Kidney disease is characterised by the improper functioning of the kidney as a result of kidney damage caused by hyperglycaemia-induced oxidative stress. The moderate hyperglycaemia seen in prediabetes can be treated using a combination of metformin and lifestyle interventions (low-calorie diets and exercising). However, patients have been reported to over-rely on pharmacological interventions, thus decreasing the efficacy of metformin, which leads to the development of type 2 diabetes mellitus (T2DM). In this study, we investigated the effects of a rhenium (V) compound in ameliorating renal dysfunction in both the presence and absence of dietary modification. Kidney function parameters, such as fluid intake and urine output, glomerular filtration rate (GFR), kidney injury molecule (KIM 1), creatinine, urea, albumin and electrolytes, were measured after 12 weeks of treatment. After treatment with the rhenium (V) compound, kidney function was restored, as evidenced by increased GRF and reduced KIM 1, podocin and aldosterone. The rhenium (V) compound ameliorated kidney function by preventing hyperglycaemia-induced oxidative stress in the kidney in both the presence and absence of dietary modification.

Prolonged exposure to high energy diets has been implicated in the development of pre-diabetes, a long-lasting condition that precedes type 2 diabetes mellitus (T2DM). A combination of pharmacological treatment and dietary interventions are recommended to prevent the progression of pre-diabetes to T2DM. However, poor patient compliance leads to negligence of the dietary intervention and thus reduced drug efficiency. Momordica balsamina (MB) has been reported to possess anti-diabetic effects in type 1 diabetic rats. However, the effects of this medicinal plant in conjunction with dietary intervention on pre-diabetes have not yet been established. Consequently, this study sought to evaluate the effects of MB on glucose homeostasis in a diet-induced pre-diabetes rat model in the presence and absence of dietary intervention. Pre-diabetes was induced on male Sprague Dawley rats by a high fat high carbohydrate (HFHC) diet for a period of 20 weeks. Pre-diabetic male Sprague Dawley rats were treated with MB (250 mg/kg p.o.) in both the presence and absence of dietary intervention once a day every third day for a period of 12 weeks. The administration of MB with and without dietary intervention resulted in significantly improved glucose homeostasis through reduced caloric intake, body weights, with reduced plasma ghrelin concentration and glycated hemoglobin by comparison to the pre-diabetic control. MB administration also improved insulin sensitivity as evidenced by the expression of glucose transporter 4 (GLUT 4) and glycogen synthase on the prediabetic treated animals. These results suggest that MB has the potential to be used to manage pre-diabetes and prevent the progression to overt type 2 diabetes as it demonstrated the ability to restore glucose homeostasis even in the absence of dietary and lifestyle intervention.

Introduction Prediabetes is an intermediate state of progression from normoglycemia to overt type 2 diabetes. Literature suggests that managing prediabetes is beneficial in delaying the onset of diabetes. Previous studies have shown that Momordica balsamina (MB) possesses anti-hyperglycaemic effects; hence in this study, its effect on renal function in diet-induced pre-diabetes was explored. Methodology Male Sprague-Dawley rats (130-180 g) were divided into six groups of six rats per group; Normal control, Prediabetic (PD), Metformin (500 mg/kg, p.o.) treated PD without dietary intervention (DI), MB (250 mg/kg, p.o.) treated PD without DI, Metformin treated PD with DI and MB treated PD with DI. The animals were treated for 12 weeks of the last 32 weeks where fluid intake and urinary output was measured. After 12 weeks, the animals were sacrificed, plasma, urine, and kidney samples were collected for biochemical analysis. Results The untreated prediabetic (PD) rats presented with increased fluid intake and urine output; increased creatinine, urea, and uric acid plasma concentrations; sodium retention; potassium loss; increased aldosterone and kidney injury molecule (KIM-1) concentration; and increased urinary podocin mRNA concentration. However, MB administration attenuated the renal markers and oxidative stress and decreased the urinary podocin mRNA expression with or without diet intervention. Conclusion MB administration, regardless of diet modification, attenuates renal dysfunction in an experimentally induced prediabetic state. This suggests that MB has beneficial properties in the management of pre-diabetes associated kidney dysfunction.