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Edible traditional Chinese medicines improve type 2 diabetes by modulating gut microbiotal metabolites

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Abstract

Type 2 diabetes mellitus (T2DM) is a metabolic disorder with intricate pathogenic mechanisms. Despite the availability of various oral medications for controlling the condition, reports of poor glycemic control in type 2 diabetes persist, possibly involving unknown pathogenic mechanisms. In recent years, the gut microbiota have emerged as a highly promising target for T2DM treatment, with the metabolites produced by gut microbiota serving as crucial intermediaries connecting gut microbiota and strongly related to T2DM. Increasingly, traditional Chinese medicine is being considered to target the gut microbiota for T2DM treatment, and many of them are edible. In studies conducted on animal models, edible traditional Chinese medicine have been shown to primarily alter three significant gut microbiotal metabolites: short-chain fatty acids, bile acids, and branched-chain amino acids. These metabolites play crucial roles in alleviating T2DM by improving glucose metabolism and reducing inflammation. This review primarily summarizes twelve edible traditional Chinese medicines that improve T2DM by modulating the aforementioned three gut microbiotal metabolites, along with potential underlying molecular mechanisms, and also incorporation of edible traditional Chinese medicines into the diets of T2DM patients and combined use with probiotics for treating T2DM are discussed.

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Abbreviations

IDF:

International Diabetes Federation

T2DM:

Type 2 diabetes mellitus

SCFAs:

Short chain fatty acids

SBAs:

Secondary bile acids

BCAAs:

Branched chain amino acid

GLP:

Ganoderma lucidum Polysaccharides

FYGL:

Fudan-Yueyang-G. lucidum

AMP:

Astragalus membranaceus Polysaccharides

LBL:

Lycium barbarum L.

LBPs:

L. barbarum Polysaccharides

DOP:

Dendrobium officinale Polysaccharide

DNJ:

1-Deoxynojirimycin

MLE:

Mulberry Leaves extract

CS:

Coix seed

CSP:

Coix seed polysaccharides

GEB:

Gastrodia elata Blume

GEBE:

Gastrodia elata Blume Extract

LJF:

Laminaria japonica fucoidan

GPCR:

G protein-coupled receptors

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Acknowledgements

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Funding

This work was supported by the Jiangxi Provincial Natural Science Foundation Key Project (20224ACB206010); Key Project of Jiangxi Province Science and Technology Key R&D Plan (20201BBG71006); and Jiangxi Provincial Science and Technology Innovation Base Plan (2020BCG74001 and 20221ZDG02011).

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  1. Shen Chen, Yiqiao Jiao, and Yiyang Han have contributed equally to this work.

Authors and Affiliations

  1. Department of Endocrinology and Metabolism, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, 330006, People’s Republic of China

    Shen Chen, Yiqiao Jiao, Yiyang Han, Jie Zhang, Yuanyuan Deng, Zilu Yu, Jiao Wang, Shasha He & Jixiong Xu

  2. Jiangxi Clinical Research Center for Endocrine and Metabolic Disease, Nanchang, Jiangxi, 330006, People’s Republic of China

    Jixiong Xu

  3. Jiangxi Branch of National Clinical Research Center for Metabolic Disease, Nanchang, Jiangxi, 330006, People’s Republic of China

    Jixiong Xu

  4. Queen Mary School, Medical College, Nanchang University, Nanchang, 330006, China

    Shen Chen, Yiqiao Jiao, Yiyang Han & Zilu Yu

  5. Department of Medical Genetics and Cell Biology, Medical College of Nanchang University, Nanchang, 330006, People’s Republic of China

    Wei Cai

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Contributions

SC, YJ and YH contributed equally to this work. SC, JZ, WC and JX conceived the idea and designed the study. SC and YH drafted the original manuscript. YD, JW and SH reviewed and edited the manuscript. YZ formatted the manuscript according to journal guidelines. JX and WC obtained the funding. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Wei Cai or Jixiong Xu.

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592_2023_2217_MOESM2_ESM.jpg

Figure S1 Illustrates the relationship between obesity and insulin resistance. Gut microbiota act as mediators. Obesity may change the metabolites of gut microbiota, which in turn leads to insulin resistance in the body, and ultimately lead to T2DM. Drawn using the software Adobe Illustrator 2023.

Supplementary file2 (JPG 53KB)

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Chen, S., Jiao, Y., Han, Y. et al. Edible traditional Chinese medicines improve type 2 diabetes by modulating gut microbiotal metabolites. Acta Diabetol 61, 393–411 (2024). https://doi.org/10.1007/s00592-023-02217-6

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