Berberine in Treatment of Type 2 Diabetes

Berberine is a compound found naturally in many plants. Berberine has a long history in traditional Chinese medicine, where it has been used to treat various ailments.[1] Now, modern science suggests that it has impressive benefits for many health concerns. [2] Some research suggests that it may help promote weight loss, lower blood sugar regulation, and minimize the risk of chronic conditions especially (pre)type 2 diabetes and non-alcoholic fatty liver disease.

How does it work?

Berberine has been tested in hundreds of studies. One of the main actions of berberine is to activate an enzyme inside cells called AMP-activated protein kinase (AMPK), according to some animal studies [3] [4] AMPK plays a key role in regulating metabolism and energy levels and is found in cells throughout your body [5] [6]. Berberine also affects other molecules inside cells and may even affect which genes are turned on or off. This could help protect against many chronic health conditions [7].

It lowers blood sugar levels

Many studies show that berberine can significantly lower blood sugar levels in people with (pre)type 2 diabetes [8].

It works via multiple mechanisms and may help [9] [10]

• improve insulin sensitivity by making the blood sugar-lowering hormone insulin more effective

• support glycolysis - breaking down sugars inside cells

• decrease sugar production in the liver

• slow the digestion of carbs in the gut

• increase the number of beneficial bacteria in the gut

In a 2008 study of 116 people with diabetes, taking 1 gram of berberine per day lowered fasting blood sugar by 20% [11]. It also lowered hemoglobin A1c (HbA1c), a marker of long-term blood sugar regulation, by 12% and improved levels of blood lipids such as triglycerides [11]. According to an older meta-analysis of 14 studies, berberine may be as effective as metformin, glipizide, and rosiglitazone [12]. It works very well in combination with lifestyle changes and has additive effects when used with other blood sugar-lowering drugs [13]

I live with my family in a small town in Bavaria in southern Germany. Nowadays, there are a lot of refugees from the Middle East and Afghanistan here. They have opened stores where you can buy more or less exotic things and food, which makes the town less boring. A few days ago, my son and I went for a walk. In one of these stores, we saw berberine roots. These are simply pieces of yellow wood. I was happy to have easy access to them. So I bought some. The package said how to make tea, which is very easy to prepare. I knew of the many health benefits of berberine, especially as a supplement in the treatment of type 2 diabetes and obesity. But somehow, I was always too lazy to buy it on Amazon. This also had to do with the fact that I am neither diabetic nor obese. Anyway, when my wife comes home late from work, we eat late for dinner. To extend the biological time of my fasting, which takes 18 hours up to the next day at noon, I drink a big cup of tea made from the roots you see in the image below.

Berberine may help you lose weight

Berberine may also be a powerful weight loss supplement. In one older 12-week trial in people with obesity, ingesting 500 milligrams (mg) of berberine three times per day caused roughly 5 pounds of weight loss, on average. The participants also lost 3.6% of their body fat [14]. Additionally, a review of 12 studies found that supplementing with berberine led to significant reductions in body weight, body mass index, and belly fat. It also decreased levels of C-reactive protein, a marker of inflammation [15]. Additionally, berberine appears to stop the development of fat cells at the molecular level, which may aid in weight loss [16]

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Scientific References

[1] PMCID: PMC6111450 PMID: 30186157 Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular, Metabolic, Hepatic, and Renal Disorders Maria A. Neag,1 Andrei Mocan,2,* Javier Echeverría,3 Raluca M. Pop,1 Corina I. Bocsan,1 Gianina Crişan,2 and Anca D. Buzoianu1

[2] PMCID: PMC8107691 PMID: 33981233, Efficacy and Safety of Berberine Alone for Several Metabolic Disorders: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Yu Ye, 1 , † Xiufen Liu, 1 , † Ninghua Wu, 1 , 2 Yanqi Han, 1 Jiawen Wang, 1 Yuandong Yu, 3 ,* and Qingjie Chen

[3] Berberine enhances the AMPK activation and autophagy and mitigates high glucose-induced apoptosis of mouse podocytes Yingli Jin 1, Shuping Liu 1, Qingshan Ma 2, Dong Xiao 3, Li Chen 4, Affiliations expand, PMID: 27887947 DOI: 10.1016/j.ejphar.2016.11.037

[4] Activation of AMPK by berberine induces hepatic lipid accumulation by upregulation of fatty acid translocase CD36 in mice You-Jin Choi 1, Kang-Yo Lee 1, Seung-Hwan Jung 1, Hyung Sik Kim 2, Gayong Shim 1, Mi-Gyeong Kim 1, Yu-Kyoung Oh 1, Seon-Hee Oh 3, Dae Won Jun 4, Byung-Hoon Lee 5, Affiliations expand, PMID: 28038998 DOI: 10.1016/j.taap.2016.12.019

[5] Nat Rev Mol Cell Biol. 2018 Feb; 19(2): 121–135., Published online 2017 Oct 4. doi: 10.1038/nrm.2017.95, PMCID: PMC5780224 NIHMSID: NIHMS912714, PMID: 28974774, AMPK: guardian of metabolism and mitochondrial homeostasis, Sébastien Herzig and Reuben J. Shaw

[6] Exp Mol Med. 2016 Jul; 48(7): e245., Published online 2016 Jul 15. doi: 10.1038/emm.2016.81, PMCID: PMC4973318 PMID: 27416781, Regulation and function of AMPK in physiology and diseases, Sang-Min Jeon1,*

[7]Therapeutic effect of berberine on metabolic diseases: Both pharmacological data and clinical evidence

Xinmei Xu 1, Huan Yi 1, Jiasi Wu 1, Tingting Kuang 2, Jing Zhang 2, Qi Li 1, Huan Du 1, Tong Xu 2, Guihua Jiang 3, Gang Fan 4 Affiliations expand PMID: 33186794 DOI: 10.1016/j.biopha.2020.110984

[8]The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Jing Guo 1, Hongdong Chen 1 2, Xueqin Zhang 1, Wenjiao Lou 1, Pingna Zhang 1, Yuheng Qiu 1, Chao Zhang 1, Yaoxian Wang 1, Wei Jing Liu 1 3 Affiliations expand PMID: 34956436 PMCID: PMC8696197 DOI: 10.1155/2021/2074610

[9] Published online 2022 Nov 16. doi: 10.3389/fphar.2022.1015045 PMCID: PMC9709280 PMID: 36467075 Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis Wenting Xie, 1 , † Fugui Su, 2 , † Guizhong Wang, 3 , † Zichong Peng, 1 , † Yaomin Xu, 1 Yi Zhang, 1 Ningning Xu, 1 Kaijian Hou, 4 Zhuping Hu, 5 Yan Chen,corresponding author 6 ,* and Rongping Chencorresponding author 1.

[10] Published online 2022 Feb 17. doi: 10.3390/molecules27041351 PMCID: PMC8874997 PMID: 35209140 Berberine, a Herbal Metabolite in the Metabolic Syndrome: The Risk Factors, Course, and Consequences of the Disease Anna Och,1,* Marek Och,2 Renata Nowak,1 Dominika Podgórska,3 and Rafał Podgórski4 John C. D’Auria, Academic Editor and Enrique Barrajon, Academic Editor

[11] Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine Yifei Zhang 1, Xiaoying Li, Dajin Zou, Wei Liu, Jialin Yang, Na Zhu, Li Huo, Miao Wang, Jie Hong, Peihong Wu, Guoguang Ren, Guang Ning Affiliations expand PMID: 18397984 DOI: 10.1210/jc.2007-2404

[12] Published online 2012 Oct 15. doi: 10.1155/2012/591654 PMCID: PMC3478874 PMID: 23118793 Berberine in the Treatment of Type 2 Diabetes Mellitus: A Systemic Review and Meta-Analysis Hui Dong, 1 ,* Nan Wang, 2 Li Zhao, 1 and Fuer Lu 1 ,*

[13] Effects of berberine on blood glucose in patients with type 2 diabetes mellitus: a systematic literature review and a meta-analysis Yaping Liang 1 2, Xiaojia Xu 1, Mingjuan Yin 1, Yan Zhang 1, Lingfeng Huang 1, Ruoling Chen 3, Jindong Ni 1 Affiliations expand PMID: 30393248 DOI: 10.1507/endocrj.EJ18-0109
[14] Lipid-lowering effect of berberine in human subjects and rats Author links open overlay panelYueshan Hu a b, Erik A. Ehli a b, Julie Kittelsrud c, Patrick J. Ronan b c, Karen Munger c, Terry Downey c, Krista Bohlen c d, Leah Callahan c, Vicki Munson c, Mike Jahnke c, Lindsey L. Marshall e, Kelly Nelson a, Patricia Huizenga a, Ryan Hansen a c, Timothy J. Soundy b, Gareth E. Davies

[15] The effect of berberine supplementation on obesity parameters, inflammation and liver function enzymes: A systematic review and meta-analysis of randomized controlled trials Omid Asbaghi 1, Niloofar Ghanbari 1, Mahdi Shekari 2, Željko Reiner 3, Elaheh Amirani 4, Jamal Hallajzadeh 5, Liaosadat Mirsafaei 6, Zatollah Asemi 7 Affiliations expand PMID: 32690176 DOI: 10.1016/j.clnesp.2020.04.010

[16] Published online 2018 Nov 8. doi: 10.2147/DMSO.S181572 PMCID: PMC6233907 PMID: 30519065 Barberry in the treatment of obesity and metabolic syndrome: possible mechanisms of action Safieh Firouzi,1,2,* Mahsa Malekahmadi,1,2,* Majid Ghayour-Mobarhan,1,3 Gordon Ferns,4 and Hamid Reza Rahimi3,5