Hyperglycemia significantly increases the risk of cardiovascular disease(CVD) in diabetics.However,it has been shown by a series of large scale international studies that intensive lowering of blood glucose levels not only has very limited benefits against cardiovascular problems in patients,but may even be harmful to patients at a high risk for CVD and/or poor long-term control of blood glucose levels.Therefore,Western medicine is faced with a paradox.One way to solve this may be administration of Chinese herbal medicines that not only regulate blood glucose,blood fat levels and blood pressure,but also act on multiple targets.These medicines can eliminate cytotoxicity of high glucose through anti-inflammatory and anti-oxidant methods,regulation of cytokines and multiple signaling molecules,and maintenance of cell vitality and the cell cycle,etc.This allows hyperglycemic conditions to exist in a healthy manner,which is called "harmless hyperglycemia" Furthermore,these cardiovascular benefits go beyond lowering blood glucose levels.The mechanisms of action not only avoid cardiovascular injury caused by intensive lowering of blood glucose levels,but also decrease the cardiovascular dangers posed by hyperglycemia.
OBJECTIVE:To assess the effect of activating blood drugs(AB drugs) on blood glucose and lipid levels of diabetic patients.METHODS:Systematic searches were conducted on 6 electronic databases and the search time was cut off in May 2016.Randomized controlled trials(RCTs) were included if they investigated diabetic patients who received Western medicine combined with AB drugs in the experimental groups and solitary usage of corresponding Western medicine or placebo in the control groups.6 outcome measures,which were considered as inclusion,were changes in fasting blood glucose(FBG),glycosylated haemoglobin A1 c(HbA1c),total triglyceride(TG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-c) and high density lipoprotein cholesterol(HDL-c).The literature quality was assessed by Cochrane score for risk of bias in Review Manager 5.2,as well as meta-analysis was performed.RESULTS:7 RCTs comprising 999 patients met all inclusion criteria.Meta-analysis showed beneficial effects of Westernmedicine combined with AB drugs on modulating FBG,TC,LDL-c and HDL-c compared with Western medicine or placebo(P<0.05),while no difference was observed in HbA1c,and TG(P>0.05).To some extent,the therapeutic effects of Western medicine combined with AB drugs were better than that of solitary usage of Western medicine or placebo.Besides,AB drugs were safe and reliable with little toxic and side-effects.CONCLUSIONS:The meta-analysis suggests beneficial effects of Western medicine combined with AB drugs on modulating blood glucose and lipids in diabetic patients.
Objective:To investigate the effect of Dan-gua Fang(丹瓜方) on adenosine 5'-monophosphate(AMP) activated protein kinase(AMPK) α expression in liver and subsequent improvement of glucose and lipid metabolism.Methods:Forty 13-week-old diabetic Goto-Kakizaki(GK) rats were randomly divided into model,Dan-gua Fang,metformin and simvastatin groups(n=10 for each),and fed high-fat diet ad libitum.Ten Wistar rats were used as normal group and fed normal diet.After 24 weeks,liver expression of AMPK α mRNA was assessed by real-time PCR.AMPK α and phospho-AMPK α protein expression in liver was evaluated by Western blot.Liver histomorphology was carried out after hematoxylin-eosin staining,and blood glucose(BG),glycosylated hemoglobin A1c(HbA1c),food intake and body weight recorded.Results:Similar AMPK α mRNA levels were found in the Dan-gua Fang group and normal group,slightly higher than the values obtained for the remaining groups(P<0.05).AMPK α protein expression in the Dan-gua Fang group animals was similar to other diabetic rats,whereas phospho-AMPK α(Thr-172) protein levels were markedly higher than in the metformin group and simvastatin group(P<0.05),respectively.However,phosphor-AMPKa/AMPK α ratios were similar in all groups.Dan-gua Fang reduced fasting blood glucose with similar strength to metformin,and was superior in reducing cholesterol,triglycerides,high-density lipoprotein cholesterol as well as improving low-density lipoprotein cholesterol in comparison with simvastatin and metformin.Dan-gua Fang decreases plasma alanine aminotransferase(ALT) significantly.Conclusion:Dan-gua Fang,while treating phlegm-stasis,could decrease BG and lipid in type 2 diabetic GK rats fed with high-fat diet,and effectively protect liver histomorphology and function.This may be partly explained by increased AMPK expression in liver.Therefore,Dan-gua Fang might be an ideal drug for comprehensive Intervention for glucose and lipid metabolism disorders in type 2 diabetes mellitus.
