Eureka Herba Indonesia Vol 1 Issue 2 2020

Eureka Herba Indonesia Journal Homepage: https://eurekabiomedical.com/index.php/EHI

Potential Of Sambung Nyawa Leaves ( Procumbens) As An Antidiabetic Medicine

Mustofa1 Faculty of Medicine, Universitas Gadjah Mada, Indonesia

A R T I C L E I N F O A B S T R A C T

Keywords: Diabetes mellitus is a metabolic disease characterized by an increase in blood sugar due to defects in insulin secretion, insulin sensitivity, or both. The number of Antidiabetik people with diabetes mellitus in Indonesia has increased every year. The number Diabetes Melitus of people with diabetes is 6.9% in 2013 to 10.9% in 2018. Various therapies have been Antioksidan. carried out for the treatment of Diabetes Mellitus, one of which is herbal therapy. Gynura Procumbens is a that is widely used as a treatment for diabetes mellitus, Corresponding author: kidney, rash and fever, and hypertension. The flavonoid content in Gynura Mustofa Procumben replaces the decrease in blood sugar. This review article attempts to E-mail address: explain the role of Gynura Procumbens as an antidiabetic therapy in previous studies. mustofa@ gmail.com The method used in this article is through searching articles through the NCBI database and Google Scholar. The results of an article search found that Gynura All authors have reviewed and Procumben has antidiabetic potential which can reduce blood sugar in patients with approved the final version of the Diabetes Mellitus manuscript. .

https://doi.org/10.37275/EHI.v1i2.8

1. Introduction the world has increased from 108 million in 1980 to Diabetes mellitus is a group of metabolic diseases 422 million in 2014 (Sarwar, 2010). Based on 2018 characterized by increased blood sugar due to defects RISKESDAS data, the highest number of diabetes in insulin secretion, insulin sensitivity, or both mellitus sufferers in Indonesia is DKI Jakarta, namely (Kharroubi, 2015). Symptoms that are complained of in 3.4%, while the lowest is NTT, namely 0.9%. Then, the diabetes mellitus sufferers are polydipsia, polyuria, total number of diabetics also increased by 6.9% in polyphagia, weight loss and tingling sensation. 2013 to 10.9% in 2018 (Riskesdas, 2018). Uncontrolled diabetes can cause serious damage to Treatment of diabetes mellitus has been using oral body systems, especially to nerves and blood vessels anti-diabetes drugs or insulin injections. Diabetics who (Sarwar, 2010). undergo drug therapy experience side effects of Diabetes Mellitus is one of the leading causes of increasing body weight, an increased risk of death worldwide. There are 3.2 million deaths caused hypoglycemia and an increased risk of chematin directly by diabetes each year. Within 1 minute, 6 (Gerstein, 2008). Thus, new strategies are needed for people died from diseases related to diabetes (Tandra, diabetes prevention and treatment. Among the best 2017). In addition, people affected by diabetes mellitus alternative therapies are herbal medicines that have have increased every year. The number of diabetics in been used since ancient times for the treatment of

32 diabetes mellitus (Rang, 2012). that there is no linear relationship between increased The Indonesian government advises the public to dose and an increase in the effect of decreasing blood take herbal medicines because of their low side effects. glucose levels (Syawal, 2015). Gynura Procumbens is a fast growing herbal plant Research also carried out by Uthia (2018) showed found in tropical Asian countries such as China, that the preliminary test of giving Sambung Hidup Thailand, Indonesia, Malaysia and Vietnam. In leaves ethanol extract was proven to reduce blood traditional medicine, this plant is widely used for the glucose levels in male white mice with diabetes mellitus treatment of diabetes, kidney disease, rashes as well induced by alloxan. The research data were analyzed to fever, and hypertension (Tan, 2016). see whether or not it affected blood glucose levels. The results showed that at a dose of 50 mg / KgBB, the 2. Research Methods ethanol extract of the leaves of Sambung Life (Gynura The method used in writing this article is a literature Procumbens) had the effect of reducing glucose levels review. The library sources used in this article consist (Uthia, 2018). of 20 libraries from books and national or international In addition, research by Andriyani with the results journals. Research literature sources in this study used of the data obtained using ANOVA analysis (α = 0.05) NCBI and Google Scholar with the keywords Gynura states that the optimal dose of the combination of the Procumbens, Diabetes Mellitus, antioxidants, herbal ethanol extract of sambiloto and ginseng leaves, antidiabetic, and others. Selection of literature source namely SASN 50:50, can reduce blood glucose levels by articles is carried out by reviewing the title and 42.86159%, reduce LPO levels by 0.01666 μM / g, abstract, namely discussing the potential of Gynura increase GSH levels by 2.5066 mm free SH. Procumbens as a diabetes mellitus drug. The year of Combination of ethanol extract of bitter and leaf herbs publication of the library sources used in the writing of continuation of life is more effective at reducing blood this article is from 2009 to 2019. glucose levels compared to giving alone (Andriyani, 2019). 3. Results and Discussion The leaves of the Gynura Procumbens plant or often Research on the benefits of Gynura Procumbens referred to as Kontak Nyawa are herbal was conducted by several researchers. The results of a belonging to the family. Connect Nyawa study conducted by Sofia (2011) showed that the plants contain flavonoids, terpenoids and phenolic ethanol extract of the leaves of gait Hidup (Gynura acids (Bodeker, 2009). This plant has a height of up to Procumbens) could reduce blood sugar levels in male 3 meters or more, stems are angular, rather soft and mice (Musmusculus) induced by alloxan. The greater watery. The leaves are oval with a light green color the dose of the ethanol extract of the leaves of Sambung (Rahman, 2013). The leaves are 6 cm long and 3.5 cm Life given, the more effective it was in reducing blood wide. The tip of the leaf is pointed, the base of the leaf sugar levels in alloxan induced mice with a p value is rounded, the edge of the leaf is shallow and the <0.05 (Sofia, 2011). petiole is 1.5 cm or more. Both surfaces of the leaves In addition, according to Syawal (2015), it was found have fine hair with pinnate affinities (Akowuah, 2012). that there was a significant difference between the The classification of Gynura Procumbens in the control group rats and the mice that were given the leaf plant world can be seen in Table 1. extract of Sambung Hidup. The results showed that the Gynura Procumben contains flavonoids and leaf extract of Sambung Hidup with a dose of 2.0 g / kg phenolic compounds that act as antioxidants. In the BW (36.16%) had a better effect on reducing blood management of diabetes mellitus, flavonoids exhibit glucose levels compared to doses of 1.0 g / kg BW strong antioxidant activity. One of the antioxidant (31.13%) and 1.5. g / kg BW (33.15%), while the results effects is that it can increase insulin action. In addition, of the calculation of the correlation coefficient show the ability of flavonoids as antioxidants can protect

3333 against the adverse effects of hyperglycemia and by reversing gluconeogenesis, an increase in insulin increase metabolism and glucose uptake. In addition to secretion or glycemic control (Pandhare, 2011). their antioxidant effects, flavonoids can act on Gynura Procumben also has the same anti-diabetic biological targets involved in type 2 diabetes mellitus mechanism as the drug metformin. G. procumbens such as α-glycosidase and DPP-4. Flavonoids can acts at a peripheral level having an insulin-like effect. effectively prevent and / or manage type 2 diabetes This herb does not stimulate insulin secretion but mellitus by being anti-free radicals (Sarian, 2017). resembles or increases insulin action. Its mechanism of Apart from that, Gynura Procumben also has a role action is to increase glucose uptake into peripheral in glucose homeostasis. Weight gain is an indicator of cells. the efficiency of glucose homeostasis (Pareek, 2009). In G. procumbens was found to increase insulin- diabetics, glucose metabolism is rare so that there is a stimulated glucose transport across skeletal muscle breakdown of fat and tissue protein into energy which membranes, similar to metformin. G. procumbens acts causes a reduction in muscle mass which results in directly in glucose uptake at the peripheral level, either weight loss (Attangwo, 2012). Gynura Procumben has alone or as an insulin coadjuvant (Zurina, 2010). several protective effects in controlling muscle wasting

Table 1. Gynira Procumbens classification Kingdom Plantae Divisio Spermatophyta Subdivision Angiosperms Class Dicotyledoneae Order Familia Asteraceae Gynura Species (gynura Procumbens)

4. CONCLUSION there is still a need for further studies on possible side Diabetes mellitus is a metabolic disease effects. characterized by increased levels of glucose in the blood. Treatment of diabetes mellitus used is oral anti- 5. REFERENCES diabetes drugs (OAD) or insulin injections. However, 1. Akowuah,G, Ahmad M, and Fei,Y.M. (2012). there are some side effects to the use of these oral drugs Effects of Gynura procumbens leaf extracts on plasma lipid peroxidation and total antioxidant so it is recommended to use herbal medicines. status in CCl4-treatedrats. Nat.Prod.J. 2,247– Gynura Procumben is an herbal plant that contains 251. flavonoids, terpenoids and phenolic acids. This plant 2. Andriyani R, Tyas YU, Dinah FA. (2019). Antidiabetic Activity Test and Antioxidant can be used as an antidiabetic herbal medicine. The Combination of Ethanol Extract of Herba mechanism of action is to increase insulin sensitivity. Sambiloto (Andrographis paniculata Ness) and This is related to increasing glucose uptake into Daun Kontak Nyawa (Gynura Procumbens) in peripheral cells so that glucose in the blood decreases. Alloxan-induced Diabetes Mellitus Rats. Indonesian Journal On Medical Science. 6 (1). The Gynura Procumbens plant can be used as an 3. Atangwho IJ, Ebong PE, Eyong EU, Asmawi alternative medicine for diabetes mellitus because it MZ, Ahmad M. (2012). Synergistic antidiabetic contains flavonoids, terpenoids and phenolic acids, but activity of Vernonia amygdalina and Azadirachta indica: biochemical effects and

34 possible mechanism. J Ethnopharmacol; Unika Widya Mandala Surabaya. 141(3): 878-887. 16. Tan HL, Chan KG, Pusparajah P, Lee LH, Goh 4. Bodeker,G,Salleh and Shekar,S.C. (2009). BH. (2016). Gynura Procumbens: An Overview Health and Beauty from the Rain of the Biological Activities. Front Pharmacol. forest:Malaysian Traditions of Ramuan. 7:52. Editions Didier Millet Pty Ltd. Kuala Lumpur. 17. Tandra, H. (2017). Everything You Need to 5. Gerstein HC. (2008). Effects of intensive Know glucose lowering in type 2 diabetes. N. Engl. J. Med. 358, 2545-2559. 6. Kharroubi AT. (2015). Diabetes mellitus: The epidemic of the century. World J Diabetes. 6(6):850. 7. Pandhare RB, Sangameswaran B. (2011). Antidiabetic activity of aqueous leaf extracts of Sesbania sesban (L) Merr in streptozotocin- induced diabetic rats. Avicenna J Med Biotech; 3(1): 37-42. 8. Pareek H, Sharma S, Khajja BS. (2009). Evaluation of hypoglycemic and anti- hyperglycemic potential of Tridax procumbens (Linn.) BMC Compl Altern Med; 9(48): 1-7. 9. Rahman,A and Asad M. (2013). Chemical and biological investigations of the leaves of Gynura procumbens. Int.J.Biosci. 3,36–43. 10. Rang, H.P et al. (2012). Pharmacology, 7thed. Churchill Livingstone. Edin burgh. 11. Basic Health Research (Riskesdas) (2018). Research and Development Agency for Health Ministry of the Republic of Indonesia in 2018. http://www.depkes.go.id/re sources / download / infoterkini / material_rakorpop_2018 / Ha sil% 20Riskesdas% 202018.p df - Accessed December 2019. 12. Sarian MN, Ahmed QU, Mat So'ad SZ, et al. (2017). Antioxidant and Antidiabetic Effects of Flavonoids: A Structure -Activity Relationship Based Study. Biomed Res Int 8386065. 13. Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio et al.(2010). Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta- analysis of 102 prospective studies. Emerging Risk Factors Collaboration. Lancet. 26;375:2215-2222. 14. Sofia. (2011). In Vivo Test of Ethanol Extract of Leaves Connect Nyawa (Gynura Procumbens) Against Decreasing Blood Sugar Levels of Male Mice (Mus musculus) Swiss Webster Diabetes Mellitus Strain. Syah Kuala Medical Journal (3). 15. Syawal Y. (2011). Effect of Dewa Leaf Extract (Gynura Procumbens) on Decreasing Blood Glucose Levels in Male White Rats Using Glucose Tolerance Test Method. Surabaya:

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