Effect of Diacerein on Metabolic Control and Inflammatory Markers in Patients with Type 2 Diabetes Using Antidiabetic Agents: A Randomized Controlled Trial

INTRODUCTION

Studies have shown that T2DM is an inflammatory disease. Thus, the present study was aimed at evaluating whether diacerein could improve the metabolic and inflammatory profile among patients with T2DM under long-term treatment with glucose-lowering agents.

METHODS

This is a double-blind, parallel, placebo-controlled trial with 72 participants randomly assigned to diacerein 50 mg or placebo for 12 weeks. The primary endpoint was the between-group difference in change in HbA1c. Secondary endpoints included the proportion of patients achieving metabolic control [HbA1c ≤ 7.0% (53 mmol/mol)] and change in inflammatory mediators.

RESULTS

Participants in the diacerein group had greater reductions in mean HbA1c level in comparison to placebo (-0.98; 95% CI: -2.02 to 0.05, P = 0.06), independently of confounding factors. The difference in HbA1c level was -1.3 (95% CI: -2.3 to -0.4) in favor of diacerein (P = 0.007) in those with <14 years of diabetes duration versus 0.05 (-0.7 to 0.8; P = 0.9) in those with longer duration. The diacerein group had a 50% increase in the number of participants at the lowest TNF-α level (≤1.46 pg/mL).

CONCLUSIONS

In patients with long-established T2DM under long-term treatment with glucose-lowering agents, diacerein improves metabolic control as measured by HbA1c level and has a favorable impact on inflammatory profile.

CLINICAL TRIAL REGISTRY

This trial is registered with Brazilian Clinical Trials Registry (ReBEC) number RBR-29j956.

Effect of diacerein on renal function and inflammatory cytokines in participants with type 2 diabetes mellitus and chronic kidney disease: A randomized controlled trial

Diacerein seems to improve metabolic control and reduce inflammatory marker levels in individuals with type 2 diabetes mellitus (Type 2 DM), but for participants with chronic kidney disease (CKD) its effect is unknown. This study aimed to evaluate the effect of diacerein vs. placebo on urinary albumin/creatinine ratio (ACR), glomerular filtration rate (GFR), and inflammatory cytokines in type 2 DM participants with CKD. Blood pressure (BP) and metabolic control were secondary outcomes. This randomized, placebo-controlled, parallel trial of adjuvant treatment of type 2 DM with diacerein enrolled seventy-two participants with CKD, aged 30–80 years, with glycated hemoglobin levels from 53–97 mmol/mol (7.0–11.0%), receiving angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antidiabetic agents. Participants randomized to diacerein or placebo were followed-up up to 90 days. Both groups had a marked reduction in ACR, but there was no effect on glomerular filtration rate. While the diacerein group had reduced TNF-α levels at the 75th percentile with a borderline significance (P = 0.05), there were no changes in the IL levels at the 75^th percentile.

Diacerein prevented the increase in blood glucose to the level observed in the placebo group (P = 0.04), improving metabolic control by 74%, reducing 24-hour diastolic BP, nighttime systolic and diastolic BP compared to the placebo group. In conclusion, among patients with type 2 DM and CKD, diacerein does not have an effect on ACR or GFR, but slows metabolic control deterioration and is associated with lower nighttime systolic and diastolic blood pressure.

Trial registration: Brazilian Clinical Trials Registry (Registro Brasileiro de Ensaios Clinicos; ReBeC) U1111-1156-0255

Strategies for Establishing a Rearing Technique for the Fruit Fly Parasitoid: Doryctobracon brasiliensis (Hymenoptera: Braconidae)

Anastrepha fraterculus (Wiedemann) (Diptera: Tephritidae) is the most important pest in South American orchards. When control measures are not adopted, this pest can cause losses of up to 100%. Doryctobracon brasiliensis (Szépligeti) (Hymenoptera: Braconidae) is a larval-pupal endoparasitoid that can be used as a native biological control agent against A. fraterculus. This study aimed to develop a rearing technique for D. brasiliensis in larvae of A. fraterculus. Trials were carried out to: 1) determine the optimal instar for parasitism, 2) define the exposure time of larvae to parasitoids, 3) determine the density requirements of A. fraterculus larvae offered to each parasitoid, and 4) evaluate the effect of diet on adults of D. brasiliensis. In all trials, we evaluated the number of offspring, parasitism rate, and sex ratio. Moreover, in the experiment to investigate the effects of diet, we determined the longevity of males and females. In both choice and nonchoice parasitism tests, the parasitoids preferred third-instar larvae of A. fraterculus over second- and first-instar larvae. An exposure time of 12 h of A. fraterculus larvae produced larger numbers of parasitoids and higher parasitism rates. The density of 15 larvae of A. fraterculus to each female of D. brasiliensis produced a larger number of offspring. A supply of honey solution (20 and 50%) to the parasitoids yielded the highest number offspring and resulted in greater longevity. Our findings can be used to support the development of a mass rearing protocol for D. brasiliensis.

Phenolic Composition and Antioxidant Activity of Edible Flowers: Insights from Synergistic Effects and Multivariate Analysis

The phenolic composition and antioxidant activity of four edible flowers-Orange marigold, yellow marigold, rose geranium, and Rosa de Santa Teresinha-were evaluated to explore their potential as natural antioxidants. Rosa de Santa Teresinha exhibited the highest total phenol content (83.34 ± 2.09 mg GA g-1 DW) and ortho-diphenol content (168.91 ± 0.15 mg GA g-1 DW), while the marigolds showed significantly lower levels (~17 mg GA g-1 DW for total phenols). Antioxidant activity, determined via ABTS, DPPH, and FRAP assays, ranged from 0.11 to 0.96 mmol Trolox g-1 DW, with rose geranium and Rosa de Santa Teresinha achieving the highest values. Theoretical antioxidant contributions, calculated based on the identified phenolic compounds, accounted for only a small fraction of the measured activity, with observed values exceeding predictions by factors of 56 to 1416, indicating the presence of synergistic interactions and additional bioactive compounds. Multivariate analyses (PCA and PLS regression) identified luteolin-7-O-glucoside and quercetin-3-O-galactoside as primary contributors to antioxidant capacity. These results underscore the importance of synergistic effects in edible flowers and highlight their potential as functional ingredients for nutraceutical applications.

Effect of Malvaviscus arboreus Flower and Leaf Extract on the Functional, Antioxidant, Rheological, Textural, and Sensory Properties of Goat Yogurt

The present study aimed to evaluate the effects of incorporating different concentrations (1% and 2%) of Malvaviscus arboreus flower (FE) and leaf (LE) extracts as functional ingredients in goat milk yogurt. This study analyzed the impact of these formulations (YFE1%, YFE2%, YLE1%, and YLE2%) on the physicochemical, bioactive, antioxidant, rheological, textural, and sensory properties of goat yogurt over a 28-day storage period. Including FE and LE extracts significantly enhanced the yogurt's antioxidant activity, reaching up to 10.17 µmol TEAC/g, and strengthened its ability to inhibit lipid oxidation during storage. This study also observed a reduction in the viability of lactic acid bacteria, particularly L. delbrueckii subsp. bulgaricus, suggesting that the extracts may have antimicrobial properties. Notably, using FE, especially at a concentration of 2% (YFE2%), improved both antioxidant and textural properties while reducing syneresis by the end of the storage period. Sensory evaluations showed positive results for YFE1% and YFE2% formulations. These findings suggest that FE has significant potential as a functional food ingredient. This research lays the groundwork for future studies exploring the integration of Malvaviscus arboreus-based ingredients into functional food products, opening new possibilities for innovation in this field.