1. Introduction
In this contemporary era, the pathogenesis and etiology of diabetes mellitus is comprehended as a highly intricate metabolic disorder attributed to the excessive glucose production in the liver [
1]. Diabetes poses a significant global health challenge, with over half a billion people affected in 2021. Projections indicate a continued rise, reaching 783.2 million people living with diabetes by 2045, contributing to high morbidity and mortality rates [
2]. The vast majority, approximately 90%, of individuals diagnosed with diabetes are battling type 2 diabetes mellitus (T2DM) which can progressively lead to severe secondary complications such as retinopathy, cardiovascular disease, cognitive decline, nephropathy, end-stage renal disease, dementia, and susceptibility to infections [
3].
Lifestyle and dietary modifications are common preventative measures employed during the initial stages of T2DM. However, as the disease progresses, advanced therapeutic strategies are often necessary to combat further deterioration. These strategies include medications such as sulfonylureas, glucosidase inhibitors, amylin analogs, meglitinides, dipeptidyl peptidase-4 (DPP-IV) enzyme inhibitors, and GLP-1 analogs [
4]. Despite the effectiveness of these pharmaceutical interventions, their widespread use is often limited by factors such as cost, limited accessibility in some regions, and severe adverse side effects. These limitations have fueled the search for alternative therapeutic approaches that are safe, economical, and effective in managing type 2 diabetes mellitus (T2DM) [
5]. In fact, traditional medicine accounting for nearly 90% of treatments of developing countries, is predominantly obtained from medicinal plants, employed in the treatment of gastrointestinal disorders, diarrhea, diabetes, wound healing, malaria, cholera, pneumonia, tuberculosis, and asthma [
5]. On top of that, the global markets for plant-derived medicines are thriving, generating over
$100 billion per year with their considerable contributions on public health [
6]. At present, more than 400 species of traditional medicinal plants have been identified, exhibiting notable antidiabetic and antihyperlipidemic effects, making them potential alternatives for T2DM treatment [
7]. These medicinal plants exhibit the potential to restore pancreatic tissue function and alleviate hyperglycemia by enhancing insulin secretion, promoting insulin-dependent metabolic processes, and inhibiting intestinal glucose absorption through α-amylase and α-glucosidase inhibition [
8,
9].
Mangifera indica, commonly referred as Mango, is a member of the
Anacardiaceae family and
Mangifera genus, which comprises around 69 species of edible fruits. The highest cultivation of mangos is known to be in India and Bangladesh, where it has been used as an essential herb in Ayurveda and indigenous medicine for over 4000 years [
10]. The bark of the plant is a familiar ethnomedicine used traditionally for the remedy of diarrhea, cancer, toothache, and urinary tract and dermal infections [
11]. The alcoholic extract of
M. indica also exhibited anti-bacterial, antioxidant, anti-ulcerogenic, hepatoprotective, and hypolipidemic activities [
12]. The isolated compounds from the leaves, bark, and peel of
M. indica included mangiferin, isomangiferin, quercetin 3-O-galactoside, quercetin 3-O-glucoside, quercetin 3-O-xyloside, quercetin 3-O-arabinoside, Iriflophenone 3-C-β-D-glucoside, quercetin and kaempferol [
13,
14]. Mangiferin, a key component of
Mangifera indica, enhances oral glucose tolerance and lipid profile, while its accompanying phytochemicals, powerful free radical scavengers like quercetin, combat ROS-induced harm through their scavenging activity [
11]. This study aimed to investigate the
in vitro and
in vivo antidiabetic and insulinotropic effects of ethanolic extract of
M. indica in STZ-induced type 2 diabetic rats to unravel the mechanistic pathways underlying its antihyperglycemic properties.
4. Discussion
In developed countries, people with diabetes have a 2- to 4-fold higher risk of cardiovascular disease compared to the general population [
31]. While oral anti-hyperglycemic agents can manage type 2 diabetes, they often require the addition of synthesized insulin, which increases the risk of undesirable side effects [
32,
33]. This has led to growing interest in plant-based organic antidiabetic drugs, which offer a promising avenue for managing diabetes with fewer side effects by potentially improving β-cell function and addressing diabetes-related disorders [
32].
Mangifera indica (MI) is an evergreen fruit tree that has played a significant role in both ancient and indigenous medical practices for more than 4000 years [
10]. Among the many bio-macromolecules found in mango leaves (MLs), protein is the most prevalent. Other nutrients that are frequently found in MLs. include nitrogen, potassium, phosphorus, iron, sodium chloride, calcium, magnesium, and vitamins A and B complex, as well as E and C [
34]. Previous studies have reported that MLs extracts are effective for treating a wide range of illnesses, including diabetes, bronchitis, diarrhea, asthma, renal, scabies, respiratory issues, syphilis, and urinary disorders [
10,
35]. However, the exact molecular mechanism underlying these effects remains unclear. The current study aimed at discovering the underlying mechanism of action of ethanolic extract of
Mangifera indica (EEMI) leaves.
The regulation of insulin secretion in the pancreatic β-cell is intricately associated with glucose metabolism in peripheral tissue [
36]. Impaired insulin secretion is considered the initial culprit in the progression towards type 2 diabetes [
37]. Our
in vitro study reveals EEMI's stimulatory effect on insulin release in a concentration-dependent manner. Both clonal BRIN-BD11 cells and isolated mouse islets exhibited increased insulin secretion at 5.6 mM and 16.7 mM glucose, respectively, signifying EEMI's role in β-cell function. To validate EEMI's insulinotropic effect, we employed alanine and GLP-1 as positive controls. These well-known insulin-modulating agents trigger insulin secretion by depolarizing ATP-sensitive K
+ channels in response to glucose, leading to membrane depolarization and elevated intracellular calcium levels [
20]. Furthermore, the presence of specific phytochemicals like alkaloids, tannins, saponins, and flavonoids in EEMI suggests its potential to increase insulin secretion through multiple mechanisms and pathways [
38,
39,
40,
41].
A carbohydrate digestion study investigated the potential of EEMI to inhibit starch breakdown. EEMI showed a concentration-dependent reduction in glucose liberation, suggesting it may act on α-amylase and α-glucosidase, enzymes crucial for breaking down carbohydrates into glucose and potentially leading to elevated blood sugar after meals [
18]. Additionally, dietary fiber content of
M. indica may deter hunger by impeding stomach emptying and delaying energy and nutrient absorption. This could contribute to reduced postprandial glucose levels [
42], consistent with previous findings that
M. indica leaf acts as a promising anti-diabetic agent by inhibiting digestive enzymes, enhancing glucose uptake, and suppressing free radicals [
43].
A subsequent
in vitro diffusion assay revealed that EEMI significantly reduced glucose absorption and diffusion over a 24 h period. These findings align with previous research suggesting that
M. indica may hinder intestinal glucose absorption due to its enriched polyphenol content [
44]. Additionally, dietary fibers are known to reduce postprandial blood sugar via a variety of mechanisms, including increasing the viscosity of small intestine fluid, decreasing glucose diffusion, and delaying digestion via α-amylase inhibition [
45].
Recent evidence highlights the key role of oxidative stress in diabetes, where it contributes to non-enzymatic protein glycation, heightened lipid peroxidation, and glucose oxidation, all of which lead to free radical generation. This, in turn, damages cellular machinery and enzymes, ultimately contributing to insulin resistance [
46]. Interestingly, our DPPH study revealed the significant radical scavenging ability of EEMI. This suggests that the
M. indica might help prevent cellular damage and improve insulin sensitivity in diabetes by reducing oxidative stress and its associated complications, such as endothelial dysfunction and inflammation [
47,
48]. Furthermore, the identified phytochemicals in this current study may be responsible for these potential effects.
Excessive food intake is a major risk factor for obesity, insulin resistance, and type 2 diabetes (T2DM). Our feeding test revealed that EEMI significantly reduces food intake in rats, indicating the effects of EEMI on appetite suppression. Previous studies suggest that Mangiferin, a compound found in
M. indica, may be responsible for this effect [
49]. An acute oral glucose tolerance test (OGTT) showed that EEMI treatment significantly improves blood sugar control in type 2 diabetic rats. This aligns with previous findings suggesting that
M. indica's phytochemicals, including Mangiferin, quercetin, kaempferol, catechin and epicatechin may enhance insulin sensitivity and directly impact blood sugar levels [
14]. Over 28 days of treatment, EEMI led to a decrease in fasting blood glucose levels and an increase in plasma insulin levels, this is consistent with previous studies of
M. indica and suggests potential insulin-secretory properties [
50]. Furthermore, liver glycogen content also increased, which indicates pancreatic beta-cell regeneration, decreased fat deposition [
28]. Notably, EEMI also led to a substantial reduction in body weight, suggesting a potential shift in energy expenditure that warrants further investigation [
28].
Non-esterified fatty acids (NEFAs) released from adipose tissue contribute to insulin resistance and β-cell dysfunction, ultimately leading to type 2 diabetes. EEMI significantly improved the lipid profile, suggesting that it may reduce NEFAs levels through various mechanisms, including blocking HMG-CoA reductase activity and hepatic glucose production, while enhancing glucose uptake. This aligns with previous findings on
M. indica's multifaceted approach to metabolic regulation [
14,
51,
52,
53].
Our analysis of EEMI revealed a diverse range of active pharmacological components, including alkaloids, tannins, saponins, flavonoids, and reducing sugars. Interestingly, several of these compounds have been linked to improved glucose management in type 2 diabetes through various mechanisms [
2,
33,
54,
55,
56]. For example, tannins and certain alkaloids have been shown to stimulate glucose absorption and regulate glucose homeostasis through different pathways such as phosphatidylinositol (PI3) and AMPK pathway [
57,
58,
59]. Additionally, combination of triterpenoid and saponins have exhibited promising results in inhibiting intestinal glucose absorption [
60]. Furthermore, the presence of antioxidant flavonoids aligns with existing research demonstrating their ability to enhance insulin secretion, protect pancreatic β-cells, and improve overall glucose tolerance in HFF- and STZ-induced diabetic rats [
61,
62]. While further investigation is crucial to pinpoint the precise role of
M. indica leaves in diabetes management, this preliminary analysis suggests EEMI possesses a fascinating combination of potentially beneficial phytochemicals warranting further exploration for their anti-diabetic potential.
Figure 1.
Insulin-releasing effects of ethanol extract of M. indica (EEMI) on (A) clonal BRIN-BD11 pancreatic β-cells, as well as (B) islets of Langerhans of the pancreas, (C) acarbose, and (D) starch digestion, expressed as bar graphs. Effect of insulin secretion from clonal pancreatic BRIN-BD11 cells and isolated mouse islets of Langerhans were measured with or without insulin secretagogues and EEMI in presence of 5.6 mM or 16.7 mM glucose. Additionally, glucose release reduction from starch was observed with or without EEMI (1.6-5000 µg/ml) and Acarbose (0.32-1000 µg/ml). Values are shown as mean ± SEM for insulin release and starch digestion; n = 4-8. *, **, *** p < 0.05 – 0.001 as compared to control.
Figure 1.
Insulin-releasing effects of ethanol extract of M. indica (EEMI) on (A) clonal BRIN-BD11 pancreatic β-cells, as well as (B) islets of Langerhans of the pancreas, (C) acarbose, and (D) starch digestion, expressed as bar graphs. Effect of insulin secretion from clonal pancreatic BRIN-BD11 cells and isolated mouse islets of Langerhans were measured with or without insulin secretagogues and EEMI in presence of 5.6 mM or 16.7 mM glucose. Additionally, glucose release reduction from starch was observed with or without EEMI (1.6-5000 µg/ml) and Acarbose (0.32-1000 µg/ml). Values are shown as mean ± SEM for insulin release and starch digestion; n = 4-8. *, **, *** p < 0.05 – 0.001 as compared to control.
Figure 2.
The effects of ethanol extract of M. indica (EEMI) on in vitro glucose diffusion at different time points of (A) 0, (B) 3, (C) 6, (D) 12, and (E) 24 hours are depicted as bar graphs. The experiment was performed with or without EEMI using dialysis tube and parameters were recorded in a time-dependent (0, 3, 6, 12, 24 h) manner for 24 h at 37°C while being shaken in an orbital shaker. Values are shown as mean ± SEM for the diffusion of glucose; n = 4. *, **, *** p < 0.05 – 0.001 as compared to control.
Figure 2.
The effects of ethanol extract of M. indica (EEMI) on in vitro glucose diffusion at different time points of (A) 0, (B) 3, (C) 6, (D) 12, and (E) 24 hours are depicted as bar graphs. The experiment was performed with or without EEMI using dialysis tube and parameters were recorded in a time-dependent (0, 3, 6, 12, 24 h) manner for 24 h at 37°C while being shaken in an orbital shaker. Values are shown as mean ± SEM for the diffusion of glucose; n = 4. *, **, *** p < 0.05 – 0.001 as compared to control.
Figure 3.
In vivo effects of ethanol extract of M. indica (EEMI) on (A) feeding test, (B) oral glucose tolerance, (C) fasting blood glucose, (D) plasma insulin, and (E) liver glycogen using STZ-induced type 2 diabetic rats are represented in graphs. The test was conducted following 28 days twice daily administration of EEMI (250 and 500 mg/kg). The food intake was noted down on 12 h fasted rats at 0, 30, 50, 90,120, 150 and 180 min whereas oral glucose tolerance test was carried out on 12 h fasted rats at 0, 30, 60, 90, 120 and 180 min after oral administration of glucose alone (18 mmol/kg, control) with EEMI (250 and 500 mg/kg) or Glibenclamide (0.5 mg/kg). Fasting blood glucose was measured from rat tail tip following a 7-day interval on 0, 7th, 14th, 21st and 28th day of the twice-daily treatment. After the 28-days treatment, plasma insulin and liver glycogen content was measured from the obtained plasma serum and extracted livers. Values are shown as mean ± SEM for each parameter; n = 6. *, **, *** p < 0.05 – 0.001 as compared to STZ-induced diabetic rats.
Figure 3.
In vivo effects of ethanol extract of M. indica (EEMI) on (A) feeding test, (B) oral glucose tolerance, (C) fasting blood glucose, (D) plasma insulin, and (E) liver glycogen using STZ-induced type 2 diabetic rats are represented in graphs. The test was conducted following 28 days twice daily administration of EEMI (250 and 500 mg/kg). The food intake was noted down on 12 h fasted rats at 0, 30, 50, 90,120, 150 and 180 min whereas oral glucose tolerance test was carried out on 12 h fasted rats at 0, 30, 60, 90, 120 and 180 min after oral administration of glucose alone (18 mmol/kg, control) with EEMI (250 and 500 mg/kg) or Glibenclamide (0.5 mg/kg). Fasting blood glucose was measured from rat tail tip following a 7-day interval on 0, 7th, 14th, 21st and 28th day of the twice-daily treatment. After the 28-days treatment, plasma insulin and liver glycogen content was measured from the obtained plasma serum and extracted livers. Values are shown as mean ± SEM for each parameter; n = 6. *, **, *** p < 0.05 – 0.001 as compared to STZ-induced diabetic rats.
Table 1.
Dose-dependent effects of DPPH scavenging activity of L-ascorbic acid and EEMI.
Table 1.
Dose-dependent effects of DPPH scavenging activity of L-ascorbic acid and EEMI.
Concentration (µg/ml) |
Ascorbic acid (% inhibition) |
EEMI (% inhibition) |
1.6 |
10.82 ± 1.32 ** |
9.95 ± 1.15 ** |
8 |
32.91 ± 1.15 *** |
30.42 ± 1.17 *** |
40 |
70.47 ± 1.85 *** |
47.25 ± 2.07 *** |
200 |
87.11 ± 1.61 *** |
62.14 ± 2.15 *** |
1000 |
95.04 ± 1.55 *** |
73.32 ± 2.25 *** |
5000 |
97.24 ± 1.10 *** |
80.99 ± 1.35 *** |
Table 2.
Chronic effects of EEMI on body weight, and lipid profile in STZ-induced type 2 diabetic rats after 28 days’ treatment.
Table 2.
Chronic effects of EEMI on body weight, and lipid profile in STZ-induced type 2 diabetic rats after 28 days’ treatment.
Days |
Treatment group |
Body wt. (gm) |
HDL (mg/dl) |
LDL (mg/dl) |
TG (mg/dl) |
Total Cholesterol (mg/dl) |
0 days |
Diabetic control |
170.0 ± 0.8 |
35.92 ± 2.8 |
57.26 ± 3.1 |
93.22 ± 2.1 |
92.00 ± 1.2 |
EEMI (250 mg/kg) |
169.3 ± 2.1 |
31.68 ± 2.7 |
46.83 ± 6.1 |
87.17 ± 6.1 |
89.10 ± 2.7 |
EEMI (500 mg/kg) |
164.9 ± 2.3 |
33.17 ± 1.7 |
52.78 ± 4.5 |
79.57 ± 5.7 |
85.97 ± 3.0 |
Glibenclamide (0.5 mg/kg) |
158.8 ± 5.2 |
34.05 ± 2.1 |
55.54 ± 3.0 |
85.00 ± 2.9 |
94.77 ± 2.4 |
7 days |
Diabetic control |
176.1 ± 3.1 |
29.92 ± 2.8 |
77.55 ± 6.9 |
118.0 ± 6.9 |
83.67 ± 3.9 |
EEMI (250 mg/kg) |
166.2 ± 2.7 |
34.39 ± 2.9 |
66.69 ± 6.1 |
107.0 ± 6.1 |
79.31 ± 1.5 |
EEMI (500 mg/kg) |
167.2 ± 1.0 |
42.10 ± 1.7 |
76.32 ± 2.3 |
105.1 ± 4.5 |
72.29 ± 2.8 |
Glibenclamide (0.5 mg/kg) |
166.9 ± 2.0 |
62.81 ± 2.6*** |
36.99 ± 3.1** |
47.55 ± 3.1** |
76.51 ± 2.9 |
14 days |
Diabetic control |
171.6 ± 0.9 |
33.91 ± 2.7 |
57.57 ± 4.1 |
98.00 ± 4.1 |
88.14 ± 2.2 |
EEMI (250 mg/kg) |
167.2 ± 1.9 |
33.61 ± 1.7 |
75.94 ± 6.1 |
116.3 ± 6.1 |
72.18 ± 1.0** |
EEMI (500 mg/kg) |
164.5 ± 3.5 |
36.05 ± 2.9 |
58.61 ± 4.5 |
84.05 ± 4.5 |
63.43 ± 4.2** |
Glibenclamide (0.5 mg/kg) |
167.8 ± 1.1 |
70.79 ± 2.9*** |
39.09 ± 3.8* |
49.65 ± 3.8*** |
53.72 ± 1.7*** |
21 days |
Diabetic control |
191.4 ± 1.5 |
37.29 ± 3.2 |
82.05 ± 3.4 |
122.5 ± 3.4 |
100.6 ± 2.5 |
EEMI (250 mg/kg) |
160.8 ± 4.4** |
26.78 ± 1.7 |
72.91 ± 6.1 |
113.2 ± 6.1 |
57.45 ± 5.2** |
EEMI (500 mg/kg) |
154.1 ± 2.3*** |
41.05 ± 2.0* |
61.45 ± 4.5* |
86.89 ± 4.5** |
63.12 ± 2.0*** |
Glibenclamide (0.5 mg/kg) |
155.4 ± 2.7*** |
85.28 ± 2.5** |
39.64 ± 0.1*** |
46.87 ± 3.4*** |
48.10 ± 1.8*** |
28 days |
Diabetic control |
196.4 ± 2.1 |
23.19 ± 2.5 |
95.88 ± 3.3 |
136.3 ± 3.3 |
105.6 ± 2.7 |
EEMI (250 mg/kg) |
154.9 ± 2.3*** |
31.62 ± 1.7 |
59.69 ± 6.1** |
100.0 ± 6.1** |
60.96 ± 3.8*** |
EEMI (500 mg/kg) |
150.0 ± 3.1*** |
42.67 ± 1.9** |
57.27 ± 4.5** |
82.71 ± 4.5*** |
57.44 ± 3.6*** |
Glibenclamide (0.5 mg/kg) |
153.1 ± 3.0*** |
92.34 ± 1.9*** |
44.37 ± 1.0*** |
41.59 ± 2.8*** |
41.66 ± 2.3*** |