Abstract
Diabetes mellitus (DM) represents a heterogeneous and multifactorial metabolic disorder, leading to diverse economic challenges and health complications, significantly affecting individuals’ lives. Type 2 diabetes (T2DM) stands as the predominant form of diabetes, with its onset influenced by a range of genetic and environmental factors. Currently, conventional diabetic medications are employed in clinical practice, but they may entail certain side effects. Fortunately, diverse natural polysaccharides extracted from plants exhibit antidiabetic properties, which have been demonstrated to effectively mitigate hyperglycemia, reverse insulin resistance, and forestall complications associated with diabetes. Consequently, exploring the utilization of these polysaccharides as adjuncts to conventional therapies has emerged as a novel research direction in recent years. Thus, this review centers on the extraction, purification, and characterization of plant polysaccharides, providing an overview of the advancements in the antidiabetic effects and mechanisms of natural polysaccharides. This perspective offers fresh insights to explore potential research domains and enhances understanding for the development of diabetic drugs derived from polysaccharides.
Introduction
The International Diabetes Federation reported that diabetes affected over 537 million individuals globally, leading to 6.7 million deaths in 2021, equating to nearly one death every 5 s (Figure 1). Expenditure on diabetes reached US $966 billion, marking an almost 316 % surge over the past 15 years. This reflects an escalation rate surpassing anticipated levels. The projected number of individuals diagnosed with diabetes is expected to reach 783 million by the year 2045. Additionally, more than 541 million adults are expected to display impaired glucose tolerance, increasing their susceptibility to the development of type 2 diabetes [1].

The prevalence estimation of diabetes by region in 2021.
Diabetes mellitus (DM) constitutes a chronic metabolic disorder that ensues when the body either ceases to produce an adequate amount of insulin or fails to effectively utilize the available insulin it produces [2]. The primary clinical manifestation of DM is hyperglycemia and additional common symptoms include polyuria, polydipsia and polyphagia [3]. In severe instances, complications may result in kidney failure, cardiovascular diseases, and diminished vision [4]. There are several types of diabetes, but 2 types are most common: type 1 (T1DM) is an autoimmune disease associated with insulin deficiency, while type 2 diabetes (T2DM), formerly known as non-insulin-dependent diabetes mellitus, is a complex metabolic and endocrine disorder characterized by high blood sugar, insulin resistance (IR), and relative insulin deficiency [5]. The latter represents the most prevalent form of DM, constituting the majority of DM cases worldwide.
T2DM exerts a considerable influence on diverse facets of an individual’s health and well-being. Untreated, these conditions impact multiple organ systems and can result in a spectrum of short-term and long-term complications. The management of T2DM necessitates lifestyle modifications, regular monitoring, and pharmacological intervention [6]. Generally, addressing hyperglycemia proves to be an effective strategy for preventing and treating T2DM [7]. Various commonly used drugs, such as biguanides, thiazolidinediones, sulfonylureas, and newer agents like glucagon-like peptide-1 (GLP-1) analogs, dipeptidyl peptidase-4 (DPP-4) inhibitors, sodium-glucose cotransporter-2 (SGLT-2) inhibitors, and G protein-coupled receptor 119 (GPR 119) agonists, have been widely utilized in the treatment of T2DM [8]. Nevertheless, common drugs are susceptible to adverse effects such as severe hypoglycemia, weight gain, and reduced therapeutic efficacy, whereas the latter are associated with higher costs. This necessitates the exploration of alternative medicines that are effective, safe, and cost-effective.
Recently, plant extracts have been described as reputedly beneficial for T2DM treatment. Chemicals with antidiabetics bioactivities, such as polyphenols, alkaloids, saponins and flavonoids, are common metabolites from plants all over the world [9]. Plants containing these chemicals are used to develop a formula for the treatment of T2DM. In recent years, numerous studies have also discovered that plant polysaccharides exhibit antidiabetic effects and studies on plant polysaccharides have rapidly evolved since then. The antidiabetic properties of polysaccharides are proposed to be regulated through a variety of mechanisms and are the focus in the last part of this review. Various sources of plant polysaccharides exhibiting a positive effect on hyperglycemia are listed in Table 1. This review focuses on the extraction, purification, and characterization of bioactive polysaccharides. Furthermore, this review delves into the underlying metabolic mechanisms linked to antidiabetic polysaccharides, with the goal of propelling the advancement of polysaccharides as promising choices for preventing and treating diabetes.
Plant source reported with antidiabetic polysaccharides.
Plant source | Common name | Effects | References |
---|---|---|---|
Triticum aestivum | Wheat | Reduces blood glucose levels | [10] |
Oryza sativa | Rice | Reduces blood glucose levels | [10] |
Zea mays | Corn | Reduces blood glucose levels | [10] |
Avena sativa | Oat | Reduces blood glucose levels | [10] |
Cucumis sativus | Cucumber | Lowers blood glucose; increases serum insulin levels | [11] |
Luffa acutangular | Ridge gourd | Reduces blood glucose levels | [11] |
Lagenaria siceraria | White gourd | Reduces blood glucose levels | [11] |
Cucurbita moshata duch | Pumpkin | Lowers blood glucose concentrations; increases serum insulin levels; inhibiting β-cell apoptosis | [11] |
Citrullus vulgaris | Watermelon | Reduces blood glucose levels; increases serum insulin concentrations; protective effect on the pancreatic β-cells | [12] |
Cucurbita ficifolia bouché | Chilacayote | Reduces blood glucose levels | [12] |
Momordica charantia | Bitter melon | Increases the uptake of glucose and secretion of adiponectin from fat cells | [12] |
Sechium edule | Choko | Reduces blood glucose levels | [12] |
Lycium barbarum | Goji berry | Reduces blood glucose levels; inhibiting β-cell apoptosis | [13, 14] |
Ophiopogon japonicus | Mondo grass | PI3K/AKT pathway activator; increasing insulin levels, and repairing islet destruction and pancreatic β-cell damage | [15] |
Astragalus membranaceus | Milkvetch root | Reduces blood glucose levels; inhibiting glucose uptake; inhibiting β-cell apoptosis; | [16, 17] |
Ganoderma lucidum | Reishi | Reduces blood glucose levels; inhibiting glucose uptake; inhibiting β-cell apoptosis | [18] |
Angelica sinensis | Chinese Angelica | Protecting and repairing pancreaticβ-cells; Lowers blood glucose; PI3K/AKT pathway activator | [19] |
Camellia sinensis | Tea | Inhibiting β-cell apoptosis and increasing β-cell numbers; Lowers blood glucose; reducing insulin resistance | [20] |
Fructus mori | Mulberry | PI3K/AKT pathway activator; Protecting and repairing pancreatic β-cells; Lowers blood glucose | [21] |
Abelmoschus esculentus | Okra | Reduces blood glucose levels | [22] |
Plant polysaccharides properties
Polysaccharides are complex carbohydrates composed of repeating units of monosaccharides linked together by glycosidic bonds formed during hydrolysis. The structure can vary from linear to highly branched, constituting both small and large molecules with low and high molecular weights. The specific structure of a polysaccharide is dictated by the types of monosaccharides present, the glycosidic bonds linking them, the branching patterns, and possible modifications. These structural variations contribute to the diverse properties and functions of polysaccharides within organisms. In plants, polysaccharides are abundantly present in cell walls, playing vital roles in the structure, support, and function of plant cells. Some of the important plant polysaccharides are cellulose, hemicellulose, pectin, gum, and starch. Table 2 summarizes the typical composition of these important plant polysaccharides. Plant polysaccharides with reported antidiabetic effects are known to exhibit specific physicochemical properties, including water solubility, fermentability, and a certain degree of viscosity.
Major polysaccharides in plants and their typical composition.
Major plant polysaccharides | Main source | Typical composition | References |
---|---|---|---|
Cellulose | A structural polysaccharide found in plants, it is present in wood, cotton, and cereal straw | β-D-glucose | [23] |
Hemicellulose | Present in the primary and secondary cell walls of vegetables | Xyloglucan Galactomannan Glucomannan Arabinoxylan β-Glucan Glucose, xylose Galactose, mannose Glucose, mannose Arabinose, xylose |
[23] |
Pectin | Found in ripe plants and fruits, particularly in the primary cell walls and middle lamella of currants and apples | Rhamnogalacturonan-I Rhamnogalacturonan-II Homogalacturonan Arabinogalactan Arabinan |
[23] |
Gum | Found in the endosperm of many plants, especially legumes | Galactose Mannose Arabinose Xylose Rhamnose |
[24] |
Starch | Can be obtained from various food products, comprising 10–20 % amylose and 80–90 % amylopectin | D-glucose | [24] |
Inulin | Tubers of Dahlia pinnata (dahlia), Cichorium intybus (chicory), Polymnia sonchifolia (yacon), and Helianthus tuberosus (Jerusalem artichoke) | D-fructose | [24] |
Extraction of plant polysaccharides
Enhancing polysaccharide yield has been a primary objective in the development of extraction strategies, given the widespread utilization of polysaccharides in the food and pharmaceutical industries. The extraction and purification steps significantly impact the yield of polysaccharides. In summary, a flowchart illustrating the relationship between extraction, purification, and characterization of polysaccharides is presented in Figure 2.

Schematic diagram of extraction, purification, and characterization relationship of plant polysaccharides. DEAE, diethylaminoethyl; Sephadex G, Sephadex Gel chromatography.
Various methods have been employed for polysaccharide extraction, encompassing the hot water method, alkaline method, acid method, enzymatic method, and microwave method. The extraction method and conditions, including time, temperature, pH value, and the type of elution solvent, can influence the composition, yield, and molecular mass of polysaccharides [25]. Prior to extraction, the plant material is typically cleaned, dried, and finely ground to augment the surface area for extraction.
Hot water extraction
Hot water extraction is the most extensively employed method for polysaccharide extraction due to its simplicity, convenience, cost-effectiveness, and environmental friendliness. In this method, hot water is employed to break the cell wall through lysis, facilitating the release of intracellular polysaccharide molecules into the solvent [26]. Nevertheless, the conditions and parameters for hot water extraction may vary depending on the plant material and the specific polysaccharides targeted for extraction. Optimization of the extraction process is imperative to attain the maximum yield and quality of the extracted polysaccharides. The water temperature typically ranges from 60 to 100 °C, and the extraction time typically falls between 30 min and 3 h [27]. Following the extraction process, the mixture of water and plant material undergoes separation. Commonly used methods for separation include filtration or centrifugation to isolate the insoluble plant residue from the aqueous extract containing the extracted polysaccharides. To concentrate the aqueous extract containing the extracted polysaccharides, techniques such as evaporation or freeze-drying may be employed to eliminate excess water.
Alkali extraction
Alkali extraction stands as another method frequently employed for extracting polysaccharides from plant materials. In this extraction method, the plant material undergoes treatment with an alkaline solution, typically sodium hydroxide (NaOH) or potassium hydroxide (KOH), to disintegrate the cell wall structure and liberate the polysaccharides [28]. The principle underlying this method is that the hydroxide ions (OH−) from the alkali disrupt the hydrogen bonding in polysaccharides, resulting in the liberation of polysaccharides into the solvent. Extraction is conducted for a specified duration using alkali at a designated temperature with a specified material-liquid ratio.
An alkaline solution is prepared by dissolving a specific concentration of NaOH or KOH in water. The concentration of the alkali solution may vary typically around 0.15–0.3 mol/L [29]. The mixture is typically maintained at an elevated temperature, often in the range of 60–90 °C, for a specific duration, around 30 min to 4 h, to allow for efficient extraction [30]. Compared to hot water extraction, alkali extraction requires additional steps for neutralizing the mixture. The alkaline extract is typically neutralized by adding an acid, such as hydrochloric acid (HCl), to adjust the pH to a more neutral range. This step is crucial to prevent the degradation of polysaccharides. Neutralization may result in the precipitation of polysaccharides, facilitating their separation from the liquid.
Acid extraction
The acid extraction method effectively disintegrates the cell wall structure of plant materials, releasing polysaccharides into the extraction solution. This method is particularly suitable for extracting pectin. However, acid extraction may lead to some degradation or modification of the extracted polysaccharides due to the harsh acidic conditions employed. The acid method operates on the principle of acid penetration of cell fractions, where H+ interferes with the hydrogen bonds in polysaccharides, releasing them into the solvent. An acid solution is prepared by dissolving a specific concentration of hydrochloric acid or sulfuric acid in water. The concentration of the acid solution may vary depending on the plant material and the desired extraction efficiency. The mixture is heated and stirred to facilitate the extraction process. It is typically maintained at an elevated temperature, often in the range of 60–90 °C, for a specified duration to enable efficient extraction [31]. Various researchers have employed this method to isolate polysaccharides with different time-temperature combinations. Similar to alkali extraction, the acid extract also requires a neutralization step. This is achieved by adding a base, such as sodium hydroxide (NaOH) or ammonium hydroxide, to adjust the pH to a more neutral range. Neutralization is crucial to neutralize the acidity and prevent degradation of the polysaccharides. This may result in the precipitation of polysaccharides, facilitating their separation from the liquid. Liu et al. [32] reported a polysaccharide yield of 36.0 % with a molecular mass of 17.3 kDa using this method. In comparison to hot water and alkali extraction methods, the acid extraction method produced polysaccharides with a high molecular mass and iron-chelating ability.
Enzymatic extraction
The enzymatic extraction principle involves the enzymatic degradation of the cell wall structure, resulting in the release of intracellular molecules into the solvent. Enzymes play a crucial role in breaking down the glycosidic bonds within the polysaccharides, leading to hydrolysis and the formation of smaller oligosaccharides or monosaccharides [30]. This process facilitates the release of polysaccharides from the plant material into the extraction solution. Various enzymes, such as cellulase, complex protease, xylanase, α-amylase, pentosan complex enzyme, flavorase, and neutral protease, have been employed for the extraction of polysaccharides 33], [34], [35], [36], [37. The choice of suitable hydrolytic enzymes markedly influences the extraction efficiency. Furthermore, the pH and time-temperature combinations during enzymatic hydrolysis also impact the rate of enzyme reactions [37]. Crude polysaccharides were further degraded by H2O2 and vitamin C to obtain polysaccharides of different molecular masses. Compared with the above methods, this method has less off-target degradation and high extraction efficiency of high molecular mass polysaccharides. Nevertheless, the selection of appropriate enzymes and optimization of influencing factors should be considered to enhance extraction efficiency and achieve the desired molecular mass of the extracted polysaccharides.
Microwave-assisted extraction
The microwave-assisted method utilizes microwave radiation in the presence of a suitable solvent to heat the solvent, enabling it to come into contact with the sample. This process aids in the distribution of analytes from the sample matrix into the solvent, thereby facilitating the extraction process. Common solvents for this method include water, aqueous alcohol solutions, and organic solvents. Shang et al. [38] found that deep eutectic solvents, specifically choline chloride and 1,4-butanediol, were effective for polysaccharide extraction from the bladder-wrack. Similarly, Silva et al. [39] used water as a solvent for polysaccharide extraction from Spirulina platensis, following the principles of green chemistry. Lin et al. [40] optimized polysaccharide extraction from Lentinus edodes through an aqueous two-phase system, employing ethanol and ammonium sulfate. In a similar vein, Cheng et al. [41] devised a technique for the concurrent extraction and purification of polysaccharides from Gentiana scabra Bunge, employing an ethanol-salt aqueous two-phase system. These studies demonstrate the potential of microwave-assisted extraction for polysaccharides, with a range of solvents being effective. By employing this method, it is crucial to optimize the extraction conditions to achieve the maximum yield. Typically, the optimized conditions of this method yield better results compared to other extraction methods [42].
In summary, several auxiliary extraction methods hold the potential to increase polysaccharide yield, decrease extraction time, and reduce energy consumption in the extraction process. A recent development involves using ionic liquids for polysaccharide extraction at low temperatures and in a short time [43]. As this innovative method is not widely adopted, further studies can explore its potential in the future.
Purification strategies of extracted plant polysaccharides
Following the extraction of polysaccharides, the samples often contain proteins, oligosaccharides, or other small molecules. The crude polysaccharide extracts may include polysaccharides with varying ionic strengths or molecular weights. The presence of non-polysaccharide components can significantly hinder the understanding of polysaccharide bioactive mechanisms [44]. Therefore, further isolation and purification are necessary to obtain pure polysaccharides. Further purification of bioactive polysaccharides from crude extracts is crucial for understanding the conformational relationships of polysaccharides and ensuring the safety of future biomedical, pharmaceutical, and food applications. Effectively separating and purifying polysaccharides typically involves the separation, purification, and determination of purity. The process encompasses the removal of impurities and the graded purification of polysaccharide fractions [45, 46].
Separation can be accomplished by employing various techniques depending on the nature of the extracted polysaccharide, such as acidity, polarity, molecular size, and other associated substances. For instance, enzymatic and precipitation methods can be employed to eliminate impurities when the specific macromolecules in the polysaccharide are unknown. Protein within the crude polysaccharides has been eliminated using methods such as the Sevag method, trichloroacetic acid method, HCl method, NaCl method, and CaCl2 method 44], [45], [46. In recent years, due to the advantages of column chromatography, such as good protein removal effects, high polysaccharide recovery rates, mild and simple conditions, and minimal impact on polysaccharide activity, column chromatography has gradually been applied to the removal of proteins from polysaccharides [47, 48]. Additionally, some polysaccharides derived from natural sources may contain numerous pigments, causing interference in subsequent characterization studies of polysaccharides. Typically, pigment can be removed by resin, activated carbon or hydrogen peroxide [49]. During the polysaccharide extraction process, the presence of inorganic salts, oligosaccharides, and other small molecular substances might occur. These impurities can be effectively removed through the process of dialysis [50, 51].
Polysaccharides are intricate biomolecules consisting of monosaccharides linked together by glycosidic bonds. The structural features of polysaccharides are determined by various factors, including the types of monosaccharides involved, the nature of glycosidic bonds, sugar sequences, chain length, degree of branching, distribution of side chains, and types of substituents. Additionally, monosaccharides commonly exist as stereoisomers. However, several polysaccharides exhibit regular main chains, including cellulose, arabinoxylan, pectin, hemicellulose, galactomannan, galactoglucomannan, xyloglucan, and pectin. Mixtures of polysaccharide fractions can potentially interfere with in-depth studies of their structure and biological activity. To obtain homogeneous polysaccharides, it is recommended to initially separate and purify crude polysaccharides. A widely utilized method for this purpose is column chromatography, encompassing both anion exchange chromatography and gel chromatography [51].
In a specific study, anion exchange chromatography was utilized to separate neutral and acidic polysaccharides. Elution was performed using distilled water and different concentrations of sodium chloride solution. Further purification of both neutral and acidic polysaccharides involved gel chromatography, resulting in the isolation of homogeneous polysaccharides with varied molecular weights [52]. Ultimately, dialysis is conducted to eliminate certain oligosaccharides from the polysaccharide solution. Following dialysis completion, the solution can be concentrated to a specific extent, followed by freezing and lyophilization using a freeze-dryer for improved storage and yield calculation. In the process of polysaccharide purification, commonly employed anion exchange chromatography columns comprise diethylaminoethyl (DEAE)-cellulose columns [53], DEAE-52 cellulose columns [54], and DEAE-sepharose fast flow columns [55]. Gel chromatography columns frequently utilized include Sephadex G-75 columns [53], Sephadex G-100 columns [56], and Superdex-200 columns [57]. The selection of an appropriate purification device is crucial, as polysaccharides purified using this method exhibit enhanced research value.
It is necessary to assess the purity of the isolated and purified polysaccharides to ensure the purity of the extracted polysaccharides. It is important to note that the purity assessment standards for polysaccharides differ from those for typical compounds. Even in the case of pure polysaccharides, their microscopic structure is inherently heterogeneous. In essence, the purity of polysaccharides can only represent the average distribution of chains with similar lengths [58]. Previously, common methods for polysaccharide purity identification included specific rotation, colorimetry, electrophoresis, etc. However, these methods are prone to errors, closely tied to the chemical nature of the detected polysaccharide, and usually necessitate cross-validation using two or more methods. Gel permeation chromatography has recently gained prominence as the most effective method for identifying polysaccharide purity. This is attributed to its high sensitivity, rapid and accurate results, and good reproducibility [59].
Characterization of antidiabetic polysaccharides
The chemical structure of active polysaccharides forms the basis for their biological activity, and the diverse structures of polysaccharides may underpin their varied biological functions. A thorough comprehension of polysaccharide structure is crucial for the enhanced utilization and development of polysaccharide products. Polysaccharides, being complex biomolecules, demonstrate a hierarchical structure. Their primary structure encompasses monosaccharide composition, molecular weight distribution, types of glycosidic bonds, sugar unit arrangement, linkage patterns, anomeric configurations, and the presence or absence of branching in the sugar chains, along with the position and length of branches [57, 60]. Due to the intricate nature of the primary structure of polysaccharides, and compared to proteins and nucleic acids, the depth of research on polysaccharides is still evolving. Therefore, current efforts in the structural characterization of polysaccharides primarily focus on the elucidation of their primary structure. Understanding the primary structure is fundamental for gaining insights into the biological activities and potential applications of polysaccharides.
Molecular weight distribution determination
The determination of polysaccharide purity is a necessary step to ensure homogeneity. The molecular weight distribution of polysaccharides can indicate whether the purified polysaccharide components are uniform or pure. Good homogeneity is a prerequisite and foundation for the subsequent process of structure identification. Gel chromatography is presently the most commonly employed method for evaluating the purity and homogeneity of polysaccharides [61, 62]. For instance, high-performance gel permeation chromatography, utilizing columns of different specifications, can be employed to assess the purity and homogeneity of polysaccharides across a range of molecular weight gradients [63].
Monosaccharide composition determination
The determination of monosaccharide composition holds paramount significance in anticipating the core structure of the targeted polysaccharide backbone and scrutinizing its physicochemical properties. Widely employed techniques for the analysis of polysaccharide monosaccharide composition encompass pre-column derivatization in conjunction with high-performance liquid chromatography analysis and capillary electrophoresis [64]. Additionally, high-performance anion exchange chromatography has emerged as a new technology for polysaccharide sample analysis in recent years [65, 66]. The principle involves the elution of monosaccharides and oligosaccharides hydrolyzed from polysaccharides under conditions with a pH>12 [67]. Polysaccharides undergo exchange separation on a high-performance anion exchange resin, with detection carried out using a pulsed amperometric detector. This method enables the direct analysis of hydrolyzed products without the need for derivatization, making it increasingly adopted in polysaccharide analysis.
Infrared spectroscopic analysis
Currently, infrared spectroscopy is widely used for determining polysaccharide structures. Infrared spectroscopy serves as a valuable tool for offering preliminary insights into the functional groups inherent in polysaccharides and evaluating the purity of such compounds [68]. This method is characterized by its simplicity in operation and a brief experimental cycle. However, due to the significant overlap of spectral peaks in infrared spectroscopy, it is insufficient for determining the functional group structures of polysaccharides on its own. It is often necessary to combine it with other methods for further elucidation [69].
Methylation analysis
Methylation analysis can be employed to determine the sequence of monosaccharide residues, the types of monosaccharide residues, and the bonding patterns in polysaccharides [70]. The commonly used methylation method involves first fully methylating the polysaccharide, freeze-drying the product, and then adding trifluoroacetic acid for complete hydrolysis. Subsequently, the hydrolyzed products are acetylated after reduction with borohydride, resulting in partially methylated alditol acetates (PMAA). Gas chromatography-mass spectrometry is utilized for the analysis of PMAA, and the results are compared with spectra in the University of Georgia PMAA Spectral Database to acquire information about the composition and linkage patterns of the residues [71].
Nuclear magnetic resonance analysis
Nuclear magnetic resonance (NMR) stands as a crucial method in the structural analysis of polysaccharides. One-dimensional spectra, including 1H-NMR and 13C-NMR spectra, serve as initial tools for determining the type of monosaccharide, the number of sugar residues, the configuration of glycosidic bonds, and other relevant information. Additionally, two-dimensional NMR spectra encompasses homonuclear shift correlated spectra (COSY, COSY-45, DQF-COSY, TQF-COSY, TOCSY, NOESY) and carbon-hydrogen correlated spectra (HSQC, HMBC) can further elucidate the connection mode of sugar residues in polysaccharides and determine the structure of repeating sugar units [72]. For instance, in 1H-NMR spectra of polysaccharides, terminal substrate signals appear between 4.5 and 5.5 ppm, while 13C-NMR spectra of polysaccharides typically show most peaks between 60 and 110 ppm [73]. Moreover, 13C, fully decoupled with integral terminal signals in NMR spectra is used to detect polysaccharide residue types, and HMBC is employed to bind hydrogen protons to distant carbon for structural skeleton analysis.
The advancement of biotechnology has led to the gradual application of technologies such as lectin identification and fluorescent labeling in the structural analysis of polysaccharides [35]. Given the intricate nature of polysaccharide structures, the selection of appropriate analytical methods is imperative, contingent upon the specific characteristics of the structures under investigation.
Antidiabetic mechanisms of plant polysaccharides
Several studies have underscored the substantial potential of plant-derived polysaccharides in diabetes management. These polysaccharides emerge as a promising reservoir for the prospective development of novel compounds with notable medical significance. The utilization of plant polysaccharides in diabetes treatment not only ensures stability and the absence of side effects but also proves efficacious in averting complications. Consequently, the identification of potent ingredients from plants emerges as an efficacious approach to diabetes prevention and treatment. Different plant polysaccharides have varying mechanisms for lowering blood glucose. Broadly, their functions include promoting insulin secretion, inhibiting apoptosis of pancreatic cells [74], enhancing insulin sensitivity, reducing insulin resistance [75], regulating enzyme activity [76], exhibiting anti-inflammatory effects [77], improving antioxidant stress capacity [78], modulating relevant signaling pathways [79], and regulating gut microbiota [80]. The flow chart of the antidiabetic mechanism of plant polysaccharides is summarized in Figure 3.

Antidiabetic mechanism of plant polysaccharides. PI3K/AKT, phosphatidylinositol-3-kinase/protein kinase B; MAPK, mitogen-activated protein kinase; PKC/NF-κB, protein kinase C/nuclear factor kappa-B; Nrf2, nuclear factor erythroid 2-related factor 2; GLP-1, glucagon like peptide-1; IL-1β, interleukin-1β; IL-6, interleukin-6; TNF-α, tumor necrosis factor-α; HK, hexokinase; GK, glucokinase; G6PD, glucose 6-phosphate dehydrogenase; PK, pyruvate kinase; IR, insulin resistance.
Promotes insulin secretion and inhibits islet cell apoptosis
Insulin, a hormone synthesized and released by pancreatic β-cells and complemented by the secretion of glucagon from pancreatic α-cells, holds a central role in preserving blood glucose equilibrium and regulating glucose homeostasis. This is accomplished by facilitating the uptake and utilization of glucose in peripheral target tissues, including the liver, muscles, and adipose tissue. Insulin further supports hepatic glycogen synthesis and improves sugar metabolism, consequently reducing postprandial blood glucose levels [81]. Plant polysaccharides contribute to blood glucose reduction by safeguarding and enhancing the activity of β-cells, inhibiting apoptosis of pancreatic cells, and effectively promoting insulin secretion.
Tang et al. [74] reported a significant improvement in glucose and lipid metabolism in T2DM rats through the administration of Astragalus polysaccharide (APS), a polysaccharide extracted from Astragalus. This beneficial effect is ascribed to the safeguarding and enhancement of β-cells, leading to an increase in insulin secretion. Additionally, APS activate the phosphatidylinositol-3-kinase (PI3K)/protein kinase B (AKT) signaling pathway. This activation results in the upregulation of GLP-1receptors, pancreatic and duodenal homeobox 1 (PDX-1), and the anti-apoptotic protein B-lymphocyte tumor-2 (Bcl-2) [82]. Concurrently, it downregulates the expression of the pro-apoptotic protein Bcl2-associated X (Bax). These molecular actions collectively impede apoptosis in mouse pancreatic β-cells (β-TC6 cell line), ultimately accomplishing the goal of reducing blood glucose levels. Research indicates that GLP-1 plays a pivotal role in safeguarding pancreatic islet cells through diverse mechanisms, exerting a notable impact on T2DM. Li et al. [83] postulated that Polygonatum cyrtonema Hua polysaccharides (PCP) possess the capability to enhance GLP-1 secretion, thereby contributing to the amelioration of diabetes.
Enhances insulin sensitivity and reduces insulin resistance
IR encompasses a range of factors that diminish the body’s responsiveness to insulin. Augmenting insulin sensitivity constitutes a crucial pathway in the regulation of blood glucose balance [81]. Individuals afflicted by IR are predisposed to diverse metabolic disorders, including T2DM, hypertension, dyslipidemia, and so on. Moreover, IR is linked to elevated levels of inflammation and alterations in lipid metabolism [84]. Current research has established a positive correlation between the insulin resistance index and serum triglycerides (TG) and fasting blood glucose while demonstrating a negative correlation with high-density lipoprotein cholesterol (HDL-C) [85]. The regulation of TG and HDL-C levels has been identified as a means to ameliorate insulin resistance. Chen et al. [86] documented that polysaccharides derived from Polygonatum sibiricum predominantly elicit hypoglycemic effects through the activation of insulin receptor substrate-1 (IRS-1), PI3K, and glucose transporter 4 (GLUT4), concurrently inhibiting the c-Jun N-terminal kinase (JNK) signaling pathway. Research findings indicate that polysaccharides extracted from Chroogomphus rutilus induce hypoglycemic effects in leptin-deficient mice by activating the adenosine monophosphate-activated protein kinase (AMPK) pathway, thereby enhancing autophagy. This cascade promotes the expression of peroxisome proliferator-activated receptor alpha (PPARα) and carnitine palmitoyltransferase-1A, resulting in heightened lipolysis and subsequent inhibition of hepatic lipid deposition. Ultimately, these effects contribute to the enhancement of insulin sensitivity [75].
Regulates enzyme activities
α-Amylase and α-glucosidase are pivotal enzymes directly engaged in starch and glycogen metabolism, with their activity intricately linked to glucose release [87]. In individuals with T2DM, the onset of insulin resistance in body cells disrupts the insulin signaling pathway, impeding glucose uptake in tissues such as adipose and muscle. The accelerated degradation of glucose by α-amylase and α-glucosidase contributes to a rapid surge in postprandial blood glucose levels [88]. Consequently, a viable strategy for diabetes management involves competitively inhibiting key digestive enzymes (α-amylase and α-glucosidase) with natural products.
This inhibition decelerates the absorption and digestion of carbohydrates in the digestive tract, effectively mitigating postprandial hyperglycemia [87]. Polysaccharides extracted from South African seaweed, such as fucoidan, demonstrate a significant inhibitory effect on the activity of α-amylase and α-glucosidase, thereby efficiently controlling blood glucose and presenting substantial potential for the treatment of T2DM [89]. Shao et al. [76] synthesized carbon nanoparticles (CNPs) derived from burdock root polysaccharides using a hydrothermal method and illustrated that CNPs can inhibit α-glucosidase activity, consequently lowering blood glucose levels in mice induced with a high-fat diet and streptozotocin. These studies collectively indicate that the direct inhibition of α-amylase and α-glucosidase activities can suppress glucose release, diminish glucose absorption, and thereby ameliorate disorders in glucose metabolism.
Disruption of glucose metabolism stands as a primary contributor to the onset of T2DM. The hydrolysis of starch by α-amylase results in the production of glucose, which, in turn, can lead to elevated blood sugar levels [90]. Essential enzymes in sugar metabolism, including hexokinase (HK), glucokinase (GK), glucose 6-phosphate dehydrogenase (G6PD), and pyruvate kinase (PK), play critical roles in this process. HK and GK serve as key catalysts in sugar metabolism by converting glucose to glucose-6-phosphate, facilitating the synthesis of liver glycogen. G6PD is a crucial enzyme in the pentose phosphate pathway, catalyzing the conversion of glucose-6-phosphate to 6-phosphoglucono-δ-lactone [91]. PK acts as a pivotal rate-limiting enzyme in sugar glycolysis. Substantial evidence indicates that individuals with T2DM exhibit diminished glucokinase activity, resulting in an imbalance in blood sugar homeostasis. Plant polysaccharides have the capacity to enhance sugar metabolism by regulating the activity of pertinent enzymes, thereby exerting control over blood sugar levels. Studies have revealed that mulberry leaf polysaccharides significantly enhance the liver lipid metabolism and sugar metabolism function in diabetic rats. This improvement is achieved by elevating liver glycogen content and enhancing liver GK activity, consequently ameliorating insulin resistance [92].
Inhibition of inflammatory factor expression
Research suggests that plant polysaccharides can exert anti-inflammatory effects by inhibiting the expression of inflammatory factors. This action prevents damage to β-cell function, ultimately leading to a reduction in blood glucose levels [93]. Qiao et al. [94] found that the mechanism by which Schisandra acidic polysaccharides improve insulin resistance involves the inhibition of inflammation. This encompasses a decrease in the levels of pro-inflammatory cytokines, including IL-1β, IL-6, TNF-α, C-reactive protein, and nuclear factor kappa-B (NF-κB), along with a reduction in their mRNA expression in liver tissue. It also entails the inhibition of the expression of phosphorylated JNK and NF-κB proteins, coupled with a substantial increase in the expression of phosphorylated IRS-1, phosphorylated PI3K, and phosphorylated AKT.
Improves antioxidant stress capacity
Diabetes patients generate a large amount of reactive oxygen species in the body, and β-cells have low antioxidant stress capacity, leading to β-cell damage, abnormal metabolism of lipids and glucose, and prolonged high-fat diet exacerbating the burden on the antioxidant system. Zhang et al. [77] reported that polysaccharides from Codonopsis lanceolata improved high-fat diet-induced insulin resistance by activating antioxidant signaling pathways. This improvement was evidenced by the repair of damaged AKT phosphorylation and high phosphorylation at Ser307 of IRS-1, a significant reduction in malondialdehyde levels, and an enhanced ratio of reduced glutathione to oxidized glutathione. Moreover, it elevated the expression of antioxidant enzymes and activated the transcription factor nuclear factor erythroid 2-related factor 2 (Nrf2) signaling pathway. Oat β-glucan complex was shown to improve diabetes by enhancing the body’s antioxidant capacity, scavenging free radicals, and preventing and reducing the occurrence of diabetes complications [95]. Coarse polysaccharides from Dendrobium officinale Kimura enhanced antioxidant capacity in the liver and pancreas of mice in a model of hyperuricemia, repairing oxidative damage to these organs [96]. In in vitro and animal experiments utilizing crude and purified polysaccharides from Huidouba, Chen et al. [97] demonstrated that these polysaccharides could effectively reduce blood glucose levels. This reduction was attributed to their ability to combat oxidative stress, inhibit α-glucosidase activity, and improve insulin resistance. Furthermore, their findings revealed that low molecular weight purified polysaccharides exhibited markedly greater blood glucose-lowering activity compared to crude polysaccharides. This observation suggests that the structure of polysaccharides can influence their activity, and the process of purification has the potential to enhance both the antioxidant and blood glucose-lowering activities of polysaccharides.
Modulates related signaling pathways
Insulin exerts its influence by interacting with insulin receptors on the cell membrane, predominantly regulating cellular physiological activities through the PI3K/AKT pathway and the mitogen-activated protein kinase (MAPK) pathway. Elevating the expression of crucial molecules within the PI3K/AKT pathway, including mRNA and relevant signal proteins, proves instrumental in enhancing β-cell function and maintaining the regulation of blood glucose levels [42]. Su et al. [79] reported that the potential mechanism driving the hypoglycemic effect of Aconitum coreanum polysaccharides in high-fat diet-induced diabetic mice includes heightened insulin sensitivity, improved glucose tolerance, suppression of inflammatory factor expression in serum and insulin-targeted tissues, and inhibition of the activation of the NF-κB cellular pathway. This leads to a reduction in the serine phosphorylation of IRS-1, subsequently restoring glucose utilization through the PI3K/AKT signaling pathway. In the in vivo hypoglycemic test of Hericium erinaceus polysaccharide, it was found that its hypoglycemic mechanism actively mediates glycogen synthesis primarily through the PI3K/AKT signaling pathway [98].
The MAPK transduction pathway encompasses the extracellular signal-regulated kinase 1/2 (ERK1/2), JNK1/2/3, p38, and ERK5 pathways, which collectively regulate a spectrum of cellular activities, including cell proliferation, differentiation, apoptosis, inflammation, and immunity [99]. It has been observed that various cytokines and stress stimuli can induce β-cell apoptosis through one or more MAPK signaling pathways. Therefore, plant polysaccharides have the potential to inhibit β-cell apoptosis by modulating the MAPK signaling pathway. For instance, spurge polysaccharides have been shown to up-regulate the phosphorylation levels of p38, NF-κB, p65, and ERK1/2 proteins in mouse macrophages. This activation stimulates the MAPK and NF-κB signaling pathways, leading to improved immunity and inhibition of diabetes mellitus [100].
Protein kinase C (PKC) functions as a multifunctional enzyme implicated in gene expression and regulation. Under high glucose conditions, PKC is activated as an inducer, subsequently triggering the activation of the NF-κB pathway. This activation, in turn, leads to inflammation and abnormal lipid metabolism in diabetic rats [101]. Li et al. [102] reported that Arctium lappa L. polysaccharides regulate lipid metabolism in diabetic rats through the PKC/NF-κB pathway, resulting in reduced levels of total cholesterol, triglycerides (TG), and low-density lipoprotein cholesterol. Nrf2 plays a crucial role in anti-oxidative stress and anti-inflammatory processes, and it has the capacity to inhibit insulin resistance. The deficiency of Nrf2 has been associated with pancreatic β-cell injury. Radix pseudostellariae polysaccharides have been shown to improve IR by activating the Nrf2 signaling pathway. This activation helps attenuate oxidative stress, inhibit hepatic inflammatory signaling, and enhance the abundance of beneficial intestinal flora [103].
Regulates intestinal flora
Various studies have highlighted that the gut microbiota can impact the body’s metabolism through pathways such as bile acid metabolism, short-chain fatty acid metabolism, and inflammatory responses [104]. Imbalances in the gut microbiota are linked to insulin resistance, and plant polysaccharides can contribute to the regulation of the gut microbiota, thereby reducing blood sugar levels. For instance, Apocynum venetum leaves polysaccharides have been shown to reverse gut microbiota imbalance in diabetic mice. This is achieved by increasing the abundance of Odoribacter, Anaerotruncus, Faecalibaculum, and Muribaculum genera while decreasing the abundance of Coprococcus, Klebsiella, and Allobaculum genera [80]. Shang et al. [105] fed diabetic mice with varying doses of purified Cordyceps militaris polysaccharides (CBPS-II) and confirmed that CBPS-II regulates the energy metabolism, gut microbiota, and lipid metabolism disorders associated with diabetes. Various serum metabolites have been identified as potential biomarkers, offering valuable insights for the early diagnosis and treatment of diabetes. Wang et al. [106] discovered that oral administration of Crataegus pinnatifida polysaccharides in spontaneous T2DM mice has hypoglycemic and hypolipidemic effects. The mechanism primarily entails a noteworthy downregulation of the elevated expression levels of G6PD, fatty acid synthase, acetyl-CoA carboxylase 1, sterol regulatory element-binding protein-1c, and peroxisome proliferator-activated receptor γ mRNA associated with gluconeogenesis and lipid synthesis. Consequently, this leads to a reduction in the Firmicutes/Bacteroidetes ratio in the intestines of diabetic mice, an augmentation in the abundance of beneficial bacteria, and a decline in the abundance of harmful bacteria.
Clinical trials of the antidiabetic effects of plant polysaccharides
Plant polysaccharides have garnered significant attention for their potential antidiabetic effects. Recent clinical trials have investigated the antidiabetic properties of various plant polysaccharides, demonstrating their promise as therapeutic agents for managing T2DM. These trials have provided valuable insights into the efficacy, safety, and mechanisms of action of these natural compounds.
A clinical trial investigated the effects of polysaccharides extracted from okra on blood glucose levels in T2DM patients. The study reported significant reductions in fasting blood glucose and HbA1c levels, suggesting improved glycemic control. The mechanism of action was attributed to the inhibition of intestinal α-glucosidase activity, which reduces postprandial glucose spikes [107]. Another trial focused on polysaccharides derived from bitter melon. Participants with T2DM who received bitter melon polysaccharide supplementation showed decreased insulin resistance and improved β-cell function. These effects were linked to the polysaccharides’ ability to modulate inflammatory pathways and enhance antioxidant defenses [108]. Clinical research on Aloe vera polysaccharides demonstrated their potential in lowering blood glucose and lipid levels in diabetic patients. The polysaccharides were found to enhance insulin sensitivity and exert anti-inflammatory effects, contributing to better metabolic control [109]. A clinical trial on ginseng polysaccharides revealed their ability to improve glycemic control and lipid profiles in T2DM patients. The study suggested that the polysaccharides might enhance insulin secretion and protect pancreatic β-cells from apoptosis, thereby improving overall glucose metabolism [110]. Research on Centella asiatica polysaccharides indicated their effectiveness in reducing blood glucose levels and oxidative stress markers in diabetic patients. The study highlighted the role of these polysaccharides in modulating key signaling pathways involved in glucose homeostasis and insulin sensitivity [111]. Lycium barbarum polysaccharide was found to significantly reduce serum glucose and increase the insulinogenic index in T2DM patients [112]. Similarly, polysaccharides from Talinum triangulare were shown to have significant hypoglycemic effects in diabetic mice [113]. Ganoderma lucidum polysaccharides were found to reduce blood glucose levels in diabetic rats, exhibiting a dose-dependent effect [114]. Finally, polysaccharides from Morus alba fruit demonstrated antihyperglycemic and antihyperlipidemic effects in a rat model of T2DM [115].
These clinical trials underscore the promising role of plant polysaccharides as adjunctive treatments for T2DM. However, further large-scale, randomized controlled trials are necessary to confirm these findings and establish standardized dosages, formulations, and long-term safety profiles.
Conclusions
Diabetes, a chronic disease with a complex pathogenesis, not only results in elevated blood glucose levels but also induces a variety of complications, leading to chronic lesions in multiple systems and organs, such as the eyes, kidneys, and nervous system. These complications can worsen the disease and pose a threat to the health of patients. The pathogenesis of diabetes mellitus remains incompletely understood, and there is a lack of curative drugs. Currently, various synthetic antidiabetic drugs are available for managing T2DM, including thiazolidinediones, meglitinides, biguanides, sulfonylureas, α-glucosidase inhibitors, GLP-1 analogues, and DPP-4 inhibitors, the long-term use of commonly prescribed clinical hypoglycemic drugs can cause adverse reactions, impact therapeutic effectiveness, and increase the risk of complications. In contrast, polysaccharides contribute positively to the treatment of diabetes and its complications, offering a natural product with low adverse effects and promising application prospects.
In this review, we discuss the extraction, purification, and characterization of plant polysaccharides, offering a comprehensive overview of recent advancements in understanding their antidiabetic effects and mechanisms. The antidiabetic properties of the polysaccharides are mediated through the following approaches: (1) promoting insulin secretion and inhibiting islet cell apoptosis, (2) enhancing insulin sensitivity and reducing insulin resistance, (3) regulating enzyme activities, (4) inhibiting inflammatory factor expression, (5) improving antioxidant stress capacity, (6) modulating related signaling pathways, (7) regulating intestinal flora. However, polysaccharides possess distinctive characteristics, and their biological activity is closely linked to factors such as relative molecular mass and chemical modification. The structural differences among various polysaccharides present challenges in extracting high-purity and homogeneous polysaccharides. Contemporary research on polysaccharide structure predominantly centers on the primary structure, particularly concerning the hypoglycemic mechanism. However, the exploration of other facets of polysaccharide action necessitates ongoing investigation. Moreover, different extraction methods can influence the hypoglycemic activity of polysaccharides, yet there is a lack of comparative research on the activity of diverse extraction methods applied to the same polysaccharide. Additionally, although polysaccharides can lower blood sugar through multiple pathways, the current understanding of their hypoglycemic mechanism is incomplete, with variations in existing studies. Furthermore, research on polysaccharides has been predominantly concentrated in animal tests, lacking a comprehensive exploration of the quantitative-effect relationship.
In summary, while polysaccharides exhibit certain hypoglycemic effects, their specific mechanism of action remains unclear. Future research should prioritize the study of advanced polysaccharide structures, continuously enhance and purify exploration into the hypoglycemic mechanism, compare the efficiency of various extraction technologies to improve biological activity, and further investigate the effects of polysaccharides on diabetic complications. These efforts will provide new directions for the development of natural and long-acting hypoglycemic drugs involving.
Funding source: Fundamental Research Grant Scheme, Faculty of Science and Technology, Universiti Kebangsaan Malaysia
Award Identifier / Grant number: FRGS/1/2024/STG02/UKM/02/1
Funding source: Academic New Talent Training Program, Xinyang Agriculture and Forestry University
Funding source: INTI International University Seed grant
Award Identifier / Grant number: INTI-FHLS-01-26-2023
Funding source: Evaluation of characteristic germplasm resources and selection of good germplasm of wild oil tea in Dabie Mountain, Henan Province, China
Award Identifier / Grant number: 242102110247
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Research ethics: Not applicable.
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Informed consent: Not applicable.
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Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: The authors state no conflict of interest.
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Research funding: This study was supported by Academic New Talent Training program, Xinyang Agriculture and Forestry University, Evaluation of characteristic germplasm resources and selection of good germplasm of wild oil tea in Dabie Mountain, Henan Province, China (242102110247), INTI International University Seed grant (INTI-FHLS-01-26-2023) and Fundamental Research Grant Scheme (FRGS/1/2024/STG02/UKM/02/1), Faculty of Science and Technology, Universiti Kebangsaan Malaysia.
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Data availability: Not applicable.
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This work is licensed under the Creative Commons Attribution 4.0 International License.
Articles in the same Issue
- Frontmatter
- Editorial
- Translational medicine and a new potential example: brain-derived neurotrophic factor (BDNF)
- Review
- Extraction, purification, characterization and antidiabetic mechanisms of plant polysaccharides: a critical review
- Research Articles
- Some animal protein antigens identified in cells of two plant species
- Determining the kinetic and optimum characteristics of glucose oxidase immobilized on polyurethane
- Efficacy and safety of sulforaphane-loaded emulsomes as tested on MCF7 and MCF10A cells
- Effect of silibinin on GAS6/sAXL and JAK/STAT pathways in human cholangiocarcinoma cell line
- The comparative evaluation of cell viability, inflammatory response, and antimicrobial activity of calcium hydroxide-bovine dentin grain
- Curcumin suppresses cell viability in breast cancer cell line by affecting the expression of miR-15a-5p
- Impact of calcium propionate on cellular behavior in A549 and DMS114 lung cancer cell lines
- The diagnostic value of serum exosomal miRNA-587 combined with hypersensitive C-reactive protein as noninvasive biomarker in early-stage non-small cell lung cancer
- Effects of YM087 and VPA985 on the T237M mutant receptor functionality in nephrogenic diabetes insipidus
- Relationship of paraoxonase-1 and paraoxonase-3 with routine laboratory tests and oxidative stress in type 2 diabetes mellitus
- Chromosomal breakage and sister chromatid exchange analysis in breast cancer patients with heterozygous BLM gene variants
- Investigation of SARS-CoV-2 release in fecal specimens of discharge COVID-19 patients
Articles in the same Issue
- Frontmatter
- Editorial
- Translational medicine and a new potential example: brain-derived neurotrophic factor (BDNF)
- Review
- Extraction, purification, characterization and antidiabetic mechanisms of plant polysaccharides: a critical review
- Research Articles
- Some animal protein antigens identified in cells of two plant species
- Determining the kinetic and optimum characteristics of glucose oxidase immobilized on polyurethane
- Efficacy and safety of sulforaphane-loaded emulsomes as tested on MCF7 and MCF10A cells
- Effect of silibinin on GAS6/sAXL and JAK/STAT pathways in human cholangiocarcinoma cell line
- The comparative evaluation of cell viability, inflammatory response, and antimicrobial activity of calcium hydroxide-bovine dentin grain
- Curcumin suppresses cell viability in breast cancer cell line by affecting the expression of miR-15a-5p
- Impact of calcium propionate on cellular behavior in A549 and DMS114 lung cancer cell lines
- The diagnostic value of serum exosomal miRNA-587 combined with hypersensitive C-reactive protein as noninvasive biomarker in early-stage non-small cell lung cancer
- Effects of YM087 and VPA985 on the T237M mutant receptor functionality in nephrogenic diabetes insipidus
- Relationship of paraoxonase-1 and paraoxonase-3 with routine laboratory tests and oxidative stress in type 2 diabetes mellitus
- Chromosomal breakage and sister chromatid exchange analysis in breast cancer patients with heterozygous BLM gene variants
- Investigation of SARS-CoV-2 release in fecal specimens of discharge COVID-19 patients