Food supplements for type 2 diabetics
DOI:
https://doi.org/10.26481/marble.2014.v2.305Abstract
With more than 382 million patients being diagnosed with type 2 diabetes and even more unknowingly suffering of diabetes and pre-diabetes, health burden will continue to grow. Diabetes is a chronic disease, characterized by an unbalanced glucose metabolism. Insulin resistance, inhibited insulin production and rising glucose levels are on the onset of diabetes type 2. The major complications occurring in diabetics are cardiovascular disease, diabetic nephropathy, diabetic retinopathy and cognitive decline resulting in depressions and loss of memory. The pathophysiology of the complications show similarities. High glucose concentrations lead to oxidative stress and endothelial dysfunction, which is amplified by the formation of advanced glycation products. Endothelial dysfunction increases a bunch of intracellular cascades resulting in the onset of inflammation, vasoconstriction, cell expansion and thrombosis. This bachelor thesis hands a solution to prevent or delay the onset of these major diabetes complications by the design of a range of food supplements, especially for diabetics. Every major complication is linked to an own food supplement. Methods. The active ingredients were chosen based on the pathophysiology of both diabetes type 2 and the complication (part 1). When the active ingredients were chosen, the excipients were discussed; a body, lubricants, moisture scavengers, firmness agents and binding agent are used to make the supplement manufacturable. To test if the excipients were added in the right amount and proportions, several tests were done. These tests include a friability test, a disintegration test and a hardness test (part 2). Results. The active ingredients include polyphenols, vitamins, plant extracts, herbs and minerals. All supplements resulted in the acceptable ranges set for every test, contain at least one health claim and are supported by scientific evidence. Discussion. When selecting the ingredients, several requirements were taken into account; every product should contain at least one related health claim and should be supported by scientific evidence, also affordability is taken into account. Based on these requirements, some ingredients have been rejected. Points of discussion of these nutritional supplements are the bioavailability and interactions of some of the ingredients, such as polyphenols. Thereby, size of the tablet and quality of the used herbal extracts are points of improvements. Conclusion. The food supplement range has reached the three most important requirements: scientific evidence, health claim and manufacturability. The range is ready for production.References
International Diabetes Federation. The IDF Diabetes Atlas Brussels2013. 5th [Available from: http://www.idf. org/diabetesatlas/data-visualisations.
Volksgezondheid Toekomst Verkenning. Nationaal Kompas Volksgezondheid Bilthoven, NL2014. 4.17:[Available from: http://www.nationaalkompas.nl/.
Williams textbook of endocrinology. 12th ed. Philadelphia: Elsevier/Saunders.
Shoback. Greenspan’s basic & clinical endocrinology 9th ed. New York: McGraw-Hill Medical2011.
Oguntibeju OO. Pathophysiology and Complications of Diabetes Mellitus: InTech; 2012. 136 p.
Folli F, Corradi D, Fanti P, Davalli A, Paez A, Giaccari A, et al. The Role of Oxidative Stress in the Pathogenesis of Type 2 Diabetes Mellitus Micro- and Macrovascular Complications: Avenues for a Mechanistic-Based Therapeutic Approach. Current Diabetes Reviews. 2011 //;7(5):313-24.
Dutch Diabetes Federation. Voedingsrichtlijn voor diabetes type 1 en 2 mersfoort2010. Available from: http:// www.apotheekkennisbank.nl/sites/default/files/content/link/uploads/NDF-Voedingsrichtlijn2010.pdf.
Koga M, Kasayama S. Clinical impact of glycated albumin as another glycemic control marker. Endocrine journal. 2010;57(9):751-62. PubMed PMID: 20724796. Epub 2010/08/21. eng.
Puddu A, Viviani GL. Advanced glycation endproducts and diabetes. Beyond vascular complications. Endocrine, metabolic & immune disorders drug targets. 2011 Jun;11(2):132-40. PubMed PMID: 21476962. Epub 2011/04/12. eng.
EU Register on Nutrition and health claims [Internet]. [cited 14 April 2014]. Available from: http://ec.europa. eu/nuhclaims/?event=search&CFID=1163301&CFTOKEN=70fb753c637cfc2a-FB40E170-C862-CE5F- 8431281B61519C9F&jsessionid=9212356a9ca37d8e894c50162e7b5b177fb4TR.
Council EPat. C1 Regulation (EC) No. 1924/2006 on nutrition and health claims made on foods 2006. Available from: http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=CONSLEG:2006R1924:20080304:EN:PDF.
EU. COMMISSION DIRECTIVE 2008/100/EC 2008. Directives on nutritional labelling for foodstuffs as regards recommeded daily allowances, energy conversion factors and definitions]. Available from: http://eur-lex. europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:285:0009:0012:EN:PDF.
Holst B, Williamson G. Nutrients and phytochemicals: from bioavailability to bioefficacy beyond antioxidants. Current opinion in biotechnology. 2008;19(2):73-82.
Linde K, Mulrow C, Berner M, Egger M. St John’s wort for depression. The Cochrane Library. 2005.
Schilter B, Andersson C, Anton R, Constable A, Kleiner J, O’Brien J, et al. Guidance for the safety assessment of botanicals and botanical preparations for use in food and food supplements. Food and Chemical Toxicology. 2003;41(12):1625-49.
Meneilly GS, Tessier D. Diabetes in elderly adults. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2001;56(1):M5-M13.
Schindler JS, Kelly JH. Swallowing disorders in the elderly. The Laryngoscope. 2002;112(4):589-602.