Protect , Preserve and Regenerate Beta CellThe Beta Cell Savior Strike at the root of T1DM & T2DM

Welcome to Cresvin … Awaken the power within

We at apex are committed to the cause of preventing all forms of Diabetes and even aim for Remission of Diabetes.

Over the past few decades, despite of substantial advances in managing Diabetes and its complications , managing diabetes still remains a major challenge all over the world.**

Regeneration of Beta Cells by Natural Remedies

As strategy protection, preservation and even regeneration of Beta Cells can go a long way in combating Diabetes and its morbid consequences. Considering the physiopathology of diabetes, preventing beta cell degeneration and stimulating the endogenous regeneration of islets will be essential approaches in treatment of diabetes. It is believed that beta cell can regenerate through the replication of pre-existing beta cells or neogenesis from stem cells and progenitor cells inside or outside the islets. Among the hundreds of plants that have been investigated for diabetes, a small fraction has shown the regenerative property [4].
Supplementation with Pterocarpus marsupium, Gymnema sylvestre, Curcumin and Resveratrol are natural remedies that help in protection, preservation and regeneration of Beta Cells by various mechanisms.

Pterocarpus marsupium
Pterocarpus is a very promising plant for combating diabetes since it has a wide variety of anti diabetic actions and is also proven in human clinical trials. The hypoglycaemic effects, antidyslipidaemic effects, antioxidative effects and the safety of the PM heartwood and the bark have been scientifically validated using a multitude of in vitro and in vivo studies. Multiple mechanisms responsible for hypoglycaemic effects of PM include Beta-cell regeneration, insulin release and insulin-like actions of some compounds isolated were identified. Additionally, inhibitions of alpha-amylase, alpha-glucosidase and protein glycation have also been demonstrated [8].

Several compounds including Pterostilbene, Pterosupin, Marsupsin, (-)-Epicatechin and Liquiritigenin isolated from the Pterocarpus marsupium were identified as compounds with hypoglycaemic effects [8].

A landmark ‘flexible dose double blind multi centre randomized controlled trial’ on 177 patients by an ICMR Study Group proved that Vijayasar (Pterocarpus marsupium) in a dose of 2-4 grams per day for 36 weeks was comparable in efficacy to Tolbutamide [28].

Another prospective, open, and non-randomized trial on 56 patients (Patidar...

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Beta Cell Protection

Regular exercise is probably one of the best options to maintain Beta cell function as well as Mitochondrial Function and ensure metabolic homeostasis. Avoidance of AGE rich foods (fried, roasted and cooked at high temperatures), inclusion antioxidant rich foods like deeply coloured fruits (eg. pomegranates, blueberries, dark grapes, oranges, mangoes and strawberries), helps to protect the ‘energy producing mitochondria’ inside the Beta cells. As mentioned above, many natural compounds in our food chain help to inhibit inflammatory cytokines like TNF alpha, NFkappaB, Interleukin-6 and even trigger anti inflammatory compounds like Interleukin-10 and Adiponectin.

Prevention of Inflammatory Damage to Beta cells

  • Supplementation with Resveratrol decreases blood glucose levels and protects Beta cells [9].
  • Resveratrol delays the onset of diabetes and also ameliorates the severity of the disease. These effects are accompanied by increased total islet number, increased number of insulitis free islets and improvement in general islet condition [9].
  • Resveratrol reduces the pathogenicity of lymphocytes by downregulation of the action of chemokines on multiple inflammatory cell types and blocking the migration of pathogenic cells to the pancreas [9].
  • Resveratrol is effective in mitigating the autoimmune destruction of β-cells [9].
  • Resveratrol reverses degenerative changes to Beta cells and prevents apoptosis of Beta cells. Resveratrol blocks the activity of Caspase-3, mainly by inhibiting the cleavage of poly (ADP-ribose) polymerase PARP [9].
  • Curcumin spices up the immune system and inhibits the release of proinflammatory cytokines like NF kappa B, TNF alpha, IL-6, IL 1b, MCP1 and reduces macrophage infiltration [10].
  • Curcumin helps prevent Diabetes by regulating epigenetic modifications [10].
  • Pterocarpus has anti-inflammatory, Beta cell protective and regenerative properties [11].
  • Pterostilbene (in Pterocarpus) ameliorated inflammation and acinar damage in pancreatitis [12].
  • Gymnema has anti inflammatory actions and useful in the treatment of diabetes. It shows positive effects on blood sugar homeostasis, controls sugar cravings, and promotes regeneration of pancreas [13]

Mitochondrial dysfunction is a primary contributor to...

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β Cell Regeneration in human pancreas is possible

The pancreas has a simplified ductal system surrounding the head, body, and tail of the pancreas, with scattered islets of cells at different sites. Pancreatic products, whether hormonal or non-hormonal, are secreted by distinct populations of cells, each at a specific location and with a specific function.

The exocrine functions of the pancreas are carried out by acinar cells; secrete pancreatic digestive enzymes (e.g. alpha-amylase, proteases and lipases). These cells are involved in regulating the neogenesis of islet cells [3].

The ductal structure of the pancreas is also formed by epithelial cells. The main physiological function of duct cells is to secrete mucus and bicarbonate. Current research suggests that duct cells play an important role in the regenerative process in the pancreas [3]

The pancreas contains exocrine acinar and ductal cells, and endocrine cells that form the Islets of Langerhans. The islet cells can be classified into five distinct glandular cell types: alpha, beta, delta, epsilon and F cells. In humans, the pancreas contains an estimated one million islet cells (Bonner-Weir et al., 2010), and the islets occupy 1–1.5% of the organ’s volume. The exocrine cells occupy 95% of the pancreas in adult humans and rodents. The adult human pancreas contains one million islets and approximately 74% of them are Beta cells [3].

Neogenesis, or the regeneration of endocrine Beta cells, occurs within a cluster of epithelial exocrine duct cells. The process commences when a subset of endocrine progenitor cells, buried within the ductal cells, starts to express Neurogenin3 (Ngn3) to form insulin secreting islets. Endocrine progenitor cells give rise to other exocrine cells including alpha cells [3].

A small peptide secreted by pancreatic acinar cells, known as “islet neogenesis-associated protein” (INGAP).
INGAP can induce Beta cell neogenesis and proliferation. It has been observed that the incubation of the INGAP peptide with human adipose tissue-derived...

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Beta Cell Mass and it’s relation to Diabetes

Beta cells in the pancreatic islets of Langerhans produce insulin. Deficiency in either beta cell mass or function, or both, can lead to insufficient level of insulin resulting in hyperglycemia (excessive levels of glucose in the blood) and diabetes. Recent studies suggest that in Type 1 and Type 2 Diabetes impairment of beta cell function is an early feature of disease pathogenesis while a substantial decrease in beta cell mass occurs more closely to clinical manifestations of diabetes. The development of novel strategies for the protection of beta cell and function could be most promising for successful diabetes treatment and prevention [6].

Insulin resistance, hormonal imbalances, stress and mitochondrial dysfunction play an important role in the pathogenesis of all form of Diabetes. The role of mental stress and pancreatic disease is now emerging.

The Prevention and Remission of Diabetes – PROD Initiative is a holistic approach, laying greater emphasis on improvement of beta cell mass and function; through diet, exercises and reduction of mental stress, in addition to medication as advised by the Physician. The total amount of insulin released, depends on the absolute number of beta cells in the pancreatic islets of Langerhans (beta cell mass) and the output of each of these cells (beta cell function).

Type 1 Diabetes (T1D) is a chronic autoimmune disorder in which the immune system attacks endogenous pancreatic beta cells resulting in insulin deficiency, chronic hyperglycemia, and long- term complications. Chronic insulitis reduces beta cell mass in the pre-diabetic phase by inducing cell death directly by cell to cell contacts or pro inflammatory cytokines.

In the pancreas, neighbouring cells can influence each other’s mass via several mechanisms. An intriguing autoimmune destructive process is triggered by pancreatic alpha cells neighbouring beta cells, which ultimately results in the reduction of beta cell mass and the appearance of...

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Repair of Beta Cells

Enhancing endogenous antioxidant and repair systems
There are approximately a 100 trillion cells in the adult human body. Each cell has the same genetic code, common to all humans, much like the hardware in our computer. All of us started as one embryonic cell in our mother’s womb. During the process of differentiation into various cell types and tissues, each cell expresses a particular set of genes. This is like a small part of the hardware in your computer, expressing or playing selected software. For example, all genes required for vision are expressed in the eyes. It still has the same genetic structure and is intimately connected to the whole body. After the differentiation of an embryonic cell into a specialized cell or tissue, it has to stay differentiated for a lifetime and perform its functions. Whole body homeostasis can continue only if the various cells and tissues perform their functions and do not revert or differentiate further. This is ensured by a set of ‘regulator genes’ which ensure that any further changes in the differentiated cells or tissue are ‘silenced’. These regulator genes are known as ‘silent information regulators’ (SIR) genes.
They perform their ‘sensing, regulation and repair’ functions through a series of enzymes known as Sirtuins.

Sirtuins
Sirtuins are quoted as “very influential cellular repair switches”, that control a wide range of key functions including protein translation, autophagy, mitochondrial function and bioenergetics, and the cellular metabolism of fats, proteins, and carbohydrates [16]. (Harrison’s Principles of Internal Medicine, 19th Edition)

SIRT1. The sirtuins are a class of histone deacetylases that inhibit gene expression. The key nutrient-sensing member of this class in mammals is SIRT1. Important downstream targets include PGC1a and NRF2, which act on mitochondrial biogenesis [16]. Resveratrol is an agonist of Sirt1 [16]. Intermittent fasting also activates Sirt1 and...

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13 Low Glycemic Index Fruits That Are Ideal For Diabetics

One of the most commonly asked question by a diabetic patient is, “Can I have fruits?” The answer to this is not a simple “yes” or “no”. Although diabetic patients can include fruits in their diet, there are some factors that the patients need to keep in mind when choosing a fruit, the most important being the glycemic index. Glycemic Index is a number which tells us about the effect of food on a person’s blood sugar level.The Glycemic Index has a scale from 0 to 100, where 100 is pure glucose. Low GI foods do not raise blood sugar level to a considerable extent like high GI foods do. So, fruits containing low GI are highly preferable. Roughly,

-GI value below 50 is considered low.

-GI value between 50 ‐60 is considered average.

-GI value above 60 is high.

-Here are the GI scores of some of the commonly available fruits: black Jamun (25), cherries (20), pear (38), apple (39), orange (40), plum (40), strawberry (41), peach (42), guava (32).

6 LOW GI FRUITS THAT ARE IDEAL FOR DIABETICS

1 . Strawberries

Apart from providing a mouth watering luster to a delicious dessert, strawberries bear a name of super food for diabetics. They are enriched with potassium (which helps in keeping blood sugar level in check), antioxidants, and vitamins. Moreover, they have low GI level. So strawberries have a lot to offer from their indulging taste to added topping of value.

Nutritional value: 100 gm strawberries has 33 Kcal calories and 8 grams of carbohydrates.

2 . Black Jamun

This fruit holds a special significance owing to its numerous qualities. Every part of Jamun holds wondrous properties to fight diabetes. Its seeds can be powdered and consumed each day in the morning on an empty stomach. The fruit pulp and bark are rich in vitamins, antioxidants and have...

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Why Beta Cells need to be saved? Very early !!

Diabetes results from a deficiency or functional impairment of insulin producing Beta cells, alone or in combination with insulin resistance (IR). The replacement or regeneration of Beta cells in humans and rodents has great promise in reversing diabetes as proven by stem cell therapies that create new human Beta cells. Here we present compelling reasons for adopting a healthy lifestyle, a balanced diet, regular physical exercise and the need for preventing and relieving stress. Beta Cells need to be saved very early in life; much earlier than we thought!
We begin life with very Limited β Cell Reserves 1

Beta Cell proliferation begins shortly after birth and continues till the age of 2 years, after which further proliferation practically stops. The rate of Beta cell proliferation is highest (1-3%) in the 1st year of life. The rate of Beta cell proliferation declines to less than 0.2% on reaching 2 years of age and the normal adult rate of Beta cell proliferation is 0.1% . Throughout adult life the Beta cell mass is relatively constant in healthy individuals.

Declining β Cell Reserves and Function due to increasing Plasma Glucose 2

Dietary intake of sugary foods and drinks combined with a sedentary lifestyle causes the fasting plasma glucose to rise steadily during adolescence and adult life.

  • Increasing FPG reduces β Cell function (relative to Insulin Sensitivity)
  • Beta cell function significantly declines by 49% in the Pre-diabetic stage (FPG between 100-126 mg/dl)
  • Beta cell function declines by 23% even in Normoglycemic adolescents (FPG between 90-100 mg/dl)

Changes in Insulin Sensitivity induce adaptations in Beta Cells

There may be an increase in neogenesis, or new beta-cell formation (replication), and an increase in the beta-cell mass, or hypertrophy, that may occur in response to Insulin Resistance and Obesity

Source: Medscape CME 11/06/2006; Beta Cell...

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Reduce IR and Save Beta Cells

Insulin resistance, inadequate insulin secretion, hormonal imbalances, stress and mitochondrial dysfunction play an important role in the pathogenesis of all form of Diabetes. Insulin Resistance results from inherited and acquired influences.
Hereditary causes of Insulin Resistance include mutations of insulin receptor, glucose transporter, and signaling proteins, although the common forms are largely unidentified.
Acquired causes of Insulin Resistance include physical inactivity, diet, medications, hyperglycemia (glucose toxicity), increased free fatty acids, and the aging process.
A sedentary lifestyle or lack of exercise reduces the function of insulin receptors present on the surface of each cell. This results in reduced muscular and tissue uptake of glucose and causes hyperglycemia. Insulin resistance results in increased insulin secretion to maintain normal glucose and lipid homeostasis. This compensatory hyperinsulinemia leads to endothelial dysfunction, atherosclerosis, metabolic syndrome, type 2 diabetes and cardiovascular diseases; in addition to Beta cell failure.

Classification of pre-receptor, receptor, and post-receptor causes of Insulin Resistance

(Source: Ref 34, Medscape – Insulin Resistance Sep 18, 2017. Author: Samuel T Olatunbosun)
Pre-receptor causes of insulin resistance include the following:

  • Abnormal insulin (mutations)
  • Anti-insulin antibodies

Receptor causes include the following:

  • Decreased number of receptors (mainly, failure to activate tyrosine kinase)
  • Reduced binding of insulin
  • Insulin receptor mutations
  • Insulin receptor–blocking antibodies

Post-receptor causes include the following:

  • Defective signal transduction
  • Mutations of GLUT4 

Mitochondrial dysfunction may play an important role in the development of insulin resistance and associated complications. Obesity, the most common cause of insulin resistance, is associated with a decreased number of receptors and with post-receptor failure to activate tyrosine kinase. Insulin binds and acts mainly through the insulin receptor and also acts via the insulin like growth factor–1 (IGF-1) receptor; cellular actions of insulin involve a wide variety of effects on post-receptor signaling pathways within target cells.

Specific causes of insulin resistance

  • Physical inactivity
  • Aging may cause insulin resistance...
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Regulate Metabolic Pathways and Hormones

Several mediators are thought to signal the pancreatic Beta cells to respond to insulin resistance. These potential signaling mediators include glucose, free fatty acids, autonomic nerves, fat-derived hormones (Adiponectin), and the gut hormone glucagon like peptide-1 (GLP-1). GLP-1 is an incretin hormone that stimulates insulin secretion, causes Beta cell mitosis while inhibiting apoptosis, inhibits glucagon secretion, and delays gastric emptying with overall anti-diabetic effects.

Leptin and Ghrelin are 2 hormones that have a major influence on energy balance. Leptin is a long-term regulator of energy balance, suppressing food intake and thereby inducing weight loss. Ghrelin is a fast-acting hormone, seemingly playing a role in meal initiation. Thyroid hormone plays a very important role in energy expenditure. They are all interconnected via complex signaling pathways. It is becoming more and more evident that proper diet, exercise, clean environment and stress reduction are the fundamental requirements for a healthy life. Advancements in medical science are slowly unraveling the complex interactions; however we are closer to a clear understanding of the complex interactions or finding a cure.

The ingredients of Cresvin Beta are meant to assist Diabetics in their fight against diabetes; under the supervision of a Diabetologist. The scientific team at Apex Laboratories Private Limited has designed Cresvin Beta for improving the functioning of the metabolic pathways and favourably altering the hormone levels; in an attempt to prevent Diabetes and also aim for remission whenever it is possible. The chances of remission are greatly increased if the various interventions are done at an early stage there are sufficient reserves of functional Beta Cells.

Some of enzymes in the metabolic pathway also play a very important role in the pathogenesis of Diabetes. The ingredients in Cresvin Beta are known to regulate these enzymes, in addition to the hormones.

One of the major anti diabetic herbal in Cresvin...

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Improve Mitochondrial Function and Biogenesis

Mitochondria are energy producing organelles inside each human cell. They are bacteria like structures which have their own genetic material or DNA, RNA and protein synthesizing systems. Just like bacteria they can divide on their own (fission) and also fuse with each other (fusion). Mitochondria have a symbiotic relationship with the main cell and there is an elaborate signaling system between them and the nucleus of the cell. Mitochondria are often affectionately nicknamed “the powerhouse of the cell.” The epithet is well earned, as one of the most important contributions of the mitochondria to the cell is the production of ATP through oxidative phosphorylation (OXPHOS).

Adenosine tri phosphate (ATP) is the ‘energy currency’ of the body and it provides the energy for all the enzyme reactions and other processes in the cells. ATP is found in all living cells whether it is humans, animals, insects or bacteria. When consumed in metabolic processes, phosphorus ion donated and it converts to either the di- or monophosphates, respectively ADP and AMP. Mitochondria regenerate ATP through OXPHOS by adding phosphorus again. The human body recycles its own body weight equivalent in ATP each day. The optimal functioning of the Mitochondria and Mitochondrial Biogenesis is thus very critical for growth and health.

Each human cell contains hundreds of mitochondria. They burn the calories in our diet with the oxygen that we breathe to make chemical energy to do work and heat to maintain our body temperature. The mitochondria generate energy by oxidizing hydrogen derived from our dietary carbohydrates (TCA cycle) and fats (Beta-oxidation) with oxygen to generate heat and ATP. As a by-product of energy production, the mitochondria also generate most of the endogenous reactive oxygen species (ROS) of the cell, and these damage the mitochondria, mtDNAs, and the cell. The number of mitochondria in any tissue depends upon the energy...

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Improve Cardiac Substrate Utilization

In Type 2 diabetes mellitus (T2DM) there is a more than 2-fold greater risk of developing heart failure (HF) and a 60%–80% greater probability of death in those with established HF. Evidence suggests that T2DM itself can drive adverse cardiac remodeling and give rise to diabetic cardiomyopathy and is reportedly evident in up to 60% of patients with T2DM. Diabetic cardiomyopathy is characterized by unexplained myocardial hypertrophy and fibrosis, with left ventricular (LV) diastolic impairment. At the cardiomyocyte level various defects including calcium mishandling and increased oxidative stress are present. Mitochondrial dysfunction is associated with abnormal myocardial structure and function in T2DM. Reductions in OXPHOS manifest in decreases in myocardial PhosphoCreatine and ATP content which have been shown in animals and humans with T2DM. [53].

Profound alterations in myocardial substrate metabolism and energetics have been shown. Crucially, these metabolic derangements precede cardiac structural and functional changes. Their early correction in animal models of T2DM aborted the development of diabetic cardiomyopathy. Consequently, metabolic abnormalities of the heart are promising therapeutic targets whose amelioration might improve outcomes in T2DM [53].

The heart is the highest energy consuming organ of the body, needing about 30kg of ATP per day. This is nearly 75-100 times the weight of the heart [53]. The mitochondria in the muscles of the heart produce the required ATP by the process of oxidative phosphorylation or OXPHOS. For continuous ATP generation there should be sufficient functional mitochondria and a continuous supply of oxygen and fuel substrates. Consistent with its high energy demands, the myocardium has the highest mitochondrial density (35% of cardiomyocyte volume versus 3%–8% in skeletal and smooth muscle cells) of any organ, and its mitochondria exhibit the greatest number of cristae which enhance OXPHOS [53].

Fatty Acids (FA) are the preferred fuel substrates and account for 70%–90% of myocardial ATP generation.Glucose...

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58. Alternative therapies in management of Diabetes

Diabetes mellitus is a metabolic disorder in the endocrine system. This dreadful disease is found in all parts of the world and becoming a serious threat of mankind health. There are lots of chemical agents available to control and to treat diabetic patients, but total recovery from diabetes has not been reported up to this date. In addition to adverse effects, drug treatments are not always satisfactory in maintaining euglycemia and avoiding late stage diabetic complications. Alternative to these synthetic agents, plants provided a potential source of hypoglycemic drugs and are widely used in several traditional systems of medicine to prevent diabetes. Several medicinal plants have been investigated for their beneficial effect in different type of diabetes. Other alternative therapies such as dietary supplements, acupuncture, hydrotherapy, and yoga therapies less likely to have the side effects of conventional approaches for diabetes.
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia, abnormal lipid, and protein metabolism along with specific long-term complication affecting the retina, kidney, and nervous system. Diabetes mellitus has a significant impact on the health, quality of life and life expectancy of patients as well as on the health care system.

Diabetes mellitus has been recognized as a growing worldwide epidemic by many health’s advocacy group including WHO. The WHO has estimated that diabetes will be one of the world leading cause of death and disability with next quarter century. The statistics are alarming; 30 million people were diagnosed with diabetes worldwide in 1985, by 1995 the number had risen to 135 million, and at the current rate there will be some 300 million by the year 2025 as predicted by the WHO.Currently, there are more than 17 million type 2 diabetic patients in the United States (or ~5.9% of the population), 11 million in Europe, and 6 million in...

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    Diet

    If you have diabetes or prediabetes, your doctor will likely recommend that you see a dietitian to help you develop a healthy eati...

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    Exercise

    Bicycling is also a form of aerobic exercise, one that makes your heart stronger and your lungs function better. A stationary bike...

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    Meditation

    Ayurveda is an ancient healthcare system that focuses on the overall health and wellbeing. It includes remedies made from the leav...