Herbal Medicines and Nutraceuticals for Diabetic Vascular Complications: Mechanisms of Action and Bioactive Phytochemicals

Abstract

Diabetes is one of the most prevalent chronic diseases throughout the world. The majority of its complications arise from vascular-related inflammation apparently initiated by endothelial cell injury. One cause of this injury has been attributed to hyperglycaemia-induced reactive oxygen species. Consequently, current drug developmental strategy has targeted specific inflammatory and oxidative stress pathways for the prevention of diabetic vascular complications. Herbal medicines have traditionally been used for the treatment of diabetes and its complications. In fact, current pre-clinical and clinical studies have demonstrated that many of them exhibit potent anti-inflammatory and anti-oxidative properties, and have also identified the active phytochemicals responsible for their activities. The present review summarises the latest research on the molecular mechanisms of diabetic vascular complications, and evaluates the level of scientific evidence for common herbal medicines and their bioactive phytochemicals. These agents have been shown to be effective through various mechanisms, particularly the NF-κB signalling pathways. Overall, herbal medicines and nutraceuticals, as well as their bioactive components, which exhibit anti-inflammatory and anti-oxidative properties, provide a promising approach for the prevention and treatment of diabetic complications.

Zingiber officinale(Ginger): A Future Outlook on Its Potential in Prevention and Treatment of Diabetes and Prediabetic States

“…[10]-Shogaol (n = 8) identified in reviews of the literature on natural products [12,13]. Metformin, currently the drug of choice in the management of hyperglycemia, in fact has its origins in a natural product [14].…”

“…A considerable amount of information exists about the underlying mechanism of their actions, and we as well as others have reviewed this literature [12,13]. It is now necessary to follow up the traditional knowledge and the large amount of pharmacological investigation in well-designed clinical programs on these herbs and development of appropriate strategies for prevention and treatment of diabetes and prediabetic and cardiovascular conditions.…”

“…Most studies fail to provide a chemical composition profile of the sample used in the clinical trial, and ginger preparations may vary enormously in their composition, depending on the extract preparation method, the origin of the ginger, and storage duration and conditions [105,106]. Variations are found in the content of gingerols and their relative distributions between [6]-, [8]-, [10]-, and [12]-(S)-gingerols, the content of shogaols (which varies greatly between fresh and stored samples), and other components such as sesquiterpenes and volatile oils, which may all be significant to various extents for the final biological effect. Differences in the study protocols may also contribute to different clinical results, especially the length of treatment, inclusion, and exclusion criteria and power of the studies.…”

Withania coagulansFruit Extract Reduces Oxidative Stress and Inflammation in Kidneys of Streptozotocin-Induced Diabetic Rats

“…People with diabetes suffer from the detrimental vascular which accounts for high morbidity and mortality [1]. Among several vascular complications, chronic renal failure and end stage renal diseases appear first and often associated with metabolic and hemodynamic alternations.…”

A Clinical Study to Evaluate the Efficacy of Guduchyadi Kwath in the Management of Diabetic Polyneuropathy

“…22 . In-vitro aldose reductase inhibition was observed with TC with an IC50 of 103 mcg/ml 22 and also showed effective and high levels of evidence for its action against Diabetic neuropathy, gastropathy and Diabetic foot ulcer 23 . Guduchi also has been extrapolated to have strong neuroprotective activity against oxygen and glucose deprivation 24 .…”