With healthcare costs rising, many affected by ailments are turning to alternative medicine for treatment. More people are choosing to complement their pharmacological regimen with dietary supplements from natural products. In this study, the compound composition of Kalanchoe Pinnata (K. pinnata) and the effects of combined preparations of K. pinnata and metformin on antioxidant activity in human skeletal muscle myoblasts (HSMMs) and human diabetic skeletal muscle myoblasts (DHSMMs) were investigated. Ultraperformance liquid chromatography fusion orbitrap mass spectrometry (UPLC-OT-FTMS) identified biologically active flavanols in K. pinnata. The main compounds identified in locally grown K. pinnata were quercetin, kaempferol, apigenin, epigallocatechin gallate (EGCG), and avicularin. Antioxidant results indicated that a combinatorial preparation of K. pinnata with metformin may modulate antioxidant responses by increasing the enzymatic activity of superoxide dismutase and increasing levels of reduced glutathione. A combination of 50 μM and 150 μg/mL of metformin and K. pinnata, respectively, resulted in a significant increase in reduced glutathione levels in non-diabetic and diabetic human skeletal muscle myoblasts and H₂O_2-stress-induced human skeletal muscle myoblasts. Additionally, a K. pinnata treatment (400 µg/mL) alone significantly increased catalase (CAT) activity for non-diabetic and diabetic human skeletal muscle myoblasts and a H₂O_2-stress-induced human skeletal muscle myoblast cell line, while significantly lowering malondialdehyde (MDA) levels. However, the treatment options were more effective at promoting cell viability after 24 h versus 72 h and did not promote cell viability after 72 h in H₂O₂-stress-induced HSMM cells. These treatment options show promise for treating oxidative-stress-mediated pathophysiological complications associated with type II diabetes.

Diabetes Mellitus is associated with systemic inflammation and oxidative stress, which may play a central role in the development of diabetic complications. In this study, combined preparations of Kalanchoe pinnata and metformin were investigated to determine the effects on inflammatory activity in human skeletal muscle myoblasts (HSMMs) and human diabetic skeletal muscle myoblasts (DHSMMs). Results showed that combinatorial preparations sustained cell viability for 3 days in both HSMM and DHSMM cells. However, a significant decrease in cellular viability occurred for both cell lines on day 5. Results also indicate that combinatorial preparations of K. pinnata may modulate immune responses by significantly upregulating proinflammatory markers, interleukin (IL) 2, and tumor necrosis factor-alpha, and upregulating the anti-inflammatory marker, IL-10, in HSMM and DHSMM cells. The combined preparations significantly downregulated the anti-inflammatory glycoprotein IL-6 in both diabetic and nondiabetic human skeletal muscle cells. The findings suggest that combined preparations of K. pinnata and metformin might be a potential immune-modulating agent that may promote inflammation and adversely affect the outcome of diabetic patients.