Today we bring you a very interesting study that has been carried out by joining collaborations from two universities, one from the United States and the other from Singapore, with the help of other study centers from countries such as Brazil, Malaysia and the United Kingdom.

The idea behind the research we set out to analyze was to learn about the postprandial metabolic effects of glucose when affected by mulberry leaf extract in people with type 2 diabetes.
The supplement studied included, in addition to the mulberry leaf extract, other bioactive ingredients such as vitamin D, chromium and fiber.

The context

People with type 2 diabetes, or who are overweight or obese often have impaired postprandial glycemic regulation, attributed to insulin resistance, beta cell dysfunction, or both. Reduction of postprandial hyperglycemia and glucose variations are important for the overall management of patients.
This has implications for symptomatic regulation and long-term vascular risk.

Most health care professionals agree that the first step in treating type 2 diabetes is to address lifestyle factors.
This includes an evaluation of how to make the combination of diet and exercise as efficient as possible.

However, even though most diets that reduce caloric intake would have an impact on sugar levels in the body, no specific nutritional intervention is typically recommended.
And the options are at the mercy of disparate factors that exclusively involve patients, such as the monetary cost of the diet, individual preferences for meals, the availability of food – either by geographical location or seasonality – and scientific evidence.

The importance of lowering postprandial glucose

In addition to an overall reduction in caloric intake or a specific reduction in carbohydrates, there are several natural dietary adjuvants that can help reduce the impact of carbohydrates, thus helping to improve postprandial glucose metabolism.

The nutritional principles by which the glycemic impact of dietary carbohydrates can be reduced in general fall into four main categories:

1. Reducing the amount of carbohydrates available for digestion, which usually involves an overall reduction in caloric intake, or switching to a low-carb diet.
2. Reduce the rate of carbohydrate digestionor, which could be achieved, for example, by substituting or combining fast-absorbing carbohydrates with slow-digesting carbohydrates or starch, or other food matrices that make carbohydrates less accessible, or by intervening in the gut microbiota (e.g., certain types of dietary fiber.
3. Reducing the rate of glucose absorption, which, for example, could be achieved by increasing intestinal transit time by combining it with fiber or adding natural products that have an inhibitory effect on the enzymes involved in carbohydrate cleavage.
4. Increase the rate of glucose removal from the blood, which could be done by pre-ingestion or with food of products that stimulate incretin and/or insulin response (e.g.
   e.g., whey proteins or proteins that improve insulin sensitivity and reduce insulin resistance.

The study in question

In order to test whether there is a supplement that helps type 2 diabetic patients reduce postprandial hyperglycemia and glucose variations after meals to obtain general glycemic control, the following study was designed: https://doi.org/10.1007/s13300-023-01379-4

In order to implement it, a food supplement containing 250 mg of mulberry leaf extract corresponding to 12.5 mg of 1-deoxynojirimycin was formulated and combined with 1.75 g of fiber, 0.75 μg vitamin D and 75 μg chromium.
At the same time, a very similar supplement was developed, but without the extract and with the same characteristics and bioactive additives.
The preparation was designed to sprinkle on meals.

Mulberry leaf extract contains iminosugar alkaloids (i.e., sugar analogues), of which 1-deoxynojirimycin (DNJ) is the most abundant and is structurally similar to glucose.

This substance competitively blocks the active site of polysaccharide-degrading enzymes in the digestive tract (i.e., a-glucosidases, such as sucrase and maltase), thereby reducing enzyme digestion and subsequent absorption of carbohydrates in the diet.

To carry it out, 30 people from Asian countries with type 2 diabetes were recruited.
The mean age was 59 years.
In these patients, glycosylated hemoglobin levels were 7.1% on average and body mass index was 26.5 kg/m2.

To test the hypothesis, two standardized breakfasts were prepared, each containing a caloric value of 350 kcal and consisting of two slices of white bread, two slices of gouda cheese (20 grams) and 250 ml of apple juice.
In this way, 10 grams of protein, 6.5 grams of fat and 55.4 grams of carbohydrates were provided, which constitutes a high-carbohydrate meal.
In one of the breakfasts, 2 grams of the supplement were sprinkled with mulberry leaf extract and on the other, the similar mixture without the extract.

As part of the assessment, postprandial glycemia (primary exploratory endpoint), insulin, and incretin hormones (GLP-1, GIP) were measured in blood samples.
Changes in incremental areas under the concentration curve (iAUC) and peak concentrations (Cmax) were compared.

The result was that the mixture based on the mulberry leaf extract relative to the mixture without the extract significantly reduced glucose iAUC. Post-meal blood sugar spikes were reduced by 15% to 20% over a total observation period that was three hours. Therefore, a mixture based on mulberry leaf extract, which is also a source of fiber, vitamin D, and chromium, can represent a convenient dietary support to improve sugar levels after a meal.

Conclusion

These results are interesting from several perspectives.
Not only do they expand the relatively limited prior knowledge base on the effects of mulberry leaf extract, but they also add to the literature that this principle supports obtaining healthy glucose levels.

In addition, this substance works even in the context of taking it with a mixed meal, specifically breakfast, which is identified as perhaps the most important meal in regulating daytime glucose levels in people with or without type 2 diabetes.

These data also confirm that the predominant mode of action of the aforementioned extract is through the reduction of the rate of glucose absorption, underscored by reductions in iAUC and Cmax of glucose, and a reduction in early insulin response, with no notable effects, as also reported by others, on insulin sensitivity GLP-1 or GE.

Thus, the results obtained support the use of a natural mixture of 2 grams of mulberry leaf extract, fiber, vitamin D and chromium in type 2 diabetes as a convenient dietary adjuvant to improve the postprandial glycometabolic response.