Fermented Canadian lowbush blueberry juice stimulates glucose uptake and AMP-activated protein kinase in insulin-sensitive cultured muscle cells and adipocytesThis article is one of a selection of papers published in this special issue (part 1 of 2) on the Safety and Efficacy of Natural Health Products.

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Abstract
Extracts of the Canadian lowbush blueberry (Vaccinium angustifolium Ait.) have recently been demonstrated to possess significant antidiabetic potential, in accordance with the traditional use of this plant as an antidiabetic natural health product. Fermentation of blueberry juice with the Serratia vaccinii bacterium is known to modify the phenolic content and increase antioxidant activity. The present study evaluated the effects of fermented blueberry juice on glucose uptake, adipogenesis, and the signaling pathways that regulate glucose transport in muscle cells and adipocytes. A 6-hour treatment with fermented juice potentiated glucose uptake by 48% in C2C12 myotubes and by 142% in 3T3-L1 adipocytes, in the presence or absence of insulin, whereas nonfermented juice had no effect on transport. Fermented juice dramatically inhibited triglyceride content during adipogenesis of 3T3-L1 cells. Chlorogenic acid and gallic acid, both major phenolic components of fermented juice, had no effect on glucose uptake. Western blot analysis of the insulin-independent AMP-activated protein kinase revealed increased phosphorylation resulting from a 6-hour treatment. This activation or the increase in glucose uptake could not be explained by increased cytosolic calcium. Fermentation with S. vaccinii is concluded to confer antidiabetic activities to blueberry juice. Although the active principles and their mechanisms of action remain to be identified, transformed blueberry juice may nevertheless represent a novel complementary therapy and a source of novel therapeutic agents against diabetes mellitus.