Melatonin: new insights on its therapeutic properties in dia
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Diabetes mellitus (DM), a frequent life-threatening metabolic disorder worldwide, is characterized by hyperglycemia caused by either insulin resistance or declined insulin secretion. In the last decades, the incidence of diabetes mellitus has been enhancing. This disease has been one of the leading cause of death worldwide, and the International Diabetes Mellitus Federation estimated that 592 million people will suffer from diabetes mellitus by the year 2035. Several investigations have indicated that diabetes mellitus, could mediate various complications, including diabetic cardiovascular complications, diabetic neuropathy, retinopathy, nephropathy and liver complications, which have been the main causes of its mortality and morbidity. Thus, it is essential to search for efficient methods for the management and prevention of diabetes mellitus and its complications.

The impact of pineal hormone on insulin secretion, carbohydrate metabolism and blood glucose has been recently demonstrated. Melatonin (N-acetyl-5-methoxytryptamine), a tryptophan-derived endocrine agent, is mainly synthetized by the pineal gland and locally by numerous other tissues. Despite the higher insulin levels in diabetic subjects, diabetes mellitus is accompanied by lower serum concentrations of melatonin in diabetic subjects. Furthermore, melatonin functions as an anti-aging, anti-inflammatory, antioxidant as well as antihypertensive agent.

Preclinical and clinical studies have shown different mechanisms of action of melatonin including reduction of glucose production, and improvement of pro-inflammatory pathways as well as oxidative stress state in DM patients. Previously, it has been revealed that melatonin treatment ameliorates DM through regulating the lipid and glucose metabolism, reducing the insulin resistance and increasing the sensitivity to insulin in experimental models of DM. It will be crucial to perform human clinical trials utilizing combinations of melatonin with current therapeutic agents for treatment and prevention of cardiomyopathy, neuropathy, retinopathy, nephropathy, and other diabetic complications.

Source: https://dmsjournal.biomedcentral.com/articles/10.1186/s13098-020-00537-z
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