Spice-Derived Bioactive Ingredients: Potential Agents or Food Adjuvant in the Management of Diabetes Mellitus

Functional foods of sub-Saharan Africa and their implications in the management of type 2 diabetes: A review

Throughout the world, the prevalence of metabolic diseases in general and type 2 diabetes (T2DM) in particular is constantly growing, and sub-Saharan Africa (SSA) is not spared. The use of functional foods is a more practical option among the different approaches used in the management of T2DM owing to the fact that they are relatively less costly, safer, and more accessible. In addition to their low glycemic index just like foods currently used to manage diabetes, functional foods contain bioactive compounds such as polyphenols, dietary fibers, saponins, and peptides. They are so named because they have additional health advantages beyond their basic nutritional worth. Bioactive compounds can be found in a variety of SSA plant-based foods, such as spices, fruits, vegetables, legumes, starchy foods, prepared foods, mixed foods, and prepared dishes. The goal of this review is to highlight some of the investigations into the effectiveness of local food and their antidiabetic mechanisms that have been studied in various SSA regions. Using the literature review as a basis, the authors state that SSA foods are rich in various bioactive compounds capable of regulating blood sugar through enhanced glucose tolerance, antioxidant effects, insulin sensitivity, and inhibition or activation of some key enzymes of the glucose metabolism that are linked to the prevention and management of T2DM. Many of the cited findings are preliminary, obtained from cell and preclinical studies, and therefore other studies need to be done to demonstrate the full potential of these foods to serve as bases for dietary guidelines.

Cinnamaldehyde supplementation acts as an insulin mimetic compound improving glucose metabolism during adolescence, but not during adulthood, in healthy male rats

PURPOSE

Adolescence is a critical period of increased vulnerability to nutritional modifications, and adolescents may respond differently from adults to dietary intake and nutraceuticals. Cinnamaldehyde, a major bioactive compound of cinnamon, improves energy metabolism, as has been shown in studies conducted primarily in adult animals. We hypothesized that cinnamaldehyde treatment may have a higher impact on the glycemic homeostasis of healthy adolescent rats than on healthy adult rats.

METHODS

Male adolescent (30 days) or adult (90 days) Wistar rats received cinnamaldehyde (40 mg/kg) for 28 days by gavage. The oral glucose tolerance test (OGTT), liver glycogen content, serum insulin concentration, serum lipid profile, and hepatic insulin signaling marker expression were evaluated.

RESULTS

Cinnamaldehyde-treated adolescent rats showed less weight gain (P = 0.041), improved OGTT (P = 0.004), increased expression of phosphorylated IRS-1 (P = 0.015), and a trend to increase phosphorylated IRS-1 (P = 0.063) in the liver of adolescent rats in the basal state. None of these parameters was modified after treatment with cinnamaldehyde in the adult group. Cumulative food intake, visceral adiposity, liver weight, serum insulin, serum lipid profile, hepatic glycogen content, and liver protein expression of IRβ, phosphorylated IRβ, AKT, phosphorylated AKT, and PTP-1B in the basal state were similar between both age groups.

CONCLUSION

In a healthy metabolic condition, cinnamaldehyde supplementation affects glycemic metabolism in adolescent rats while promoting no changes in adult rats.

Formulation, Characterization and Permeability Studies of Fenugreek (Trigonella foenum-graecum) Containing Self-Emulsifying Drug Delivery System (SEDDS)

Fenugreek is used as a spice and a traditional herbal medicine for a variety of purposes, given its antidiabetic and antioxidant effects. Self-emulsifying drug delivery systems (SEDDS) of herbal drugs are targets of extensive research aiming to increase bioavailability and stability. The study’s objective was to formulate SEDDS containing Trigonella foenum-graecum extract to improve the stability of herbal extract and to increase their permeability through a Caco-2 monolayer. A characterized fenugreek dry extract was used for the formulations, while the SEDDS properties were examined by particle size analysis and zeta potential measurements. Permeability assays were carried out on Caco-2 cell monolayers, the integrity of which was monitored by follow-up trans-epithelial electric resistance measurements (TEER). Cytocompatibility was tested by the MTT method, and an indirect dissolution test was performed, using DPPH antioxidant reagent. Two different SEDDS compositions were formulated from a standardized fenugreek dry extract at either the micro- or the nanoemulsion scale with sufficient stability, enhanced bioavailability of the compounds, and sustained release from HPMC capsules. Based on our results, a modern, non-toxic, cytocompatible fenugreek SEDDS formulation with high antioxidant capacity was developed in order to improve the permeability and bioavailability of all components.

Thymoquinone's Antiviral Effects: It is Time to be Proven in the Covid-19 Pandemic Era and its Omicron Variant Surge

The COVID-19 pandemic has impacted every country in the world. With more than 400 million cases and more than 5.5 million deaths. The FDA either approved or authorized the emergency use for three vaccines against COVID-19. The treatment options of COVID-19 are very limited. Multiple complementary and alternative medicine modalities were suggested to be efficacious in the treatment of COVID-19 such as Thymoquinone. The effects of Thymoquinone have been examined and multiple studies indicate a promising beneficial effect. However, the current body of research is limited in terms of its scope, quality, and quantity. While higher-quality studies are required, physicians do not routinely recommend the use of marketed supplements of natural products, including Thymoquinone for COVID-19. Given the numerous suggested positive effects of Thymoquinone, including anti-inflammatory and antimicrobial properties, additional research is required to confirm or refute these promising benefits. Complementary and alternative medicine is an area that requires additional evidence-based practice and research to confirm effects observed in clinical practice.

Neuroprotective efficacy of 4-Hydroxyisoleucine in experimentally induced intracerebral hemorrhage

Intracerebral hemorrhage (ICH) is a severe form of brain injury, which is a major cause of mortality in humans. Hydrocephalus and cerebral hematoma lead to severe neurological deficits. A single autologous blood (ALB) injection in rats' brains induces hemorrhage and other conditions that regularly interfere with the standard treatment of several cellular and molecular pathways. Several studies have found that IGF-1/GLP-1 decreases the production of inflammatory markers in peripheral tissues, while some have found that they also have pro-inflammatory functions. Since these receptors are down-regulated in hemorrhagic situations, we looked into the potential neuroprotective effect of 4-hydroxyisoleucine (4-HI); 50 mg/kg and 100 mg/kg, an active compound Trigonellafoenum-graecum, on post-hemorrhagic deficits in rats. Long-term oral administration of 4-HI for 35 days has improved behavioral and neurochemical deficits and severe pathological changes and improved cellular and molecular markers, apoptotic markers in the ALB-induced ICH experimental model.

Furthermore, the findings revealed that 4-HI also improved the levels of other neurotransmitters (Ach, DOPA, GABA, glutamate); inflammatory cytokines (TNF-alpha, IL-1β, IL-17), and oxidative stress markers (MDA, nitrite, LDH, AchE, SOD, CAT, GPx, GSH) in the brain when evaluated after Day 35. There is no proven treatment available for the prevention of post-brain hemorrhage and neurochemical malfunction; available therapy is only for symptomatic relief of the patient. Thus, 4-HI could be a potential clinical approach for treating post-brain haemorrhage and neurochemical changes caused by neurological damage. Furthermore, 4-HI may be linked to other standard therapeutic therapies utilized in ICH as a potential pharmacological intervention.

Thymoquinone: A small molecule from nature with high therapeutic potential

Thymoquinone (TQ; 2-isopropyl-5-methylbenzo-1, 4-quinone), the main active constituent of Nigella sativa, has been proven to have great therapeutic properties in numerous in vivo and in vitro models. Nevertheless, this molecule is not yet in clinical trials, largely because of its poor bioavailability and hydrophobicity. This review examines the different activities of TQ, as well as various combination therapies, nanotechnologies and clinical trials involving TQ. The TQ nanoparticle formulation shows better bioavailability than free TQ, and it is time for clinical trials of these formulations to realize the potential of TQ as a therapeutic.

Optimization of Thymoquinone-Loaded Self-Nanoemulsion for Management of Indomethacin-Induced Ulcer

To improve the water solubility of thymoquinone (TQ), a major constituent of Nigella sativa seed oil, a TQ-loaded self-nanoemulsifying drug delivery system (SNEDDS) was prepared. The SNEDDS formulation was optimized using almond oil (AO) (Oil; X1), tween 80 (surfactant; X2) and polyethylene glycol 200 (PEG 200) (cosurfactant; X3) compounds as independent variables. The results showed that the globule size ranged from 65 to 320 nm. In addition, a strong agreement was reached between the system estimation and the experimental values of globule size. To evaluate the gastroprotective effect of optimized TQ-loaded SNEDDS against indomethacin (Indo.)-induced gastric ulcers in comparison with non-emulsified TQ, the ulcer index and histopathological changes were estimated. Optimized TQ-loaded SNEDDS showed improved gastroprotective activity against Indo.-induced ulcers relative to the non-emulsified TQ. In addition, the gastroprotective index was improved by 2-fold in TQ-loaded SNEDDS as compared to non-emulsified TQ. This is attributed to the strong antioxidant and the cytoprotective activities of the TQ. These results demonstrate enhancement of the efficacy of TQ through the optimized SNEDDS.

Low to no cost remedies for the management of diabetes mellitus; global health concern

Purpose

Diabetes mellitus (DM) is a chronic non-communicable endocrine and metabolic disease that is thought to be the fastest emerging health challenge of the twenty-first century. Presently, 90% of diabetic population is handicapped with T2-DM, and the majority of pre-diabetes on the way to T2-DM progression. By keeping in view, a review article has been compiled to highlight the significance of value aided effective, low-cost, safe, and useful remedies that could easily be accessible to the global community in order to moderate the possibility of DM and related complications.

Methods

Literature search for this review was carried out using scientific databases including PubMed, EBSCO, Scopus, Web of science, and google scholar. Whilst, value aided articles were selected on the basis of their therapeutic potential, safety profile and outreach.

Results

Escalating research data validated that herbal remedies and physical activities significantly prevents hyperglycemia, hyperlipidemia, and other complications in people with T2-DM.

Conclusion

Globally, nearly half-billion individuals are living with diabetes. Therefore, it is urged to embrace herbal remedies and physical mediation in our daily routine in order to tackle such devastating disorder.

Involvement of mTOR/Survivin signaling pathway in TUA(2β, 3β, 23-trihydroxy-urs-12-ene-28-olic acid)-induced apoptosis in human gastric cancer cell line BGC823 cells

ETHNO-PHARMACOLOGICAL RELEVANCE

A natural ursolic compound, 2β,3β,23-trihydroxy-urs-12-ene-28-olic acid (TUA) was isolated from the root of Actinidiafulvicoma Hance. (A.fulvicoma Radix), which is used as a traditional hebal medicine to cure innominate inflammation of unknown origin of the digestive tract in the She nationality.

AIM OF THE STUDY

The aim of present study was to investigate the effects of TUA on gastric cancer and to clarify the potential mechanisms in human gastric cancer cell line BGC823 cells in vitro and in vivo.

MATERIALS AND METHODS

Cell proliferation, apoptosis, cell cycle, autophagy were all measured by MTS assay, flow cytometry following exposure to TUA. The mRNA expressions of PI3K, AKT, mTOR, P70S6K, Survivin and the protein expressions of p-PI3K, p-AKT, p-mTOR, p-P70S6K, Survivin were determined by qRT-PCR and Western blotting analysis, respectively. In vivo antitumor activity of TUA was assessed in a xenograft model.

RESULTS

In vitro studies showed that TUA significantly suppressed the viability of BGC823 cells in a concentration- and time-dependent manner but not GES-1 non-tumorigenic human gastric epithelial cells. TUA also significantly increased the apoptosis rate and the sub G2 population by cell cycle analysis in a concentration dependent manner. Exposure to TUA decreased PI3K, AKT, mTOR, P70S6K, Survivin mRNA, inhibited the phosphorylation of major receptors involved in autophagy and apoptosis, such as PI3K, AKT, mTOR and P70S6K, while reduced the expression of Survivin in BGC cells. In vivo studies showed that TUA decreased tumor volume and tumor weight and also down regulated the autophagy-related proteins expression.

CONCLUSIONS

TUA occupies underlying antitumor effects, the potential mechanisms may involve the suppression of mTOR/Survivin pathways connected to autophagy and the activation of apoptotic pathways in gastric cancer cells.

Potential Interplay between Nrf2, TRPA1, and TRPV1 in Nutrients for the Control of COVID-19

In this article, we propose that differences in COVID-19 morbidity may be associated with transient receptor potential ankyrin 1 (TRPA1) and/or transient receptor potential vanilloid 1 (TRPV1) activation as well as desensitization. TRPA1 and TRPV1 induce inflammation and play a key role in the physiology of almost all organs. They may augment sensory or vagal nerve discharges to evoke pain and several symptoms of COVID-19, including cough, nasal obstruction, vomiting, diarrhea, and, at least partly, sudden and severe loss of smell and taste. TRPA1 can be activated by reactive oxygen species and may therefore be up-regulated in COVID-19. TRPA1 and TRPV1 channels can be activated by pungent compounds including many nuclear factor (erythroid-derived 2) (Nrf2)-interacting foods leading to channel desensitization. Interactions between Nrf2-associated nutrients and TRPA1/TRPV1 may be partly responsible for the severity of some of the COVID-19 symptoms. The regulation by Nrf2 of TRPA1/TRPV1 is still unclear, but suggested from very limited clinical evidence. In COVID-19, it is proposed that rapid desensitization of TRAP1/TRPV1 by some ingredients in foods could reduce symptom severity and provide new therapeutic strategies.

Delonix regia a Folklore Remedy for Diabetes; Attenuates Oxidative Stress and Modulates Type II Diabetes Mellitus

BACKGROUND

The folkloric profile of Delonix regia demonstrates that it can be used in the management of diabetes.

OBJECTIVE

The present study was conducted to evaluate the safety profile of the aerial part extracts of Delonix regia and their antidiabetic potential along with improvement in oxidative stress.

MATERIALS AND METHODS

Phytochemical screening, total phenolic, and flavonoid contents along with in-vitro antioxidant and alpha-amylase inhibitory activities were determined. HPLC analysis, acute toxicity, glucose tolerance, in-vivo antidiabetic effect along with the influence on biochemical, oxidative stress parameters, and comet assay of the active extract were performed and assessed.

RESULTS

Total phenolic (831.6±0.002 mg/g GAE) and flavonoid (361.4±0.002 mg/g QE) contents were found to be higher in the methanolic extract. Inhibitory concentration IC50 indicated better results for the methanolic extract in DPPH (47.6μg/mL) and alpha-amylase inhibitory (14.61μg/mL) assays. HPLC analysis of the methanolic extract confirmed the presence of quercetin, gallic acid, caffeic acid, cinnamic acid, ferulic acid, and p-coumaric acid. Acute oral toxicity exhibited no mortality and morbidity during the 24h period. The methanolic extract showed better tolerance to glucose. Streptozotocin- nicotinamide (55-110 mg/kg) induced hyperglycemia declined along with improvement in hematological, biochemical parameters and oxidative stress markers (SOD, CAT, H202) in a dose-dependent manner. The maximum effect was recorded at 500mg/kg dose. Comet assay was performed for genotoxic studies and it was observed that the methanolic extract of Delonix regia showed the maximum genoprotective effect at 100μg/mL.

CONCLUSION

The findings suggest that the methanolic aerial part extract of Delonix regia exhibited hypoglycemic, antioxidant, and hypolipidemic activities. The antidiabetic effect was comparable to glibenclamide suggesting its therapeutic use as a natural anti-diabetic remedy.

Tylophora hirsuta (Wall.) Extracts Ameliorate Diabetes Associated with Inflammation in Alloxan-induced Diabetic Rats

BACKGROUND

Tylophora hirsuta (Wall) has long been used as traditional medicine for the treatment of diabetes. The current study is designed to evaluate the anti-diabetic and anti-inflammatory activity of different extracts of aerial parts of Tylophora hirsuta.

METHODS

Sequential maceration was conducted to obtain extracts. Total phenolic contents were determined by the Folin-Ciocalteau method. The anti-oxidant activity was assessed by DPPH free radical scavenging assay. The extracts were tested for its inhibitory activity against α-amylase in-vitro. In-vivo anti-diabetic assay was conducted using alloxan-induced diabetic model and OGTT was conducted on normal rats. ELISA was used to determine the pro-inflammatory cytokines (TNF-α and IL-6). The polyphenolic composition of the extract was analyzed using an HPLC system.

RESULTS

Aqueous extract exhibited highest total phenolic contents (985.24± 3.82 mg GAE/100 g DW), antioxidant activity (IC50 = 786.70 ± 5.23 μg/mL), and alpha-amylase inhibition (IC50 =352.8 μg/mL). The aqueous extract of Tylophora hirsuta showed remarkable in-vivo anti-diabetic activity. Results were compared with standard drug glibenclamide. Alloxan induced diabetic mediated alterations in liver function enzymes, renal function determinants, and lipid parameters were significantly restored in aqueous extract treated diabetic rats. A significant reduction in pro-inflammatory cytokines (p<0.001) was observed when compared to the control group. HPLC analysis confirms the presence of quercetin, gallic acid, cinnamic acid, and p-coumaric acid.

CONCLUSION

These results showed that Tylophora hirsuta possesses strong anti-diabetic and anti-inflammatory potentials and justify its folklore use for the management of diabetes.

In vitro antioxidant activity and polyphenolic content of commonly used spices from Ethiopia

INTRODUCTION

In this study, the antioxidative effectiveness, and polyphenolic content of methanol and aqueous extracts of spices such as Lippia adoensis (Koseret), Nigella sativa (Thikur azmud), Piper capense (Timiz), Thymus schimperi (Tosign) and Trachyspermum ammi (Netchazmud), consumed among people of Ethiopia were investigated.

METHODS

The antioxidant activity was assessed via established in vitro assay models such as 2, 2-Diphenyl-1-Picrylhydrazyl (DPPH) radical quenching assay, reducing power assay and reactive nitrogen species (RNS) inhibitory potential. Total phenolics content was measured according to Folin-Ciocalteu's method and total flavonoid content was estimated by using Aluminium chloride colorimetric method.

RESULTS

The results showed that the total phenolic content was highest in both methanol (720 ± 0.04 mg GAE/100 g extract DW) and aqueous (580 ± 0.08 mg GAE/100 g DW) extracts of L. adoensis. Among the five tested spices, the methanol and aqueous extracts of L. adoensis exerted the strongest DPPH radical quenching activity with IC50values of 49.17 ± 1.26 and 20.99 ± 8.6 μg/mL, respectively. Both methanol and aqueous extracts of L. adoensis showed notable reducing capacity. The highest RNS scavenging activity was shown by both methanol (IC50 597.21 ± 6.99 μg/mL) and aqueous (IC50 = 551.5 ± 28.9 μg/mL) extracts of L. adoensis. High to moderate positive correlations were observed between total phenolic contents and in vitro antioxidant assays. This indicates that the antioxidant activities of the tested spices are attributed to the phenolic contents.

CONCLUSION

The results of the present work revealed that the tested spices demonstrated high phenolic contents and antioxidant properties. Thus, these spices are worth considering as important sources of natural antioxidant agents.

Treatment with cinnamaldehyde reduces the visceral adiposity and regulates lipid metabolism, autophagy and endoplasmic reticulum stress in the liver of a rat model of early obesity

Nutrition at early stages of life contributes to the alarming incidence of childhood obesity, insulin resistance and hepatoesteatosis. Cinnamaldehyde, major component of cinnamon, increases insulin sensitivity and modulates adiposity and lipid metabolism. The aim of this study was to analyze the impact of cinnamaldehyde treatment during adolescence in a rat model of early obesity. Litter size reduction was used to induce overfeeding and early obesity. At postnatal day 30 (adolescence), the male Wistar rats received cinnamaldehyde by gavage (40 mg/kg of body weight/day) for 29 days and were studied at the end of treatment at 60 days old or 4 months thereafter (180 days old). At 60 days of age, the treatment with cinnamaldehyde promoted reduced visceral adiposity, serum triacylglycerol, and attenuation of energy efficiency and insulin resistance. In the liver, it reduced lipid synthesis, stimulated autophagy and reduced ER stress. At 180 days of age, animals treated with cinnamaldehyde during the adolescence exhibited normalization of visceral adiposity and energy efficiency, and attenuation of hyperphagia, serum hypertriglyceridemia and hepatic triacylglycerol content, with molecular markers indicative of reduced hepatic synthesis. However, the beneficial effect observed at 60 days of age on glucose homeostasis, autophagy and ER stress was lost. Therefore, the cinnamaldehyde supplementation during the adolescence has short- and long-term metabolic beneficial effects, highlighting its potential as an adjuvant in the treatment of early obesity.

Identification and Isolation of Active Compounds from Astragalus membranaceus that Improve Insulin Secretion by Regulating Pancreatic β-Cell Metabolism

In type 2 diabetes (T2D), insufficient secretion of insulin from the pancreatic β-cells contributes to high blood glucose levels, associated with metabolic dysregulation. Interest in natural products to complement or replace existing antidiabetic medications has increased. In this study, we examined the effect of Astragalus membranaceus extract (ASME) and its compounds 1-9 on glucose-stimulated insulin secretion (GSIS) from pancreatic β-cells. ASME and compounds 1-9 isolated from A. membranaceus stimulated insulin secretion in INS-1 cells without inducing cytotoxicity. A further experiment showed that compounds 2, 3, and 5 enhanced the phosphorylation of total insulin receptor substrate-2 (IRS-2), phosphatidylinositol 3-kinase (PI3K), and Akt, and activated pancreatic and duodenal homeobox-1 (PDX-1) and peroxisome proliferator-activated receptor-γ (PPAR-γ), which are associated with β-cell function and insulin secretion. The data suggest that two isoflavonoids (2 and 3) and a nucleoside (compound 5), isolated from the roots of A. membranaceus, have the potential to improve insulin secretion in β-cells, representing the first step towards the development of potent antidiabetic drugs.

Curcumin and Type 2 Diabetes Mellitus: Prevention and Treatment

Type 2 diabetes mellitus (T2DM) is an ensemble of metabolic diseases that has reached pandemic dimensions all over the world. The multifactorial nature of the pathology makes patient management, which includes lifelong drug therapy and lifestyle modification, extremely challenging. It is well known that T2DM is a preventable disease, therefore lowering the incidence of new T2DM cases could be a key strategy to reduce the global impact of diabetes. Currently, there is growing evidence on the efficacy of the use of medicinal plants supplements for T2DM prevention and management. Among these medicinal plants, curcumin is gaining a growing interest in the scientific community. Curcumin is a bioactive molecule present in the rhizome of the Curcuma longa plant, also known as turmeric. Curcumin has different pharmacological and biological effects that have been described by both in vitro and in vivo studies, and include antioxidant, cardio-protective, anti-inflammatory, anti-microbial, nephro-protective, anti-neoplastic, hepato-protective, immunomodulatory, hypoglycaemic and anti-rheumatic effects. In animal models, curcumin extract delays diabetes development, improves β-cell functions, prevents β-cell death, and decreases insulin resistance. The present review focuses on pre-clinical and clinical trials on curcumin supplementation in T2DM and discusses the peculiar mechanisms by which curcumin might ameliorate diabetes management.

GLP-1 mediates the modulating effect of thymoquinone on feeding behaviors in diabetic rats

Background: Thymoquinone (TQ) is a safe nutrient isolated from the seeds or volatile oil extract of Nigella sativa. In addition to its benefits in glucose regulation, TQ improves feeding disorders in diabetic animals. Glucagon-like peptide-1 (GLP-1) analogs improve glycemic control and ameliorate obesity or hyperphagia. Therefore, the present study aimed to investigate the role of GLP-1 in TQ-induced anorexia. Method: Type 2 diabetes was induced in rats by nicotinamide and streptozotocin injection. TQ was orally administered to diabetic rats at different doses for 45 days. Following TQ treatment, changes in serum glucose levels, GLP-1 concentration, body weight, food intake, and water intake were determined. To further explore the interaction between GLP-1 and TQ, the inhibitor of dipeptidyl peptidase 4, sitagliptin and the GLP-1 receptor antagonist exendin 9-39 (Ex 9-39) were separately administered to TQ- or vehicle-treated diabetic rats. Results: TQ treatment attenuated hyperglycemia and reduced hyperphagy and water intake in streptozotocin-induced diabetic rats in a dose-dependent manner. Moreover, TQ treatment elevated plasma GLP-1 levels compared to those in control rats. The effects of TQ were enhanced by treatment with sitagliptin and reduced by the injection of Ex 9-39 into the brain. In contrast, similar treatment with another antioxidant (either ascorbic acid or N-acetylcysteine) produced the same anorexic effect as TQ without changing the plasma GLP-1 levels in diabetic rats. Therefore, TQ attenuated hyperphagy while increasing plasma GLP-1 levels and had antioxidant-like effects. Conclusion: TQ increased endogenous GLP-1 levels to reduce hyperphagy in diabetic rats.