Molecular mechanisms of antidiabetic effect of betulinic acid in lotus rhizome.

OBJECTIVES: To explain the bio-physiological mechanisms of the antidiabetic effect of betulinic acid in Lotus rhizome.

BACKGROUND: Even though Sri Lankan native medicine uses Lotus rhizome as a medicinal food for diabetes mellitus, its antidiabetic property has not been scientifically explained yet. It is found to compose several medicinally active components with antidiabetic properties, including Betulinic acid.

METHODS: A narrator review was conducted with a literature search in PubMed and Google Scholar databases using the search terms "Nelumbo nucifera rhizome", "Lotus rhizome", "phytochemicals", "antidiabetic effect", "hypoglycaemic effect" "Betulinic acid", and "molecular mechanism".

RESULTS: The triterpenoid, Betulinic acid exerts its antidiabetic effect via seven bio-physiological mechanisms including, inhibiting α-glucosidase and α-amylase, upregulating the expression of peroxisome proliferator-activated receptor gamma coactivator-1 α, enhancing AS160 protein phosphorylation, stimulating adenosine monophosphate-activated protein kinase activation, stimulating Glucose transporter type 4 synthesis and translocation, inhibiting Protein Tyrosine Phosphatase 1 B activity preventing dephosphorylation of insulin receptor and stimulating Takeda-G-protein-receptor-5 resulting in an increased release of insulin from insulin-containing granulesCONCLUSION: The available scientific knowledge explains that betulinic acid in Lotus rhizome can improve glucose homeostasis contributing to the antidiabetic effect of this root (Tab. 1, Fig. 6, Ref. 29).