“…Both clinical and preclinical studies ( Table 3) have shown that berberine could alleviate insulin resistance and reduce blood glucose [60,72,75,124,139,140], which is likely due to the protection of pancreatic β-cells [56,137,140] and restoration of insulin secretion [56,139,142]. Molecular mechanisms underlying berberine's pancreatic protection include modulation of anti-apoptotic Bax and pro-apoptotic Bcl-2 expression levels [138], activation of AMPK [139,142], restoration of sirtuin 1 (SIRT1) [141] and induction of uncoupling protein 2 (UCP2) [142]. SIRT1 is a nicotinamide adenine dinucleotide + -dependent histone deacetylase that plays crucial roles in the protection of pancreatic β-cells against inflammation and oxidative stress [149]; UCP2 regulates redox homeostasis and insulin expression in β-cells.…”