Clinical outcomes of diabetic foot management with Circulat.

Major and minor lower-extremity amputation is a common complication among diabetics. Various sources indicate diabetic foot ulcer prevalence at between 2.2% and 15% in diabetics. This study evaluates the efficacy and tolerance of a standardized plant extract combination, Circulat, developed for the prevention and treatment of severe manifestations of type 2 diabetes, such as necrotic damage of the foot. Thus, a retrospective cohort study was carried out in 174 patients treated with Circulat with diabetic foot grades D1-D3, according to The University of Texas Wound Classification System, in 50 medical centers, from 2004 to 2007. Circulat obtained 50.57% complete cure of diabetic foot, significant improvement in 37.9% and prevented amputation in 88.5% of the study's total population. The treatment was well tolerated. Four patients (2.3%) had slight gastrointestinal unrest which did not warrant suspension of treatment.

Analysis of effects of the herbal preparation Circulat on gene expression levels in cultured human fibroblasts.

Circulat is a systemic standardized plant extract formulation that was developed for the prevention of severe manifestations of type 2 diabetes such as necrotic damage of the plantar foot. With the aim of revealing the molecular mechanisms underlying Circulat's biological activity, the effects of Circulat treatment on gene expression levels were examined in the cultured human fibroblast cell line MRC-5 using Affymetrix oligonucleotide microarrays. The analysis identified 187 genes, the expression levels of which underwent significant changes upon Circulat treatment. These include four genes (IL6, HMGA1, SLC19A2 and C4A) that have been implicated previously in the development of diabetes. A large proportion of the identified genes are involved in energy metabolism, protein synthesis, glucose metabolism and signaling pathways. Synergistic action of the Circulat components has also been revealed. Prospective applications of microarray analysis in phytopharmacology are discussed.