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| Date: October 29, 2004 || HC# 070443-267 |
Re: Use of Indian Plants to Manage Type 2 Diabetes
Saxena A, Vikram N. Role of selected Indian plants in management of type 2 diabetes: a review. J Altern Complement Med. 2004;10(2):369-378.
Diabetes mellitus is a disease characterized by hyperglycemia, or high levels of blood glucose, caused by an absolute or relative deficiency of insulin and insulin resistance. Type 2 diabetes is the most common form of the disease. Treatment options offered by conventional medicine can have several adverse effects. Alternative systems of medicine, such as Ayurveda and Unani, are used widely in India. The authors, from the All Indian Institute of Medical Sciences in New Delhi, review the literature for the following Indian herbs and their use for the treatment of type 2 diabetes:
• Bitter melon (Momordica charantia)
• Fenugreek (Trigonella foenum-graecum)
• Indian kino tree (Pterocarpus marsupium)
• Gymnema (Gymnema sylvestre)
• Turmeric (Curcuma longa)
• Indian tinospora (Tinospora cordifolia)
• Neem (Margosa tree; Azadirachta indica)
• Ivy gourd (Coccinia grandis; a.k.a. C. indica)
• Bael tree (Holy fruit tree; Aegle marmelos)
• Pomegranate (Punica granatum)
In the reviewed studies, most of the herbs exhibited hypoglycemic, hypolipidemic, and antioxidant effects in animals as well as in humans, which may be helpful in the treatment of diabetes and its associated complications. The exact mechanism of action, however, still needs to be shown, say the authors. Because these herbs exhibit few known toxic effects in therapeutic dosages, they may be better than the available oral hypoglycemic agents.
In their analysis of the studies, the authors observed that most of the plants stimulate beta cells to release insulin. Gymnema, bitter melon, and an extract of the Indian kino tree may help to regenerate or increase the number of beta cells, which is an important discovery because none of the conventional oral hypoglycemic agents exhibit this action.1-3 Plants such as pomegranate and neem exhibited extrapancreatic effects. Bitter melon and fenugreek exhibited increased glucose uptake by tissues in vitro and decreased gastric emptying. An important active ingredient isolated from Indian kino was shown to affect the activity of the enzyme cathepsin-B, which converts proinsulin to insulin.
Studies show that the antioxidant action of bitter melon, turmeric, and tinospora may help to reduce the chronic complications of diabetes. Turmeric reduces the lipid peroxidation and has been shown to reduce diabetic dyslipidemia and nephropathy in animal experimental models.4,5 Bitter melon has been shown to delay the development of nonretinal ocular disease and nephropathy in diabetic rats.6
Fenugreek, tinospora, ivy gourd, and bitter melon regulate the activities of certain enzymes, aiding the metabolic control of diabetes. The authors report on animal studies of the leaf extract of the bael tree that noted it to have a hypoglycemic activity similar to that of insulin.
Because their observations are based on few studies (most of which are animal studies of short duration and small sample size), the authors feel it is inappropriate to comment on the efficacy of these herbs in humans. "However, these observations need to be further evaluated in human beings. If proven to be effective, these herbs can be incorporated in the treatment of diabetes as alternatives to conventional hypoglycemic agents, thereby overcoming the limitations of conventional oral hypoglycemic agents such as undesirable side effects and tolerance," they write.
1. Ahmed I, Adeghate E, Sharma AK, Pallot DJ, Singh J. Effects of Momordica charantia fruit juice on islet morphology in the pancreas of the streptozotocin-diabetic rats. Diabetes Res Clin Pract. 1998;40:145-151.
2. Chakravarthy BK, Gupta S, Gambhir SS, Gode KD. Pancreatic beta-cell regeneration in rats by (−)-epicatechin. Lancet. 1982;2:759-760.
3, Shanmugasundaram ER, Gopinath KL, Radha Shanmugasundaram K, Rajendra VA. Possible regeneration of the islets of Langerhans in streptozotocin diabetic rats given Gymnema sylvestre leaf extracts. J Ethnopharmacol. 1990a;30:265-279.
4. Babu PS, Srinivasan K. Hypolipidemic action of curcumin, the active principle of turmeric (Curcuma longa) in STZ induced diabetic rats. Mol Cell Biochem. 1997;166:169-175.
5. Suresh Babu P, Srinivasan K. Amelioration of renal lesions associated with diabetes by dietary curcumin in streptozotocin diabetic rats. Mol Cell Biochem. 1998;181:87-96.
6. Srivastava Y, Venkatakrishna-Bhatt H, Verma Y, Prem AS. Retardation of retinopathy by Momordica charantia L. (bitter gourd) fruit extract in alloxan diabetic rats. Indian J Exp Biol. 1987;25:571-572.