Abstract
Type 2 diabetes mellitus (T2DM) is the most widespread form of diabetes, characterized by chronic hyperglycaemia, insulin resistance, and inefficient insulin secretion and action. Primary care in T2DM is pharmacological, using drugs of several groups that include insulin sensitisers (e.g., biguanides, thiazolidinediones), insulin secretagogues (e.g., sulphonylureas, meglinides), alpha-glucosidase inhibitors, and the newest incretin-based therapies and sodium–glucose co-transporter 2 inhibitors. However, their long-term application can cause many harmful side effects, emphasising the importance of the using natural therapeutic products. Natural health substances including non-flavonoid polyphenols (e.g., resveratrol, curcumin, tannins, and lignans), flavonoids (e.g., anthocyanins, epigallocatechin gallate, quercetin, naringin, rutin, and kaempferol), plant fruits, vegetables and other products (e.g., garlic, green tea, blackcurrant, rowanberry, bilberry, strawberry, cornelian cherry, olive oil, sesame oil, and carrot) may be a safer alternative to primary pharmacological therapy. They are recommended as food supplements to prevent and/or ameliorate T2DM-related complications. In the advanced stage of T2DM, the combination therapy of synthetic agents and natural compounds with synergistic interactions makes the treatment more efficient. In this review, both pharmaceutical drugs and selected natural products, as well as combination therapies, are characterized. Mechanisms of their action and possible negative side effects are also provided.
Highlights
Diabetic bone disease is reported as an important secondary complication of Type 2 diabetes mellitus (T2DM). This abnormality is manifested by altered bone mineral density (BMD), disorders of skeletal microarchitecture and bone metabolism, decreased bone strength, and the lower expression of genes associated with osteoblast function [12,13]
Because T2DM is a progressive disease characterized by escalating hyperglycaemia, its treatment requires the use of higher doses or combination therapy to maintain glycaemic control [48,81]
Resveratrol, curcumin, and quercetin are able to interact with the PPARγ receptor, as well as pioglitazone and other thiazolidinediones [127], suggesting their ability to increase the efficacy of these pharmaceuticals
Summary
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. T2DM is a chronic endocrine disorder characterized by hyperglycaemia, insulin resistance, ineffective insulin secretion by the pancreas [2,3], and increased hepatic glucose production [4]. These conditions manage lower glucose transport to the liver, muscle cells and fat cells [5]. Diabetic bone disease is reported as an important secondary complication of T2DM This abnormality is manifested by altered bone mineral density (BMD), disorders of skeletal microarchitecture and bone metabolism, decreased bone strength, and the lower expression of genes associated with osteoblast function [12,13]. Molecular mechanisms of T2DM are provided in order to better understand this issue
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