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Review
. 2022 Oct;36(10):3709-3765.
doi: 10.1002/ptr.7564. Epub 2022 Aug 1.

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature

Giuseppe Derosa  1   2   3   4   5 , Angela D'Angelo  1   5 , Pamela Maffioli  2   3   4
Affiliations
Review

The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature

Giuseppe Derosa et al. Phytother Res. 2022 Oct.

Abstract

Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post-prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega-3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long-term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose-lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.

Keywords: IFG; IGT; dysglycemia; nutraceuticals; pre-diabetes.

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Conflict of interest statement

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties. No writing assistance was utilized in the production of this manuscript.

Figures

FIGURE 1
FIGURE 1
Proposed mechanisms of action of Berberis in glucose metabolism regulation. AMPK, adenosine monophosphate‐activated protein kinase; G6Pase, glucose‐6‐phosphatase; PEPCK, phosphoenolpyruvate carboxykinase
FIGURE 2
FIGURE 2
Proposed hypoglycemic mechanisms of Lagerstroemia speciose. P, adenosine monophosphate; PPAR‐α/γ, peroxisome proliferator‐activated receptor‐α/γ
FIGURE 3
FIGURE 3
Potential hypoglycemic mechanisms of action of Curcuma longa. AMP, adenosine monophosphate; G6Pase, glucose‐6‐phosphatase; NF‐κB: nuclear factor kappa chain transcription in B cells; PEPCK: phosphoenolpyruvate carboxykinase; PPAR‐γ, peroxisome proliferator‐activated receptor‐γ
FIGURE 4
FIGURE 4
Potential mechanisms for hypoglycemic action of Cyamopsis tetragonolobus. GIP, gastric inhibitory polypeptide; GLP‐1, glucagon‐like peptide‐1; PPG, post‐prandial glucose; SCFAs, short‐chain fatty acids
FIGURE 5
FIGURE 5
Possible mechanisms of action for Omega‐3 in glycemic control
FIGURE 6
FIGURE 6
Potential glucose‐lowering mechanisms of Plantago ovata
FIGURE 7
FIGURE 7
Potential mechanisms for hypoglycemic effect of Allium cepa. AMPK, adenosine monophospate‐activated protein kinase; GLUT4, glucose transporter 4; SIRT1, silent information regulator 1
FIGURE 8
FIGURE 8
Hypoglycemic effects of Stevia rebaudiana extracts. Akt, serine/threonine kinase; GLUT4, glucose transporter 4; PEPCK, phosphoenolpyruvate carboxykinase; PI3K, phosphatidylinositol 3‐kinase; TRPM5, transient receptor potential cation channel subfamily melastin 5
FIGURE 9
FIGURE 9
Potential mechanisms of Gymnema sylvestre hypoglycemic action
FIGURE 10
FIGURE 10
Potential mechanisms of Panax ginseng and Panax quinquefolius hypoglycemic effect. GLUT, glucose transporter; MDA, malondialdehyde; SOD, superoxide dismutase
FIGURE 11
FIGURE 11
Hypoglycemic effects of Citrus. AMPK, 5′ adenosine monophosphate‐activated protein kinase; CAT, catalase; G6Pase, glucose 6‐phosphatase; G6PD, glucose‐6‐phosphate dehydrogenase; GLUT, glucose transporter; GPx, glutathione peroxidase; GSH, reduced glutathione; IL, interleukin; LPO, lipid peroxidation; NF‐κB, nuclear factor‐kappaB; NO, nitric oxide; PEPCK, phosphoenolpyruvate carboxykinase; PI3K, phosphatidylinositol 3‐kinase; PPAR‐γ, peroxisome proliferator activated receptor gamma; SOD, superoxide dismutase
FIGURE 12
FIGURE 12
Hypoglycemic effects of Trigonella faenum graecum compounds. Phosphorylation at serine 473. 4‐OH‐Ile, 4‐Hydroxyisoleucine; Akt, serine/threonine kinase; G6Pase, glucose‐6‐phosphatase; GLUT, glucose transporter; PI3K, phosphatidylinositol 3‐kinase; PPAR‐γ, peroxisome proliferator‐activated receptor‐γ
FIGURE 13
FIGURE 13
Proposed mechanisms of glucose‐lowering action of Eugenia jambolana. PPAR‐γ, peroxisome proliferator‐activated receptor‐γ
FIGURE 14
FIGURE 14
Hypoglycemic effects of Ascophyllum nodosum and Fucus vesiculosus. ACC, acetyl‐CoA carboxylase; Akt, serine/threonine protein kinase; AMPK, adenosine monophosphate‐activated protein kinase; GgPase, glucose‐6‐phosphatase; GLUT, glucose transporter; PEPCK, phosphoenolpyruvate carboxykinase
FIGURE 15
FIGURE 15
Hypoglycemic effects of Ilex paraguariensis. AMPK, adenosine monophosphate‐activated protein kinase; GLUT4, glucose transporter 4
FIGURE 16
FIGURE 16
Hypoglycemic effects of Morus. G6Pase, glucose‐6‐phosphatase; GK, glucokinase; GLUT2, glucose transporter 2; PEPCK, phosphoenolpyruvate carboxykinase; PFK, phosphofructokinase; PI3K/AKT, phosphatidylinositol‐3‐kinase/protein kinase B; PK, pyruvate kinase; SGLT1, intestinal sodium glucose co‐transporter 1
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