Phytomedicine for Diabetes Mellitus: an Overview
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Research in Pharmacy 1(4) : 28-37, 2011 ISSN : 2231-539X www.researchinpharmacy.com Review Article Phytomedicine for Diabetes mellitus: An overview Uma Makheswari M and Sudarsanam D* Department of advanced Zoology & Bio Technology, Medical Lab Technology & Bio-medical Instrumentation Science, Loyola College – 600 034, India *Corresponding author email: [email protected] Diabetes mellitus is a complex metabolic disorder resulting from either insulin insufficiency or insulin dysfunction. Diabetes mellitus affect most of the people of both developed and developing countries. The treatment of diabetes with synthetic drugs is costly and chances of side effects are high. Phytomedicine has been used since ancient time in many parts of the world where access to modern medicine is limited. Low-fat vegan diet has improved glycemic control in type II diabetic patients. Photochemical identified from medicinal plants presents an exciting opportunity for the development of new types of therapeutics for diabetes mellitus. Most prevalent of photochemical groups are the alkaloids, terpenes, and phenolics. Several formulations like herbal teas, extracts, decoctions, infusions, tinctures, etc are prepared from medicinal plants. Despite considerable progress in the development of synthetic drugs, the search for the invention of phytomedicine as alternative therapy is progressing. Keywords: Diabetes mellitus, phytomedicine, vegan diet, synthetic drugs. India is the largest producer of Diabetes mellitus medicinal herbs and is called as botanical Diabetes mellitus is a complex garden of the world. Ayurveda, Unani, metabolic disorder resulting from either Siddha and Folk (also called tribal) medicines insulin insufficiency or insulin dysfunction. are the major systems of Indian medicines. Type I diabetes (insulin dependent) is caused Among these systems, Ayurveda is most due to insulin insufficiency. Type II diabetes developed and widely practiced in India. A (insulin independent) is due to number of plants have been described in immunological destruction of pancreatic β Ayurveda and other traditional medicine for cells leading to insulin deficiency. Type II the treatment of diabetes. Isolation of the diabetes is characterized with insulin main compounds from the active extract is a resistance. It is the more common form of crucial step in all research activities for diabetes constituting 90% of the diabetic developing a novel phytomedicine for population. Symptoms for both diabetic diabetes mellitus. conditions may include: (i) high levels of sugar in the blood; (ii) unusual thirst; (iii) Uma Makheswari M & Sudarsanam / Research in Pharmacy 1(4) : 28-37, 2011 frequent urination; (iv) extreme hunger; (v) possess pancreatic beta cells regenerating, loss of weight; (vi) nausea and vomiting; (vii) insulin releasing and fighting the problem of blurred vision; (viii) Excessive tiredness, insulin resistance (Welihinda et al., 1982). irritability etc. Anti diabetic plants also possess strong antioxidant/free-radical scavenging Glycemic control properties. Glycemic control is a medical term referring to the typical levels of blood sugar Phytochemicals (glucose) in a person with diabetes mellitus. Plants have evolved secondary "Perfect glycemic control" would mean that biochemical pathways allowing them to glucose levels were always normal (70– synthesize a raft of chemicals, often in 130 mg/dl, or 3.9-7.2 mmol/L) and response to specific environmental stimuli, indistinguishable from a person without such as herbivore-induced damage, pathogen diabetes. Control and outcomes of both types attacks, or nutrient depravation (Raymond et I and II diabetes may be improved by al., 2000; Hermsmeier et al., 2001). These patients. Home glucose meters can be used secondary metabolites increase their overall to regularly measure their glucose levels ability to survive and overcome local (Gray et al., 2000). The American Diabetes challenges by allowing them to interact with Association in 1994 recommended that 60- their environment. These chemicals also help 70% of caloric intake should be in the form of humans to protect themselves against carbohydrates. But some researchers claim diseases and are called Photochemical. Thus that 40% is better, (Garg et al., 1994) while there is a need to know about the health others claim benefits for a high-fiber, 75% benefits and possible risks to ensure the carbohydrate diet (Kiehm et al., 1976). efficacy and safety of dietary supplements. Importance of phytomedicine Photochemical are chemical Traditional herbal medicine has been compounds that occur naturally in plants that used since ancient time in many parts of the have protective or disease preventive world. The many side effects of insulin properties. Each type of fruit or vegetable therapy and other oral hypoglycemic agents may contain hundreds of photochemical. necessitate the use of more effective and safer Selenium, for example, is involved with antidiabetic drugs. For example, long-term major metabolic pathways, including thyroid use of Metformin (Bolen et al., 2007) causes hormone metabolism and immune function diarrhea, nausea, gas, weakness, indigestion, (Brown and Arthur, 2001). These abdominal discomfort and headache. Plant photochemical show multiple beneficial based drug are considered to be less toxic effects in combating diabetes and diabetes- and free from side effects than synthetic one. related complications. Hence, they play an important role as alternative medicine. Phytomedicines are The herbal drug preparation mainly whole, fragmented or cut, plants parts (phytomedicine) is obtained subjecting herbal of plants, algae, fungi, lichen in an drugs to treatments such as extraction, unprocessed state, usually in a dried form, distillation, fractionation, purification, but sometimes fresh. Herbal drugs are concentration and fermentation. These defined by their botanical (scientific) include cut or powered herbal drugs, binomial. The active principles present in tinctures, extracts, essential oils, fatty oils, medicinal plants have been reported to expressed juices and processed exudates. 29 Uma Makheswari M & Sudarsanam / Research in Pharmacy 1(4) : 28-37, 2011 Getting enough phytochemicals disease (Liu and Manson, 2001; Bazzano et Food provides not only essential al., 2003) and diabetes (Colditz et al., 1992; nutrients needed for life but also other Feskens et al., 1995). Fruit and vegetable biologically active compounds for health consumption was inversely related to promotion and disease prevention. The incident type II diabetes (Ford and Mokdad, easiest way to get more photochemical is to 2001). More than 5000 photochemical have eat more fruit (blueberries, cherries, apple…) been identified, but a large percentage still and vegetables (cauliflower, cabbage, remains unknown. Largest and most carrots...). Fruits and vegetables contain many prevalent of photochemical groups are the beneficial nutrients and photochemical that is alkaloids, terpenes, and phenolics. thought to protect against cardiovascular Table I: Medicinal plants used for the treatment of Diabetes mellitus Medicinal Family Common Distribution Part Active Reference Plant Names Used Ingredient Aloe vera Asphodelaceae Goddess, North Africa, Leaf, gel Polysaccharid Eshun and Kumari, Canary extract es, Mannans, He, 2004 Guarpatha Islands, Lophenol, Spain, India Lectins Azadirachta Meliaceae Neem, Myanmar, fruit, Nimbin, Pillai and indica Nimtree India, leaf, Nimbidin, Santhakuma Sri Lanka, flower, Nimbinin, ri, 1981 Pakistan seed Azadirachtin Momordica Cucurbitaceae Karela, United Fruit, Charantin Lolitkar and charantia Bittermelon, States, India seed Rajarama Bittergourd. Rao, 1962 Gymnema Asclepiadaceae Gudmar, Tropical Leaf Gymnemic Sugihara et sylvestre Periploca of regions of callus, acids, al., 2000 the woods Africa, Asia stem Gymnema saponin Holostemma Asclepiadaceae Holostemma Sri Lanka, Root Flavonoids, Iwu, 1980 ada-kodien creeper, India, Tannins, Charivel Myanmar, Terpenoids China Alkaloids their names often contain suffixes "idine", The name "alkaloids" was introduced "anine", "aline", "inine", etc. There are also at in 1819 by the German chemist Carl F.W. least 86 alkaloids containing the root "vin" Meissner. Alkaloids are a structurally diverse (extracted from the Vinca plant). group of over 12,000 cyclic nitrogen- Most plants contain several alkaloids. containing compounds that are found in over Their mixture is extracted first and then 20% of plant species (Zulak et al., 2006). individual alkaloids are separated. Biological Alkaloids are most common in flowering precursors of most alkaloids areamino acids, plants, especially in Fabaceae, Ranunculaceae such as ornithine, lysine, phenylalanine, and Solanaceae (Filho et al., 2006). If several tyrosine, tryptophan, histidine, aspartic acid alkaloids are extracted from one plant then and anthranilic acid. Alkaloids such as 30 Uma Makheswari M & Sudarsanam / Research in Pharmacy 1(4) : 28-37, 2011 aconitine, anisodamine, charantine, leurosine Terpenes can be used for the prevention show antidiabetic effects (Li et al., 2004). and/or treatment of diabetes type II, obesity and neuropathy. Berberine a quaternary ammonium salt from the protoberberine group of isoquinoline Phenolics alkaloids is used successfully in experimental In organic chemistry, phenols, (Wang et al., 2010) and human diabetes sometimes called phenolics, are a class of mellitus (Gu et al., 2010). It is found in such chemical compounds consisting of a hydroxyl plants