Chondroitin sulfate in osteoarthritis management among diabetic patients: molecular mechanisms and clinical potential
Osteoarthritis and type 2 diabetes mellitus are two prevalent chronic conditions that impose a substantial burden on healthcare systems worldwide. The comorbidity of type 2 diabetes mellitus and osteoarthritis (especially in individuals with overweight/obesity) presents a formidable challenge due to the potential synergistic effects of these conditions on metabolism and joint health. Chronic low-grade systemic inflammation plays a pivotal role in the development of both type 2 diabetes mellitus and osteoarthritis and is a common feature they share. Chondroitin sulfate is a naturally occurring glycosaminoglycan integral to the structure and function of articular cartilage. It has gained attention as a potential therapeutic agent for osteoarthritis due to its multifaceted mechanisms of action, including an effect on transcriptional factors and signaling pathways associated with chronic low-grade systemic inflammation. Chondroitin sulfate originated from natural sources, including standardized small marine fish extract, and can be regarded as a promising means in the therapy of osteoarthritis and type 2 diabetes mellitus. It can serve as an illustrative medication able to alleviate NF-κB-mediated inflammatory and metabolic disorders. Standardized small marine fish extract demonstrates anti-inflammatory, antioxidant, antidiabetic, anti-cancer, antimicrobial, anti-hypertensive, and wound healing properties.