HERBAL MEDICINES TO TREAT DIABETES MELLITUS

ALOE VERA

Aloe vera is a product of the prickly but succulent aloe vera plant, which has been used in herbal medicine for thousands of years due to its healing, rejuvenating and soothing properties.

Preliminary research suggests that intake of aloe vera juice can help improve blood glucose levels andmay therefore be useful in treating people with diabetes.  1

Aloe has also been linked with:

Decreased blood lipids (fats) in patients with abnormally high levels of these molecules in the blood (e.g. some people with type 2 diabetes) and/or acute hepatitis (liver disease)

Decreased swelling and faster healing of wound injuries. Leg wounds and ulcers are common complications of diabetes, and they typically take longer time to heal than in healthy non-diabetic individuals.  2

These positive effects are thought to be due to the presence of compounds such as lectins, mannans and anthraquinones.

BITTER MELON

Bitter melon, also known as bitter gourd or ampalaya (in Philippines), is a unique vegetable-fruit that can be used as food or medicine.

It is the edible part of the plant Momordica Charantia, which is a vine of the Cucurbitaceae family and is considered the most bitter among all fruits and vegetables.

The bitter melon itself grows off the vine as a green, oblong-shaped fruit with a distinct warty exterior - though its size, texture and bitterness vary between the different regions in which it grows - and is rich in vital vitamins and minerals.

In addition to being a food ingredient, bitter melon has also long been used as a herbal remedy for a range of ailments, including type 2 diabetes.

The fruit contains at least three active substances with anti-diabetic properties, including charantin, which has been confirmed to have a blood glucose-lowering effect, vicine and an insulin-like compound known as polypeptide-p.

These substances either work individually or together to help reduce blood sugar levels.

It is also known that bitter melon contains a lectin that reduces blood glucose concentrations by acting on peripheral tissues and suppressing appetite - similar to the effects of insulin in the brain.

This lectin is thought to be a major factor behind the hypoglycemic effect that develops after eating bitter melon.

A number of clinical studies have been conducted to evaluate the efficacy of bitter melon in the treatment of diabetes.

In January 2011, the results of a four-week clinical trial were published in the Journal of Ethnopharmacology, which showed that a 2,000 mg daily dose of bitter melon significantly reduced  blood glucose levels among patients with type 2 diabetes, although the hypoglycemic effect was less than a 1,000 mg/day dose of metformin.  3

Other older studies have also suggested an association between bitter melon intake and improved glycemic control, while a report published in the March 2008 issue of Chemistry and Biology found that bitter melon increased cellular uptake of glucose and improved glucose tolerance.  4

However, research published in the Journal of Clinical Epidemiology in 2007 failed to show any benefits of bitter melon for poorly controlled type 2 diabetes, while another clinical review published two years later in the British Journal of Nutrition stated that more, better-designed and clinical trials are required to confirm the fruit’s role in diabetes treatment.  5

Bitter melon can be taken in several forms; it can be eaten as a fruit, made into juice, the seeds can be added to food in a powdered form, or it can be used in the form of a decoction by boiling pieces of the melon in water. Alternatively, bitter melon extract can be bought as an herbal supplement.

The fruit itself is available in Asian food stores and grocery shops, while other forms of the fruit-vegetable can be found in most health food shops.

If thinking of adding bitter melon to diet, make sure limit to no more than two ounces of bitter melon (or more than two melons) a day, as excessive consumption can cause mild abdominal pain or diarrhea. 

CINNAMON

Cinnamon is a sweet but pungent spice that is derived from the inner bark of the branches of wild cinnamon trees, which grow in tropical areas across Southeast Asia, South America and the Caribbean.

Cinnamon, often used in cooking and baking, is increasingly being linked to improvements in the treatment of conditions such as diabetes mellitus.

Research has suggested that cinnamon can help to improve blood glucose levels and increase insulin sensitivity.

Results from a clinical study published in the Diabetes Care journal in 2003 suggest that cassia cinnamon (cinnamon bark) improves blood glucose and cholesterol levels in people with type 2 diabetes, and may reduce risk factors associated with diabetes and cardiovascular disease.  6

A daily intake of just 1, 3, or 6 grams was shown to reduce serum glucose, triglyceride, LDL or bad cholesterol and total cholesterol after 40 days among 60 middle-aged diabetics.

Another study reported in the July 2000 edition of Agricultural Research Magazine found that consuming just 1g of cinnamon per day can increase insulin sensitivity and help manage or reverse type 2 diabetes. 7

In addition, more recent analysis published in 2007 in The American Journal of Clinical Nutrition showed that 6g of cinnamon slows stomach emptying and significantly reduces hyperglycemia after meals (postprandial blood glucose) without affecting satiety. 

As a result of the scientific evidence available, many health experts claim that cinnamon contains properties that are beneficial for blood sugar regulation and treatment of type 2 diabetes.

However, bear in mind that like many natural compounds cinnamon is yet to be medically approved for prevention or treatment of any disease.

The majority of the health benefits are associated with use of true cinnamon (also known as Ceylon cinnamon) and not cassia bark cinnamon, which is the species involved in most diabetes research.

In the UK, cinnamon is sold in many forms, including cinnamon sticks, powder, tea, oil and tablet supplements (cinnamon extract). These products can be found in most health stores and Asian food shops, as well as in larger supermarkets.

DAIKON

Daikon is a white fleshed radish that has a very mild taste and is very low in calories, coming in at around 6 calories per ounce. Because of the multitude of benefits it gives, daikon is considered a superfood. It contains large amounts of enzymes that aid in fat and starch digestion as well as high levels of vitamin C, phosphorus and potassium. It also contains other phyto-nutrients that fight cancer. The extract from the seed is also a powerful immune booster and cancer fighter. 8

Daikon radishes provide some soluble fiber that makes the person feel full which may reduce appetite. Also, it lowers LDL cholesterol reducing the risk of heart disease. It regulates blood sugar which may reduce the onset risk or symptoms of metabolic syndrome and diabetes. Lastly, it may reduce the risk of colorectal cancer, and help manage diarrhea. 9 

EGGPLANT

Add eggplant to anti-diabetes arsenal to help keep blood sugar levels under control. Often brought on by excess weight, diabetes undermines insulin production, sending blood sugar soaring. This can triple levels of free radicals– unstable molecules which can wreak havoc on healthy cells — contributing to a variety of diabetic woes, ranging from kidney failure to heart disease and blindness.

A study from the University of Massachusetts found that extracts from several eggplant varieties — purple, white and graffiti — inhibited an enzyme that converts starch to blood sugar. The eggplant compounds restrained the glucose-releasing enzyme by as much as 60%, and the effect correlated with antioxidant activity, which also helps squelch blood sugar-generated free radicals. 10

FENUGREEK

Fenugreek is an aromatic plant that has many uses, both culinary - fenugreek is a key ingredient of curries and other Indian recipes - and medicinal.

The plant, which is widely grown in South Asia, North Africa and parts of the Mediterranean, has small round leaves and also produces long pods that contain distinctive bitter-tasting seeds.

The leaves are either sold as a vegetable (fresh leaves, sprouts, and microgreens) commonly known as methi, or as an herb (dried leaves), while the seeds are used both whole and in powdered form as a spice.

As well as being a popular cooking ingredient, fenugreek has a number of health benefits and is used in both Ayurvedic and traditional Chinese medicine.

Fenugreek seeds (trigonella foenum graecum) are high in soluble fibre, which helps lower blood sugar by slowing down digestion and absorption of carbohydrates. This suggests they may be effective in treating people with diabetes.

Multiple studies have been carried out to investigate the potential anti-diabetic benefits of fenugreek.

Of these, several clinical trials showed that fenugreek seeds can improve most metabolic symptoms associated with both type 1 and type 2 diabetes in humans by lowering blood glucose levels and improving glucose tolerance.

In one study, researchers in India found that adding 100 grams of defatted fenugreek seed powder to the daily diet of patients with insulin-dependent (type 1) diabetes significantly reduced their fasting blood glucose levels, improved glucose tolerance and also lowered total cholesterol, LDL or ‘bad’ cholesterol and triglycerides.

In another controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in post-meal blood glucose, while a separate study found that taking 2.5 grams of fenugreek twice a day for three months lowered blood sugar levels in people with mild, but not severe, type 2 diabetes.

Fenugreek leaves (methi) and seeds can be found in most Asian food stores, while herbal supplements containing fenugreek seed powder and/or fenugreek seed extract in capsule form are available through most health food companies. 11

GINGER

Ginger is the thick knotted underground stem (rhizome) of the plant Zingiber officinale that has been used for centuries in Asian cuisine and medicine.

Native to Africa, India, China, Australia and Jamaica, it is commonly used as a spice or flavouring agent in cooking, as an alternative ‘herbal’ treatment for various ailments such as nausea and indigestion, and for fragrance in soaps and cosmetics.

Ginger rhizome can be used fresh, dried and powdered, or as a juice or oil. It has a pungent and sharp aroma and adds a strong spicy flavour to food and drink.

A study published in the August 2012 edition of the natural product journal Planta Medica suggested that ginger may improve long-term blood sugar control for people with type 2 diabetes.

Researchers from the University of Sydney, Australia, found that extracts from Buderim Ginger (Australian grown ginger) rich in gingerols - the major active component of ginger rhizome - can increase uptake of glucose into muscle cells without using insulin, and may therefore assist in the management of high blood sugar levels.

In the December 2009 issue of the European Journal of Pharmacology, researchers reported that two different ginger extracts, spissum and an oily extract, interact with serotonin receptors to reveres their effect on insulin secretion.

Treatment with the extracts led to a 35 per cent drop in blood glucose levels and a 10 per cent increase in plasma insulin levels.

A study published in the August 2010 edition of Molecular Vision revealed that a small daily dose of ginger helped delay the onset and progression of cataracts - one of the sight-related complications of long-term diabetes - in diabetic rats.

It’s also worth noting that ginger has a very low glycemic index (GI). Low GI foods break down slowly to form glucose and therefore do not trigger a spike in blood sugar levels as high GI foods do. 12

HEARTS OF PALM

Hearts of palm is a type of vegetable harvested from a number of palm tree species. The edible cores from the palm tree stems are firm and smooth, and described as resembling the flavor of an artichoke. Its crisp texture makes the food an ideal addition to salads and stir-fry meals. Palm hearts also contain beneficial nutrients and contribute to a healthy diet.

Most of the calories in palm hearts come from carbohydrates. A 1-ounce serving has 7 grams of total carbohydrates, including energy-providing complex carbs and natural sugars. You'll also get 0.4 grams of fiber, which isn't a large amount, but since most Americans barely consume half of their recommended daily allowance of fiber, every little bit helps. It's best known as roughage that keeps you regular, but fiber is also essential for lowering cholesterol and preventing spikes in blood sugar that can lead to weight gain and type 2 diabetes. 13

JICAMA

A round, bulbous root vegetable with origins in the Mexican peninsula, jicama (pronounced hee-cama) is part of the legume family and grows on vines. This little-known tuber is grown in the warm climates of Central America, the Caribbean, the Andes Mountain regions, and Southern Asia, where it's an important as well as extremely versatile food source.

Low in calories but high in a few vital nutrients, jicama is a bit of a contradiction when it comes to its starch content. It provides one-quarter of what's needed daily in fiber per serving. But not just any fiber - jicama's fiber is infused with oligofructose inulin, which has zero calories and doesn't metabolize in the body. Inulin, a fructan, promotes bone health by enhancing absorption of calcium from other foods, protecting against osteoporosis. Inulin has a prebiotic role in the intestine – it promotes “good” bacteria growth that maintains both a healthy colon and balanced immunity. Because it has a very low glycemic index, jicama is a great food for diabetics, and low in calories for those interested in weight reduction. 14

REFERENCES

1 Yongchaiyudha, S., Rungpitarangsi, V., Bunyapraphatsara, N., Chokechaijaroenporn, O.

(1996). Antidiabetic activity of Aloe vera L juice. I. Clinical trial in new cases of diabetes

mellitus. Phytomedicine, 3, 241–243.

2 Bunyapraphatsara, N., Yongchaiyudha, S., Rungpitarangsi, V., Chokechaijaroenporn, O.

(1996). Antidiabetic activity of Aloe vera L juice. II. Clinical trial in diabetes mellitus patients in

combination with glibenclamide. Phytomedicine, 3, 245–248.

3 Fuangchan, A. (2011). Hypoglycemic Effect of Bitter Melon Compared With Metformin

in Newly Diagnosed Type 2 Diabetes Patients. Journal of Ethnopharmacology, 12, 40-45.

4 Leung, L. (2009). Anti-Diabetic and Hypoglycaemic Effects of Momordica

Charantia (Bitter Melon): A Mini Review. British Journal of Nutrition, 53, 60-69.

5 Dans, A.M. (2007). The Effect of Momordica Charantia Capsule Preparation on

Glycemic Control in Type 2 Diabetes Mellitus Needs Further Studies. Journal of Clinical

Epidemiology, 81, 462-465.

6 Khan, A., Khattak, K., Sadfar, M., Anderson, R., Khan, M. (2003). Cinnamon

improves glucose and lipids of people with type 2 diabetes. Diabetes Care, 26, 3215-3218.

7 Anderson, R . (2000, May 16). Cinnamon Extracts Boost Insulin Sensitivity.

Agricultural Research Magazine, 145, 58-59.

8  Daly, A., Franz, M., Holzmeister, L.A., Kulkarni, K., O'Connell, B., Wheeler, M.

(2003). New diabetes nutrition resources. Diabetes Care, 103, 832-834.

9 Pastors, J.G., Warshaw, H., Daly, A., Franz, M., Kulkarni, K. (2002). The evidence

of the effectiveness of medical nutrition therapy in diabetes management. Diabetes Care, 25,

608-613.

10 Magioli, C.E. (2005). Eggplant (Solanum melongena L.): tissue culture, genetic

transformation and use as an alternative model plant. Acta bot bras, 19(1), 139–148.

11 Unwin, D., Unwin, J. (2014). Low carbohydrate diet to achieve weight loss and

improve HbA1c in type 2 diabetes and pre-diabetes: experience from one general

practice. Practical Diabetes, 31 (2), 76–79.

12 Shirdel, Z., Mirbadalzadeh, H., Madani, H. (2009). Anti-diabetic and anti lipidemic

properties of ginger in comparison glibenclamide in alloxan-diabetes rat. Iran J Diab Lipid

Disorders, 9(1), 7-15.

13 American Diabetes Association. (2008). Nutrition recommendations and

interventions for diabetes. Diabetes Care, 31(1) 61-78.

14  Institute of Medicine. (2005). Dietary Reference Intakes for Energy,

Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein and Amino Acids. National

Academies Press,145, 388.