Advances in the Management of Diabetes and Overweight using Incretinbased Pharmacotherapies

Throughout the previous three decades, the secretion of glucagon-like peptide-1 hormone has attracted much attention to attain possible therapy goals for the treatment of both hypoglycaemic along type II diabetes militates and overweight. The pharmaceutical generation of peptides similar to hypoglycaemia-based medicines is exemplified by agonists of the GLP- 1R (Glucagon-like peptide-1 receptors). Pharmacokinetic profiles are continuously being improved, beginning with the native hormone with a two- to three-minute quarter and progressing through growth every day with once-drug combinations. Due to contradictory data that indicate stimulation or inhibition of the Glucagon-like peptide receptor, the Glucose-dependent insulin tropic peptide receptor offers favorable effects on systemic metabolism. The recent Glp-1R (Glucagon-like peptide-1 receptor-) targeting monomolecular drugs has demonstrated therapeutic effectiveness and has stoked interest in Glucose-dependent insulin tropic polypeptide antagonism as a treatment for overweight and diabetes mellitus. These drugs have been shown to dramatically improve carbohydrates with body weight management in sick people who have obesity and type II diabetes mellitus. In this study, recent breakthroughs in compelling therapeutic interventions are discussed, and the biology and pharmacology of the glucose-like peptide are reviewed.

Nutraceutical Activity of Anthocyanins from the Edible Berries of Rhamnus pompana

We present the inhibitory properties of the R. pompana anthocyanin fraction (RPAF) and its major constituents on alpha-glucosidase (AG), pancreatic lipase (PL), HMG-CoA reductase, and ornithine decarboxylase (ODC). The effect of RPAF was also evaluated in ICR male mice subjected to oral glucose tolerance test (OGTT) and hypercaloric/atherogenic diet for 30 days. RP-HPLC/MS profiling revealed that RPAF contained five major anthocyanins and induced slight inhibition on PL and HMG-CoA reductase (IC50 , 245-338 μg mL-1 ) whereas strong activity on AG and ODC (IC50 , 130-133 μg mL-1 ) was observed. Kinetic studies and molecular docking with pelargonidin-3-O-rutinoside (P3R) on ODC, revealed changes in Km (0.9514-0.9746 mM) and Vmax (1.96-2.32 μmol mg-1  min-1 ) suggesting mixed inhibition and molecular interaction with two active sites of ODC. P3R showed antiproliferative activity (IC50, 46.5 μM) and decreased polyamine accumulation in DLD-1 cells. The results of OGTT confirmed that RPAF regulates postprandial glucose levels in diabetic animals which experienced a significant glucose depletion (30 %; p<0.001) from 30 to 120 min post-treatment. Prolonged supplementation of RPAF caused significant decrease (p<0.001) in plasma glucose, total cholesterol, LDL-c and triglycerides as well as significant increase (p<0.001) of HDL-c compared with normoglycemic untreated animals.

GC-MS analysis of n-hexane extract of Fagonia indica Burm.f. with hypoglycaemic potential

The present study was aimed at gas chromatography-mass spectrometry (GC-MS) analytical investigation of n-hexane extract of the aerial parts of Fagonia indica to identify hypoglycaemic compounds. Also, to investigate this extract for lactase enzyme inhibition responsible for hypoglycaemic activity. Phytochemical screening, GC-MS analysis and lactase inhibition of n-hexane extract was performed by the standard methods. GC-MS analytical study identified 15 compounds in this extract. The maximum percentage of lactase enzyme inhibition of n-hexane extract was 26.21 ± 1.25% (IC50 value of 311.2 ± 16.09 μg/mL) at 100 μg/mL concentration. The standard acarbose showed lactase inhibition of 63.21 ± 0.92% (IC50 value of 32.51 ± 0.85 µg/mL) at the same concentration. n-Hexane extract can be a potential source in the management of diabetes due to the presence of biologically active hypoglycaemic compounds.

Potential health benefits of Nigella sativa on diabetes mellitus and its complications: A review from laboratory studies to clinical trials

This review aims to gather and summarize up-to-date information on the potential health benefits of Nigella sativa (NS) on diabetes mellitus (DM) and its complications from different animal models, clinical trials and in vitro studies. DM is one of the most prevalent metabolic disorders resulting from chronic hyperglycaemia due to problems in insulin secretion, insulin action or both. It affects people regardless of age, gender and race. The main consequence of DM development is the metabolic dysregulation of glucose homeostasis. Current treatments for DM include pharmacological therapy, insulin and diabetic therapy targeting β cells. Some of these therapeutic approaches are promising; however, their safety and effectiveness remain elusive. Since ancient times, medicinal plants have been used and proven effective against diseases. These plants are believed to be effective and benefit physiological and pathological processes, as they can be used to prevent, reduce or treat multiple diseases. Nigella sativa Linn. is an annual indigenous herbaceous plant belonging to Ranunculaceae, the buttercup family. NS exhibits multifactorial activities; it could ameliorate oxidative, inflammatory, apoptotic and insulinotropic effects and inhibit carbohydrate digestive enzymes. Thus, this review demonstrates the therapeutic potential of NS that could be used as a complement or adjuvant for the management of DM and its complications. However, future research should be able to replicate and fill in the gaps of the study conducted to introduce NS safely to patients with DM.

Regulatory Effect of Mung Bean Peptide on Prediabetic Mice Induced by High-Fat Diet

Dietary supplementation with mung bean peptides (MBPs) has several health benefits. However, the effect of MBPs on prediabetes and gut microbiota imbalance caused by a high-fat diet (HFD) has not been thoroughly studied. In this study, dietary supplementation with MBPs for 5 weeks significantly reduced HFD-induced body weight gain, hyperglycaemia, hyperlipidaemia, insulin resistance, inflammation, and oxidative stress and alleviated liver and kidney damage in mice. In addition, it significantly reversed the HFD-induced gut microbiota imbalance, increased the gut microbial diversity, and decreased the abundance of Firmicutes and Bacteroidetes in prediabetic mice. Furthermore, we identified Lachnospiraceae_NK4A136 and Lactobacillus as important eubacteria with the potential to alleviate the clinical symptoms of prediabetes. According to PICRUSt2 analysis, the changes in intestinal microflora induced by MBPs diet intervention may be related to the downregulation of expression of genes such as rocR, lysX1, and grdA and regulation of seven pathways, including pyruvate, succinic acid, and butyric acid. Moreover, 17 genera with significantly altered levels in the intestine of HFD-fed mice, including Akkermansia, Roseburia, and Ruminiclostridium, were significantly correlated with 26 important differential metabolites, such as D-glutathione, anti-oleic acid, and cucurbitacin. Overall, these results show that MBPs diet intervention plays a key role in the management of HFD-induced prediabetes.

The beneficial effects of Ganoderma lucidum on cardiovascular and metabolic disease risk

CONTEXT

Various herbal medicines are thought to be useful in the management of cardiometabolic disease and its risk factors. Ganoderma lucidum (Curtis) P. Karst. (Ganodermataceae), also known as Lingzhi, has received considerable attention for various indications, including some related to the prevention and treatment of cardiovascular and metabolic disease by ameliorating major cardiovascular risk factors.

OBJECTIVE

This review focuses on the major studies of the whole plant, plant extract, and specific active compounds isolated from G. lucidum in relation to the main risk factors for cardiometabolic disease.

METHODS

References from major databases including PubMed, Web of Science, and Google Scholar were compiled. The search terms used were Ganoderma lucidum, Lingzhi, Reishi, cardiovascular, hypoglycaemic, diabetes, dyslipidaemia, antihypertensive, and anti-inflammatory.

RESULTS

A number of in vitro studies and in vivo animal models have found that G. lucidum possesses antioxidative, antihypertensive, hypoglycaemic, lipid-lowering, and anti-inflammatory properties, but the health benefits in clinical trials are inconsistent. Among these potential health benefits, the most compelling evidence thus far is its hypoglycaemic effects in patients with type 2 diabetes or hyperglycaemia.

CONCLUSIONS

The inconsistent evidence about the potential health benefits of G. lucidum is possibly because of the use of different Ganoderma formulations and different study populations. Further large controlled clinical studies are therefore needed to clarify the potential benefits of G. lucidum preparations standardised by known active components in the prevention and treatment of cardiometabolic disease.

Bioguided fractionation of hypoglycaemic component in methanol extract of Vernonia amygdalina: an in vivo study

Nine components (C1-C9) were isolated from chloroform fraction of fractionated methanol extracts of Vernonia amygdalina leaves (FMEVA) by column chromatography. All the components C1 to C9 were purified and screened for hypoglycaemic activities in type-2 diabetic rats. The most potent hypoglycaemic component was elucidated on the basis of extensive spectroscopic (1D-, 2D-NMR, GC-MS, FTIR) data analysis. The Component C5 was found to be the most potent hypoglycaemic in reducing blood glucose by 12.55 ± 3.55% at 4 h post-oral administration, when compared to the positive (18.07 ± 1.20%) and negative (-1.99 ± 0.43%) controls. The spectroscopic data analysis reveals that the isolated compound has a structure consistent with 11β,13-dihydrovernolide. The isolated compound is part of the hypoglycaemic components present in V. amygdalina leaves that is responsible for the anti-diabetic activities. Further research is needed in the development of this compound or its derivatives for pharmaceutical use.

In vitro and in vivo studies of Cucurbita pepo L. flowers: chemical profile and bioactivity

Edible flowers consumption has increased in recent years due to their rich content of healthy phytochemicals. The aim of this study was to analyse the chemical profile of Cucurbita pepo L. flowers, and to explore their antioxidant and hypoglycaemic properties. Moreover, in order to assess in vivo effects, biochemical analysis, Reactive Oxygen Metabolites (d-ROMs) and Biological Antioxidant Potential (BAP) tests were performed on mice serum. High Performance Liquid Chromatography-Diode Array Detection (HPLC-DAD) analyses revealed the presence of (+)-catechin, (-)-epicatechin, rutin, and syringic acid as main constituents. 2,2'-Azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) and Ferric Reducing Antioxidant Power (FRAP) tests showed interesting results. The extract exhibited the strongest inhibitory effect on α-glucosidase (IC₅₀ of 144.77 μg/mL). In vivo results confirmed the hypoglycaemic effects, also affecting lipid metabolism but did not revealed benefits on ROS production. These results may add some information supporting the use of C. pepo flowers as functional foods and/or nutraceuticals.

Nutritional composition of Stevia rebaudiana, a sweet herb, and its hypoglycaemic and hypolipidaemic effect on patients with non-insulin dependent diabetes mellitus

BACKGROUND

The prevalence of diabetes is rapidly rising all over the globe at an alarming rate. India shelters the highest number of diabetics and is thus known as the 'Diabetes Capital of the World'. The chemical management of diabetes has side effects and hence the present study was undertaken to assess the hypoglycaemic and hypolipidaemic effect of Stevia rebaudiana in patients with type 2 diabetes, non-insulin dependent diabetes mellitus (NIDDM). Its nutritional composition and use as a sweetener substitute were also assessed.

RESULTS

Chemical analysis of dried Stevia leaf powder revealed it to be a nutritious herb with a good iron and fibre content. Intervention trials in diabetics revealed that it significantly lowered fasting and post-prandial blood glucose levels. The serum triglycerides and VLDL-C levels were also significantly reduced.

CONCLUSION

Hence it can be said that Stevia can safely be used as an anti-diabetic herb, as a sweetener substitute and may help to prevent cardiovascular diseases in patients with long-standing diabetes. © 2016 Society of Chemical Industry.

Optimised extraction of β-carotene from Spirulina platensis and hypoglycaemic effect in streptozotocin-induced diabetic mice

BACKGROUND

Spirulina platensis is rich in β-carotene, which possesses many important biological activities. This study investigated the ultrasound-assisted extraction and purification of β-carotene from Spirulina platensis by using response surface methodology (RSM), determined its antioxidant capacity in vitro and explored its hypoglycaemic effect in diabetic mice.

RESULTS

The raw β-carotene extract with a concentration of 1942.14 ± 10.03 µg mL(-1) was obtained at the optimised condition by RSM (0.40 of the solid-liquid ratio, 51% of the extraction power, and 17 min of the extraction time), and the purity of evaporated β-carotene extract reached 816.32 ± 10.57 mg g(-1) after purified by a NKA-9 resin with a sampling and elution rate of 1 mL min(-1) . The β-carotene extract scavenged 1,1-diphenyl-2-picrylhydrazyl and hydroxyl free radicals with the highest ratios of 44 ± 0.26% and 35 ± 0.45% respectively, and exhibited strong inhibiting capacity on anti-lipid peroxidation. The blood glucose level of streptozotocin-induced diabetic mice was significantly reduced from 15.81 ± 1.71 mmol L(-1) to 8.10 ± 0.88 mmol L(-1) after 10 d administration of the β-carotene extract [100 mg kg(-1) body weight (BW)], and the increased food and water intakes in the diabetic mice were also significantly relieved after β-carotene treatment.

CONCLUSION

Our results suggested that extraction of β-carotene from Spirulina platensis had potential prospects in scaled-up industrialisation and healthcare applications.

Antidiabetic andantioxidant properties, and α-amylase and α-glucosidase inhibition effects of triterpene saponins from Piper auritum

Bioactivity-guided fractionation of methanol extracts from leaves of Piper auritum produced four triterpenoid saponin compounds 1-4. Structures were established based on interpretation of mass spectrometry (MS), nuclear magnetic resonance (NMR) data. 21-(p-methoxycinnamoyl)-olean-12-ene-28oic cid-3-O-α-L-arabinopyranosyl-(1→2)-β-D-glucopyranoside (1) and olean-12-ene-28 methyl ester-3-O-α-L-arabinofuranosyl-(1→2)-β-D-glucopyranoside (2) were orally administered to diabetic mice at dosage of 10 mg/kg of body weight per day for 30 days and resultant biochemical parameters were studied. Both compounds significantly (p<0.05) decreased serum glucose, total cholesterol, and triglyceride levels, compared with controls. Low density lipoprotein and high density lipoprotein cholesterol levels were ameliorated. The effects of lipid peroxidation and oxidative stress in the liver, pancreas, and kidney were reversed, with reductions insulin resistance and stimulation of insulin production. β-Glucosidase activities were studied in vitro. Compounds 1 and 2 can be used to improve glucose and lipid metabolism and to reduce the imbalance between generation of reactive oxygen species and scavenging enzyme activities for prevention of diabetic complications.

cystidiosus mushrooms in healthy volunteers and type 2 diabetic patients on diet control and the possible mechanisms of action

This study determined the oral hypoglycaemic effect of suspensions of freeze dried and powdered (SFDP) Pleurotus ostreatus (P.o) and Pleurotus cystidiosus (P.c), using healthy human volunteers and Type 2 diabetic patients on diet control at a dose of 50 mg/kg/body weight, followed by a glucose load. The possible hypoglycaemic mechanisms were evaluated using rats, by examining intestinal glucose absorption and serum levels of insulin, glucokinase (GK) and glycogen synthase kinase (GSK). The P.o and P.c showed a significant reduction (P < 0.05) in fasting and postprandial serum glucose levels of healthy volunteers and reduced the postprandial serum glucose levels and increased the serum insulin levels (P < 0.05) of Type 2 diabetic patients. The P.o and P.c increased the intestinal absorption of glucose but simultaneously reduced the serum glucose levels (P < 0.05) in rats. Both mushrooms reduced the serum GSK and promoted insulin secretion while P.c increased serum GK (P < 0.05). The hypoglycaemic activity of P.o and P.c makes mushrooms beneficial functional foods in diabetes mellitus. The mechanism of hypoglycaemic activity of P.o and P.c is possibly by increasing GK activity and promoting insulin secretion and thereby increasing the utilization of glucose by peripheral tissues, inhibiting GSK and promoting glycogen synthesis.

Hypoglycemic and antihyperglycemic effect of Ceiba pentandra L. Gaertn in normal and streptozotocin-induced diabetic rats

BACKGROUND

Ceiba pentandra (L.) Gaertn, commonly called silk-cotton tree, has been extensively used by traditional medicine practitioners in Northern and Eastern Nigeria in the control and management of diabetes.

OBJECTIVE

To evaluate the hypoglycaemic and anti-hyperglycaemic effect of ethanolic extract of Ceiba pentandra bark in normal and streptozotocin induced diabetic rats.

METHOD

Screening activity of the extract was carried out by OGTT. Diabetes mellitus was induced with streptozotocin and graded doses of the ethanolic bark extract (200 and 400 mg/kg, b.w.) were then administered to the experimentally diabetic rats. The blood glucose level was measured at different time intervals.

RESULTS

The single dose study of C. pentandra extract at two different doses produced no significant hypoglycaemic effect in normal rats but C. pentandra (200 mg/kg) significantly decreased blood glucose level in diabetic rats. In OGTT, C. pentandra (200 mg/kg) significantly reduced elevated glucose level in normal and diabetic rats. In long term (21 days) study, C. pentandra (200 mg/kg) significantly decreased blood glucose level, total cholesterol and triglycerides level, prevented degeneration of liver and pancreas, and increased serum insulin level and liver glycogen content in diabetic rats. Acute toxicity study in rats did not show any signs of toxicity up to the dose of 2000 mg/kg b.w.

CONCLUSION

The results reveal that the extract improved glucose tolerance in normal and streptozotocin-induced diabetic rats. Thus the study suggests that the C. pentandra bark extract could be beneficial in the management of type I diabetes.

(Moraceae) leaf aqueous extract in rats

The hypotensive and hypoglycaemic effects of Ficus exasperata (Vahl) (family: Moraceae) leaf aqueous extract (FEE) were investigated in experimental rat models. In this study, spontaneously-hypertensive rats (SHR) (type 1 diabetes), obese Zucker (type 2 diabetes) and Wistar rats were used. Three (A, B and C) groups of rats, each group consisting of 10 rats, were used. Group A Wistar rats received distilled water in quantities equivalent to the volume of streptozotocin (STZ) and FEE administered intraperitoneally to treated rats. Diabetes mellitus was induced in the SHR group B rats by multiple low-dose (MLD) intraperitoneal injections of STZ (40 mg/kg body weight) to induce type 1 diabetes. The animals in group C were the obese Zucker rats with non-insulin-independent diabetes mellitus (NDDM) (type 2 diabetes) on genetic basis. F. exasperata leaf aqueous extract (FEE, 100 mg/kg/day p.o.) was administered orally by orogastric intubation to fasted Groups B and C rats. In groups B and C rats, administration of FEE commenced 4 weeks post STZ injection, and continued for the next 4 consecutive weeks. Group A rats gave normal biochemical and morphological findings. Group B rats exhibited pronounced polyuria, hypoinsulinaemia, hyperlipidaemia and hyperglycaemia. These findings were also observed in group C rats, except that there was hyperinsilinaemia. Histopathological study of the aortic blood vessels showed extensive collagen fiber formation as well as perivascular fibrosis in both groups B and C rats. Four weeks of oral administration of F. exasperata leaf aqueous extract to diabetic groups of rats decreased blood glucose, blood pressure and lipid profiles. Administration of FEE (100 mg/kg p.o.) also restored the microanatomy of the blood vessels to almost normal levels. The findings of this study suggest that F. exasperata leaf aqueous extract possesses hypoglycaemic, hypotensive and hypolipidaemic properties. These findings lend biomedical and pharmacological support to the folkloric, ethnomedical uses of the plant in the management and/or control of diabetes and hypertension among the Yoruba-speaking people of Western Nigeria.

Persistence of acidosis in alloxan-induced diabetic rats treated with the juice of Asystasia gangetica leaves

BACKGROUND

Diabetes mellitus is gradually becoming a global health burden leading to an increase in the search for herbal hypoglycemic agents as alternatives to synthetic ones. Asystasia gangetica is one of the herbs used in folklore system of medicine for managing hypoglycaemia associated with diabetes.

MATERIALS AND METHODS

The influence of the juice of A. gangetica leaf on alloxan-induced diabetic rats was assessed by treating diabetic rats with 25%, 50% and 75% fresh juice and glibenclamide for 5 weeks. Afterwards, the plasma concentrations of glucose, triacylglycerols, total cholesterol, high-density lipoprotein (HDL) cholesterol, thiobarbituric acid reactive substances and bicarbonate were assayed spectrophotometrically.

RESULTS

Treatment of the diabetic rats with the juice significantly (P < 0.05) reduced the elevated plasma levels of glucose to a level not significantly (P > 0.05) different from that of glibenclamide. The juice also significantly (P < 0.05) reduced the plasma lipid peroxidation and improved the lipid profile, as indicated by a significant (P < 0.05) reduction in the total cholesterol: HDL cholesterol ratio. However, there was a significant (P < 0.05) rise in the level of bicarbonate as result of the juice treatment from 28.15 ± 2.82 mmol/l in normal control to 60.83 ± 17.46 mmol/l in diabetic control and to 122.20 ± 34.68 mmol/l, 120.95 ± 35.09 mmol/l and 115.85 ± 11.79 mmol/l in 25%, 50% and 75% juice, respectively.

CONCLUSION

Therefore, this inability of A. gangetica to prevent acidosis detracts from the potential of its usefulness in managing diabetes.

Hypoglycaemic and hypolipidaemic effects of Withania somnifera root and leaf extracts on alloxan-induced diabetic rats

Withania somnifera is an important medicinal plant, which is used in traditional medicine to cure many diseases. Flavonoids were determined in the extracts of W. somnifera root (WSREt) and leaf (WSLEt). The amounts of total flavonoids found in WSREt and WSLEt were 530 and 520 mg/100 g dry weight (DW), respectively. Hypoglycaemic and hypolipidaemic effects of WSREt and WSLEt were also investigated in alloxan-induced diabetic rats. WSREt and WSLEt and the standard drug glibenclamide were orally administered daily to diabetic rats for eight weeks. After the treatment period, urine sugar, blood glucose, haemoglobin (Hb), glycosylated haemoglobin (HbA1C), liver glycogen, serum and tissues lipids, serum and tissues proteins, liver glucose-6-phosphatase (G6P) and serum enzymes like aspartate transaminase (AST), alanine transaminase (ALT), acid phosphatase (ACP) and alkaline phosphatase (ALP) levels were determined. The levels of urine sugar, blood glucose, HbA1C, G6P, AST, ALT, ACP, ALP, serum lipids except high density lipoprotein-bound cholesterol (HDL-c) and tissues like liver, kidney and heart lipids were significantly (p < 0.05) increased, however Hb, total protein, albumin, albumin:globulin (A:G) ratio, tissues protein and glycogen were significantly (p < 0.05) decreased in alloxan-induced diabetic rats. Treatment of the diabetic rats with WSREt, WSLEt and glibenclamide restored the changes of the above parameters to their normal level after eight weeks of treatment, indicating that WSREt and WSLEt possess hypoglycaemic and hypolipidaemic activities in alloxan-induced diabetes mellitus (DM) rats.