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Blood Sugar Management Support presented by

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Blood Sugar Management Support

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“Diabetes is passed that way -- over and down, like a knight in chess.” - Maile Meloy, an American Fiction Writer

“Diabetes is caused by melancholy.” - Thomas Willis (1621 – 1673)

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Diabetes Talks... Listen to it

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ccording to WHO, diabetes mellitus is a chronic/metabolic disease that results when the pancreas does not produce enough insulin (i.e. a defect in its secretion) or when the body cannot effectively use the insulin it produces (i.e. a defect in its action) or both - leading to hyperglycemia - a condition wherein an increased concentration of glucose in the blood is observed (1).

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The World Health Organization (WHO) developed a tagline “Stay Super! Beat Diabetes” to commemorate “World Health Day” on 7 April 2016. The campaign drew attention to the world-wide growth in diabetes and related complications, educating people about this chronic disease by designing various posters for use world-wide.

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D

iabetes mellitus is categorized into several types on the basis of etiology.

The two most common are: • type 1, previously known as insulin dependent diabetes mellitus (IDDM) or childhood-onset diabetes, is characterized by a lack of insulin production, and

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• type 2, formerly called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes, is caused by the body’s ineffective use of insulin.

O

ther forms of diabetes include congenital diabetes (due to genetic defects of insulin secretion), cystic fibrosis-related diabetes, gestational diabetes (hyperglycemia that is first recognized during pregnancy) and steroid diabetes (induced by high doses of glucocorticoids) (1, 2).

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T

ype 2 diabetes is the most common and its prevalence has been on the rise across the world. In some countries it is viewed as an epidemic, as number of diabetics is expected to double in the next decade (3). According to National Diabetes Statistics Report (2014) by Centers for Disease Control and Prevention, 29.1 million people, or 9.3% of the U.S. population, have diabetes. The growth rates of diabetes in children are alarming: every year an estimated 18,436 and 5,089 people under 20 years of age in the United States are newly diagnosed with type 1 and type 2, respectively (4).

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iabetes can lead to other serious conditions as uncontrolled glucose levels affect many parts of the body. Diabetics are vulnerable to various short- and long‑term complications such as high blood pressure, elevated levels of blood LDL cholesterol, blindness and other eye problems, nerve disease, non-alcoholic fatty liver disease, periodontal (gum) disease, hearing loss, erectile dysfunction, depression, complications of pregnancy, heart disease, stroke, kidney failure, and premature death (4).

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part from increased levels of blood glucose, other conditions that play an important role in diabetes and related complications include glycosylated

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haemoglobin (HbA1c), generation of free radicals [e.g. reactive oxygen species (ROS)], oxidative damage to liver and kidney, increased lipid peroxidation, alteration in the levels of carbohydrate metabolic enzymes and depletion of several antioxidant enzymes.

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t has also been reported that the insulin secretory defect could result from either defects of β-cell function or a reduction in β-cell mass. Most quantitative estimates indicate that type 2 diabetes associates with either no change or <30% reduction in β-cell mass (5).

P

ersistent hyperglycemia is known to increase production of free radicals (especially ROS) due to glucose autooxidation, protein glycosylation (6–8) and decreased levels of antioxidant enzymes like catalase (CAT), glutathione peroxidase (GSH-Px) and superoxide dismutase (SOD), thus resulting in cellular defense imbalance followed by cell dysfunction and destruction, thereby injuring tissues. Hence, susceptibility of various tissues to oxidative stress (particularly β islets, as they have the lowest level of intrinsic antioxidant defense and development of diabetes-related complications are critically influenced by the level of these antioxidant enzymes (9, 10).

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SABINSAâ&#x20AC;&#x2122;S NATURAL PRODUCTS FOR HEALTHY BLOOD SUGAR MANAGEMENT

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iabetes can be managed by lifestyle and diet modifications, and medications to lower blood glucose levels. Effective patient education on self-care practices stressing the importance of healthful eating and regular exercise are key in managing the disease, and can help people with diabetes stay healthy.

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long with lifestyle and behavioral modifications, integrated intervention with Sabinsaâ&#x20AC;&#x2122;s wide range of products could be effective in managing healthy glycemic levels in people with diabetes and to achieve optimal endurance.

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FENUMANNANS®

60% GALACTOMANNAN

FENUGREEK

A

standardized extract from the seeds of Trigonella foenum-graecum, commonly known as fenugreek, contains a minimum of 60% Galactomannan, which is made up of galactose and mannose units.

TRIGONELLA FOENUM-GRAECUM www.sabinsa.com

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FENUMANNANSÂŽ

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raditional Use: Seeds of fenugreek are more widely recommended for type 2 diabetic patients. They have long been used in food as well as traditionally in

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the management of diabetes. Beneficial effects have been demonstrated in diabetic animals and both type 1 and 2 diabetic subjects (11â&#x20AC;&#x201C;13).

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FENUMANNANS®

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echanism of Action: The mode of action of fenugreek may be due the presence of alkaloids. It has been found to reduce the elevated blood glucose level, reduce lipid profile to almost normal level as well as suppressed oxidative stress (14). The compound 4-hydroxy isoleucine, isolated from fenugreek seed extract, has been shown to increases glucose-induced insulin release. Fenugreek extract is also reported to increase the number of insulin receptors, stimulate glucose-dependent insulin secretion and inhibit the activities of blood sugar modulating enzymes, such as α-amylase and sucrose (15–18).

Condition Treated

Study Type

Type 2 Diabetes, hyperlipidemia

Randomized, controlled, double-blind study (n=25)

Type 2 Diabetes

Randomized, cross-over study (n=10)

Type 2 Diabetes

Randomized, cross-over study (n=15)

Type 2 Diabetes

Case series with matched control (n=12)

Type 1 Diabetes, hyperlipidemia

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Randomized, cross-over study (n=10)

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linical Study: Several studies have reported that fenugreek extract helps in managing healthy blood sugar levels. In one particular study, fenugreek was found to significantly improve mean fasting blood glucose levels (from 157 mg/dL to 116 mg/dL, p<0.05) and glucose tolerance test. The 24-hour urinary glucose excretion was statistically significant in comparison with the control (19). A compilation of the various clinical studies using fenugreek seed extract is below.

Dosage

Results

References

Improved fasting 1 g hydroalcoholic glucose and extract of glucose tolerance Gupta et al., 2001 fenugreek seed test, and altered insulin resistance 25 g powdered Improved Raghuram et al., fenugreek seed peripheral glucose 1994 (twice daily) utilization Significant mean 100 g defatted improvement in Sharma et al., fasting glucose fenugreek seed 1990 powder and glucose tolerance test Improvement in Neeraja and Boiled fenugreek acute glycemic Rajyalakshmi, seeds response 1996 100 g defatted fenugreek seed powder

Significant mean improvement in fasting glucose and glucose tolerance test

Sharma et al., 1990

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CINNAMON EXTRACT

20% POLYPHENOLS

CINNAMOMUM CASSIA www.sabinsa.com

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innamon extract from the bark of Cinnamomum cassia is standardized to contain 20% Polyphenols. It has a long history of use as a spice and flavoring agent, in addition to use in traditional remedies.

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CINNAMON EXTRACT

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everal in vitro and in vivo studies have indicated that cinnamon may mimic insulin effects and thus may improve glucose utilization. In vitro studies have shown that cinnamon enhances glucose uptake by activating insulin receptor (IR) kinase activity, autophosphorylation of IR, glycogen synthesis

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and glycogen synthase activity (20). In vivo, cinnamon extract was found to enhance glucose utilization in rats in a dose-dependent manner by potentiating insulin-stimulated tyrosine phosphorylation of IR- β, IR substrate (IRS)-1 and the IRS-1 association with phosphatidylinositol (PI) 3-kinase (21).

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CINNAMON EXTRACT

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linical Studies: Seventy-nine people diagnosed with type 2 diabetes were randomly assigned to take cinnamon extract or placebo three times a day for 4 months. At the end of the study it was observed that mean absolute and percentage differences between the pre- and post-intervention fasting plasma glucose level of the cinnamon and placebo groups were significantly different. Cinnamon extract was thus found to have a positive effect in reducing fasting plasma

glucose concentrations in diabetic patients with poor glycemic control (22).

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n another randomized study, 109 type 2 diabetic patients (HbA1C >7.0) across three primary care clinics at a United States military base, were randomly assigned to consume cinnamon extract or placebo for 90 days. Results showed that cinnamon extract lowered HbA1C by 0.83% compared with 0.37% by usual care alone (23).

Baseline HbA1C

Final HbA1C

Difference

Treatment group (n = 55)

8.47 ± 1.8

7.64 ± 1.7

–0.83 (95% CI, 0.46–1.20)

Control group (n = 54)

8.28 ± 1.3

7.91 ± 1.5

–0.37 (95% CI, 0.15–0.59)

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innamon extract has also been reported to have a positive effect on healthy lipid profiles. In a 40-day clinical trial, 60 people having type 2 diabetes (30 men and 30 women) were randomly divided to receive cinnamon extract or placebo. After a washout period of 20 days, their blood glucose

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and lipid profiles were analyzed. Cinnamon extract significantly reduced the mean fasting serum glucose (18–29%), triglyceride (23–30%), LDL cholesterol (7–27%) and total cholesterol (12–26%) levels; while no significant changes were noted in the placebo group (24).

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FABENOL® AND FABENOL® MAX

NATURAL CARBOHYDRATE BLOCKER

PHASEOLUS VULGARIS www.sabinsa.com

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abenol® and Fabenol® Max are standardized extracts of Phaseolus vulgaris (common bean, kidney bean). Fabenol® is a natural carbohydrate blocker with α-amylase inhibitory activity.

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FABENOLÂŽ AND FABENOLÂŽ MAX

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linical Study: In a pilot study, after-meal blood sugar levels were measured in a group of healthy subjects after taking 50 g of carbohydrate in the form of

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wheat, rice and other high-carbohydrate plant foods. Data showed that Phaseolus vulgaris inhibited the average post-ingestion spike in blood sugar by a remarkable 67% (25).

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PTEROSOL® WS

5% C-GLYCOSIDES

PTEROCARPUS MARSUPIUM www.sabinsa.com

P

terosol® WS is obtained from the heartwood of Pterocarpus marsupium. Sabinsa offers Pterosin™ WS standardized to contain a minimum of 5% C-glycosides.

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PTEROSOLÂŽ WS

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raditional Uses: Pterocarpus marsupium, commonly known as Vijaysar, is traditionally used in the management of diabetes and hyperlipidemia. Since ancient times, Ayurvedic practitioners used wood blocks or pieces of Pterocarpus to control

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diabetes. The wood pieces were soaked in water overnight, sieved and consumed by diabetic patients. This was further improved by preparing tumblers carved from the wood of Pterocarpus in which water was stored overnight and consumed by diabetic patients the following day.

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PTEROSOLÂŽ WS

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terostilbene was identified as the major phenolic compound in drakshasava, a traditional Ayurvedic medicinal preparation used to treat cardiovascular and related problems (26). terocarpus marsupium contains several naturally occurring C-glycosides, which may be responsible for its anti-diabetic activity.

Blood Glucose (mg/dl)

echanism of Action: It is believed to regulate high blood glucose level by inhibiting sodium glucose cotransporters (SGLT2), which play a key role in reabsorption of glucose in the kidney by catalyzing the active transport of glucose into the blood stream. Hence, high blood glucose levels in type 2 diabetic patients lead to saturation of SGLT receptors, which in turn results in increased excretion of glucose in the urine. It has been observed that such patients also express higher numbers of SGLT2â&#x20AC;&#x201D;resulting in elevated renal glucose uptake leading to glucotoxicity. Thus, blockage of SGLT2 is considered as a novel therapeutic approach as it causes increased urinary glucose excretion followed by reduced plasma glucose levels. Several structures with C-glycosidic linkages are SGTL2 inhibitors (Flozins) and they do

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not target major physiological defects in type 2 diabetics, and are thus potentially promising. Several SGLT2 inhibitors are in Phase III clinical trials (27).

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linical Studies: A 12-week, flexible-dose, open trial was undertaken in 4 centers in India. Increasing doses of 2g, 3g and 4g (4 weeks each) of Pterocarpus extract were given to type 2 patients. Study results revealed that dried aqueous extract controlled both fasting and post-prandial glucose levels (28).

250

Initial

At 12 weeks

200 150 100 50 0

Fasting

Post-prandial

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PTEROSOL® WS

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n another multi-center, flexible-dose clinical study involving 172 patients, blood glucose lowering efficacy of Pterocarpus was evaluated. Data suggested that glycemic control efficacy of Pterocarpus (dose: 2–4 g/day)

was comparable to that of Tolbutamide (0.75– 1.5g/day) (86% vs. 94% patients, respectively), and was sustained up to 72 weeks. In addition, 4g/day dose of Pterocarpus was found to be safe (29).

Blood Glucose Level (mmol/L)

Parameters

Treatment Groups

At baseline

At Week-36

Pterocarpus (n=172)

9.4

7.0

Tolbutamide (n=177)

9.4

6.7

Pterocarpus (n=172)

13.9

9.6

Tolbutamide (n=177)

13.8

9.4

Fasting

Post-prandial

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SALARETIN®

20% SAPONINS AND 1% MANGIFERIN

SALACIA RETICULATA www.sabinsa.com

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alaretin® is a standardized extract from the bark of Salacia reticulata. It is standardized to contain a minimum of 20% Saponins and 1% Mangiferin.

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SALARETIN®

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raditional Use: Like many Salacia species (Salacia prenoides, Salacia macrosperma, and Salacia oblonga), Salacia reticulata has been used as an oral antidiabetic agent by Ayurvedic practitioners. Based on the extensive use of S. reticulata in Ayurveda, roots (commonly described as acrid and bitter) and stems are believed to contain chemical constituents having potent antidiabetic properties. Traditionally, an aqueous decoction of the roots of S. reticulata is prescribed for people with diabetes.

M

Enzyme Activity (units/ml)

echanism of Action: α-glucosidase inhibitors are found to delay the digestion, in turn the absorption of carbohydrates in the small intestine—thus preventing increased blood glucose concentration after a carbohydrate load (30). Antidiabetic action of S. reticulata is

0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0.1 0

attributed to its α-glucosidase inhibitory activity in the intestine.

A I

water-soluble fraction (25–100 mg/kg, p.o.) prepared from the roots and stems of S. reticulata strongly inhibited elevations in rats’ serum glucose levels after the administration of sucrose or maltose.

n vitro studies revealed that Salaretin® effectively inhibits α-amylase, the enzyme that catalyzes the breakdown of dietary starch to simple sugars, thereby potentially inhibiting starch digestion. In one such study, the extract was found to inhibit α-amylase (derived from porcine pancreas) in a dosedependent manner, with 68.75% inhibition at a concentration of 35 µg/ml.

IC50

0

10

15

20

25

30

35

Conc. (µg/ml) Enzyme source : Porcine pancreas

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MOMORDICIN®

0.5% CHARANTIN AND BITTER PRINCIPLES

MOMORDICA CHARANTIA

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M

omordicin® is obtained from the dried fruits of Momordica charantia. It is standardized to contain a minimum of 0.5% Charantin and Bitter Principles. The fruits of Momordica charantia are widely known for their antidiabetic activity.

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MOMORDICINÂŽ

M C

echanism of Action: Physiological experiments have shown that M. charantia can stimulate insulin secretion by regeneration of β cells and induce glucose uptake in liver. linical Studies: Aqueous, homogenized suspension of the M. charantia pulp was given to 100 type 2 patients. A significant reduction in both fasting and post-prandial (2 h after 75 g of oral glucose intake) serum glucose

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levels (p<0.001) was reported. Hypoglycaemic action was observed in 86% of the cases (31).

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n another clinical study, following an overnight fast, 18 type II diabetes patients underwent glucose tolerance test after receiving 100 ml distilled water 30 min. before the glucose load. The test was repeated the next day, with the patients receiving 100 ml of M. charantia juice instead of distilled water before the glucose load. Data showed that glucose tolerance was improved in 73% of the patients (32).

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GS4 PLUS®

GYMNEMIC ACIDS

GYMNEMA SYLVESTRE

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G

S4 Plus® is obtained from the leaves of Gymnema sylvestre, known in Hindi as ‘Gurmar’ meaning ‘Destroyer of Sugar’. GS4 Plus® is standardized to contain a minimum of 25% or 75% Gymnemic Acids.

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GS4 PLUSÂŽ

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linical Studies: A study was carried out on type 1 individuals to assess the effectiveness of G. sylvestre in regenerating the beta cells and controlling glucose homeostasis. Thirty seven

patients were given insulin alone and 27 patients were given 2 capsules of GS4 (200 mg each) per day along with insulin. It was observed that dependence on insulin significantly reduced with GS4 supplementation (33).

A - Insulin Alone

B - Insulin + GS4

Insulin units / days

60 50 40 30 20 10 0

Initial

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12 Months

Initial

8 Months 18 Months 24 Months

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GS4 PLUSÂŽ

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Healthy subjects

Serum insulin levels (ÂľU/ml)

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n another study, 25 type 2 patients were given conventional anti-hyperglycemic drugs, while 22 patients were given 400 mg capsule of GS4/day plus drugs. Better glycemic control was observed with GS4 supplementation as observed by increase in insulin levels both in fasting as well as post-prandial blood glucose analysis (34).

Conventional drugs alone

GS4 supplementation

100 80

P < 0.01

60 40 20 0

P < 0.01

Fasting insulin level

Postprandial insulin level

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SABERRY®

10% β-GLUCOGALLIN

EMBLICA OFFICINALIS

www.sabinsa.com

S

aberry® is an ORAC-dense Phytonutrient™ extracted from the fruits of Emblica officinalis or the Indian gooseberry (Amla). It is standardized for minimum 10% β-glucogallin.

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SABERRY®

O

RAC VALUES: Brunswick Laboratory, Wareham, Massachusetts, US has evaluated the efficacy of Saberry® using state-of-the-art ORAC tests.

total ORAC hydro ORAC lipo ORAC (H-ORAC + (H-ORAC)

(L-ORAC)

(µmol TE/100 g)

(µmol TE/100 g)

267,800

400

L-ORAC)

HORAC

NORAC

(µmol CAE/100 g)

(µmol TE/100 g)

34,500

90,400

(µmol TE/100 g)

268,200

SORAC (SOD) (kunitsSODeq/100 g)

10,200

SOAC (µmol VitE/100 g)

135,100

Broad-spectrum antioxidant activity is based on the values of ORACTotal [hydrophilic (H-ORAC) and lipophilic (L-ORAC)-Peroxyl Radical Absorbance Capacity)], HORAC (Hydroxyl Radical Absorbance Capacity). NORAC (Peroxynitrite Radical Absorbance Capacity), SOAC (Singlet Oxygen Absorbance Capacity) and SOD (Superoxide dismutase equivalent activity, corresponding to Superoxide Radical Absorbance Capacity).

S

aberry® is a leader among water-soluble phytonutrients in terms of broadspectrum antioxidant activity, showing a combined ORAC value of 358,600 µmol TE/100g* (*TE/g: Trolox Equivalent/100 g; Vit E/g: alpha-tocopherol Equivalent/100 g; CAE/g: Caffeic Acid Equivalent/100 g).

M

echanism of Action: Aldose reductase is a rate-limiting enzyme in the polyol pathway associated with the conversion of glucose to sorbitol. This enzyme is found in the eye (cornea, retina,

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lens), kidney, myelin sheath and also in other tissues. Amla extract has been found to inhibit this enzyme, thus playing an important role in preventing diabetic retinopathy.

E

mblica officinalis extract inhibited rat lens and recombinant human aldose reductase with IC5o values 0.72 and 0.88 mg/ml, respectively. The inhibition of aldose reductase by E. officinalis tannins was found to be comparable to, or better than quercetin (35).

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MANAGE DIABETES BY:

Eating Healthy Diet

Abstinence from Smoking, Tobacco etc.

Keeping Your Weight under Check Daily Physical Activity

Sticking to Medications

DIABETES: FACT FILE •• Diabetes is the 7th leading cause of death in the US1 •• 1 out of every 4 people (> 65 years old) are diabetic1 •• 1 out of every 3 children (i.e. 33%) (those who are born in the year 2000) will develop diabetes in their lifetime, with a projected increase up to 65% in 20502 •• Early signs of heart disease and kidney damage could be seen in some youth with type 2 diabetes3 Centers for Disease Control and Prevention: National diabetes statistics report: estimates of diabetes and its burden in the United States A, GA: U.S. Department of Health and Human Services; 2014. 2 Narayan et al. (2003) JAMA. 290(14):1884–90. 3 TODAY Study Group. Diabetes Care 2013; 36: 1735–74. 1

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Management of Oxidative Stress and Diabetes with Curcumin C3 Complex®: A Potentially Effective Approach •• Oxidative stress has a major role in the pathogenesis of type 2 diabetes and associated complications •• Curcuminoids (including curcumin, Demethoxycurcumin and bisdemethoxycurcumin), polyphenolic pigments present in turmeric (Curcuma longa), have been known to possess potent antioxidant property •• Curcuminoids suppress lipid peroxidation, scavenge free radical as well as improve activities of enzymatic antioxidants—key to counter oxidative stress and enhance antioxidant capacity •• In a recent randomized placebocontrolled clinical study, 118 type 2 diabetics were given combination of Curcumin C3 Complex® (1000 mg/day) and BioPerine® (10 mg/day, as a bioavailability enhancer) for 8 weeks •• Analysis of overnight fasting blood samples (at baseline and at the end of the study) suggested a significant improvement in total antioxidant capacity, SOD activity and decreased malondialdehyde levels, a lipid peroxidation marker •• Sabinsa’s Curcumin C3 Complex® is obtained from the dried rhizomes of Curcuma longa and standardized to 95% curcuminoids Reference: Panahi et al. (2016) Inflammopharmacology. DOI: 10.1007/s10787-016-0301-4

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LactoSpore® Supplementation Can Help Keep Blood Glucose Levels in Check •• The growing popularity of probiotics is being driven by research into various health benefits, including blood sugar management •• Evidences suggest that specific strains of bacteria (e.g. Lactobacillus and Bifidobacterium) can help maintain healthy blood glucose levels •• Additionally, recent studies have shown that carefully designed combinations of probiotics and bioactive molecules have synergistic effects •• Supplementation of LactoSpore® in combination with cinnamon extract in mice demonstrated significantly decreased blood glucose level both in experimentally-induced hyperglycemia model and fasting blood glucose levels •• LactoSpore® is a shelf-stable, clinically-validated probiotic preparation from Sabinsa that contains L-(+)-lactic acid producing Bacillus coagulans MTCC5856 (earlier known as Lactobacillus sporogenes) Reference: Vaclav V, Jana V (2013) Am J Immunol. 9(4):103–9.

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REFERENCES 1.

Anonymous (2017). Available at: http://www.who.int/topics/diabetes_ mellitus/en/ Accessed on: 19 Jan 2017. 2. Bastaki S. (2005) Int J Diabetes Metab. 13:111–34. 3. Olokoba et al. (2012) Oman Med J. 27(4):269–73. 4. Centers for Disease Control and Prevention: National diabetes statistics report: estimates of diabetes and its burden in the United States A, GA: U.S. Department of Health and Human Services; 2014. 5. Rahier et al. (1983) Diabetologia. 24(5):366–71. 6. Aragno et al. (1999) Free Radic Biol Med. 26(11–12):1467–74. 7. Rousselot et al. (2000) Diabetes Metab. 26:163–76. 8. Robertson et al. (2004) J Biol Chem. 279(41):42351–4. 9. Lenzen et al. (1996) Free Radic Biol Med. 20(3):463–6. 10. West et al. (2000) Diabetic Med. 17:171–180. 11. Wan-Li Xue et al. (2007) Asia Pac J Clin Nutr. 16(Suppl. 1):422–6. 12. Moorthy et al. (2010) Indian J Exp Biol. 48:1111–8. 13. Renuka et al. (2009) Int J Pharm Tech Res. 1(4):1580–4. 14. Helmy et al. (2007) J Appl Sci Res. 3(10):1073–83. 15. Sauvaire et al. (1998) Diabetes. 47:206–10. 16. Raghuram et al. (1994) Phytother Res. 8:83–6. 17. Ajabnoor MA, Tilmisany AK. (1988) J Ethnopharmacol. 22:45–9. 18. Amin et al. (1987) Diabetes. 36:211a. 19. Sharma et al. (1990) Nutr Res. 10:731–9. 20. Jarvill-Taylor et al. (2001) J Am Coll Nutr. 20:327–36. 21. Qin et al. (2003) Diabetes Res Clin Pract. 62:139–48. 22. Mang et al. (2006) Eur J Clin Invest. 36:340–44. 23. Carwford P. (2009) JABFM. 22(5):507–12 24. Khan et al. (2003) Diabetes Care. 26:3215–8. 25. Dilawari et al. (1981) Am J Clin Nutr. 34(11):2450–3. 26. Paul et al. (1999) J Ethnopharmacol. 68(1–3):71–6. 27. Chao EC, Henry RR. (2010) Nat Rev Drug Discov. 9:551–9. 28. ICMR. (1998) Indian J Med Res. 108:24–9. 29. ICMR. (2005) Diabetologia Croatia. 34(1):13–20. 30. Yoshikawa et al. (1997) Tetrahydron Lett. 38:8367-70. 31. Ahmad et al. (1999) Bangladesh Med Res Counc Bull. 25(1):11–3. 32. Welihinda et al. (1986) J Ethnopharmacol. 17:277–82. 33. Shanmugasundaram et al. (1990) J Ethnopharmacol. 30:281–94. 34. Baskaran et al. (1990) J Ethnopharmacol. 30:295–305. 35. Suryanarayana et al. (2004) Mol Vis. 10:148–54.

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www.sabinsa.com

Sabinsa, founded in 1988, provides alternative and complementary natural products for human nutrition and well-being. Sabinsa has pioneered the introduction of more than 120 ingredients, ranging from standardized botanicals, natural cosmeceuticals, to multi-enzyme blends and production of a shelfstable probiotic. To support these products, there are numerous privately funded clinical studies in conjunction with prestigious institutions studying these products in a very consistent manner. Sabinsa is globally positioned with 1,000 people working in manufacturing and distribution facilities, and 120 full-time scientists conducting on-going research in India and the United States. Ingredients by Sabinsa are both Kosher and Halal certified.

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For more information, contact info@sabinsa.com.

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