Prospects for the use of grape polyphenols in patients with type 1 diabetes mellitus

According to epidemiological studies, the number of patients with type 1 diabetes mellitus (DM1) in the Russian Federation is 277.1 thousand people. The number of patients continues to grow, as well as the prevalence and mortality rates, especially the negative trend is the average age of those who died from DM1, in particular for the female sex for the period from 2010 to 2022 this indicator decreased from 62.1 to 56.0 years. Glycation of structural molecules of organs and tissues leads to their dysfunction and subsequent disability of the patient. Despite the development of pharmacological industry and widespread availability of insulin preparations, not all patients reach target values of glycated hemoglobin. The development of secondary disorders mediated by insulin deficiency and impaired glycemia, such as dyslipidemia, low-intensity inflammation, metabolic endotoxinemia, and oxidative stress leads to vascular channel wall damage, significantly increasing cardiovascular risk in patients with DM1. Taking into account the whole spectrum of pathogenetic disorders in patients with DM1, a promising direction is the search for additional ways of regulation, including the use of biologically active compounds contained in plant materials, and in particular polyphenols. Literature data confirm the anti-inflammatory, antioxidant and hypoglycemic effects of polyphenols. Given the wide availability of polyphenols in the diet, their multifactorial impact on metabolic pathways, these compounds are a promising tool to influence the pathogenesis of various pathologies, including DM1. In view of the above, this review focuses on the influence of plant polyphenols, in particular grape polyphenols, on the pathogenesis of DM1, and possible ways of using polyphenol-rich foods/drugs to reduce risks in patients with DM1. By analyzing the MedLine (PubMed) databases, a search was conducted using the keywords, «diabetes type 1», «polyphenols», «inflammation» and «dyslipidemia» and a search of the eLibrary library using the keywords, «diabetes type 1», «polyphenols», «inflammation» and «dyslipidemia». Most of the scientific articles presented in this literature review were published in the last 5 years. The data presented in this review suggest that grape polyphenols are a potential agent that, in combination with mainstream disease therapy, can influence the underlying pathogenetic mechanisms of DM1, leading to improved glycemic control, achievement of lipid profile targets, and reduction of oxidative stress. Further study of polyphenols contained in grapes and grapes products will make it possible to create an effective and, most importantly, safe therapeutic agent for the reduction of cardiorespiratory stress.

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