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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.

Gymnema sylvestre, a plant typical of India, has long been known for its hypoglycemic effects. The objective of this study was to evaluate the effect of G. sylvestre administration on glycemic cont...

Proso millets are eco-friendly smart grains rich in minerals and phytochemical compounds that preserve the health of the individuals. The bioactives present in proso millet gives protection against metabolic syndromes and lifestyle diseases. Hypoglycemic effects of millets, in general are much appreciated and currently millets are used in valorizing the food products due to its functional key elements. In spite of its health benefits and agronomical and economical prospective, millets lost its fame especially in developing countries and it has not reached the massive population may be due to processing difficulty and reduction in production area. This article presents reviews and research investigations about agronomical advantages, post harvest handling protocols, nutraceutical and functional properties and methods of valorizing the proso millet.

Purpose Non-communicable diseases such as type 2 diabetes, hypertension, cancers and cardiovascular diseases have become a major health concern globally. As literature claims that frequent consumption of fruits and vegetables can delay the onset of type 2 diabetes and its complications, this paper aims to evaluate the potential hypoglycemic properties in five types of non-leafy vegetables (pumpkin, sweet potato, bitter gourd, onion and lady’s finger), which are commonly available in Malaysia. Design/methodology/approach Articles were identified through several main search engines, including Pubmed, Google Scholar, Taylor and Francis Online, EDS, Wiley, ScienceDirect and Scopus. The search was limited to selected keywords to refine the outcome. Findings All the five types of non-leafy vegetables demonstrate hypoglycemic properties to some extent. Emerging findings indicate that there are several phytonutrients in the non-leafy vegetables contributing to the hypoglycemic effects. To date, the underlying mechanism of action remains to be elucidated, although a number of potential mechanisms of action have been proposed in the literature. Originality/value This review provides some insights into the hypoglycemic properties in non-leafy vegetables. In addition, phytonutrients that are responsible for the hypoglycemic effects and their mechanism of action are also highlighted.

Diabetes mellitus (DM) is a chronic progressive systemic disease caused by a metabolic disorder. In recent years, a large number of studies have shown that certain traditional Chinese medicines and their bioactive ingredients have obvious hypoglycemic effects. This literature review focuses on medicine food homology (MFH) and medicinal health food (MHF) species used in China with a hypoglycemic function and emphasizes the bioactive ingredients and their pharmacological effects. The bioactive ingredients of MFH and MHF have been divided into six categories: saponins, flavonoids, terpenoids, alkaloids, polysaccharides, and others; and their sources, models, efficacy, and mechanisms of action have been described. It is noteworthy that the mechanisms of the bioactive ingredients of MFH and MHF with hypoglycemic effects have been summarized as follows: a) insulin-mimetic effects and restoration of the damaged pancreas; b) effect on glucose metabolism; c) increased insulin sensitivity and improved insulin resistance; and d) regulation of intestinal flora. We conclude that this review provides useful data and information to support the further investigation and application of MFH and MHF to treat DM.

Dietary intervention in type 2 diabetes mellitus (T2DM) is a hotspot in international research because of potential threats to human health. Phellinus baumii, a wild fungus traditionally used as a food and medicine source, is now cultivated in certain East Asian countries, and is rich in polyphenols, which are effective anti-inflammatory ingredients useful in treatment of T2DM, with fewer side effects than drugs. To examine the hypoglycaemic effects of Phellinus baumii phenolics (PPE), the metabolite profiles of T2DM mice induced by streptozotocin after PPE intervention were systematically analyzed. Here, 10 normal mice were given normal saline as control group, and 50 model mice were randomly assigned to five groups and daily intragastric administrated with saline, metformin (100 mg/kg), and PPE (50, 100, 150 mg/kg of body weight), for 60 days. The pro-inflammatory factor contents of lipopolysaccharide stimulation of RAW 264.7 cells were decreased in a dose-dependent manner after PPE treatment, we propose that PPE could exert anti-inflammatory properties. PPE could also effectively reduce blood glucose levels, increased insulin sensitivity, and improved other glucolipid metabolism. Q-PCR results suggested that the hypoglycemic effects of PPE might be through activating IRS1/PI3K/AKT pathway in diabetic mice. These results suggest that PPE has strong potential as dietary components in the prevention or management of T2DM.

The incidence rate of diabetes has been increasing every year in nearly all nations and regions. The traditional control of diabetes using transdermal insulin delivery by metal needles is generally associated with pain and potential infections. While microneedle arrays (MAs) have emerged as painless delivery techniques, the integration of MA systems with electronic devices to precisely control drug delivery has rarely been realized. In this study, we developed an iontophoresis-microneedle array patch (IMAP) powered by a portable smartphone for the active and controllable transdermal delivery of insulin. The IMAP in situ integrates iontophoresis and charged nanovesicles into one patch, achieving a one-step drug administration strategy of “penetration, diffusion and iontophoresis”. The MA of the IMAP is first pressed on the skin to create microholes and then is retracted, followed by the iontophoresis delivery of insulin-loaded nanovesicles through these microholes in an electrically controlled manner. This method has synergistically and remarkably enhanced controlled insulin delivery. The amount of insulin can be effectively regulated by the IMAP by applying different current intensities. This in vivo study has demonstrated that the IMAP effectively delivers insulin and produces robust hypoglycemic effects in a type-1 diabetic rat model, with more advanced controllability and efficiency than delivery by a pristine microneedle or iontophoresis. The IMAP system shows high potential for diabetes therapy and the capacity to provide active as well as long-term glycemic regulation without medical staff care. A device developed by researchers in China uses a microneedle array to efficiently and painlessly deliver precise doses of insulin and can be used by patients without help from medical staff. The new system was developed by a team led by Xi Xie and Lelun Jiang of Sun Yat-Sen University. The array of microneedles is pressed against the skin to create micro-holes and then automatically retracted. A mild electric current then drives charged nanovesicles carrying insulin through the holes. The circuit is powered and controlled via a smartphone, which can alter the intensity of the current to determine the dosage of insulin delivered. The team showed that the device effectively delivered insulin to a diabetic rat model with no obvious harmful effects. It thus offers a powerful tool for efficient, controllable, and convenient delivery of macromolecular drugs.

Quinoa (Chenopodium quinoa Willd.) is native to the Andean region and has attracted a global growing interest due its unique nutritional value. The protein content of quinoa grains is higher than other cereals while it has better distribution of essential amino acids. It can be used as an alternative to milk proteins. Additionally, quinoa contains a high amount of essential fatty acids, minerals, vitamins, dietary fibers, and carbohydrates with beneficial hypoglycemic effects while being gluten-free. Furthermore, the quinoa plant is resistant to cold, salt, and drought, which leaves no doubt as to why it has been called the “golden grain”. On that account, production of quinoa and its products followed an increasing trend that gained attraction in 2013, as it was proclaimed to be the international year of quinoa. In this respect, this review provides an overview of the published results regarding the nutritional and biological properties of quinoa that have been cultivated in different parts of the world during the last two decades. This review sheds light on how traditional quinoa processing and products evolved and are being adopted into novel food processing and modern food products, as well as noting the potential of side stream processing of quinoa by-products in various industrial sectors. Furthermore, this review moves beyond the technological aspects of quinoa production by addressing the socio-economic and environmental challenges of its production, consumption, and marketizations to reflect a holistic view of promoting the production and consumption of quinoa., We acknowledge the EIT Food education program which provided the funds for an open access publication in the context of the winning prize for top students of the summer school “Food Tech Transitions: reconnecting agri-food, technology, and society” (project number 19162)., info:eu-repo/semantics/publishedVersion

The purpose of this study was to evaluate the effects of oral administration of cinnamon extract (CE) in rats fed on high fat diet (HFD). Thirty two adult male albino rats were divided into four groups; control group, HFD group, HFD group treated by cinnamon and the last group was treated with cinnamon extract. In HFD group, rats were fed on HFD for two months. In HFD group treated by cinnamon, rats fed on HFD for two months then CE was orally administered for a period of 4 weeks at a dose of 200 mg/kg body weight. In CE treated group, rats were fed on standard diet for two months then orally administered CE for a period of 4 weeks at a dose of 200 mg/kg body weight. The obtained results indicated that the oral administration of cinnamon extract has antihyperlipidemic effect that improving the lipid profile. There were reductions in the levels of serum triglycerides, LDL-C, VLDL-C (P≤ 0.01) and total cholesterol (P

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.

Aim The aim of this study was to investigate the immediate effect of bitter gourd, Knol-khol, and ash gourd juices on blood glucose level among Type II diabetes mellitus patients. Methods In 2015, pilot study was conducted randomly enrolling 30 patients with type 2 diabetes mellitus into three groups in SRK college, India. The first group received bitter gourd juice at FBS range between 120 to 300 mg per dl. The second, third group received Knol-khol, ash gourd juice respectively in the same range of fasting blood sugar level. Blood sugar level was evaluated ½ hour interval till 2 h after received respective juices. Data were collected for statistical analysis. Results The mean blood glucose concentration in bitter gourd group was not statistically significant between time points, (P = .176). However, 90 min after the intake of bitter gourd juice shows statistical significant reduction of blood glucose level when compare with fasting level, (p = .049). After Knol khol juice the mean blood glucose level differed statistically significant between time points, shown in (p = .029). But no statistical changes seen in ash gourd group. As a result bitter gourd juice is immediately reducing the blood glucose level, while Knol khol juice reduces the blood sugar level gradually for longer period of 120 min. Conclusion This study shows the significance of hypoglycemic effects of bitter gourd and Knol khol juices among the type 2 Diabetic patients. Hence Bitter gourd juice, Knol khol juices may be beneficial in Diabetes patients to reduce the blood glucose level., Graphical abstract

Graphical abstract, The recent discoveries in the fields of pathogenesis and management of diabetic nephropathy have revolutionized the knowledge about this disease. Little was added to the management of diabetic nephropathy after the introduction of renin angiotensin system blockers. The ineffective role of the renin- angiotensin system blockers in primary prevention of diabetic nephropathy in type 1 diabetes mellitus necessitated the search for other early therapeutic interventions that target alternative pathogenic mechanisms. Among the different classes of oral hypoglycemic agents, recent studies highlighted the distinguished mechanisms of sodium glucose transporter 2 blockers and dipeptidyl peptidase-4 inhibitors that settle their renoprotective actions beyond the hypoglycemic effects. The introduction of antioxidant and anti-inflammatory agents to this field had also added wealth of knowledge. However, many of these agents are still waiting well-designed clinical studies in order to prove their beneficial therapeutic role. The aim of this review of literature is to highlight the recent advances in understanding the pathogenesis, diagnosis, the established and the potential renoprotective therapeutic agents that would prevent the development or the progression of diabetic nephropathy.

Hepatic-directed insulin utilizes a hepatocyte-targeting moiety passively attaching free insulin, improving subcutaneous insulin’s hepatic biodistribution. We assessed injections of HDV-insulin lispro (HDV-L) vs. insulin lispro (LIS) in T1DM in a 26-week, multicenter, randomized, double-blind trial of 176 subjects (randomized 2:1 HDV-L:LIS) with A1C 7.0-10.5% treated with basal insulin glargine or degludec. Primary objective was HDV-L A1C non-inferiority (prespecified margin 0.4%). Mean A1C change to week 26 was -0.09% (HDV-L) and -0.16% (LIS), (estimated treatment difference, HDV-L - LIS: +0.09% [95% CI -0.18 to 0.35]), confirming HDV-L non-inferiority. A1C status modified treatment group effect on “severe” hypoglycemia (subjectively categorized by investigators as “mild,” “moderate,” “severe,” or “life threatening”) incidence (interaction p-value Disclosure D.C. Klonoff: Consultant; Self; EOFlow, Lifecare, Inc., Merck & Co., Inc., Novo Nordisk A/S, Roche Diagnostic USA, Voluntis USA. B.W. Bode: Consultant; Self; ADOCIA, Lexicon Pharmaceuticals, Inc., Novo Nordisk Inc. Research Support; Self; Becton, Dickinson and Company, Dexcom, Inc., Diasome Pharmaceuticals, Inc., Eli Lilly and Company, Eyenuk Inc., Insulet Corporation, National Institutes of Health, Novo Nordisk Inc., Sanofi Research & Development, Senseonics, Xeris Pharmaceuticals, Inc. Speaker's Bureau; Self; AstraZeneca, Boehringer Ingelheim Pharmaceuticals, Inc., Janssen Pharmaceuticals, Inc., Novo Nordisk Inc., Sanofi US, Senseonics. Stock/Shareholder; Self; AgaMatrix, Glytec, LLC. N.J. Cohen: None. W. Geho: Board Member; Self; Diasome Pharmaceuticals, Inc. D.B. Muchmore: Consultant; Self; ADOCIA, Capillary Biomedical, Inc., Diasome Pharmaceuticals, Inc., Zucara Therapeutics Inc. Stock/Shareholder; Self; Capillary Biomedical, Inc., Diasome Pharmaceuticals, Inc. Funding JDRF

Background: Cardiovascular complications account for the majority of deaths caused by diabetes mellitus. Platelet hyperactivity has been shown to increase the risk of thrombotic events and is a therapeutic target for their prevention in diabetes. Modulation of platelet function by diabetes agents in addition to their hypoglycemic effects would contribute to cardiovascular protection. Newly introduced antidiabetic drugs of sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon like peptide-1 receptor agonists (GLP-1RA) and dipeptidyl peptidase-4 inhibitors may have anti-platelet effects, and in the case of SGLT2i and GLP-1RA may contribute to their proven cardiovascular benefit that has been shown clinically. Objective: Here, we reviewed the potential effects of these agents on platelet function in diabetes. Results and Conclusion: GLP-1RA and DPP-4i drugs have antiplatelet properties beyond their primary hypoglycemic effects. Whilst we have little direct evidence for the antiplatelet effects of SGLT2 inhibitors, some studies have shown that these agents may inhibit platelet aggregation and reduce the risk of thrombotic events in diabetes.

The study was aimed to determine whether treatment with oat oligopeptides (OOPs) could modulate hyperglycemia related to type 2 diabetes mellitus (T2DM) in Sprague&ndash, Dawley (SD) rats. Diabetic SD rats modeling by a joint effect of high-calorie diet for 45 days and twice intraperitoneal injection of 30 mg/kg streptozotocin at one-week interval were observed with or without OOPs administration (0.25, 0.50, 1.00, and 2.00 g/kg Body Weight) for 12 weeks. Fasting blood glucose (FBG), oral glucose test tolerance (OGTT), serum insulin, level of antioxidant, and hepatic enzymes were measured. In addition, frequency of micturition was recorded in this study for the first time. It was observed that the administration of OOPs (2.00 g/kg Body Weight) resulted in a significant decrease (p &lt, 0.05) in FBG since 6th week and a significant decrease (p &lt, 0.05) in the OGTT-AUC on 6th and 10th week. In addition, the administration of OOPs (2.00 g/kg Body Weight) reduced HOMA-IR index and 24-h urine volume significantly (p &lt, 0.05) whereas increased SOD activity significantly (p &lt, 0.05). These results suggested that OOPs may have a hypoglycemic effect in diabetic rats.

Artocarpus heterophyllusLam., which is commonly known as jackfruit is a tropical climacteric fruit, belonging to Moraceae family, is native to Western Ghats of India and common in Asia, Africa, and some regions in South America. It is known to be the largest edible fruit in the world. Jackfruit is rich in nutrients including carbohydrates, proteins, vitamins, minerals, and phytochemicals. Both the seeds and the flesh of jackfruit are consumed as curries and boiled forms, while the flesh in fully ripen stage can be eaten directly as a fruit. Several countries have developed different food products such as jam, jellies, marmalades, and ice creams using pureed jackfruit. The several parts of jack tree including fruits, leaves, and barks have been extensively used in traditional medicine due to its anticarcinogenic, antimicrobial, antifungal, anti-inflammatory, wound healing, and hypoglycemic effects. Despite all these benefits, unfortunately, the fruit is underutilized in commercial scale processing in regions where it is grown. The aim of this review is to disseminate the knowledge on nutritional and health benefits of jackfruit, in order to promote utilization of jackfruit for commercial scale food production.

Background: Diabetes mellitus is a metabolic disorder in which there is increased blood sugar level, glycosuria, dyslipidemia and sometimes ketonemia occurs. Increased blood sugar level leads to characteristic symptoms such as polydipsia, polyurea, blurring of vision, polyphagia and weight loss.Methods: Healthy male Wister rats weighing between 150-250 gm were taken. Total 2 groups A and B were prepared and each group contains 6 animals. Group A was administered voglibose as 0.6 mg/70 kg body weight. Group B was administered vildagliptin as 100 mg/70 kg body weight. Diabetes was induced in group A and B by administration of 120 mg/kg body weight of nicotinamide and 60 mg/kg body weight of streptozocin intraperitoneally. Streptozocin was administered after 15-20 minutes of administration of nicotinamide. After 72 hours of streptozotocin injection, fasting blood glucose level was determined and induction of diabetes was confirmed. The fasting blood samples were collected from all the groups on further days 7, 14, 21 and 28 day to determine the glucose level by glucometer. Results: The decline in fasting blood sugar level by voglibose was 36.4% on day 7, 40.2% on day 14, 43.94% on day 21 and 46.4% on day 28. The reduction in Fasting blood sugar level by vildagliptin was 49% on day 7, 52.25% on day 14 and 54% on day 21 and 28. Thus in group B rats, decline was maximal on day 7 and little fall was recorded on subsequent days. It suggests good efficacy as vildagliptin normalized the blood glucose level effectively. Conclusions: Vildagliptin was found significantly more effective in lowering fasting blood glucose level than voglibose.

Raspberry leaf is commonly consumed by pregnant women. Hypoglycemic effects have been documented with other species within the plant family. Whether raspberry leaf affects glycemic control in gestational diabetes mellitus (GDM) is unknown.A 38-year-old nulliparous woman with GDM developed hypoglycemia requiring lowered insulin dose after consuming raspberry leaf tea at 32 weeks of gestation. The temporal relationship was confirmed by the patient's self-withdrawal and reintroduction of the herb. Fetal surveillance and growth were reassuring. A cesarean delivery was performed at 39 weeks of gestation. The neonate did not experience hypoglycemia or other complications. Placental biopsy revealed normal findings.Consumption of raspberry leaf may lead to reduced insulin requirements in GDM. Women with GDM should be cautioned about its use and their glucose levels more closely monitored.

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.

Diabetes mellitus is one of the most prevalent chronic diseases in the world; one of its main characteristics is chronic hyperglycemia. Pharmacotherapy and other alternatives such as regular exercise are among the therapeutic methods used to control this pathology and participate in glycemic control, as well as the ingestion of plant extracts with antioxidant effects. Among the different plants used for this purpose, curcumin has potential to be used to attenuate the hyperglycemic condition triggered by diabetes mellitus (DM). Some prior studies suggest that this plant has antioxidant and hypoglycemic potential. This review aims to evaluate the antioxidant and hypoglycemic potential of curcumin supplementation in Type 1 DM (T1DM) and Type 2 DM (T2DM). The search considered articles published between 2010 and 2019 in English and Portuguese, and a theoretical survey of relevant information was conducted in the main databases of scientific publications, including the Virtual Health Library and its indexed databases, PubMed, LILACS (Latin American and Caribbean Literature on Health Sciences—Health Information for Latin America and the Caribbean—BIREME/PAHO/WHO), and Scientific Electronic Library Online (SciELO). The associated use of turmeric and physical exercise has demonstrated antioxidant, anti-inflammatory, and hypoglycemic effects, suggesting that these could be used as potential therapeutic methods to improve the quality of life and survival of diabetic patients.

Objective: To demonstrate important points regarding the possible hypoglycemic effects of sulfasalazine and suggest possible underlying mechanism(s) accounting for sulfasalazine-induced hypoglycemia.Methods: We describe a case of reversible sulfasalazine-induced hypoglycemia, review the literature, and discuss a potential mechanism accounting for sulfasalazine-induced hypoglycemia.Results: A 63-year-old man with Crohn disease treated with sulfasalazine and type 2 diabetes complicated by end-stage renal disease was admitted for treatment of persistent hypoglycemia. Insulinoma was initially suspected, but localization studies including endoscopic ultrasound were negative. This raised the possibility of sulfasalazine-induced hypoglycemia. Three days after sulfasalazine was stopped, he became normoglycemic. Hypoglycemia has not recurred since discontinuing sulfasalazine.Conclusion: Clinicians should be aware of the potential hypoglycemic effect of sulfasalazine. Doses should be reduced in patients with impaired renal function, and it should be discontinued if otherwise unexplained hypoglycemia develops.Abbreviations: CT = computed tomography; ESRD = end-stage renal disease

O objetivo deste estudo foi revisar a literatura sobre o efeito da farinha da casca do maracujá amarelo (Passiflora edulis f. flavicarpa) nos distúrbios metabólicos que compõem a síndrome metabólica. Trata-se de uma revisão sistemática, realizada por meio do levantamento bibliográfico de estudos publicados entre 2005 e 2017, indexados nas bases de dados IBECS, PubMed, CisSaúde, Cochrame, MedCarib, Lilacs, Medline e SciELO, bem como no Google Scholar, bancos de teses e dissertações. Os estudos selecionados avaliaram o efeito do uso da casca do maracujá amarelo (P. edulis) sobre os parâmetros da síndrome metabólica. Os estudos experimentais demonstraram discordâncias quanto ao efeito hipoglicemiante e resultados positivos quanto ao efeito hipotensor. Em pesquisas realizadas com humanos saudáveis, a suplementação com 30 gramas da farinha da casca de P. edulis demonstrou eficiência na redução glicêmica e lipidêmica para LDL e colesterol total, sem toxicidade. Em estudos com portadores de síndrome metabólica e diabetes mellitus tipo 2, os efeitos hipolipemiantes e hipoglicemiantes também foram demonstrados. Entretanto, ainda há escassez de publicações sobre o uso da casca de P. edulis para tratamento de distúrbios metabólicos, sendo necessária padronização metodológica que viabilize sua recomendação na prática clínica.DOI: 10.12957/demetra.2018.28957

Background Berberine is one of the most important examples of a Chinese traditional medicine that has hypoglycemic effects but there have been no randomized controlled trials of the drug in a larger sample. In addition, the use of probiotic biotherapy to maintain an appropriate intestinal flora may represent an effective early intervention for hyperglycemia. Unfortunately, there has been a shortage of relevant research on this possibility at the population level. This study was designed to determine the hypoglycemic effect and safety of both bifidobacteria and berberine administration to newly diagnosed patients with pre-diabetes or diabetes mellitus. Methods/design This is a multicenter, double-blind, randomized, and parallel-controlled study that includes a run-in period of 2 weeks and a treatment period of 16 weeks, which will be conducted between June 2015 and October 2018. The 300 randomized patients will be assigned to the following four groups for 16 weeks’ treatment: Bifidobacterium, berberine, Bifidobacterium combined berberine, and placebo control groups. The primary outcome is the absolute value of fasting plasma glucose compared with baseline after 16 weeks of treatment. Discussion This is the first randomized controlled trial to determine the hypoglycemic effect and safety of both bifidobacteria and berberine administration to newly diagnosed patients with pre-diabetes or diabetes mellitus. It may provide support for the use of berberine and bifidobacteria in the treatment of diabetes. Trial registration ClinicalTrials.gov, ID: NCT03330184. Retrospectively registered on 18 October 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-018-2438-5) contains supplementary material, which is available to authorized users.

The aim of this study was to evaluate the efficacy of the anti-inflammatory effects of propolis on the systemic and local effects on experimental periodontitis and diabetes. Fifty-six Wistar rats were divided into seven groups: (1) negative-control (NC), (2) periodontitis (P), (3) diabetes (D), (4) diabetes+periodontitis (DP), (5) periodontitis+propolis (P-Pro), (6) diabetes+propolis (D-Pro), and (7) diabetes+periodontitis+propolis (DP-Pro). Periodontitis was induced by ligature placement and diabetes was induced by streptozotocin injection. Propolis (Pro) was administrated by oral gavage (100 mg/kg/day). On day 21, plasma was obtained for analysis and alveolar bone level was evaluated using histomorphometric analysis. Compared to NC the final blood glucose levels for D-Pro was not significantly different (P=.052), however, D, DP, and DP-Pro were significantly different. There were no statistically significant differences in blood glucose concentrations between P and P-Pro, between D and D-Pro, and between DP and DP-Pro. All groups showed significantly more alveolar bone loss compared with NC. A significant difference in bone loss was found between P and P-Pro, and DP and DP-Pro, however there was no difference between D and D-Pro. Plasma interleukin 1beta (IL-1 beta), tumor necrosis factor-alpha (TNF-alpha), and matrix metalloproteinase-8 (MMP-8) levels were not significantly different among groups. In conclusion, propolis reduced fasting blood glucose levels in diabetes. In addition, propolis might be beneficial as an adjunct treatment of diabetes associated periodontitis and periodontitis without diabetes.

To investigate the hypoglycemic effect of the submerged culture of the Ceriporia lacerata mycelium (CL01) species, in-vitro and in-vivo tests were executed using INS-1 and 3T3-L1 cells, normal and diabetic mice. CL01 exhibited an inhibitory effect on cell death through dexamethasone in the INS-1 cells, and increased the GLUT4 expression in the 3T3-L1 cells. A hematological monitoring test was executed using diabetic mice divided into four groups : normal control (G1), negative control (G2), positive control (G3), and CL01 250 mg/kg (G4) groups, which were fed daily for 6 weeks. The body weight gain, food intake, and water intake of G4 were not significantly different from those of G2. After 5 weeks, the blood glucose levels of G4 were significantly different from those of G2. After 6 weeks, the plasma insulin levels of G4 increased by about 36% compared to those of G2, and the plasma C-peptide levels of G4 were lower by about 18%. than those of G3. The results of the oral glucose tolerance test (OGTT) showed that CL01 lessened the blood glucose levels of G4 by 15% compared to G2. It was concluded that CL01 stimulates the proliferation of beta cells and promotes insulin secretion and may thus have a potential in improving the hypoglycemic effects among the diabetic symptoms.

Over the past decades, Chinese herbal medicines (CHM) have been extensively and intensively studied through from both clinical and experimental perspectives and CHM have been proved to be effective in the treatment of diabetes mellitus (DM). This study, by searching ancient records and modern research papers, reviewed CHM in terms of their clinical application and principal mechanism in the treatment of DM. We summarized the use of CHM mentioned in 54 famous ancient materia medica monographs and searched papers on the hypoglycemic effect of several representative CHM. Main mechanisms and limitations of CHM and further research direction for DM were discussed. On the basis of the study, we were led to conclude that TCM, as a main form of complementary and alternative medicine (CAM), was well recorded in ancient literatures and has less adverse effects as shown by modern studies. The mechanisms of CHM treatment of DM are complex, multilink, and multitarget, so we should find main hypoglycemic mechanism through doing research on CHM monomer active constituents. Many CHM monomer constituents possess noteworthy hypoglycemic effects. Therefore, developing a novel natural product for DM and its complications is of much significance. It is strongly significant to pay close attention to CHM for treatment of DM and its complications.

Efficacy and safety of a drug and its plasma concentration are closely correlated, and plasma concentrations are used as an index of the drug’s effects. Therefore, it is important to understand the relationship between the drug’s plasma concentration and its effects. Plasma glucose control of diabetics retards its progression and glimepiride is widely used for its treatment. In the present study, pharmacokinetic-pharmacodynamic analysis of glimepiride was performed in Wistar rats, with normal plasma glucose levels (Normal), and streptozotocin-induced type 1 diabetes rats (Type 1) and type 2 diabetes GK rats (Type 2). The PK-PD model was structured to investigate time-dependent plasma glucose changes in relation to the plasma concentration, and the PK and PD characteristics of glimepiride were investigated. PK analysis of glimepiride in the three groups showed no significant differences in total body Clearance (CL) and half-life of the β phase. Plasma concentration profiles at a 0.5 mg/kg dose increased in the following order; Type 1, Normal, and Type 2 groups. The area under the plasma concentration-time curves for glimepiride was dosedependent in Normal and Type 2 groups. The CL decreased in the Type 2 group compared to the other groups at a 0.5 mg/kg dose. The maximum decrease in the plasma glucose level was increased in the following order; Normal, Type 2, and Type 1. From the estimated PK-PD analysis, the plasma glimepiride concentration necessary to produce hypoglycemic effects was higher, and the responsiveness of the drug at a drug concentration at the half-maximum effect was quicker, in the Type 2 group compared to the other groups. These effects of glimepiride were considered to improve the pathological condition. This study of the PK-PD characteristics of glimepiride is useful for prediction of the influence of drug-drug interactions and the change in clinical conditions of patients.

Diabetic nephropathy (DN) is not only the most common cause of end-stage renal disease world-wide but also increases the risk of mortality up to fourteen times compared to normoalbuminuric diabetic patients. After a long time of inertia, recent advances in the management of diabetes have added a valuable share to the effort of prevention and slowing the progression of DN. Beyond their hypoglycemic effects, dipeptidyl peptidase-4 inhibitors, and sodium glucose transporter 2 inhibitors have shown unique renoprotective mechanisms in both type 1 (T1DM) and type 2 diabetes mellitus (T2DM). Advances in this field included, in addition, the introduction of many anti-oxidant and anti-inflammatory agents that proved in experimental and in vitro studies to add significant impact on development and progression of DN. Most of these agents are still waiting for clinical studies to confirm their safety and efficacy. Beside their role in improving plans of management, the new discoveries have improved our understanding of the pathogenesis of DN. This review will cover the updates in established and potential therapeutic modalities that would improve the management of DN after discussing the pathogenic pathways that help in understanding the mechanism of action of these different treatments.

Buckwheat is rich in active substances with hypoglycemic effects. Submerged fermentation, as the method of brewing buckwheat vinegar, not only has the advantages of shortening production cycle, saving materials etc, but also has high functional active substances. In this study, the process of the submerged fermentation of acetic acid fermentation was optimized by the orthogonal experiments of L9 (34), which was also on the basis of single factor experiments. The results indicated that the conversion rate of acetic acid can become 95.8% when the initial alcohol at 6% (v / v), inoculum at 10%, fermentation temperature 30°Cand fermentation time 60 h.

The aim of this study was to investigate effects and mechanisms of electroacupuncture (EA) on blood glucose and insulin sensitivity in mice fed a high-fat diet. Both wild-type (WT) and adipose ectonucleotide pyrophosphate phosphodiesterase (ENPP1) transgenic (TG) mice were fed a high-fat diet for 12 wk; for each mouse, an intraperitoneal glucose tolerance test (IPGTT) and insulin tolerance test (ITT) were performed with or without EA at abdomen or auricular areas. A high-fat diet-induced insulin resistance in both WT and TG mice. In the WT mice, EA at 3 Hz and 15 Hz, but not at 1 Hz or 100 Hz, via CV4+CV12 significantly reduced postprandial glucose levels; EA at 3 Hz was most potent. The glucose level was reduced by 61.7% at 60 min and 74.5% at 120 min with EA at 3 Hz (all P < 0.001 vs. control). Similar hypoglycemic effect was noted in the TG mice. On the contrary, EA at auricular points increased postprandial glucose level ( P < 0.03). 4). EA at 3 Hz via CV4+CV12 significantly enhanced the decrease of blood glucose after insulin injection, suggesting improvement of insulin sensitivity. Plasma free fatty acid was significantly suppressed by 42.5% at 15 min and 50.8% at 30 min with EA ( P < 0.01) in both WT and TG mice. EA improves glucose tolerance in both WT and TG mice fed a high-fat diet, and the effect is associated with stimulation parameters and acupoints and is probably attributed to the reduction of free fatty acid.

Objectives : The purpose of this study was to evaluate boiled rice made from unpolished rice, Job`s Tears, and extract from medicinal herbs mixture (HGMCJE) for hypoglycemic effect on STZ-induced diabetic rats. Methods : In the response of glucose tolerance, control and diabetic rats groups was intubated with glucose and HGMCJE. Furthermore, boiled 100% polished rice (P rice), boiled unpolished rice mixed with white rice and Job`s tears (polished rice:unpolished rice:Job`s tears

Artemisia sieberi a member of Compositae family is an endemic species in Iran and commonly named “desert worm wood” or “dermaneh”. It has some pharmacological activities such as antimicrobial, antinociceptive, insecticidal and hypoglycemic effects as its traditional uses and used for treatment of malaria and coccidiosis.

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.

Diabetes and related neurological complications are serious worldwide public health problems. The increasing number of affected individuals make it necessary to implement novel nutritional and therapeutic interventions. The tree Moringa oleifera (MO) has been used as a food source and for traditional medicine purposes due to possible antihyperglycemic, antioxidant, anti-inflammatory, and lipid regulating properties. These properties may be explained by the presence of numerous phytochemicals in the leaves, fruits, roots and, oil of the tree. The evidence for acute antihyperglycemic effects of MO extract on diabetic animal models seems to be robust, but more chronic and long-term studies are needed. In contrast, the hypoglycemic effects of MO on humans are not as clear. The scarce number of human studies, together with a diverse range of methodologies and MO doses, may explain this. In addition, evidence regarding changes in insulin levels due to MO intervention is ambiguous, both in animal and human studies. Therefore, more structured studies are needed to clarify if MO has an effect on insulin levels or activity. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Aloe vera is one of many medicinal plants used as hypoglycemic. Higher glucose levels are one of the characteristics of diabetes mellitus. This research aimed to study effectiveness of Aloe vera peel extract on insulin and serum glucose levels of rats with type 2 diabetic. Twenty Wistar rats were induced intraperitoneally using single dose of 65 mg/kg of streptozotocin (STZ) and 230 mg/kg of nicotinamide acid (NA). The rats were divided into control and treatment groups, which was supplemented using 100 mg/kg, 200 mg/kg and 400 mg/kg body weight of Aloe vera peel extracts for 28 days, respectively. The serum glucose levels were measured after three days of induction, 2 and 4 weeks after treatment, while the insulin levels were measured after three days of induction and at the end of treatment. In the control groups, the serum glucose levels in the second and fourth weeks remained significantly higher (p

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.

In the present study, the ethanolic extract of Achyranthus aspera L. Leaves (EEA) were investigated for their pharmacognostic characteristics and hypoglycemic effects. The pharmacognosy of the plant was carried out using microscopic and macroscopic tools. Macroscopic studies revealed that the leaves were cauline, ramel, opposite, exstipulate, simple, sub-sessile, ovate, entire, acute, unicostate, reticulate, rough, coriaceous and hairy. The stem was erect, herbaceous, quadrangular, branched, solid, green and pubescent, while various internal parts were observed using powder drug for microscopic study. The hypoglycemic effect of the plant was studied in healthy normoglycemic rabbits. The EEA was tested in three doses (100, 150 and 200 mg/kg), and a dose dependent hypoglycemic effect was observed. The most significant hypoglycemic effect was observed against higher dose (200 mg/kg) which remained for 5 h while the hypoglycemic effect remained significant for 3 h against the lower dose. It was concluded that EEA has hypoglycemic properties and it is recommended for the treatment of diabetes mellitus II. Key words: Pharmacognostic, hypoglycemic, Achyranthus aspera L.

Ethnopharmacological relevance Type 2 diabetes is the most common type of diabetes and its prevalence is rapidly increasing throughout the world. Modifications of lifestyle such as suitable diet and exercise programs along with pharmacotherapy and education of patients are beneficial therapies for patients with type 2 diabetes. The ethnopharmacological use of herbal medicines, many of them part of our diet as spices, vegetables and fruits, has been developed for the treatment of diabetes due to inexpensiveness, easy availability and few side effects. Aim of the study Our aim is to present a review for researchers who are interested in the biologically active dietary plants traditionally utilized in the treatment of diabetes. Materials and methods Information was obtained from a literature search of electronic databases such as Google Scholar, Pubmed, Sci Finder and Cochrane. Common and scientific name of the fruits, vegetables, beverages, oils and spices and the words ‘antidiabetic’, ‘hypoglycemic’, ‘anti-hyperglycemic’, ‘type 2 diabetes’ were used as keywords for search. Results Certain fruits and vegetables are functional foods and their consumption reduces the incidence of type 2 diabetes. Hypoglycemic effects of fruits and vegetables may be due to their inducing nature on pancreatic β-cells for insulin secretion, or bioactive compounds such as flavonoids, alkaloids and anthocyanins, which act as insulin-like molecules or insulin secretagogues. Conclusion This write-up covers hypoglycemic, anti-hyperglycemic and anti-diabetic activities of some dietary fruits, vegetables, beverages, oils and spices and their active hypoglycemic constituents. Including such plant species in the diet might improve management of type 2 diabetes.

Vijayasar ( Pterocarpus marsupium ) has been mentioned in Charak Samhita , as a remedy for Madhumeha (Diabetes Mellitus). A study conducted by ICMR (Indian Council of Medical Research) revealed that the hypoglycemic effects of Vijayasar are comparable to that of tolbutamide. Karela ( Mormordica charantia ) is another herb used in Madhumeha and it is a routinely used vegetable in Nepal. In this study we measured the effectiveness of Karela in patients of Madhumeha and compared with that of Vijayasar . A total of sixty four patients diagnosed with Madhumeha (Fasting Blood Glucose ≥126mg/dl or Post Prandial Blood Glucose≥200mg/dl) were given either Karela or Vijayasar powder two times a day for one month, along with dietary and lifestyle advices and their blood glucose levels were measured before initiating treatment and after one month of treatment. Changes in the subjective complaints of Madhumeha like Prabhutamutrata, Avilmutrata, etc. and appearance of adverse events were also evaluated. Randomization of treatment was done and dosage was titrated on the basis of glycemic control and duration of Madhumeha . The mean reductions in fasting blood glucose and post prandial blood glucose in Karela treated group are 60.83 mg/dl and 79.74 mg/dl respectively and that in Vijayasar treated. Karela is a safe and effective medicine in the management of Madhumeha and it is as effective as Vijayasar.

Background Diabetes mellitus is a metabolic disorder of multiple aetiology characterised by hyperglycemia resulting from defects in insulin secretion, insulin action or both. It is a global epidemic ravaging both developed and developing countries. The situation will worsen if nothing is done urgently. In fact, the need to identify natural products with antidiabetic potentials is of great importance as supported by several research efforts all over the world, in search of antidiabetic plant based products that are safe and efficacious. Available literatures show that several phytochemicals with antidiabetic properties have been identified in certain plants amongst which include Uvaria chamae. The potentials of Uvaria chamae as an antidiabetic and hypolipidemic drug-candidate are thus tested. Methods Diabetes mellitus was experimentally induced after the rats were fasted overnight by administering intraperitoneally, 60 mg/kg streptozotocin. After 72 h, the rats with plasma glucose levels >200 mg/dl were classified as diabetic. A total of six groups containing five rats per group were used. One group of diabetic rats was untreated. Three diabetic groups, each were treated orally with 100, 250 and 400 mg/kg body weight of the extract. Another diabetic group was treated with insulin (0.5 IU/kg) subcutaneously. The control received 0.5 ml (2% solution) of acacia orally. The treatment was for 8 days. The effects of the extract on weight, plasma glucose and other biochemical parameters were evaluated using standard procedures. Results The diabetic rats treated with the extract showed significant reductions (p

Aim. There is evidence thatAnethum graveolens(AG) has been used for centuries in Asian traditional medicine, and its constituents have useful effects on the control and management of diabetes and cardiovascular disorders. AG has many useful effects, including hypolipidemic and hypoglycemic effects, and it has been reported to reduce the incidence of diabetic complications. It acts mainly by affecting antioxidant capacity and change in some genes in glucose and lipid pathways. The aim of the present paper was to summarize pharmacological effects of AG in the management of diabetes.Methods. To prepare this review, a pharmacological and phytochemical literature survey was performed using Scopus, PubMed, and Web of Science. Also, some historical and ethnopharmacological literature sources were used.Results. This review plans to provide readers with an assessment of the pharmacological effects of AG, especially in diabetes.Conclusion. The paper highlights the therapeutic effects of AG which would aid in supporting their safe use in the management of diabetes and cardiovascular diseases.

Objectives: The 4-Aminoquinoline, Chloroquine is still indicated for treatment of malaria fever due to sensitive Plasmodium species. The hypoglycemic effects of Chloroquine have been sparsely reported in human and animal models of type 2 diabetes and a widely held perception among health caregivers in this part of the world is that administering intramuscularly Chloroquine to fasting malaria patients could be complicated by syncope directly caused by hypoglycemia. This study investigated the effects of a single adult human intramuscular bolus of Chloroquine on the blood glucose level in fasting normoglycemic Wistar rats. Methods: Fifteen acclimatized adult male rats were randomly divided into three groups of 5 per group. Group I and II rats were fasted overnight and received 4.17 mg/kg of intramuscular Chloroquine in the morning. Group III rats were also fasted but received 1ml of sterile water injection. Fasting blood sugar level was determined immediately after injection and at 2 hour and 4 hour intervals using Accucheck glucometer. Results: The results were recorded as Mean ± SEM. The mean sugar levels of the groups were compared with each other within a given time point as well between the different time intervals within a given group using Student’s t test of significance. There were no observable statistical significant differences between the Mean blood glucose levels of the groups. Conclusion: The results of this study suggest that intramuscular Chloroquine injection in fasted normoglycemic rats did not lower significantly lower their blood glucose level and syncope in fasting adult humans immediately following treatment by this route was likely the result of a cardiovascular complication rather than from a Chloroquine-induced hypoglycemic effect.

Since ancient period in India, Madhumeha (diabetes mellitus) has been treated using indigenous medicines. A rapid increase in the occurrence of diabetes is a serious threat to the humankind. The drugs originated from new bioactive plants have shown more efficacy than oral hypoglycemic agents used in the clinical therapy. Recently attention has been directed toward the selection and confirmation of plants with antidiabetic potential. A number of studies have confirmed the benefits of Ayurvedic plants with hypoglycemic effects in the management of this disorder. These plants usually delay the diabetic complications and rectify the metabolic abnormalities. The present chapter reviews the Ayurvedic perspective of diabetes and the various plants used in diabetes treatment with their mechanism of action and pharmacological test results. Also, the article emphasizes the rational use of traditional as well as indigenous natural medicines.

Banaba (Lagerstroemia speciosaL.) extracts have been used for many years in folk medicine to treat diabetes, with the first published research study being reported in 1940. This review summarizes the current literature regarding banaba and its constituents. The hypoglycemic effects of banaba have be