Procyanidins and their healthy protective effects against type 2 diabetes.

This review focuses on the role of procyanidins, the main group of flavonoids, on type 2 diabetes mellitus (T2DM) and insulin resistance. We compile the role of procyanidins on several animal models, and we evaluate their effects on target tissues and analyze the mechanisms involved. Procyanidin treatments in fructose or high-fat induced insulin resistant models were found to improve the damage induced by the diet, thus improving glycemia and insulin sensitivity. The same positive effects were also reported in models of late stage T2DM, in which pancreatic β-cells can no longer counteract hyperglycemia. More controversial results were found in genetically obese or cafeteria diet-induced insulin resistant models. Human studies, although limited, further support the hypoglycemic effect of procyanidins. Regarding their mechanisms, procyanidins have been found to target several tissues involved in glucose homeostasis, which is also discussed in the present review. In insulin-sensitive tissues, procyanidins modulate glucose uptake and lipogenesis and improve their oxidative/inflammatory state, the disruption of which is important in T2DM development. In the insulin-producing tissue, the pancreas, procyanidins modulate insulin secretion and production and β-cell mass, although the available results are divergent. Finally, the gut is another potential target for procyanidins. The available data suggest that modulation of the active glucagon-like peptide-1 (GLP-1) levels could partially explain the reported antihyperglycemic effect of these natural compounds.