12 Jun 2017 --- Affecting approximately 380 million people worldwide, diabetes is a leading cause of range of ailments, including kidney failure, amputations, cardiovascular diseases and stroke. According to the Diabetes Research Institute, diabetes takes more lives on a yearly basis than AIDS and breast cancer combined. NutritionInsight looks at some of the most recent diabetes-related research and some of the novel approaches and solutions to tackling this condition.

In combination with classic medical interventions, a balanced diet and sufficient exercise remain key in controlling (the symptoms of) diabetes. However, there appear to be growing opportunities and scientific foundations for the development of food products and nutritional supplements targeting this disease.

Probiotics and Microbiome
The association between the gut microbiome, diabetes and probiotics has been the topic of a number of studies over the past months.

A study from the University of Otago, Wellington and the University of Auckland has looked at how a naturally occurring probiotic reduces the risk of developing diabetes during pregnancy and lowers fasting blood sugar and found that it may reduce the risk of gestational diabetes by nearly 70 percent. Moreover, researchers from the University of Eastern Finland found that a high concentration of indolepropionic acid protects against type 2 diabetes. Indolepropionic acid is a metabolite produced by intestinal bacteria, and its production is boosted by a fiber-rich diet, again pointing to the importance of a healthy diet, but also potentially opening up opportunities for the development of fiber supplementation suitable for patients with diabetes.

Meanwhile, a recent study at Sahlgrenska Academy and the University of Girona indicates that the clinical effect of metformin is achieved through modulation of the gut microbiota, providing a clearer picture of how the classic diabetes medication works. Metformin is the cornerstone treatment of type 2 diabetes, its main effects are improved insulin sensitivity and decreased hepatic glucose output. The lead author of this study, Professor of Molecular Medicine Fredrik Bäckhed, had previously shown that the gut microbiota is altered in patients with type 2 diabetes and after bariatric surgery. By conducting a clinical study in patients with new onset diabetes, the group could clarify how the gut microbiome is affected by metformin.

Through experiments in the laboratory, the researchers demonstrated that metformin increases the growth of several bacterial species that are linked to improved metabolism.

“Imagine if we can change the intestinal flora in the future so that more people respond to treatment, and that adverse events can be reduced by changing the gut microbiota of patients who will take metformin,” notes Prof. Bäckhed.

Natural Ingredients in the Spotlight
A number of naturally produced ingredients are receiving attention for their potential anti-diabetic effects, including resveratrol, macroalgae and curcumin.

Resveratrol
Resveratrol is an antioxidant that is found in the skin of red grapes, as well as in red wine, peanuts and some berries.

“Research presented at the American Heart Association's Arteriosclerosis, Thrombosis and Vascular Biology and Peripheral Vascular Disease 2017 Scientific Sessions in Minnesota has examined the effect of resveratrol on artery stiffness in people with diabetes. It found that resveratrol reduces arterial stiffness. The fact that The National Heart, Lung, and Blood Institute and the National Center for Complementary and Integrative Health in the US funded this study looking at resveratrol supplementation and diabetes indicates the real potential of resveratrol in becoming a valuable part of the treatment and prevention of type 2 diabetes,” Clare Panchoo, Sales and Marketing Manager EMEA (Nutrition) at Evolva, tells NutritionInsight.

“For healthy older populations, a resveratrol supplement could help to maintain healthy blood flow, reduce artery stiffness and so reduce pre-diabetic risk factors. Clinical evidence suggests that resveratrol influences multiple pathways involved in energy metabolism and may particularly mimic the effect of a calorie-restricted diet,” Panchoo adds.

Pointing to a growing body of studies on resveratrol conducted using patients with type 2 diabetes, Panchoo says resveratrol supplementation may reverse the blood vessel abnormalities (artery stiffness) that occur with aging and are more pronounced in people with type 2 diabetes, improve insulin sensitivity, reduce post-meal peak plasma glucose levels and reduce fasting blood glucose levels.

Seaweed
“The currently understood anti-diabetic effects of seaweed are attributed to a class of bioactive compounds called ‘polyphenols.’ Of the three seaweed varieties (brown, red and green), brown seaweeds contain the highest levels of polyphenols,” Marinova’s Claire Smoorenburg tells NutritionInsight.

“Polyphenols are protective compounds found in seaweed that help defend against environmental stresses such as UV and pathogens,” Dr. Fitton, Chief Scientist at Marinova, explains to NutritionInsight, adding that “seaweed extracts are increasingly becoming valued as a functional food ingredient, as evidence continues to emerge about their bioactivity and potential health benefits. Marinova is undertaking extensive research to investigate the effects of our fucoidan extracts in managing diabetes and other chronic diseases.”

According to research by Murray et al., polyphenols from marine macroalgae have shown many positive health-related effects, with evidence for the anti-hyperglycaemic, anti-hyperlipidaemic, anti-inflammatory and antioxidant effects of marine polyphenols found in cell and animal models.

Meanwhile, a separate study by Lopes et al (2017) has indicated that “Phlorotannins [a type of polyphenol] are not only promising in avoiding hyperglycaemia, through their extraordinary capacity to inhibit glucose absorption, but are also capable of treating diabetes-associated disorders through their capacity of protecting cells from glucose-induced toxicity, in diagnosed DMT2 individuals. To date, the in vivo studies available are a clear evidence of phlorotannins capacity to invert a situation of cell death triggered by high glucose levels.”

Curcumin
Another ingredient praised for its potential to alleviate diabetic symptoms is the currently “trending” curcumin, which is the subject of a range of studies pointing to its anti-inflammatory and digestive properties, among others. A number of studies have underlined curcumin’s potential to help alleviate symptoms of type 2 diabetes as well as to delay development of type 2 diabetes in the prediabetic population.

The beneficial properties of curcumin have led to high demand from the nutraceutical industry for the production of dietary and herbal supplements. With a range of new product launches and studies into its efficacy, turmeric stood out at Vitafoods Europe as an ingredient to watch out for in the coming months.

Taking an Active Approach
Considering the rising numbers of people diagnosed with diabetes, it is not surprising that researchers, consumers and suppliers are looking into different approaches and ingredients to prevent and manage these conditions.

From the food and beverage supplier side, growth continues to be sporadic for new product launches tracked with a diabetic positioning. According to global product launch data tracked by Innova Market Insights, there was a +16% increase in product launch activity in 2016 from 2015. The leading market sub-categories with a diabetic positioning in 2016 were sugar & sweeteners, accounting for 13% of product launches tracked, followed by sports powders (8%) and sweet spreads (5%).

In addition, manufacturers often broaden product appeal to a wider range of consumers with general “blood sugar control” claims without reference to diabetics or the disease itself. NutritionInsight currently features an overview of a range of new products with a diabetic positioning.

With consumers closely scrutinizing product labels and increasingly demanding what are deemed as natural and sustainable ingredients and dietary solutions, a range of options is opening up for suppliers to come up with nutritional aids to address the needs of diabetic and pre-diabetic populations.