title: An evaluation of the effect of a topical product containing C-xyloside and blueberry extract on the appearance of type II diabetic skin.
abstract: BACKGROUND
  Diabetes is a multisystem disease caused by the presence of chronic hyperglycemia, which leads to increased oxidative stress. Many of the changes observed in type II diabetic patients can be traced to the increased production of advanced glycation end products, also known as AGEs. AGEs are produced as a result of a nonenzymatic reaction with glucose interacting with proteins, lipids, and nucleic acids. AGEs are also present in normal skin with advancing age and contribute to the senescence of many body organs, including the skin.
  
  
  OBJECTIVE
  This research evaluated the effect of a topical product formulation containing blueberry extract, an AGE inhibitor, and C-xyloside, a GAG synthesis stimulator, applied twice daily on the hand, arm, and facial skin of 20 type II diabetic females. Diabetic skin was chosen for evaluation because AGEs are found in increased concentration in diabetic skin, representing a model for accelerated aging.
  
  
  METHODS
  This single-center study enrolled 20 female type II diabetics aged 55+ years with mild to moderate fine lines, wrinkles, and hyperpigmentation on the face and hands. Subjects used the study product on their face, hand, and inner forearm twice daily for 12 weeks. Ordinal grading on a 4-point scale (0 = none, 1 = mild, 2 =moderate, 3 = severe) of facial fine lines, wrinkles, firmness, radiance, skin tone, skin smoothness, hyperpigmentation, creping, density, sagging, and overall appearance was performed by the investigator at baseline, week 4, week 8, and week 12. Tolerability, subject assessments, digital photography, AGE measurements, skin caliper measurements, and corneometry were also performed at each time point.
  
  
  RESULTS
  19/20 subjects successfully completed the study. The presence of AGEs was documented by skin autofluorescence. The 12-week duration of the study was insufficient to measure a change in skin AGEs, but longer application of the study product might produce different results. No tolerability issues were noted. There was a statistically significant increase in skin caliper measurements on the face (P = 0.004) and arm (P = 0.014) as well as corneometry measurements (P < 0.001) consistent with enhanced moisturization at week 12. The dermatologist investigator also found statistically significant improvement in fine lines (P = 0.01), firmness (P = 0.011), radiance (P < 0.001), skin tone (P = 0.014), skin smoothness (P < 0.001), creping (P < 0.004), and overall appearance (P < 0.001).
  
  
  CONCLUSIONS
  This study examined a topical product containing an AGE inhibitor and a GAG synthesis stimulator designed for the unique needs of diabetic skin.
authors.affiliation: Dermatology Consulting Services, High Point, NC, USA. zdraelos@northstate.net
authors.forename: Zoe Diana
authors.initials: ZD
authors.lastname: Draelos
authors.forename: Margarita
authors.initials: M
authors.lastname: Yatskayer
authors.forename: Susana
authors.initials: S
authors.lastname: Raab
authors.forename: Christian
authors.initials: C
authors.lastname: Oresajo
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D000975:Antioxidants / Q000494:pharmacology / Q000627:therapeutic use*; D029798:Blueberry Plants; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000188:drug therapy; D005145:Face / Q000473:pathology; D005260:Female; D005542:Forearm / Q000473:pathology; D017127:Glycation End Products, Advanced / Q000096:biosynthesis; D006027:Glycosides / Q000494:pharmacology / Q000627:therapeutic use*; D006225:Hand / Q000473:pathology; D006801:Humans; D017495:Hyperpigmentation / Q000188:drug therapy; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods*; D010936:Plant Extracts / Q000494:pharmacology / Q000627:therapeutic use*; D015595:Skin Aging / Q000187:drug effects* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000975:Antioxidants; C531898:C-xylopyranoside-2-hydroxypropane; D017127:Glycation End Products, Advanced; D006027:Glycosides; D010936:Plant Extracts