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Berberine is the main active component of Coptis chinensis French, which has been used to treat diabetes for thousands of years. Type 2 diabetes is a worldwide health threat and its treatment is limited by availability of effective medications. All of the existing oral hypoglycemic agents have subsequent failure after long term administration.

In vitro: Berberine was found to be able to increase the glucose consumption and/or glucose uptake in the absence of insulin in adipocytes, hepatocytes and myotubes. The enhancing glucose metabolism of berberine might be due to glycolysis stimulation, which was related to the mitochondria oxidation inhibition. Berberine might also act as an alpha-glucosidase inhibitor. In addition, berberine inhibited activities of disaccharidases and decreased glucose transportation cross the intestinal epithelium [1].

In vivo: In diet-induced obese rats, berberine was found to reduce insulin resistance, similar to metformin. Berberin and metformin improved insulin resistance and liver glycogen level in insulin resistance models, but had no effect on insulin, blood glucose, lipid levels and muscle triglyceride depots [2].

Clinical trial: A pilot study was conducted to determine the efficacy and safety of berberine in the treatment of type 2 diabete. The hypoglycemic effect of berberine was found to be similar to that of metformin. Significant decreases in fasting blood glucose, hemoglobin A1c, plasma triglycerides and postprandial blood glucose were observed in the berberine treatment group [1].

References:
[1] Yin J,Xing H,Ye J.  Efficacy of berberine in patients with type 2 diabetes mellitus. Metabolism.2008 May;57(5):712-7.
[2] Gao CR,Zhang JQ,Huang QL.  Experimental study on berberin raised insulin sensitivity in insulin resistance rat models. Zhongguo Zhong Xi Yi Jie He Za Zhi.1997 Mar;17(3):162-4.