Clinical translation of "a diabetes outcome progression trial": ADOPT appropriate combination oral therapies in type 2 diabetes

Effects of dietary inclusion of Bambara groundnut and sweet orange peels on streptozotocin/HFD type-2 induced diabetes mellitus complications and related biochemical parameters

The effects of dietary inclusion of Bambara groundnut and sweet orange peels composite bread on low-dose streptozotocin and high-fat diet (HFD)-induced type-2 diabetes mellitus (T2D) complications was evaluated in the present study. Male experimental rats-induced T2D were administered with acarbose (standard) and fed with Bambara groundnut and sweet orange peels composite bread for a period of 14 days while monitoring their blood glucose levels. More so, the activities of angiotensin-I-converting enzyme (ACE), serum aspartate aminotransferase, alkaline phosphatase, and alanine aminotransferase activities, as well as nitric oxide (NO), reactive oxygen species (ROS), albumin, total bilirubin, creatinine, urea, and uric acid serum concentrations were assayed for. Diabetic untreated rats showed disorders in ACE, AST, ALT, and ALP activities, and NO, ROS, glucose, albumin, bilirubin, creatinine, urea, uric acid levels, as well as lipid profiles. Interestingly, these disorders were significantly ameliorated in composite bread diet-fed rats in comparison to the diabetic untreated rats. Meanwhile, the presence of polyphenols in the Bambara groundnut and sweet orange peels composite bread diet could have aided the amelioration of these metabolic disorders after the 14th day of administration. Finally, it was proposed that the ability of Bambara groundnut-wheat and sweet orange peel composite bread to treat T2D and its complications makes it a more successful therapy than medications that just target one of the diseased states. PRACTICAL APPLICATIONS: Diabetes mellitus is a global and chronic disease that presently affects 536.6 million people alongside 1.5 million deaths directly attributed to it yearly. Several drug and medicinal agents have been employed for the management of diabetes but those drugs are mostly limited to the management of diabetes while the associated complications are most untreated, while drugs that can manage diabetes and its related complications mostly come at high prices. Therefore, there is an urgent need to evaluate legumes, such as Bambara groundnut, with proven therapeutic potential in the management of diabetes and its complications. However, the Bambara groundnut takes a long period to prepare for a meal, therefore including it in a ready-to-eat product will not only improve its acceptability but also add to economic improvement. Furthermore, adding a waste product, sweet orange peels, will both add flavor and source of additional antioxidant attributes.

Evaluation of the Antihyperglycemic and Antihyperlipidemic Activity of Saussurea hypoleuca Root in Alloxan-Induced Diabetes in Rat Model and Correlation to Its Major Secondary Metabolites

Saussurea hypoleuca belongs to the family Asteraceae, which has previously shown hepatoprotective, anticancer, and antioxidant activity. This study aimed to evaluate the antihyperglycemic and antihyperlipidemic activity of its root methanol extract and various fractions for the first time. This was performed using alloxan-induced diabetes in the rat model for both short, and long-term periods using different administration doses. Different biochemical parameters were studied and further consolidated by histopathological examination and in silico molecular modeling. The results showed that in the long-term study, at a dose of 400 mg/kg b.wt, the ethyl acetate fraction caused a pronounced reduction in fasting blood glucose level (FBG) and glycated hemoglobin (HbA_1c) by 77.2% and 36.8%, respectively, compared to the diabetic group. This was confirmed by the histopathological examination of the animals’ pancreatic sections. The ethyl acetate fraction also showed a reduction in total cholesterol (TC), total glycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels. It improved kidney and liver functions, causing a reduction in aspartate aminotransferase (AST), alkaline phosphatase (ALP), alanine transaminase (ALT), urea, and creatinine levels. This is mainly attributed to its richness in secondary metabolites. Molecular docking showed that all the tested compounds showed certain inhibitory potential towards human α-glucosidase (HAG) and ATP citrate lyase (ACL). Thus, Saussurea hypoleuca roots can help in the management of hyperglycemia, hyperlipidemia, and hepatic and kidney dysfunction.

African star apple fruit pulp-supplemented diet modulates fertility-related biomolecules in the testis and epididymis of high-fat diet/streptozotocin-induced diabetic rats

This study evaluated the modulatory effect of African star apple fruit (ASAF) pulp inclusive diet on biomolecules associated with reproductive function in the testis and epididymis of high-fat diet/streptozotocin-induced diabetic male rats. The rats were divided into seven groups: control, diabetic control, diabetic rats treated with metformin, diabetic rats served with diet having 5 and 10% ASAF, respectively, and control rats served with diet containing 5%, and 10% ASAF respectively for 14 days. There were noticeable decrease in sperm parameters, reproductive hormone, glycogen, nitric oxide, total thiol, nonprotein thiol levels, and testicular 3β- and 17β-hydroxysteroid dehydrogenase activities and concomitant increase in cholesterol, reactive oxygen species, malondialdehyde levels, and arginase activity compared to the control. Nevertheless, ASAFs reversed all these parameters toward the control levels. Therefore, these findings suggest that ASAF pulp-supplemented diet might be an active approach in controlling male reproductive dysfunction induced by diabetes. PRACTICAL APPLICATIONS: The results suggest that ASAF pulp-supplemented diet might be an active approach in controlling male reproductive dysfunction induced by diabetes through alterations in the levels of blood glucose, glycogen, cholesterol, nitric oxide, reproductive hormones, activities of steroidogenic enzymes, arginase, and sperm characteristics as well as the antioxidant status in the testes and epididymis.

Ameliorative impact of cold-pressed Rosmarinus officinalis oil against liver toxicity and genotoxic effects in streptozotocin-induced diabetic rats and their offspring

Diabetes mellitus (DM) is a chronic, lifelong condition threatening human health. Rosmarinus officinalis oil (RO) could have a future role in DM therapy. This study evaluated the composition and antioxidative potential of RO. Antidiabetic traits of RO in streptozotocin (STZ)-induced diabetic rats was also studied considering the ameliorative impact against embryogenesis defects using in vitro and in vivo biochemical, histological, and genetic assays. RO was investigated for fatty acids and bioactive compounds (tocols and total phenolic compounds), and antiradical potential against DPPH^• radicals. The genetic effects were investigated using comet assay and DNA fragmentation test. DM was induced to albino rats by injecting 60 mg/kg of STZ, while RO (100 mg/kg b.w.) was administered. The pregnant animals were divided into four groups; control (C), RO-treated (RO), diabetic (D), and combined diabetic with RO-treated (D-RO). The study was conducted for 180 days. In RO, the contents of polyunsaturated fatty acids, monounsaturated fatty acids, and saturated fatty acids were 42.3%, 41.7%, and 15.8%, respectively. The levels of α-, β-, γ-, and δ-tocopherols were 280, 20, 1,025, and 35 mg/100 g RO, respectively. RO contained 7.2 mg GAE/g of total phenolic compounds (TPC), while RO quenched 70% of DPPH^• radicals. While glucose levels reached the highest in DM rats, treating STZ-induced diabetic animals with RO-resoluted serum glucose levels. RO reduced the highest levels of serum chemistry parameters were recorded in DM animals. Histological photographs of maternal and fetus liver exhibited degenerated hepatic cells and congestion central vein. Comet cells and DNA fragments were significantly decreased in D-RO group comparing to the DM group. RO exhibited antidiabetic capabilities, and thus, it could be utilized as a functional ingredient in novel foods, nutraceuticals, and dietary supplements for diabetic patients. PRACTICAL APPLICATIONS: RO is rich in bioactive phytochemicals (tocols and phenolic compounds) with antiradical and antihyperglycemic capabilities. Tocols and phenolics are active in radical scavenging of reactive nitrogen species (i.e., peroxynitrite and nitrogen dioxide), and in the prevention of DNA bases nitration. Our results demonstrated that RO could improve the disturbed metabolism of carbohydrate in STZ-diabetic animals. The potential mode of action of bioactive compounds in RO most likely encompasses the intracellular pathway involved in glucose homeostasis or insulin signaling. In addition, the suppression of oxidative stress by phenolic compounds could provide to the antidiabetic impacts of RO. Our data supported that RO could be utilized to ameliorate DM. Protection with RO directed high protection of the maternal organs and offspring against the oxidative stress of diabetes due to the antihyperlipidemic effects and the antioxidant capabilities of RO.

Antihyperglycemic, hypolipidemic, hepatoprotective and antioxidative effects of dietary clove (Szyzgium aromaticum) bud powder in a high-fat diet/streptozotocin-induced diabetes rat model

BACKGROUND

Syzygium aromaticum (L.) Merr. & Perry (clove) bud is an important spice used in the preparation of several delicacies and in folklore for diabetes management. The present study was convened to assess the effects of dietary clove bud powder (CBP) on biochemical parameters in a type 2 diabetes rat model, induced by a combination of high-fat diet and low-dose streptozotocin (35 mg kg⁻¹) for 30 days.

RESULTS

Diabetic rats were placed on dietary regimen containing 20-40 g kg⁻¹ clove bud powder. The results revealed that there was no significant (P > 0.05) difference in the average feed intake and weight changes between the rat groups. Furthermore, supplementation with CBP gradually reduced blood glucose level in diabetic rat compared to control diabetic rats without CBP supplementation (DBC). Moreover, reduced activity of α-glucosidase was observed in CBP and metformin-treated rat groups when compared to that of the DBC rat group. In addition, the DBC group had significantly (P < 0.05) higher lipid concentrations (except for high-density lipoprotein cholesterol) when compared to all other groups. Furthermore, CBP had significantly (P < 0.05) reduced activity of liver enzymes (alanine aminotransferase, aspartate aminotransferase and alkaline phosphatase) and showed elevated levels of antioxidant status (glutathione, ascorbic acid, superoxide dismutase and catalase).

CONCLUSION

The results suggest that the clove bud diet may attenuate hyperglycemia, hyperlipidemia, hepatotoxicity and oxidative stress in the type 2 diabetic condition.

Modulation of the pancreatic islet-stress axis as a novel potential therapeutic target in diabetes mellitus

Loss of pancreatic islet function and insulin-producing beta cell mass is a central hallmark in the pathogenesis of both type 1 and type 2 diabetes. While in type 1 diabetes this phenomenon is due to an extensive destruction of beta cells caused by an autoimmune process, the mechanisms resulting in beta cell failure in type 2 diabetes are different and less clear. Also, beta cell destruction in type 1 diabetes occurs early and is the initial step in the pathogenetic process, while beta cell loss in type 2 diabetes after an initial phase of hyperinsulinemia due to the underlying insulin resistance occurs relatively late and it is less pronounced. Since diabetes mellitus is the most frequent endocrine disease, with an increasing high prevalence worldwide, huge efforts have been made over the past many decades to identify predisposing genetic, environmental, and nutritional factors in order to develop effective strategies to prevent the disease. In parallel, extensive studies in different cell systems and animal models have helped to elucidate our understanding of the physiologic function of islets and to gain insight into the immunological and non-immunological mechanisms of beta cell destruction and failure. Furthermore, currently emerging concepts of beta cell regeneration (e.g., the restoration of the beta cell pool by regenerative, proliferative and antiapoptotic processes, and recovery of physiologic islet function) apparently is yielding the first promising results. Recent insights into the complex endocrine and paracrine mechanisms regulating the physiologic function of pancreatic islets, as well as beta cell life and death, constitute an essential part of this new and exciting area of diabetology. For example, understanding of the physiological role of glucagon-like peptide 1 has resulted in the successful clinical implementation of incretin-based therapies over the last years. Further, recent data suggesting paracrine effects of growth hormone-releasing hormone and corticotropin-releasing hormone on the regulation of pancreatic islet function, survival, and proliferation as well as on local glucocorticoid metabolism provide evidence for a potential role of the pancreatic islet-stress axis in the pathophysiology of diabetes mellitus. In this chapter, we provide a comprehensive overview of current preventive and regenerative concepts as a basis for the development of novel therapeutic approaches to the treatment of diabetes mellitus. A particular focus is given on the potential of the pancreatic islet-stress axis in the development of novel regenerative strategies.

An update on preventive and regenerative therapies in diabetes mellitus

Type 1A (immune-mediated) and type 2 diabetes mellitus are two of the most common severe chronic illnesses, affecting over 230 million people worldwide with an estimated global prevalence of 5.1%. Although type 1 and type 2 diabetes differ greatly in modes of pathogenesis, these illnesses share a common pathology and consequences characterized by loss of functional beta-cell mass and subsequent dysregulation of carbohydrate and lipid metabolism. Since therapy for diabetes and the associated complications poses enormous public health and economic burdens, novel preventive and regenerative therapies have emerged in the past decade with the aim to preserve beta-cell mass and delay the onset of diabetes. The goal of this review is to provide a comprehensive overview of current efforts in the fight against diabetes, and attempts to document all strategies that have emerged in clinical studies within the past 25 years. First, strategies to identify individuals at risk, ranging from whole-genome scans to autoantibody screening, will be discussed. Second, novel approaches to prevent or delay the onset of disease will be covered. Particular focus is given on emerging strategies for individuals at risk for type 1 diabetes that target T-cell regulation and induction of tolerance, while new pharmaceutical concepts in combination with lifestyle interventions are discussed within the scope of type 2 diabetes prevention. Lastly, important efforts to halt disease progression with emphasis on beta-cell regeneration are presented.