of Preventive Pharmacy and Toxicology, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea
| | - Se-Young Choung
- Department of Preventive Pharmacy and Toxicology, College of Pharmacy, Kyung Hee University, Seoul, Republic of Korea
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25
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da Silva Dias JC. Nutritional and Health Benefits of Carrots and Their Seed Extracts. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/fns.2014.522227] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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26
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Ruz M, Carrasco F, Rojas P, Codoceo J, Inostroza J, Basfi-fer K, Valencia A, Vásquez K, Galgani J, Pérez A, López G, Arredondo M, Perez-Bravo F. Zinc as a potential coadjuvant in therapy for type 2 diabetes. Food Nutr Bull 2013; 34:215-21. [PMID: 23964394 DOI: 10.1177/156482651303400210] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Type 2 diabetes is highly prevalent in populations having high rates of overweight and obesity. It is a chronic condition responsible for long-term severe dysfunction of several organs, including the kidneys, heart, blood vessels, and eyes. Although there are a number of pharmacologic products in the market to treat insulin resistance and impaired insulin secretion--the most prominent features of this disease--interventions directed at preserving the integrity and function of beta-cells in the long term are less available. The use of some nutrients with important cellular protective roles that may lead to a preservation of beta-cells has not been fully tested; among these, zinc may be an interesting candidate. OBJECTIVE To assess the potential of zinc supplementation as coadjuvant to diabetes therapy. METHODS This article reviews the available information on the use of zinc as part of diabetes therapy. RESULTS Cellular and animal models provide information on the insulin mimetic action of zinc, as well as its role as a regulator of oxidative stress, inflammation, apoptosis, and insulin secretion. Zinc supplementation studies in humans are limited, although some positive effects have been reported; mainly, a modest but significant reduction in fasting glucose and a trend to decreased glycated hemoglobin (HbA1c). CONCLUSIONS Zinc supplementation may have beneficial effects on glycemic control. Nevertheless, among the studies considered, the vast majority lasted for 6 months or less, suggesting the importance of conducting long-duration studies given the characteristics of type 2 diabetes as a chronic disease.
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Affiliation(s)
- Manuel Ruz
- Department of Nutrition, Faculty of Medicine, University of Chile, Independencia 1027, Correo 7, Santiago, Chile.
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Covolo L, Capelli M, Ceretti E, Feretti D, Caimi L, Gelatti U. Nutritional supplements for diabetes sold on the internet: business or health promotion? BMC Public Health 2013; 13:777. [PMID: 23978193 PMCID: PMC3766237 DOI: 10.1186/1471-2458-13-777] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2013] [Accepted: 08/02/2013] [Indexed: 12/12/2022] Open
Abstract
Background Diabetes is one of the most widespread chronic disease. Although many medications are available for the treatment and prevention of diabetes, many people turn to nutritional supplements (NSs). In these years, the online sales have contributed to the growth of use of nutritional supplement. The aim of the research was to investigate the type of information provided by sales websites on NSs, and analyse the existence of scientific evidence about some of the most common ingredients found in available NSs for diabetes. Methods A web search was conducted in April 2012 to identify web sites selling NSs in the treatment of diabetes using Google, Yahoo and Bing! and the key word used was “diabetes nutritional supplements”. Website content was evaluated for the quality of information available to consumers and for the presence of a complete list of ingredients in the first NS suggested by the site. Subsequently, in order to analyze the scientific evidence on the efficacy of these supplements a PubMed search was carried out on the ingredients that were shared in at least 3 nutritional supplements. Results A total of 10 websites selling NSs were selected. Only half of the websites had a Food and Drug Administration disclaimer and 40% declared clearly that the NS offered was not a substitute for proper medication. A total of 10 NS ingredients were searched for on PubMed. Systematic reviews, meta-analyses or randomized control trials were present for all the ingredients except one. Most of the studies, however, were of poor quality and/or the results were conflicting. Conclusions Easy internet access to NSs lacking in adequate medical information and strong scientific evidence is a matter of public health concern, mainly considering that a misleading information could lead to an improper prevention both in healthy people and people suffering from diabetes. There is a clear need for more trials to assess the efficacy and safety of these NSs, better quality control of websites, more informed physicians and greater public awareness of these widely used products.
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Affiliation(s)
- Loredana Covolo
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
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Abstract
The biochemical perturbations in diabetes mellitus (DM) create the conditions for the production of free radicals, the consequence of which is increased oxidative stress. Evidence has accrued over the past 2 decades that suggests that oxidative stress is an important pathogenetic factor in the development of diabetic retinopathy (DR). Experimental data show that the use of strategies that ameliorate oxidative stress can prevent and retard the development of DR in the animal model. Clinical observations also suggest that reducing oxidative stress may help to reverse pathological manifestations of DR. The present article constitutes an examination of the role of antioxidants in the management of DR and the current state of clinically relevant knowledge.
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Affiliation(s)
- Michael Williams
- Medical Ophthalmology, Department of Ophthalmology, Royal Victoria Hospital, Belfast Health and Social Care Trust, Belfast, BT12 6BA, Northern Ireland, UK
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29
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Fan W, Chen K, Zheng G, Wang W, Teng A, Liu A, Ming D, Yan P. Role of liver fatty acid binding protein in hepatocellular injury: Effect of CrPic treatment. J Inorg Biochem 2013; 124:46-53. [DOI: 10.1016/j.jinorgbio.2013.03.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2012] [Revised: 03/21/2013] [Accepted: 03/22/2013] [Indexed: 01/02/2023]
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Nebbioso M, Pranno F, Pescosolido N. Lipoic acid in animal models and clinical use in diabetic retinopathy. Expert Opin Pharmacother 2013; 14:1829-38. [DOI: 10.1517/14656566.2013.813483] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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31
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Belobrajdic DP, Bird AR. The potential role of phytochemicals in wholegrain cereals for the prevention of type-2 diabetes. Nutr J 2013; 12:62. [PMID: 23679924 PMCID: PMC3658901 DOI: 10.1186/1475-2891-12-62] [Citation(s) in RCA: 106] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 04/24/2013] [Indexed: 01/18/2023] Open
Abstract
Diets high in wholegrains are associated with a 20-30% reduction in risk of developing type-2 diabetes (T2D), which is attributed to a variety of wholegrain components, notably dietary fibre, vitamins, minerals and phytochemicals. Most phytochemicals function as antioxidants in vitro and have the potential to mitigate oxidative stress and inflammation which are implicated in the pathogenesis of T2D. In this review we compare the content and bioavailability of phytochemicals in wheat, barley, rice, rye and oat varieties and critically evaluate the evidence for wholegrain cereals and cereal fractions increasing plasma phytochemical concentrations and reducing oxidative stress and inflammation in humans. Phytochemical content varies considerably within and among the major cereal varieties. Differences in genetics and agro-climatic conditions explain much of the variation. For a number of the major phytochemicals, such as phenolics and flavanoids, their content in grains may be high but because these compounds are tightly bound to the cell wall matrix, their bioavailability is often limited. Clinical trials show that postprandial plasma phenolic concentrations are increased after consumption of wholegrain wheat or wheat bran however the magnitude of the response is usually modest and transient. Whether this is sufficient to bolster antioxidant defences and translates into improved health outcomes is still uncertain. Increased phytochemical bioavailability may be achieved through bio-processing of grains but the improvements so far are small and have not yet led to changes in clinical or physiological markers associated with reduced risk of T2D. Furthermore, the effect of wholegrain cereals and cereal fractions on biomarkers of oxidative stress or strengthening antioxidant defence in healthy individuals is generally small or nonexistent, whereas biomarkers of systemic inflammation tend to be reduced in people consuming high intakes of wholegrains. Future dietary intervention studies seeking to establish a direct role of phytochemicals in mediating the metabolic health benefits of wholegrains, and their potential for mitigating disease progression, should consider using varieties that deliver the highest possible levels of bioavailable phytochemicals in the context of whole foods and diets. Both postprandial and prolonged responses in systemic phytochemical concentrations and markers of inflammation and oxidative stress should be assessed along with changes related to health outcomes in healthy individuals as well as those with metabolic disease.
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Affiliation(s)
- Damien P Belobrajdic
- Commonwealth Scientific & Industrial Research Organisation-CSIRO, Food Futures National Flagship, GPO BOX 10041, Adelaide, SA 5000, Australia.
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32
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Deng R. A review of the hypoglycemic effects of five commonly used herbal food supplements. Recent Pat Food Nutr Agric 2012; 4:50-60. [PMID: 22329631 DOI: 10.2174/2212798411204010050] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2011] [Revised: 02/06/2012] [Accepted: 01/30/2012] [Indexed: 12/27/2022]
Abstract
Hyperglycemia is a pathological condition associated with prediabetes and diabetes. The incidence of prediabetes and diabetes is increasing and imposes great burden on healthcare worldwide. Patients with prediabetes and diabetes have significantly increased risk for cardiovascular diseases and other complications. Currently, management of hyperglycemia includes pharmacological interventions, physical exercise, and change of life style and diet. Food supplements have increasingly become attractive alternatives to prevent or treat hyperglycemia, especially for subjects with mild hyperglycemia. This review summarized current patents and patent applications with relevant literature on five commonly used food supplements with claims of hypoglycemic effects, including emblica officinalis (gooseberry), fenugreek, green tea, momordica charantia (bitter melon) and cinnamon. The data from human clinical studies did not support a recommendation for all five supplements to manage hyperglycemia. Fenugreek and composite supplements containing emblica officinalis showed the most consistency in lowering fasting blood sugar (FBS) or glycated hemoglobin (HbA1c) levels in diabetic patients. The hypoglycemic effects of cinnamon and momordica charantia were demonstrated in most of the trials with some exceptions. However, green tea exhibited limited benefits in reducing FBS or HbA1c levels and should not be recommended for managing hyperglycemia. Certain limitations are noticed in a considerable number of clinical studies including small sample size, poor experimental design and considerable variations in participant population, preparation format, daily dose, and treatment duration. Future studies with more defined participants, standardized preparation and dose, and improved trial design and size are warranted.
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Affiliation(s)
- Ruitang Deng
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, University of Rhode Island, 41 Lower College Road, Kingston, RI 02881, USA.
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Lazarou C, Panagiotakos D, Matalas AL. The role of diet in prevention and management of type 2 diabetes: implications for public health. Crit Rev Food Sci Nutr 2012; 52:382-9. [PMID: 22369258 DOI: 10.1080/10408398.2010.500258] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
The aim of this review is to examine the current scientific knowledge on the relationship between diet and Type 2 diabetes and consider further implications for public health. The review focuses on the main nutritional elements which have been identified as significant in the prevention and management of Type 2 diabetes. Research findings on the role of carbohydrate, fiber, alcohol, and individual fatty acids are discussed, while the role of specific micro-nutrients and the influence of obesity are comprehensively presented. The association between dietary habits and Type 2 diabetes etiology and management is also reviewed, in order to examine the positive effects of adherence to a healthy dietary pattern, including the plausible role of the Mediterranean diet.
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Liu J, Bao W, Jiang M, Zhang Y, Zhang X, Liu L. Chromium, selenium, and zinc multimineral enriched yeast supplementation ameliorates diabetes symptom in streptozocin-induced mice. Biol Trace Elem Res 2012; 146:236-45. [PMID: 22081404 DOI: 10.1007/s12011-011-9248-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Accepted: 10/25/2011] [Indexed: 12/28/2022]
Abstract
Chromium, selenium, and zinc malnutrition has been implicated in the pathogenesis of diabetic mellitus. This study aims to investigate the effects of novel multiminerals-enriched yeast (MMEY) which are minerals supplementation containing elevated levels of chromium, selenium, and zinc simultaneously in a diabetic animal model. Streptozocin-induced diabetic male Balb/c mice (n = 80) were randomly divided into diabetes control group and three treatment groups. They were administrated oral gavages with low, medium, or high doses of MMEY, respectively. Meanwhile, healthy male Balb/c mice (n = 40) of the same body weight were randomly assigned into normal control group and high dose of MMEY control group. After 8 weeks duration of treatment, the animals were sacrificed by cervical dislocation. Serum glucose concentrations, lipid profiles, oxidative/antioxidant, and immunity status were determined. No significant adverse effects were observed in the high-dose MMEY control group. Treatment of the diabetic mice with medium- or high-dose MMEY significantly decreased serum glucose, triglyceride, total cholesterol, and malondialdehyde and increased high-density lipoprotein cholesterol, glutathione, and the activities of superoxide dismutase and glutathione peroxidase. In addition, MMEY ameliorated the pathological damage of the pancreatic islets, elevated the thymus or spleen coefficient, and increased the expressions of interleukin-2 and -4 in spleen lymphocytes compared with unsupplemented diabetic mice. In conclusion, these results indicate that supplemental MMEY inhibits hyperglycemia, abates oxidative stress, modulates disorders of lipid metabolism, and reduces the impairment of immune function in diabetic mice; especially notable are the protective effects of medium doses of MMEY on the islet cells of diabetic mice.
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Affiliation(s)
- Jun Liu
- Department of Nutrition and Food Hygiene, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Road, Wuhan 430030, People's Republic of China
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36
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Schoonees A, Visser J, Musekiwa A, Volmink J. Pycnogenol® (extract of French maritime pine bark) for the treatment of chronic disorders. Cochrane Database Syst Rev 2012:CD008294. [PMID: 22513958 DOI: 10.1002/14651858.cd008294.pub4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Oxidative stress has been implicated in the development of a number of conditions including cancer, arthritic disorders and cardiovascular disease. Pycnogenol(®), a herbal dietary supplement derived from French maritime pine bark extract, is standardised to contain 70% procyanidin which is a powerful antioxidant. Pycnogenol(®) is marketed as a supplement for preventing or treating a wide range of chronic conditions. OBJECTIVES To assess the efficacy and safety of Pycnogenol(®) for the treatment of chronic disorders. SEARCH METHODS We searched CENTRAL (until 18 September 2010), MEDLINE (until 18 September 2010) and EMBASE (until 13 October 2010) as well as three trial registries. We also contacted the manufacturer of Pycnogenol(®) and hand-searched bibliographies of included studies. SELECTION CRITERIA Randomised controlled trials evaluating the effectiveness of Pycnogenol(®) in adults or children with any chronic disorder were included. We assessed clinical outcomes directly related to the disorder (stratified as participant- and investigator-reported) and all-cause mortality as primary outcomes. We also assessed adverse events and biomarkers of oxidative stress. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted all data and assessed risk of bias. A third author additionally extracted information on outcomes and results. With three exceptions, results for outcomes across studies could not be pooled. MAIN RESULTS This review includes 15 trials with a total of 791 participants that have evaluated Pycnogenol(®) for the treatment of seven different chronic disorders. These included asthma (two studies; N = 86), attention deficit hyperactivity disorder (one study; N = 61), chronic venous insufficiency (two studies; N = 60), diabetes mellitus (four studies; N = 201), erectile dysfunction (one study; N = 21), hypertension (two studies; N = 69) and osteoarthritis (three studies; N = 293). Two of the studies were conducted exclusively in children; the others involved adults.Due to small sample size, limited numbers of trials per condition, variation in outcomes evaluated and outcome measures used, as well as the risk of bias in the included studies, no definitive conclusions regarding the efficacy or safety of Pycnogenol(®) are possible. AUTHORS' CONCLUSIONS Current evidence is insufficient to support Pycnogenol(®) use for the treatment of any chronic disorder. Well-designed, adequately powered trials are needed to establish the value of this treatment.
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Affiliation(s)
- Anel Schoonees
- Division of Human Nutrition, Stellenbosch University,Tygerberg, South Africa
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Abstract
BACKGROUND Oxidative stress has been implicated in the development of a number of conditions including cancer, arthritic disorders and cardiovascular disease. Pycnogenol(®), a herbal dietary supplement derived from French maritime pine bark extract, is standardised to contain 70% procyanidin which is a powerful antioxidant. Pycnogenol(®) is marketed as a supplement for preventing or treating a wide range of chronic conditions. OBJECTIVES To assess the efficacy and safety of Pycnogenol(®) for the treatment of chronic disorders. SEARCH METHODS We searched CENTRAL (until 18 September 2010), MEDLINE (until 18 September 2010) and EMBASE (until 13 October 2010) as well as three trial registries. We also contacted the manufacturer of Pycnogenol(®) and hand-searched bibliographies of included studies. SELECTION CRITERIA Randomised controlled trials evaluating the effectiveness of Pycnogenol(®) in adults or children with any chronic disorder were included. We assessed clinical outcomes directly related to the disorder (stratified as participant- and investigator-reported) and all-cause mortality as primary outcomes. We also assessed adverse events and biomarkers of oxidative stress. DATA COLLECTION AND ANALYSIS Two authors independently assessed trial eligibility, extracted all data and assessed risk of bias. A third author additionally extracted information on outcomes and results. With three exceptions, results for outcomes across studies could not be pooled. MAIN RESULTS This review includes 15 trials with a total of 791 participants that have evaluated Pycnogenol(®) for the treatment of seven different chronic disorders. These included asthma (two studies; N = 86), attention deficit hyperactivity disorder (one study; N = 61), chronic venous insufficiency (two studies; N = 60), diabetes mellitus (four studies; N = 201), erectile dysfunction (one study; N = 21), hypertension (two studies; N = 69) and osteoarthritis (three studies; N = 293). Two of the studies were conducted exclusively in children; the others involved adults.Due to small sample size, limited numbers of trials per condition, variation in outcomes evaluated and outcome measures used, as well as the risk of bias in the included studies, no definitive conclusions regarding the efficacy or safety of Pycnogenol(®) are possible. AUTHORS' CONCLUSIONS Current evidence is insufficient to support Pycnogenol(®) use for the treatment of any chronic disorder. Well-designed, adequately powered trials are needed to establish the value of this treatment.
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Affiliation(s)
- Anel Schoonees
- Division of Human Nutrition, Stellenbosch University, Francie van Zijl Drive, Tygerberg, Western Cape, South Africa, 7505
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Ola MS, Nawaz MI, Siddiquei MM, Al-Amro S, Abu El-Asrar AM. Recent advances in understanding the biochemical and molecular mechanism of diabetic retinopathy. J Diabetes Complications 2012; 26:56-64. [PMID: 22226482 DOI: 10.1016/j.jdiacomp.2011.11.004] [Citation(s) in RCA: 125] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 11/17/2011] [Accepted: 11/17/2011] [Indexed: 02/07/2023]
Abstract
One of the major complications in patients with diabetes is diabetic retinopathy (DR), a leading cause of blindness worldwide. It takes several years before any clinical signs of retinopathy appear in diabetic patients, which gives an ample opportunity for scientists to uncover biochemical and molecular mechanism implicated early in the development and progression of the disease. During the past few decades, research progress has been made in investigating the pathophysiology of the disease; however, due to nonavailability of human retinal samples at different stages of the disease and also due to lack of a proper animal model of DR, the exact molecular mechanism has not been elucidated, making therapeutic a difficult task. In this review article, we have discussed a number of diabetes-induced metabolites such as glucose, lipids, amino acids, and other related factors and molecules that are implicated in the pathophysiology of the DR. Furthermore, we have highlighted neurodegeneration and regulation of neurotrophic factors, being recognized as early events that may be involved in the pathology of the disease in the course of DR. An understanding of the biochemical and molecular changes especially early in the diabetic retina may lead to new and effective therapies towards prevention and amelioration of DR, which is important for the millions of individuals who already have or are likely to develop the disease before a cure becomes available.
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Affiliation(s)
- Mohammad Shamsul Ola
- Department of Ophthalmology, College of Medicine, King Saud University, KAUH, Riyadh, KSA.
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Wilkinson JT, Fraunfelder FW. Use of Herbal Medicines and Nutritional Supplements in Ocular Disorders. Drugs 2011; 71:2421-34. [DOI: 10.2165/11596840-000000000-00000] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Navas-Carretero S, Cuervo M, Abete I, Zulet MA, Martínez JA. Frequent consumption of selenium-enriched chicken meat by adults causes weight loss and maintains their antioxidant status. Biol Trace Elem Res 2011; 143:8-19. [PMID: 20809267 DOI: 10.1007/s12011-010-8831-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 08/13/2010] [Indexed: 12/19/2022]
Abstract
To assess the effects of a moderately high-protein intake on the body composition, biochemical, and antioxidant status parameters in young adults depending on either selenium- (Se) or non-enriched chicken consumption. The volunteers (n = 24) that completed the 10-week nutritional intervention were distributed in two parallel groups and randomly assigned to follow an isocaloric diet with moderately high content in protein (30% energy), either with the consumption of four 200 g portions/week of Se- or non-enriched chicken breasts. Blood samples were taken at the beginning and at the end of the study and body composition was monitored during the trial. There was a significant reduction in weight, accompanying a decrease on fat mass in both groups, while fat-free mass remained unchanged during the 10 weeks of intervention, without differences between both dietary groups. Selenium blood levels and plasma glutathione peroxidase activity, as well as lipid, glucose, and selected inflammation biomarkers remained stable during the intervention period in both dietary groups. Frequent chicken consumption, within a controlled diet with a moderately high content in protein, produced a slight but statistically significant weight reduction mainly due to the loss of fat mass. An extra Se supplementation (22 μg/day) in the Se-enriched chicken breast did not affect tachyphylactic antioxidant status of the participants neither inflammatory-related markers after weight loss.
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Affiliation(s)
- Santiago Navas-Carretero
- Department of Nutrition and Food Sciences, Physiology and Toxicology, Faculty of Pharmacy, University of Navarra, Irunlarrea 1, 31008 Pamplona, Navarra, Spain
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Canale RE, Farney TM, McCarthy CG, Bloomer RJ. A blend of phellodendron and crape myrtle improves glucose tolerance in exercise-trained men. Nutr Metab Insights 2011; 4:39-47. [PMID: 23946660 PMCID: PMC3738470 DOI: 10.4137/nmi.s7837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: The purpose of this study was to investigate the acute effects of a nutritional supplement containing a proprietary blend of Phellodendron and Crape Myrtle on serum glucose and insulin in response to a modified oral glucose tolerance test (OGTT). Methods: Using a randomized, double-blind, cross-over design, 10 exercise-trained, non-diabetic men reported to the lab in a 10 hour fasted state, on two different mornings separated by 1–2 weeks, and were subjected to an OGTT by ingesting a 75 gram dextrose solution. Fifteen minutes prior to the OGTT subjects ingested either a dietary supplement containing a blend of Phellodendron and Crape Myrtle (SUPP) or a placebo (PLA). Blood samples were collected before ingestion of the SUPP or PLA and at 15, 30, 45, 60, and 75 minutes post-ingestion of the dextrose load. Samples were analyzed for serum glucose and insulin. Results: In relation to serum glucose, a condition effect was noted (P = 0.01), with values lower for SUPP compared to PLA. In relation to serum insulin, a trend for a condition effect was noted (P = 0.06), with values lower for SUPP compared to PLA. Conclusion: These findings indicate that acute ingestion of a dietary supplement containing a blend of Phellodendron and Crape Myrtle can lower the serum glucose response to a modified OGTT, while resulting in a non-significant attenuation in insulin response. These data are specific to a small sample of exercise-trained, non-diabetic men.
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Affiliation(s)
- Robert E Canale
- Cardiorespiratory and Metabolic Laboratory, The University of Memphis, Memphis, TN 38152, USA
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Kim YJ, Kim YA, Yokozawa T. Pycnogenol modulates apoptosis by suppressing oxidative stress and inflammation in high glucose-treated renal tubular cells. Food Chem Toxicol 2011; 49:2196-201. [DOI: 10.1016/j.fct.2011.06.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 05/27/2011] [Accepted: 06/04/2011] [Indexed: 11/26/2022]
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Sharma S, Agrawal RP, Choudhary M, Jain S, Goyal S, Agarwal V. Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. J Trace Elem Med Biol 2011; 25:149-53. [PMID: 21570271 DOI: 10.1016/j.jtemb.2011.03.003] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Revised: 02/10/2011] [Accepted: 03/30/2011] [Indexed: 11/18/2022]
Abstract
PROJECT Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism. It influences glucose metabolism by potentiating the action as taking part in insulin signal amplification mechanism. A placebo-controlled single blind, prospective study was carried out to investigate the effect of chromium supplementation on blood glucose, HbA(1)C and lipid profile in newly onset patients with type-2 diabetes. PROCEDURE Total 40 newly onset type-2 diabetics were selected and after 1 month stabilization further randomly divided into two groups viz. study group and placebo group. The study group received 9 g brewer's yeast (42 μg Cr) daily and the other placebo group received yeast devoid of chromium for 3 months. Subjects were instructed not to change their normal eating and living habits. Fasting blood glucose, HbA(1)C and lipid profile were analyzed at beginning and completion of the study. RESULTS Results revealed that fasting blood glucose level significantly reduced in the subjects consuming yeast supplemented with chromium (197.65±6.68 to 103.68±6.64 mg/dL; p<0.001). HbA(1)C values improved significantly from 9.51±0.26% to 6.86±0.28%; p<0.001 indicating better glycaemic control. In experimental group total cholesterol, TG and LDL levels were also significantly reduced from 199.66±3.11 to 189.26±3.01 mg/dL; p<0.02, 144.94±8.31 to 126.01±8.26; p<0.05 and 119.19±1.71 to 99.58±1.10; p<0.001 respectively. CONCLUSIONS These data demonstrate beneficial effect of chromium supplementation on glycaemic control and lipid variables in subjects with newly onset type-2 diabetes.
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Affiliation(s)
- Shilpi Sharma
- College of Home Science, MPUA&T, Udaipur, Rajasthan, India
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Gray B, Swick J, Ronnenberg AG. Vitamin E and adiponectin: proposed mechanism for vitamin E-induced improvement in insulin sensitivity. Nutr Rev 2011; 69:155-61. [PMID: 21348879 DOI: 10.1111/j.1753-4887.2011.00377.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Insulin resistance and type 2 diabetes have been treated with the PPARγ agonists thiazolidinediones, or TZDs, since the 1990s. One mechanism by which these drugs may work is through PPARγ-mediated upregulation of adiponectin, an endogenous adipokine that has been shown to increase insulin sensitivity. Interestingly, α- and γ-tocopherol, two vitamin E vitamers, have structural similarities to the TZDs and have also been linked to enhanced insulin sensitivity. A recent study identified a novel function of α- and γ-tocopherol in 3T3-L1 preadipocytes: upregulation of an endogenous ligand involved in activating PPARγ. This study also found that tocopherols dramatically enhanced adiponectin expression and that this effect was mediated through a PPARγ-dependent process. These findings illustrate a possible mechanistic link between vitamin E and insulin sensitivity.
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Affiliation(s)
- Brianna Gray
- Department of Nutrition, University of Massachusetts, Amherst, Massachusetts 01003, USA
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Lebel M, Picard F, Ferland G, Gaudreau P. Drugs, nutrients, and phytoactive principles improving the health span of rodent models of human age-related diseases. J Gerontol A Biol Sci Med Sci 2011; 67:140-51. [PMID: 21393422 DOI: 10.1093/gerona/glr038] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Rodents are often the species of choice to examine the effect of drugs on survival and on the progression of specific diseased tissues. This statement is also true for research laboratories working in the field of nutrition and aging. In addition to diets that can reduce the life expectancy of rodents, such as diabetogenic or high-fat diets, genetically modified rodents exhibiting different accelerated age-associated diseases also provide important biologic tools to decipher the impact of drugs, nutrients, or phytoactive compounds on their health and life span. This review covers some of the chemicals believed to decelerate the appearance of age-related diseases in different rodent models. Such chemicals include antioxidants, anti-inflammatory molecules, modulators of metabolic sensors, calorie restriction mimetics, and vegetal polyphenolic compounds that affect mitochondrial functions, cellular proliferation or differentiation as well as cell functionality.
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Affiliation(s)
- Michel Lebel
- Department of Molecular Biology, Medical Biochemistry, and Pathology, Centre de Recherche en Cancérologie de l'Université Laval, Hôpital Hôtel-Dieu de Québec, 9 McMahon Street, Québec City, Québec, Canada G1R 2J6.
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Abstract
As the baby boom generation ages, it is anticipated that half a million cases per year will be added to the 19 to 21 million Americans not living in institutions or serving in the military who have low vision or blindness. The 4 major causes of vision loss and blindness in the United States are cataract, diabetic retinopathy, glaucoma, and age-related macular degeneration. All 4 diseases involve change in the microcirculation in eye structures. Holistic approaches to health incorporate attention to individuals' lifestyle choices. Relevant research literature was reviewed to identify strategies for lifestyle modification that nurses can use to prevent or slow progression of these diseases. Prevention strategies in general are those that promote avoidance of cardiovascular disease and diabetes. Because vision loss has been shown to be associated with diminished quality of life and increased mortality, lifestyle changes that prevent or moderate the impact of these diseases are an important focus of nursing care.
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Jain SK, Croad JL, Velusamy T, Rains JL, Bull R. Chromium dinicocysteinate supplementation can lower blood glucose, CRP, MCP-1, ICAM-1, creatinine, apparently mediated by elevated blood vitamin C and adiponectin and inhibition of NFkappaB, Akt, and Glut-2 in livers of zucker diabetic fatty rats. Mol Nutr Food Res 2011; 54:1371-80. [PMID: 20306473 DOI: 10.1002/mnfr.200900177] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Chromium and cysteine supplementation can improve glucose metabolism in animal studies. This study examined the hypothesis that a cysteinate complex of chromium is significantly beneficial than either of them in lowering blood glucose and vascular inflammation markers in Zucker diabetic fatty (ZDF) rats. Starting at the age of 6 wk, ZDF rats were supplemented orally (daily gavages for 8 more weeks) with saline-placebo (D) or chromium (400 microg Cr/Kg body weight) as chromium dinicocysteinate (CDNC), chromium dinicotinate (CDN) or chromium picolinate (CP) or equimolar L-cysteine (LC, img/Kg body weight), and fed Purina 5008 diet for 8 wk. ZDF rats of 6 wk age before any supplementations and onset of diabetes were considered as baseline. D rats showed elevated levels of fasting blood glucose, HbA(1), CRP, MCP-1, ICAM-1 and oxidative stress (lipid peroxidation) and lower adiponectin and vitamin C, when compared with baseline rats. In comparison to D group, CDNC group had significantly lower blood glucose, HbA(1), CRP, MCP-1, ICAM-1 and lipid peroxidation and increased vitamin C and adiponectin levels. CDN, CP or LC showed significantly less or no effect on these biomarkers. Only CDNC lowered blood creatinine levels in comparison to D. While CDN and CP had no effect, activation of NFkappaB, Akt and glucose transporter-2 levels were decreased, insulin receptor substrate 1 (IRS-1) activation increased in livers of CDNC-rats. CDNC effect on glycemia, NFkappaB, Akt and IRS-1 in liver was significantly greater compared with LC. Blood chromium levels did not differ between Cr-groups. Exogenous vitamin C supplementation significantly inhibited MCP-1 secretion in U937 monocytes cultured in high-glucose-medium. CDNC is a potent hypoglycemic compound with anti-inflammatory activity apparently mediated by elevated blood vitamin C and adiponectin and inhibition of NFkappaB, Akt, and Glut-2 and increased IRS-1 activation in livers of type 2 diabetic rats.
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Affiliation(s)
- Sushil K Jain
- Department of Pediatrics, Louisiana State University Health Sciences Center, Shreveport, LA 71130, USA.
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Garcia-Bailo B, El-Sohemy A, Haddad PS, Arora P, Benzaied F, Karmali M, Badawi A. Vitamins D, C, and E in the prevention of type 2 diabetes mellitus: modulation of inflammation and oxidative stress. Biologics 2011; 5:7-19. [PMID: 21383912 PMCID: PMC3044790 DOI: 10.2147/btt.s14417] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2011] [Indexed: 12/15/2022]
Abstract
The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, and certain population subgroups are especially vulnerable to the disease. To reduce T2DM risk and progression at the population level, preventative strategies are needed that can be implemented on a population-wide scale with minimal cost and effort. Chronic low-grade inflammation resulting from oxidative stress and imbalances in the innate immune system has been associated with obesity, metabolic syndrome, and insulin resistance – critical stages in the development and progression of T2DM. Therefore, inflammation may play a causal role in the pathogenesis of T2DM, and reducing it via modulation of oxidative stress and the innate immune response could lead to a status of improved insulin sensitivity and delayed disease onset. Dietary supplementation with anti-inflammatory and antioxidant nutritional factors, such as micronutrients, might present a novel strategy toward the prevention and control of T2DM at the population level. This review examines current knowledge linking oxidation, inflammatory signaling pathways, and vitamin supplementation or intake to the risk of T2DM. The concept that micronutrients, via attenuation of inflammation, could be employed as a novel preventive measure for T2DM is evaluated in the context of its relevance to public health.
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Affiliation(s)
- Bibiana Garcia-Bailo
- Office for Biotechnology, Genomics and Population Health, Public Health Agency of Canada, Toronto, ON, Canada
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Wiernsperger N, Rapin J. Trace elements in glucometabolic disorders: an update. Diabetol Metab Syndr 2010; 2:70. [PMID: 21167072 PMCID: PMC3023745 DOI: 10.1186/1758-5996-2-70] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Accepted: 12/19/2010] [Indexed: 12/17/2022] Open
Abstract
Many trace elements, among which metals, are indispensable for proper functioning of a myriad of biochemical reactions, more particularly as enzyme cofactors. This is particularly true for the vast set of processes involved in regulation of glucose homeostasis, being it in glucose metabolism itself or in hormonal control, especially insulin. The role and importance of trace elements such as chromium, zinc, selenium, lithium and vanadium are much less evident and subjected to chronic debate. This review updates our actual knowledge concerning these five trace elements. A careful survey of the literature shows that while theoretical postulates from some key roles of these elements had led to real hopes for therapy of insulin resistance and diabetes, the limited experience based on available data indicates that beneficial effects and use of most of them are subjected to caution, given the narrow window between safe and unsafe doses. Clear therapeutic benefit in these pathologies is presently doubtful but some data indicate that these metals may have a clinical interest in patients presenting deficiencies in individual metal levels. The same holds true for an association of some trace elements such as chromium or zinc with oral antidiabetics. However, this area is essentially unexplored in adequate clinical trials, which are worth being performed.
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Affiliation(s)
| | - JeanRobert Rapin
- Faculté de Médecine/Pharmacie, Université de Bourgogne, 3 Bld jeanne d'Arc, F-21000 Dijon (France
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Rytter E, Vessby B, Åsgård R, Ersson C, Moussavian S, Sjödin A, Abramsson-Zetterberg L, Möller L, Basu S. Supplementation with a combination of antioxidants does not affect glycaemic control, oxidative stress or inflammation in type 2 diabetes subjects. Free Radic Res 2010; 44:1445-53. [DOI: 10.3109/10715762.2010.515219] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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