The Efficacy of Spirulina Supplementation on Diabetes

Version	Summary	Created by	Modification	Content Size	Created at	Operation
1		Valeria Prete	--	2432	2024-02-27 12:40:14	\|
2	format correct	Wendy Huang	Meta information modification	2432	2024-02-29 08:46:20	\|

The Efficacy of Spirulina Supplementation on Diabetes

This entry is adapted from the peer-reviewed paper 10.3390/nu16050642

As a result of rising mortality rates due to cardiovascular diseases (CVDs), there has been a growing urgency to find alternative approaches to conventional pharmaceutical treatment to prevent the onset of chronic diseases. Arthrospira platensis, commonly known as Spirulina, is a blue-green cyanobacterium, classified as a “superfood”, used worldwide as a nutraceutical food supplement due to its remarkable nutritional value, lack of toxicity, and therapeutic effects. Many research studies have demonstrated that Spirulina has therapeutic functions such as antioxidant, anti-inflammatory, hypolipidemic, antidiabetic, and brain-protective properties.

Spirulina supplementation diabetes blood glucose level antioxidant metformin

1. Introduction

Arthrospira platensis is a photosynthetic, microscopic filamentous blue-green microalga classified as a cyanobacterium belonging to the Microcoleaceae family ^[1]. A. maxima and A. platensis, commonly known as “Spirulina”, are the two most studied species for their considerable nutritional and therapeutic properties. Spirulina inhabits tropical regions, particularly alkaline lakes with a pH 11 and a high concentration of carbonate and bicarbonate salts. Additionally, these algae can survive in extreme environments, such as the frozen lakes of Antarctica ^[2]^[3]. These microorganisms were first discovered in Lake Texcoco in Mexico. The Aztecs were among the first to incorporate this microalga into their diet, particularly in the creation of a blue-green cake known as “tecuitlatl”, as unearthed by the Spanish army during their conquest of Mexico ^[4]. Since ancient times, Spirulina has been utilized for its beneficial characteristics. Today, Spirulina is still used in a wide range of applications. In recent decades, it has garnered the classification of a “superfood” because of its copious protein content (60–70% by dry weight) as well as its abundance of carbohydrates, essential fatty acids, vitamins, minerals, and pigments like carotenes, chlorophyll a, and phycocyanin ^[5]. Because of its impressive nutritional value, is widely utilized in both the food and pharmaceutical fields. In the food industry, Spirulina is used as a nutraceutical food supplement, added to foods such as baked goods, beverages, dairy products, sports supplements, and baby food ^[6]. On the other hand, the pharmaceutical sector has produced tablets, dehydrated powders or encapsulated forms, which are marketed as “nutraceuticals” ^[7].

As a consequence of the considerable market demand for Spirulina products, S. platensis has been classified as generally recognized as safe (GRAS) by the Food and Drug Administration (FDA) ^[8]. Many research studies have demonstrated that Spirulina has therapeutic functions such as antioxidant, anti-inflammatory, hypolipidemic, antidiabetic, and brain-protective properties ^[9]^[10]^[11]. Remarkably, the abundant presence of natural pigments endows Spirulina with antioxidant potential, notably carotenoids and C-phycocyanin ^[12]^[13]. Several research investigations indicated that β-carotene, diadinoxanthin, diatoxanthin, and C-phycocyanin exhibited very high scavenging activity ^[14]^[15]. Thanks to its antioxidant properties, this microalga is considered beneficial in preventing cardiovascular diseases ^[11]. Today, CVDs are the main cause of death globally ^[16]. Therefore, drug therapies used today to prevent certain predisposing disorders such as diabetes, hypertension, and dyslipidemia display many benefits and, at the same time, some adverse effects. For this reason, the use of nutraceuticals, such as Spirulina, has been shown promising results as a support therapy for the maintenance of cardiovascular health and the reduction in cardiovascular risk ^[17]^[18]. This renewed focus on functional-food-based therapy is now seen as a new strategy to achieve a healthy generation. In the 21st century, it is essential to follow the ideologies established by Hippocrates (460–377 B.C.), who claimed “Let food be your medicine” ^[19].

In the last decade, there has been a gradual increase in individuals afflicted with type 2 diabetes ^[20]. Diabetes mellitus (DM) represents a complex disease marked by elevated glucose levels and an increased basal metabolic rate because of a defect in insulin signaling.

In these conditions, hyperglycemia adversely affects the integrity of cellular membranes, leading to insulin resistance in both the liver and peripheral tissues and producing reactive oxygen species (ROS) ^[21].

Moreover, type 2 diabetes accounts for approximately 90% of all diagnosed cases of diabetes and is considered a risk factor for the development of CVDs, including myocardial infarction, peripheral vascular disease (PVD), heart failure, stroke, retinopathy, and neuropathy, as a result of microvascular and macrovascular complications due to hyperglycemia ^[22].

One of the proposed pharmacological approaches to treat hyperglycemia in diabetes is the utilization of metformin ^[23]. Generally, metformin has no impact on lipid profiles in subjects diagnosed with type 2 diabetes ^[24].

However, it is important to note that before considering the use of metformin, which can induce side effects of similar to those of digestive disorders, such as diarrhea and nausea ^[25], there are preventive measures that can be taken to avoid the development of diabetes. Pre-diabetes is a condition that occurs before the onset of diabetes, where blood sugar levels are higher than the normal range but not high enough to be considered type 2 diabetes.

Although it is often not possible to avoid the onset of the disease, exercise and food supplements can delay or improve the management of the disease because of improvements insulin sensitivity ^[26]. Furthermore, the bioactive ingredients contained in some food supplements, such as polyphenols, polysaccharides, and others, can affect the modulation of glucose metabolism ^[27].

Considerable research has focused on studying natural compounds with antihyperglycemic properties, such as Spirulina. Furthermore, unlike metformin, S. platensis not only reduces circulating glucose levels but can also influence lipoprotein metabolism, high levels of which are associated with diabetes. This would represent a possible cardiovascular benefit in diabetic patients ^[28].

Spirulina has gained attention as a functional food due to its potential to lower blood glucose levels, control cholesterol, and provide antioxidant benefits.

2. Clinical Studies

A recent randomized, double-blind, placebo-controlled study included 60 patients under usual treatment with metformin for type 2 diabetes ^[29]. The results suggest that 2 g of Spirulina platensis given as four capsules before meals, in addition to metformin therapy, markedly improved glycemic parameters, including glycosylated hemoglobin (HbA1c) (p < 0.001) and fasting blood glucose levels (FBS) (p < 0.001), compared to the placebo group under metformin treatment only. Hence, the supplementation of 2 g/day of S. platensis for 3 months is considered safe and free of side effects, making it an effective treatment option for the management of type 2 diabetes and its associated complications ^[29]. In line with this evidence, Alam et al. ^[30] evaluated that the administration of 7 g twice daily of Spirulina powder in patients with no pharmacological treatment can reduce FBS (p < 0.01) and postprandial glycemia (PPBS) similarly to the control group who received two capsules of 500 mg metformin before meals for 45 days. The authors observed no statistically significant differences in HbA1C levels induced by Spirulina treatment. As stated by the authors, this scenario could probably be due to the short duration of treatment and the small sample size. Further studies are needed to evaluate its pharmacological effect and its usefulness as a reliable alternative to classic antidiabetic agents ^[30]. Sowjanya and colleagues ^[31] divided diabetic patients into two groups. The first group (EG-1) was given 2 g of Spirulina contained in two snack bars (25 g each) in the mid-morning and evening. The second group (EG-2) was given two Spirulina capsules in the morning and evening, while the control group was given no supplementation. In both the EG-1 and EG-2 groups, their FBS, PPBS and HbA1c levels were significantly more reduced from the baseline to the endpoint both in males (p < 0.01) than in females (p < 0.05). In the EG-1 group, the reduction in FBS and PPBS levels was greater than in the EG-2 group, possibly due to the synergistic effects of other nutritional ingredients. In addition, the reduction in FBS and PPBS in females is lower than that in males ^[31]. Another clinical study showed that 2 g/day of Spirulina capsules, taken during lunch and dinner for 2 months, led to a reduction in FBS, PPBS, and HbA1c (p < 0.05) from the baseline to the endpoint ^[32]. A similar effect was induced by a dosage of 8 g of Spirulina administered daily for 3 months in tablet form to 50 patients with type 2 diabetes treated with their usual antidiabetic therapy, but the reduction in HbA1c levels was not significant. It is possible that Spirulina can lower serum glucose levels in the short term, but it may require a longer treatment period to affect hemoglobin A1C levels ^[33]. The reduction in the HbA1c level highlighted suggests an improvement in the regulation of long-term glucose management.

Moreover, in Cretan patients with non-alcoholic fatty liver disease (NAFLD), 6 g/day Spirulina (Greek production) supplementation for six months led to a significant reduction in the HOMA-IR index, a measure representing an enhancement in insulin sensitivity ^[34]. The main characteristics at the baseline and after Spirulina supplementation of the included studies are shown in Table 1.

Table 1. Detailed characteristics of the included studies on diabetic patients.

References	Patients’ Cohort	Dose of Spirulina	Duration Treatment (Weeks/Months)	Outcomes in Spirulina Group; (p-Value)	Outcomes in Control Group; (p-Value)	p-Value
				HbA1c (mg/dL)	HbA1c (mg/dL)
				Baseline 8.87 ± 0.29	Baseline 8.47 ± 0.21	0.65
				End 7.44 ± 0.20	End 8.15 ± 0.17	NA
Karizi et al., 2022 ^[29]	Spirulina + Metformin group;	2 g/day	3 months	p = 0.001	p = 0.016
	Placebo + Metformin group			FBS (mg/dL)	FBS (mg/dL)
				Baseline 167.30 ± 4.34	Baseline 227.60 ± 67.85	0.47
				End 136.33 ± 4.42	End 165.47 ± 3.37	NA
				p = 0.001	p = 0.99
				HbA1c (mg/dL)	HbA1c (mg/dL)
				Baseline 9.73 ± 1.92	Baseline 9.61 ± 1.49	0.862
				End 9.95 ± 2.11	End 9.15 ± 2.03	0.303
				p = 0.525	p = 0.459
				FBS (mg/dL)	FBS (mg/dL)
Alam et al., 2016 ^[30]	Spirulina group;	7 g/day	45 days	Baseline 245.53 ± 78.95	Baseline 227.60 ± 67.85	0.525
	Placebo + Metformin group			End 204.87 ± 78.15	End 191.80 ± 78.91	0.65
				p = 0.003	p = 0.212
				PPBS (mg/dL)	PPBS (mg/dL)
				Baseline 345.73 ± 98.33	Baseline 329.60 ± 72.92	NA
				End 303.67 ± 96.16	End 282.80 ± 99.90	NA
				NA	NA
				HbA1c (mg/dL)	HbA1c (mg/dL)
				Baseline EG-I M 9.19 ± 0.88; W 8.88 ± 0.70 EG-II M 7.33 ± 0.54; W 7.20 ± 0.33	Baseline M 8.00 ± 1.05; W 8.64 ± 0.79	NA
				End EG-I M 7.11 ± 0.64; W 7.64 ± 0.48 EG-II M 6.48 ± 0.36; W 6.58 ± 0.35	End M 7.98 ± 1.03; W 8.62 ± 0.74	NA
				EG-I M p < 0.01; W p < 0.01 EG-II M p < 0.01 W p < 0.01	M n.s; W n.s
	EG1 group;			FBS (mg/dL)	FBS (mg/dL)
Sowjanya et al., 2022 ^[31]	EG2 group	2 g/day	3 months	Baseline EG-I M 138.00 ± 18.39; W 128.08 ± 11.76 EG-II M 135.02 ± 18.22; W 132.33 ± 10.89	Baseline M 146.10 ± 25.29; W 135.12 ± 10.27	NA
	Control group			End EG-I M 122.21 ± 14.48; W 111.00 ± 14.48 EG-II M 119.31 ± 14.33; W 123.12 ± 9.81	End M 141.43 ± 20.84; W 130.12 ± 9.76
				EG-I M p < 0.01; W p < 0.01 EG-II M p < 0.01; W p < 0.05	M n.s; W n.s	NA
				PPBS (mg/dL)	PPBS (mg/dL)
				Baseline EG-I M 210.33 ± 28.99; W 212.12 ± 39.45 EG-II M 197.45 ± 23.31 W 190.03 ± 14.86	Baseline M 206.17 ± 22.83; W 179.24 ± 17.82	NA
				End EG-I M 165.56 ± 25.35; W 175.58 ± 32.11 EG-II M 171.28 ± 24.77 W 175.50 ± 18.38	End M 202.37 ± 22.76; W 172.09 ± 15.49	NA
				EG-I M p < 0.01; W p < 0.01 EG-II M p < 0.01; W p < 0.05	M n.s; W n.s
				HbA1c (mg/dL)	HbA1c (mg/dL)
				Baseline 9.0 ± 2.3	Baseline 8.7 ± 1.5	NA
				End 8.0 ± 1.3	End 8.7 ± 1.3	NA
				p < 0.05	n.s
				FBS (mg/dL)	FBS (mg/dL)
				Baseline 161.7 ± 48.6	Baseline 164.3 ± 59.4	NA
Parikh et al., 2001 ^[32]	Spirulina group;	2 g/day	2 months	End 142.4 ± 27.4	End 165.1 ± 44.3	NA
	Control group			NA	NA
				PPBS (mg/dL)	PPBS (mg/dL)
				Baseline 264.9 6 65.2	Baseline 215.2 6 67.3	NA
				End 248.8 6 68.9	End 212.3 6 57.6	NA
				NA	NA
				FBS (mg/dL)
Beihaghi et al., 2017 ^[33]	Spirulina group;	8 g/day	3 months	Baseline 158.1 ± 44.2	NA
	Control group			End 127.8 ± 36.7
				NA

Abbreviations: HbA1c, glycosylated hemoglobin; FBS, fasting blood glucose levels; PPBS, post-prandial blood glucose; EG1, Experimental group-1 who received Spirulina snack bar; EG2, Experimental group-2 who received Spirulina capsules; NA, not available. n.s, not significant.

Overall, Spirulina supplementation has been shown to be an effective agent for hyperglycemia; however, it is necessary to increase the number of studies and the duration of the treatment to confirm its effect on the regulation of HbA1c levels, indicative of long-term glucose management. These studies pave the way for future research on the use of nutraceuticals as an adjunct to basic therapy in managing diabetes mellitus.

3. Animal Studies

Similar research on the hypoglycemic property of Spirulina has been conducted in animal models. Spirulina oral supplementation in different concentrations (5, 10, and 15 mg/kg body weight) in streptozotocin-diabetic rats led to a decrease in FBS levels and, on the other hand, elevated plasma insulin and serum C-peptide concentrations (p < 0.05). Moreover, the researchers observed an increase in total hemoglobin levels in the Spirulina-treated group, which may be indirectly proportional to HbA1c formation, due to its ability to lower circulating glucose levels and its high iron content which is crucial for the metabolism of hemoglobin ^[35].

Further, the oral administration of Spirulina in albino diabetic rat models, at 10, 20, and 30 mg/kg body weight diluted in distillated water, resulted in a significant dose-dependent reduction in FBS compared to the diabetic control group (p < 0.01) ^[36].

Also, El-Sayed and colleagues ^[37] demonstrated that phenolic compounds and phycocyanin contained in Spirulina are responsible for the hypoglycemic effect. The four groups of diabetic rats treated for 30 days with oral Spirulina biomass suspension (50 mg/kg body weight), phycocyanin (50 mg/kg body weight), phycocyanobilin (982 µg/kg body weight), and phycopeptide (49 mg/kg body weight), respectively, showed a reduction in fasting blood glucose level and in the HOMA-IR score, which highlights insulin resistance, compared to the control and glibenclamide groups (p ≤ 0.05). In addition, a histopathological analysis revealed that diabetic rats treated with Spirulina, phycocyanin, and phycopeptide showed an improvement in their HOMA β-score which revealed an improvement in β cell function (p ≤ 0.05) ^[37].

4. Mechanism of Action

Although the mechanisms are not fully understood, Spirulina could be involved in pancreatic insulin secretion by islet β-cells or facilitate glucose transport from the blood to peripheral tissues ^[35].

The insulin-releasing impact of S. platensis occurs through a multitude of pathways, such as the adenylate cyclase/cAMP or phosphatidylinositol pathway or through direct influence on membrane depolarization ^[38].

Proteins extracted from Spirulina have been found to improve glucose entry into liver cells and promote glycogen synthesis by increasing the activities of hexokinase (HK) and pyruvate kinase (PK), which ultimately leads to lower blood glucose levels and improves insulin resistance.

Additionally, three peptides extracted from Spirulina platensis inhibit α-amylase, α-glucosidase, and dipeptidyl peptidase-4 (DPP-IV), which are critical enzymes involved in glycemic control. This makes them useful targets in treating type 2 diabetes ^[39].

The high fiber content of Spirulina may hinder glucose absorption, leading to a glucose-lowering effect ^[40].

According to Hozayen and colleagues ^[41], Spirulina could have a positive impact in diabetic rats enhancing serum adiponectin and decreasing TNF-α levels. High levels of adiponectin are commonly known to improve insulin sensitivity, while low levels of a pro-inflammatory cytokine TNF-α enhance glucose production in the liver and the ability of insulin to stimulate glucose uptake in peripheral tissues. Furthermore, the antioxidant capacity caused by Spirulina supplementation has been shown to increase GSH levels and SOD and GPx activity. As a result, it protects against oxidative-stress-induced cell damage associated with diabetes ^[41].

Some authors believe that the antioxidant capacity of Spirulina is attributed to phycocyanin. Selenium-bound phycocyanopeptide or/and phycocyanobilin are known for their antioxidant action in preventing diabetes-induced pancreatic cell damage, while chromium-bound phycocyanopeptide activates insulin receptors ^[37].

As a consequence of increased antioxidant enzymes, malondialdehyde (MDA) levels are decreased following Spirulina supplementation ^[42].

Lastly, Sadek et al. ^[43] provided evidence that Spirulina exerts its antidiabetic effect by attenuating the upregulation of gluconeogenic enzyme pyruvate carboxylase (PC) and pro-apoptotic Bax and caspase-3 (CASP-3) gene expression in diabetic rats, thereby resulting from its antioxidant activity. Furthermore, Spirulina has been shown to possess anti-apoptotic properties by mitigating the expression of pro-apoptotic MAPK pathways, consequently leading to the attenuation of apoptotic pathways induced by diabetes ^[43].

References

Komárek, J.; Kaštovský, J.; Mareš, J.; Johansen, J.R. Taxonomic classification of cyanoprokaryotes (cyanobacterial genera) 2014, using a polyphasic approach. Preslia 2014, 86, 295–335.
Volkmann, H.; Imianovsky, U.; Oliveira, J.L.; Sant’Anna, E.S. Cultivation of Arthrospira (Spirulina) platensis in desalinator wastewater and salinated synthetic medium: Protein content and amino-acid profile. Braz. J. Microbiol. 2008, 39, 98–101.
Tamagnini, P.; Axelsson, R.; Lindberg, P.; Oxelfelt, F.; Wünschiers, R.B.; Lindblad, P. Hydrogenases and hydrogen metabolism of cyanobacteria. Microbiol. Mol. Biol. Rev. 2002, 66, 1–20.
Vonshak, A. Spirulina Platensis Arthrospira: Physiology, Cell-Biology and Biotechnology; CRC Press: Boca Raton, FL, USA, 1997.
Kulshreshtha, A.; Jarouliya, U.; Bhadauriya, P.; Prasad, G.; Bisen, P. Spirulina in health care management. Curr. Pharm. Biotechnol. 2008, 9, 400–405.
Ahmad, A.M.R.; Intikhab, A.; Zafar, S.; Farooq, U.; Shah, H.B.U.; Akram, S.; Abid, J.; Parveen, Z.; Iqbal, S. Spirulina, an FDA-approved functional food: Worth the hype? Cell. Mol. Biol. 2023, 69, 137–144.
Lafarga, T. Effect of microalgal biomass incorporation into foods: Nutritional and sensorial attributes of the end products. Algal Res. 2019, 41, 101566.
Morais, M.G.D.; Vaz, B.D.S.; Morais, E.G.D.; Costa, J.A.V. Biological effects of Spirulina (Arthrospira) biopolymers and biomass in the development of nanostructured scaffolds. BioMed Res. Int. 2014, 2014, 762705.
Karkos, P.; Leong, S.; Karkos, C.; Sivaji, N.; Assimakopoulos, D. Spirulina in clinical practice: Evidence-based human applications. Evid.-Based Complement. Altern. Med. 2011, 2011, 531053.
Chei, S.; Oh, H.; Song, J. Spirulina maxima extract prevents activation of the NLRP3 in ammasome by inhibiting ERK signaling. Sci. Rep. 2020, 10, 2075.
Deng, R.; Chow, T.J. Hypolipidemic, antioxidant, and antiinflammatory activities of microalgae Spirulina. Cardiovasc. Ther. 2010, 28, e33–e45.
Rao, A.V.; Rao, L.G. Carotenoids and human health. Pharmacol. Res. 2007, 55, 207–216.
Grover, P.; Bhatnagar, A.; Kumari, N.; Bhatt, A.N.; Nishad, D.K.; Purkayastha, J. C-Phycocyanin-a novel protein from Spirulina platensis-In vivo toxicity, antioxidant and immunomodulatory studies. Saudi J. Biol. Sci. 2021, 28, 1853–1859.
Sommella, E.; Conte, G.M.; Salviati, E.; Pepe, G.; Bertamino, A.; Ostacolo, C.; Sansone, F.; Prete, F.D.; Aquino, R.P.; Campiglia, P. Fast profiling of natural pigments in different spirulina (Arthrospira platensis) dietary supplements by DI-FT-ICR and evaluation of their antioxidant potential by pre-column DPPH-UHPLC assay. Molecules 2018, 23, 1152.
Bhat, V.B.; Madyastha, K. C-phycocyanin: A potent peroxyl radical scavenger in vivo and in vitro. Biochem. Biophys. Res. Commun. 2000, 275, 20–25.
Gaidai, O.; Cao, Y.; Loginov, S. Global cardiovascular diseases death rate prediction. Curr. Probl. Cardiol. 2023, 48, 101622.
Zhao, J. Nutraceuticals, nutritional therapy, phytonutrients, and phytotherapy for improvement of human health: A perspective on plant biotechnology application. Recent Pat. Biotechnol. 2007, 1, 75–97.
ElFar, O.A.; Billa, N.; Lim, H.R.; Chew, K.W.; Cheah, W.Y.; Munawaroh, H.S.H.; Balakrishnan, D.; Show, P.L. Advances in delivery methods of Arthrospira platensis (spirulina) for enhanced therapeutic outcomes. Bioengineered 2022, 13, 14681–14718.
Chauhan, B.; Kumar, G.; Kalam, N.; Ansari, S.H. Current concepts and prospects of herbal nutraceutical: A review. J. Adv. Pharm. Technol. Res. 2013, 4, 4.
Haddad, J.A.; Haddad, A.N. The past decade in type 2 diabetes and future challenges. Hormones 2018, 17, 451–459.
Ha, H.; Kim, K.H. Pathogenesis of diabetic nephropathy: The role of oxidative stress and protein kinase C. Diabetes Res. Clin. Pract. 1999, 45, 147–151.
Hu, F.B. Globalization of diabetes: The role of diet, lifestyle, and genes. Diabetes Care 2011, 34, 1249–1257.
American Diabetes, A. Standards of Medical Care in Diabetes-2019 Abridged for Primary Care Providers. Clin. Diabetes 2019, 37, 11–34.
Wulffele, M.G.; Kooy, A.; de Zeeuw, D.; Stehouwer, C.D.; Gansevoort, R.T. The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: A systematic review. J. Intern. Med. 2004, 256, 1–14.
Saluja, M.; Pareek, K.K.; Swami, Y.K. Study of Diversity of Metformin Related Gastrointestinal Side Effects. J. Assoc. Physicians India 2020, 68, 36–38.
Sivaraman, S.; Weickert, M.O. Nutrition and exercise in the treatment of type 2 diabetes mellitus. Hamdan Med. J. 2012, 5, 131–144.
Meng, X.; Li, Q.; Shi, R.; Chang, J.; Chang, H.; Li, M. Food supplements could be an effective improvement of diabetes mellitus: A review. J. Future Foods 2021, 1, 67–81.
Ray, K.K.; Seshasai, S.R.; Wijesuriya, S.; Sivakumaran, R.; Nethercott, S.; Preiss, D.; Erqou, S.; Sattar, N. Effect of intensive control of glucose on cardiovascular outcomes and death in patients with diabetes mellitus: A meta-analysis of randomised controlled trials. Lancet 2009, 373, 1765–1772.
Karizi, S.R.; Armanmehr, F.; Azadi, H.G.; Zahroodi, H.S.; Ghalibaf, A.M.; Bazzaz, B.S.F.; Abbaspour, M.; Boskabadi, J.; Eslami, S.; Taherzadeh, Z. A randomized, double-blind placebo-controlled add-on trial to assess the efficacy, safety, and anti-atherogenic effect of spirulina platensis in patients with inadequately controlled type 2 diabetes mellitus. Phytother. Res. 2023, 37, 1435–1448.
Alam, A.; Ma, S.; Quamri, A.; Fatima, S.; Roqaiya, M.; Ahmad, Z. Efficacy of Spirulina (Tahlab) in Patients of Type 2 Diabetes Mellitus (Ziabetus Shakri)—A Randomized Controlled Trial. J. Diabetes Metab. 2016, 7, 1–5.
Sowjanya, M.; Manjula, K. Effect of Food-based Approach with Spirulina on Blood Glucose Profile of Non-insulin Dependent Diabetics. Asian Pac. J. Health Sci. 2022.
Parikh, P.; Mani, U.V.; Iyer, U.M. Role of Spirulina in the Control of Glycemia and Lipidemia in Type 2 Diabetes Mellitus. J. Med. Food 2001, 4, 193–199.
Beihaghi, M.; Ghodrati Azadi, H.; Taherzadeh, Z.; Bahrami, H.R. The effects of oral administration of spirulina platensis (cultured iranian) on blood glucose and glycosylated hemoglobin blood in type ii diabetes mellitus patients. Iran. J. Diabetes Lipid Disord. 2017, 16, 183–190.
Mazokopakis, E.E.; Papadomanolaki, M.G.; Fousteris, A.A.; Kotsiris, D.A.; Lampadakis, I.M.; Ganotakis, E.S. The hepatoprotective and hypolipidemic effects of Spirulina (Arthrospira platensis) supplementation in a Cretan population with non-alcoholic fatty liver disease: A prospective pilot study. Ann. Gastroenterol. Q. Publ. Hell. Soc. Gastroenterol. 2014, 27, 387–394.
Layam, A.; Reddy, C.K. Antidiabetic property of spirulina. Diabetol. Croat. 2006, 35, 29–33.
El-Moataaz, S.; Ismael, H.; Abo-Rhyem, S.M. Assessment of Chemical Composition of Spirulina Platensis and its Effect on Fasting Blood Glucose and Lipid Profile in Diabetic Rats. J. High Inst. Public Health 2019, 49, 199–211.
El-Sayed, E.-S.M.; Hikal, M.S.; Khair, B.E.A.E.; El-Ghobashy, R.E.; El-Assar, A.M. Hypoglycemic and hypolipidemic effects of spirulina platensis, phycocyanin, phycocyanopeptide and phycocyanobilin on male diabetic rats. Arab Univ. J. Agric. Sci. 2018, 26, 1121–1134.
Hannan, J.M.A.; Ansari, P.; Azam, S.; Flatt, P.R.; Abdel Wahab, Y.H.A. Effects of Spirulina platensis on insulin secretion, dipeptidyl peptidase IV activity and both carbohydrate digestion and absorption indicate potential as an adjunctive therapy for diabetes. Br. J. Nutr. 2020, 124, 1021–1034.
Hu, S.; Fan, X.; Qi, P.; Zhang, X. Identification of anti-diabetes peptides from Spirulina platensis. J. Funct. Foods 2019, 56, 333–341.
Yamina, M.; Oumelkheir, S.; Ismail, M. Effect of Adding the Spirulina (Arthrospira platensis), to Date Syrup on Glycemic Response and its Effectiveness to Reduce Post Prandial Blood Glucose. Int. J. Sci. Res. 2015, 4, 837–840.
Hozayen, W.G.; Mahmoud, A.M.; Soliman, H.A.; Mostafa, S.R. Spirulina versicolor improves insulin sensitivity and attenuates hyperglycemia-mediated oxidative stress in fructose-fed rats. J. Intercult. Ethnopharmacol. 2016, 5, 57–64.
Brito, A.D.F.; Silva, A.S.; de Oliveira, C.V.C.; de Souza, A.A.; Ferreira, P.B.; de Souza, I.L.L.; da Cunha Araujo, L.C.; da Silva Félix, G.; de Souza Sampaio, R.; Tavares, R.L.; et al. Spirulina platensis prevents oxidative stress and inflammation promoted by strength training in rats: Dose-response relation study. Sci. Rep. 2020, 10, 6382.
Sadek, K.M.; Lebda, M.A.; Nasr, S.M.; Shoukry, M. Spirulina platensis prevents hyperglycemia in rats by modulating gluconeogenesis and apoptosis via modification of oxidative stress and MAPK-pathways. Biomed. Pharmacother. 2017, 92, 1085–1094.

© Text is available under the terms and conditions of the Creative Commons Attribution (CC BY) license; additional terms may apply. By using this site, you agree to the Terms and Conditions and Privacy Policy.

Upload a video for this entry

Information

Subjects: Nutrition & Dietetics

Contributors MDPI registered users' name will be linked to their SciProfiles pages. To register with us, please refer to https://encyclopedia.pub/register :

Valeria Prete

Angela Carmelita Abate

Paola Di Pietro

Massimiliano De Lucia

Carmine Vecchione

Albino Carrizzo

View Times: 120

Entry Collection: Hypertension and Cardiovascular Diseases

Update Date: 29 Feb 2024

Table of Contents

Video Upload Options

Confirm