Dietary non-starch plant polysaccharides: Multi-mechanisms for managing diabetic microvascular complications

The global burden of diabetes has been exacerbated by a shift in dietary patterns toward diets rich in refined sugars, saturated fats and energy-dense nutrients. Diabetes is a metabolic disease characterized by chronic hyperglycemia. Persistently elevated blood glucose levels can lead to microvascular complications that contribute greatly to reduced quality of life, disability or death. The pathogenesis of diabetic microvascular complications is highly complex, involving multidimensional interactions encompassing metabolic disorders, oxidative stress, and inflammatory cascades. This complexity poses a major challenge for the treatment of diabetic microvascular complications. Dietary non-starch plant polysaccharides (NSPs) have shown promise as modulators of diabetes-related microvascular complications due to their unique bioactivities, including anti-inflammatory, hypoglycemic, hypolipidemic, antioxidant, and immunomodulatory effects. The results showed that NSPs alleviate inflammation and oxidative stress by regulating the Nrf2/NF-κB/TGF-β/Smad signaling pathway, affecting the polarization of macrophages and T cells. In addition, NSPs ameliorate diabetic microvascular complications such as metabolic syndrome, diabetic nephropathy, diabetic retinopathy, and impaired diabetic wound healing by improving shared pathological networks such as glucolipid metabolism and gut microbiota-metabolites.