Depression with Comorbid Diabetes: What Evidence Exists for Treatments Using Traditional Chinese Medicine and Natural Products?

Yanting Lu,Ke Ma,Furong Wang,Shijun Wang,Xueqin Gao,Tao An,Hu Tian

doi:10.3389/fphar.2020.596362

Abstract

Comorbidity between diabetes mellitus (DM) and depression, two chronic and devastating diseases spreading worldwide, has been confirmed by a large body of epidemiological and clinical studies. Due to the bidirectional relationship between DM and depression, this comorbidity leads to poorer outcomes in both conditions. Given the adverse effects and limited effectiveness of the existing therapies for depression associated with diabetes, the development of novel therapeutic drugs with more potency and fewer side effects is still the most important goal. Hence, many researchers have made great efforts to investigate the potential usefulness of traditional Chinese medicine (TCM) and natural products, including natural extracts and purified compounds, in the treatment of comorbid depression in diabetes. Here, we reviewed the related literature on TCM and natural products that can remedy the comorbidity of diabetes and depression and presented them on the basis of their mechanism of action, focusing on shared risk factors, including insulin resistance, oxidative stress and inflammation, and nervous disturbances. In short, this review suggests that TCM and natural products could expand the therapeutic alternatives to ameliorate the association between DM and depressive disorders.

Highlights

Diabetes mellitus (DM) is a prevalent chronic metabolic disease characterized by high blood glucose levels, whereas depression is a mood disorder that is marked by a loss of interest, constant sadness, feelings of guilt or low self-worth, tiredness, disturbed sleep or appetite, and poor concentration (Koye et al, 2018; Lim et al, 2018; Lu et al, 2019)
Some hospital-based cross-sectional studies have further clarified the comorbidity between diabetes mellitus (DM) and depression (Khassawneh et al, 2020; Tusa et al, 2020)
We summarized traditional Chinese medicine (TCM) formulae and natural products with antidiabetic depression activities as well as several mechanisms related to their activities

Summary

Introduction

Diabetes mellitus (DM) is a prevalent chronic metabolic disease characterized by high blood glucose levels, whereas depression is a mood disorder that is marked by a loss of interest, constant sadness, feelings of guilt or low self-worth, tiredness, disturbed sleep or appetite, and poor concentration (Koye et al, 2018; Lim et al, 2018; Lu et al, 2019). In chronic unpredictable mild stress (CUMS) rats, decoction of Pinellia and Magnolia Bark has been found to regulate InsR/IRS1/AKT insulin signaling, to decrease the level of serum corticosterone (CORT), and to improve glucose tolerance in both peripheral liver and brain regions (Jia et al, 2017).

Results

Conclusion