Berberis vulgaris in the treatment of insulin resistance

Metabolic syndrome, also known as syndrome X; It is a health problem that is frequently encountered as a result of the spread of obesity in the society and causes the occurrence of chronic diseases such as diabetes, cardiovascular diseases and hypertension that significantly affect health. It develops on the basis of metabolic deterioration, also called insulin resistance, and occurs with the addition of parameters such as abdominal obesity, high blood pressure, and increased blood cholesterol.

Currently, heart diseases and diabetes are the leading causes of death in the society. For this reason, it is very important for public health to prevent the occurrence of these disorders and to treat them effectively. Prevention or treatment of metabolic syndrome depends on effective fight against insulin resistance. In order to realize this struggle, it is necessary to find an answer to the question of “what is insulin resistance.”

What is insulin resistance?

To understand insulin resistance well, it is necessary to know the function of insulin. Insulin hormone is a hormone secreted from the pancreas into the blood in our body and plays a fundamental role in the regulation of all metabolic events, especially blood sugar. Especially in cases where blood sugar is elevated, its secretion increases and ensures that blood sugar remains within normal limits.

In some cases, the function of the cells taking blood sugar from the blood in response to the insulin hormone decreases. In this case, the pancreas starts producing more insulin than normal to lower blood sugar. This condition is called insulin resistance. In other words, cells cannot lower blood sugar by resisting existing insulin.

What causes insulin resistance?

The mechanism by which insulin resistance occurs is biologically quite complex and associated with a wide variety of causes. However, the development of insulin resistance is directly related to the metabolism of fat and cholesterol in the body and the presence of obesity. While the insulin hormone lowers blood sugar, it increases fat synthesis. In connection with obesity, the ability of insulin to lower blood sugar begins to decrease in proportion to the increase in the amount of fat in the blood.
Similarly, the development of hypertension can be observed because the pressure in the blood vessels increases due to the excess weight and the amount of fat. Insulin resistance, obesity, high blood fat and cholesterol, and hypertension are all called metabolic syndrome.
In this sense, health problems that can cause insulin resistance can be listed as follows:

  • Obesity
  • High calorie, high carbohydrate, high sugar diet
  • Low physical activity (sedentary) lifestyle.
  • Taking steroid-containing medication for a long period of time.
  • Various endocrinological disorders such as Cushing's disease, polycystic ovary syndrome.

If insulin resistance is not treated, blood sugar regulation mechanisms are completely disrupted, insulin production decreases and diabetes occurs. Likewise, cardiovascular diseases may occur due to high fat content and hypertension. (1)

What are the symptoms of insulin resistance?

Usually, insulin resistance does not show any clinical symptoms. According to the data obtained during routine blood tests, insulin resistance can be mentioned. However, since insulin resistance is related to the inability to use the blood sugar present in the blood effectively and efficiently, the clinical symptoms are also related to this condition and other components of the metabolic syndrome. (2)

Weight gain and obesity: As a result of the increase in the amount of insulin, fat production also increases and abdominal obesity occurs, especially due to the increase in fat around the waist. In this sense, > 94 cm in men,> 80 cm in women or a body-mass index> 30 kg / m2 indicates insulin resistance.

  • High blood cholesterol: Especially with LDL cholesterol called "low density lipoprotein cholesterol", total cholesterol and triglyceride values increase. Related to this, a decrease is observed in the level of "high density lipoprotein" cholesterol (HDL cholesterol), which is also known as "good cholesterol" in the society.
  • Feeling hungry or eating too much: The body starts to produce more insulin so that blood sugar can be lowered. In addition, as the cells' intake of blood sugar from the blood is also impaired, a feeling of hunger occurs and the need to eat more may be felt.
  • High blood pressure: Hypertension may develop in proportion to the increase in the amount of fat. Accordingly, it is significant that systolic blood pressure is> 130 mmHg; It is significant that diastolic blood pressure is> 85 mmHg.
  • Fasting and postprandial blood sugar: In insulin resistance, blood sugar is observed to be higher than normal, although it is not at the level of diabetes. In this sense, it is significant that fasting blood glucose is> 100 mg / dl.
  • Fatigue and decrease in concentration: The metabolism of muscle and nerve tissues is disrupted due to high blood sugar.
  • Color changes in the skin: The color changes seen in the folds of the skin, called acanthosis nigricans, may indicate insulin resistance.

What is done to treat insulin resistance?

In order to correct insulin resistance, it is important to solve the basic problem in the mechanism of its occurrence. This is due to lowering blood sugar and regulation of fat metabolism. In this sense, today's approach to the solution of insulin resistance is as follows:
The patient is advised to make some changes in his daily lifestyle. Accordingly, it is recommended to avoid unnecessary and excessive carbohydrate consumption by recommending a healthy and balanced diet.

It is recommended to increase daily physical activity and to do regular sports.

It is requested to quit smoking and alcohol.

Studies for weight loss are planned. In this sense, special dietitian programs and exercises can be prepared.

Oral antidiabetic drugs are often used to correct insulin resistance. Among these, drugs containing metformin are particularly preferred. Metformin contributes to the reduction of insulin resistance by suppressing various biological mechanisms that increase blood sugar and helps regulate fat metabolism. Since insulin resistance causes diabetes when not treated, initiation of metformin at this stage is effective in preventing and treating diabetes.

Berberis vulgaris as a treatment method for insulin resistance

Nowadays, alternative treatment methods apart from the above methods are getting more and more important. One of the prominent ones among these is the use of berberis vulgaris. Berberis vulgaris; It is a type of shrub with yellow or orange leaves. As a result of the studies, it has been determined that thanks to the substance called berberine in its structure, it reduces blood sugar by interacting with various biological substances in metabolic pathways, regulating fat metabolism and helping to lose weight.

In this sense, it has been determined by the researches that berberis vulgaris has the following effects:

  • It increases the blood sugar lowering effect of insulin by lowering insulin resistance. (3)
  • It improves the body's ability to use blood sugar, called glycolysis.
  • It reduces blood sugar production in the liver. (3)
  • It slows down the breakdown of carbohydrates in the intestines.
  • It increases the number of beneficial bacteria in the intestines.
  • It is also effective in the treatment of diabetes by reducing the values important in the follow-up of diabetes such as hemoglobin A1c. (4)
  • It helps to reduce cholesterol and triglyceride levels. (4)

Thanks to these properties, Berberis vulgaris is compared to the drug metformin, which is frequently used in the treatment of insulin resistance in recent years. Studies have shown that the therapeutic effect of berberine against insulin resistance is as strong as antidiabetic drugs such as metformin, glipizide and rosiglitazone. (5)

The use of berberine has been found to be very effective in returning blood sugar to normal with lifestyle changes. (6)

There are studies showing that berberis vulgaris improves insulin resistance by helping to lose weight in its regular and long-term use. (7) In the study, the body mass index of obese people who took 300 mg of berberine three times a day decreased from 31.5 to 27.4 at the end of 12 weeks and improvements in health parameters were found.

It has also been shown that berberine can be protective against heart diseases as well as insulin resistance, as it reduces cholesterol levels in the blood. (8)

In addition to all these features, studies have been conducted on the possible side effects of berberine. It has not been found to cause any serious side effects. (9) Reported side effects are often related to the digestive system, especially abdominal pain, bloating, constipation and diarrhea.
Compared to these, besides the effects of metformin in the treatment of insulin resistance, it may cause life-threatening side effects such as hypoglycemia and lactic acidosis. It also has effects that reduce the quality of life such as vitamin B12 deficiency and various digestive problems. Being easily accessible due to the low cost of berberine is another advantage over metformin.

Considering all these, the use of berberis vulgaris emerges as an important alternative in terms of insulin resistance treatment and a healthy life, and offers a method that is as effective as the metformin therapy, which is frequently used today.

References

(1) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878431/

(2) https://www.webmd.com/diabetes/insulin-resistance-syndrome#:~:text=Insulin%20resistance%20is%20when%20cells,blood%20sugar%20levels%20go%20up.

(3) https://www.ncbi.nlm.nih.gov/pubmed/25861268

(4) https://www.ncbi.nlm.nih.gov/pubmed/18397984

(5) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3478874/

(6) https://www.ncbi.nlm.nih.gov/pubmed/25498346

(7) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3310165/

(8) https://www.ncbi.nlm.nih.gov/pubmed/23512497

(9) https://www.ncbi.nlm.nih.gov/pubmed/18442638

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