Effect of natural polyphenols on diabetes mellitus (type-2) with myocardial infarction: a double-blind placebo controlled trial
Keywords:Coronary artery disease, Diabetes mellitus type-2, Fasting plasma glucose, Myocardial infarction, Pomegranate extract of whole fruit, Reactive oxygen species
Background: Diabetes Mellitus Type-2(T2D); is a leading disease in world wide. T2D is a clinical syndrome characterized by hyperglycaemia. Hyperglycemias are caused by an absolute or relative deficiency of insulin and due to insulin resistance. Diabetic patients are highly prone to Reactive Oxygen Species (ROS) and leads to Cardio vascular complications. Several medicines have been recommended to cure T2D; and still discovery of newer drugs are in process. Now a day, the focus of researches in diabetes includes discovery of newer anti-diabetic agents as well as isolating the active compounds from herbal sources. One such herbal source is pomegranate. Pomegranate is polyphenols and antioxidants rich fruit; which has potency to cure T2D and ROS.
Methods: A Pomegranate Extract of Whole Fruit (PEWF) was prepared as tablet of 300mg to investigate its effects in patients with T2D. Total 40 participants of either gender with nested cases of T2D with Myocardial Infarction (MI) were included in study. All participants were assigned in two groups (20 each). One group was under “Add On” therapy of PEWF and matching placebos of same colour, shape and size were used as comparator agent for second group (300mg BD for 1 month).
Results: Levels of biochemical markers related to T2D were compared to analysed pre and post drug effects by Z test, chi square test and by coefficient of variations. Results highlighted that those participants who were under “add-on” therapy of PEWF showed highly prognostic significance. Thus, PEWF should be consumed in diet as food supplementation.
Conclusions: In conclusion, polyphenols and antioxidants rich fruit supplements should be taken in diet for healthy living.
Narayan KMV. The diabetes pandemic: looking for the silver lining. Clinical Diabetes. 2005;23(2):51-2.
Whiting DR, Guariguata L, Weil C, Shaw J. IDF diabetes atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diab Res Clin Prac. 2011 Dec 1;94(3):311-21.
Martin Gallan P, Carrascosa A, Gussinye M, Dominguez C. Biomarkers of diabetes associated oxidative stress and antioxidant status in young diabetic patient with or without subclinical complications. Free Rad Biol Med. 2003;34:1563-74.
Basu A, Penugonda K. Pomegranate juice: a heart-healthy fruit juice. Nutrition reviews. 2009 Jan 1;67(1):49-56.
WHO. Technical Report Series. Diet Nutrition and prevention of chronic diseases. Geneva: World Health Organisation, 2003. Available at: https://apps.who.int/iris/bitstream/handle/10665/42665/WHO_TRS_916.pdf;jsessionid=637AF47D4753DB100498E4C457B35493?sequence=1.
Collier E, Watkinson A, Cleland CF, Roth J. Partial purification and characterization of an insulin-like material from spinach and Lemna gibba. J Biol Chem.1987;262:6238-41.
Shanmugasundaram ER, Gopith K, Radha SK, Rajendran VM. Possible regeneration of the islets of Langerhans in streptozotocin diabetic rats given Gymnema sylvestere leaf extract. J Ethno Pharmacol. 1990;30:265-9.
Kartz SR, Newman RA, Lansky EP. Punica granatum: heuristic treatment for diabetes mellitus. J Medicinal Food. 2007;10(2):213-7.
Elfalleh W, Hannachi H, Tlili N, Yahia Y, Nasri N, Ferchichi A. Total phenolic contents and antioxidant activities of pomegranate peel, seed, leaf and flower. J Med Plants Res. 2012 Aug 31;6(32):4724-30.
Medjakovic S, Jungbauer A. Pomegranate: a fruit that ameliorates metabolic syndrome. Food Functions. 2013;4:19-39.
Banihani S, Swedan S, Alguraan Z. Pomegranate and type 2 diabetes. Nutrition Res. 2013 May 1;33(5):341-8.
Donath MY, Shoelson SE. Type 2 diabetes as an inflammatory disease. Natural Review Immunol. 2011;11:98-107.
Bierhaus A, Chevion S, Chevion M, Hofmann M,Quehenberger P, Illmer T, et al. Advanced glycation end product-induced activation of NF-kappa B is suppressed by alpha-lipoic acid in cultured endothelial cells. Diabetes. 1997;46:1481-90.
Aggarwal BB, Shishodia S. Suppression of the nuclear factor-kappa B activation pathway by spice-derived phytochemicals: reasoning for seasoning. Annals of the New York academy Sci. 2004;1030-4.
Francis GA, Annicotte JS, Auwerx J. PPAR agonists in the treatment of atherosclerosis. Current Opinion Pharmacol. 2003;3:186-91.
Huang TH, Peng G, Kota BP, Li GQ, Yamahara J, Roufogalis BD, et al. Anti-diabetic action of Punica granatum flower extract: activation of PPAR-gamma and identification of an active component. Toxicol App Pharmacol. 2005;207:160-9.
Ahmed I, Adeghate E, Sharma AK, Pallot DJ, Singh J. Effects of Momordica charantia fruit juice on islet morphology in the pancreas of the streptozotocin-diabetic rats. Diab Res Clin Prac. 1998;40:145-51.
Chakravarthy BK, Gupta S, Gambhir SS, Gode KD. Pancreatic beta-cell regeneration in rats by epicatechin. Lancet. 1981;2:759-60.
Shanmugasundaram ER, Gopinath KL, Radha Shanmugasundaram K, Rajendra VM. Possible regeneration of the islets of Langerhans in streptozotocin diabetic rats given Gymnema sylvestre leaf extracts. J Ethno Pharmacol. 1990;30:265-79.