The role of triterpenes in the management of diabetes mellitus and its complications

Diabetes mellitus is a chronic metabolic disease which is a serious global problem. In 2010 an estimated 285 million people had diabetes and within the next 20 years this value is expected to almost double. Many antidiabetic therapies focus on improving insulin sensitivity, increasing insulin production, and/or decreasing the level of blood glucose. Although a number of synthetic medicines are available, drugs of natural origin have aroused great interest. Triterpenes seem to demonstrate adequate properties. Many experiments have shown that these compounds have several antidiabetic mechanisms. They can inhibit enzymes involved in glucose metabolism, prevent the development of insulin resistance and normalize plasma glucose and insulin levels. These natural compounds, in contrast to synthetic drugs, apart from producing a hypoglycemic effect have also been found to manifest hypolipidemic and anti-obesity activity. Triterpenes are also promising agents in the prevention of diabetic complications. They have strong antioxidant activity and inhibit the formation of advanced glycation end products, implicated in the pathogenesis of diabetic nephropathy, embryopathy, neuropathy or impaired wound healing. Until now very few clinical studies have been concerned with the application of triterpenes in treating diabetes. However, due to their great therapeutic potential, these compounds deserve special attention.