Effects and mechanisms of berberine in diabetes treatment. Abstract. Berberine from Rhizoma Coptidis is an oral hypoglycemic agent with anti- dyslipidemia and anti- obesity activities. Its metabolic activity of regulating blood glucose and lipids has been widely studied and evidenced in patients and various animal models. Berberine is known as an AMP- activated protein kinase (AMPK) activator. Its insulin- independent hypoglycemic effect is related to inhibition of mitochondrial function, stimulation of glycolysis and activation of AMPK pathway.
Additionally, berberine may also act as an О±- glucosidase inhibitor. In the newly- diagnosed type 2 diabetic patients, berberine is able to lower blood insulin level via enhancing insulin sensitivity.
However, in patients with poor ОІ- cell function, berberine may improve insulin secretion via resuscitating exhausted islets. Furthermore, berberine may have extra beneficial effects on diabetic cardiovascular complications due to its cholesterol- lowering, anti- arrhythmias and nitric oxide (NO) inducing properties. The antioxidant and aldose reductase inhibitory activities of berberine may be useful in alleviating diabetic nephropathy. Although evidence from animal and human studies consistently supports the therapeutic activities of berberine, large- scale multicenter trials are still necessary to evaluate the efficacy of berberine on diabetes and its related complications. Graphical abstract. The insulin- independent hypoglycemic effect of berberine is related to inhibition of mitochondrial function, stimulation of glycolysis and activation of AMPK pathway. Additionally, the antioxidant and aldose reductase inhibitory activities of berberine may be useful in alleviating diabetic nephropathy.
- Références : 1- Bhutada P, Mundhada Y, Bansod K, Tawari S, Patil S, Dixit P, Umathe S, Mundhada D. Protection of cholinergic and antioxidant system contributes to the effect of berberine ameliorating memory dysfunction in.
- Berberine is a compound extracted from a variety of herbs. It is supplemented for its anti-diabetic effects, which rival the potency of some pharmaceuticals.
- Figure 2. Mechanism of berberine in regulation of metabolism: (1) Berberine enhances glucose uptake through induction of glycolysis, which is due to inhibition of aerobic respiratory. AMPK activation is a consequence of.
Key words. Berberine; Diabetes mellitus; Complications; Traditional Chinese medicine. Introduction. Berberine is the major active component of Rhizoma Coptidis, a popular traditional Chinese herb in the treatment of diabetes and inflammation. The content of berberine in Rhizoma Coptidis is 5. Rhizoma Coptidis is made from several plants including Coptis chinensis French, Coptis deltoidea C. Y. Cheng et Hsiao and Coptis teetoides C. Y. Cheng. The earliest record of Rhizoma Coptidis as a medicinal herb was in A.
D. 2. 00 in The Herbal Classic of the Divine Plowman (Shen Nong Ben Cao Jing). In about A. D. 5. Rhizoma Coptidis was recorded for the first time in a book titled “Note of Elite Physicians”. However, in most ancient books, the major therapeutic activity of Rhizoma Coptidis is considered as anti- infection or anti- inflammation because infectious diseases were much more popular than diabetes in ancient time 1 and 2.
Although the Chinese name of berberine, Huangliansu, means element of Rhizoma Coptidis, most berberine used in medical practice are not extracted from this herb because of high cost. Usually, it is prepared from other herbs such as Berberis amurense Rupr. Phellodendron amurense Rupr.
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Learn how berberine, a powerful plant extract, works to naturally treat various health conditions and discover what research has to say about it. Resveratrol induces mitochondrial biogenesis and protects against metabolic decline, but whether SIRT1 mediates these benefits is the subject of debate. To circ.
Among many chemical forms of berberine, i. The antimicrobial activity of berberine is well- established in treatment of infection caused by bacteria, viruses, fungi, protozoans and helminthes. In China, berberine is an over- the- counter drug for the treatment of bacterial diarrhea. In 1. 98. 8, the hypoglycemic effect of berberine was firstly reported when berberine was prescribed to treat diarrhea in diabetic patients. Since then, berberine has been used as an anti- diabetic agent in folk medicine of China. Efficacy of berberine on diabetic patients.
Numerous clinical reports about the hypoglycemic action of berberine can be found in Chinese literatures. Berberine was claimed to have a comparable activity to sulphonureas or metformin in reducing blood glucose, although most of the studies were not well designed.
Up to now, berberine has been tested in several clinical trials. Our study confirmed that administration of berberine (0. FBG) and postprandial blood glucose (PBG) in patients with newly- diagnosed type 2 diabetes. Hemoglobin A1c (Hb. A1c) levels were dropped by 2.
In poorly- controlled diabetic patients with insulin injection, berberine reduced Hb. A1c by 0. 8%. In addition to the hypoglycemic action, plasma triglycerides, total cholesterol and low- density lipoprotein (LDL) were decreased with berberine treatment, too. The similar results were also reported by another group. In this two- center, randomized, double- blind trial, Hb. A1c decreased by 0. All parameters including blood glucose and lipids were improved significantly. In short- term clinical trials, only minor gastrointestinal adverse events, such as constipation, flatulence and diarrhea, were observed.
In our study, no significant changes of plasma alanine aminotransferase (ALT), Оі- glutamyl transpeptidase (Оі- GT), and creatinine were observed. In another study, serum ALT, aspartate aminotransaminase (AST) and Оі- GT were significantly reduced in the berberine group. This indicates berberine has no liver or kidney toxicity at the dose given in above studies. Although hypoglycemic effect of berberine was reported in mounting Chinese literature evidence, large scale, long- term clinical trial are still needed to evaluate the efficacy of berberine in the treatment of diabetes.
Berberine on glucose metabolism in animals. Berberine was shown to decrease blood glucose, enhance insulin sensitivity and reduce weight gain in both dietary and genetic rodent models of type 2 diabetes. In high- fat diet induced obese rats, berberine decreased FBG, PBG, fasting insulin, homeostasis model of assessment- insulin resistance (HOMA- IR) and body weight. In low dose of streptozotocin (STZ) and high- fat diet induced type 2 diabetic rats, berberine treatment significantly decreased FBG and improved insulin tolerance. In leptin receptor- deficient db/db mice, glucose tolerance was improved and body weight was reduced with berberine 7.
In alloxan- induced type 1 diabetic rats, berberine also restored the injured pancreas. Berberine and islet function. Impacts of berberine on islet are controversial. Our previous work showed that berberine had no insulin secretagogue effects on ОІ- TC3 cells in vitro. Berberine restored pancreatic islet hyperthophy back to normal. Our clinical trial showed that berberine lowered fasting insulin levels in the newly diagnosed type 2 diabetic patients.
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However, in the poorly- controlled diabetic patients with insulin injection, berberine did raise the fasting and postprandial C- peptide levels. The data suggest although berberine did not stimulate the insulin secretion directly, it may be able to improve the islet function in patients unresponsive to oral hypoglycemic agents. Dr. Zhou's work. 12 indicated that berberine reduced plasma insulin levels in high- fat diet fed rats and blunted insulin secretion in MIN6 ОІ- cells and isolated rat islets directly. However, other groups reported that berberine decreased blood glucose via islet protection in Nonobese diabetic (NOD) mice—a spontaneous type 1 diabetic model 1.
The effects of increasing islet numbers and blood insulin levels were not observed in berberine treated db/db mice. Thus, these results indicate berberine may have a two- way regulation in pancreas islets.
In typical type 2 diabetes with notable insulin resistance, berberine lowered blood insulin level through increasing insulin sensitivity. However, in type 1 diabetes or the late stage of type 2 diabetes characterized by poor ОІ- cell function, berberine was able to increase insulin secretion via repairing destructed or exhausted islets, which may be related to its antioxidant and anti- lipid peroxidation properties 1.