Exploring the Anti-Diabetic Potential of Anthocyanins: From Biochemical Pathways to Human Trials

Diabetes mellitus (DM) is a global health challenge with increasing prevalence rates, particularly in low- and middle-income countries. Anthocyanins (ACs) are potential bioactive compounds found in various fruits and vegetables, attracting the attention of researchers due to their possible role in managing diabetes and its complications. Studies have demonstrated the beneficial effects of ACs on blood sugar levels, insulin sensitivity, and glucose tolerance. These effects may be associated with multiple mechanisms, including increased glucose transporter type 4 (GLUT4) expression, enhanced glucose uptake, AMP-activated protein kinase (AMPK) and protein kinase C (PKC) phosphorylation, improved insulin sensitivity, activation of phosphoinositide 3-kinase/protein kinase B (PI3K/AKT) signaling, increased glutathione (GSH) synthesis, production of short-chain fatty acids (SCFAs), glucagon-like peptide-1 (GLP-1) secretion, induction of antioxidant enzymes, improved beta-cell functioning, and activation of insulin signaling pathways. The activity of enzymes (alpha amylase, glucosidase, and dipeptidyl peptidase-IV [DPP-IV]) and the expression of inflammatory biomarkers (tumor necrosis factor [TNF], IL6, and MCP1) are reduced. These findings suggest the potential of ACs as adjunctive therapies. However, further studies, including well-structured clinical trials, are needed to explore the optimal dosage and long-term efficacy of ACs in diabetes management.