Resveratrol in diabetes and pancreatic function: implications for the exocrine–endocrine pancreatic axis–a systematic review

Pancreatic dysfunction plays an important role in the development and progression of diabetes mellitus. Resveratrol, a naturally occurring polyphenolic compound, has attracted considerable interest due to its antioxidant, anti-inflammatory, and metabolic regulatory properties. The aim of this systematic review was to synthesize available evidence regarding the metabolic and pancreatic effects of resveratrol in diabetes mellitus. A systematic literature search of the PubMed/MEDLINE database (2011-2025) identified preclinical studies, randomized controlled trials, systematic reviews, and meta-analyses investigating resveratrol in diabetic contexts. Evidence from experimental and clinical studies indicates that resveratrol may improve glycemic control, attenuate inflammatory responses, reduce oxidative stress, and protect pancreatic β-cell function, primarily through activation of signaling pathways such as sirtuin-1 (SIRT1) and AMP-activated protein kinase (AMPK). Most available evidence originates from studies in type 2 diabetes mellitus or experimental models of diabetes. Nevertheless, several mechanisms identified in these studies-including modulation of oxidative stress, inflammation, and pancreatic tissue remodeling-may also be relevant to diseases characterized by combined exocrine and endocrine pancreatic dysfunction. In this context, resveratrol may influence biological processes related to the exocrine-endocrine pancreatic axis, including pancreatic inflammation, fibrosis, and β-cell preservation. Overall, current evidence supports the metabolic and pancreatic protective effects of resveratrol in diabetes. However, direct studies investigating its role in pancreatogenic diabetes remain scarce. Future research specifically targeting pancreatic diseases associated with diabetes is needed to clarify the therapeutic potential of resveratrol in disorders affecting the exocrine-endocrine pancreatic axis.