Effects and Mechanisms of Tea for the Prevention and Management of Diabetes Mellitus and Diabetic Complications: An Updated Review
Abstract
:1. Introduction
2. Epidemiological Investigations
3. Experimental Studies
3.1. Diabetes Mellitus
3.1.1. Type 1 Diabetes Mellitus (T1DM)
3.1.2. Type 2 Diabetes Mellitus (T2DM)
3.2. Diabetic Complications
3.2.1. Diabetic Nephropathy
3.2.2. Diabetic Cardiovascular Diseases
3.2.3. Diabetic Neuropathy
3.2.4. Diabetic Retinopathy
3.2.5. Diabetic Hepatopathy
3.2.6. Other Complications
3.3. Adjuvant Therapy
4. Clinical Trials
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
References
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Diseases | Tea Type | Study Type | Participants | Dose | Results | Ref. |
---|---|---|---|---|---|---|
Diabetes mellitus | Tea | Prospective cohort study | Individuals (N = 7006) aged 32–88 without diabetes mellitus | N/A | The consumption of tea showed an decreased risk of diabetes mellitus for nonelderly adults who had previously lost weight. | [24] |
Diabetes mellitus | Green tea | Cohort study | Elderly Japanese men and women (N = 11,717) | N/A | Women with a higher intake of green tea had a lower risk of diabetes mellitus. | [26] |
Diabetes mellitus | Black Tea | placebo-controlled study | Total participants (N = 24) aged 20–60 | N/A | Drinking black tea could decrease postprandial blood sugar. | [39] |
T2DM | Tea | Population-based cohort study | Danish non-diabetic women with singleton pregnancies (N = 71,239) | 8 cups per day | The consumption of tea showed protective effects against T2DM (RR = 0.55, 95% CI (0.55, 1.08)). | [23] |
T2DM | Tea | Prospective Cohort study. | African American women (N = 46,906) | N/A | The consumption of tea wasn’t associated with T2DM. | [19] |
T2DM | Tea | Prospective cohort study. | British men (N = 4055) and women (N = 1768) | N/A | Tea intake was beneficial for DM (HR = 0.66, 95% CI (0.61, 1.22)), p < 0.05. | [25] |
T2DM | Tea | Case-Control study | Newly diagnosed diabetic cases (N = 599) Hospital-based controls (N = 599) | 2 cups per day | Habitual drinking tea could reduce the risk of T2DM (OR = 0.66, 95% CI (0.49–0.89)). | [29] |
T2DM | Tea | Case-Cohort Study | Total participants (N = 16,835) | ≥1 cups per day | The consumption of tea has negative relation with T2DM 1 cup/day (HR = 0.84, 95% CI (0.71, 1.00)) ≥2 cups/day (HR = 0.93, 95% CI (0.81, 1.05)) | [40] |
T2DM | Tea | Meta-analysis | Total participants (N = 545,517); Cases with T2DM (N = 37,445) | N/A | The consumption of tea has negative relation with T2DM (p = 0.02). | [34] |
T2DM | Tea | Meta-analysis | N/A | N/A | Drinking tea daily (≥3 cups/day) is associated with a lower risk of T2DM (RR = 0.84, 95% CI (0.73, 0.97)) | [35] |
T2DM | Tea | Meta-analysis | Total participants (N = 324,141); Cases with T2DM (N = 11,400) | N/A | Tea consumption a ≥4 cups per day may lower the risk of T2DM. | [18] |
T2DM | Tea | Meta-analysis | Total participants (N = 457,922) | N/A | The consumption of tea was associated with reduced risk of diabetes mellitus. | [33] |
T2DM | Tea | Descriptive study | Total participants (N = 940) | N/A | Long-term tea intake had effects on the prevention and treatment of diabetes mellitus. | [32] |
T2DM | Green tea | Meta-analysis | N/A | N/A | The consumption of tea wasn’t associated with T2DM. | [38] |
T2DM | Green tea | Meta-analysis | N/A | N/A | Tea or tea extract could maintain stable fasting insulin level in patients with T2DM. | [6] |
T2DM | Green tea | Meta-analysis | Total participants (N = 510) | N/A | Green tea had no effect on insulin sensitivity and blood glucose control. | [37] |
T2DM | Black tea | Cohort study. | Total participants (N = 36,908) | ≥1 cups per day | Black tea had association with T2DM (RR = 0.86, 95% CI (0.74, 1.00)). | [27] |
T2DM | Oolong tea | Prospective cohort study. | Japanese male workers (N = 4975) | ≥1 cups per day | Long-term consumption of oolong tea may be a predictive factor for new onset diabetes mellitus. 1 cup/day (HR = 1.00, 95% CI (0.67–1.49)). ≥2cups /day (HR = 1.64, 95% CI (1.11–2.40)) | [36] |
Diabetic nephropathy | Green tea | Cohort study | Diabetic patients (N = 42) | N/A | Green tea extract could reduce proteinuria in diabetic patients. | [41] |
Diabetic Retinopathy | Green tea | Case-Control Study | Cases with diabetic retinopathy (N = 100) and diabetic patients without retinopathy (N = 100) | N/A | Long-term drinking green tea had preventive effects on diabetic retinopathy (OR = 0.49, 95% CI (0.26–0.90)). | [30] |
Tea Types | Constituents | Diseases Types | Study Types | Models | Dose | Effects | Mechanisms | Ref. |
---|---|---|---|---|---|---|---|---|
Green tea | EGCG | Diabetic cardiovascular disease | In vivo | Alloxan-induced diabetic rabbits | 50 mg/kg/day | Improved late endothelial progenitor cells(L-EPCs); Promoted reendothelialization. | Activated Akt/eNOS pathway | [136] |
EGCG | Diabetic cardiomyopathy | In vivo | Wistar rats | 50 mg/kg/day | Enhanced cardiac function; Increased ADSC repair capability; | ↑ Insulin-like growth factor 1 ↑ H9c2 cell cycle | [137] | |
EGCG | diabetic neuropathy | In vivo | Male Wistar rats | 0.1% (w/v) | Improved cerebral function. | ↓ Neuronal degeneration ↓ Apoptotic cell death | [138] | |
Polyphenols | Diabetic Retinopathy | In vivo | Wistar-Kyoto rats | 5.7 g/kg/day | Protected the retina against glutamate toxicity. | ↓ ROS | [122] | |
Polyphenols | Diabetic cardiovascular disease | In vivo | Male Wistar rats | 0.8, 1.6, and 3.2 g/L | Reduced fat deposit; Ameliorated hypoadiponectinemia in HF-fed rats; Relieved high glucose-induced adiponectin decrease. | ↓ Extracellular signal regulated kinase 1/2 phosphorylation ↑ PPARγ ↓ Adiponectin decrease | [139] | |
Polyphenols | Diabetic cardiovascular disease | In vitro | Cardiac muscle of rats | 200 mg/kg | Ameliorated the effects of high-fructose diet on insulin signaling, lipid metabolism and inflammation. | ↑ PI3k, Akt1 ↑ Glut1, Glut4, glycogen synthase 1 ↑ Anti-inflammatory protein ↓ GSK-3β, TNF, IL-1B and IL-6 | [53] | |
Diabetic cardiovascular disease | In vivo | STZ-induced rats | 300 mg/kg/day | Protected rat heart. | ↓ [Ca2+] and [Na+] ↑ Activities of Ca2+-ATPase and Na+/K+-ATPase | [94] | ||
Diabetic cardiovascular disease | In vivo | STZ-induced rats | 300 mg/kg/day | Reduced the risk of diabetic cardiovascular disease. | ↓ Cholesterol, triglyceride ↓ Free fatty acid and LDL-C ↑ HDL-C | [140] | ||
Diabetic cardiomyopathy | In vivo | Diabetic rats | 300 mg/kg/day | Treated diabetic cardiomyopathy. | ↓ AGEs ↓ Ollagen cross-linking | [100] | ||
diabetic retinopathy | In vivo | Rats | 200 mg/kg/day | Prevented and treated diabetic retinopathy. | ↓ SOD and catalase enzyme | [123] | ||
Diabetic hepatopathy | In vivo | Male Wistar rats | 1.5% (w/v) | Prevented diabetic tissue injury. | ↑ GSH-Px, SOD, catalase | [126] | ||
Diabetic hepatopathy | In vivo | Male Wistar rats | 1.5% (w/v) | Pretected tissue. | ↑ GSH-Px, SOD, catalase ↓ MDA, alkaline phosphatase | [141] | ||
Diabetic nephropathy and hepatopathy | In vivo | Male Sprague-Dawley rats | 0.1% (w/v) | Protected renal and hepatic tissues from injury. | ↑ Total antioxidant levels ↓ Malonyldialdehyde (MDA) ↓ Angiotensin II AT1 receptor | [130] | ||
Diabetes mellitus-induced periodontitis | In vivo | STZ-induced rats | N/A | Treated diabetes mellitus-induced periodontitis. | ↓ TNF-α and RANKL ↑ RUNX-2, OPG ↑ Interleukin-10 (IL-10) | [131] | ||
diabetic spinal cord | In vivo | STZ-induced rats | N/A | Improved diabetic spinal cord. | ↑ GFAP | [142] | ||
Black tea | T1DM | In vivo | Female CD-1 mice | 0.01% (w/v) | Promoted insulin secretion and regenerated damaged pancreas and protected pancreatic β- cells. | ↓ Nitrosative stressRUNX-2, OPG↓ ROS | [20] | |
Diabetes mellitus | In vivo | STZ-induced rats | 0.5 mL/day | Regenerated damaged pancreas and protected pancreatic β-cells. | ↓ Nitrosative stress | [143] | ||
T2DM | In vivo | STZ-induced rats | 0.01 mL/g/day | Ameliorated diabetes mellitus associated oxidative stress. | ↑ GSH | [144] | ||
Diabetic complication | In vivo | Diabetic animals | 50 mg/mL | Attenuated oxidative stress mediated tissue damage. | ↓ DNA fragmentation ↓ Activation of caspase-3 ↑ Oxidative stress related parameters | [108] | ||
Diabetic tissue injury | In vivo | Adult male Wistar albino rat | 50 and 100 mg/kg/day | Protected the liver | ↑ Cellular antioxidant capacity ↓ Membrane lipid peroxidation ↓ Oxidative stress | [17] | ||
EGC, GC, GCG | bone metabolism | In vitro | Cultured rat osteoblast-like osteosarcoma cell line UMR-106 | N/A | Improved bone metabolism | ↑ Osteoblast activity ↓ Osteoclast differentiation | [132] | |
White tea | T2DM | In vivo | Male Sprague-Dawley rats | 0.5% (w/v) | Lowered blood sugar levels. | ↑ Insulin sensitivity ↑ The synthesis of liver glycogen | [62] | |
Diabetic cardiovascular diseases | In vivo | Male Wistar rats | 0.01 mg/mL | Prevented cardiovascular diseases. | ↑ Insulin sensitivity ↑ Cardiac acetate and alanine contents and protein oxidation | [88] | ||
Diabetes mellitus | In vitro | human hepatocellular carcinoma (HepG2) cell | 25 mg/mL | Improved glucose and lipid metabolism. | ↓ Glucose uptake and transport | [145] | ||
Diabetic reproductive dysfunction | In vivo | STZ-induced prediabetic rat model | 10 mg/mL | Improved epididymal sperm motility and restored sperm viability. | ↓ GLUT3 protein ↑ Lactate dehydrogenase ↑ Lactate content. | [146] | ||
Dark tea | EGCG, ECG | Diabetes mellitus | In vitro | N/A | 50 mg/mL | Treated diabetes mellitus. | ↓ α-glucosidase | [65] |
TP,TPS | Diabetes mellitus | In vivo | Diabetic rats | 50 mg/kg | Reduced postprandial blood sugar. | ↓ α-glucosidase | [147] | |
Polysaccharides | T2DM | In vivo | Male ICR mice | 40 mg/kg | Lowered the blood glucose levels and reversed oxidative stress. | ↑ SOD activity ↑ Malondialdehyde contents ↑ GSH-Px | [148] | |
T2DM | In vivo | Male ICR mice | 1 and 5 mg/kg | Improved insulin resistance. | ↓ α-glucosidase Maintain α-amylase | [66] | ||
T2DM | In vitro In vivo | HepG2 cells db/db mice | 100, 200, and 400 mg/kg/day | Improved insulin resistance and maintained glucose homeostasis. | ↑ Glucose uptake ↓ Intestinal sucrase, maltase, and porcine pancreatic amylase activity | [5] | ||
T2DM | In vivo | Male Sprague−Dawley rats | 400 mg/kg/day | Alleviated insulin resistance and chronic kidney disease. | ↓ SIRP-α ↑ PI3K/Akt ↑ Nrf2 expression in kidney ↓ GSK-3β phosphorylation Activated Akt/GLUT4, FoxO1 and mTOR/S6k1 pathways | [69] | ||
diabetic nephropathy | In vivo | db/db mice and db/m mice | 1 g/kg/day | Attenuated the increases in urinary albumin, serum creatinine, and mesangial matrix. | ↓ AGEs ↓ Receptor for AGE expression in glomeruli ↓ Carbonyl compounds | [73] | ||
Onloog tea | Polysaccharide | diabetic tissue and kidney | In vivo | STZ-induced diabetic diabetic mice | 50, 100, and 200 mg/kg | Prevented diabetic tissue and kidney diseases. | ↑ SOD and GSH-PX activity ↓ MDA | [87] |
Polysaccharide | Diabetic immune disease | In vivo | STZ-induced diabetic mice | 100, 300, and 600 mg/kg in mice 50, 100, and 200 mg/kg in rats | Improved immunomodulatory function. | ↑ The activity of NK cellsIntensify DTH ↑ Phagocytotic function of peritoneal macrophage | [149] | |
Yellow tea | EGCGGCG | Diabetes mellitus | In vitro | N/A | 1% (w/v) | CGC reduced postprandial blood sugar more effectively. | ↓ α-glucosidase | [71] |
Diabetic complications | In vivo | db/db mice | N/A | Lowered the serum total and low-density lipoprotein cholesterol and triglyceride levels. Increased glucose tolerance. | ↓ The lipid synthesis ↓ SRET fator1, SREP 1 ↓ Acetyl-CoA carboxylase α, ↓ Fatty acid synthase | [15] | ||
Tea | EGCG | T1DM | In vitro | RINm5F cells | 20-40 uM | Protected pro-inflammatory cytokine and induced injuries in insulin-producing cells. | ↓ iNOS and NO | [47] |
T1DM | in vivo | C57BL/KsJ mice | 100 mg/kg/day | Protected pancreatic islets. | ↓ iNOS | [150] | ||
EGCG | T2DM | In vivo | Diabetic patients | 300, 600, and 900 mg/day | Decreased pathogenesis of proinflammation and improved diabetes mellitus. | ↓ Free radicals ↓ S100A12-RAGE axis by stimulating sRAGE | [57] | |
Catechins | T2DM | In vivo In vitro | Male obese KK-ay and C57BL/6J mice; 3T3-L1 adipocytes | 20 mg/kg/day | Decreased glucose levels and increased glucose tolerance in animals. | ↓ ROS ↓ JNK phosphorylation ↑ GLUT-4 translocation | [48] | |
EGCG | T2DM | In vitro | Human HepG2 cells | N/A | Attenuated insulin signaling blockade. | ↓ Phosphorylation of IRS-1 ↑ 5′AMPK | [52] | |
EGCG | T2DM | In vivo | Sprague-Dawley rats | 1-100 uM | Improved endothelial dysfunction and insulin resistance and protected against myocardial I/R injury. | ↑ NO via PI3k pathway ↑ Plasma adiponectin | [95] | |
diabetic nephropathy | In vivo | Diabetic SHR rats | 5.7 g/kg/day | Reduced podocyte apoptosis, foot process effacement and albuminuria. | ↓ GSK3-p53 ↑ LRP6 | [78] | ||
diabetic nephropathy | In vivo | STZ-induced diabetic rats | 5% (w/v) | Improved diabetic nephropathy. | ↓ MMP-9, TIMP-1 ↑ MMP-2 ,TIMP-2 | [83] | ||
diabetic nephropathy | In vivo | Male Sprague-Dawley rats | 0.25% and 0.5% (w/w) | Reduced renal oxidative damage and inflammatory reactions. | ↑ Activity of 5′-lipoxygenase ↓ Ieukotriene B-4 | [81] | ||
Catechins | diabetic nephropathy | In vivo | Sprague-Dawley rats | 0.25% and 0.5% (w/w) | Improved kidney function. | ↓ Thromboxane A(2) synthesis ↑ Prostacyclin synthesis | [151,152] |
Tea Types | Diseases Types | Study Types | Participants | Dose and Duration | Results | Ref. |
---|---|---|---|---|---|---|
Green tea | Diabetes mellitus | RCT | Patients with T2DM (N = 63) | 0, 2, 4 cups per day | ↓ Body weight, body mass index, waist circumference and systolic blood pressure. | [155] |
Green tea | Diabetes mellitus and diabetic nephropathy | RCT | Patients with diabetes mellitus (N = 60) | 2 capsules containing 1120 mg polyphenols per day for 20 weeks. | No significant effect on diabetes mellitus and diabetic nephropathy. | [158] |
Green tea | T2DM and diabetic cardiomyopathy | RCT | Subjects with T2DM and lipid abnormalities (N = 92) | 500 mg per day | ↓ Triglyceride ↑ High density lipoprotein cholesterol ↑ Glucagon-like peptide 1 in the therapeutic arm | [156] |
Green tea | Diabetic osteoporosis | RCT | Patients with diabetes mellitus (N = 35) | 1120 mg polyphenols per day | ↑ Bone mineral content ↓ PTH | [153] |
Green tea | Bone turnover induced by diabetes mellitus | RCT | Patients with T2DM (N = 72) | 500 mg per day | ↓ Fasting serum osteocalcin ↓ FBG ↓ HbA1C | [154] |
Black tea | T2DM and diabetic cardiovascular | N/A | Patients with T2DM (N = 46) | 150, 300, 450, and 600 mL black tea during the weeks 1, 2, 3 and 4. | ↓ Serum malondialdehyde ↓ Serum C-reactive protein ↑ Glutathione | [58] |
Oolong tea | T2DM | N/A | Patients with T2DM | 1500 mL per day | ↓ Concentrations of plasma glucose and fructosamine | [73] |
Green and black tea | T2DM | RCT | White persons (N = 49) | 0, 375, or 750 mg per day for 3 months | No significant effect on T2DM. | [159] |
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Meng, J.-M.; Cao, S.-Y.; Wei, X.-L.; Gan, R.-Y.; Wang, Y.-F.; Cai, S.-X.; Xu, X.-Y.; Zhang, P.-Z.; Li, H.-B. Effects and Mechanisms of Tea for the Prevention and Management of Diabetes Mellitus and Diabetic Complications: An Updated Review. Antioxidants 2019, 8, 170. https://doi.org/10.3390/antiox8060170
Meng J-M, Cao S-Y, Wei X-L, Gan R-Y, Wang Y-F, Cai S-X, Xu X-Y, Zhang P-Z, Li H-B. Effects and Mechanisms of Tea for the Prevention and Management of Diabetes Mellitus and Diabetic Complications: An Updated Review. Antioxidants. 2019; 8(6):170. https://doi.org/10.3390/antiox8060170
Chicago/Turabian StyleMeng, Jin-Ming, Shi-Yu Cao, Xin-Lin Wei, Ren-You Gan, Yuan-Feng Wang, Shu-Xian Cai, Xiao-Yu Xu, Pang-Zhen Zhang, and Hua-Bin Li. 2019. "Effects and Mechanisms of Tea for the Prevention and Management of Diabetes Mellitus and Diabetic Complications: An Updated Review" Antioxidants 8, no. 6: 170. https://doi.org/10.3390/antiox8060170