Berberine Protects Against Metformin-associated Lactic Acidosis in Induced Diabetes Mellitus

Overview

Journal Iran J Basic Med Sci

Publisher Mashhad University of Medical Sciences

Specialty General Medicine

Date 2017 Jun 29

PMID 28656086

Citations 7

Authors

Suhail Ahmed Almani

Iqbal Ahmed Memon

Tariq Zaffar Shaikh

Haji Khan Khoharo

Ikramuddin Ujjan

Affiliations

Soon will be listed here.

Abstract

Objectives: Causality of occurrence of metformin-associated lactic acidosis (MALA) is a clinical problem. Currently, there is no drug available to prevent MALA. The present study was conducted to evaluate the protective effect of Berberine (BBR) against MALA in induced diabetic rat model.

Materials And Methods: A sample of 75 healthy male Wistar rats was randomly selected according to inclusion and exclusion criteria. 75 male Wistar rats were randomly divided into a control and 4 experimental groups. Streptozotocin (STZ) in citrate buffer (pH 4.5) at a dose of 45 mg/kg was injected for induction of diabetes mellitus and rats achieving fasting blood glucose >250 mg/dl were included. Blood samples were collected 18 hr after the last dose of metformin and berberine. Ethical approval was taken before the study was conducted. Staistix 10.0 (USA) software was used for data analysis.

Results: Berberine decreased MALA. Metformin, metformin + BBR 50 mg/kg bwt, and metformin + BBR 100 mg/kg bwt showed serum lactate as 1.87±0.4 mmol/lL, 1.62 ± 0.44 mmol/l and 1.47± 0.45 mmol/l, respectively (=0.0001). Insulin resistance and liver enzymes were improved in BBR treated rats.

Conclusion: The present study reports berberine protects against MALA in streptozocin-induced diabetes mellitus.

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References

Papanas N, Maltezos E, Mikhailidis D . Metformin and heart failure: never say never again. Expert Opin Pharmacother. 2011; 13(1):1-8. DOI: 10.1517/14656566.2012.638283. View

Lepelley M, Giai J, Yahiaoui N, Chanoine S, Villier C . Lactic Acidosis in Diabetic Population: Is Metformin Implicated? Results of a Matched Case-Control Study Performed on the Type 2 Diabetes Population of Grenoble Hospital University. J Diabetes Res. 2016; 2016:3545914. PMC: 4789438. DOI: 10.1155/2016/3545914. View

Biradar V, Moran J, Peake S, Peter J . Metformin-associated lactic acidosis (MALA): clinical profile and outcomes in patients admitted to the intensive care unit. Crit Care Resusc. 2011; 12(3):191-5. View

Scale T, Harvey J . Diabetes, metformin and lactic acidosis. Clin Endocrinol (Oxf). 2010; 74(2):191-6. DOI: 10.1111/j.1365-2265.2010.03891.x. View

Turner R, Cull C, Frighi V, Holman R . Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Prospective Diabetes Study (UKPDS) Group. JAMA. 1999; 281(21):2005-12. DOI: 10.1001/jama.281.21.2005. View

Yin J, Gao Z, Liu D, Liu Z, Ye J . Berberine improves glucose metabolism through induction of glycolysis. Am J Physiol Endocrinol Metab. 2007; 294(1):E148-56. PMC: 2464622. DOI: 10.1152/ajpendo.00211.2007. View

Chowdhury T, Wright R, Yaqoob M . Using metformin in the presence of renal disease. BMJ. 2015; 350:h1758. DOI: 10.1136/bmj.h1758. View

Eurich D, McAlister F, Blackburn D, Majumdar S, Tsuyuki R, Varney J . Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review. BMJ. 2007; 335(7618):497. PMC: 1971204. DOI: 10.1136/bmj.39314.620174.80. View

Calabrese A, Coley K, DaPos S, Swanson D, Rao R . Evaluation of prescribing practices: risk of lactic acidosis with metformin therapy. Arch Intern Med. 2002; 162(4):434-7. DOI: 10.1001/archinte.162.4.434. View

10.

Li X, Zhao Z, Huang M, Feng R, He C, Ma C . Effect of Berberine on promoting the excretion of cholesterol in high-fat diet-induced hyperlipidemic hamsters. J Transl Med. 2015; 13:278. PMC: 4549888. DOI: 10.1186/s12967-015-0629-3. View

11.

Wheaton W, Weinberg S, Hamanaka R, Soberanes S, Sullivan L, Anso E . Metformin inhibits mitochondrial complex I of cancer cells to reduce tumorigenesis. Elife. 2014; 3:e02242. PMC: 4017650. DOI: 10.7554/eLife.02242. View

12.

Vecchio S, Protti A . Metformin-induced lactic acidosis: no one left behind. Crit Care. 2011; 15(1):107. PMC: 3222034. DOI: 10.1186/cc9404. View

13.

Lalau J, Race J . Lactic acidosis in metformin-treated patients. Prognostic value of arterial lactate levels and plasma metformin concentrations. Drug Saf. 1999; 20(4):377-84. DOI: 10.2165/00002018-199920040-00006. View

14.

Lalau J . Lactic acidosis induced by metformin: incidence, management and prevention. Drug Saf. 2010; 33(9):727-40. DOI: 10.2165/11536790-000000000-00000. View

15.

Vasisht K, Chen S, Peng Y, Bakris G . Limitations of metformin use in patients with kidney disease: are they warranted?. Diabetes Obes Metab. 2010; 12(12):1079-83. DOI: 10.1111/j.1463-1326.2010.01295.x. View

16.

Guariguata L, Whiting D, Hambleton I, Beagley J, Linnenkamp U, Shaw J . Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014; 103(2):137-49. DOI: 10.1016/j.diabres.2013.11.002. View

17.

Inzucchi S, Bergenstal R, Buse J, Diamant M, Ferrannini E, Nauck M . Management of hyperglycaemia in type 2 diabetes: a patient-centered approach. Position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetologia. 2012; 55(6):1577-96. DOI: 10.1007/s00125-012-2534-0. View

18.

Cryer D, Nicholas S, Henry D, Mills D, Stadel B . Comparative outcomes study of metformin intervention versus conventional approach the COSMIC Approach Study. Diabetes Care. 2005; 28(3):539-43. DOI: 10.2337/diacare.28.3.539. View

19.

Manning P, Sutherland W, Walker R, Williams S, de Jong S, Ryalls A . Effect of high-dose vitamin E on insulin resistance and associated parameters in overweight subjects. Diabetes Care. 2004; 27(9):2166-71. DOI: 10.2337/diacare.27.9.2166. View

20.

Ni Y . [Therapeutic effect of berberine on 60 patients with type II diabetes mellitus and experimental research]. Zhong Xi Yi Jie He Za Zhi. 1988; 8(12):711-3, 707. View