Ameliorating Effect of Aqueous Ginger Extract And Exercise On Insulin Resistance in Fructose Induced Type 2 Diabetic Rats Through Upregulation of Serum Sirtuin-1

Introduction:The mounting prevalence of type 2 diabetes mellitus (T2DM) in developing countries calls for an immediate need to find novel treatment strategies that not only target its underlying pathological process but are also safe and cost effective. Aims &Objectives:To determine the effect of ginger supplementation, exercise and their combination on insulin resistance (IR) and levels of serum sirtuin 1 (SIRT1) in fructose induced type 2 diabetic rat model. Material &Methods:This randomized controlled trial was conducted at animal laboratory of Postgraduate Medical Institute Lahore, Pakistan, from January 2021 to June 2021, in which thirty rats were randomly allocated to five groups with six rats in each.Rats belonging to group1 (Normal Control) were given normal rat chow diet. Diabetes was induced in groups 2, 3 and 4 by administering 25% fructose diet, following which, group 2 was reserved as diabetic/positive control (PC) and continued to receive 25 %fructose diet only. Animals of group 3 received aqueous ginger extract (GE), group 4 underwent swimming exercise (EX) and group 5 received their combination (GE+EX) for 8 weeks. Aqueous ginger extract was prepared in the Pharmacology lab at PGMI where 50 gm of fresh ginger was blended with 75ml of 0.9% NaCl and filtered thrice. The obtained filtrate was centrifuged at a speed of 2000 rpm for ten minutes. The clear supernatant fraction was made to reach 100 ml mark using NaCl resulting in a concentration of 500 mg/ml which was used for oral administration. Data was entered and analyzed using SPSS version 26, a p-value of ?0.05 was considered significant. Results:The results of the current study showed development of T2DM with 25% fructose supplementation in PC group, resulting in significantly high level of IR along with a significant reduction in levels of serum SIRT1. Aqueousginger extract group as well as the exercise group, both individually showed a significant reduction in IR as compared to the diabetic group and this was associated with significantly increased level of serum SIRT1 (p<0.05). However, most pronounced effect was seen in the combination group having lowest level of IR associated with a statistically significant increase in SIRT1 levels (p<0.05). Conclusion: Aqueousginger extract supplementation and exercise training, alone and in combination have the potential to significantly ameliorate IR in T2DM through its positive influence on serum SIRT1.However, the combination group has the most pronounced effect reflecting a potential synergistic effect of both interventions. Ginger supplementation and exercise may be introduced as safer, cost effective and natural adjunct to anti diabetic drugs hence lowering their potentially harmful side effects.