Ilex paraguariensis, white mulberry and chromium picolinate in patients with pre-diabetes

Application of natural compounds in the treatment and prevention of prediabetes

Prediabetes is an intermediate stage in the development of type 2 diabetes mellitus characterized by impaired fasting glucose and/or impaired glucose tolerance. Prediabetes generally has no obvious clinical symptoms, and most patients are found in health examinations or due to other diseases. Reactive hypoglycemia may indicate the possibility of early diabetes. Without effective preventive measures, prediabetes can progress to diabetes leading to serious public health problems. Therefore, early diagnosis and intervention are important. Many animal experiments and clinical trials have proven that natural compounds substantially improve glucose metabolism disorder. The active ingredients are mainly alkaloids, polysaccharides, saponins, terpenoids, flavonoids and polyphenols. Their mechanism of action mainly involves improved insulin sensitivity and insulin resistance, inhibited activity of alpha-glucosidase, antioxidant activity, anti-inflammatory, regulation of gut microbiota and activating of peroxisome proliferator-activated receptor-γ. This paper reviews the mechanisms of action of natural compounds on prediabetes and the status of related research.

A Blend Consisting of Agaran from Seaweed Gracilaria birdiae and Chromium Picolinate Is a Better Antioxidant Agent than These Two Compounds Alone

A blend refers to the combination of two or more components to achieve properties that are superior to those found in the individual products used for their production. Gracilaria birdiae agaran (SPGb) and chromium picolinate (ChrPic) are both antioxidant agents. However, there is no documentation of blends that incorporate agarans and ChrPic. Hence, the objective of this study was to generate blends containing SPGb and ChrPic that exhibit enhanced antioxidant activity compared to SPGb or ChrPic alone. ChrPic was commercially acquired, while SPGb was extracted from the seaweed. Five blends (B1; B2; B3; B4; B5) were produced, and tests indicated B5 as the best antioxidant blend. B5 was not cytotoxic or genotoxic. H₂O₂ (0.6 mM) induced toxicity in fibroblasts (3T3), and this effect was abolished by B5 (0.05 mg·mL^-1); neither ChrPic nor SPGb showed this effect. The cells also showed no signs of toxicity when exposed to H₂O₂ after being incubated with B5 and ChrPic for 24 h. In another experiment, cells were incubated with H₂O₂ and later exposed to SPGb, ChrPic, or B5. Again, SPGb was not effective, while cells exposed to ChrPic and B5 reduced MTT by 100%. The data demonstrated that B5 has activity superior to SPGb and ChrPic and points to B5 as a product to be used in future in vivo tests to confirm its antioxidant action. It may also be indicated as a possible nutraceutical agent.

Yerba mate (Ilex paraguariensis A. St.-Hil.) for new therapeutic and nutraceutical interventions: A review of patents issued in the last 20 years (2000-2020)

It has been estimated that more than 70% of all drugs approved worldwide between 1981 and 2006 for human health are derived from or structurally similar to natural compounds. The identification of biological matrices containing bioactive compounds with therapeutic and nutraceutical potential is necessary to supply the global market demands. Researches have indicated that the consumption of dry and aqueous extracts of Ilex paraguariensis A. St.-Hil. is safe, providing that plant biomass does not be exposed to smoke over the drying process, avoiding contamination (e.g., ) with polycyclic aromatic hydrocarbon compounds, and can might help avoiding many diseases, with important potential applications in the pharma and nutraceutical industries. A survey was carried out covering the main therapeutic and nutraceutical studies performed on I. paraguariensis extracts and their relationship with the global patents granted in the last 20 years for the products using this specie in their composition. In the PubMed database, by searching for the term "Ilex paraguariensis," an output with 497 scientific publications was found. Each paper was analyzed individually and 26 publications encompassing exclusively therapeutical and nutraceutical approaches of that plant species were selected. For the patent screening regarding Ilex-derived products, the survey considered three patent databases: European Patent Office (EPO) (Espacenet), World Intellectual Property Organization, WIPO), and National Institute of Industrial Property (NIIP-Brazil). The criterion chosen to select the patents in the databases was the inclusion of the terms "Ilex paraguariensis" and "yerba mate" in the title and/or in the abstract, considering the patents issued from 2000 to 2020. Additionally, only patents with therapeutic and nutraceutical potential were considered on the survey. The screening and selection of the documents were performed independently by two researchers and the information cross-checked at the end. This review contributes to show the state of the art over the last 20 years on the knowledge about the therapeutical and nutraceutical usages of the yerba mate, associated to a certain number of issued patents. The patent survey afforded 62 relevant documents covering products based on Ilex paraguariensis biomass. Considering the number of patents issued, most of them are related to the pharmaceutical area (30), followed by food supplements and beverages (17), cosmetics (10) and, finally, nutraceuticals (5). A detailed analysis of the patents issued showed that most are related to pharmaceutical grade products, generally, marketed as oral and injectable compositions for treatments of obesity, insulin resistance, hyperlipemia and diabetes mellitus, arteriosclerosis, neurological diseases, and SARS-Cov-2, for example. In this work, a curious fact is that there are few patents for food, cosmetics, and nutraceuticals products containing yerba mate. Therefore, it seems to be relevant to take into account the potential of that species as source of bioactive compounds for the development of new products not only intended to the pharma sector. In this sense, 26 reports were identified showing possibilities and trendiness in developing new yerba mate based products, such as packaging, biopesticides, antiseptics, and food supply, expanding the possibilities of technological applications of this plant species.

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature

Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.

Commercial yerba mate (Ilex paraguariensis) produced in South America: Determination of dithiocarbamate residues by gas chromatography-mass spectrometry

This work presents an easy and quick miniaturized procedure for the analysis of dithiocarbamates fungicides (DTC), by GC-MS, in yerba mate, an important product in South America. The sample amount, the volume of extracting solvent and acid solution, and the time of hot bath shaking were minimized. A clean-up procedure based on PSA, GCB and MgSO4 was studied in order to improve analytical signal and reduce GC-MS system damage. Blank yerba mate samples were spiked with thiram at equivalent CS₂ concentrations of 0.1, 0.3, 0.5 and 1 mg kg^-1. The validated method at least 2 times faster than the traditional method and was according to the latest European guidelines for pesticide residue analysis. Linearity, limits of detection and quantification, matrix effects, trueness and precision were assessed. Sixty-five commercialized samples from southern Brazil and Argentina were analyzed; 14% of samples presented CS₂ concentration greater than LOQ (0.1 mg kg^-1).

Metabolic Actions of a Supplement of Ilex Paraguariensis (An Extract of the Leaf Standardized to 2% I-Deoxinojirimcina), White Mulberry and Chromium Picolinate in Nondiabetic Subects with Dysglycemia: A Randomized Trial

Aim: To prove if a nutraceutical containing Ilex paraguariensis (Ilex L. spp. Aquifoliales) (an extract of the leaf standardized to 2% I-deoxinojirimcina), white mulberry (Morus spp., Moraceae), and chromium picolinate can be effective in improving glycemic status in subject with dysglycemia. Methods: We randomized patients to consume placebo or the nutraceutical, self-administered once a day, one tablet at breakfast, for 3 months. Results: A reduction in fasting plasma glucose, postprandial glucose, and glycated hemoglobin was observed with the nutraceutical combination, both compared to baseline and placebo. Data suggested a decrease in the Homeostasis Model Assessment index with the nutraceutical, both compared to baseline and placebo. The M value, an index of insulin sensitivity, obtained after nutraceutical treatment was higher compared to baseline. We recorded a decrease in total cholesterol, low-density lipoprotein-cholesterol, and triglycerides with the nutraceutical combination compared to baseline and placebo. A decrease in high-sensitivity C-reactive protein was observed with the nutraceutical combination compared to baseline and placebo. Conclusions: A nutraceutical containing Ilex paraguariensis, white mulberry, and chromium picolinate can be helpful in improving glycemic status and lipid profile in dysglycemic subjects.

Abscisic Acid Treatment in Patients with Prediabetes

Aim: to evaluate the effects of abscisic acid (ABA), contained in dwarf peaches, on the regression of impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) conditions. Materials and methods: sixty-five patients with IFG or IGT were randomized to take ABA or placebo for 3 months. We evaluated: fasting plasma glucose (FPG), postprandial plasma glucose (PPG), glycated hemoglobin (HbA_1c), fasting plasma insulin (FPI), homeostatic model assessment of insulin resistance (HOMA-IR), lipid profile and high sensitivity C-reactive protein (Hs-CRP). At baseline, and after 3 months, all patients underwent an oral glucose tolerance test (OGTT), an euglycemic hyperinsulinemic clamp, and a glucagon test. Results: a significant reduction of HbA_1c, FPG, PPG, FPI and HOMA-IR was observed in the ABA group. After 3 months, 26.7% of patients returned to a normal glycemic status in the ABA group versus zero patients in placebo group; 20.0% were classified as IFG and 53.3% as IGT in the nutraceutical group versus 33.3% and 63.3% in the placebo group. The M value was higher in the ABA group at the end of the treatment. Finally, Hs-CRP was reduced after 3 months of ABA consumption. Conclusions: abscisic acid can be effective in ameliorating glyco-metabolic compensation and in reducing inflammatory status in patients with IFG or IGT.