Nutraceuticals used in Management of Type 2 Diabetes

Abstract

The rising incidence and severe effects, type 2 diabetes mellitus (T2DM) is a worldwide health emergency. Because of their capacity to enhance insulin sensitivity, lower inflammation, and avert problems associated with diabetes, nutraceuticals have become a viable adjunct or alternative therapy option, even if traditional medicines continue to be the mainstay of management. The function of many nutraceuticals in the management of type 2 diabetes is examined in this review, including fatty acids, vitamins, minerals, and herbal extracts. These substances\' potential to enhance glycaemic management and general metabolic health is highlighted, along with the processes by which they work. Issues like safety and standardisation are discussed, and the future direction of this field\'s research is highlighted, especially with regard to clinical validation and the best ways to dose medications.

Introduction

Type 2 Diabetes Mellitus (T2DM) is a widespread metabolic disorder characterized by insulin resistance, impaired insulin secretion, and persistent hyperglycemia. It is driven by lifestyle factors such as obesity, poor diet, sedentary behavior, and genetic predisposition. Long-term complications include cardiovascular disease, neuropathy, nephropathy, and retinopathy.

Traditional treatments involve lifestyle modifications and medications like insulin, metformin, and sulfonylureas. While effective, these treatments often have side effects and long-term limitations, prompting interest in complementary therapies such as nutraceuticals—bioactive compounds derived from foods with health benefits beyond basic nutrition.

Nutraceuticals in T2DM Management

Nutraceuticals may serve as adjuncts or alternatives to conventional therapies, with benefits like lower cost, fewer side effects, and potential for long-term use. They act through several mechanisms:

• Enhancing insulin sensitivity

• Modulating glucose metabolism

• Reducing inflammation and oxidative stress

• Supporting pancreatic beta-cell function

• Altering gut microbiota

Key Categories and Examples:

1. Plant-Based Compounds:

   • Cinnamon: Improves insulin sensitivity; lowers blood glucose.

   • Bitter Melon: Mimics insulin activity.

   • Fenugreek: High in soluble fiber; slows carbohydrate absorption.

   • Turmeric (Curcumin): Anti-inflammatory; enhances insulin sensitivity.

   • Berberine: Activates AMPK (like metformin); lowers glucose and lipids.

2. Vitamins and Minerals:

   • Vitamin D: Improves insulin function; deficiency linked to T2DM.

   • Chromium: Enhances insulin signaling and glucose transport.

   • Magnesium: Involved in glucose metabolism; deficiency linked to insulin resistance.

3. Fatty Acids:

   • Omega-3 (EPA & DHA): Anti-inflammatory; improves lipid profile and insulin sensitivity.

   • Alpha-Lipoic Acid (ALA): Antioxidant; helps with neuropathy and glucose regulation.

4. Peptides & Amino Acids:

   • L-arginine: Precursor to nitric oxide; improves blood flow and insulin response.

Mechanisms of Action:

• Anti-inflammatory: Reduces insulin resistance and systemic inflammation (e.g., curcumin, omega-3).

• Antioxidant effects: Combat oxidative stress; protect beta-cells (e.g., ALA, vitamins C & E).

• Insulin Sensitization: Improves insulin receptor activity and glucose uptake (e.g., chromium, omega-3).

• Beta-cell support: Stimulates or mimics insulin secretion (e.g., Gymnema, bitter melon).

• Enzyme inhibition: Slows carbohydrate digestion and glucose absorption (e.g., cinnamon, green tea).

• Gut microbiota modulation: Enhances metabolism and reduces inflammation (e.g., inulin, probiotics).

Challenges and Future Directions:

• Standardization issues: Variability in product quality, concentration, and bioavailability.

• Limited clinical data: Few large-scale, long-term trials confirming safety and efficacy.

• Drug interactions: Unknown interactions with conventional medications.

• Regulatory gaps: Less oversight compared to pharmaceuticals.

Future research should focus on:

• Standardizing nutraceutical products

• Identifying effective dosages and combinations

• Conducting rigorous human clinical trials

• Exploring synergy with conventional therapies

Conclusion

The potential advantages including increased insulin sensitivity, better glycaemic control, and fewer complications, nutraceuticals provide a novel and promising way to controlling Type 2 diabetes. The value of several herbs, vitamins, minerals, and bioactive substances in integrated care is highlighted by the increasing amount of research demonstrating their effectiveness in managing diabetes. However, before these medications can be broadly included into traditional therapy regimens, issues including safety, standardisation, and the requirement for extensive clinical studies must be resolved. Future studies should concentrate on maximizing the use of nutraceuticals, comprehending how they work, and developing precise protocols for integrating them into clinical practice

References

[1] Ali F, Bakar MFA, Saari N. Nutraceuticals and functional foods for the management of Type 2 Diabetes Mellitus. Evid Based Complement Alternat Med. 2014;2014:1–14. [2] Bailey CJ, Day C. Metformin: Its botanical background. Practical Diabetes Int. 2004;21(3):115–7. [3] Ríos JL, Francini F, Schinella GR. Natural products for the treatment of Type 2 diabetes mellitus. Planta Med. 2015;81(12–13):975–94. [4] Vinayagam R, Xu B. Antidiabetic properties of dietary flavonoids: A cellular mechanism review. Nutrition and Metabolic (Lond). 2015;12(1):60. [5] Patel DK, Kumar R, Laloo D, Hemalatha S. Natural medicines from plant source used for therapy of diabetes mellitus: An overview of its pharmacological aspects. Asian Pac J Trop Dis. 2012;2(3):239–50. [6] Anandharajan R, Jaiganesh S, Shankernarayan NP. Antihyperglycemic activity of Gymnema sylvestre leaf extract. Pharm Biol. 2006;44(8):574–9. [7] Ghorbani A. Best herbs for managing diabetes: A review of clinical studies. Braz J Pharm Sci. 2013;49(3):413–22. [8] Kumar S, Kumar V. A review on the role of nutraceuticals in the management of diabetes mellitus. World J Pharmacy and Pharmaceutical Sci. 2013;2(6):4686–701. [9] Bhattacharya S. Phytotherapeutic approach to diabetes mellitus: An overview. Int J Pharm Sci Res. 2011;2(9):2331–9. [10] Vuksan V, Sievenpiper JL. Herbal remedies in the management of diabetes: Lessons learned from the study of ginseng. Nutrition, Metabolism Cardiovasc Dis. 2005;15(3):149–60. [11] Modak M, et al. Indian herbs and herbal drugs used for the treatment of diabetes. J Clin Biochemistry and Nutrition. 2007;40(3):163–73. [12] Goyal RK, Kadam DS. Effect of long-term feeding of fenugreek seeds on glycemic control and metabolic parameters in Type 2 diabetic patients. Nutr Res. 2005;25(11):1111–5. [13] Marles RJ, Farnsworth NR. Antidiabetic plants and their active constituents. Phytomedicine. 1995;2(2):137–89. [14] Yeh GY, Eisenberg DM, Kaptchuk TJ, Phillips RS. Systematic review of herbs and dietary supplements for glycemic control in diabetes. Diabetes Care. 2003;26(4):1277–94. [15] Kooti W, et al. Herbal, plant-derived and dietary supplements for the control of diabetes mellitus: A review. Evid Based Complement Alternat Med. 2016;2016:1–13. [16] Gray AM, Flatt PR. Insulin-releasing and insulin-like activity of the traditional antidiabetic plant Coriandrum sativum (coriander). Br J Nutr. 1999;81(3):203–9. [17] Sheela CG, Augusti KT. Antidiabetic effects of S-allyl cysteine sulphoxide isolated from garlic Allium sativum Linn. Indian J Exp Biol. 1992;30(6):523–6. [18] Eidi A, Eidi M. Antidiabetic effects of sage (Salvia officinalis L.) leaves in normal and streptozotocin-induced diabetic rats. Diabetes Metabolic Syndr. 2009;3(1):40–4. [19] Bhattacharya SK, Satyan KS. Experimental methods for evaluation of psychotropic agents in rodents: II. Antidepressants. Indian J Exp Biol. 1997;35(6):552–8. [20] Asgary, S, et al. Effect of Nigella sativa on Type 2 diabetes mellitus: A systematic review. J Endocrinol Invest. 2014;37(7):635–42. [21] Xu J, et al. Green tea polyphenols: Nutraceuticals with potential for the prevention and treatment of diabetes. Front Bioscience. 2013;18(5):1600–12. [22] Basch E, et al. Bitter melon (Momordicacharantia): A review of efficacy and safety. Am J Health System Pharm. 2003;60(4):356–9. [23] Grover JK, Yadav S, Vats V. Medicinal plants of India with antidiabetic potential. J Ethnopharmacology . 2002;81(1):81–100. [24] Tiwari AK, Rao JM. Diabetes mellitus and multiple therapeutic approaches of phytochemicals: Present status and future prospects. Curr Sci. 2002;83(1):30–8. [25] Prabhakar PK, Doble M. Interaction of phytochemicals with hypoglycemic drugs on glucose uptake in L6 myotubes. Phytomedicine. 2008;15(12):1050–7. [26] Achike FI, Kwan CY. Phytochemicals in the management of Type 2 diabetes: Panacea or illusion? Clin Exp Pharmacology Physiol. 2003;30(11):842–6. [27] Singh R, et al. Herbal treatment for Type 2 diabetes in India: A review. J Diabetes MetabDisord. 2009;8(1):1–5. [28] Jamshidi N, Cohen MM. The clinical efficacy and safety of herbal medicine in the treatment of Type 2 diabetes: A systematic review. Integrative Med Res. 2017;6(2):112–24. [29] Bhutani J, Vishnoi R, Abdin MZ. Role of nutraceuticals in Type 2 diabetes mellitus: A review. J Diabetes Metabolic Disorder. 2020;19(2):961–71. [30] Rasouli H, Hosseini-Ghazvini SM, Adibi H, Khodarahmi R. Nutraceuticals for the treatment of diabetes and its complications: A review of clinical evidence. Phytotherapy Res. 2017;31(10):1459–71. [31] Kalra EK. Nutraceutical—definition and introduction. AAPS PharmSci. 2003;5(3):E25. [32] Brower V. Nutraceuticals: poised for a healthy slice of the healthcare market? Nat Biotechnol. 1998;16(8):728–731. [33] Gupta S, Chauhan D, Mehla K, Sood P, Nair A. An overview of nutraceuticals: current scenario. J Basic Clin Pharm. 2010;1(2):55–62. [34] Wildman REC, editor. Handbook of Nutraceuticals and Functional Foods. 2nd ed. Boca Raton: CRC Press; 2006. [35] Bagchi D. Nutraceutical and functional food regulations in the United States and around the world. 2nd ed. Amsterdam: Academic Press; 2014. [36] Kaur IP, Kapoor S, Mahadik KR, Khar RK. Studies on formulation and in vitro evaluation of ophthalmic preparations of acetazolamide. Indian J Pharm Sci. 2000;62(5):383–387. [37] Santini A, Cammarata SM, Capone G, Ianaro A, Tenore GC, Pani L, et al. Nutraceuticals: opening the debate for a regulatory framework. Br J ClinPharmacol. 2018;84(4):659–672. [38] Martirosyan DM, Singh J. A new definition of functional food by FFC: what makes a new definition unique? Funct Foods Health Dis. 2015;5(6):209–223. [39] Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med. 2014;5(12):1487–1499. [40] Shahidi F. Nutraceuticals and functional foods: whole versus processed foods. Trends Food Sci Technol. 2009;20(9):376–387.

Copyright

Copyright © 2025 Miss. Srushti Santosh Ingale, Miss. Rekha C. Kolape, Mr. Nitin Gawai, Miss. Harshada Gaikwad. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.