| Titre : | Milk Thistle (Silybum marianum) As a Potential Therapeutic Agent For Type 2 Diabetes |
| Auteurs : | Ouazani Fatima Zohra, Auteur ; Tabti Ghadir, Auteur ; Nasr-Eddine KEBIR, Directeur de thèse |
| Type de document : | texte imprimé |
| Editeur : | Dr. Moulay Tahar Université Saida, Faculté des Sciences Naturelles et de la Vie, 2024/2025 |
| Format : | 98 p / 29 CM |
| Accompagnement : | CD |
| Langues: | Anglais |
| Langues originales: | Anglais |
| Catégories : | |
| Mots-clés: | Diabetes mellitus ; Milk thistle (Silybum marianum ; Silymarin ; Insulin resistance ; Oxidative stress ; Glycemic control |
| Résumé : |
Diabetes mellitus is a chronic metabolic disorder marked by persistent
hyperglycemia due to impaired insulin secretion, insulin resistance, or both. Given the rising global prevalence of diabetes, there is growing interest in complementary therapies alongside conventional treatments. This thesis investigates the therapeutic potential of Silybum marianum (milk thistle), focusing on its bioactive constituent silymarin, through an integrative approach combining literature review, mechanistic evaluation, and field- based survey data. The pharmacological review highlights silymarin’s antioxidant, anti-inflammatory, and insulin-sensitizing properties, which contribute to improved glycemic control. A quantitative survey involving 100 diabetic patients and 10 healthcare providers revealed that although 76% of patients were aware of milk thistle, only 3% had used it for diabetes management. Among those users, all reported reductions in fasting blood glucose without adverse effects, despite not consulting their physician. Additionally, 79% of patients indicated willingness to use milk thistle if medically endorsed. Among physicians, 50% were aware of its potential benefits, though none had recommended it due to insufficient clinical evidence. Nevertheless, 70% viewed it as conditionally safe and expressed openness to future use pending stronger scientific validation. In conclusion, while silymarin demonstrates promising antidiabetic mechanisms, its integration into clinical practice requires robust clinical trials, regulatory oversight, and physician education to ensure evidence-based application in diabetes care. |
| Note de contenu : |
INTRODUCTION ............................................................................................................... 1 CHAPTER 01 :MILK THISLE ......................................................................................... 7 1.Milk Thistle (Silybum marianum) and Silymarin in Diabetes Management ................. 8 1.2. Pharmacological Actions of Silymarin in Diabetes .................................................... 8 1.3. Effects on Lipid Metabolism and Glycemic Control.................................................. 9 1.4. Clinical Evidence for Milk Thistle in Diabetes ........................................................ 10 2. Historical studies ......................................................................................................... 10 3. Ecological studies ........................................................................................................ 11 4. Botanical studies: ......................................................................................................... 11 4.1 .Scotch Thistle (Onopordum acanthium) ................................................................... 12 4.1.1. Leaves ................................................................................................................ 13 4.1.2. Flowers .............................................................................................................. 14 4.1.3. Seeds (Achenes) ................................................................................................ 15 5. Description................................................................................................................... 16 5.1. Morphology .............................................................................................................. 16 5.2. Biology and Physiology............................................................................................ 16 6.Taxonomy and Chemical Structure .............................................................................. 17 6.1. Silymarin .................................................................................................................. 17 6.2. Biosynthesis and Accumulation ............................................................................... 18 6.3. Extraction Methods................................................................................................... 19 6.4. Biotechnological Production .................................................................................... 20 CHAPTER 2: ANTIDIABETIC POTENTIAL OF MILK THISTLE ....................... 21 1 . Phytochemical Composition of Milk Thistle Key Bioactive Compounds ................. 22 2. Distinct Mechanisms Underlying the Antidiabetic Action of Milk Thistle ................ 23 2.1. Hepatic Effects ......................................................................................................... 23 2.1.1. Inhibition of Gluconeogenesis and Glycogenolysis .......................................... 23 ixTable of content 2.1.2. Modulation of Lipid Metabolism and Steatosis ................................................ 24 2.1.3. Redox Balance and Inflammatory Signaling ..................................................... 24 2.1.4. Clinical Data in NAFLD and T2DM ................................................................. 25 2.2. Skeletal Muscle Effects ............................................................................................ 26 2.2.1. Enhancement of Insulin Signal Transduction .................................................... 26 2.2.2. PI3K/Akt Pathway Restoration and GLUT4 Translocation .............................. 26 2.2.3. Contextual Considerations and Model-Specific Effects .................................... 27 2.3. Adipose Tissue Modulation ...................................................................................... 27 2.3.1. Anti-adipogenic Actions in Preadipocytes ........................................................ 27 2.3.2. Regulation of Adipokine Profiles and Insulin Sensitivity ................................. 27 2.3.3. In Vivo Effects on Adiposity and Inflammation ............................................... 27 2.4. Silibin’s anti-obesity and anti-diabetic properties .................................................... 28 2.4.1 In vitro studies .................................................................................................... 28 2.4.2 Animal ex vivo studies ....................................................................................... 29 2.4.3 Animal in vivo studies ........................................................................................ 30 3. Antidiabetic Effects of Milk Thistle: Protection of Pancreatic β-Cells: ...................... 32 3.1 . Mechanisms of β-Cell Protection: ........................................................................... 32 3.1.1. Anti-Inflammatory Effects: ............................................................................... 32 3.1.2. Antioxidant Action ............................................................................................ 32 3.1.3. Regulation of Apoptotic Pathways .................................................................... 32 3.2. In Vitro Evidence: .................................................................................................... 32 3.3. In Vivo Animal Studies ............................................................................................ 32 4. Meta-Analytical Evaluation of Milk Thistle (Silybum marianum) in the Management of Type 2 Diabetes Mellitus: Therapeutic Efficacy and Mechanistic Insights ................ 32 4.1. Silymarin Inhibits Cytokine-Stimulated Pancreatic Beta Cells by Blocking the ERK1/2 Pathway: ............................................................................................................ 33 4.2. Hypoglycemic effect of silychristin A from Silybum marianum fruit via protecting pancreatic islet β cells from oxidative damage and inhibiting α-glucosidase activity in vitro and in rats with type 1 diabetes: .............................................................................. 37 4.3. Antidiabetic Effects of Milk Thistle: Improves Insulin Sensitivity and Lowers Insulin Resistance: ........................................................................................................... 37 4.3.1. Mechanisms of Action:..................................................................................... 37 4.3.2. Therapeutic Potential of Milk Thistle in Modulating PPARγ Activity and Enhancing Insulin Sensitivity: ..................................................................................... 38 xTable of content 4.4. Silymarin as a Therapeutic Agent in Insulin Resistance and Metabolic Dysregulation................................................................................................................... 39 4.4.1. Silymarin and Lipid Metabolism: ...................................................................... 39 4.4.2. Silymarin in Pancreatic Damage Recovery and Carbohydrate Metabolism: .... 41 4.4.3. Silymarin ameliorates insulin resistance (IR):................................................... 43 4.4.4 Silymarin in clinical trials: ................................................................................ 44 4.4.5. Antioxidant and Anti-inflammatory Effects: ..................................................... 47 PART II:CHAPTER 03: MATERIALS AND METHODS ........................................... 48 1.Materials and Methods ................................................................................................. 49 1.1. Survey Among Diabetic Patients .............................................................................. 49 1.2. Survey Among Healthcare Professionals ................................................................. 59 1.2.1. Physicians’ Responses Regarding Milk Thistle (Silybum marianum) and Diabetes Management ................................................................................................. 63 1.3. Data Analysis ............................................................................................................ 63 PART III:CHAPTER 04 : RESULTS AND DISCUSSION ......................................... 64 1. Results: ........................................................................................................................ 65 2. Discussion of Findings and Key Results : ................................................................... 66 2.1 Perspectives from Diabetic Patients ......................................................................... 66 2.2 Perspectives from Healthcare Professionals .............................................................. 67 2.3 Implications ............................................................................................................... 68 CONCLUSION .................................................................................................................. 69 Conclusion: ...................................................................................................................... 70 Recommendations ....................................................................................................... 72 BIBLIOGRAPHICS REFERENCES .............................................................................. 73 ANNEXES .......................................................................................................................... 96 Investigative Study on Milk Thistle Use in Diabetics ..................................................... 97 Questionnaire for Diabetic Patients ............................................................................. 97 Questionnaire for Doctors (Endocrinologists, General Practitioners, etc.) ................. 98 |
Exemplaires
| Code-barres | Cote | Support | Localisation | Section | Disponibilité |
|---|---|---|---|---|---|
| aucun exemplaire |
Documents numériques (1)
BUC-M 000214 Adobe Acrobat PDF |
