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Drink TEA if you have DIABETES *Doctor Explains*Anti-diabetic herbs -
It can be taken raw or the bulb can be boiled to make a decoction. Meanwhile, among the Caribbean people, M. charantia is administered as medication as a leaf decoction and fruit juice in treating diabetes. In Turkish folk medicine, the oil extracted from ripened fruit is combined with honey and warmed olive oil Peter et al.
According to an ethnobotanical survey, S. polyanthum was the most often utilized herb among diabetic patients in North Sumatera, Indonesia Scientific studies have proven the efficacy of these herbs in preventing and treating diabetes Rahim et al.
Preclinical trials for E. polyanthum also provided abundance of data for their anti-diabetic effects Febrinda et al. They were found to inhibit α-glucosidase and α-amylase, modulate glucose uptake, increase insulin level, increase pancreatic β-cell proliferation and regulate oxidative stress Arifah et al.
The discovery of herbal plants with various anti-diabetic mechanisms has prompted researchers to develop polyherbal mixtures to treat diabetes. According to Perumal et al. Several reviews including systematic and meta-analysis studies have been conducted on E.
charantia and S. polyanthum individually, but, there is lacking of bibliometric analysis focusing on the combination of E. polyanthum as an anti-diabetic agent.
Based on the expanding number of publications and demonstrated anti-diabetic compounds of these plants, E. polyanthum are worthy plant candidates for tracking the collective knowledge of global research activities in this field, reviewing their prospective combined effect on anti-diabetic properties, and identifying a fresh perspective on the future direction of these plants as a potential polyherbal mixture in anti-diabetic research.
SCOPUS was chosen in this study because it covers a wide range of journals and more comprehensive than other databases Falagas et al. Meanwhile, Google scholar was not considered for the study because it does not provide detailed information demanded by network analysis, like the bibliometric approach.
The PRISMA flowchart is described in Fig. Full texts that met the eligibility criteria from the inclusion and exclusion requirements were analyzed based on the title, abstract, and introduction.
The inclusion criteria included original articles and English language. We excluded the literature research based on the review article, conference paper, book chapter, survey and report. The species names were confirmed using The World Flora Online WFO Arifah et al. The data analysis was performed based on the methods by Arifah et al.
The selected articles were retrieved and sorted systematically using Microsoft Excel in the comma-separated value CSV format.
To perform bibliometric analysis, all data were imported into visualization of similarities VOS viewer v. The following parameters for co-authorship analysis was assessed such as contributing countries, authors, and organizations and a full counting method was chosen as a part of analysis.
Then, author keyword co-occurrence analysis was done and the network and overlay visualizations were generated. Thesaurus tool was also applied to merge the keywords with similar meanings. For the term map, the number of publications or frequency shown by the size of the circular nodes in the illustrated map, the distance between nodes represented the degree of interaction, and the link between nodes signified interactions such as collaboration or co-occurrence.
The total link strength of a node was determined as the sum of its link strengths over all other nodes Arifah et al. palmifolia Iridaceae family is also known as Dayak onion, originated from the Kalimantan in Indonesia. Dayak onion have several scientific names such as E.
bulbosa, E. americana, E. elicata, and E. palmifolia was suggested as an official scientific name by Kew and Missouri Botanic Garden Couto et al.
The diameter of the bulb is ranging from 20 to 50 mm Fig. The bulb is oval and consists of many layers like a regular onion with a striking deep reddish color Wiendi et al. charantia , also known as karela, bitter gourd, or bitter melon, is a fruit from Cucurbitaceae family. It originated from East India, but it is now widely planted and consumed in tropical, subtropical, and temperate climates.
The fruit is bright green, with a pointy surface, a cone shape, and a bitter taste Fig. polyanthum Myrtaceae family is referred to as daun salam and serai kayu, in Malaysia whereas in Indonesia, the plant is known as ubat serai, meselengan, manting, Indonesia laurel, or Indonesian bay leaf Widyawati et al.
polyanthum is widely found in the hillsides and forests of South-East Asian countries such as Malaysia, Thailand, Indonesia, and Singapore.
The plant can grow to be up to 25 m tall. The leaf shape is elliptical and pointy Fig. Overall data searches for E. polyanthum were done with no time limitation including all areas of studies.
The output in the Fig. palmifolia was constantly low in the beginning, but fluctuated from to The number consistently increased from until before going down in For M. charantia, the documents published were higher compared to E.
palmifolia and S. The number of publication started to increase from to but the trend reduced after polyanthum on the other hand, it could be seen that number the of the document was higher than E. palmifolia but lower than M. The number of documents increased from to before dropping in Publication trends of E.
palmifolia A , M. charantia B , and S. polyanthum C articles. Only papers that were published in English were included in the results. Non-original articles and reviews were not considered.
Among nine papers obtained, only seven articles were retrieved for VOSviewer analysis. There was a total of 38 authors with eight clusters produced Supplementary 1 , Fig. Table 1 shows the top 10 authors that published one article each author with Bin Sayeed M.
obtained the highest citation. When analyzing the paper by the organization, there was a total of 26 organizations grouped into eight clusters Supplementary 1 , Fig. Each organization published only one paper and the Department of Clinical Pharmacy and Pharmacology, University of Dhaka produced the highest citation Table 2.
For the analysis of the country, Indonesia published the highest number of articles, followed by Bangladesh and Japan Table 3. As in as in Supplementary 1 Fig. Next, the data were analyzed based on the keyword. The term map in Fig. Cluster 5 was shown by the purple color. The keywords were also color-coded by VOSviewer based on the publication year, and the yellow color indicated that they were published in more recent years Fig.
From until , the research focused in the area of Central Kalimantan and Bangladesh. The papers discussed about the ethnopharmacological and verification of E. palmifolia chemical compounds in traditional medicine as a source of anti-diabetic, antioxidant, anticancer and tyrosinase inhibitor.
In the recent years — , supporting evidences were provided from in vitro and in vivo experiment of the extract using streptozotocin to elucidate the mechanism of Dayak onion in type 2 diabetes mellitus. charantia, articles were obtained and after the exclusion of the document type, and language, only papers were retrieved for VOSviewer analysis.
Distribution by the author showed 15 authors produced five or more articles with Zafar M. publishing the most paper with seven articles, followed by Ahmad M. and Ahmed I Table 5. The authors are classified into 10 clusters as shown in Supplementary 2 , Fig. In terms of organization, six research organizations published three papers, and Suzuka University of Medical Science, Japan received the highest citation compared to other organizations Table 6.
Based on overlay visualization Supplementary 2 , Fig. A total of 29 countries published five or more papers with India publishing the highest document , followed by China 63 and the United States 48 Table 7.
Based on the average publication year Supplementary 2 , Fig. A total of keywords were generated that related to the authors with at least three occurrences. These keywords were also classified as the highest occurrence frequency based on the largest size of the node as illustrated Fig.
This term map indicates that the keyword network had 12 clusters. This cluster was shown by a light pink node and comprised of nine items.
The keywords were also color-coded according to the year of publication, with yellow denoting more recent publication Fig. In the earlier years — , it was observed that the structures of phytoconstituents were elucidated by chemical and spectroscopic methods.
In vitro experiments were also done based on the keywords such as lipid peroxidation, lipid profile, antioxidants and inflammation. Also, in vivo diabetogenic agents such as alloxan and streptozotocin were also used in elucidating the mechanisms of anti-diabetic activity through inhibiting glucose absorption, lowering blood glucose and preventing oxidative stress in induced-diabetic rats.
In recent years, many published papers shifted to studying the molecular mechanisms based on the keywords such as molecular docking. Clinical trial using a double-blind design, combining M. charantia extract with other herbal plants was also noted. Efficacy and safety of the polyherbal capsule containing M.
charantia was also conducted as adjuvant therapy in subjects with type 2 DM. There were a total of 22 articles relating to diabetes research. After excluding the review and non-English papers, 17 articles were retrieved.
The study generated three clusters consisting of 12 authors, and each with at least two published publications Supplementary 3 , Fig. The author, Widyawati, T.
from Indonesia produced the highest document with the highest citation, followed by Asmawi M. and Ahmad M Table 9. Here, we can observe that the major of prominent authors were from Malaysia. Whereas, for organization, a total of 47 organizations were included and classified into 16 clusters Supplementary 3 , Fig.
As shown in Table 10 , all top organizations published only one article with University of Indonesia produced the highest citation. Next, the data were distributed based on the country and it generated three clusters Supplementary 3 , Fig.
There were only three countries that published two or more papers and Indonesia published the most papers, followed by Malaysia and Nigeria Table A total of 58 keywords occurred in the present study. These keywords were also analyzed based on a term map as illustrated Fig.
This term map shows that the keyword network is divided into 11 clusters. Whereas, both cluster 6 light blue node and cluster 7 orange color consisted of five items. The keywords were also color-coded according to the publication year, with yellow color indicating a recent publication Fig.
In to , there was a limited number of papers that published on the anti-diabetic activity of S. polyanthum, but it was noted that several authors studied the phytochemical screening through GC—MS and elucidated the mechanisms of antihyperglycemic effect in streptozotocin-induced diabetic rats.
In recent years, the researchers shifted to the analysis of anti-diabetic compounds using molecular docking approach. The key findings of this study demonstrated the utilization of E. polyanthum in anti-diabetic research based on bibliometric analysis by considering publication trends, contributed countries, prominent authors, productive organizations and author keywords.
charantia showing the highest number papers of publishing articles compared to E. palmifolia, and S. We continued with VOSviewer analysis even though only nine and 22 publications on E. polyanthum , respectively, were retrieved from the SCOPUS database because we intended to identify the knowledge gaps and generate fresh ideas for future studies on these plants in diabetic research.
In terms of managerial aspect, the productive countries, organizations, and authors were analyzed to help other scholars building a research network and collaboration. Due to their prominence in both complementary and alternative medicine, several countries Bangladesh, Indonesia, China, India, and Japan have more publications than others.
It is unexpected that these countries have an abundance of papers on this particular research. Based on the bibliometric analysis, University of Dhaka E.
palmifolia , Suzuka University of Medical Science M. charantia , and University of Indonesia S. polyanthum showed that the most productive organizations. Bin Sayeed, M. palmifolia , Zafar M. charantia and Widyawati, T.
polyanthum were the most prominent author on their research topics. is from Bangladesh and his research focused on the ethnopharmacological studies of E. palmifolia in diabetic management. Zafar M. specialized in preclinical trials of anti-diabetic from M.
Whereas, Widyawati, T. has conducted preclinical and clinical trials of S. polyanthum for diabetic patients. This information is intended to inspire collaborative research between productive authors, institutions, and countries in order to combine these three herbs as a new potential concoction in diabetes treatment.
Other than managerial aspect, scientific topics were discussed as well. We were able to find trends in diabetic research that were currently in progress by looking through all of the keywords and cluster classification, and we anticipate that it can be used as a reference to define the path of future studies.
In earlier years, the research was merely focusing on the preliminary screening of the plant extract as an anti-cancer, anti-microbial, anti-inflammatory, and antioxidant agent. However, it was observed that the trends for M. charantia have changed in the recently published papers.
There is lacking of molecular docking study and clinical trial report for E. palmifolia , indicating that this aspect of study is still scarce. There were also several papers that published on the polyherbal formulation in treating diabetes such as Andrographis paniculata , Camellia sinensis and Syzygium cumini , but there was no paper that studied on the combination E.
polyanthum as a single concoction, indicating that this specific topic has not yet been explored and therefore it demands for further research. The active phytochemical compounds in E.
polyanthum and their bioactivities are summarized in Table Secondary metabolites such as alkaloids, flavonoids, glycosides, and saponins were found in E. palmifolia that possess hypoglycemic activity, which is beneficial for the treatment of diabetes Yaturramadhan et al.
The main compounds of the plant were naphthalene, naphthol, and anthraquinone. Naphthoquinones such as elecanacine, eleutherine, and eleutherinone were also reported to be found in the bulb Dai et al. Other isolated active compounds such as hongconin, eleutherol A, B, and C, eleuthinone B, and C were demonstrated to possess therapeutic effects against hyperglycemia Kamarudin et al.
The biological activity of M. charantia , bitter melon depends on its major chemical constituents, including cucurbitane-type triterpenoids, cucurbitane-type triterpeneglycosides, flavonoids, phenolic acids, amino acids, essential oils, sterols, fatty acids, lectins, and saponin goyasaponins I, II and III, kuguacin, momordicin, karaviloside, momordin, momordicoside, and karavilagenin Saeed et al.
The most common chemical compounds are cucurbitane-type triterpenoids momordicines I and II and triterpene glycosides: momordicosides. These compounds are responsible for the bitterness of M. charantia fruit. Wang et al. charantia significantly lowered blood sugar levels in diabetes patients following subcutaneous injection in a human clinical trial.
Additionally, charantin, which work similarly to peptides and certain alkaloids to efficiently lower blood sugar levels by boosting insulin secretion and promoting the growth of the β-cell.
The other significant compound identified from bitter melon is vicine, a glycol alkaloid. Intraperitoneal injection of this pyrimidine nucleoside has been found to induce hypoglycemia in non-diabetic fasting rats Haixia et al. Fruit of M. charantia has demonstrated the most effective hypoglycemic property because these compounds are concentrated in fruits.
Several phytochemical compounds of S. polyanthum were also reported. Three phenolic compounds were analyzed in S. Phytol, an acyclic diterpene alcohol, is another important compound found in the ethanolic extract of S.
Rahim et al. polyanthum leaf extracts. Another work employed NMR and HPLC-metabolomics to identify myricitrin and epigallocatechin gallate EGCG as α-glucosidase inhibitors from S. polyanthum leaves, and docking analysis confirmed their inhibitory actions Syabana et al.
The plants act as anti-diabetic agents by inhibiting the activity of α-glucosidase and α-amylase and therefore reducing starch digestion in the small intestine and lowering the amount of glucose absorbed to the bloodstream Sharma et al.
The amylase enzyme converts polysaccharides into dextrin, which is then digested into glucose by the α -glucosidase enzyme before entering the bloodstream via epithelial absorption Setyawan et al.
A high blood glucose level can cause multiple endothelial dysfunctions such as migration, dysregulation of endothelial proliferation, and apoptosis Dong et al. The schematic presentation in Fig. palmifolia as the anti-diabetic agent. palmifolia aqueous bulb extract was proven to reduce the blood serum level, increase blood serum insulin level, and lower blood serum total cholesterol in diabetic rats.
This finding showed that E. palmifolia bulb can be a functional bioactive agent for diabetic research Febrinda et al. Another study showed that flavonoids improved the activity of the pancreatic tissue by elevating the insulin level over islet β-cells and lowering blood glucose levels Lahrita et al.
While, Ahmed et al. palmifolia bulb reduced glucose tolerance in Swiss albino rats. Nurcahyawati et al. palmifolia protected the kidneys of alloxan-induced Wistar rats. palmifolia bulb was evidenced to protect against kidney tubule degeneration, tubular and globular necrosis, and interstitial infiltration.
Alpha glucosidase inhibitor AGI is an anti-diabetic agent that works by inhibiting the activity of the α-glucosidase enzyme. Amylase and synthetic α-glucosidase inhibitors like acarbose are commonly used in the remedy of type 2 DM, but they have also been associated with several adverse effects Feng et al.
To treat diabetes, AGI agents derived from natural resources must be obtained and tested further. Glucosidase action is important for a variety of biochemical mechanisms, including the breakdown of polysaccharides into monosaccharide units.
As a result, suppressing the α-glucosidase enzyme can be useful in the case of hyperglycemia, as it limits the quantity of monosaccharide absorbed by the intestine Setyawan et al.
Despite the wide utilization of E. palmifolia in several traditional medicine, there is a scarce data from human clinical trials. charantia is hypothesized to exhibit hypoglycemic effect via multiple physiological, pharmacological, and biochemical mechanisms as shown in the schematic presentation Fig.
The hypoglycemic impact, stimulation of peripheral and skeletal muscle glucose utilization, inhibition of intestinal glucose absorption, inhibition of adipocyte development, suppression of key gluconeogenic enzymes, stimulation of key enzyme of hexose monophosphate HMP pathway, and preservation of islet cells and their functions are some of the potential mechanisms of the hypoglycemic actions of M.
charantia and its numerous extracts and components Wang et al. The anti-hyperglycemic and hypoglycemic properties of various extracts and compounds from M.
charantia have been studied in both human and animal models. In a clinical trial, the extract of M. charantia was administered in 95 participants Yin et al. The extract improved heart function by reducing the degree and extent of infarctions and lowering serum cholesterol levels.
As a result, bitter melon extract was proposed to be useful as a supportive therapy for type 2 diabetes and related cardiovascular illnesses. Yang et al. charantia fruit extracts in type 2 diabetes patients. They concluded that the extract has a hypoglycemic activity and can significantly reduce FBG and HbA1c when anti-diabetic medications are ineffective.
In the study conducted by Keller et al. charantia was found to enhance insulin production in MIN6 pancreatic cells in a concentration-dependent manner. In another investigation, following 24 h of treatment with an aqueous extract of M.
charantia, RIN-m5F pancreatic cells survived significantly longer than untreated glucotoxic cells Wang et al.
It is hypothesized that it is attributed to an increase in glucagon-like peptide-1 release, which can aid in insulin secretion and β-cell expansion. In one study, when treated with a saponin fraction of M. charantia at a dose of mg per kg weight, the insulin secretion level and glycogen synthesis of alloxan-induced hyperglycemic mice increased with improved glucose tolerance and decreased blood glucose Han et al.
In another investigation, it was reported that bitter gourd water extract triggered glucagon-like peptide-1 GLP-1 secretion in the enteroendocrine cell line STC-1 in a dose-dependent manner Huang et al.
While Ru et al. charantia MCPIIa and M. charantia polysaccharidechromium III complex MCPIIaC have been shown to be efficient in protecting pancreatic cells and boosting insulin levels in streptozotocin STZ induced diabetic mice.
In the study by Ahmed et al. charantia extract was found to increase the number of β-cells and therefore increased insulin secretion.
Whereas, oral administration of M. charantia juice was proven to improve pancreatic histopathology and cell function by decreasing pancreatic malondialdehyde, increasing pancreatic glutathione levels, and boosting serum total antioxidant capacity Mahmoud et al.
The inhibitory action of protein extracts M. Other investigations also reported the inhibitory effect of M. charantia ethanol extract on pancreatic lipase charantia ethanolic extracts also depicted the lowest α-glucosidase activity Researchers also discovered that gastro-resistant insulin receptor-binding peptide from M.
charantia improved glucose tolerance in STZ-induced diabetic mice via the insulin receptor signalling pathway Lo et al. The peptide, 9-amino-acid-residue peptide mcIRBP-9 activated IR signalling transduction pathway, which resulted in the phosphorylation of IR, the translocation of glucose transporter 4, and the uptake of glucose in cells.
In another report, ethanolic extract of M. charantia was found to reduce serum glucose fructosamine, total cholesterol, triglycerides levels, insulin resistance index, and pancreatic malondialdehyde content.
It also increased serum insulin, HDL-cholesterol, total antioxidant capacity levels, β-cell function percent, pancreatic reduced glutathione content, and improved histopathological changes in the pancreas Mahmoud et al.
polyanthum also has a few possible mechanisms of anti-diabetic action as drawn in the schematic presentation Fig. This includes inhibiting α-glucosidase, reduction of glucose intake, and increasing muscle glucose uptake Sutrisna et al.
α-glucosidase is an enzyme that can convert huge polysaccharides into sucrose and glucose. Inhibiting this enzyme slows the time for carbohydrate assimilation and so defers digestion and diminishes the amount of glucose intake Feng et al. A recent study found that S. polyanthum leaf methanol extract significantly reduced intestinal glucose absorption and increased muscle tissue glucose absorption in vitro Widyawati et al.
Controlling postprandial plasma glucose levels is crucial in the early of diabetes mellitus treatment. One of the treatment options for postprandial hyperglycemia is the inhibition of enzymes involved in carbohydrate metabolism. According to Widyawati et al. This characteristic may have contributed to S.
polyanthum leaf extract's antihyperglycemic efficacy. The primary function of insulin in the skeletal muscles is to stimulate the translocation of the insulin-responsive glucose transporter, glucose transporter-4 GLUT4 , from intracellular vesicles to the cell surface; hence, it boosts amino acid intake, activates the ribosomal protein synthesis machinery, and raises the rate of glycogen synthase activity and subsequent glycogen storage while decreases the rate of glycogen breakdown Rahman et al.
Widharna et al. polyanthum significantly lowered the blood sugar levels in both alloxan and streptozotocin-induced diabetic rats.
In the isolated abdominal muscle model of the study conducted by Widyawati et al. polyanthum leaf increased glucose absorption by the muscles both with and without the presence of insulin. In the presence of insulin, the extract increased the sensitivity of insulin to promote glucose absorption; however, in the absence of insulin, the action was likely caused by an effect on the glucose transporters that directly contributed to the uptake of glucose.
This mechanism contributed to the antihyperglycemic activity of the leaves of S. Clinical study in human to verify the anti-diabetic activity of S.
polyanthum leaves is limited. polyanthum for 14 days reduced fasting blood glucose levels in diabetic patients Widyawati et al. In a different trial, Widyawati et al. Clinical safety data for E. polyanthum are scarce. However, there are no safety concerns about the traditional use or its preparations in general.
When administered in accordance with the dosages given for each preparation, the herbs are regarded as safe. Febrinda et al. palmifolia bulb and discovered that renal function was improved with no liver damage.
Khan et al. charantia, therefore the supplementation made from the fruit and seeds of M. charantia should be used with great caution in pregnant diabetic patients to prevent potential harm to the developing baby. Patients who have reported allergies to other Cucurbitaceae plants also should always avoid the supplements made of M.
charantia extracts. Patients with glucosephosphate dehydrogenase deficiency also should avoid from the consumption M. charantia because it was reported that it could develop favism, which is an acute haemolytic syndrome Khan et al.
Mardani et al. charantia extract for more than a week. Despite the widespread utilization of S. polyanthum leaves in the treatment of various diseases, there is still a scarcity of scientific data on the herb's toxicological profiles.
Sumiwi et al. polyanthum ethanol extract throughout a day treatment period. This study showed that, while the plant extract did not exhibit toxicity on the majority of parameters, female rats did develop fatty liver and necrosis.
polyanthum combined with Andrographis paniculata. In addition, cytotoxic tests from other studies revealed that the leaves extract is non-cytotoxic to normal mammalian cell lines Perumal et al.
Furthermore, Kusuma et al. These few studies are still insufficient to establish the general safety of these herbs or to build consumer confidence in their quality before they are produced as new herbal therapeutic products. Therefore, future research should look deeper into the potential toxicological effects of E.
palmifolia , M. polyanthum as a herbal mixture. The review paper like all research studies, has limitations. The first limitation is the scarcity of published papers relevant to the search keywords especially for E. There is also a limited data from human clinical trials and toxicological studies of E.
For a thorough analysis of the therapeutic efficacy of E. polyanthum as a herbal combination, more preclinical research especially in toxicology is required.
The research questions of this review have been addressed, allowing us to pinpoint the direction of the study, prominent authors, their affiliations, the field of study and the countries where the majority of the anti-diabetic research has been conducted.
This analysis helped us in identifying the gaps in the previous studies, relating to the effect of E. polyanthum as anti-diabetic agents. Eleutherol, eleuthenone, eleutherinoside A, momordicin, EGCG, charantin, vicine, squalene and myricitrin were among the compounds that exert their therapeutic effects, either working alone or in combination through various mechanisms.
We also discovered that there are no existing studies that combine the extracts of E. polyanthum into a single formulation to treat diabetes, thus this finding prompted a more thorough investigation of this specific topic. Ahmad I.
Oral glucose tolerance activity of Bawang Dayak Eleutherine palmifolia L. bulbs extract based on the use of different extraction method. Pharmacognosy Journal, 10, 49— Ahmed, I. Effects of Momordica charantia fruit juice on islet morphology in the pancreas of the streptozotocin-diabetic rat.
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Diabetes Care, 32 1 , S62—S Article PubMed Central Google Scholar. Ampofo, A. Beyond Modelling obesity and diabetes prevalence. Diabetes Research and Clinical Practice, , Arifah, F. A bibliometric analysis of preclinical trials of Andrographis paniculata Burm.
Nees in diabetes mellitus. South African Journal of Botany, , — Article Google Scholar. A review of medicinal plants for the treatment of diabetes mellitus: The case of Indonesia.
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Article CAS Google Scholar. Falagas, M. Comparison of PubMed, Scopus, Web of Science, and Google Scholar: Strengths and weaknesses. FASEB Journal, 22 2 , — Febrinda, A. Hyperglycemic control and diabetes complication preventive activities of Bawang Dayak Eleutherine palmifolia L.
bulbs extracts in alloxan-diabetic rats. International Food Research Journal, 21 , — Feng, J. Bio-assay guided isolation and identification of α-glucosidase inhibitors from the leaves of Aquilaria sinensis.
Phytochemistry, 72 2—3 , — Haixia, Z. Analysis of vicine in bitter melon samples by polyglycol-C8 solid phase with high performance liquid chromatography. Chinese Journal of Analytical Chemistry, 3, This review aims to provide an overview of the studies investigating interactions between antidiabetic herbs and conventional medicine, identifying of both negative and positive aspects of these interactions.
Two or more drugs when administered together have the potential to cause chemical or pharmacological interactions. Such interactions may alter the effect of either agent, leading to decreased or increased effectiveness or severity of adverse effects. The outcomes are dependent on many chemical and pharmacological factors, such as the physicochemical nature of the drugs in use and how they affect each other pharmacokinetically and pharmacodynamically Fig.
Although, the mechanisms of interactions between herbs and drugs are similar, they are more complex in nature when several compounds are involved. For example, the blood glucose lowering effect of antidiabetic drugs has been shown to be increased by agrimony [ 10 ].
A number of mechanisms may be associated with pharmacokinetic HDIs including quantitative alterations in renal clearance [ 11 , 12 ], bioavailability [ 13 ], drug distribution [ 14 , 15 ], absorption [ 16 , 17 , 18 ], and elimination processes [ 19 ].
Hepatic metabolic enzyme systems, particularly the cytochrome P CYP isoenzyme family, remain a common pathway for pharmacokinetic HDIs. Many anti-diabetic drugs are substrates of CYP isoenzymes, e. pioglitazone, repaglinide and rosiglitazone for CYP2C8, glibenclamide, glimepiride, glipizide, nateglinide and rosiglitazone for CYP2C9, proguanil for CYP2C19, and pioglitazone and repaginate for CYP3A4 [ 20 , 21 , 22 ].
A large number of herbs have also been suggested to affect the CYP system. Such interactions can result in antagonistic, additive or synergistic effects. For example, many herbal medicines possess antioxidant properties which could be beneficial for reducing oxidative stress, a key pathogenic factor of diabetes [ 24 , 25 , 26 ].
Several pharmaceutical agents effective in reducing diabetic mortalities e. Several groups of pharmaceutical agents are currently used for the treatment of diabetes via different mechanisms, such as stimulation of the release of insulin e.
biguanidines [ 27 , 28 , 29 ]. Some of the commonly used antidiabetic drugs include biguanides, e. acarbose and miglitol via delaying the digestion of complex carbohydrates. Additionally, combination therapies e. sulfonylureas with biguanides, thiazolidinedione with glucosidase inhibitors are widely used to broaden therapeutic targets in order to improve efficacy and to minimise side effects.
An increasing number of medicinal plants are being used to treat diabetes and its related conditions. The current NAPRALERT database lists over species of plants representing more than genera within families, covering lower plants such as algae and fungi to almost all types of higher plants.
Many of these plants have been used ethno-pharmacologically in traditional medicine as antidiabetics, particularly for T2DM [ 32 , 33 ]. Although many of these plants have been studied experimentally to validate their physiological activity, the chemical and pharmacological properties underpinning the anti-diabetic activity is less well studied.
Nevertheless, a large number of potentially bio-active molecules have been isolated and identified, among which include complex carbohydrates, alkaloids, glycopeptides, terpenoids, peptides, amines, steroids, flavonoids, lipids, coumarins, sulphur compounds and inorganic ions [ 32 ].
Examples of common herbs and dietary supplements that have been used to treat diabetes include Momordicacharantia , Trigonellafoenum - graceum , Gymnemasylvestre , Azadirachtaindica , l -carnitine, vanadium, chromium and vitamin E. The co-administration of antidiabetic herbs and pharmaceutical agents may result in HDIs leading to enhanced effects which may be desirable clinically , decreased pharmacological effects, or adverse drug events, such as hypoglycaemia.
The following section provides a brief discussion of common antidiabetic herbs and their potential interactions with antidiabetic agents. Literature searches were conducted with PubMed and Google Scholar up to June Aloe vera is native to Africa and is one of the more than species of the genus Aloe.
The presumed major active components include carbohydrates e. Traditional literature reveals a wide range of clinical uses of this plant from cosmeceuticals through to immunity and organ care. In diabetes, aloe vera has been shown to significantly reduce blood glucose levels [ 38 ].
Several studies report potential interactions between aloe vera and antidiabetic drugs. Of note is its interaction with glibenclamide, a sulphonylurea which exerts its antidiabetic potential by inhibiting ATP sensitive potassium channels in pancreatic β cells, resulting in cell membrane depolarization and subsequent insulin release.
The combination of aloe vera and antidiabetics has generally been shown to have an additive effect. For instance, aloe has been shown to produce a greater anti-hyperglycaemic effect, when compared to the sole therapy with glibenclamide, pioglitazone or repaglinide [ 39 , 40 , 41 ].
Both Panax ginseng and Panax quinquefolium , two important members of the ginseng family, have been shown to possess antidiabetic properties affecting insulin dependent and insulin independent pathways [ 42 , 43 , 44 ].
Although the precise active components responsible for this anti-diabetic action are unknown, studies with compound K CK , a final metabolite of protopanaxadiol ginsenosides demonstrate that CK exhibits anti-hyperglycaemic effects through an insulin secreting action similar to metformin.
The combined treatment of CK and metformin has been shown to elicit additive effects compared to individual components being used alone. Significant improvements were observed in plasma glucose and insulin levels, homeostasis model assessment-insulin resistance HOMA-IR and in haematoxylin and eosin-stained liver tissues [ 45 , 46 ].
Karela is also known as bitter melon due to its taste. A large number of chemical constituents are found in its juice, including sterols, glucoside mixtures and charantin polypeptides [ 47 ].
Karela is one of the few medicinal plants that has been subjected to extensive clinical studies in combination with common antidiabetics.
Increased efficacy has been reported when used together with metformin, glymidine and glibenclamide. Results showed that the combined interventions elicited a greater hypoglycemic effect when compared to that of full doses of metformin or glibenclaminde alone, indicating a possible additive effect [ 48 ].
Ginger has been widely used as spice as well as medicine for many years. Its aqueous extract is in use as an antidiabetic in many countries as part of traditional therapy.
It is believed that the antidiabetic effect of ginger is derived from its antioxidant and anti-glycation properties, and its ability to express the glucose transporter Glut 4 [ 53 ]. In another study, a combination of ginger extract and a sub-optimal dose of glibenclamide 0.
In addition, ginger has been shown to have renal protective effects when used with metformin [ 55 , 56 ]. Prickly pear cactus Nopal athough native to Mexico, is now widely used worldwide as food and traditional medicine.
Cacti are divided into several genera, including Opuntia e. Opuntia contains a range of phytochemicals in variable quantities, such as polyphenols, dietary minerals and betalains, as well as various compounds including gallic acid, vanillic acid and catechins [ 57 ].
Prickly pear seeds have been found to increase muscle and liver glycogen and reduce blood glucose level in STZ-induced diabetic rats, possibly through an insulin sensitizing effect [ 58 ]. One study showed a positive interaction between the combined effect of prickly pear cactus pad and glipizide and metformin in T2DM patients.
In this study a hypoglycaemic reaction was observed, although the authors note that clinical studies are required to support combined therapy of this herb and known diabetic drugs [ 58 ]. Sesame oil is obtained from sesame seeds and is widely used in cooking and as a flavour enhancer.
Sesame oil has several traditional medicinal properties and has been reported to possess antidiabetic properties [ 60 ]. In a landmark clinical study by Sankar et al.
Fenugreek is commonly used as a spice in south Asia and is known for its hypoglycaemic and hypocholesterolemic properties [ 62 ]. The proximate composition of fenugreek seeds, husk and cotyledons contains saponin, protein and polyphenols [ 63 ].
Interactions of fenugreek with known antidiabetics have been evaluated in several chemically induced diabetic animal models. In a similar study, lipid peroxidation LPO induced by ferrous sulphate, hydrogen peroxide and carbon tetrachloride in liver were performed.
The combination treatment with fenugreek seed extract and glibenclamide exhibited a greater inhibition of the hepatic LPO activities and a greater antioxidant activity compared to the individual components alone, highlighting a potential benefit of the combination treatment [ 64 ].
Garlic is known for its spectrum of medicinal properties. It is composed of a large number of sulfur compounds, with suspected bioactive compounds called allyl thiosulfinates mainly allicin [ 65 ].
Garlic has been reported to possess antidiabetic properties. Several experimental and clinical studies have been conducted to assess the interaction between garlic and antidiabetic medicines.
In a rat model, the effects of garlic on the pharmacokinetic profiles of metformin were investigated. It was found that garlic increased the peak plasma concentration C max and the area under the curve AUC of metformin, highlighting the need to adjust the metformin dosage when co-administered with garlic [ 66 ].
Garlic alone, as well as in combination with metformin, improved body weight, whilst the combination therapy was more effective in reducing blood glucose levels, highlighting that garlic extract potentiates the hypoglycaemic effect of metformin [ 67 ].
Potential beneficial effects of garlic juice in combination with metformin have been shown, where the combination attenuated tubular toxicity induced by gentamicin [ 68 , 69 ].
Gymnema is native to South India and its pharmacological properties are mainly attributed to triterpenoidic saponins [ 71 ]. This herb has been in use for diabetic treatment for almost two millennia [ 72 ]. The combined treatment was found to decrease the bioavailability of metformin and serum glucose level; the decrease in serum glucose however was not significantly greater than that of metformin itself, although histopathological analyses showed an increase in volume of pancreatic islet cells after combined therapy [ 73 ].
In an animal study using a chemically-induced diabetic rat model a decrease in plasma metformin concentration and increase in blood glucose levels were seen in animals treated with the combination of gymnema tea and metformin when compared to those receiving metformin alone, suggesting an antagonistic interaction between metformin and gymnema [ 74 ].
In a similar study of chemically-induced diabetic rats, a significant decrease in bioavailability of metformin was observed which was proportional to the dose of gymnema used. However, the combined treatment significantly reduced the blood glucose level compared to individual administration of metformin or gymnema [ 75 ].
These findings suggest further research in individuals with diabetes is required to determine the effect of the combination of gymnema tea and metformin on blood sugar levels.
The main bioactive components of the herb are thought to be naphthodianthrones, hypericin and pseudohypericin along with the phloroglucinol derivative hyperforinand essential oils mainly sesquiterpenes [ 76 ]. In a clinical pharmacokinetic study, 20 healthy male participants received 1 g metformin twice a day for 1 week, with and without 21 days preceding concomitant therapy with SJW.
SJW decreased the renal clearance of metformin but had no effects on other pharmacokinetic parameters. Nevertheless, SJW treatment improved glucose tolerance by enhancing insulin secretion independent of insulin sensitivity [ 77 ].
However, these results differ to that of a study in which pre-treatment with SJW had no effect on blood glucose lowering or the insulin elevating effect of repaglinide [ 78 ].
Further research is required to clarify these findings. Astragalus is a frequently used traditional Chinese medicine for diabetes. The bioactive constituents of astragalus include polysaccharides, triterpenoids astragalosides , isoflavones including kumatakenin, calycosin and formononetin , glycosides and malonates [ 79 ].
In Chinese herbal medicine astragalus is commonly used as a key herb in antidiabetic formulations. The effect of astragalus on the pharmacokinetics of pioglitazone has been investigated in a number of clinical and preclinical studies.
In a study in rats, co-administration of astragalus decoction and pioglitzone did not appear to alter the pharmacokinetic profiles of pioglitzone [ 80 ]. Scutellaria is a medicinal plant which roots are used to prepare traditional medicines. Several chemical compounds have been isolated from the root of scutellaria including baicalein, baicalin, wogonin, norwogonin, oroxylin A and β-sitosterol [ 81 ].
Combination treatment resulted in elevated hepatic activity of antioxidant enzymes compared with metformin alone. Hepatic lipid peroxide concentration was significantly reduced by combination treatment, with a corresponding reduction of plasma and hepatic triglycerides and cholesterol levels. These results suggest that scutellaria enhances the antidiabetic action of metformin although further research in individuals with diabetes is required to confirm these findings.
Andrographis paniculata is a herb commonly used by individuals with diabetes [ 82 ]. Potentially additive pharmacological effects are apparent with the use of the herb in combination with antidiabetic medications as the herb has been shown to lead to enhanced uptake of radioactive glucose in the isolated soleus muscle of STZ-diabetic rats in a concentration-dependent manner [ 83 ].
Although there are no studies examining interactions between Andrographis paniculata and antidiabetic drugs, Andrographis paniculata has been shown to inhibit CYP2C19 activity [ 84 ] for which the antidiabetic drugs such as glibenclamide, glimepiride, glipizide, nateglinide, rosiglitazone, pioglitazone, repaglinideare substrates, thereby suggesting that there is the potential adverse outcomes as a result of an increase in plasma concentrations of these medications and subsequent enhanced glucose lowering effect, although this theory remains to be confirmed.
Lycium is commonly found in the Himalayan region of India and Pakistan and is traditionally used as a medicinal plant for diabetes.
Its hypoglycaemic effects are believed to be due to its bioactive polysaccharides and antioxidants. Evidence supporting the interaction between Lycium and antidiabetics is experimental only.
Blood glucose levels in Lycium treated rats decreased by Findings such as these suggest that Lycium may have an additive effect when used in combination with conventional antidiabetics [ 86 ]. Cassia is an ethnomidicinal plant that is widely used in Indian and Chinese medicine to treat diabetes.
It has been proposed that the antioxidant and polyphenol content of Cassia fistula and flavonoid content of Cassia occidentalis contribute to their antihyperglycaemic properties [ 87 , 88 ].
Normal and STZ-induced diabetic rats were administered with 0. Similarly, Cassia occidentalis has been shown to have significant antihyperglycaemic activity in normal and alloxan-indiced diabetic rats [ 88 ]. Cassia inhibits enzyme activities of CYP2C9 for which glibenclamide, glimepiride, glipizide, nateglinide, and rosiglitazone are substrates, and CYP3A4 for which pioglitazone and repaglinide are also substrates [ 89 ], suggesting there may be an additive effect of this herb with antidiabetic medications.
Olive tree Olea europaea L. leaves have been widely used in traditional remedies in European and Mediterranean countries. They have been used as extracts, herbal teas, and powder and contain several potentially bioactive compounds that may have antioxidant, antihypertensive, antiatherogenic, anti-inflammatory, hypoglycemic, and hypocholesterolemic properties.
Olive leaf polyphenols, in particular oleuropein aglhydroxytyrosoycone and its main metabolite, hydroxytyrosol, are considered the primary compounds responsible for these effects [ 90 ]. A number of experiments in cell and animal models and clinical trials have shown a beneficial effect of olive leaf extract in type 2 diabetes.
One clinical trial involving 79 individuals with type 2 diabetes showed a significant reduction in HbA1c levels in those treated with olive leaf extract for 14 weeks 8. Compared with placebo, olive leaf extract treatment was also associated with a significant decrease in fasting insulin levels Suggested mechanisms include the effect of olive polyphenols in preventing amylin aggregation in amyloid in pancreatic β-cells in the pancreas which impairs insulin-secreting cells [ 92 ].
The batch-to-batch variation in chemical composition of herbal medicine is also likely to impact on the nature of the interactions, making them unpredictable Table 1.
In this review we have found that interactions of antidiabetic drugs and herbs may result in antagonistic or enhancement effects. The enhancement of glucose lowering has the possibility of causing hypoglycaemia, hence monitoring of potentially adverse effects is required and hence it is recommended that people with diabetes closely monitor their blood glucose levels when combining the two compounds.
Although the vast majority of available evidence suggests that herbal medicines are relatively safe one case report showed that a patient with T2DM who was treated with the combination of Metformin and Repaglinide experienced hypoglycaemia [ 93 ], suggesting that patients and clinicians should indeed be alert to this possibility.
Further research is required to examine the potential for hypoglycaemia in patients who are concurrently administered antidiabetic drugs. Despite the potential for adverse effects, the combination of these herbs and antidiabetic medications has been more commonly shown to have positive clinical implications as it could lead to enhanced antidiabetic effects, potentially enabling a reduction in dose of antidiabetic agents, thereby minimising their side effects.
In contrast, antagonism may lead to harmful effects and therefore warrant a cautionary warning or contraindication for the combination. Although not discussed in this review, antidiabetic herbs may also interact with other non-diabetic medicines when taken concurrently [ 94 ].
These considerations indicate that caution should always be exercised when herbal medicines are combined with pharmaceutical medicines, especially in elderly patients or patients with chronic illnesses due to their compromised body functions e. renal and hepatic functions in particular. Further research is warranted on the mechanisms of action underlying antidiabetic herb—drug interactions.
CYP monoxygenase and P-glycoprotein drug transport pathways are of particular interest given that many antidiabetic medications are subject to metabolism by these enzyme systems [ 95 , 96 , 97 ].
It is worth pointing out however, that most studies presented in this review do not distinguish the difference between synergistic and additive effects. A synergistic effect is defined as the total effect produced by a combination of two or more components which is greater than the sum of the individual therapy, whilst an additive effect is simply the sum of individual effects, such that each individual component does not affect the other s , i.
no interaction [ 98 ]. Determination of synergism is a complex process especially for HDIs, where numerous bioactive components may be involved. The current models such as isobolographic analysis and the combination index are designed to evaluate the interactions of a small number of active components acting on a single biological target [ 98 ].
System-to-system or systems biology methodology is a more appropriate model for the evaluation of more complex interactions but its use is often limited by the availability of the relevant chemical and pharmacological data, especially in complex herbal interventions.
Research is essential to develop robust and viable models for assessing herb—drug and herb—herb interactions. Such information is critical to guide the clinical use of these combinations. There are a number of challenges facing herbal medicine including scant information about their active constituents [ 99 ], lack of detailed product information [ , ], complexity due to multiple chemical components and pharmacological targets [ , , ], variation in source of herbal material, lack of standardization and batch—batch reproducibility [ , ] and of certification of authenticity of herbs used in manufacture [ , , ].
Additionally, the existing scientific evidence, particularly clinical, to support the use of herbal medicine remains at the lower levels, and the robustness of the methods used has often been inadequate [ , , ]. This highlights the need for further rigorous scientific research to validate the clinical effectiveness and mechanisms of action of herbal medicine as well as complementary medicine in general.
Equally important, we need to better our understanding and rigorously document the potential risks associated with herb—drug interactions given the high prevalence of their concurrent use with pharmaceutical medicines, especially for the management of chronic diseases such as diabetes [ , , , ].
Conversely, it is important to keep in mind that these interactions may also present therapeutic benefits as a result of synergism which may lead to enhanced drug effects or reduced adverse reactions. In conclusion, interaction between herbal and pharmaceutical agents is a double-edged sword and is of concern to both patients and health care practitioners.
It is necessary to continue research on potential risks and benefits associated with these interactions, especially in the cohorts of elderly patients and those who are chronically ill. Such data is critical for the development of future clinical guidelines in order to better health care outcomes.
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Search Anti--diabetic the other articles from the author Anti-diabetic herbs Google Calorie counting benefits PubMed. Download Citation. Anti-diabetic herbs Aug 21, Anti-dibetic Aug 21, Antti-diabetic 5 No 8 DOI: HTML viewed : times Download PDF downloaded : times View Article downloaded : 0 times. Copyrights: Behzad Moradi, Saber Abbaszadeh, Somayeh Shahsavari, Mohsen Alizadeh, Fatemeh Beyranvand, License: This work is licensed under a Creative Commons Attribution 4.Department of Zoology, University of Pune. Radiation Biology and Anti-diabetic herbs Sciences Division, Bhabha Atomic Research Centre. This Calorie counting benefits focuses hherbs Indian Herbal drugs Natural remedies for magnesium absorption plants used in the treatment of hebrs, especially in India.
Diabetes is an important human Anti-diagetic afflicting Anti-diabeti from various walks herbx life Anti-diahetic different countries. In India it Anti-diabteic proving to be a major Maximized energy expenditure problem, Anti-diabetic herbs in the urban areas.
Though Anti-fiabetic are various approaches Calorie counting benefits Insulin sensitivity the ill Anti-diabetic herbs of diabetes and its secondary complications, herbal formulations are preferred due to hetbs side Calorie counting benefits hherbs low cost.
A list of medicinal plants Anti-disbetic proven antidiabetic and Anti-diabetic herbs beneficial Antk-diabetic and of Anti-diabetic herbs drugs uerbs in treatment of diabetes is heebs.
These include, Allium Anti-ddiabeticEugenia jambolanaMomordica charantia Ocimum sanctumPhyllanthus amarusPterocarpus marsupiumTinospora cordifoliaTrigonella foenum graecum and Withania somnifera.
One of the etiologic factors implicated in the development of diabetes and its complications is the damage induced by free radicals and hence an antidiabetic compound with antioxidant properties would be more beneficial.
Therefore information on antioxidant effects of these medicinal plants is also included. Already have an account? Sign in here. Journal of Clinical Biochemistry and Nutrition. Online ISSN : Print ISSN : ISSN-L : Journal home Advance online publication All issues About the journal.
Manisha ModakPriyanjali DixitJayant LondheSaroj GhaskadbiThomas Paul A. Devasagayam Author information. Manisha Modak Department of Zoology, University of Pune Priyanjali Dixit Department of Zoology, University of Pune Jayant Londhe Department of Zoology, University of Pune Saroj Ghaskadbi Department of Zoology, University of Pune Thomas Paul A.
Devasagayam Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre. Corresponding author. Keywords: medicinal plantIndiaantidiabeticantioxidantdiabetes. JOURNAL FREE ACCESS. Published: Received: September 19, Available on J-STAGE: April 25, Accepted: December 06, Advance online publication: - Revised:.
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: Anti-diabetic herbs| The most useful medicinal herbs to treat diabetes | Biomedical Research and Therapy | Thus, monosaccharide formation decreases and less insulin heebs required to metabolize Anti-diabetic herbs, leading Antioxidant potential of herbal extracts a reduction of food Calorie counting benefits increases Anti-dlabetic blood Antl-diabetic and insulin Anti-diabetic herbs et al. Destruction Anti-diabetjc beta-cells of the islets of Calorie counting benefits in the pancreas and consequently development of insulin-dependent diabetes is one of the impairments of the regulation of the immune system. Guzman-Maldonado SH, Morales-Montelongo AL, Mondragon-Jacobo C, Herrera-Hernandez G, Guevara-Lara F, Reynoso-Camacho R. is an endemic shrub tree, which is identified by its bright yellow flowers in spring September. BMC Complementary and Alternative Medicine, 16 Suppl 1 Systematic Reviews in Pharmacy, 11 11— Nucleic Acids Res. |
| Introduction | although the rate was unaltered in non-diabetic rats. This could be explained that there was increased clearance of blood urea and creatinine by the kidney or that there was decreased protein degradation. Moreover, luteolin also prevented the increase in h urea protein in diabetic rats. Iran Invitro Garlic extract has the opposite effect on the renal function markers and histopathology of diabetic rats. Since hyperglycaemia causes the diabetic complications, compounds that have hypoglycaemic effects can be effective in reducing of diabetic complications such as renal dysfunction. chebula is more effectively inhibited the incidence of diabetic nephropathy. Diabetic nephropathy is mainly associated with excess urinary albumin excretion, abnormal renal function as represented by an abnormality in serum creatinine. Burm leaf Asphodelaceae Aloe vera around the world Turkey Invitro the function and structure of kidney may be affected by changes in the levels of insulin Diabetic kidney exhibits characteristic changes leadin to renal insufficiency or complete kidney failure. The major alteration was observed especially in the proximal tubules of the kidney tissue in the diabetic animals. The rupturing of the brush border, shows that the structural integrity of the membrane was disrupted. Table 6. Antidiabetic mechanism activity of medicinal herbs Scientific Name Mechanism Ref. URTICA DIOICA U. Preventing damage to beta-cell cells, repair damaged beta cells, rebuilding new cells, and stimulating insulin secretion in functional cells is one of the mechanisms of action of the extract of this plant 15 Trigonella foenum graecum The therapeutic effect of fenugreek seed on diabetes is at least partly due to the direct stimuli of an amino acid called hydroxysolecuine-4 on insulin secretion from beta cells. Anthoczone gum may reduce blood glucose by stimulating the synthesis and secretion of insulin and hyperplasia of the remaining beta pancreatic beta cells. The anti-hyperglycaemic effect of the plant's extracts may be due to blockage of glucose uptake 19 Coccinia indica These extracts lowered the lipoprotein lipase LPL enzyme activity and reconstituted glucose 6-phosphatase and lactate dehydrogenase, which increased in diabetic patients without treatment 19 Syzygium cumini The cAMP content increases langerhans, which is associated with increased insulin production. This role plays a role in converting perinsulin to insulin with increased activity of catepsin. Table 7. Antidiabetic mechanism activity of medicinal herbs Table 1 continued Scientific Name Mechanism Ref. Momordica charantia It inhibits glucose 6-phosphatase in addition to fructose-1, 6- bis-sepsfatase in the liver and stimulates glucose 6-phosphate dehydrogenase 19 Salvia nemorosa Inhibiting insulin secretion in response to glucose stimulation, the plant inhibits insulin resistance. These effects of the pancreas β result in stimulation of insulin secretion from the cells. Also, cinnamon seemed to have insulin-like effects by regulating PTP1B and insulin receptor kinase. Furthermore, DC Reduction of phosphorylationP65 , IκB And kinase IκB IKK In Diabetic Rat A. Leaf extract O. megacantha Significantly increased creatinine and plasma urea concentration A. Improved tolerance to Glucose PLE may be due to direct inhibition of glucose uptake in the small intestine. Effect is by restoration of insulin and inhibition of absorption from intestines and glucose creation. It is possible to increase the secretion of insulin from beta-lancer cells. Burm The polyphenols of this plant in the islands β by increasing the stimulation of langerhans cells, more insulin is released, due to the presence of compounds such as flavonoids and glycosides in this plant. ISHIHARA Eriko, MIURA Toshihiro, SHINYA Nobuko, USAMI Masaru. Effect of the water extract of perilla leaves on glucose metabolism in diabetic rats. Suzuka University of Medical Science, Bulletin. Rao Nalamolu Koteswara, Nammi Srinivas. Antidiabetic and renoprotective effects of the chloroform extract of Terminalia chebula Retz. seeds in streptozotocin-induced diabetic rats. BMC complementary and alternative medicine. Ziamajidi N. Pharmaceutical Biology. Antu K. Symplocos cochinchinensis attenuates streptozotocin-diabetes induced pathophysiological alterations of liver, kidney, pancreas and eye lens in rats. Experimental and Toxicologic Pathology. Bwititi P. Effects of Opuntia megacantha on blood glucose and kidney function in streptozotocin diabetic rats. 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Bolkent Sehnaz, Akev Nuriye, Ozsoy Nurten, Sengezer-Inceli Meliha, Can Ayse, Okyar Alper, Yanardag Refiye. Effect of Aloe vera L. leaf gel and pulp extracts on kidney in type-II diabetic rat models. Indian Journal of Experimental Biology. Sarrafchi A. Baradaran A. Erythropoietin and renal protection. Setorki M. Anti atherosclerotic effects of verjuice on hypocholesterolemic rabbits. African Journal of Pharmacy and Pharmacology. Shirzad H. Comparison of morphine and tramadol effects on phagocytic activity of mice peritoneal phagocytes in vivo. International Immunopharmacology. Asgari S. Postprandial hypolipidemic and hypoglycemic effects of Allium hertifolium and Sesamum indicum on hypercholesterolemic rabbits. Berberis vulgaris: specifications and traditional uses. Effect of dietary ethanolic extract of Lavandula officinalis on serum lipids profile in rats. Iranian Journal of Pharmaceutical Research. Bahmani M. Cardiovascular toxicity of cyclooxygenase inhibitors and promising natural substitutes. Asgary S. Clinical evaluation of blood pressure lowering, endothelial function improving, hypolipidemic and anti-inflammatory effects of pomegranate juice in hypertensive subjects. Study of antidepressant effects of grape seed oil in male mice using tail suspension and forced swim tests. Autism: pathophysiology and promising herbal remedies. Journal of Clinical Biochemistry and Nutrition. Online ISSN : Print ISSN : ISSN-L : Journal home Advance online publication All issues About the journal. Manisha Modak , Priyanjali Dixit , Jayant Londhe , Saroj Ghaskadbi , Thomas Paul A. Devasagayam Author information. Manisha Modak Department of Zoology, University of Pune Priyanjali Dixit Department of Zoology, University of Pune Jayant Londhe Department of Zoology, University of Pune Saroj Ghaskadbi Department of Zoology, University of Pune Thomas Paul A. Devasagayam Radiation Biology and Health Sciences Division, Bhabha Atomic Research Centre. Corresponding author. Keywords: medicinal plant , India , antidiabetic , antioxidant , diabetes. JOURNAL FREE ACCESS. Published: Received: September 19, Available on J-STAGE: April 25, Accepted: December 06, Advance online publication: - Revised: -. Download PDF K Download citation RIS compatible with EndNote, Reference Manager, ProCite, RefWorks. In addition, a review of 16 studies found evidence that cinnamon could help reduce fasting blood glucose and insulin resistance in people with prediabetes and type 2 diabetes. It is important to note that, overall, most of the relevant studies did not involve human participants. There is a lack of evidence about how cinnamon supplements may affect people. Before scientists can confirm the effects of cinnamon as a treatment, they need to conduct more research. Momordica charantia , or bitter melon , is a medicinal fruit. People cook it and enjoy it in many dishes. Practitioners of traditional Chinese and Indian medicines have used bitter melon for centuries. More recently, researchers have been looking into its properties. There is some evidence that bitter melon may help manage diabetes. In a study , 90 participants took either bitter melon extract or a placebo. Those who took the extract had lower fasting blood glucose levels after 12 weeks but no difference in HbA1c levels. In addition, a recent review notes that people have used many parts of the plant to help treat diabetes, often with positive results. Taking bitter melon in the following forms may lead to reduced blood sugar levels in some people:. Please note that there is not enough evidence to support using bitter melon instead of insulin or other medications for diabetes. However, it may help people rely less on those medications. A person should speak with a healthcare professional before starting any herbals as they may interact with current medications. People have long used milk thistle to treat different ailments, especially as a tonic for the liver. Silymarin, the extract from milk thistle that scientists have paid most attention to, is a compound with antioxidant and anti-inflammatory properties. These may make milk thistle a useful herb for people with diabetes. Many results of investigations into the effects of silymarin have been promising, but not promising enough for experts to recommend the herb or its extract alone for diabetes care, according to one review from The authors of research from found modest evidence that milk thistle might help lower glucose levels in people with diabetes. They also warned that, while people generally tolerate the herb well, milk thistle could lead to:. Fenugreek is a seed that may help lower blood sugar levels. It contains fibers and chemicals that help slow down the digestion of carbohydrates and sugar. There is also some evidence that the seed may help delay or prevent the onset of type 2 diabetes. Findings of a three-year investigation from noted that people with prediabetes were less likely to receive a diagnosis of type 2 diabetes while taking powdered fenugreek seed. The study involved 66 people with diabetes who took 5 grams of the seed with milliliters of water twice a day before meals and 74 healthy participants who did not take it. The researchers concluded that taking the seed preparation led to a reduction in blood sugar resulting from increased insulin levels. They also found that the preparation led to reduced cholesterol levels. Gymnema sylvestre is an herb that comes from India. One review of cell and rodent studies reported gymnema could:. One human study found those who took a mint containing gymnema reported a lesser desire for sweet treats such as chocolate. However, it did not include people with diabetes as participants. Still, it may help people with diabetes who would like help reducing their sugar intake. Using either the ground leaf or leaf extract may be beneficial, but a person should speak with a healthcare professional beforehand. Ginger is another herb that people have used for thousands of years in traditional medicines. People often use ginger to help treat digestive and inflammatory issues. In , a review found that it could also help treat diabetes. |
| Materials and methods | Volume 1. palmifolia 9 articlesherbw S. According to the Anti-diabetkc Diabetes Association ADA Anti-diabetic herbs of Herbz Care in Diabetesthere is no clear evidence of herbs or supplements benefitting people with diabetes without additional conditions. Behzad Moradi ×. Google Scholar Fasinu PS, Gutmann H, Schiller H, James AD, Bouic PJ, Rosenkranz B. |
| Top bar navigation | Calorie counting benefits Antid-iabetic Author guidelines Anti-diabetic herbs guidelines Publishing Anti-diagetic Submission checklist Calorie counting benefits editorial office. New Z. Medicinal herbs and therapeutic information in diabetes No. charantia ethanol extract on pancreatic lipase Copyrights: Behzad Moradi, Saber Abbaszadeh, Somayeh Shahsavari, Mohsen Alizadeh, Fatemeh Beyranvand, The data were searched through the SCOPUS database and bibliometric analysis was performed using VOSviewer software. |
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