Amelioration of pancreatic and renal derangements in streptozotocin-induced diabetic rats by polyphenol extracts of Ginger (Zingiber officinale) rhizome

Can Polyherbal Medicine be used for the Treatment of Diabetes? - A Review of Historical Classics, Research Evidence and Current Prevention Programs

Diabetes mellitus (DM), a chronic medical condition, has attained a global pandemic status over the last few decades affecting millions of people. Despite a variety of synthetic drugs available in the market, the use of herbal medicines for managing diabetes is gaining importance because of being comparatively safer. This article reviews the result of a substantial literature search on polyherbal formulations (PHFs) developed and evaluated with potential for DM. The accumulated data in the literature allowed us to enlist 76PHFs consisting of different parts of 147 plant species belonging to 58 botanical families. The documented plant species are laden with bioactive components with anti-diabetic properties and thus draw attention. The most favoured ingredient for PHFs was leaves of Gymnema sylvestre and seeds of Trigonella foenum-graecum used in 27 and 22 formulations, respectively. Apart from herbs, shilajit (exudates from high mountain rocks) formed an important component of 9 PHFs, whereas calcined Mytilus margaritiferus and goat pancreas were used in Dolabi, the most commonly used tablet form of PHF in Indian markets. The healing properties of PHFs against diabetes have been examined in both pre-clinical studies and clinical trials. However, the mechanism(s) of action of PHFs are still unclear and considered the pitfalls inherent in understanding the benefits of PHFs. From the information available based on experimental systems, it could be concluded that plant-derived medicines will have a considerable role to play in the control of diabetes provided the challenges related to their bioavailability, bioefficacy, optimal dose, lack of characterization, ambiguous mechanism of action, and clinical efficiency are addressed.

Mechanism of Anti-Diabetic Activity from Sweet Potato (Ipomoea batatas): A Systematic Review

This study aims to provide an overview of the compounds found in sweet potato (Ipomoea batatas) that contribute to its anti-diabetic activity and the mechanisms by which they act. A comprehensive literature search was conducted using electronic databases, such as PubMed, Scopus, and Science Direct, with specific search terms and Boolean operators. A total of 269 articles were initially retrieved, but after applying inclusion and exclusion criteria only 28 articles were selected for further review. Among the findings, four varieties of sweet potato were identified as having potential anti-diabetic properties. Phenolic acids, flavonols, flavanones, and anthocyanidins are responsible for the anti-diabetic activity of sweet potatoes. The anti-diabetic mechanism of sweet potatoes was determined using a combination of components with multi-target actions. The results of these studies provide evidence that Ipomoea batatas is effective in the treatment of type 2 diabetes.

The effect of zingiber officinale on prooxidant-antioxidant balance and glycemic control in diabetic patients with ESRD undergoing hemodialysis: a double-blind randomized control trial

BACKGROUND

Diabetes management in hemodialysis patients with end-stage renal disease needs precision to avoid complications. The study aimed to investigate the effect of ginger supplementation on prooxidant-antioxidant balance, glycemic management, and renal function in diabetic hemodialysis patients.

TRIAL DESIGN AND METHODS

Forty-four patients were randomly allocated to either the ginger or the placebo group in this randomized, double blind, placebo-controlled study. Patients in the ginger group received 2000 mg/d ginger for eight weeks, whereas those in the placebo group received equivalent placebos. After a 12- to 14-h fast, serum levels of fasting blood glucose (FBG), insulin, urea, creatinine, and prooxidant-antioxidant balance (PAB) were measured at baseline and at the end of the study. The homeostatic model evaluation of insulin resistance was used to determine insulin resistance (HOMA-IR).

RESULTS

Serum levels of FBG (p = 0.001), HOMA-IR (p = 0.001), and urea (p = 0.017) were considerably lower in the ginger group compared to baseline, and the difference was significant when compared to the placebo group (p < 0.05). Moreover, ginger supplementation decreased serum levels of creatinine (p = 0.034) and PAB (p = 0.013) within the group, but the effect was insignificant between groups (p > 0.05). On the other hand, insulin levels did not vary significantly across and among the groups (p > 0.05).

CONCLUSION

In summary, this study indicated that in diabetic hemodialysis patients, ginger could result to lower blood glucose levels, enhanced insulin sensitivity, and lower serum urea levels. Further studies with a more extended intervention period and various doses and forms of ginger are needed.

TRIAL REGISTRATION

IRCT20191109045382N2. (06/07/2020), Retrospectively registered, https://www.irct.ir/trial/48467.

Renoprotective effects of the ginger (Zingiber officinale) on Diabetic kidney disease, current knowledge and future direction: a systematic review of animal studies

OBJECTIVE

Diabetic kidney disease affects approximately 40% of diabetic patients and is the leading cause of chronic kidney disease (CKD) worldwide. As a result, preventing renal complications in diabetic patients is critical. Ginger (Zingiber Officinale Rosco) is a popular spice and natral medicine. The present study was a systematic review focused on the existing evidence of the renoprotective effect of ginger extract on some features of diabetic kidney disease.

METHODS

The literature was searched in online databases such as PubMed, Scopus, EMBASE, ProQuest databases, and Google Scholar from inception to July 2022.

RESULTS

This review included 41 articles that met the eligibility criteria. Ginger supplementation was found to be associated with a significant decrease in blood glucose in 28 studies. Nine studies showed a significant reduction in malondialdehyde (MDA) after supplementation. Also, seventeen studies showed decreased serum levels of creatinine. Fifteen studies reported a decrease in total cholesterol (TC) and fourteen studies showed a lowered triglycerides (TG) concentrations. In twenty-six studies, ginger reduced renal injuries due to diabetes.

CONCLUSION

Ginger may improve blood sugar indices, lipid profile, some inflammatory markers, oxidative stress, and pathologic injuries in diabetic kidney disease. However, future well-designed clinical trials and meta-analyses are required for a solid consensus.

Melatonin ameliorates the adrenal and pancreatic alterations in streptozotocin-induced diabetic rats: Clinical, biochemical, and descriptive histopathological studies

Previous studies have demonstrated the beneficial effects of melatonin in diabetic rats. However, limited studies have been conducted on the potential effects of melatonin on the descriptive histopathological and morphometric findings in different compartments of the adrenal glands in diabetic animal models. In this study, using a streptozotocin (STZ)-induced diabetic rat model, we sought to examine histological alterations in the pancreas and adrenal glands and observe the effect of the administration of melatonin on the histopathology and morphology of the pancreas and the adrenal gland cortex and medulla that are altered by STZ-induced hyperglycemia. Rats were randomly assigned to four different groups: Group I, normal control; Group II, melatonin group (MT) (10 mg/kg/day); Group III, (diabetic STZ group), and Group IV, diabetic (STZ) + melatonin group (MT). Throughout the experiment, the animals' fasting blood sugar levels were measured. Blood was obtained to determine the animals' cumulative blood sugar levels after sacrification. For histological and morphometrical evaluations, the pancreatic and adrenal gland tissues were dissected and processed. Our results showed that diabetic rats receiving melatonin significantly (P < 0.05) improved their fasting blood sugar and cumulative blood sugar levels compared to the diabetic group not receiving melatonin. Furthermore, histopathological examinations of the pancreatic and adrenal tissues of the diabetic rats indicated the occurrence of severe histopathological and morphometric changes. Morphometric analysis of the adrenals indicated a significant increase (P < 0.05) in the thickness of the cortex zones [zona glomerulosa (ZG), zona fasciculata (ZF), and zona reticularis (ZR)] for the diabetic STZ group compared with other groups, and a significant decrease (P < 0.05) in the diameter of the in adrenal gland medullas in the diabetic STZ rats compared to the other groups. Furthermore, treatment with melatonin restored these changes in both the pancreatic and adrenal gland tissues and produced a significant (P < 0.05) improvement in the cortex and medulla thickness compared to the untreated diabetic rats. Overall, melatonin significantly reduced the hyperglycemic levels of glucose in diabetic rats and reversed the majority of histopathological alterations in the tissues of the pancreas and adrenals, demonstrating its anti-diabetic activity.

Sweet potato (Ipomoea batatas L.) leaf polyphenols ameliorate hyperglycemia in type 2 diabetes mellitus mice

The hypoglycemic effects and potential mechanism of sweet potato leaf polyphenols (SPLP) on type 2 diabetes mellitus (T2DM) were investigated. Results showed that oral administration of SPLP to mice could alleviate body weight loss, decrease fasting blood glucose levels (by 64.78%) and improve oral glucose tolerance compared with those of untreated diabetic mice. Furthermore, increased fasting serum insulin levels (by 100.11%), ameliorated insulin resistance and improved hepatic glycogen (by 126.78%) and muscle glycogen (increased by 135.85%) were observed in the SPLP treatment group. SPLP also could reverse dyslipidemia, as indicated by decreased total cholesterol, triglycerides, low density lipoprotein-cholesterol and promoted high density lipoprotein-cholesterol. Histopathological analysis revealed that SPLP could relieve liver inflammation and maintain the islet structure to inhibit β-cell apoptosis. A quantitative real-time polymerase chain reaction confirmed that SPLP could up-regulate the phosphatidylinositol 3-kinase/protein kinase B/glycogen synthase kinase-3β signaling pathway to improve glucose metabolism and up-regulate the phosphatidylinositol 3-kinase/protein kinase B/glucose transporter 4 signaling pathway in the skeletal muscle to enhance glucose transport. This study provides useful information to support the application of SPLP as a natural product for the treatment of T2DM.

Review of Distribution, Extraction Methods, and Health Benefits of Bound Phenolics in Food Plants

Phenolic compounds are important functional bioactive substances distributed in various food plants. They have gained wide interest from researchers due to their multiple health benefits. There are two forms of phenolic compounds: free form and bound form. The latter is also called bound phenolics (BPs), which are found mainly in the cell wall and distributed in various tissues/organs of the plant body. They can either chemically bind to macromolecules and food matrixes or be physically entrapped in food matrixes and intact cells. Various isolation methods, including chemical, biological, and physical methods, have been employed to extract BPs from plants. BPs have been shown to have strong biological activities, including antioxidant, probiotic, anticancer, anti-inflammation, antiobesity, and antidiabetic effects as well as beneficial effects on central nervous system diseases. This review summarizes research findings on these topics to help in better understanding of BPs and provide comprehensive information on their health effects.

The effect of clomiphene citrate, herbal mixture, and herbal mixture along with clomiphene citrate on clinical and para-clinical parameters in infertile women with polycystic ovary syndrome: a randomized controlled clinical trial

INTRODUCTION

To evaluate the effect of a herbal mixture (i.e., Mentha spicata, Zingiber officinale, Cinnamomum zeylanicum, and Citrus sinensis) alone and in combination with clomiphene citrate (CC) compared to CC on the treatment of polycystic ovary syndrome (PCOS).

MATERIAL AND METHODS

This single-blind randomized clinical trial was conducted on 60 infertile participants with PCOS who were randomly divided into three groups. After spontaneous or progestin-induced withdrawal bleeding, group 1 (n = 20) received routine treatment with CC (50-150 mg) for three menstrual cycles from the 3^rd to 5^th day of menstruation for 5 days while group 2 (n = 20) and group 3 (n = 20) received herbal mixture capsules 700 mg/day and the herbal mixture along with CC for 3 months, respectively. Finally, several related parameters were measured, including the level of sex steroids, homeostatic model assessment for insulin resistance (HOMA-IR), lipid profile (primary outcomes), thyroid hormones, and clinical features. The analysis was based on intention-to-treat analysis.

RESULTS

No statistically significant differences were observed between the groups in terms of socio-demographic characteristics. However, after adjustment for baseline, luteinizing hormone (aMD = 4.9; 95% CI: 3.7-6.2), luteinizing hormone/follicle-stimulating hormone (aMD = 0.9; 95% CI: 0.7-1.2), total testosterone (aMD = -0.12; 95% CI: -0.2 to -0.01) in group 2 and free testosterone (aMD = -6.0; 95% CI: -9.7 to -2.3) in group 3 revealed a significant difference compared to group 1. In addition, HOMA-IR in group 2 (aMD = -1.3; 95% CI: -2.4 to -0.2) decreased significantly compared to group 1. Further, total cholesterol, triglycerides, low-density lipoprotein cholesterol, and very low-density lipoprotein cholesterol decreased significantly in group 2 (aMD = -21.8; 95% CI: -31.5 to -12.1; aMD = -29.9; 95% CI: -47.9 to -12.0; aMD = -21.2; 95% CI: -31.3 to -11.1; aMD = -5.1; 95% CI: -7.5 to -2.7) and group 3 (aMD = -18.3; 95% CI: -27.4 to -9.2; aMD = -26.9; 95% CI: -43.8 to -9.9; aMD = -21.4; 95% CI: -31.1 to -11.7; aMD = -5.9; 95% CI: -8.3 to -3.6) compared to group 1, respectively. However, high-density lipoproteins cholesterol in group 2 (aMD = 6.8; 95% CI: 2.9-10.7) and group 3 (aMD = 10.7; 95% CI: 7.2-14.7) increased remarkably compared to group 1. Overall, clinical outcomes improved significantly in all groups (p < 0.05).

CONCLUSIONS

In general, the herbal mixture along with CC was found to improve free testosterone, HOMA-IR, lipid profile, and clinical features of PCOS women.

Cross-talk between 10-gingerol and its anti-cancerous potential: a recent update

Since time immortal, ginger, as an ancient herb, has been used throughout the world in foods and beverages due to its typical strong and pungent flavor. Besides its use as a spice, it also serves as an excellent source of several bioactive phenolics, including nonvolatile pungent compounds, such as gingerols, paradols, shogaols, and gingerones. Gingerols constitute key ingredients in fresh ginger, with the most abundant being 6-gingerol (6-G), 8-gingerol (8-G), and 10-gingerol (10-G). Many studies have investigated the various valuable pharmacological properties of these ingredients and experimentally verified the mechanistic aspects of their health effects; however, to date, most research on the anti-cancerous activities of gingerols have focused largely on 6-G. Thus, the present article deals with the number of recent studies that have indicated and highlighted the role of 10-G with respect to its cancer prevention attributes in particular and its anti-inflammatory, anti-oxidant, anti-microbial, and gastrointestinal tract protective potential in general. The purpose of this review is to provide an overview of all the experimentally validated health benefits of 10-G for nutraceutical applications. The various findings have warranted the further investigation of 10-G and its possible use in various cancer treatments as well as its promising role as a chemo-preventive agent.

Geraniol improves the impaired vascular reactivity in diabetes and metabolic syndrome through calcium channel blocking effect

AIM

The aim of the present study is to investigate the effect and possible mechanism of action of geraniol on the impaired vascular reactivity of aortic rings isolated from diabetes or metabolic syndrome (MS) -induced rats.

METHODS

Male Wistar rats were divided into control, type 1 diabetes and metabolic syndrome (MS) groups. Diabetes was induced by a single intraperitoneal injection of streptozotocin (50mg/kg) and left for 10weeks to develop vascular complications. MS was induced by adding 10% fructose and 3% salt to water and diet for 12weeks. The present study investigated the effect of in vitro incubation with geraniol (10-300μM) on the vasoconstrictor response to phenylephrine (PE) and the vasodilator response to acetylcholine (ACh) as well as its effect on aortae incubated with methylglyoxal (MG) as an advanced glycation end product (AGE). To investigate the mechanism of action of geraniol, different blockers are used, including Nω-nitro-L-arginine methyl ester hydrochloride (L-NAME, 100μM), tetraethylammonium chloride (TEA, 10mM), and indomethacin (INDO, 5μM). Moreover, the effect of calcium chloride (CaCl2) on aortic rings precontracted with PE or potassium chloride (KCl) was examined.

RESULTS

Thirty minutes incubation with geraniol alleviated the exaggerated vasoconstriction in aortae isolated from diabetic or MS animals or in vitro exposed to MG in a concentration-dependent manner. In addition, geraniol improved the vasodilatation response of diabetic or MS aortae or aortae exposed to MG. In search for the mechanism; geraniol produced concentration-dependent relaxation of both PE and KCl-precontracted aorta. Geraniol relaxation was not affected by L-NAME, INDO or TEA. However, geraniol significantly inhibited voltage dependent and receptor mediated Ca(2+)-induced contraction activated by KCl or PE respectively.

CONCLUSION

In conclusion, geraniol ameliorates impaired vascular reactivity in experimentally induced diabetes and MS. The effect may be partially attributed to an endothelium-independent pathway involving blockage of both voltage dependent and receptor operated calcium channel.

Jiang Tang Xiao Ke Granule, a Classic Chinese Herbal Formula, Improves the Effect of Metformin on Lipid and Glucose Metabolism in Diabetic Mice

In the present study, the hypoglycemic, hypolipidemic, and antioxidative effects of metformin (MET) combined with Jiang Tang Xiao Ke (JTXK) granule derived from the “Di Huang Tang” were evaluated in mice with type 2 diabetes mellitus (DM) induced by high-fat diet/streptozotocin. DM mice were orally treated with MET (0.19 g/kg) either alone or combined with different doses (1.75, 3.5, or 7 g/kg) of JTXK for 4 weeks. Results showed that the serum and hepatic glucose, lipids, and oxidative stress levels were elevated in DM mice, when compared with the normal mice. MET treatment decreased FBG and serum glucagon levels of DM mice. Combination treatment with MET and JTXK 3.5 g/kg increased the hypoglycemia and insulin sensitivity at 4 weeks when compared with the DM mice treated with MET alone. However, neither MET nor MET/JTXK treatment could completely reverse the hyperglycemia in DM mice. JTXK enhanced the serum triglyceride (TG) and hepatic lipid-lowering effect of MET in a dose-dependent manner in DM mice. JTXK 1.75 and 3.5 g/kg improved the hepatoprotective effect of MET in DM mice. Synergistic effect of combination treatment with MET and JTXK on antioxidant stress was also found in DM mice compared with MET alone.

Protective effect of zingerone on increased vascular contractility in diabetic rat aorta

The aim of the present study was to investigate the effect and possible mechanism of action of zingerone, the main constituent of ginger, on vascular reactivity in isolated aorta from diabetic rats. The results show that incubation of aortae with zingerone alleviates the exaggerated vasoconstriction of diabetic aortae to phenylephrine, as well as the impaired relaxatory response to acetylcholine in a concentration-dependent manner. Furthermore, Zingerone directly relax phenylephrine-precontracted aortae. The vasorelaxatory response is significantly attenuated by the nitric oxide synthase inhibitor Nω-nitro-l-arginine methyl ester hydrochloride and the guanylate cyclase inhibitor methylene blue but no effect of either the potassium channels blocker tetraethylammonium chloride, or the cyclooxygenase inhibitor indomethacin was observed. Zingerone had no effect on advanced glycation end product formation as well. In conclusion, zingerone ameliorates enhanced vascular contraction in diabetic aortae which may be mediated by its vasodilator effect through NO- and guanylate cyclase stimulation.