Combined Inositols, α-Lactalbumin, Gymnema Sylvestre and Zinc Improve the Lipid Metabolic Profile of Patients with Type 2 Diabetes Mellitus: A Randomized Clinical Trial

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Dec 23

PMID 38137721

Authors

Alessandro Nani

Federico Bertuzzi

Elena Meneghini

Elena Mion

Basilio Pintaudi

Affiliations

Soon will be listed here.

Abstract

Type 2 diabetes mellitus (T2DM) is characterized by high blood glucose levels and lipid alterations. Besides pharmacological treatment, lifestyle modifications and nutraceuticals can be used to manage glucose and lipid profiles, which is crucial for preventing, or avoiding, serious consequences associated with the condition. This randomized controlled clinical trial on 75 patients with T2DM evaluated the effects of a combination of myo-inositol and d-chiro-inositol (40:1), α-lactalbumin, Gymnema sylvestre, and zinc on glucose and lipid profile. The intention-to-treat analysis displayed no significant differences in glucose parameters between the groups; however, the study group displayed reduced levels of total cholesterol ( = 0.01) and LDL ( = 0.03) after 3 months of supplementation. A subgroup analysis involving patients who did not modify their antidiabetic therapy, after 6 months displayed improved levels of total cholesterol ( = 0.03) and LDL ( = 0.04) in the study group versus placebo, along with a greater body weight reduction ( = 0.03) after 3 months. Furthermore, within the study group, levels of HDL ( = 0.03) and triglycerides ( = 0.04) improved after 3 months. These findings support supplementation with myo-inositol and d-chiro-inositol (40:1), α-lactalbumin, Gymnema sylvestre, and zinc as an adjuvant and safe strategy to manage the lipid profiles of patients with T2DM.

References

Pothuraju R, Sharma R, Chagalamarri J, Jangra S, Kavadi P . A systematic review of Gymnema sylvestre in obesity and diabetes management. J Sci Food Agric. 2013; 94(5):834-40. DOI: 10.1002/jsfa.6458. View

Farooq D, Alamri A, Alwhahabi B, Metwally A, Kareem K . The status of zinc in type 2 diabetic patients and its association with glycemic control. J Family Community Med. 2020; 27(1):29-36. PMC: 6984028. DOI: 10.4103/jfcm.JFCM_113_19. View

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N . Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9 edition. Diabetes Res Clin Pract. 2019; 157:107843. DOI: 10.1016/j.diabres.2019.107843. View

Zuniga L, Gonzalez-Ortiz M, Martinez-Abundis E . Effect of Gymnema sylvestre Administration on Metabolic Syndrome, Insulin Sensitivity, and Insulin Secretion. J Med Food. 2017; 20(8):750-754. DOI: 10.1089/jmf.2017.0001. View

DasNandy A, Patil V, Hegde H, Harish D, Roy S . Elucidating type 2 diabetes mellitus risk factor by promoting lipid metabolism with gymnemagenin: An and approach. Front Pharmacol. 2022; 13:1074342. PMC: 9792475. DOI: 10.3389/fphar.2022.1074342. View

Parhofer K . Interaction between Glucose and Lipid Metabolism: More than Diabetic Dyslipidemia. Diabetes Metab J. 2015; 39(5):353-62. PMC: 4641964. DOI: 10.4093/dmj.2015.39.5.353. View

Cardinale V, Lepore E, Basciani S, Artale S, Nordio M, Bizzarri M . Positive Effects of α-Lactalbumin in the Management of Symptoms of Polycystic Ovary Syndrome. Nutrients. 2022; 14(15). PMC: 9370664. DOI: 10.3390/nu14153220. View

Taskinen M, Boren J . New insights into the pathophysiology of dyslipidemia in type 2 diabetes. Atherosclerosis. 2015; 239(2):483-95. DOI: 10.1016/j.atherosclerosis.2015.01.039. View

Benelli E, Del Ghianda S, Di Cosmo C, Tonacchera M . A Combined Therapy with Myo-Inositol and D-Chiro-Inositol Improves Endocrine Parameters and Insulin Resistance in PCOS Young Overweight Women. Int J Endocrinol. 2016; 2016:3204083. PMC: 4963579. DOI: 10.1155/2016/3204083. View

10.

Poznyak A, Grechko A, Poggio P, Myasoedova V, Alfieri V, Orekhov A . The Diabetes Mellitus-Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation. Int J Mol Sci. 2020; 21(5). PMC: 7084712. DOI: 10.3390/ijms21051835. View

11.

Sanchez-Garrido M, Tena-Sempere M . Metabolic dysfunction in polycystic ovary syndrome: Pathogenic role of androgen excess and potential therapeutic strategies. Mol Metab. 2020; 35:100937. PMC: 7115104. DOI: 10.1016/j.molmet.2020.01.001. View

12.

Chapman M, Ginsberg H, Amarenco P, Andreotti F, Boren J, Catapano A . Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for management. Eur Heart J. 2011; 32(11):1345-61. PMC: 3105250. DOI: 10.1093/eurheartj/ehr112. View

13.

Turner R, Millns H, Neil H, Stratton I, Manley S, Matthews D . Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom Prospective Diabetes Study (UKPDS: 23). BMJ. 1998; 316(7134):823-8. PMC: 28484. DOI: 10.1136/bmj.316.7134.823. View

14.

Gao J, Song J, Du M, Mao X . Bovine α-Lactalbumin Hydrolysates (α-LAH) Ameliorate Adipose Insulin Resistance and Inflammation in High-Fat Diet-Fed C57BL/6J Mice. Nutrients. 2018; 10(2). PMC: 5852818. DOI: 10.3390/nu10020242. View

15.

Pintaudi B, Di Vieste G, Bonomo M . The Effectiveness of Myo-Inositol and D-Chiro Inositol Treatment in Type 2 Diabetes. Int J Endocrinol. 2016; 2016:9132052. PMC: 5078644. DOI: 10.1155/2016/9132052. View

16.

Tabrizi R, Ostadmohammadi V, Lankarani K, Peymani P, Akbari M, Kolahdooz F . The effects of inositol supplementation on lipid profiles among patients with metabolic diseases: a systematic review and meta-analysis of randomized controlled trials. Lipids Health Dis. 2018; 17(1):123. PMC: 5968598. DOI: 10.1186/s12944-018-0779-4. View

17.

Ranasinghe P, Wathurapatha W, Ishara M, Jayawardana R, Galappatthy P, Katulanda P . Effects of Zinc supplementation on serum lipids: a systematic review and meta-analysis. Nutr Metab (Lond). 2015; 12:26. PMC: 4523910. DOI: 10.1186/s12986-015-0023-4. View

18.

Lepore E, Lauretta R, Bianchini M, Mormando M, Di Lorenzo C, Unfer V . Inositols Depletion and Resistance: Principal Mechanisms and Therapeutic Strategies. Int J Mol Sci. 2021; 22(13). PMC: 8268915. DOI: 10.3390/ijms22136796. View

19.

Olechnowicz J, Tinkov A, Skalny A, Suliburska J . Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci. 2017; 68(1):19-31. PMC: 5754376. DOI: 10.1007/s12576-017-0571-7. View

20.

Kamenov Z, Gateva A, Dinicola S, Unfer V . Comparing the Efficacy of Myo-Inositol Plus α-Lactalbumin vs. Myo-Inositol Alone on Reproductive and Metabolic Disturbances of Polycystic Ovary Syndrome. Metabolites. 2023; 13(6). PMC: 10304700. DOI: 10.3390/metabo13060717. View