Diabetes mellitus is characterized by an absolute or relative deficiency in insulin secreted by beta-pancreatic cells and an increase in insulin resistance or impaired insulin action in target tissues (
9,
10).
Alpha-glucosidase hydrolyzes α (
1-
4) bonding from the non-regenerating end of starch and produces glucose. The alpha-glucosidase enzyme comprises five domains (A, B, C, D, and E) and 868 amino acids. The catalytic site of alpha-glucosidase contains Asp542-Glu444-Asp443 amino acids (
11).
There are approximately 945 species of Salvia, highly diverse in ecology, life form, morphology, and karyology (
12). It has been reported that plant foods, rich in polyphenols, have similar effects with insulin on glucose utilization. Moreover, inhibitors of key enzymes, such as alpha-amylase and alpha-glucosidase, prevent type 2 diabetes (
13).
The most dominant metabolites in the
Salvia species are terpenoids, which have the highest biological activity in these species (
14,
15). A wide range of natural compounds such as flavonoids, steroids, terpenoids, for instance, have been identified as alpha-glucosidase inhibitors (
16).
The results of this study shed light on the fact that dichloromethane and methanol extracts of
S. officinalis and
S. macilenta affect alpha-glucosidase inhibition and their IC
50 (
Table 1).
These results are in line with the results of a study by Hamidpour (2014) reporting that
S. officinalis is utilized as a traditional anti-diabetic drug in several countries, and its reducing effects on glucose were shown in animal studies. The study found that methanol extract of
S. officinalis significantly reduced serum glucose in type 1 diabetic rats without affecting pancreatic insulin production. In addition, it has been suggested that consumption of
S. officinalis tea is as effective as metformin in reducing blood sugar, and by lowering glucose production in the liver and increasing insulin function, it is capable of lowering blood sugar (
17).
These results are consistent with the findings of Ghorbani (2016), who identified the phytochemical compounds of
S. officinalis in flowers, leaves, and stems, involving alkaloids, carbohydrates, fatty acids, glycoside derivatives such as flavonoid glycosides, phenolic compounds, and terpenoids which had anti-mutagenic, anti-inflammatory, and hypoglycemic effects and could increase memory (
18).
The findings of Proenca (2017) revealed that the flavonoids present in the genus
Salvia could be substituted for other alpha glucose inhibitors, and their buildings are the determining factors for the above-mentioned effects. Proenca used acarbose as a positive control (
19).
Diabetes mellitus is believed to be the most serious chronic metabolic disease. According to the WHO, nearly 180 million people are currently diagnosed with type 2 diabetes. In addition, serious complications of diabetes mellitus, such as retinopathy and cataracts, could also trigger serious problems for patients. One of the treatments for diabetes is to delay glucose uptake by inhibiting carbohydrate-hydrolyzing enzymes (
20,
21). Studies have shown that flavonoids are a good alternative to alpha-glucosidase inhibitors. The structure of the flavonoids and the position and number of OH are the determining factors (
19). Research has shown that about 411 compounds of terpenes and flavonoids, phenols, and steroids have potent inhibitory activity against alpha-glucosidase (
22).
The percentage of inhibition exhibited that acarbose, as a standard at 10 mg/mL, was at the highest level of inhibition with 52.18%. At the concentration of 5 mg/mL, methanol extract of
S. officinalis depicted the highest inhibition (38.9%) after acarbose. Based on
Table 2, the inhibition type showed that methanol extract of
S. macilenta with Km = 3.73 ± 0.83mmol and Vmax = 0.002 ± 0.0002μmol/min was uncompetitive. Dichloromethane extract of
S. macilenta with Km = 3.36 ± 0.65 mmol and Vmax = 0.0025 ± 0.0001 μmol/min revealed mixed inhibition which is not affected by the substrate concentration. Acarbose with Km = 5.22 ±1.04 mmol and Vmax = 0.0028 ± 0.0003 μmol/min revealed competitive inhibition which is affected by the substrate concentration. Dichloromethane and methanol extracts of
S. officinalis, based on
Table 2, showed mixed inhibition with Km = 4.46 ± 1.17 mmol, Vmax = 0.0024 ± 0.003 μmol/min, and Km = 4.37 ± 0.57 mmol, Vmax = 0.0025 ± 0.0001 μmol/min, respectively.
Mixed and uncompetitive inhibitors have a greater enzyme inhibitory capacity than acarbose, as a competitive inhibitor, and against acarbose, their inhibitory potency is not influenced by substrate concentration (
23,
24).
One of the limitations of this study was that the experiments were only performed in vitro.
Another limitation herein was the toxic and carcinogenic effects of some plant-derived compounds, which make them unsuitable for therapeutic applications. Therefore, it is important to investigate the cytotoxic potential of plant extracts to validate the safety of medicinal plant extracts or compounds before their therapeutic applications.
Further studies should be directed towards chemical isolation, purification, and characterization of these two extracts to elucidate the compounds responsible for inhibition potential since these might play a significant role in the development of anti-diabetic agents. Furthermore, it is recommended to perform the experiments in vivo for finding the mechanisms of the utilized extracts in inhibiting alpha-glucosidase.