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In the EDICT trial, 221 drug-naive patients with recently diagnosed T2D were randomized to initial simultaneous therapy comprising a combination of agents known to improve insulin secretion and sensitivity (metformin, pioglitazone, and exenatide) or treatment with sequential therapy (i.e., an escalating dose of metformin followed by sequential addition of a sulfonylurea and insulin glargine)
Immunofluorescence and confocal microscopy Cells were labeled at 37 C with 1 M SNAP-Surface 488 in HEPES-bicarbonate buffer (120 mM NaCl, 4.8 mM KCl, 24 mM NaHCO 3 , 0.5 mM Na 2 HPO 4 , 5 mM HEPES, 2.5 mM CaCl 2 , and 1.2 mM MgCl 2 , saturated with 95% O 2 /5% CO 2 , pH 7.4) plus 3 mM glucose and 1% BSA, stimulated with agonists at 11 mM glucose for the indicated times, fixed and processed for immunofluorescence with mouse anti-Rab11 (610657, BD Biosciences, 1/20) or anti-rodent GLP-1R monoclonal antibody (Mab 7F38, DSHB, 2 g l 1 ) plus Alexa Fluor 546 secondary (Life Technologies, 1/200), mounted in Prolong Diamond antifade reagent with 4,6-diamidino-2-phenylindole (Life Technologies) and imaged with a Zeiss LSM-780 inverted confocal laser-scanning microscope in a 63/1.4 numerical aperture oil-immersion objective and analyzed in Image J
Consequently, berberine improves insulin sensitivity and enhances fatty acid oxidation, similar to semaglutide
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