International Journal of Clinical Case Reports 2024, Vol.14, No.6, 327-338 http://medscipublisher.com/index.php/ijccr 332 5.2 Effects on blood glucose levels and insulin sensitivity The administration of Eucommia ulmoides leaves extract (ELE) has shown promising results in improving insulin sensitivity and modulating blood glucose levels. In fructose-drinking rats, a 4-week treatment with ELE at doses of 500 and 1 000 mg/kg significantly decreased plasma insulin levels and the Homeostasis Model Assessment ratio (HOMA-IR), an index of insulin resistance, without affecting blood glucose levels (Jin et al., 2010). This suggests that ELE can effectively enhance insulin sensitivity. Similarly, other studies have demonstrated that phytochemicals from different plants, including Eucommia ulmoides, can reduce blood glucose levels and improve lipid profiles, further supporting their potential as antidiabetic agents (Forid et al., 2021; Krawczyk et al., 2022). 5.3 Histopathological analysis of pancreatic tissue Histopathological analyses have provided insights into the protective effects of Eucommia ulmoides on pancreatic tissue. In a study involving Long–Evans rats, treatment with phytochemicals fromEucommia ulmoides resulted in significant improvements in pancreatic tissue architecture compared to diabetic control groups. This was evidenced by reduced damage and better preservation of pancreatic cells (Forid et al., 2021). These findings are consistent with other research indicating that the antioxidant properties of phytochemicals can protect pancreatic cells from oxidative stress and damage, thereby supporting their antidiabetic potential (Ahangarpour et al., 2019; Alam et al., 2022). 6 Case Studies 6.1 Clinical trials onEucommia ulmoides extracts Clinical trials have demonstrated the potential of Eucommia ulmoides extracts in managing various health conditions, including hypertension and diabetes. A controlled clinical trial evaluated the safety and efficacy of a standardized Eucommia ulmoides bark extract in reducing blood pressure. The study involved 24 healthy adults with blood pressure between 120-160/80-100 mmHg, who were administered 500 mg of the extract three times daily for eight weeks. The results indicated no toxicity and a significant reduction in blood pressure, suggesting the extract's potential as a nutraceutical intervention for prehypertension (Greenway et al., 2011). Additionally, another study highlighted the antioxidant effects of Eucommia ulmoides leaf extract in type 2 diabetic mice, showing significant improvements in blood glucose levels and antioxidant enzyme activities, which are beneficial for managing diabetes complications (Park et al., 2006). 6.2 Comparative studies with other antidiabetic agents Comparative studies have shown that Eucommia ulmoides extracts can be as effective as conventional antidiabetic agents. For instance, an ethanol extract of Eucommia ulmoides leaves (EEUL) was found to inhibit α -glucosidase and glucose transport in Caco-2 cells, with inhibitory activity comparable to that of acarbose, a standard antidiabetic drug. This suggests that EEUL could serve as a beneficial source of inhibitors for carbohydrate-utilizing enzymes and glucose transporters, potentially aiding in hyperglycemia management (Zhang et al., 2015). Furthermore, a study on the total flavonoids fromEucommia ulmoides leaves (TFEL) demonstrated their ability to improve insulin resistance and regulate sex hormones in a rat model of polycystic ovary syndrome with insulin resistance (PCOS-IR), showing effects similar to those of metformin, a commonly used antidiabetic medication (Peng et al., 2021). 6.3 Long-term efficacy and safety profiles Long-term studies on the efficacy and safety of Eucommia ulmoides extracts have provided promising results. A study on fructose-drinking rats (FDRs) showed that a 4-week treatment with Eucommia ulmoides leaves extract (ELE) significantly decreased plasma insulin levels and improved insulin resistance without affecting blood glucose levels. The treatment also ameliorated abnormal perivascular innervation, indicating the extract's potential in preventing insulin resistance and related complications (Jin et al., 2010). Another long-term study on streptozotocin-induced diabetic rats revealed that Eucommia ulmoides leaf extract (EULE) improved erectile dysfunction by protecting endothelial function and enhancing the hypothalamic-pituitary-gonadal axis function, further supporting its therapeutic potential in diabetes-associated complications (Fu et al., 2019). These findings
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