The Potential Roles of Artemisinin and Its Derivatives in the Treatment of Type 2 Diabetes Mellitus.

Type 2 diabetes mellitus (T2DM) is a chronic disease that has become a global public health problem. Studies on T2DM prevention and treatment mostly focus on discovering therapeutic drugs. Artemisinin and its derivatives were originally used as antimalarial treatments. In recent years, the roles of artemisinins in T2DM have attracted much attention. Artemisinin treatments not only attenuate insulin resistance and restore islet ß-cell function in T2DM but also have potential therapeutic effects on diabetic complications, including diabetic kidney disease, cognitive impairment, diabetic retinopathy, and diabetic cardiovascular disease. Many in vitro and in vivo experiments have confirmed the therapeutic utility of artemisinin and its derivatives on T2DM, but no article has systematically demonstrated the specific role artemisinin plays in the treatment of T2DM. This review summarizes the potential therapeutic effects and mechanism of artemisinin and its derivatives in T2DM and associated complications, providing a reference for subsequent related research.

The Herbal Medicine Scutellaria-Coptis Alleviates Intestinal Mucosal Barrier Damage in Diabetic Rats by Inhibiting Inflammation and Modulating the Gut Microbiota.

Recent studies have confirmed that increased intestinal permeability and gut-origin lipopolysaccharide (LPS) translocation are important causes of metabolic inflammation in type 2 diabetes (T2D), but there are no recognized therapies for targeting this pathological state. Scutellaria baicalensis and Coptis chinensis are a classic herbal pair often used to treat diabetes and various intestinal diseases, and repair of intestinal barrier damage may be at the core of their therapeutic mechanism. This study investigated the effects of oral administration of Scutellaria-Coptis (SC) on the intestinal mucosal barrier in diabetic rats and explored the underlying mechanism from the perspective of anti-inflammatory and gut microbiota-modulatory effects. The main results showed that, in addition to regulating glycolipid metabolism disorders and inhibiting serum inflammatory factors, SC could also upregulate the expression levels of the tight junction proteins claudin-1, occludin, and zonula occludens (ZO-1), significantly improve intestinal epithelial damage, and inhibit excessive LPS translocation into the blood circulation. Furthermore, it was found that SC could reduce the levels of the inflammatory factors interleukin-1ß (IL-1ß), IL-6, and tumour necrosis factor-α (TNF-α) in intestinal tissue and that the anti-inflammatory effects involved the TLR-4/TRIF and TNFR-1/NF-κB signalling pathways. Moreover, SC had a strong inhibitory effect on some potential enteropathogenic bacteria and LPS-producing bacteria, such as Proteobacteria, Enterobacteriaceae, Enterobacter, Escherichia-Shigella, and Enterococcus, and could also promote the proliferation of butyrate-producing bacteria, such as Lachnospiraceae and Prevotellaceae. Taken together, the hypoglycaemic effects of SC were related to the protection of the intestinal mucosal barrier, and the mechanisms might be related to the inhibition of intestinal inflammation and the regulation of the gut microbiota.

Effects of probiotics on blood glucose, biomarkers of inflammation and oxidative stress in pregnant women with gestational diabetes mellitus: A meta-analysis of randomized controlled trials.

BACKGROUND: The role of probiotics supplementation in gestational diabetes mellitus (GDM) remains controversial. We conducted this meta-analysis to investigate the effects of probiotics on fasting blood glucose (FBG), high-sensitivity C-reactive protein (hs-CRP), total glutathione (GSH), malonaldehyde (MDA) and nitric oxide (NO) levels in pregnant women with GDM. METHODS: We systematically searched the Cochrane Library, Embase and PubMed electronic databases up to November 2018. A meta-analysis was then conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures. RESULTS: A total of 7 studies were enrolled in the final meta-analysis. Data showed that probiotics reduced FBG (WMD: -3.19mg/dl, 95% CI: -5.55 to -0.82, P=0.008) in pregnant women with GDM. Sub-group analysis suggested that the effect of probiotics on lowering FBG was more significant in patients with a baseline FBG ≥92mg/dl (WMD: -3.62mg/dl, 95% CI: -6.64 to -0.60, P=0.019), a duration of probiotic treatment ≤6 weeks (WMD: -3.24mg/dl, 95% CI: -4.96 to -1.53, P=0.000) and a dose<6×109 colony-forming unit (CFU) (WMD: -3.37mg/dl, 95% CI: -6.64 to -0.10, P=0.043). In addition, probiotics were effective in reducing hs-CRP and MDA in pregnant women with GDM, but had no significant effect on either GSH or NO. CONCLUSION: This meta-analysis suggests that probiotics supplementation might have a small effect on the reduction of FBG in pregnant women with GDM, and might have certain effects on some biomarkers of inflammation and oxidative stress. However, given the heterogeneity between studies, the results should be interpreted with caution but are worthy of further investigation.

Does synbiotic supplementation affect body weight, body mass index, and high-sensitivity C-reactive protein levels in patients with type 2 diabetes? Protocol for a systematic review and meta-analysis.

BACKGROUND: The number of patients with type 2 diabetes mellitus (T2DM) is surging currently. Synbiotic as a supplement based on gut microbiota may be beneficial to improve the metabolism of T2DM. However, the results of clinical studies show that the role of synbiotic in weight management in patients with T2DM is controversial. In this context, we have formulated this protocol. The study will evaluate the effects of synbiotic supplementation on body weight, body mass index (BMI), and high-sensitivity C-reactive protein (hs-CRP) levels in patients with T2DM. METHODS: The electronic databases PubMed, Embase, and the Cochrane Library will be searched for relevant literature from inception. Literature search, data extraction, and methodological quality assessment will be carried out independently by two researchers. All randomized controlled trials (RCTs) that met the criteria will be included. A meta-analysis will be conducted using weighted mean difference (WMD) and 95% confidence interval (CI) as effect measures. RESULTS: This systematic review and meta-analysis will mainly assess the effects of synbiotic supplementation on body weight and BMI in T2DM patients. Secondary outcome indicators will include hs-CRP. CONCLUSION: This systematic review and meta-analysis will quantify the value of synbiotic supplement in weight management of patients with T2DM through a comprehensive evaluation of the current clinical evidence, so as to provide a basis for clinical application. PROSPERO REGISTRATION NUMBER: CRD42019132974.

Gut Microbiota, a Potential New Target for Chinese Herbal Medicines in Treating Diabetes Mellitus.

The gut microbiota, as an important factor affecting host health, plays a significant role in the occurrence and development of diabetes mellitus (DM), and the mechanism may be related to excessive endotoxins, altered short-chain fatty acids (SCFAs), and disordered bile acid metabolism. Traditional Chinese medicine (TCM) has a long history of treating DM, but its mechanism is not very clear. Recent research has suggested that Chinese herbal medicine can improve glucose metabolism by remodeling the gut microbiota, which opens new avenues for further research on hypoglycemic mechanisms. This review presents the recent progress of Chinese herbs, herbal extracts, and herbal compound preparations in treating DM through regulating the gut microbiota and summarizes the main mechanisms involved, namely, anti-inflammatory and antioxidative effects, protecting the intestinal barrier and inhibiting lipotoxicity. In addition, some suggestions for improvement are also proposed.