CommunicationResveratrol supplementation improves glycemic control in type 2 diabetes mellitus☆
Introduction
Diabetes mellitus (DM) is a common, serious, chronic, and currently incurable metabolic disorder of worldwide significance. India is identified as the diabetes capital of the world, with the current estimated 50.8 million diabetic patients. The worldwide prevalence is 285 million in 2010, and by 2030, the number is expected to increase to 438 million. Most will have type 2 DM (T2DM) [1].
The disease is known to be associated with a high risk of microvascular and macrovascular complications and very often leads to premature death. Despite the availability of many antidiabetic agents and pharmacotherapies, targeting cardiovascular risk factors, the morbidity, mortality, and economic consequences of DM is still a great burden to patients, society, health care systems, and the economy. Many pharmacologic and nonpharmacologic interventions have been developed based on current understanding of the pathophysiology of T2DM. However, the existing treatments have limitations either because of their side effects, particularly weight gain and hypoglycemia, or contraindications that limit their use. Furthermore, none of the current therapies have a significant impact on the associated risk factors. There is a need, therefore, for new therapies that may improve not only hypoglycemic effect but also the associated problems.
Resveratrol (3,5,4'-trihydroxystilbene) is a naturally occurring phytoalexin. The richest source of this compound is Polygonum cuspidatum Reynoutria japonica, a plant that has been used in oriental folk medicine. Considerable amount of resveratrol is found, among others, in grapevine and peanuts. This compound is available today in various dosage forms and is recommended as a dietary supplement. Although numerous animal studies have been reported on its wide-ranging beneficial effects including DM [2], [3], [4], [5], [6], only limited clinical data are available concerning its potential effects [7]. We hypothesized that oral supplementation of resveratrol would improve the glycemic control and the associated risk factors in patients with T2DM. The present study was therefore undertaken to test the hypothesis. The objective of the present study was therefore to investigate the effect of oral supplementation of resveratrol on the glycemic control and the associated risk factors in patients with T2DM in a prospective, open-label, randomized, controlled model. Resveratrol was administered orally to patients with T2DM for a period of 3 months, and the hemoglobin A1c (HbA1c), body weight, body mass index (BMI), systolic and diastolic blood pressures, lipid profile, urea nitrogen, creatinine, and protein measurements were performed at both baseline and after 3-month follow-up.
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Study design and participants
The design was prospective, open-label, randomized, controlled study involving patients with T2DM. A total of 62 patients with T2DM were enrolled after explaining the objectives of the study at the screening visit and verifying the inclusion criteria. The main inclusion criteria were patients with known T2DM, aged between 30 and 70 years, either sex, with or without comorbidities, minimum of 6 months of ongoing oral hypoglycemic treatment (metformin and/or glibenclamide), and 3 years duration
Results
Baseline characteristics of the patients enrolled in the study are summarized in Table 1. Of 32 patients in the control group, 2 moved to other places because of job relocation, and 1 discontinued for personal reasons. Of the 30 intervention subjects, 2 were lost during the follow-up. Data obtained for 29 patients in the control group and 28 patients for intervention group were thus used for the analyses at the end of 3 months. In the control group, 3 patients were on metformin; 3, on
Discussion
To the best of our knowledge, this is the first clinical study to evaluate the effect of resveratrol as supplement in Indian patients with T2DM. The study clearly reveals that daily oral supplementation of resveratrol in patients with T2DM for a period of 3 months significantly reduces HbA1c, systolic blood pressure, total cholesterol, and total protein. The study also reveals that resveratrol decreases LDL-C, fasting blood glucose, and diastolic blood pressure. However, the latter observations
Acknowledgment
The authors thank the Indian Council of Medical Research for the award of a Senior Research Fellowship to Jayesh Kumar Bhatt and Biotivia Bioceuticals International, United States, for their generous gift of resveratrol capsules. All authors have been involved at each draft stage and have seen the final manuscript for submission.
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Duality of interest: The authors declare that there is no duality of interest associated with this manuscript.