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Background The history and the discovery of the benefits of traditional medicines are fascinating over wide variety of disease. Various molecules have been erupted from traditional medicine for various diseases through reverse pharmacology. In current scenario plant-based medicines backed by modern scientific evidences are one of the most promising therapies in diabetes management. Scope and approach Garlic (allicin), European barberry (berberine), Bitter gourd (charantin, polypeptide-p), Sweet potato (adiponectin, tiliroside), Orka (quercetin, hyperin) are some plants that have been used in folk medicine as well as traditional healing systems and are being assessed for their hypoglycemic effects in modern medicine. Key findings and conclusions “Old wine in new bottle” proverb applies traditional medicine in new modern medicine. Various novel delivery aspects have modified the pharmacokinetics of phytochemicals and indirectly enhance the bioavailability, which in turn gives fruitful effect of their therapeutic action.

Background Xyloglucan (XyG) is a ubiquitous polysaccharide that possesses hypoglycemic effects, antihyperlipidemia effects, gut barrier protective properties, and positive effects on coronary heart disease. As a nonstarch polysaccharide, XyG cannot be processed directly by enzymes encoded on the human genome. After being ingested, XyG transits the large intestine where it becomes food for the intestinal microbial community. The species within the intestinal microbiota use various strategies to recognize and degrade XyG. However, most current studies focus on the industrial application of XyG. We must examine the beneficial effects of XyG on human health and the roles that the gut microbiota play in XyG degradation. Scope and approach The current review summarizes the relationship between XyG and intestinal microbiota, including the degradation process of XyG by gut Bacteroidetes and the influence of XyG on the intestinal microbiota. In addition, the possible effects of XyG or its microbial degradation products on human health are presented. Key findings and conclusions XyG breakdown in the large intestine is mediated by several proteins encoded on XyG utilization loci. Surface glycan-binding proteins and glycan-degrading enzymes encoded on XyG utilization loci are the main components that utilize XyGs in the large intestine. Secondary metabolites and fermentation end products that are generated in XyG degradation by gut microbiota can improve human health. The beneficial effects of XyG on human health may be realized through its microbial degradation.

The present study was undertaken to examine the antidiabetic potential of naturally occurring peptides and hydrolysate fractions from easy-to-cook (ETC) and hard-to-cook (HTC) beans. All fractions were tested regarding their in vitro inhibitory activities against α-amylase and α-glucosidase as well as in vivo anti-hyperglycemic and hypoglycemic effects. Results evidenced that the peptide fractions with the lowest molecular weight (3 kDa) have the highest inhibitory activities, and a 16.9%-89.1% inhibition of α-amylase and 34.4%-89.2% inhibition of α-glucosidase were observed. Regarding the antihyperglycemic activity, the fraction ETCNO3-10 showed a better performance than the positive control (acarbose). In addition, results from hypoglycemic activity evidenced that the tested peptide fractions were able to decrease the glucose levels at the same extension of glibenclamide, maintaining a constant basal glucose level without a postprandial hyperglycemia peak. Finally, it is possible to suggest that the naturally occurring peptides and hydrolysate fractions obtained from ETC and HTC common beans could be used in functional food production or pharmaceutical formulations to prevent diabetes.

Recently, there has an increased focus on the isolation, chemical properties and bioactivities of polysaccharides from buckwheat (Fagopyrum Mill), which is a member of the Polygonaceae family. Phytochemical and pharmacological studies have shown that polysaccharides are important biologically-active components of buckwheat, with numerous biological activities, including antioxidant, antitumor, immunomodulatory, antihypertensive and hypoglycemic effects. The purpose of this mini-review is to appraise available literature describing the extraction, separation, purification, structural characterization and biological activities of polysaccharides isolated from buckwheat. This mini-review also provides a foundation for the further investigation, production and application of buckwheat polysaccharides as functional foods and therapeutic agents.

The prevalence of natural health product (NHP) use in Canada is extensive. Patients with chronic diseases, including diabetes, use NHPs at a higher rate than the general population. Many NHPs exert hypoglycemic effects, among other effects relevant to diabetes management. To provide a practical, clinical review of NHPs with such effects targeted to pharmacists, a literature search was performed to collect data on the efficacy and safety profiles of 10 commonly used NHPs that exert antidiabetic properties. The following NHPs are included in this clinical review: alpha-lipoic acid, chromium, magnesium, bitter melon, cinnamon, fenugreek, gymnema, milk thistle, Reishi mushroom and white mulberry. Given the potential of NHPs to additively cause hypoglycemia when used concurrently with conventional medications, pharmacists should be up to date with current evidence around NHPs that may affect diabetes care to prevent adverse reactions and interactions. In addition, effective and respectful communication with patients around NHP use and collaboration with various health-care providers are essential in the patient care process.

Polygonum multiflorum (PM) has been used as a tonic edible plant and is a popular anti-ageing dietary supplement. Trans-2,3,5,4′-tetrahydroxystilbene 2-O-β-glucopyranoside (trans-THSG) is the major active compound in PM. It was found to have potent anti-inflammatory effects in RAW 264.7 macrophage cells and in TPA-induced mouse ear edema model. Research in the significance and rational of traditional process of post-harvested PM has been neglected. With the aid of modern analytical technology, we studied the major phytochemical transformation of PM solution from trans- to cis-THSG under UV light, reminiscent of traditional process, and further evaluated the hypoglycemic effects of the processed PM extract. In a high fat diet-induced type 2 diabetic mice model, processed PM extract containing cis- and trans-THSG (ratio = 2:3) exhibited significant hypoglycemic capacity, while pure trans-THSG and unprocessed PM extract (cis-/trans-THSG ratio = 1:20) did not, suggesting the importance of anti-diabetic effect of cis-THSG and PM natural process.

This research established an optimized method for the extraction and enrichment of flavonoids from R. corchorifolius fruit. Under the optimized extraction conditions, 12 flavonoids (1–12) were isolated, of which six (2–4, 9–10, 12) were obtained from R. corchorifolius for the first time. Compound 4 showed significant α-glucosidase (4.96 μM) and α-amylase (8.04 μM) inhibitory effects. Molecular modeling revealed that compound 4 exhibits strong binding with the active sites of α-glucosidase and α-amylase. Lineweaver-Burk plot analysis and surface plasmon resonance revealed the possible dynamic binding mechanism of the flavonoids with α-glucosidase and α-amylase. The enriched flavonoids and compound 4 showed significant hypoglycemic effects in mice administered a high dose of glucose. In this study, a variety of flavonoids with hypoglycemic activity were found for the first time, revealing the rich chemical composition of R. corchorifolius fruit and highlighting the potential value of R. corchorifolius fruit flavonoids as dietary supplements.

In order to investigate the hypoglycemic effects and potential mechanism of recombinant irisin on diabetes, STZ-induced diabetic mice were established and treated with irisin. The results showed that daily water and food intake, and blood glucose significantly decreased after various concentrations of recombinant irisin treatment by intraperitoneal injection, of which 1.0 mg/kg was the optimal dose for lowering blood glucose. However, the body weight exhibited no significant difference during the treatment within groups, although the 0.9% NaCl treated group showed a trend of decreased body weight and the irisin treated groups showed a tendency of increasing weight. The oral glucose tolerance was improved, and serum insulin and circulating irisin content were significantly elevated in diabetic mice after 1.0 mg/kg irisin-injection treatment, compared to diabetic mice treated with 0.9% NaCl. 1.0 mg/kg irisin-injection also significantly increased the expression of energy and metabolism-related genes. In addition, oral administration of irisin lowered the blood glucose in diabetic mice. Our data suggested that irisin could lower blood glucose in insulin-deficient diabetic mice, to some extent, through irisin-mediated induction of energy and metabolic genes expression. These observations laid a foundation for the development of irisin-based therapy.

Backgrounds Diabetes mellitus, especially type 2 diabetes, with its fast-rising prevalence, has become a global epidemic. Mulberry (Morus alba L.) leaf has been known to have hypoglycemic effects since ancient times. In Asia mulberry leaf is used as tea to complement the treatment of diabetes mellitus. The methods by which mulberry leaf affects the body and its mechanism when combined with chemical agents have been studied extensively. Conclusions We summarize the possible mechanisms of the anti-diabetic effects of mulberry leaf based on extraction procedures, in vitro and in vivo experiments, and clinical trials. We also discuss the hypothesis that crosstalk and “critical nodes” may be useful for a deeper molecular understanding of the treatment and prevention of diabetes with mulberry leaf.

Hardy kiwi (Actinidia arguta) is a climbing, perennial and dioecious vine from Actinidiaceae family, native from Asia and valued as ornamental and traditional medicine. In the last decade, the growing interest as fruit-bearing plant encourage the expanding cultivation of A. arguta mainly to fruits production, particularly in Europe and North America. A. arguta plants have an extensive range ofbioactive compoundsthat can be obtained from different botanical structures, such as fruits, leaves, flowers and stems. These bioactive molecules, with well-recognized health-promoting properties, include phenolic compounds, minerals, carbohydrates or even volatile substances, with a great potential to be used in several formulations of food products. Phytochemical studies on this plant reported hypoglycemic effects as well as antioxidant and anti-inflammatory activities, among others. The traditional uses ofA. arguta have been experimentally proved byin vitroandin vivostudies, in which its bioactivities were associated to its phytochemical composition. This review aims to assess and summarize the phytochemical and healthy properties ofthe different botanical parts of A. arguta, describing their bioactive composition and exploring it potential functional properties on foodstuffs.

Two-layered dissolving microneedles (DMs) containing the long-acting insulin analog, insulin glargine (IG), were prepared and a pharmacodynamic study was performed to evaluate the prolonged hypoglycemic effects of IG DMs in rats. DMs were approximately 487 ± 16 sm (n = 8) in length and 293 ± 8 sm (n = 8) in diameter at their base. The length of the insulin-loaded space was approximately 225 ± 21 sm (n = 8). The level of IG in DMs was 3.96 ± 0.33 U (n = 8). In a one-month stability study, 98.2 ± 1.7 % (n = 8) of IG was recovered at 40 °C. A dissolution study revealed that 82.7 ± 10.3 % (n = 5) of IG was released within 2 min. The hypoglycemic effects of IG DMs were evaluated in rats in which subcutaneous injection preparations were used as the positive control. Decreased plasma glucose levels were maintained for 10 h. The total area above the plasma glucose level (AAG, % of the pre-dose level) vs. time curve as an index of the hypoglycemic effect was 147.5 ± 34.0 %-h (n = 5). AAG increased to 194.3 ± 20.6 %-h (n = 5) when the dose of IG was increased to 5.87 ± 0.85 U (n = 5). The relative pharmacological availabilities of IG from DMs were 79.1 ± 18.3 % (n = 5) and 85.3 ± 9.0 % (n = 5). A pharmacokinetic study showed that plasma IG levels were maintained between 100 and 200 sU/mL for 9 h. These results clearly demonstrated the usefulness of DM in obtaining long-term hypoglycemic effects in rats.

Okara is the byproduct of tofu or soymilk production process. The okara used in this paper contains 58.60% total dietary fiber (TDF), 55.63% insoluble dietary fiber (IDF) and 1.91% soluble dietary fiber (SDF). Okara may be considered a good source of dietary fiber for the high fiber content, cheap cost and wide resource. Okara dietary fiber mainly consists of arabinose, galactose, xylose and galacturonic acid, and its molecular weight is from 724 kDa to 2081 kDa. Replacing 25%, 15% or 10% wheat flour with okara powder to make noodle, steamed bread or bread, the three okara foods have almost similar taste and quality to control foods. Their TDF contents increase from 7.97%, 13.83% and 14.97% to 25.71%, 21.95% and 22.73%, respectively, compared to control foods, and the enhancement is mainly IDF. The hypoglycemic effects of these okara foods were evaluated by glycemic index (GI) using in vivo study. The results showed the GI for okara bread, okara steamed bread and okara noodle were 49±8, 54±2 and 52±14, respectively, referring to glucose (GI=100). The GI of okara foods was distinctly lower than that of control foods (bread 67±3, steamed bread 86±10, and noodle 77±11). The hypoglycemic effect could be caused by okara dietary fiber. The study suggests that replacing part wheat flour with okara powder to make principal foods is a potential method for okara's application.

Insect tea, listed in the “Compendium of Materia Medica” by Li Shizhen, is not only a traditional drink for the ethnic minority in southwest China, but also one of China's traditional export commodities. Insect tea is made of the feces of insects that feed on plants, and characterized by minimal dose, enjoyable tea flavor, few tea-residues, and superb transparency. Insect tea has been used to clear summer heat, protect the spleen and stomach, and facilitate digestion. Modern research has suggested that insect tea is safe and nutritional, and it has blood lipid lowering, antihypertensive and hypoglycemic effects. At present, due to the household production of insect tea, there are a variety of species of tea-producing insects and feeding plants. In the present review, we summarized the types, civilian applications, nutritional value, pharmacological activity and safety of insect tea, in an effort to provide scientific knowledge for future study.

Two-layered dissolving microneedles (DMs) containing intermediate-acting insulin, protamine sulfate insulin (PSI), were prepared. Then a pharmacodynamic study was performed to evaluate the prolonged hypoglycemic effects in rats. The DMs were approximately 497±5 μm long, with 303±3 μm diameter at their base. The length of the insulin loaded space was 182±4 μm. PSI contents in DMs were 0.51±0.02 IU. A three-month stability study showed that 99.9±1.4% of PSI was recovered at 4 °C. As the temperature increased to 40 °C, recovery decreased to 97.5±2.0%. PSI was released within 5 min from DMs. Hypoglycemic effects of PSI DMs were evaluated in rats where subcutaneous injection preparations were used as references. Total area above the plasma glucose level (% of the pre-dose level) vs. time curve as an index of hypoglycemic effect was 144.0±16.0% h and 243.3±8.5% h for PSI DMs at 1.46 and 3.28 IU/kg. The relative pharmacologic availability of PSI from DMs were 100.2±9.8% and 91.4±4.1%. No significant difference of hypoglycemic curves was found between DMs and injection solutions, which suggests the usefulness of two-layered DMs of PSI for the displacement therapy of sc injection preparation.

Sesquiterpene glycoside, nerolidol-3-O-alpha-l-rhamnopyranosyl(1-->4)-alpha-l-rhamnopyranosyl(1-->2)-[alpha-l-rhamnopyranosyl(1-->6)]-beta-d-glucopyranoside was isolated from dried leaves of loquat [Eriobotrya japonica (Thunb.) Lindl., Rosaceae]. Hypoglycemic effects of this natural product were assessed in normal and alloxan-diabetic mice model. Animals received orally administration of the sesquiterpene glycoside in dose of 25 and 75 mg/kg. The anti-hyperglycemic effect was compared with gliclazide's. The dose of 25 and 75 mg/kg both exerted a significant (p

Background Insulin glargine is a long-acting insulin that can cause prolonged hypoglycemia when misdosed or overdosed subcutaneously. There are no reports of intravenous overdoses of insulin glargine. Objectives We present a case of a patient inadvertently given a large intravenous dose of insulin glargine (100 units) who had an unremarkable course. Case Report A 46-year-old woman with a history of type 2 diabetes was found to be hyperglycemic and was mistakenly given an intravenous bolus of 100 units of insulin glargine. She did not become hypoglycemic, did not require parenteral dextrose, and her blood sugar readings stabilized within 3 h. She was admitted and observed for 17 h and discharged without complication. Conclusion To our knowledge, this is the first report of a significant intravenous insulin glargine administration. This patient had an unremarkable course and recovered without any parenteral glucose. This case, along with prior studies on healthy volunteers, suggests that unlike subcutaneous overdoses, intravenous insulin glargine misdose/overdose may not need prolonged observation; an observation time of 6 h may be sufficient in these patients.

Momordica charantia (karela) is commonly used as an antidiabetic and antihyperglycemic agent in Asian, Oriental and Latin American countries. This study was undertaken to investigate the effects of long term feeding (10 weeks) of M. charantia fruit extract on blood plasma and tissue lipid profiles in normal and streptozotocin (STZ)-induced Type 1 diabetic rats. The results show that there was a significant (P0.05) increase in plasma non-esterified cholesterol, triglycerides and phospholipids in STZ-induced diabetic rats, accompanied by a decrease in high density lipoprotein (HDL)-cholesterol. A moderate increase in plasma (LPO) product, malonedialdehyde (MDA), and about two-fold increase in kidney LPO was also observed in STZ-induced diabetic rats. The treatment of diabetic rats with M. charantia fruit extract over a 10-week period returned these levels close to normal. In addition, karela juice also exhibited an inhibitory effect on membrane LPO under in vitro conditions. These results suggest that M. charantia fruit extract exhibits hypolipidemic as well as hypoglycemic effects in the STZ-induced diabetic rat.

The positive influence of Aloe vera, a tropical cactus, on the healing of full-thickness wounds in diabetic rats is reported. Full-thickness excision/incision wounds were created on the back of rats, and treated either by topical application on the wound surface or by oral administration of the Aloe vera gel to the rat. Wound granulation tissues were removed on various days and the collagen, hexosamine, total protein and DNA contents were determined, in addition to the rates of wound contraction and period of epithelialization. Measurements of tensile strength were made on treated/untreated incision wounds. The results indicated that Aloe vera treatment of wounds in diabetic rats may enhance the process of wound healing by influencing phases such as inflammation, fibroplasia, collagen synthesis and maturation, and wound contraction. These effects may be due to the reported hypoglycemic effects of the aloe gel.

A recently developed pharmacokinetic model of the insulin-glucose system has been used to investigate the contribution of insulin-induced suppression of endogenous glucose production (EGP) to the hypoglycemic effect of insulin in the treatment of diabetic ketoacidosis and to determine the influence of the initial degree of hyperglycemia on the course of insulin treatment. Simulations of the time course of glucose concentration in the plasma following low-dose insulin therapy indicate that the hypoglycemic action of insulin is largely due to insulin-dependent glucose utilization and that suppression of EGP, if it occurs at all, contributes little to the overall effect. Nevertheless, a particularly useful characteristic of the pharmacokinetic model of the insulin-glucose system that assumes little or no suppression of EGP is its ability to predict glucose rebound when insulin has been effectively depleted. Other simulations reveal that the initial degree of hyperglycemia has little influence on the clinical outcome of low-dose insulin treatment of diabetic ketoacidosis. According to the simulation, 0.1 (U/kg)/hr intravenous infusion of insulin will produce satisfactory control of plasma glucose concentrations within 5–8 hr, assuming initial glucose concentrations ranging from 500 to 1500 mg/dl.

1. 1. The effect of melatonin treatment (one or three injections daily) on plasma glucose levels in sham-operated and pinealectomized goldfish was examined. 2. 2. Melatonin significantly decreases blood glucose levels in sham-operated but not pinealectomized goldfish when the animals are maintained under continuous light. 3. 3. Melatonin significantly increased liver glycogen levels in both sham-operated and pinealectomized goldfish maintained under continuous light. 4. 4. The effect of melatonin on carbohydrate metabolism appears to be multifaceted as this hormones' hypoglycemie effects are pineal dependent while glycogenic effects are pineal independent.