Application of dietary supplements in the prevention of type 2 diabetes-related cardiovascular complications

Abstract

Type 2 diabetes, which accounts for the vast majority of diabetes worldwide is the result of a lowered sensitivity of the insulin receptors, resulting in impaired sugar metabolism is and chronic hyperglycaemia. There is no cure for type 2 diabetes, though some people with prediabetes and diabetes manage to reach and hold normal blood sugar levels, thus avoiding most of the complications that come with chronic hyperglycaemia; this is sometimes referred to as 'reversing diabetes'. A healthy diet, with sufficient amounts of fruits, nuts, and vegetables is positively correlated with maintaining glycaemic control and prevention of diabetes-related complications.Whereas many different dietary phytochemicals have been considered to play a role in the glycaemic control and in prevention of degenerative diseases, there is currently no consensus on a particular mode of action. In this review, a range of pre-clinical studies and intervention studies, including randomised double-blind, placebo controlled clinical studies, are considered that investigate the role of dietary compounds in the prevention of type 2 diabetesrelated complications. Three generic mechanisms of action can be discerned: compounds that reduce sugar uptake, compounds that restore insulin function, and compounds that attenuate the effects of oxidative stress and chronic inflammation. Particularly the latter has received wide attention in the form of activation of the Nrf2-antioxidant response element signalling pathway by various polyphenolic or triterpenoid compounds. Although individual reports may present models with clear looking signalling cascades, an overall review shows that many biologically active compounds in the human diet are pan assay interference substances that alter several cell functions simultaneously, which makes them less attractive for drug development.

Natural products in drug discovery and human health

“…Therefore, there is a great interest in developing a-glucosidase inhibitors, which, currently, are considered as first-line drugs for treating type-2 diabetes. Hussain et al (2020) reviewed aglucosidase inhibitors, reported in the last 40 years, isolated from fungi.…”

The protective effects of flavonoids and carotenoids against diabetic complications—A review of in vivo evidence

“…Notably, flavonoids and carotenoids, natural phytochemicals commonly found in edible fruits and vegetables (F&V), have been shown to mediate immune-inflammatory responses and modulate non-cytokine mediators such as reactive oxygen species and nitric oxide (NO), thus potentially protecting against diabetes-related complications (24-27). A large body of research has focused on the preventive effects of flavonoids and carotenoids against the immediate effects of T2DM (28)(29)(30)(31)(32), but their protective effects against diabetic complications have remained less studied, with clinical evidence emerging but still limited (33,34). This review will primarily discuss the therapeutic potential of dietary flavonoids and carotenoids in preventing/treating diabetic complications based on in vivo evidence and examine the possible mechanistic bases involved with a particular focus on the immune-inflammation modulatory effects of those chemicals.…”

Exercise Interventions Combined With Dietary Supplements in Type 2 Diabetes Mellitus Patients—A Systematic Review of Relevant Health Outcomes

“…A potential benefit related to these outcomes has also been suggested for the intake of various dietary supplements (DS) in T2DM [for excellent reviews on their effects and mechanisms of action, see (6)(7)(8)]. These dietary supplements include, for example, vitamins such as vitamin C, folic acid or vitamin D (9)(10)(11), minerals such as chromium or zinc (12,13), dietary fiber (14), amino acids like L-arginine (15), complex fruit, vegetable-or plant extracts such as pomegranate, broccoli sprouts or tea extracts (16)(17)(18).…”

“…Given the benefits of regular physical exercise in T2DM patients (5) and the increasing interest in DS intake (6)(7)(8), the aim of this systematic review is to shed light on the effects of physical exercise programs combined with DS intake on health outcomes in T2DM patients, primarily on BMI, body fat mass, glycemic control, insulin sensitivity, the lipid profile, oxidative stress/antioxidative capacity and/or inflammatory markers/molecules. These variables may predict diabetes complications, adverse cardiovascular events and mortality (19)(20)(21)(22)(23)(24).…”