Polyoxidovanadates a new therapeutic alternative for neurodegenerative and aging diseases

Aging is a natural phenomenon characterized by a progressive decline in physiological integrity,leading to a deterioration of cognitive function and increasing the risk of suffering from chronic-degenerative diseases,including cardiovascular diseases,osteoporosis,cancer,diabetes,and neurodegeneration.Aging is considered the major risk factor for Parkinson’s and Alzheimer’s disease develops.Likewise,diabetes and insulin resistance constitute additional risk factors for developing neurodegenerative disorders.Currently,no treatment can effectively reverse these neurodegenerative pathologies.However,some antidiabetic drugs have opened the possibility of being used against neurodegenerative processes.In the previous framework,Vanadium species have demonstrated a notable antidiabetic effect.Our research group evaluated polyoxidovanadates such as decavanadate and metforminium-decavanadate with preventive and corrective activity on neurodegeneration in brain-specific areas from rats with metabolic syndrome.The results suggest that these polyoxidovanadates induce neuronal and cognitive restoration mechanisms.This review aims to describe the therapeutic potential of polyoxidovanadates as insulin-enhancer agents in the brain,constituting a therapeutic alternative for aging and neurodegenerative diseases.

Preclinical Evaluation of the Antidiabetic Effect and Phytochemical HPLC-MS ESI-QTOF Analysis of Sclerocarya birrea (A. Rich) Hoscht Bark of Trunk Aqueous Extract in Alloxan-Induced Diabetic Wistar Rat

Introduction: Diabetes is a serious public health problem requiring complex treatment. Numerous ethnopharmacological studies have reported the traditional use of Sclerocarya birrea in managing diabetic patients. This study aims to demonstrate, preclinically, the antidiabetic effects of the aqueous decoction of S. birrea trunk bark. Methods: Phytochemical analysis was performed by HPLC-MS. The effects of the extracts (Sb5 and Sb25) and 0.9% NaCl on the normal blood glucose levels of the animals were determined. Diabetes induction was performed intraperitoneally by administering a single dose of alloxan (150 mg/kg) in normoglycemic rats. The antidiabetic effects of the extracts (Allox + Sb5, Allox + Sb25) and glibenclamide (Allox + Glib5) were determined in Alloxan-induced diabetic animals for four weeks. Results: Interpretation of mass spectra obtained by HPLC-MS allowed the tentative identification of vanillic acid-4-sulfate and rhamnetin in Sb extract. Investigated doses of Sb extract showed an antidiabetic impact similar to the reference, glibenclamide, with a return to normal blood glucose in all treated rats only after 4 days of treatment. Furthermore, Sb extract treatments reduced weight loss in diabetic rats. Sb had no negative impact on the balance of total cholesterol, triglycerides, high-density lipoprotein (HDL), and low-density lipoprotein (LDL). Conclusion: The present study demonstrated the antidiabetic efficacy and, to some extent, the beneficial effects of Sb extract on Alloxan-induced diabetic rats’ health. Detection of antidiabetic phytochemicals such as vanillic acid-4-sulfate and rhamnetin would justify this pharmacological property of the aqueous decoction of S. birrea trunk bark.

Antidiabetic Properties of Bidens pilosa and Its Polyacetylenic Compounds for Management of Diabetes: Systematic Review

Bidens pilosa is a member of the Asteraceae family that is widely distributed across the tropics. It has been utilized by different communities both as food and medicinal herb. This plant and its polyacetylenic compounds hold potential as a natural antidiabetic intervention that can be used to combat this global public health problem. Bioactive compounds found in this plant constitute promising interventions for combating obesity which is a major risk factor for the development of type 2 diabetes. These phytocompounds can work independently or synergistically to modulate appetite, lipase activity, adipogenesis and adipocyte apoptosis. However, the efficacy, mode of action and scope of management of diabetes by these compounds remains elusive. The current review aims to summarize data on efficacy in the management of diabetes, an antidiabetic candidate polyacetylenic compound and possible biological activities as an antidiabetic agent from the available literature. Much emphasis has been directed to cytopiloyne as a representative of polyacetylenic compounds extracted from Bidens pilosa and its activity on diabetic animal models. The majority of the studies conducted on animal models described antidiabetic mechanisms that range from hypoglycemic to secretagogue activity of cytopiloyne in a dose-dependent manner. A clinical trial pilot indicated improved glycemic control of Bidens pilosa formulation among diabetic patients in the study. Bidens pilosa and its compounds are highly potent antidiabetic agent(s) that should be graduated to an intervention for management of diabetes through pre-clinical and clinical trials to elucidate its efficacy and safety.

Insulin-mimetic compound hexaquis(benzylammonium) decavanadate is antilipolytic in human fat cells

AIM To assess in rodent and human adipocytes the antilipolytic capacity of hexaquis(benzylammonium) decavanadate(B6V10), previously shown to exert antidiabetic effects in rodent models, such as lowering free fatty acids(FFA) and glucose circulating levels.METHODS Adipose tissue(AT) samples were obtained after informed consent from overweight women undergoing plastic surgery. Comparison of the effects of B6V10 and reference antilipolytic agents(insulin,benzylamine,vanadate) on the lipolytic activity was performed on adipocytes freshly isolated from rat, mouse and human AT. Glycerol release was measured using colorimetric assay as an index of lipolytic activity. The influence of B6V10 and reference agents on glucose transport into human fat cells was determined using the radiolabelled 2-deoxyglucose uptake assay.RESULTS In all the species studied, B6V10 exhibited a dosedependent inhibition of adipocyte lipolysis when triglyceride breakdown was moderately enhanced by β-adrenergic receptor stimulation. B6V10 exerted on human adipocyte a maximal lipolysis inhibition of glycerol release that was stronger than that elicited by insulin. However, B6V10 did not inhibit basal and maximally stimulated lipolysis. When incubated at dose ≥ 10 μmol/L, B6V10 stimulated by twofold the glucose uptake in human fat cells, but-similarly to benzylamine-without reaching the maximal effect of insulin, while it reproduced one-half of the insulin-stimulation of lipogenesis in mouse fat cells. CONCLUSION B6V10 exerts insulin-like actions in adipocytes, including lipolysis inhibition and glucose transport activation. B6V10 may be useful in limiting lipotoxicity related to obesity and insulin resistance.

Introducing New Peptide Extracts from Saccharomyces cerevisiae and Achatina achatina Fluids with Strong Inhibitory Activities on Human α-Amylase

This study aimed at exploring for new natural peptides with strong inhibitory capabilities on α-amylase, the main metabolic enzyme that regulates mellitus diabetes, in order to contribute in controlling this global pandemic. It has consisted in heat shock (to 60°C, 70°C, 80°C, 90°C and 100°C for 10, 20 and 30 minutes) of crude proteins extracted from biomass and extracellular parts of Saccharomyces cerevisiae under cultivation, and from the digestive fluid of the giant snail Achatina achatina, and in-vitro assays of the resulting solutions, as effectors, in human α-amylase catalyzing reactions. The results showed that whatever the temperature and time of treatment, an increase (from 2.65 to 3.98-fold) in proteins concentration was noticed. When blended up to 75 microliters in reaction mixtures, the three peptide extracts showed beyond 11% of inhibition of initial α-amylase activity. By reducing samples volume, only 5 microliters of the studied peptide extracts representing 4.70 μg of S. cerevisiae biomass peptides, 0.55 μg of S. cerevisiae extracellular peptides or 1.05 μg of peptides from the digestive fluid A. achatina were quite sufficient to induce complete (100%) inhibition of the human α-amylase activity. Compared to the inhibitory effect obtained from 2.50 μg of acarbose, a renowned antidiabetic, the studied peptide effectors showed more pronounced inhibitory activities. So, we can positively state that S. cerevisiae as well as A. achatina are both capable of synthesizing proteins made up of small inhibitory peptides which deserve purification and structural analysis for potential exploitation as healthy antidiabetic drugs.

Update on the treatment of type 2 diabetes mellitus

To achieve good metabolic control in diabetes and keep long term, a combination of changes in lifestyle and pharmacological treatment is necessary. Achieving near-normal glycated hemoglobin significantly, decreases risk of macrovascular and microvascular complications. At present there are different treatments, both oral and injectable, available for the treatment of type 2 diabetes mellitus(T2DM). Treatment algorithms designed to reduce the development or progression of the complications of diabetes emphasizes the need for good glycaemic control. The aim of this review is to perform an update on the benefits and limitations of different drugs, both current and future, for the treatment of T2 DM. Initial intervention should focus on lifestyle changes. Moreover, changes in lifestyle have proven to be beneficial, but for many patients is a complication keep long term. Physicians should be familiar with the different types of existing drugs for the treatment of diabetes and select the most effective, safe and better tolerated by patients. Metformin remains the first choice of treatment for most patients. Other alternative or second-line treatment options should be individualized depending on the characteristics of each patient. This article reviews the treatments available for patients with T2 DM, with an emphasis on agents introduced within the last decade.

Moringa oleifera:A review on nutritive importance and its medicinal application

Moringa oleifera,native to India,grows in the tropical and subtropical regions of the world.It is commonly known as‘drumstick tree’or‘horseradish tree’.Moringa can withstand both severe drought and mild frost conditions and hence widely cultivated across the world.With its high nutritive values,every part of the tree is suitable for either nutritional or commercial purposes.The leaves are rich in minerals,vitamins and other essential phytochemicals.Extracts from the leaves are used to treat malnutrition,augment breast milk in lactating mothers.It is used as potential antioxidant,anticancer,anti-inflammatory,antidiabetic and antimicrobial agent.M.oleifera seed,a natural coagulant is extensively used in water treatment.The scientific effort of this research provides insights on the use of moringa as a cure for diabetes and cancer and fortification of moringa in commercial products.This review explores the use of moringa across disciplines for its medicinal value and deals with cultivation,nutrition,commercial and prominent pharmacological properties of this“Miracle Tree”.

Transdermal drug delivery systems in diabetes management: A review

Diabetes mellitus is a chronic disease in which there is an insufficient production of insulin by the pancreas, or the insulin produced is unable to be utilized effectively by the body. Diabetes affects more than 415 million people globally and is estimated to strike about 642 million people in 2040. The WHO reported that diabetes will become the seventh biggest cause of mortality in 2030. Insulin injection and oral hypoglycemic agents remain the primary treatments in diabetes management. These often present with poor patient compliance. However, over the last decade, transdermal systems in diabetes management have gained increasing attention and emerged as a potential hope in diabetes management owing to the advantages that they offer as compared to invasive injection and oral dosage forms. This review presents the recent advances and developments in transdermal research to achieve better diabetes management. Different technologies and approaches have been explored and applied to the transdermal systems to optimize diabetes management. Studies have shown that these transdermal systems demonstrate higher bioavailability compared to oral administration due to the avoidance of first-pass hepatic metabolism and a sustained drug release pattern. Besides that, transdermal systems have the advantage of reducing dosing frequency as drugs are released at a predetermined rate and control blood glucose level over a prolonged time, contributing to better patient compliance. In summary, the transdermal system is a field worth exploring due to its significant advantages over oral route in administration of antidiabetic drugs and biosensing of blood glucose level to ensure better clinical outcomes in diabetes management.

Antidiabetic activity of alcoholic leaves extract of Alangium lamarckii Thwaites on streptozotocin-nicotinamide induced type 2 diabetic rats

Objective:To investigate antidiabetic potential of alcoholic leaves extract of Alangium lamarekii (A.lamarckii) on streptozotocin-nicotinamide induced type 2 diabetic rats.Methods:Oral glucose tolerance test was done by inducing hyperglycemic state via administration of glucose in water(2 g/kg).Single dose of alcoholic leaves extract of.4.lamarckii(250 and 500 mg/kg,p.o.) were administered to normoglycemic,hyperglycemic rats.Type 2 diabetes was induced by single intraperitoneal injection of nicotinamide(110 mg/kg) followed by streptozotocin(65 mg/kg).The study also included estimations of blood plasma glucose,lipid profile,liver glycogen,body weight and antioxidant status in normal and diabetic rats.Results:Admistration of alcoholic extract of A.lamarekii at two dosage 250 and 500 rag/kg,p.o.did not showed any significant change in blood glucose level of normoglycemic rats(P】0.05).whereas,oral glucose tolerance test depicted reduction in blood glucose level(P【0.05).The streptozotocin-nicotinamide induced diabetic rats, significantly decreased the blood plasma glucose level(P【0.001) comparable to glibenclamide (10 mg/kg),restored the lipid profile and showed improvement in liver glycogen,body weight and antioxidant status in diabetic rats.Conclusions:Present finding demonstrated the significant antidiabetic activity of alcoholic leaves extract of.4.lamarekii.

Antidiabetic and haematological effect of aqueous extract of stem bark of Afzelia africana(Smith) on streptozotocin-induced diabetic Wistar rats

Objective:To investigate the antidiabetic properties of aqueous extract of stem bark of Afzelia africana(A.africana)and its beneficial effect on haematological parameters in streptozotocin induced diabetic rats.Methods:A total of 30 rats including 24 diabetic and 6 normal rats were used for this study.Diabetes was induced in male Wistar rats by intraperitoneal injection of streptozotocin.After being confirmed diabetic,animals were orally treated with distilled water or extracts at 100 or 200 mg/kg body weight daily for 10 days.The haematological parameters including red blood and white blood cells and their functional indices were evaluated in diabetic treated groups compared with the controls.Results:The extract significantly reduced the blood glucose levels while the best result was obtained at 200 mg/kg body weight The feed and water intake in diabetic rats were significantly reduced while weight loss was minimized at both dosages.Similarly,the levels of red blood,white blood cells and their functional indices were significantly improved after extract administration at both doses.Conclusions:It can be concluded that the aqueous extract of bark of A.africana possesses antihyperglycemic properties.In addition,the extract can prevent various complications of diabetes and improve some haematological parameters.Further experimental investigation is needed to exploit its relevant therapeutic effect to substantiate its ethnomedicinal usage.

A review on promising phytochemical, nutritional and glycemic control studies on Moringa oleifera Lam. in tropical and sub-tropical regions

Plants have provided sources to find novel compounds. These plants are being used as therapeutic purposes since the birth of mankind. The traditional healers normally utilize medicinal plants as crude drugs while scientists using the folk claim as guides to explore medicinal plants. Moringa oleifera is a famous edible plant having therapeutic and nutritive values. The present study was designed to cumulate the research data regarding to what extent, phytochemical, nutritional and glycemic control studies has been explored using its different extracts. The articles indicated that the powder, aqueous, methanol and ethanol extracts of Moringa oleifera(leaves, pods, seeds, stem and root bark) have significant therapeutic herbal potential to treat diabetes mellitus. Collectively, the mechanism behind is intestinal glucose inhibition, insulin release as well as decrease in insulin resistance probably regeneration of b-cells of pancreas, increase in glutathione and reduction in malondialdehyde. Conclusively, this article give descriptive information about antidiabetic effect, claimed marker compounds and proposed antihyperglycemic mechanism of a single plant. It can be suggested a potential herbal source to treat diabetes mellitus as being widely accepted by major population as nutrition and therapeutic agent.

An overview on antidiabetic medicinal plants having insulin mimetic property

Diabetes mellitus is one of the common metabolic disorders acquiring around 2.8%of the world's population and is anticipated to cross 5.4%by the year 2025.Since long back herbal medicines have been the highly esteemed source of medicine therefore,they have become a growing part of modern,high-tech medicine.In view of the above aspects the present review provides profiles of plants(65 species) with hypoglycaemic properties,available through literature source from various database with proper categorization according to the parts used,mode of reduction in blood glucose(insulinomimetic or insulin secretagugues activity) and active phyloconsliluents having insulin mimetics activity.From the review it was suggested that,plant showing hypoglycemic potential mainly belongs to the family Leguminoseae,Lamiaceae,Liliaceae,Cucurbitaceae, Asteraceae,Moraceae,Rosaceae and Araliaceae.The most active plants are Allium sativum. Gymnema sylvestre,Citrullus colocynthis,Trigonella foenum greacum,Momordica charantia and Ficuts bengalensis.The review describes some new bioactive drugs and isolated compounds from plants such as roseoside,epigallocatechin gallate,beta-pyrazol-1-ylalanine,cinchonain Ib,leucocyandin 3-O-beta-d-galactosyl cellobioside,leucopelargonidin-3- O-alpha-L rhamuoside,glycyrrhetinic acid,dehydrotrametenolic acid,strictinin,isostrictinin,pedunculagin, epicatechin and christinin-A showing significant insulinomimetic and antidiabetic activity with more efficacy than conventional hypoglycaemic agents.Thus,from the review majorly,the antidiabetic activity of medicinal plants is attributed to the presence of polyphenols,flavonoida, terpenoids,coumarins and other constituents which show reduction in blood glucose levels.The review also discusses the management aspect of diabetes mellitus using these plants and their active principles.

Antihyperglycemic effect of Hypericum perforatum ethyl acetate extract on streptozotocin-induced diabetic rats

Objective:To evaluate the antihyperglycemic activity of ethyl acetate extract of Hypericum perforatum(H.perforatum)in streptozotocin(STZ)-induced diabetic rats.Methods:Acute toxicity and oral glucose tolerance lest were performed in normal rats.Male albino rats were rendered diabetic by ST/(40 mg/kg,intraperitoneally).H.perforatum ethyl acetate extract was orally administered to diabetic rats at SO,100 and 200 mg/kg doses for 15 days to determine the antihyperglycemic activity.Biochemical parameters were determined at the end of the treatment.Results:H.perforatum ethyl acetate extract showed dose dependant fall in fasting blood glucose(FBG).After 30 min of extract administration,FBG was reduced significantly when compared with normal rats.H.perforatum ethyl acetate extract produced significant reduction in plasma glucose level,serum total cholesterol,triglycerides,glucose-6-phosphatase levels.Tissue glycogen content,HDL-cholesterol,glucose-6-phosphate dehydrogenase were significantly increased compared with diabetic control.No death or lethal effect was observed in the toxic study.Conclusions:The results demonstrate that H.perforatum ethyl acetate extract possesses potent antihyperglycemic activity in STZ induced diabetic rats.

Evaluation of the anti-diabetic properties of Mucuna pruriens seed extract

Objective:To explore the antidiabetic properties of Mucuna pruriens(M.pruriens).Methods: Diabetes was induced in Wistar rats by single intravenous injection of 120 mg/kg of alloxan monohydrate and different doses of the extract were administered to diabetic rats.The blood glucose level was determined using a glucometer and results were compared with normal and untreated diabetic rats.The acute toxicity was also determined in albino mice.Results:Results showed that the administration of 5,10,20,30,40,50,and 100 mg/kg of the crude ethanolic extract of M.pruriens seeds to alloxan-induced diabetic rats(plasma glucose 】 450 mg/dL) resulted in 18.6%,24.9%,30.8%,41.4%,49.7%,53.1%and 55.4%reduction,respectively in blood glucose level of the diabetic rats after 8h of treatment while the administration of glibenclamide (5 mg/kg/day) resulted in 59.7%reduction.Chronic administration of the extract resulted in a significant dose dependent reduction in the blood glucose level(P【0.001).It also showed that the antidiabetic activity of M.pruriens seeds resides in the methanolic and ethanolic fractions of the extract.Acute toxicity studies indicated that the extract was relatively safe at low doses,although some adverse reactions were observed at higher doses(8-32 mg/kg body weight),no death was recorded.Furthermore,oral administration of M.pruriens seed extract also significandy reduced the weight loss associated with diabetes.Conclusions:The study clearly supports the traditional use of M.pruriens for the treatment of diabetes and indicates that the plant could be a good source of potent antidiabetic drug.

Investigation of hypoglycemic,hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark in diabetic rats

Objective:To investigate the hypoglycemic,hypolipidemic and antioxidant activities of aqueous extract of Terminalia paniculata bark(AETPB) in streptozotocin(STZ)-mduced diabetic rats.Methods:Acute toxicity was studied in rats after the oral administration of AETPB to determine the dose to assess hypoglycemic activity.In rats,diabetes was induced by injection of STZ(60 mg/kg,i.p.) and diabetes was confirmed 72 h after induction,and then allowed for 14 days to stabilize blood glucose level.In diabetic rats,AETPB was orally given for 28 days and its effect on blood glucose and body weight was determined on a weekly basis.At the end of the experimental day,fasting blood sample was collected to estimate the haemoglobin(Hb),glycosylated haemoglobin(HbA1c),serum creatinine,urea,serum glutamate-pyruvate transaminase(SGPT),serum glutamate-oxaloacetate transaminase(SGOT) and insulin levels. The liver and kidney were collected to determine antioxidants levels in diabetic rats.Results: Oral administration of AETPB did not exhibit toxicity and death at a dose of 2000 mg/kg.AETPB treated diabetic rats significantly(P<0.001,P<0.01 and P<0.05) reduced elevated blood glucose, HbAlc,creatinine,urea,SGPT and SGOT levels when compared with diabetic control rats.The body weight,Hb,insulin and total protein levels were significantly(P<0.001,P<0.01 and P<0.05) increased in diabetic rats treated with AETPB compared to diabetic control rats.In diabetic rats, AETPB treatment significantly reversed abnormal status of antioxidants and lipid profile levels towards near normal levels compared to diabetic control rats.Conclusions:Present study results confirm that AETPB possesses significant hypoglycemic,hypolipidemic and antioxidant activities in diabetic condition.

Antidiabetic activity of methanolic bark extract of Alhizia odoratissima Benth.in alloxan induced diabetic albino mice

Objective:To evaluate the antidiabetic potential of methanolic extract of Albizia odoratissima Benth.bark in alloxan induced diabetic mice.Methods:Group-Ⅰ(normal control) mice received only basal diet without any treatment.In Group-Ⅱ(Diabetic control) mice,diabetes was induced by alloxan(150 mg/kg i.p.) and received only Tween 80.5%v/v in normal saline. Group-Ⅲand Group-Ⅳmice received metformin(10 mg/kg) and gliclazide(10 mg/kg) as standard drugs.Group-ⅤandⅥmice received methanolic bark extract of Albizia odoratissima at doses of 250 and 500 mg/kg body weight p.o.,respectively.Results:The results of the study indicates that Albizia odoratissima bark extract significantly(P【0.01) reduced the blood sugar level.The bark extract also significantly reduced the levels of serum cholesterol,triglycerides, serum glutamic-oxaloacetic transaminase,serum glutamic-pyruvic transaminase,alkaline phosphatase and decreases level of total proteins in alloxan induced diabetic mice.Conclusions: Methanolic extract of Albizia odoratissima has protective effects on the protection of vital tissues(pancreas,kidney,liver,heart and spleen),thereby reducing the causation of diabetes in experimental animals.

A Study on the Protective Effect of Cynodon dactylon Leaves Extract in Diabetic Rats

Objective To investigate the antidiabetic, antioxidant and hypolipidemic efficacy of Cynodon dactylon in diabetic rats. Methods The experimental rats were randomly divided into three groups： Group I： control; Group II： Alloxan diabetic, untreated; and Group III： Alloxan diabetic treated with ethanolic extract of C. dactylon leaves （450 mg/kg bw）. Experimental diabetes was induced by alloxan in a single dose of 150 mg/kg bw. Results A Significant diminution of fasting blood sugar level was observed and also significant increase in HDL and decrease （P0.05） in cholesterol, triglyceride, LDL and VLDL were observed after 15 days of treatment. The investigation also revealed, the activities of AST, ALT, ALP, AP, LDH, and CPK （P0.05） were decreased in the extract‐supplemented group. The significant decrease in protein content and SOD, CAT, GPx, and GSH （P0.05） activity and increase in LPO in plasma were found to be ameliorated after treatment. Conclusion Our result supports the fact that administration of extract of C. dactylon leave is able to reduce hyperglycemia and hyperlipidemia risk and also reduced the oxidative stress in diabetic rats.

Association between hepatocellular carcinoma and type 2 diabetes mellitus in Italy:Potential role of insulin

AIM: To investigate the relationships between Type 2 diabetes mellitus (DM2) and the risk of hepatocellular carcinoma (HCC). METHODS: We studied the association between DM2 and HCC in a large case-control study that enrolled 465 consecutive Caucasian patients with HCC (78.3% males, mean age 68.5 ± 8.9 years) compared with an age and sex matched control group of 490 subjects. RESULTS: Prevalence of DM2 was significantly higher in HCC patients (31.2% vs 12.7%; OR = 3.12, 95% CI: 2.22-4.43) and in HCC cases with alcohol abuse. DM2 has been diagnosed before the appearance of HCC in 84.1% of diabetic HCC subjects with mean duration of 141.5 mo, higher in cases treated with insulin than in those with oral antidiabetic agents (171.5 vs 118.7 mo). Compared to controls, males DM2 with HCC were more frequently treated with insulin (38.1% vs 17.6%, P = 0.009) and with sulfonylurea with or without metformin than with diet with or without metformin (84% vs 68.3%, P = 0.049). CONCLUSION: DM2 in our patients is associated with a 3-fold increase risk of HCC. In most of our cases DM2 pre-existed to HCC. Patients with DM2 and chronic liver disease, particularly insulin treated males, should be considered for HCC close surveillance programs.

Phytotherapy in diabetes: Review on potential mechanistic perspectives

Diabetes mellitus(DM) is a widely spread epidemic dis ease that results from the absence of insulin, decreased secretion and/or impaired function. Since DM is a multi factorial disease, the available pharmaceuticals, despite their sensible treatment, target mostly one pathway to control hyperglycemia and encounter several side effects. Therefore, new therapeutic paradigms aim to hit several pathways using only one agent. Tradition ally, antidiabetic plants and/or their active constituents may fulfill this need. More than 200 species of plants possess antidiabetic properties which were evaluated mostly by screening tests without digging far for the exact mode of action. Searching among the differen literature resources and various database and in view o the above aspects, the present article provides a com prehensive review on the available antidiabetic plants that have been approved by pharmacological and clini cal evaluations, and which their mechanism(s) of ac tion is assured. These plants are categorized according to their proved mode of action and are classified into those that act by inhibiting glucose absorption from in testine, increasing insulin secretion from the pancreasinhibiting glucose production from hepatocytes, or enhancing glucose uptake by adipose and muscle tissues. The current review also highlights those that mimic in their action the new peptide analogs, such as exenatide, liraglutide and dipeptidylpeptidase-4 inhibitors that increase glucagon-like peptide-1 serum concentration and slow down the gastric emptying.

Parkinson’s disease and diabetes mellitus: common mechanisms and treatment repurposing

In the last decade,attention has become greater to the relationship between neurodegeneration and abnormal insulin signaling in the central nervous system,as insulin in the brain is implicated in neuronal survival,plasticity,oxidative stress and neuroinflammation.Diabetes mellitus and Parkinson’s disease are both aging-associated diseases that are turning into epidemics worldwide.Diabetes mellitus and insulin resistance not only increase the possibility of developing Parkinson’s disease but can also determine the prognosis and progression of Parkinsonian symptoms.Today,there are no available curative or disease modifying treatments for Parkinson’s disease,but the role of insulin and antidiabetic medications in neurodegeneration opens a door to treatment repurposing to fight against Parkinson’s disease,both in diabetic and nondiabetic Parkinsonian patients.Furthermore,it is essential to comprehend how a frequent and treatable disease such as diabetes can influence the progression of neurodegeneration in a challenging disease such as Parkinson’s disease.Here,we review the present evidence on the connection between Parkinson’s disease and diabetes and the consequential implications of the existing antidiabetic molecules in the severity and development of Parkinsonism,with a particular focus on glucagon-like peptide-1 receptor agonists.