diabetes prevention

Scientists study Canadian medicinal plants to explore natural cures for diabetes

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Image: Scientists study Canadian medicinal plants to explore natural cures for diabetes

Diabetes is a complex disease that leads to a wide variety of complications, one of the most common of which is diabetic nephropathy (DN) or kidney damage. A team of researchers from Canada sought to identify natural extracts, found in the eastern James Bay area, with potent anti-apoptotic properties that can prevent kidney cell death characteristic of DN. Their study was published in BMC Complementary and Alternative Medicine.

When it was first recorded in ancient Egypt, diabetes was considered mainly a rare disease. Today, it has exploded into a worldwide epidemic, with about 422 million sufferers on the planet in 2014. The prevalence of the disease is known to be spreading steadily, particularly in mid- to low-income countries.

One of the most dangerous complications of diabetes is DN, which is usually a precursor to kidney failure when left unaddressed. It is just one of the many results of the abnormal apoptotic process that occurs as a result of diabetes.

Apoptosis or cellular death is a natural process that’s essential to the continued balance of the human body. Because of it, old, dysfunctional cells are replaced by new ones. A proof of its importance is how its absence can cause the development of severe diseases, such as cancer.

But as with everything, too much apoptosis is hardly a good thing. In diabetes, the cells go through apoptosis at an abnormal rate. It usually starts with the death of the pancreatic beta cells, the cells responsible for producing the hormone insulin. The insufficiency in insulin results in a jump in blood glucose levels, which leads to more cellular death. Apart from kidney cells, those in the liver and the nervous system are also at a considerable risk.

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DN is one of the most common offshoots of diabetes among the people of the Cree nation in Canada, according to the study’s authors. This has prompted them to look into potential natural treatments that are readily available in the area. They compiled a list of 17 plant species:

  • Balsam fir – Abies balsamea (L.) Mill.
  • Speckled alder – Alnus incana subsp. rugosa (Du Roi) R.T. Clausen
  • Creeping snowberry – Gaultheria hispidula (L.) Muhl.
  • Ground juniper – Juniperus communis L.
  • Sheep Laurel – Kalmia angustifolia L.
  • Tamarack – Larix laricina Du Roi (K. Koch)
  • Common clubmoss – Lycopodium clavatum L.
  • White spruce – Picea glauca (Moench) Voss
  • Black spruce – Picea mariana (P. Mill.) BSP
  • Jack pine – Pinus banksiana Lamb.
  • Balsam poplar – Populus balsamifera L.
  • Labrador tea – Rhododendron groenlandicum (Oeder) Kron and Judd
  • Northern Labrador tea – Rhododendron tomentosum (Stokes) Harmaja subsp. subarcticum (Harmaja) G. Wallace
  • Tealeaf willow – Salix planifolia Pursh
  • Pitcher plant – Sarracenia purpurea L.
  • Showy mountain ash – Sorbus decora (Sarg.) C.K. Schneid.
  • Mountain cranberry – Vaccinium vitis-idaea L.

Extracts were obtained from specific parts of the different plants. The researchers then took cultures of Madin-Darby Canine Kidney (MDCK) cells, which are cells from a cocker spaniel that are used for biological studies involving the kidneys. They induced damage on the MDCK cells by the administration of a hypertonic medium. This particular step was performed in the presence or absence of each of the 17 plant extracts’ maximal nontoxic concentrations. After 18 hours of treatment, the cells were examined to determine the cytoprotective and anti-apoptotic effects of the extracts. The researchers then looked at the effect of the treatment on the activity of caspases-3, -8, and -9, all of which play an important role in apoptosis.

After the test, the researchers identified Gaultheria hispidula and Abies balsamea as having the most potent cytoprotective and anti-apoptotic effects. The said extracts prevented apoptosis by blocking the activity of caspase-9 in the mitochondrial apoptotic signaling pathway.

People who drink moderate amounts of coffee each day have a lower risk of death from disease

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Image: People who drink moderate amounts of coffee each day have a lower risk of death from disease

Many people drink coffee for an energy boost, but do you know that it can also prolong your life? A study published in the journal Circulation revealed that moderate amounts — or less than five cups — of coffee each day can lower your risk of death from many diseases, such as cardiovascular disease, Type 2 diabetes, and nervous system disorders. It can also lower death risk due to suicide.

The study’s researchers explained this effect could be attributed to coffee’s naturally occurring chemical compounds. These bioactive compounds reduce insulin resistance and systematic inflammation, which might be responsible for the association between coffee and mortality. (Related: Coffee drinkers have a lower mortality rate and lower risk of various cancers.)

The researchers reached this conclusion after analyzing the coffee consumption every four years of participants from three large studies: 74,890 women in the Nurses’ Health Study; 93,054 women in the Nurses’ Health Study 2; and 40,557 men in the Health Professionals Follow-up Study. They did this by using validated food questionnaires. During the follow-up period of up to 30 years, 19,524 women and 12,432 men died from different causes.

They found that people who often consumed coffee tend to smoke cigarettes and drink alcohol. To differentiate the effects of coffee from smoking, they carried out their analysis again among non-smokers. Through this, the protective benefits of coffee on deaths became even more apparent.

With these findings, the researchers suggested that regular intake of coffee could be included as part of a healthy, balanced diet. However, pregnant women and children should consider the potential high intake of caffeine from coffee or other drinks.

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Because the study was not designed to show a direct cause and effect relationship between coffee consumption and dying from illness, the researchers noted that the findings should be interpreted with caution. Still, this study contributes to the claim that moderate consumption of coffee offers health benefits.

The many benefits of coffee

Many studies have shown that drinking a cup of coffee provides health benefits. Here are some of them:

  • Coffee helps prevent diabetes: A study conducted by University of California, Los Angeles (UCLA) researchers showed that drinking coffee helps prevent Type 2 diabetes by increasing levels of the protein sex hormone-binding globulin (SHBG), which regulates hormones that influence the development of Type 2 diabetes. Researchers from Harvard School of Public Health (HSPH) also found that increased coffee intake may lower Type 2 diabetes risk.
  • Coffee protects against Parkinson’s disease: Studies have shown that consuming more coffee and caffeine may significantly lower the risk of Parkinson’s disease. It has also been reported that the caffeine content of coffee may help control movement in people with Parkinson’s disease.
  • Coffee keeps the liver healthy: Coffee has some protective effects on the liver. Studies have shown that regular intake of coffee can protect against liver diseases, such as primary sclerosing cholangitis (PSC) and cirrhosis of the liver, especially alcoholic cirrhosis. Drinking decaffeinated coffee also decreases liver enzyme levels. Research has also shown that coffee may help ward off cancer. A study by Italian researchers revealed that coffee intake cuts the risk of liver cancer by up to 40 percent. Moreover, some of the results indicate that drinking three cups of coffee a day may reduce liver cancer risk by more than 50 percent.
  • Coffee prevents heart disease: A study conducted by Beth Israel Deaconess Medical Center (BIDMC) and HSPC researchers showed that moderate coffee intake, or two European cups, each day prevents heart failure. Drinking four European cups a day can lower heart failure risk by 11 percent.

Metformin Rarely Prescribed to Prevent Diabetes

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Although metformin can help prevent diabetes onset in those at high risk, the medication is rarely prescribed for this purpose.

A new study published in the Annals of Internal Medicine evaluated the use of metformin in 17,352 patients aged 19 to 58 years with prediabetes, a health state indicated by abnormally high blood sugar levels. The analysis revealed only 3.7% of these patients were prescribed metformin between 2010 and 2012.

In an exclusive interview with Pharmacy Times, lead study author Tannaz Moin, MD, MBA, MSHS, described several possible culprits behind low metformin use among prediabetics, including poor provider and patient awareness of evidence surrounding diabetes prevention, a reluctance to “medicalize” prediabetes, and the drug’s lack of FDA approval for use in diabetes prevention.

“It is likely that many factors contribute simultaneously and this is going to be an important area of needed future study,” Dr. Moin told Pharmacy Times.

Given their medication knowledge and relationships with both prescribers and patients, pharmacists can play an important role in increasing the use of metformin in patients with prediabetes, Dr. Moin noted.

“Pharmacists have expertise in metformin prescription data, including existing safety considerations,” she said. “This expertise can help both providers and patients make more informed decisions surrounding metformin use.”

Dr. Moin recommended that pharmacists educate patients about evidence-based treatment options for diabetes prevention and provide them with an overview of the relative risks and benefits of preventative metformin therapy to help them make appropriate treatment decisions.

“Patients with prediabetes have varying levels of risk, and there are trade-offs with every treatment choice, so it is critical that we engage patients in a fully informed and shared decision-making process,” Dr. Moin toldPharmacy Times.

Her research team also found:

  • 4.8% of prediabetic women were prescribed metformin, compared with 2.8% of prediabetic men.
  • 6.6% of obese patients with prediabetes were prescribed metformin, compared with 3.5% of prediabetics who were not obese.
  • 4.2% of prediabetics with at least 2 other chronic diseases received prescriptions for metformin, compared with 2.8% of prediabetics with no other chronic diseases.

The authors acknowledged a number of potential study limitations, including a lack of access to data on participation in lifestyle programs, possible misclassification of prediabetes and metformin use, and their inability to independently verify patients’ eligibility to receive metformin.