23^rd International Conference on Herbal and Alternative Remedies for Diabetes and Endocrine Disorders November 2-4, 2017 Bangkok, Thailand

Biography:

Peter Mansfield was a Research Fellow in Community Medicine at UCH Medical School, London before beginning Good Healthkeeping, an experimental GP practice intended to encourage health. He is now an Aviation Medical Specialist with extensive experience in the prolongation of health in middle aged pilots. He has published several books, articles in learned journals and has presented at a number of International conferences.

Abstract:

This paper relates the history of diabetes type-2, from the beginning of settled farming and explains why there has from the 1950s until recently been so little emphasis on the prevention and reversal of the disease. Pilots and others in the early stages of diabetes have reversed their condition permanently by limiting carbohydrate intake. With little or no glucose in the blood, there is no diabetic challenge. Carbohydrate intake has in the past year been linked by nutritional academics with diabetes risk. Carbohydrate restriction is the underlying principle of several diets. The Atkins diet undermines blood lipids and insulin response to a glucose load. The Paleolithic diet goes further by additionally limiting dairy produce. Food combining and the Montignac diet, separate fat and starch which makes weight gain impossible. All are mutually compatible. The prize that motivates the pilot is unrestricted certification as fit to fly. The general public has no such motivation, so diabetes is unnecessarily prevalent. We need to develop charges, no-claims discounts or tax incentives to encourage the general public to follow the pilot's example.

Biography:

Anshu Rathi is working as a Team Lead at Aimil Pharmaceuticals (India) Ltd. She has wide range of publications in various national and international journals.

Abstract:

Introduction & Aim: According to International Diabetes Federation, 415 million adults were living with diabetes in 2015 and this number is expected to increase to around 642 million by 2040. The Scientists of India, Council for Scientific & Industrial Research (CSIR) has realized the alarming rise in incidence of diabetes and developed scientifically validated, anti-diabetic ayurvedic drug to prevent and treat Diabetes mellitus type-2. CSIR, has been ranked 12^th in the world among the government institutions. The drug has been developed jointly by scientist of National Botanical Research Institute (NBRI) and Central Institute for Medicinal & Aromatic Plants (CIMAP), the Lucknow, India-based research units of CSIR. Scientists of NBRI and CIMAP made an in-depth study on 500 anti-diabetic herbs from ancient literature of Indian System of Medicine Ayurveda (Caraka Samhita, Sushruta Samhita, Astanga Hridaya and Bhavprakash) and finally identified the six herbs (Berberis aristata, Tinospora cordifolia, Pterocarpus marsupium, Gymnema sylvestre, Rubia cordifoila and Trigonella foenumgraecum). Pre-clinical studies conducted by CSIR on BGR-34 produced encouraging results in diabetes induced experimental subjects (unpublished data CSIR). Encouraged by the preclinical outcome, CSIR moved to investigate the active components from BGR-34 and we moved to test its clinical efficacy, with an aim to ensure the scientific validity, efficacy and safety of BGR-34 on blood glucose regulation with type-2 diabetes mellitus based on clinical studies.

Methodology: A double blind placebo controlled clinical study of BGR-34 in patients with type-2 DM was approved by the independent human ethics committee of Aggarwal Dharmarth Hospital, New Delhi, India.

Findings: BGR-34, showed promising result with respect to glycemic parameters in patient with type-2 diabetes with significant reduction in fasting blood sugar by 34.3%, post prandial blood sugar by 35.5% and glycosylated hemoglobin by 20.31% as compared to placebo group showing reduction by 13.2%, 10.9 % and 10.87 % respectively. The trial has also been registered to CTRI, India.

Conclusion & Significance: BGR 34 has been investigated to contain a number of active biomolecule molecules including the compound berberine (Berberis aristata), a natural dipeptidyl peptidase IV (DPP-4) inhibitor, that act by increasing endogenous GLP-1 and GIP concentrations (Fig-1). Via this mechanism, insulin secretion is glucose-dependently stimulated and glucagon secretion inhibited.

Biography:

Layanne C C Arauj has her graduation degree in Biomedicine, Masters in Cell and Molecular Biology and she is currently a Doctoral student in Human Physiology at the Biomedical Sciences Institute of the University of São Paulo, working on various subjects like obesity, insulin resistance, hepatic steatosis and intestinal microbiota in the Laboratory of Intracellular Signaling.

Abstract:

The non-alcoholic fatty liver disease (NAFLD) is a clinical manifestation of metabolic syndrome. With the worldwide increase in obesity, there is also a burden of NAFLD that is estimated in the range of 20-30%. NAFLD includes the benign hepatic steatosis and the hepatic steatosis associated with inflammatory infiltrates, the non-alcoholic steatohepatitis (NASH). NASH may lead to liver cirrhosis and to hepatocellular carcinoma (HCC) and about 10 to 20% of people with NAFLD develop NASH. Therefore, we investigated the effect of the herbal extract Uncaria tomentosa (Ut) (50 mg/kg, crude extract, for 5 consecutive days) on the non-alcoholic fatty liver disease (NAFLD) of the diet-induced obese (DIO) and genetically obese (ob/ob) mice. Both obese mice exhibited lipid droplets in the liver. The DIO mice had macro vesicular steatosis, whereas the ob/ob mice exhibited micro vesicular steatosis. The Ut treatment induced 35% and 20% reduction in the number of lipid droplets in the both obese animals, respectively. The Ut treatment reduced the serine phosphorylation of IRS-1 by 25% and by 40%, in the liver of DIO and of ob/ob mice respectively. Furthermore, the Ut treatment improved the inflammatory balance in the liver of both obese animals. There were reduced pro-inflammatory index (mRNA IL-1b/IL-10) to approximately 20% and decreased the pro-macrophage activation (mRNA F4/80/Arginase-1) to 12% in the DIO mice and reduced to 39% the pro-macrophage activation in the ob/ob mice compared to respective vehicle controls. Results herein reported, prompted to the conclusion that Uncaria tomentosa not only improves insulin sensitivity but also transforms NASH to a benign hepatic steatosis in two distinct models of obese mice. These effects are associated with a reduction in inflammatory conditions and decreased liver steatosis (steatohepatitis). 

Biography:

Dr Nicolas Wiernsperger is a french physiologist and pharmacologist. He has been head of research department on cerebrovascular accidents at Novartis (Switzerland) until 1984. He established as a world recognized specialist of microcirculation. From 1985 to 2005 he was appointed Head of International Pharmacological Development and Senior Pharmacologist at Merck KgA in Lyon. He was also head of a private/public research unit on diabetes microvascular complications at Lyon University. He is an international recognized expert of cardiometabolic diseases and aging. He has published close to 150 papers as well as 2 books. He has been teaching as Invited Professor at several universities. Since 2005 he deals with the development of new drugs as well as,more recently, nutraceuticals.

Abstract:

The diabetes field has experienced several major and spectacular changes in our knowledge over the last decade. In particular epidemiological studies as well as results from large-scale clinical trials have challenged the classical views. Regrettably these novelties have rather been at odd with previous traditional views. Thus these studies not only revealed that treating established has at best limited effects on cardiovascular outcome but they also showed that lifestyle measures in prediabetic patients have essentially failed as compared with logical expectations.

Thus one comes to the conclusion that the earlier the better. This implies to detect the subjects at risk and to find alternative therapeutic and preventive measures. The identification of early pathological changes leading to insulin resistance long before diabetes installs shows that low grade chronic inflammation and oxidative stress are among the most important causes. Today we know the origins of these deleterious mechanisms. Therefore intervening as early as possible with potent herbal compounds targeting these mechanisms appears to be a promising method. There is nowadays clearly increasing awareness of this problem but it will require another decade at best to see if phytochemicals fulfill the large expectations we put on them.

Biography:

Alev Onder is a Professor in Ankara University, Department of Pharmacognosy. She has spent a year in long-term research programs regarding the anticancer activity of coumarins and liverworts in Meiji Pharmaceutical College and Tokushima Bunri University in Japan and in Seoul National University, South Korea. She is a Lecturer in aromatherapy and natural products. Currently, she has been investigating numerous modern medicinal plants for treatment of erectile dysfunction and in natural products (in particular on coumarins), essential oils, liverworts, and their biological activity in Pharmacognosy and Phytochemistry. 

Abstract:

Diabetes mellitus (DM) is the second greatest risk factor for erectile dysfunction (ED), following age. Phosphodiesterase type-5 inhibitors (PDE5i), which are recommended as first-line treatment for ED, are not effective in the management of diabetes-associated ED. Currently, many medicinal plants and secondary metabolites are natural remedies for ED. A tropical plant, Syzygium aromaticum (L.) Merrill & Perry or clove (Eugenia caryophyll, Caryophyllus aromaticus L.) from the Myrtaceae family has aphrodisiac activity. In Europe, Asia and the oriental world, it has been used for culinary and medicinal purposes for centuries, either alone or in combination with other spices (Figure-1). It is reported to be used as sexual invigorators in India, besides many useful effects in the world. The plant simply contains polyphenols and eugenol (E) which are the major components of the clove oil from aromatic flower buds (70-85%). The clove shows antioxidant, antimicrobial, antinociceptive, antiviral and cytotoxic properties. In the previous study, treatment with 50% ethanolic extract of clove significantly increased the sexual activity of normal male rats. The aim of this study is to investigate the possible beneficial effects of clove oil (CO) and its component E on rat corpus cavernosum (CC) from Streptozotocin-induced diabetic rats. 20 adult male Sprague-Dawley rats were equally divided into control and diabetic groups. Diabetes was induced by a single intraperitoneal injection of streptozotocin (45 mg/kg). Isolated rat CC strips were placed in organ baths containing Krebs solution. The relaxant responses to CO (25-100 μL) and E (25-100 μL) were investigated in rat CC after precontraction with phenylephrine (10^-5 M). CO and E induced remarkable relaxations of CC strips in a concentration-dependent manner in control and diabetic rats (100%). As a conclusion, CO and E caused pronounced penile erection in diabetic rats. We suggest that both may be a successful treatment strategy in diabetic patients with ED who do not respond to PDE-5i. 

Biography:

Abbas Tavakolian Arjmand is an Associate Professor at Shahrood Azad University of Medical Sciences. His research interest in Metabolic Syndrome, Obesity, Insulin/IGF-1 Receptor Cross-Talk, PCOS. He has wide range of publications in various National and International journals.

Abstract:

Background & Aim: A growing body of evidence considers the cryptogenic cirrhosis as the immediate offspring of type-2 diabetes mellitus (T2DM). We would suggest that, the majority of reported cases of cryptogenic cirrhosis are actually the result of surreptitious or under-estimated alcohol consumption in conjunction with underlying metabolic syndrome, not the direct consequence or a chronic complication of T2DM. For further clarification of the issue, a population of T2DM patients living in a closed religious society where alcohol production, distribution and consumption were legally and ritually banned, were investigated for manifestations of cirrhosis and end-stage liver disease.

Materials & Methods: In a prospective observational study, 132 T2DM patients (43 males and 89 females) were consecutively enrolled. They were interviewed and carefully investigated for any stigmata of chronic liver failure and cirrhosis. Then, an all-inclusive panel of liver function tests completed with viral markers, immunological markers and abdominal sonography were carried out. Liver biopsy was considered once academically and ethically indicated.

Results: The average age of patients was 58±10.9 years (range, 31-83 years), and the duration of diabetes was 7.4±6 years (range, 1-25 years). BMI came out as 34.9±5.3 with mean waist circumference of 71.2±11.5 cm. To our surprise, from 132 T2DM patients only eight (6%) displayed mild to moderate abnormal liver enzyme levels, of which only 2 cases had liver enzyme levels of more than twice normal. With regard to our main concern, only two subjects (1.5%) manifested overt liver failure and cirrhosis, of which, one person tested positive for HCVAb and the other disclosed eventually to have been drinking alcohol heavily at younger ages for years while living abroad.

Conclusion: We would suggest, if alcoholic liver disease as a major confounding variable- becomes efficiently eliminated from the relevant studies, T2DM, per se, would seldom persist as a direct causative risk for cryptogenic cirrhosis. We believe that T2DM, NAFLD and cryptogenic cirrhosis are all the results of a superior pathogenic process, the metabolic syndrome or better to say insulin resistance syndrome. As a matter of fact, the terrifying prevalence of cryptogenic cirrhosis is the outcome of awful impact of hyperinsulinemia of metabolic syndrome on surreptitious and over-looked alcoholic liver disease.

Biography:

Anniline C Teng is currently a Medical student, currently doing Internship in Manila Central University Hospital in EDSA, Caloocan City, Philippines.

Abstract:

Diabetes is presently a serious worldwide epidemic, affecting about 382 million people globally in 2013 and directly causing the deaths of more than 1.5 million people in 2012. This study evaluates the glucose-lowering potential of Abelmoschus esculentus L. (Okra) in diabetic rat models as compared to the commercial drug acarbose. In this randomized, double-blind experimental study, 48 streptozotocin-induced diabetic male Sprague Dawley rats aged 75-90 days old and weighing 150-250 grams were divided into three groups: (1) Experimental group which was given 300 mg/kg aqueous extract of Abelmoschus esculentus L. (okra), (2) Positive control group which was given 15 mg/kg acarbose and (3) Negative control group which was given 5 mL/kg distilled water. All groups were concurrently treated once daily orally for 7 days. Blood glucose levels were measured one hour after treatment administration using EasyTouch® glucometer. The safety of okra extract and acarbose were also determined based on subject mortality. After 7 days, the experimental group and the positive control group demonstrated glucose-lowering effects. However, the decrease in blood glucose from the baseline up to day 7 was statistically significant only in the experimental group (p-value<0.05). Comparison of the glucose values among all the groups on day 7 demonstrated a significant difference in the experimental group (p value=0.02). This showed that okra extract exhibited a time-dependent effect. Also, statistical analysis of mortality which yielded a non-significant result established the safety of acarbose and okra extract as used in the study. 

These findings prove the potential beneficial effect of Abelmoschus esculentus L. (okra) in the treatment of diabetes through its glucose-lowering effect which has been exhibited to be comparable to that of the commercially prepared drug acarbose. Thus, it may be developed and used to treat type-2 diabetes in humans.

Biography:

Angelique Arcambal is persuing her PhD from University of Reunion, France, under the supervision of Professor Marie-Paule Gonthier. Marie-Paule Gonthier is a Professor of Nutrition at the Medicine School of the University of Reunion in France. She has received her PhD degree in Nutrition from the Medicine School of Clermont-Ferrand, France. Her work consisted on evaluating the bioavailability of dietary antioxidant polyphenols in humans and demonstrated the role of the gut microflora on polyphenol metabolic fate. During her Post-Doctoral position at the National Research Center of Naples, Italy, she contributed to the understanding of the effects of endocannabinoids derived from dietary lipids on adipose tissue biology and reported the overproduction of endocannabinoids from human adipocytes and pancreatic beta cells during obesity and type-2 diabetes.

Abstract:

Type-2 diabetes promotes vascular complications, leading to neurological disorders such as stroke. Indeed, hyperglycemia alters the blood-brain barrier integrity by deregulating the cerebral endothelial cell function. Oxidative stress may play a causal role. Thus, the biological effect of plant polyphenols known to exert antioxidant capacities is of high interest. We evaluated the effect of polyphenols from the medicinal plant Antirhea borbonica referred in the French Pharmacopeia for antidiabetic properties, on the production of redox and vasoactive markers from cerebral endothelial cells exposed to hyperglycemia. Polyphenols extracted from Antirhea borbonica were identified by UPLC-MS method. Then, their action on murine bEnd.3 cerebral endothelial cells exposed to hyperglycemia was determined by measuring the intracellular levels of free radicals (DCFH-DA assay), SOD activities (enzymatic assay) and the production of redox and vasoactive molecules (RT-qPCR, DAF-FM assay). We found that Antirhea borbonica exhibited a high content (4%, w/w) of polyphenols including caffeic acid, chlorogenic acid, kaempferol and quercetin. Plant polyphenols decreased hyperglycemia-induced production of free radicals and NADPH oxidase 4 gene expression. Moreover, plant polyphenols counteracted the deregulation of Cu/ZnSOD activity and Nrf2 redox transcriptional factor gene expression mediated by hyperglycemia. Preconditioning of cells with specific inhibitors targeting the signaling molecules JNK, ERK, PI3K and NFκB modulated hyperglycemia-induced oxidative stress and showed their possible involvement in polyphenol action. Polyphenols also abrogated hyperglycemia-mediated down-regulation of the intracellular levels of NO vasodilatator. Interestingly, caffeic and chlorogenic acids detected among the major polyphenols of Antirhea borbonica exerted similar protective effects. Collectively, these findings demonstrated that polyphenols extracted from Antirhea borbonica protected cerebral endothelial cells against hyperglycemia-mediated oxidative stress. Further studies are in progress to evaluate the in vivo benefits of plant polyphenols on a mouse model exposed to hyperglycemia and middle cerebral artery occlusion to mimic a cerebral ischemia during type-2 diabetes.

Biography:

Jayshree Dutta is a Research Scholar in Department of Biotechnology, Gauhati University, Guwahati, Assam. She has been working in the field of anti-diabetic medicinal plants from last five years. She has completed her Masters in Biotechnology and is very much interested in the emerging field of Pharmaceutical Biotechnology leading to drug discovery. She had earlier documented few plants having hypoglycemic potentiality from North East region of India via tremendous field survey.

Abstract:

Diabetes mellitus is one of the fast-growing health problems in both developing and developed nations. A wide and diverse range of plants reported in Indian literature are used in the treatment of diabetes mellitus. Being a store house of medicinal plants, the north-eastern part of India serves as reservoir of traditional based knowledge for treatment of several diseases including diabetes. In the present study, the leave part of Terminalia chebula Retz was accessed for its hypoglycemic potentiality both in vitro and in vivo. Initial in vitro test was performed using enzyme α-amylase and α-glucosidase. In vitro analysis was followed by in vivo hypoglycemic evaluation in alloxan induced diabetic rat model. Terminalia chebula leaves has demonstrated a moderate level of α-amylase inhibition (70.46%) with IC₅₀-06.09±0.342 mg/mL and very high yeast α-glucosidase inhibition (100%) with IC₅₀-0.956±0.342 mg/mL compared to standard reference drug acarbose. Oral carbohydrate tolerance test of methanol extract T. chebula leaves revealed that oral administration of the extract at the dose of (300 mg/kg b.w) to maltose loaded diabetic rats significantly (P<0.05) suppressed the rise of post-prandial blood glucose level compared to the standard drug acarbose. The phytochemical analysis reveals that the crude methanol extract of T. chebula leaves is very rich in phytoconstituents like phenol, tannin flavonoids, terpenoid and glycosides compared to petroleum ether extract and acetone extract. The total phenol and flavonoid content of T. chebula leaves was found to be 123.64±1.09 mg/g and 184.23±2.34 mg/g respectively. The study concludes that the leaf part of T. chebula is a potential inhibitor of enzyme α-glucosidase that can be employed for further for development of suitable anti-diabetic formulation working against postprandial hyperglycemia.