Diabetes and medicinal plants-A review

Diabetes and medicinal plants-A review

Diabetes mellitus (DM), both insulin-dependent DM (IDDM) and non-insulindependent
DM (NIDDM) is a common and serious metabolic disorder throughout
the world. Traditional plant treatments have been used throughout the world for the
therapy of diabetes mellitus. Among many medications and other alternative
medicines, several herbs have been known to cure and control diabetes; additionally
they have no side effects. The present paper is an attempt to list of the plants with
anti-diabetic and related beneficial effects originating from different parts of world.
History showed that medicinal plants have been used in traditional healing around
the world for a long time to treat diabetes; this is because such herbal plants have
hypoglycemic properties and other beneficial properties, as reported in scientific
literature. There are 136 such plants described in this review which clearly shows
the importance of herbal plants in the treatment of diabetes mellitus. The effects of
these plants may delay the development of diabetic complications and provide a
rich source for antioxidants that are known to prevent/delay different diseased
states.
Key words: Diabetes mellitus, Medicinal plants, Hypoglycemic, Antioxidant
Received: 25 Sep 2011 / Revised: 29 Sep 2011 / Accepted: 30 Sep 2011 / Online publication: 19 Oct 2011
1. INTRODUCTION
Diabetes mellitus is a common and very prevalent disease
affecting the citizens of both developed and developing
countries. It is estimated that 25% of the world population is
affected by this disease. Diabetes mellitus is caused by the
abnormality of carbohydrate metabolism which is linked to
low blood insulin level or insensitivity of target organs to
insulin [1]. Despite considerable progress in the treatment of
diabetes by oral hypoglycemic agents, search for newer drugs
continues because the existing synthetic drugs have several
limitations. The herbal drugs with antidiabetic activity are yet
to be commercially formulated as modern medicines, even
though they have been acclaimed for their therapeutic
properties in the traditional systems of medicine [2]. The
plants provide a potential source of hypoglycemic drugs
because many plants and plant derived compounds have been
used in the treatment of diabetes. Many Indian plants have
been investigated for their beneficial use in different types of
diabetes and reports occur in numerous scientific journals.
Ayurveda and other traditional medicinal system for the
treatment of diabetes describe a number of plants used as
herbal drugs. Hence, they play an important role as
alternative medicine due to less side effects and low cost. The
active principles present in medicinal plants have been
reported to possess pancreatic beta cells re-generating, insulin
releasing and fighting the problem of insulin resistance [3].
Hyperglycemia is involved in the etiology of development of
diabetic complications. Hypoglycemic herbs increase insulin
secretion, enhance glucose uptake by adipose or muscle
tissues and inhibit glucose absorption from intestine and
glucose production from liver [4]. Insulin and oral
hypoglycemic agents like sulphonylureas and biguanides are
still the major players in the management but there is quest
for the development of more effective anti-diabetic agents.
2. MEDICINAL PLANTS WITH ANTIDIABETIC AND
RELATED BENEFICIAL PROPERTIES
2.1 Abelmoschus moschatus Medik (Malvaceae)
It is an aromatic medicinal plant, which is native to India.
Myricelin, an active principle of A. moschatus, improves
insulin sensitivity through increased post-receptor insulin
signaling mediated by enhancements in IRS-1-associated
PI3-kinase and GLUT 4 activity in muscles of obese Zucker
rats. Myricetin might be used as a model substance for the
development of antidiabetic compounds [5].
2.2 Acacia arabica (Lam) Wild. (Mimosaceae)
It is found all over India. The plant extract acts as an
antidiabetic agent by acting as secretagouge to release
insulin. It induces hypoglycemia in control rats but not in
G.B. Kavishankar1,
N. Lakshmidevi1*,
S. Mahadeva Murthy2,
H.S. Prakash3,
S.R. Niranjana3
1Department of Microbiology, University
of Mysore, Manasagangotri, Mysore,
India-570 006
2Department of Microbiology, University
of Mysore, Yuvaraja’s college, Mysore,
India-570 005
3Department of Biotechnology, University
of Mysore, Manasagangotri, Mysore,
India-570 006
*Correspondence:
Dr. N. Lakshmidevi
Landline: +91 0821-4258019
E-mail: kavigawli@gmail.com
G.B. Kavishankar et al., Int J Pharm Biomed Sci 2011, 2(3), 65-80
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66
alloxanized animals. Powdered seeds of A. arabica when
administered (2, 3 and 4 g/kg body weight) to normal rabbits,
induces hypoglycemic effect by initiating release of insulin
from pancreatic beta cells [6].
2.3 Achyranthes aspera L (Amaranthaceae)
It is distributed throughout the tropical world. Oral
administration of A. aspera powder produces a significant
dose-related hypoglycemic effect in normal as well as in
diabetic rabbits. The water and methanol extracts also
decreases blood glucose levels in normal and alloxan diabetic
rabbits. The acute toxicity study in rabbits does not reveal
any adverse or side effects of this folk medicine at dosages
up to 8 g/kg orally. The plant could act by providing certain
necessary elements like calcium, zinc, magnesium,
manganese and copper to the beta-cells [7].
2.4 Achyrocline satureioides (Less) DC (Asteraceae)
It is a medicinal plant symbol of Rio Grande do Sul state
in Brazil. A new prenylated dibenzofuran, achyrofuran, a
compound derived from A. satureioides significantly lowered
blood glucose levels when administered orally at 20 mg/kg
q.d [8]. The aqueous extract of the aerial parts of A.
satureioides administered before bromobenzene (BB), at the
dose of 300mg/kg, inhibited the increase of liver ALT and
AST, whereas, the BB-induced liver shows increase of
thiobarbituric acid reacting substances (TBARS) content.
Also it significantly increases the depleted levels of liver
glutathione and bile flow in rats. In addition, at the same
dose, a significant increase in the bile flow of rats was found.
The results obtained with the aqueous extract of A.
satureioides support its use in popular medicine as a
hepatoprotective and digestive agent, and the effects might be
mediated through the antioxidant and choleretic activities [9].
2.5 Acosmium panamense Schott. (Leguminosae)
Oral application of water extracts at doses of 20 and 200
mg/kg and of butanol extracts at doses of 20 and 100 mg/kg
significantly lowers the plasma glucose levels in diabetic rats
within 3 h in streptozotocin (STZ)-induced diabetic rats [10].
2.6 Aegle marmelose (L) Corr. (Rutaceae)
A species of tree native to India, it is present throughout
Southeast Asia as a naturalized species. A significant
decrease in liver glycogen of diabetic rats is reversed to
almost the normal level by the leaf extract and it also
decreases the blood urea and serum cholesterol. A similar
effect is seen with insulin treatment and the results indicate
that the active principle in A. marmelos leaf extract has
similar hypoglycemic activity to insulin treatment [11].
2.7 Agrimony eupatoria L. (agrimony) (Rosaceae)
Agrimony, when incorporated into the diet (62.5 g/kg)
and drinking water (2.5 g/L) counters the weight loss,
polydipsia, hyperphagia and hyperglycemia of STZ-diabetic
mice. Aqueous extract (1mg/mL) stimulates insulin secretion
from the BRIN-BDII pancreatic B-cell line, 2-deoxy-glucose
transport, glucose oxidation and incorporation of glucose into
glycogen in mouse abdominal muscle comparable with
0.1μM-insulin. These results demonstrate the presence of
antihyperglycemic, insulin-releasing and insulin-like activity
in A. eupatoria [12].
2.8 Ajuga iva L. Schreberr (Medit) (Lamiaceae)
A species native to Europe, Asia and Africa. Single and
repeated oral administration of the water extract of A. iva L
(AT) at a dose of 10 mg/kg produces a slight and significant
decrease in plasma glucose levels in normal rats 6 h after
administration and after 3 weeks of treatment. It continuously
decreases thereafter and shows rapid normalization, which
concludes A.iva possess a strong hypoglycemic effect in
diabetic rats, and supports its traditional use in diabetes
mellitus control [13].
2.9 Allium cepa L. (onion): (Liliaceae)
Allium cepa is known only in cultivation but related wild
species occur in Central Asia. Various ether soluble fractions
as well as insoluble fractions of dried onion powder show
anti-hyperglycemic activity in diabetic rabbits. A. cepa also
known to have antioxidant and hypolipidemic activity.
Administration of a sulfur containing amino acid, S-methyl
cysteine sulphoxide (SMCS) (200 mg/kg for 45 days) to
alloxan induced diabetic rats significantly controlled blood
glucose as well as lipids in serum and tissues. It normalizes
the activities of liver hexokinase, glucose 6-phosphatase and
HMG Co A reductase [14, 15]. When diabetic patients were
given single oral dose of 50 g of onion juice, it significantly
controlled post-prandial glucose levels [16].
2.10 Allium sativum L. (garlic): (Liliaceae)
It is a perennial herb cultivated throughout India. Oral
administration of the garlic extract significantly decreases
serum glucose, total cholesterol, triglycerides, urea, uric acid,
creatinine, AST and ALT levels, while increases serum
insulin in diabetic rats but not in normal rats when compared
with antidiabetic drug glibenclamide. The antidiabetic effect
of the extract was more effective than glibenclamide. It is
concluded that the plant must be considered as excellent
candidate for future studies on diabetes mellitus [17].
2.11 Aloe barbadensis Mill.(Liliaceae)
The species has been widely cultivated throughout the
world. Treatment of chronic but no single dose of exudates of
Aloe barbadensis leaves shows hypoglycemic effect in
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67
alloxanized diabetic rats. Single as well as chronic doses of
bitter principle of the same plant also show hypoglycemic
effect in diabetic rats. This action is through stimulation of
synthesis and/or release of insulin from pancreatic beta cells
[18].
2.12 Aloe vera (L) Burm.(Asphodelaceae)
It grows in arid climates and is widely distributed in
Africa, India and other arid areas. Aloe vera gel at 200 mg/kg
1possessessignificant antidiabetic, cardioprotective activity,
reduces the increased TBARS, maintains the Superoxide
dismutase and Catalase activity up to the normal level and
increases reduced glutathione by four times in diabetic rats
[19]. The leaf pulp extract showed hypoglycemic activity on
IDDM and NIDDM rats, the effectiveness being enhanced
for type II diabetes in comparison with glibenclamide [20].
2.13 Andrographis paniculata Burm. (Acanthaceae)
It is a herbaceous plant native to India, Sri Lanka and
widely cultivated in southern Asia. Oral administration of
andrographis significantly increases the activity of SOD and
Catalase. Also decreases blood glucose levels due to its
antioxidant properties [21]. The ethanolic extract of A.
paniculata possesses antidiabetic property and may be
attributed at least in part to increase glucose metabolism. Its
hypotriglyceridemic effect is also beneficial in the diabetic
state [22].
2.14 Annona squamosa L (Annonaceae)
It is a small well-branched tree or shrub, grows at lower
altitudes. Administration of 15 mg/kg/day of isolated
juercetin-3-O-glucoside from Annona squamosa leaves for 10
consecutive days to the hyperglycemic animals reverse these
effects and simultaneously inhibits the activity of hepatic
GIucose-6-phosphatase. It further decreases the hepatic and
renal lipid peroxidation with a concomitant increase in the
activities of antioxidative enzymes, such as Catalase and
Superoxide dismutase as well as glutathione content,
indicating its safe and antiperoxidative effects [23].
2.15 Artemisia herba-alba Asso (Med).(Asteraceae)
It is a perennial shrub that grows commonly on the
steppes of Northern Africa, Arabian Peninsula, Western Asia
and Southwestern Europe. Oral administration of 0.39 g/kg
body weight of the aqueous extract of the leaves or barks
produces a significant reduction in blood glucose level, while
the aqueous extract of roots and methanolic extract of the
aerial parts of the plant produce almost no reduction in blood
glucose level. The extract of the aerial parts of the plant seem
to have minimal adverse effect and high LD50 value [24].
2.16 Artemisia dracunculus L. (Asteraceae)
Commonly known as "dragon herb". It is native to a wide
area of the Northern Hemisphere from easternmost Europe
across central and eastern Asia to India, western North
America, and south to northern Mexico. At doses of 50-
500rag/kg/day, the hypoglycemic activity of the extract
enhances 3-5-fold with the bio-enhancer Labrasol, making it
comparable to the activity of the anti-diabetic drug metformin
[25]. Tarralin, an ethanolic extract lowers elevated blood
glucose levels by 24% relative to control animals. The extract
also increases the binding of glucagon-like peptide to its
receptor in vitro. These results indicate that tarralin has
antihyperglycemic activity and plays a potential role in the
management of diabetic status [26].
2.17 Astragalus membranaceus Bunge (Fisch.):
(Leguminosae)
It is used in traditional Chinese medicine. The protective
mechanism of AGS-IV, a new glycoside of cycloartane-type
triterpene isolated from the root of A. membranaceus (Fisch.)
decreases the blood glucose concentration and HbAlC levels,
and increases plasma insulin levels. AGS-IV increases the
activity of glutathione peroxidase in nerves, depress the
activation of aldose reductase in erythrocytes, and decreases
the accumulation of advanced glycation end products in both
nerves and erythrocytes. Moreover, elevates Na+, K+-
ATPase activity in both the nerves and erythrocytes of
diabetic rats. These results indicate that AGS-IV exerts
protective effects against the progression of peripheral
neuropathy in STZ-induced diabetes in rats through several
interrelated mechanisms [27].
2.18 Averrhoa bilimbi L (Oxalidaceae)
The plant is mainly found in Asia and in some other parts
of the world. At a dose of 125-mg/kg-body weight, the
aqueous fraction (AF), butanol-soluble fraction (BuF) and the
reference drug metformin (500 mg/kg body weight),
produces significant blood glucose-lowering effect in the
diabetic rats when compared to the vehicle (distilled water).
Also Hepatic glucose-6-phosphatase activity in AF- and
metformin-treated groups is lower, but not in BuF-treated
groups, compared to that in vehicle-treated group. These
results indicate that AF is more potent than BuF in the
amelioration of hyperglycemia in STZ-diabeiic rats and is a
potential source for the isolation of new orally active agent(s)
for anti-diabetic therapy [28].
2.19 Azadirachta-indica A. Juss. (Meliaceae)
Commonly known as Neem. It is a tree native to India,
Burma, Bangladesh, Sri Lanka, Malaysia and Pakistan,
growing in tropical and semi-tropical regions. A low (0.5g
tid) and high (2g tid) doses of powdered part, aqueous extract
and alcoholic extract of A. indica shows significant
hypoglycemic activity in high dose and can be successfully
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combined with oral hypoglycemic agents in type-2 diabetic
patients whose diabetes is not controlled by these agents [29].
2.20 Bauhinia candicans Benth (Leguminosae)
A medicinal plant indigenous to sub-tropical regions of
Argentina and southern Brazil. The effect of different
fractions of methanolic extract of B. candicans leaves (8
mg/kg) shows hypoglycemic activity along with a reduced
urinary glucose excretion. Among the fractions, the butanolic
fraction (fraction III) exhibits highest activity. Moreover,
fraction III reduces plasma glucose level in normal, as well
as, glucose loaded rabbits. These results suggest that B.
candicans increases the peripheral metabolism of glucose
[30].
2.21 Bauhinia forficate Link. (Caesalpinaceae)
Commonly known as Pata de Vaca, native to Brazil and
Peru. Oral administration of kaempferilrin , a major flavonoid
compound of the n-butanol fraction from B. forficata leaves
leads to a significant hypoglycemic effect in normal and in
alloxan-induced diabetic rats. In normal rats, kaempferitrin
lowers blood glucose only with the higher dose of (200
mg/kg) at 1 h after treatment and also shows antioxidant
properties [31]. Administraton of aqueous, ethanolic and
hexanic extracts daily for 7 days at doses of 200 and 400
mg/kg, p.o., to the alloxan-diabetic rats shows significant
reductions in plasma glucose, triglycerides, total cholesterol
and HDL-cholesterol after treatment with the extracts and
glibenclamide (standard drug) as compared to the diabetic
controls [32].
2.22 Bidens pilosa L (Asteraceae)
It is known as Spanish Needle. The butanol fraction of B.
pilosa inhibits the differentiation of naive helper T (ThO)
cells into Thl cells but enhances their transition into type II
helper T (Th2) cells, thus can prevent diabetes pausibly via
suppressing the differentiation of ThO cells into Thl cells and
promoting that of ThO cells into Th2 cells, thus preventing
autoimmune diabetes in non-obese diabetic mice [33].
2.23 Biophytum sensitivum (L) DC. (Oxalidaceae)
The annual perennial herbaceous plant is a traditional
medicine in Nepal. Initial dose-response studies shows a dose
of 200 mg/kg body weight is optimum for hypoglycemia. In
16-h fasted non-diabetic rabbits, a single administration
brings about a 16.1% fall in fasting plasma glucose at the end
of 1 and 2 h, and the hypoglycemic effect persists at the end
of 6 h (13.8% fall). Serum insulin levels shows a significant
rise in the treated animals, which suggests a pancreatic mode
of action (i.e. insulinotropic effect), suggesting that the
hypoglycemic response of B. sensitivum may be mediated
through stimulating the synthesis/release of insulin from the
beta cells of Langerhans [34].
2.24 Bixa orellana L. (Bixaceae)
It is a shrub or small tree from the tropical region of the
Americas. This annatto extract decreases blood glucose levels
in fasting normoglycaemic and streptozotocin-induced
diabetic dogs. In normal dogs, it suppresses the postprandial
rise in blood glucose after an oral glucose load and also
causes an increase in insulin-to-glucose ratio in normal dogs.
Increased insulin levels were not due to increased insulin
synthesis as after 1h residence time and half-hour
postprandial, decreases C-peptide levels. It is concluded that
B. orellana (annatto) lowers blood glucose by stimulating
peripheral utilization of glucose, and it is possible that this
glucose-lowering extract might be of pharmacological
importance [35].
2.25 Brassica nigra (L) Koch (Brassicaceae)
It is an annual weedy plant cultivated for its seeds and is
native to the southern Mediterranean region of Europe.
Administration of 200 mg/kg body weight of aqueous extract
to diabetic animals daily once for one month brings down
fasting serum glucose (FSG) levels while in the untreated
group FSG remains at a higher value. In the treated animals
the increase in glycosylated hemoglobin (HbAlc) and serum
lipids is much less when compared with the levels in
untreated diabetic controls [36].
2.26 Bryonia alba L.(Cucurbitaceae)
It is a flowering plant native to western Eurasia and
adjacent regions, such as North Africa, the Canary Islands
and South Asia. Administration of trihydroxyoctadecadienoic
acids obtained from the roots of the native Armenian plant B.
alba L. (0.05 mg/kg/day for 15 days. Lin.) restores the
disordered lipid metabolism of alloxan-diabetic rats.
Metabolic changes induced in diabetes significantly restores
towards their normal values with the exception of diminished
triglyceride content of muscle which does not restores. Thus,
they can influence the profile of the formation of stable
prostaglandins by actions downstream of prostaglandin
endoperoxides [37].
2.27 Bumelia sartorum Mart. (Sapotaceae)
It has been mentioned in Brazilian folklore for its reputed
use in the treatment of diabetes mellitus and inflammatory
disorders. Bassic acid, an unsaturated triterpene acid isolated
from ethanol extract of B. sartorum root bark, elicits
significant hypoglycemic activity and increases plasma
insulin levels significantly in alloxan-diabetic rats and alters
the pattern of glucose tolerance in these animals [38]. Besides
hypoglycemic activity, the extract also elicits significant antiG.
B. Kavishankar et al., Int J Pharm Biomed Sci 2011, 2(3), 65-80
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69
inflammatory activity, but shows no significant effects on
blood pressure, respiration or on the various isolated tissue
preparations [39].
2.28 Caesalpinia bonducella (L) Roxb.
(Caesalpinaceae)
The oral administration of the extracts (300 mg/kg)
produces significant antihyperglycemic action as well as
lowers the BUN levels significantly. The action of the
extracts on diabetes induced hyperlipidemia significantly
lowers the elevated cholesterol as well as LDL level. The
antihyperglycemic action of the extracts may be due to the
blocking of glucose absorption. The drug has the potential to
act as antidiabetic as well as antihyperlipidemic [40].
2.29 Cajanus cajan (L) Millsp. (Papilionaceae)
Single doses of unroasted seeds (60% and 80%) on
administration to normal as well as alloxanized mice shows
significant reduction in the serum glucose levels after 1-2 hr
and a significant rise at 3 hr. In case of roasted seeds, on
other hand serum glucose levels increases during 3 hr
experimental period. It is therefore concluded that roasting of
seeds at high temperature for half an hour period results in
the total loss of hypoglycemic principle but not the
hyperglycemic principle present in the seeds [41].
2.30 Carum carvi L.(CC) (Apiaceae) / Capparis spinosa
L. (CS) (Capparidaceae)
(CC) is a biennial plant native to western Asia, Europe
and Northern Africa and (CS) is native in Israel and eastern
part of Mediterranean. After a single dose or 14 daily doses,
oral administration of the aqueous CC and CS extracts (20
mg/kg) produces a significant decrease on blood glucose
levels in STZ diabetic rats, and brings down to nearly normal
after 2 weeks. There is no high significant change on blood
glucose levels or basal plasma insulin concentrations in
normal rats after both acute and chronic treatments with CS
and CC [42].
2.31 Casearia esculenta Roxb. (Flacourtiaceae)
Casearia esculenta root (Roxb.) is widely used in
traditional system of medicine to treat diabetes in India. Oral
administration of aqueous extract of root (300 mg/kg body
weight) for 45 days results in a significant reduction in blood
glucose and in the activities of glucose-6-phosphatase and
fructose-1,6-bisphosphatase and an increase in the activity of
liver hexokinase. However, in the case of 200 mg/kg body
weight of extract, it shows less activity. The study clearly
shows that the root extract of C. esculenta possesses potent
antihyperglycemic activity but weaker than that of
glibenclamide [43].
2.32 Cassia auriculata L.(Caesalpinaceae)
It occurs in the dry regions of India and Sri Lanka. Oral
administration of CLEt- to mildly diabetic (MD) and severely
diabetic (SD) rats at a dose of 400 mg/kg once a day for 15
days shows significant reduction in fasting blood glucose,
also enhances the activity of hepatic hexokinase,
phosphofructokinase, suppresses glucose-6-phosphatase and
fructose-l,6-bisphosphatase in both MD and SD rats.
Histopathological examination of pancreatic sections reveals
increased number of islets and beta-cells in CLEt-treated MD
as well as SD rats [44].
2.33 Catharanthus roseus (L)G.Don.(Apocynaceae)
Oral administration at dose-dependent of 0.5, 0.75 and 1.0
mL/kg body weight reduced the blood glucose of both
normal and diabetic rabbits comparable with that of the
standard drug, glibenclamide. The results indicate a
prolonged action in reduction of blood glucose by C. roseus
and the mode of action of the active compound(s) is probably
mediated through enhance secretion of insulin from the betacells
of Langerhans or through extra pancreatic mechanism
[45].
2.34 Chamaemelum nobile (L) All. (Asteraceae)
It is a low perennial plant found in dry fields and around
gardens in Europe, North America, and Argentina. Single
oral administration at a dose of 20mg/kg body weight of C.
nobile aqueous extract reduces blood glucose levels after 6h
in normal rats and in STZ diabetic rats. After 15 days of
treatment, Basal plasma insulin concentrations remain
unchanged [46].
2.35 Cichorium intybus L.(Asteraceae)
A bushy perennial herbaceous plant, which lives as a wild
plant on roadsides in its native Europe, and in North America
and Australia. A dose of 125 mg of plant extract/kg body
weight exhibits the most potent hypoglycemic effect.
Moreover, daily administration of Cichorium intybus (C1E)
(125 mg/kg) for 14 days to diabetic rats attenuates serum
glucose by 20%, triglycerides by 91% and total cholesterol
by 16%. In addition, hepatic glucose-6-phosphatase activity
(Glc-6-Pase) markedly reduces by CIE [47].
2.36 Clausena anisata (Willd) Benth. (Rutaceae)
At a dose of 800 mg/kg p.o., Clausena anisata (Wild)
Hook (CAME) reduces the mean basal blood glucose
concentrations of fasted normal and fasted diabetic rats by
57.52 and 51.30%, respectively [48].
2.37 Coccinia indica Wt & Arn. (Cucurbitaceae)
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An indigenous plant used in Ayurvedic medicine in India.
Dried extracts of C. indica (500 mg/kg body weight)
administered to diabetic patients for 6 weeks restores the
activities of enzyme lipoprotein lipase (LPL), glucose-6-
phosphatase and lactate dehydrogenase, which rises in
untreated diabetics [49].
2.38 Coriandrum sativum L (Apiaceae)
An annual herb native to southern Europe and North
Africa to southwestern Asia. Coriander seed extract (200
mg/kg) significantly increases the activity of the beta cells in
comparison with the diabetic control rats and decreases
serum glucose in streptozotocin-induced diabetic rats and
releases insulin from the beta cells of the pancreas [50]. The
extract shows antihyperglycemic, insulin-releasing and
insulin-like activity [51].
2.39 Cuminum cyminum L (Apiaceae)
A flowering plant native from the East Mediterranean to
East India. The seeds extract of C. cyminum (CC) causes a
reduction in blood glucose, glycosylated hemoglobin,
creatinine, blood urea nitrogen and improved serum insulin
and glycogen (liver and skeletal muscle) content. It shows
significant reduction in renal oxidative stress and AGE when
compared to diabetic control and glibenclamide. CC and
glibenclamide improved antioxidant status in kidney and
pancreas of diabetic rats [52].
2.40 Cuminum nigrum L (Apiaceae)
It grows mainly in Central Asia and India. Oral
administration of the flavonoid contents of the plant causes
hypoglycemic effect at a dose range of 0.5 to 1.5 g/kg, both
in normal and alloxan-diabetic rabbits [53]. Curcumin
promotes AMPK activation and glucose uptake with
increased insulin sensitivity in muscle cells as a potential
anti-diabetic therapeutic agent [54].
2.41 Cyamopsis tetragonoloba (L) Taubert.
(Papilionaceae)
The species are distributed across Africa, Asia and the
Pacific. The aqueous extract of beans at 250 mg/kg body wt.
significantly lowers blood glucose levels in alloxan-induced
diabetic rats within 3 h of administration. Continuation for 10
days produces statistically significant reduction in the blood
glucose levels while shows marginal activity is in normal and
glucose-loaded rats [55].
2.42 Dioscorea dumetorum (Kunth)
Pax.(Dioscoreaceae)
It is mainly found in West and Central Africa. At a dose
of 20 mg/kg, the fasting blood sugar in normoglycemic
rabbits reduces from 112 mg/100 mL to 55 mg/100 mL after
4h. In alloxan diabetic rabbits, the blood sugar lowers from
520 mg/100 mL to 286 mg/100 mL at the same time interval.
The aqueous fraction of the methanol extract produces
comparable effects at 100 mg/kg. Whereas, chloroform
fraction rises the fasting blood sugar of normal rabbits to 196
mg/100 mL after 6h. The hypoglycemic effects are compared
to those of tolbutamide [56].
2.43 Eclipta alba (L) Hassk. (Asteraceae)
It is widely distributed throughout India, China, Thailand,
and Brazil. Oral administration of leaf suspension of E. alba
(2 and 4 g/kg body weight) for 60 days results in significant
reduction in blood glucose, glycosylated hemoglobin
HbA(l)c. The extract decreases the activities of glucose-6-
phosphatase and fructose-1,6-bisphosphatase, and increase
the activity of liver hexokinase. Thus, oral administration of
E. alba possess potent antihyperglycemic activity [57].
2.44 Emblica officinalis Gaertn. (Euphorbiaceae)
Different solvent extracts of E. officinalis acts as
α-amylase and α-glucosidase inhibitor. Significant
antiglycation activity also confirms the therapeutic potential
of these extracts against diabetes. Methanol extracts
significantly inhibits the oxidation of LDL under in vitro
conditions [58].
2.45 Enicostema littorale blume (Gentianaceae)
Dried plant equivalent extract of 1.5 g/100 g body weight
causes significant decrease in glycosylated haemoglobin,
liver glucose-6-phosphatase activity and increase in serum
insulin levels of the diabetic rats. There is no toxicity
parameter of extract treated diabetic rats as compared to
diabetic control rats. The above results suggest that E.
littorale is a potent antidiabetic agent without any toxic effect
[59].
2.46 Ficus bengalensis L. (Moraceae)
A reputed plant commonly known as "banyan tree" in
Ayurvedic literature. At a dose of 100 mg/kg for one month,
there is significant decrease in blood and urine sugar, certain
lipid components in serum, tissues and glucose-6-
phosphatase activity in liver, but increase in body weight, the
activities of hexokinase and HMG-COA reductase in tissues
as compared to diabetic control. The mechanism of action of
the principle may be related to its protective/inhibitory action
against the insulin degradative processes [60].
2.47 Fraxinus excelsior L (Oleaceae)
The aqueous extract at a dose of 10 mg/kg/h produces a
significant decrease in blood glucose levels in normal rats
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71
and even more in diabetic rats. A potent increase of
glycosuria concludes inhibition of renal glucose reabsorption.
This renal effect might be at least one mechanism explaining
the hypoglycemic activity of this plant in normal and diabetic
rats [61].
2.48 Garcinia kola Heckel (W & C Afr)( (Clusiaceae)
It is found in Africa mainly in subtropical or tropical
moist lowland forests. The extract decreases the activity of
microsomal glucose-6-phosphatase and lipid peroxidation
(LPO) products [62]. At a dose of 100 mg/kg, the fasting
blood sugar in normoglycemic rabbits reduces from 115
mg/100 mL to 65 mg/100 mL after 4 h. In alloxan diabetic
rabbits, the blood sugar lowers from 506 mg/100 mL to 285
mg/100 mL at 12 h. Kolaviron, a mixture of C-3/C-8 linked
biflavonoids obtained from Garcinia kola produces
significant hypoglycemic effects [63].
2.49 Gongronema latifolium Endl. (Asclepiadaceae)
The origin of the plant is traced to Nigeria in West Africa.
The aqueous extract of G. latifolium is able to significantly
increase the activities of hepatic hexokinase and decrease the
activities of glucokinase, but does not produce any change in
the hepatic glycogen and both hepatic and blood glucose
content of diabetic rats [64]. The effects of oral
administration of aqueous and ethanolic leaf extracts increase
the activity of superoxide dismutase and the level of reduced
glutathione. The aqueous extract further increases the activity
of glutathione reductase while the ethanolic extract causes a
significant increase in the activity of glutathione peroxidase
and glucose-6-phosphate dehydrogenase and a significant
decrease in lipid peroxidation. These results suggest that the
extracts from G. latifolium leaves could exert their
antidiabetic activities through their antioxidant properties
[65].
2.50 Helicteres isora L., As.(Sterculiaceae)
Distributed widely in forests throughout India. The hot
water extract of fruit of H. isora exhibits significant
antioxidant activity and moderate antidiabetic activity [66], at
200 mg/mL dose it shows glucose uptake activity and found
to be active comparable with insulin and metformin [67]. The
ethanolic extract has insulin-sensitizing and hypolipidemic
activity and has the potential for use in the treatment of type-
2 diabetes [68].
2.51 Hypoxis hemerocallidea conn Corm (African
potato) (Hypoxidaceae)
At a dose of 800 mg/kg, the plant extract causes 30.20%
and 48.54% reductions in the blood glucose concentrations of
fasted normal and STZ-treated diabetic rats respectively.
Thus, possesses hypoglycemic activity [69].
2.52 Inula racemosa Hook.f.(Asteraceae)
It grows in the temperate and alpine western Himalayas.
The petroleum ether extract of roots lowers plasma insulin
and glucose levels within 75 min of oral administration to
albino rats and it significantly counteracts adrenaline-induced
hyperglycemia in rats. The extract further shows negative
inotropic and negative chronotropic effects on frog heart. All
these findings indicate that one of the constituents of I.
racemosa may have adrenergic beta-blocking activity [70].
2.53 Lagerstroemia speciosa (L) Pers.(Lythraceae)
L. speciosa standardized to 1% corosolic acid (Glucosol)
at daily dosages of 32 and 48mg for 2 weeks shows
significant reduction in the blood glucose levels. Glucosol in
a soft gel capsule formulation shows a 30% decrease in blood
glucose levels compared to 20% drop with dry-powder filled
hard gelatin capsule formulation, suggesting that the soft gel
formulation has a better bioavailability than a dry-powder
formulation [71].
2.54 Lepidium sativum L. (Brassicaceae)
It is a fast-growing, edible herb. The aqueous LS extract
at a dose of 10 mg/kg/h causes a potent inhibition of renal
glucose reabsorption which in turn reduces blood sugar. This
renal effect is at least one mechanism explaining the
hypoglycemic activity of this plant in normal and diabetic
rats [72].
2.55 Mangifera indica L.(Anacardiaceae)
The aqueous extract produces reduction of blood glucose
level in normoglycemic and glucose-induced hyperglycemia,
but does not have any effect on streptozotocin-induced
diabetic mice under the same conditions when compared with
that of an oral dose of chlorpropamide. The result indicates
that the aqueous extract of the leaves of M. indica possess
hypoglycemic activity [73].
2.56 Momordica charantia L. (Cucurbitaceae)
M. charantia (bitter melon) is commonly known as
vegetable insulin. An oral sucrose tolerance test reveals that
administration of aqueous extract (AE), methanol fraction
(MF) or methanol insoluble fraction (MIF) each significantly
suppresses plasma glucose levels at 30 min as compared with
control. In addition, the plasma insulin level at 30 min also
lowers after MF administration than the control in the oral
sucrose tolerance test, these results demonstrates that bitter
melon suppresses postprandial hyperglycemia by inhibition
of α-glucosidase activity [74].
2.57 Morinda lucida Benth.(Rubiaceae)
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72
The extract demonstrates a significant and dosedependent
hypoglycemic activity within 4 h after oral
administration in normal rats. In hyperglycemic rats, the
extract produces a significant anti-diabetic effect from day 3
after oral administration, with 400 mg/kg extract-treated
animals. These results suggest that the leaves of M. lucida
have a strong glucose lowering property when administered
to streptozotocin-treated rats [75].
2.58 Myrcia uniflora Barb., Rods.(Myricaceae)
A plant is widely used in northern Brazil for treatment of
diabetes. The aqueous extracts of Myrcia has a beneficial
effect on the diabetic state, mainly by improving metabolic
parameters of glucose homeostasis which reduces
hyperglycemia, polyphagia, polydipsia, urine volume and the
urinary excretion of glucose and urea. Also, Myrcia
administration for 3 weeks has no effect on the weight of
epididymal and retroperitoneal adipose tissue, or on the
concentrations of pancreatic and serum insulin [76].
2.59 Nigella sativa L (Ranunculaceae)
Oral administration of ethanol extract of N. sativa seeds
(300 mg/kg body weight/day) to streptozotocin induced
diabetic rats for 30 days significantly reduces the elevated
levels of blood glucose, lipids, plasma insulin and improved
altered levels of lipid peroxidation products (TBARS and
hydroperoxides) and antioxidant enzymes like catalase,
superoxide dismutase, reduced glutathione and glutathione
peroxidase in liver and kidney. The results confirm the
antidiabetic activity of N. sativa seeds extract [77].
2.60 Ocimum sanctum L. (Lamiaceae)
It is commonly known as Tulsi. Since ancient times, this
plant is known for its medicinal properties. The aqueous
extract of leaves shows significant reduction in blood sugar
level in both normal and alloxan induced diabetic rats [78].
Significant reduction in fasting blood glucose, uronic acid,
total amino acid, total cholesterol, triglyceride and total lipid
indicate the hypoglycemic and hypolipidemic effects of tulsi
in diabetic rats [79]. Oral administration of plant extract (200
mg/kg) for 30 days leads to decrease in the plasma glucose
level. Renal glycogen content increases 10 fold while skeletal
muscle and hepatic glycogen levels decreases by 68 and 75%
respectively in diabetic rats as compared to control [80]. This
plant also shows antioxidant, antibacterial, antifungal,
antiviral, antiasthemitic, antistress, antitumor, gastric
antiulcer activity, antimutagenic and immunostimulant
activities.
2.61 Origanum vulgare L. (Lamiaceae)
It is native to warm-temperate western and southwestern
Eurasia and the Mediterranean region. Oral administration of
the aqueous extract (20 mg/kg) produces significant decrease
on blood glucose levels in STZ diabetic rats. However, the
blood glucose levels gets normalised from the fourth day
after daily repeated oral administration of aqueous OV
extract (20 mg/kg). This concludes that an aqueous extract of
O. Vulgare exhibits anti-hyperglycemic activity in STZ rats
without affecting basal plasma insulin concentrations [81].
2.62 Otholobium pubescens L. (Papilionaceae)
The known compound bakuchiol, isolated from an extract
of O. pubescens reduces blood glucose levels in a dosedependent
fashion in db/db mice and displays no
hypoglycemic effect in lean mice at 250 mg/kg q.d. An oral
dose of bakuchiol at 150 mg/kg q.d. in the fat-fed,
streptozotocin (STZ)-treated rat, a new rodent model for type
2 diabetes, significantly lowers plasma glucose and
triglyceride levels [82].
2.63 Paeonia lactiflora Pall.(Paeoniaceae)
Paeoniflorin and 8-debenzoylpaeoniflorin isolated from
the dried root of P. lactiflora pall produces a significant
blood sugar lowering effect in streptozotocin-treated rats and
has a maximum effect at 25 min after treatment and this
hypoglycemic action is also observed in normoglycemic rats
only at 1 mg/kg. Plasma insulin does not change in
paeoniflorin-treated normoglycemic rats indicating an
insulin-independent action [83].
2.64 Panax ginseng C. Meyer. (Araliaceae)
The roots are taken orally in the treatment of type II
diabetes. Extracts of ginseng species shows
antihyperglycemic activity associated with increased
peroxisome proliferator-activated receptor gamma expression
and adenosine monophosphate-activated protein kinase
phosphorylation in liver and muscle [84]. Oral administration
of P. ginseng root improves insulin sensitivity and may be
used as an adjuvant therapy for treating diabetic patients with
insulin resistance [85].
2.65 Phyllanthus amarus Schum & Thonn.
(Euphorbiaceae)
A traditional Ayurveda herb used in southern India.
Methanolic extract of P. amarus has potential anti-oxidant
activity as it could inhibit lipid peroxidation, and scavenge
hydroxyl and superoxide radicals in vitro. This extract also
reduces the blood sugar in alloxanized diabetic rats [86].
2.66 Psidium guajava L. (Myrtaceae)
An indigenous medicinal plant used to control diabetes in
Indian System of Medicine. Ethanol stem bark extract
exhibits statistically significant hypoglycemic activity in
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73
alloxan-induced hyperglycemic rats but devoid of
hypoglycemic effect in normal and glucose loaded rats
(OGTT) [87]. Aqueous extract shows hypolipidaemic activity
in addition to its hypoglycemic and antidiabetic activity [88].
2.67 Pterocarpus marsupium Roxb.(Papilionaceae)
It is widely used in 'Ayurveda' as 'Rasayana' for
management of various metabolic disorders. An aqueous
extract of P. marsupium wood, at an oral dose of 250 mg/kg,
shows statistically significant hypoglycemic activity [89].
Marsupin, pterosupin and Iiquiritigenin obtained from this
plant show antihyperlipidemic activity [90]. (-)Epicatechin,
its active principle, has been found to be insulinogenic,
enhancing insulin release and conversion of proinsulin to
insulin in vitro. Like insulin, (-)epicatechin stimulates oxygen
uptake in fat cells and tissue slices of various organs,
increases glycogen content of rat diaphragm in a dosedependent
manner [91].
2.68 Retama raetam (RR) (Forssk) Webb.
(Papilionaceae)
The aqueous extract of RR at a dose of 20mg/kg
significantly reduces the blood glucose in normal rats 6h after
a single oral administration and two weeks after repeated oral
administration. This hypoglycemic effect is more pronounced
in streptozotocin (STZ) diabetic rats. The aqueous extract of
RR has no effect on basal plasma insulin levels [92]. Also
causes a potent inhibition of renal glucose reabsorption [93].
These findings suggest that the aqueous extract of RR
possess significant hypoglycemic effect in both normal and
STZ diabetic rats.
2.69 Salacia reticulate W. (Celastraceae)
Supplementation of 0.01 % solution of the extract as
drinking water prevents the elevation of the plasma glucose
level and intestinal α-glucosidase activities in type 1 diabetic
mice. This treatment also prevents the elevation of the
plasma, pancreatic, and kidney lipid peroxide levels,
lowering of the plasma insulin level, and elevation of the
kidney aldose reductase activities in diabetic mice. These
results suggest that the water extract of the leaves of
S. reticulata could be a beneficial food material for the
prevention of diabetes and obesity because of its multiple
effects [94].
2.70 Spergularia purpurea (SP) (Pers) G,
Donf.(Caryophyllaceae)
The aqueous extract at a dose of 10 mg/kg produces a
significant decrease in blood glucose levels in normal rats,
and even more in diabetic rats. This hypoglycemic effect
might be due to an extra-pancreatic action of the aqueous
extract of SP, since the basal plasma insulin concentrations
unchange after SP treatment. This concludes that aqueous
extract perfusion of SP inhibits endogenous glucose
production in mice [95].
2.71 Suaeda fruticosa (SF) Euras (Chenopodiaceae)
The aqueous extract at a dose of 192 mg/kg produces a
significant decrease in blood glucose levels in normal rats,
and even more in diabetic rats. This hypoglycemic effect
might be due to an extra-pancreatic action of the aqueous
extract of SF, since that the levels of plasma insulin unchange
between the values before and after treatment. The effect of
the aqueous extract on the plasma cholesterol is significant in
both normal and diabetic rats but, there is no significant
effect of SF on plasma triglycerides in both groups [96].
2.72 Syzigium cumini (L) Skeels.(Myrtaceae)
Commonly known as 'Jamun’, is widely used in Indian
folk medicine for the treatment of diabetes mellitus. Oral
administration of 2.5 and 5.0 g/kg body weight of the
aqueous extract of the seed for 6 weeks results in significant
reduction in blood glucose and an increase in total
haemoglobin, but in the case of 7.5 g/kg body weight the
effect is not significant. The aqueous extract also decreases
free radical formation which clearly shows the antioxidant
property. Thus the study shows that Jamun seed extract
(JSEt) has hypoglycemic action [97].
2.73 Tamarindus indica L. (Caesalpinaceae)
Aqueous extract of seed of T. indica when given to mild
diabetic (MD) and severe diabetic (SD) rats at the dose of 80
mg and 120 mg/0.5 mL distilled water/100 g body weight/d
respectively for 14 days, the extract shows attenuation of
hyperglycemia and hyperlipidemia in streptozotocin-induced
diabetic rats [98].
2.74 Telfaria occidentalis Hook. (Cucurbitaceae)
It is a tropical vine grown in West Africa as a leaf
vegetable and for its edible seeds. The aqueous extract given
orally in 1 g/kg to the mice 60 minutes before glucose
administration reduces the blood glucose level from day two
when compared with that of chlorpropamide (200 mg/kg)
under the same conditions. The results of this study indicates
that the aqueous extract of the leaves of T. occidentalis
possess hypoglycemic activity [99].
2.75 Tinospora cordifolia Miers. (Menispermaceae)
Commonly known as Guduchi, an herbaceous vine
indigenous to the tropical areas of India, Myanmar and Sri
Lanka. Oral administration of an aqueous T. cordifolia root
extract to alloxan diabetic rats causes a significant reduction
in blood glucose and brain lipids. Though the aqueous extract
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Table 1
Medicinal plants with antidiabetic and their reported effect on experimental models
Botanical Name Family Antidiabetic and other beneficial effects References
Achiliea santolina L. Asteraceae Hypoglycemic, antioxidant [103]
Artemisia patterns Asteraceae Hypoglycemic, increases peripheral glucose utilization [104]
Areca catechu L. Arecaceae Hypoglycemic [105]
Beta vulgaris L. Chenopodiaceae Increases glucose tolerance in OGTT [106]
Boerhaavia diffusa L. Nyctaginaceae Decreases blood glucose level and increases plasma insulin levels, antioxidant [107]
Bombax ceiba L. Malvaceae Hypoglycemic [108]
Butea manosperma (Lam) Caesalpinaceae Anti-hyperglycemic [109]
Carum carvi L.
Capparis spinosa L.
Apiaceae
Capparidaceae
Potent anti-hyperglycemic [110]
Cogniauxia podoleana Baillon
Bail Ion
Cucurbitaceae Hypoglycemic and anti-hyperglycemic [111]
Commelina communis L. Conimelinaceae Anti-hyperglycemic, management of non-insulin-dependent diabetes. [112]
Croton cajucara Benth Euphorbiaceae Anti-hyperglycemic [113,114]
Curcuma longa L. Zingiberaceae Hypoglycemic, plays a role in PPAR-gamma activation [115]
Cynodon dactylon Pers Poaceae Anti-hyperglycemic [116]
Enicostemma littorale Blume Gentianaceae Decreases plasma glucose level, glycosylated haemoglobin and glucose-6-phosphatase
activity in liver
[117]
Eriobotrya japonica Lindl. Rosaceae Hypoglycemic [118]
Gentiana olivieri L. Gentianaceae Hypoglycemic, anti-hyperlipidemic [119]
Ginkgo biloba L. Ginkgoaceae Hypoglycemic, increases pancreatic beta-cell in NIDDM [120,121]
Globularia alypum L. Globulariaceae Hypoglycemic, increases plasma insulin levels [122]
Glycyrrhiza uralensis Fish. Papilionaceae PPAR-gamma ligand-binding activity, decreases the blood glucose levels [123]
Gymnema nwntanum Hook Asclepiadaceae Anti-peroxidative, antioxidant, may prevent the cholinergic neural and retinal complications
of hyperglycemia in diabetes
[124]
Gymnema sylvestre R. Br. Asclepiadaceae Hypoglycemic. Hypolipidemic [125]
Hintonia standleyana Rubiaceae Anti-hyperglycemic [126]
Ibervillea sonorae S. Cucurbitaceae Acute and chronic hypoglycemic [127]
Ipomoea aquatic Forsk. Convolvulaceae Decreases serum glucose concentration by 29.4% in Type II diabetic patients. hypoglycemic[128]
Kalopanax pictus Thumb. Araliaceae Anti-diabetic activity, hypocholesterolmic and hypolipidemic [129]
Lagerstroemia speciosa L. Lythraceae Insulin-like actions, glucose uptake, anti-adipogenesis [130,131]
Medicago saliva L. Fabaceae Anti-hyperglycemic, insulin-releasing and insulin-like activity [132]
Morus alba L. Moraceae Protects pancreatic beta cells from degeneration anddiminishes lipid peroxidation [133]
Morus indica. L. Moraceae Hypoglycemic [134,135]
Morus inignis L. Moraceae Hypoglycemic [136]
Murraya koenigii L. Rutaceae Hypoglycemic, increases glycogenesis,decreases gluconeogenesis and glycogenolysis [137]
Nelumbo nucifera L. Neluntbonaceae Improves glucose tolerance and potentiates the action of exogenouslyinjected insulin [138]
Nigella saliva Gaertn. Ranunculaceae Decreases oxidative stress and preserves pancreatic beta-cell integrity. [139]
Ocimum gratissinuim L. Var. Lamiaceae Hypoglycemic [140]
Pandanus odorus Ridl. Pandanaceae Hypoglycemic, increases serum insulin levels and liver glycogen [141]
Parmentieru edulis A.DC Bignoniaceae Hypoglycemic [142]
Phyllanthus sellowianus
Mull.Arg.
Euphorbiaceae Hypoglycemic [143]
Psacalium decompositum (Gray)
H.
Asteraceae Hypoglycemic [144]
Psacalium peltatum (Kunth) Asteraceae Anti-hyperglycemic [145]
Punica granatum L. Punicaceae Improves postprandial hyperglycemia in type 2 diabetes and obesity by inhibiting intestinal
alpha-glucosidase activity
[146]
Solaria oblonga Celastraceae Hypoglycemic and possess anti-oxidant activity [147]
Sambucus nigra L. Adoxaceae Insulin-releasing and insulin-like activity [148]
Sanguis draxonis Apocynaceae Increase insulin sensitivity and improve the development of insulin resistance in rats [149]
Sclerocarya birea (A.Rich) Anacardiaceae Hypoglycemic [150]
Scoparia dulcis L. Scrophariaceae Hypoglycemic, antihyperlipidemic, antidiabetic [151,152]
Swertia chirayita (Roxb) Gentianaceae Stimulates insulin release from islets [153]
Syzygium alternifolium (Wt)
Walp.
Myrtaceae Hypoglycemic, antihyperglycemic and antihyperlipidemic [154.155]
Terminalia bellirica (Gaertn) Combretaceae Stimulates insulin secretion. Enhances insulin action andinhibits both protein glycation and
starch digestion
[156]
Terminalia chebula Retz. Combretaceae Dose-dependent glucose lowering effect, antidiabetic and renoprotective,decreases hepatic
and skeletal muscle glycogen content, increases insulin release from the pancreatic islets
[157-159]
Teucriumpolium Lamiaceae Increases insulin release, antioxidant and hypoglycemic [160]
Tinospora cordifolia Miers.. Menispermaceae Hypoglycemic [161]
Tinospora crispa (L) Hook. Menispermaceae Anti-hyperglycemic, stimulates insulin release from islets [162]
Urtica dioica L. Urticaceae Anti-hyperglycemic [163]
Urtica pilulifera L. Urticaceae Hypoglycemic [ 164]
Vinca rosea L. Apocynaceae Anti-hyperglycemic [165]
Withania soimifera (L) Dunal Solanaceae Hypoglycemic, antioxidant, diuretic and hypocholesterolemic [166,167]
Withania coagulans Dunal Solanaceae Anti-hyperglycemic, anti-hyperlipidemic and hypoglycemic [168,169]
Zizyphus sativa Gaertn Rhamnaceae Hypoglycemic [170]
Zizyphus spina-christi L. Rhamnaceae Insulinotropic, hypoglycemic anddepressant effect on the central nervous system [171]
Zygophyllum gaetulum Emb Zygophyllaceae Hypoglycemic, increases plasma insulin levels [172]
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75
Table 2
Synthetic drugs and their side effects
Agent Mechanism Site of action Advantages Side effects
Sulphonylureas Stimulating insulin production
by inhibiting the K-ATP
channel
Pancreatic beta cells Effective and inexpensive Hypoglycemia and weight gain.
Metformin Decreases insulin resistance Liver Weight loss
Does not cause
hypoglycemia
Nausea and diarrhea.
Hypoglycemia occurs when combined with
sulfonylurea or insulin.
Thiazolidinediones Reduce insulin resistance by
activating PPAR-γ
GI tract Low risk Increased liver enzymes, weight
gain,edema, mild anemia.
α-glucosidase inhibitors Reduces intestinal glucose
absorption
Fat, muscle Decreases postprandial
plasma triglyceride levels
Diarrhea, abdominal pain, flatulence;
Serum levels of transaminases increases at
doses.
at a dose of 400 mg/kg could elicit significant
antihyperglycemic effect in different animal models, its effect
is equivalent to only one unit/kg of insulin [100].
2.76 Trigonella foenum graecum L. (fenugreek)
(Papilionaceae)
Used both as an herb (the leaves) and as a spice (the seed)
and cultivated worldwide as a semi-arid crop. Oral
administration of 2 and 8 g/kg of plant extract produces dose
dependent decrease in the blood glucose levels in both
normal as well as diabetic rats [101]. Administration of
fenugreek seeds improves glucose metabolism and
normalizes creatinine kinase activity in heart, skeletal muscle
and liver of diabetic rats. It also reduces hepatic and renal
glucose-6-phosphalase and fructose -1, 6-biphosphatase
activity [102].
3. SYNTHETIC DRUGS AND HERBAL MEDICINE
Oral hypoglycemic drugs are used only in the treatment of
type 2 diabetes which is a disorder involving resistance to
secreted insulin. Type 1 diabetes involves lack of insulin and
requires insulin for treatment. There are now four classes of
hypoglycemic drugs: These drugs are approved for use only
in patients with type 2 diabetes and are used in patients who
have not responded to diet, weight reduction, and exercise.
They are not approved for the treatment of women who are
pregnant with diabetes.
Sulfonylureas are the most widely used drugs for the
treatment of type 2 diabetes and appear to function by
stimulating insulin secretion. The net effect is increased
responsiveness of ß-cells (insulin secreting cells located
in the pancreas) to both glucose and non-glucose
secretagogues, resulting in more insulin being released at all
blood glucose concentrations. Sulfonylureas may also have
extra-pancreatic effects, one of which is to increase tissue
sensitivity to insulin, but the clinical importance of these
effects is minimal (Table 2).
Metformin is an oral antidiabetic drug in the biguanide
class. It is the first-line drug of choice for the treatment of
type 2 diabetes, in particular, in overweight and obese people
and those with normal kidney function. It is effective only in
the presence of insulin. But, in contrast to sulfonylureas, it
does not directly stimulate insulin secretion. Its major effect
is to increase insulin action. One important effect appears to
be suppression of glucose output from the liver.
Thiazolidinediones or TZDs act by binding to PPARs
(peroxisome proliferator-activated receptors), a group of
receptor molecules inside the cell nucleus, specifically
PPARγ (gamma). The ligands for these receptors are free
fatty acids (FFAs) and eicosanoids. When activated, the
receptor migrates to the DNA, activating transcription of a
number of specific genes. TZDs reverse insulin resistance by
acting on muscle, fat and to a lesser extent liver to increase
glucose utilization and diminish glucose production and are
also effective when given in combination with metformin.
Alpha-glucosidase inhibitors inhibit the upper
gastrointestinal enzymes that convert dietary starch and other
complex carbohydrates into simple sugars which can be
absorbed. The result is to slow the absorption of glucose after
meals. Alpha-glucosidase inhibitors are used to establish
greater glycemic control over hyperglycemia in diabetes
mellitus type 2, particularly with regard to postprandial
hyperglycemia. They may be used as monotherapy in
conjunction with an appropriate diabetic diet and exercise or
with other anti-diabetic drugs.
Herbs have been used for healing purposes and to
promote wellness since from the ancient times and are not
categorized as medicines but treated as food since they are
natural products. Nowadays, herbal medicines, health and
dietary supplements are flooding the markets. The use in the
right way provides effective and safe treatment for many
ailments and the effectiveness is mostly subjective to the
patient. The potency varies based on the genetic variation,
growing conditions, timing and method of harvesting,
exposure to air, light, moisture, and type of preservation of
the herbs. Herbal medicines can be used for healing purposes
and to promote wellness and are not addictive or habit
forming, but are powerful nutritional agents that support the
body naturally. They promote health and serve as excellent
healing agents without side effects. Chinese herbs are taken
as tonics to enhance physical and mental well-being and can
nourish the body's deepest and most basic elements. They are
G.B. Kavishankar et al., Int J Pharm Biomed Sci 2011, 2(3), 65-80
©2011 PharmaInterScience Publishers. All rights reserved. www.pharmainterscience.com
76
also safe and effective for health, healing, weight
loss/gain/maintenance.
Herbal medicines are great body balancers that help
regulate body functions, can be used to support balance
process of our body and offer the nutrients that the body fails
to receive due to poor diet or environmental deficiencies in
the soil and air. They can be used to treat many diseases such
as diabetes, asthma, eczema, premenstrual syndrome,
rheumatoid arthritis, migraine, menopausal symptoms,
chronic fatigue, and irritable bowel syndrome, etc., and can
be used for maintaining general health. Herbal preparations
are best when taken under the guidance of a trained
professional. When used correctly, herbal medicines are
considered safer than conventional medications. People are
greatly concerned about the efficacy and side effects of many
synthetic drugs, and hence choose herbal medicines for
providing a safe and natural alternative treatment for many
health problems. The use is widespread and growing, In fact,
herbs are always the alternative medicine and primary source.
The advantages of using herbal medicines are numerous.
They tend to be more effective for long-standing health
complaints that don't respond well to traditional medicine.
Herbs typically have fewer side effects, and may be safer to
use over time.
4. CONCLUSIONS
Diabetes is a serious metabolic disorder. Differences in
social structure, psychic stress, obesity, hormonal imbalance
and heredity are optimizing the growth of pandemic. At
present, the treatment of diabetes mainly involves a sustained
reduction in hyperglycemia by the use of biguanides,
thiazolidinediones, sulphonylureas, D-phenylalanine
derivatives, meglitinides and α-glucosidase inhibitors in
addition to insulin. However, due to unwanted side effects
the efficacies of these compounds are debatable and there is a
demand for new compounds for the treatment of diabetes
[173,174]. Hence, plants have been suggested as a rich, as yet
unexplored source of potentially useful antidiabetic drugs.
However, only a few have been subjected to detailed
scientific investigation due to a lack of mechanism-based
available in vitro assays [175-177]. These efforts may
provide treatment for all and justify the role of novel
traditional medicinal plants having anti-diabetic potentials.
ACKNOWLEDGMENTS
The authors are thankful to UGC and MHRD (IOE), New
Delhi for financial support and to the Department of Applied
Botany and Biotechnology, University of Mysore, Mysore,
India.
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