Integrative Therapy with Moringa oleifera Leaf Extract and Sitagliptin Potentiates Antidiabetic, Antidyslipidemic, and Hepatoprotective Effects in Streptozotocin-Induced Diabetic Rats

Introduction: In diabetics, hyperglycemia leads to dyslipidemia and liver damage. Integrative therapy combining traditional medicine with a conventional antidiabetic drug is an innovative strategy to alleviate these issues with a lower dose and fewer adverse effects. Therefore, we investigated the antidiabetic, antidyslipidemic, and hepatoprotective effects of Moringa oleifera leaf extract, alone and in combination with sitagliptin, at a comparatively lower dose in streptozotocin-induced diabetic rats. Methods: Thirty (30) Swiss albino male rats were allocated into five groups. Except for the normal control group, diabetes was induced using a single dose of streptozotocin (STZ, 45 mg/kg, intraperitoneally). Over a 4-week experimental period, the effects of SGT (Sitagliptin, 100 mg/70 kg BW), MoLE (Moringa oleifera leaves extract, 200 mg/kg BW), and SGT + MoLE (integrative therapy of sitagliptin, 50 mg/70 kg BW with ethanolic M. oleifera leaves extract, 100 mg/kg BW) were evaluated. The study assessed blood glucose, glycosylated hemoglobin (HbA1c), serum lipid profile, triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol (LDL-c) and liver function markers such as protein level (albumin, globulin) and serum enzymes, alanine transaminase (ALT) and aspartate transaminase (AST), alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT). Results and Discussion: The SGT, MoLE, and SGT + MoLE groups showed a significant reduction (p < 0.05) in plasma glucose ((5.98 ± 0.44) mmol/L, (6.10 ± 0.50) mmol/L and (5.74 ± 0.53) mmol/L, respectively) compared to diabetic control ((13.76 ± 0.83) mmol/L) as well as HbA1c levels (4.70% ± 0.48%, 5.24% ± 0.67% and 4.30% ± 0.23%, respectively) compared to diabetic control rats (9.38% ± 0.54%) after 4 weeks of treatment. Diabetics rats treated with SGT, MoLE, and SGT + MoLE significantly attenuated the elevation of total cholesterol ((102.9 ± 7.09) mg/dL vs (88.48 ± 6.354) mg/dL, (90.38 ± 6.419) mg/dL and (81.24 ± 5.767) mg/dL, respectively; diabetics vs SGT, MoLE, and SGT + MoLE treated group), triglycerides ((83.22 ± 7.75) mg/dL vs (72.08 ± 5.40) mg/dL, (75.24 ± 5.29) mg/dL and (70.84 ± 6.80) mg/dL, respectively), LDL cholesterol ((78.12 ± 6.98) mg/dL vs (58.90 ± 6.20) mg/dL, (61.96 ± 6.05) mg/dL and (60.26 ± 7.42) mg/dL, respectively), while attenuated reduced level of HDL