title: Coadjuvants in the Diabetic Complications: Nutraceuticals and Drugs with Pleiotropic Effects.
abstract: Because diabetes mellitus (DM) is a multifactorial metabolic disease, its prevention and treatment has been a constant challenge for basic and clinical investigators focused on translating their discoveries into clinical treatment of this complex disorder. In this review, we highlight recent experimental and clinical evidences of potential coadjuvants in the management of DM, such as polyphenols (quercetin, resveratrol and silymarin), cultured probiotic microorganisms and drugs acting through direct/indirect or pleiotropic effects on glycemic control in DM. Among several options, we highlight new promising therapeutic coadjuvants, including chemical scavengers, the probiotic kefir and the phosphodiesterase 5 inhibitors, which besides the reduction of hyperglycemia and ameliorate insulin resistance, they reduce oxidative stress and improve endothelial dysfunction in the systemic vascular circulation. In the near future, experimental studies are expected to clear the intracellular pathways involving coadjuvants. The design of clinical trials may also contribute to new strategies with coadjuvants against the harmful effects of diabetic complications.
authors.affiliation: Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil. pereiratmc@gmail.com.|Federal Institute of Education, Science and Technology (IFES), 29106-010 Vila Velha, Brazil. pereiratmc@gmail.com.
authors.forename: Thiago Melo Costa
authors.initials: TM
authors.lastname: Pereira
authors.affiliation: Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil. drfabiospimenta@hotmail.com.|Burn Treatment Center, Children State Hospital, 29056-030 Vitoria, Brazil. drfabiospimenta@hotmail.com.
authors.forename: Fabio Silva
authors.initials: FS
authors.lastname: Pimenta
authors.affiliation: Federal Institute of Education, Science and Technology (IFES), 29106-010 Vila Velha, Brazil. cella.porto@gmail.com.
authors.forename: Marcella Lima
authors.initials: ML
authors.lastname: Porto
authors.affiliation: Department of Pathophysiology, Montes Claros State University, 39401-089, Montes Claros, Brazil. marcelobaldo@ymail.com.
authors.forename: Marcelo Perim
authors.initials: MP
authors.lastname: Baldo
authors.affiliation: Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil. biancacampagnaro@yahoo.com.br.
authors.forename: Bianca Prandi
authors.initials: BP
authors.lastname: Campagnaro
authors.affiliation: Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil. agatagava@hotmail.com.|Division of Nephrology, McMaster University, Hamilton, ON L8N 4A6, Canada. agatagava@hotmail.com.
authors.forename: Agata Lages
authors.initials: AL
authors.lastname: Gava
authors.affiliation: Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil. meyrelle.vix@terra.com.br.
authors.forename: Silvana Santos
authors.initials: SS
authors.lastname: Meyrelles
authors.affiliation: Pharmaceutical Sciences Graduate Program, Vila Velha University (UVV), Av. Comissario Jose Dantas Melo 21, Boa Vista, 29102-920 Vila Velha, Brazil. evasquez@pq.cnpq.br.|Laboratory of Translational Physiology, Federal University of Espirito Santo (Ufes), 29047-100 Vitoria, Brazil. evasquez@pq.cnpq.br.
authors.forename: Elisardo Corral
authors.initials: EC
authors.lastname: Vasquez
mesh_terms: D000277:Adjuvants, Pharmaceutic / Q000627:therapeutic use*; D001688:Biological Products / Q000627:therapeutic use; D048909:Diabetes Complications / Q000150:complications / Q000188:drug therapy*; D019587:Dietary Supplements; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000188:drug therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*
chemical_list: D000277:Adjuvants, Pharmaceutic; D001688:Biological Products; D007004:Hypoglycemic Agents
keywords: antioxidants; diabetes; kefir; phosphodiesterase inhibitors; polyphenols; probiotic; quercetin; resveratrol; sildenafil; silymarin