Abstract
Diabetes mellitus is a group of metabolic disorders characterized by hyperglycaemia, and predicted by the World Health Organization as the expected 7th leading cause of death in 2030. Diabetes mellitus type 2 (DMT2) comprises the majority of diabetic individuals around the world (90%–95%). Pathophysiologically, this disorder results from a deregulation of glucose homeostasis, worsened by overweight and by a sedentary lifestyle, culminating in life-threatening cardiovascular events. The currently available anti-diabetic drugs are not devoid of undesirable side effects, sometimes responsible for poor therapeutic compliance. This represents a challenge for contemporary medicine, and stimulates research focused on the development of safer and more efficient anti-diabetic therapies. Amongst the most promising sources of new bioactive molecules, seaweeds represent valuable, but still underexploited, biofactories for drug discovery and product development. In this review, the role of phlorotannins, a class of polyphenols exclusively produced by brown seaweeds, in the management of DMT2 will be discussed, focusing on various pharmacologically relevant mechanisms and targets, including pancreatic, hepatic and intestinal enzymes, glucose transport and metabolism, glucose-induced toxicity and β-cell cytoprotection, and considering numerous in vitro and in vivo surveys.
Highlights
Diabetes mellitus (DM) is a heterogeneous disease with a considerably high variation in clinical presentation and progression
Considering the evidence provided by phlorotannins in reducing postprandial glucose, it seems evident that a great part of their activity is related to their capacity to inhibit glucose absorption through the inhibition of carbohydrate-digesting enzymes
These observations allow us to classify phlorotannins as multi-target antidiabetic agents once, if in the one hand they have the ability to reduce the absorption of carbohydrates from diet, reducing postprandial hyperglycaemia, on the other hand, they act on hepatic enzymes, reducing endogenous glucose production and contributing to the control of fasting hyperglycaemia
Summary
Diabetes mellitus (DM) is a heterogeneous disease with a considerably high variation in clinical presentation and progression. The monotherapy selection is based on clinical and biochemical assessment of the patient, the drug doses being titrated according to glycaemia response; dual and triple combination therapy is necessary when monotherapy is insufficient [6] Despite their clinical effectiveness, currently available anti-diabetic drugs are not devoid of undesirable side effects, such as risk of hypoglycaemia, flatulence, weight gain and enhancement of gastrointestinal problems, which can sometimes be responsible for therapeutic non-compliance. Despite the enormous variety of marine drugs with anti-diabetic potential explored in the last decades, in this review we will exclusively focus on and cover the anti-diabetic potential of phlorotannins This class of brown seaweed polyphenols will be explored for their capacity to manage DMT2 via various pharmacologically relevant targets, and compared with the reference drugs
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