Musabayane C T
Department of Human Physiology, Faculty of Medicine, University of KwaZulu-Natal, Durban, South Africa.
Cardiovasc J Afr. 2012 Sep;23(8):462-8. doi: 10.5830/CVJA-2012-025.
Diabetes mellitus is one of the most common chronic global diseases affecting children and adolescents in both the developed and developing nations. The major types of diabetes mellitus are type 1 and type 2, the former arising from inadequate production of insulin due to pancreatic β-cell dysfunction, and the latter from reduced sensitivity to insulin in the target tissues and/or inadequate insulin secretion. Sustained hyperglycaemia is a common result of uncontrolled diabetes and, over time, can damage the heart, eyes, kidneys and nerves, mainly through deteriorating blood vessels supplying the organs. Microvascular (retinopathy and nephropathy) and macrovascular (atherosclerotic) disorders are the leading causes of morbidity and mortality in diabetic patients. Therefore, emphasis on diabetes care and management is on optimal blood glucose control to avert these adverse outcomes. Studies have demonstrated that diabetic nephropathy is associated with increased cardiovascular mortality. In general, about one in three patients with diabetes develops end-stage renal disease (ESRD) which proceeds to diabetic nephropathy (DN), the principal cause of significant morbidity and mortality in diabetes. Hypertension, a well-established major risk factor for cardiovascular disease contributes to ESRD in diabetes. Clinical evidence suggests that there is no effective treatment for diabetic nephropathy and prevention of the progression of diabetic nephropathy. However, biomedical evidence indicates that some plant extracts have beneficial effects on certain processes associated with reduced renal function in diabetes mellitus. On the other hand, other plant extracts may be hazardous in diabetes, as reports indicate impairment of renal function. This article outlines therapeutic and pharmacological evidence supporting the potential of some medicinal plants to control or compensate for diabetes-associated complications, with particular emphasis on kidney function and hypertension.
糖尿病是影响发达国家和发展中国家儿童及青少年的最常见慢性全球性疾病之一。糖尿病的主要类型为1型和2型，前者是由于胰腺β细胞功能障碍导致胰岛素分泌不足引起的，后者则是由于靶组织对胰岛素的敏感性降低和/或胰岛素分泌不足所致。持续性高血糖是糖尿病控制不佳的常见结果，随着时间的推移，主要通过损害供应器官的血管，可损害心脏、眼睛、肾脏和神经。微血管（视网膜病变和肾病）和大血管（动脉粥样硬化）疾病是糖尿病患者发病和死亡的主要原因。因此，糖尿病护理和管理的重点是优化血糖控制以避免这些不良后果。研究表明，糖尿病肾病与心血管死亡率增加有关。一般来说，约三分之一的糖尿病患者会发展为终末期肾病（ESRD），进而发展为糖尿病肾病（DN），这是糖尿病患者发病和死亡的主要原因。高血压是心血管疾病公认的主要危险因素，它会导致糖尿病患者发生ESRD。临床证据表明，糖尿病肾病没有有效的治疗方法，也无法预防糖尿病肾病的进展。然而，生物医学证据表明，一些植物提取物对糖尿病中与肾功能降低相关的某些过程具有有益作用。另一方面，其他植物提取物在糖尿病中可能是有害的，因为有报告表明其会损害肾功能。本文概述了支持某些药用植物控制或补偿糖尿病相关并发症潜力的治疗和药理学证据，特别强调了肾功能和高血压。
