Diabetes and metabolic disease are common condition of the West. The predominance of these diseases is rapidly increasing worldwide and is becoming a major health problem. (Kahn et al. 2006) Diabetes mellitus affected an estimated 285 million people worldwide in 2013 and is expected to affect 439 million people by 2030. (Shaw JE 2010)
The story of observing berberine’s (one of the bioactive compounds of Berberis vulgaris) antidiabetic effect started in the 80’s. The authors of a research (Yan-xia & An-qiang 1995) accidentally found it when berberine was used to treat diarrhoea for patients who suffered from diabetes. According to that result, berberine was used to treat non-insulin dependent diabetes mellitus (NIDDM) during 1983 to 1987. (Yan-xia & An-qiang 1995)
What is pancreas and how does it work?
The pancreas, which is a retroperitoneal gland, lies posterior to the greater curvature of the stomach. This organ is made up of small clusters of glandular epithelial cells. There are two types of pancreatic cells: the dark-stained cells from acini, connected to ducts, and islet cells of light-stained clusters (Islet of Langehans). The cells in Islet of Langehans secrete a mixture of hormones (glucagon, insulin, somatostatin and pancreatic polypeptide – which help control blood sugar levels) providing endocrine function of the pancreas. (Tortora 2011)
The acinar cells secrete digestive enzymes (called pancreatic juice) into the pancreatic duct (duct of Wirsung). (Fehmann HC 1995)
Centroaciner cells take place in the lumen of the acinus (the origin of the secretory duct).
The lumen of the acinus leads into the intralobular ducts. These ducts are covered by low columnar epithelial cells. They look almost the same as centroacinar cells. In these areas, there are goblet cells and sometime argetaffin cells as well. Monoclonal antibodies of pancreas are reactive with acinar, ductal and islet cells.
In case of feeding and digestion the acinar cells go through cyclic morphological changes. The zymogen granule content of the cells is depleted after consuming a large amount of meal. Size of them decrease with number of granules. After depletion of these granules, the Golgi apparatus at the apex of the cell start expanding. The reductions in size and number of granules “occur with a substantial increase in pancreatic enzyme secretion”. (Feldman & Friedman 2010)
Causes of Pancreatic Disorders
In case of pancreatic problem pancreatic beta cells are damaged or become dysfunctional because of the oxidative stress, the persistently high glucose or lipid levels, inflammatory mediators released from the adipose tissue and endoplasmic reticulum. Oxidative stress and inflammation are proved to be critical for the pathogenesis. (Li 2014)
Regarding age range of patients, pancreatic diseases are increasingly recognized in the pediatric age group. The occurrence of acute pancreatitis, acute recurrent pancreatitis and chronic pancreatitis in case of children is getting the same amount as that of adults.
Although cystic fibrosis is still the most common cause of exocrine pancreatic insufficiency. “Other causes such as chronic pancreatitis may be as common as Shwachman-Diamond syndrome.” Long-term effects of pancreatic diseases (especially in cases of children) reflect the challenging life with nutritional deficiencies, pancreatogenic diabetes and potentially pancreatic cancer. (Uc & Fishman 2017)
Plants with berberine content as a traditional remedy for pancreas problems
About 1200 plants have been claimed to have compounds with antidiabetic properties, and over 400 plants and their bioactive compounds have been scientifically evaluated for type 2 diabetes treatment. (Kalasz 2011)
The effect of berberine on insulin secretion is controversial. Berberine is an isoquinoline alkaloid present in several plants, like Berberis spp. and Coptis spp. Berberine is a conventional component both in Chinese medicine and Ayurveda. It is also characterized by a diversity of pharmacological effects. (Imenshahidi and Hossenzadeh 2016)
Nowadays there is a noticeable growing scientific interest in its anti-diabetic action which seem to be increasingly prevalent among Western societies, thanks to its important role in activating AMP-activated protein kinase (AMPK). It is a key enzyme in metabolism. (Xu and Xiao et al. 2014)
The majority of these studies (see references) investigated in this blog post suggests that there might be a significant benefit to patients with type 2 diabetes mellitus from treatment with berberine extract.
There were some adverse reactions reported like (minor digestive issues that tended to resolve 2 weeks in the study) by patients treated with type 2 diabetes mellitus.
Overall, these researches have concluded that berberine is a safe and effective therapy for improvement in insulin action but more studies should focus on human experiments to validate the metabolism-modulating and pancreas rejuvenating activities of berberine in vivo.
The inhibitory effect of barberry on oxidative stress was not observed in all the human researches.
As for these studies, only those patients can benefit where pancreas problems had not been occurred by stress as mental health factor.
Only two studies overviewed papers about pancreatic cell reproduction. The authors’ strategical approach for the prevention and treatment of diabetes was maintaining pancreatic beta cell function and increasing pancreatic beta cell mass to discover novel antidiabetics. (Sin Oh 2015; Cernea and Dobreanu 2013)
Although the evidence that berberine influences the recovery of pancreas islet beta-cells in animal research (Yan-xia & An-qiang et al. 1995) looks promising, further randomized, double blind active or placebo controlled research is imperative.
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