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References

Alarcon-Aguilara FJ, Roman-Ramos R, Perez-Gutierrez S, Aguilar-Contreras A, Contreras-Weber CC, Flores-Saenz JL. Study of the anti-hyperglycemic effect of plants used as antidiabetics. J Ethnopharmacol 1998 Jun;61(2):101-110.
Abstract: The purpose of this research was to study the anti-hyperglycemic effect of 28 medicinal plants used in the treatment of diabetes mellitus. Each plant was processed in the traditional way and intragastrically administered to temporarily hyperglycemic rabbits. The results showed that eight out of the 28 studied plants significantly decrease the hyperglycemic peak and/or the area under the glucose tolerance curve. These plants were: Guazuma ulmifolia, Tournefortia hirsutissima, Lepechinia caulescens, Rhizophora mangle, Musa sapientum, Trigonella foenum graceum, Turnera diffusa, and Euphorbia prostrata. The results suggest the validity of their clinical use in diabetes mellitus control, after their toxicological investigation.

al-Hader AA, Hasan ZA, Aqel MB. Hyperglycemic and insulin release inhibitory effects of Rosmarinus officinalis. J Ethnopharmacol 1994 Jul 22;43(3):217-221.
Abstract: The effects of the volatile oil extracted from the leaves of Rosmarinus officinalis on glucose and insulin levels were investigated in normal rabbits, after the administration of an intraperitoneal glucose tolerance test (GTT). Also, the effects of the volatile oil on fasting plasma glucose levels, were studied in alloxan diabetic rabbits. In normal rabbits, the intramuscular (i.m.) administration of the volatile oil (25 mg/kg) produced 20% (P < 0.05), 27% (P < 0.01) and 55% (P < 0.001) increases in plasma glucose levels, above those of control animals, at the 60, 90 and 120 min intervals, respectively, following the administration of the intraperitoneal (i.p.) glucose test. The same treatment also resulted in a 30% (P < 0.002) decrease in serum insulin level, in comparison with that of control rabbits at the 30 min interval. In alloxan diabetic rabbits, R. officinalis volatile oil increased fasting plasma glucose levels by 17% (P < 0.05) above those of untreated animals 6 h after its administration. These data suggest that the volatile oil of R. officinalis has hyperglycemic and insulin release inhibitory effects in the rabbit.

Ali L, Azad Khan AK, Hassan Z, Mosihuzzaman M, Nahar N, Nasreen T, Nur-e-Alam M, Rokeya B. Characterization of the hypoglycemic effects of Trigonella foenum graecum seed. Planta Med 1995 Aug;61(4):358-360. (Letter)
Abstract: The whole powder of Trigonella foenum graecum seeds and its extracts were tested for their hypoglycemic effect on normal and diabetic model rats. The powder, its methanol extract, and the residue remaining after methanol extraction had significant hypoglycemic effects when fed simultaneously with glucose. The water extract of the methanol extractive-free residue of the seed powder showed significant hypoglycemic activity at different prandial states. The Soluble Dietary Fibre (SDF) fraction showed no effect on the fasting blood glucose levels of nondiabetic or NIDDM model rats. However, when fed simultaneously with glucose, it showed a significant hypoglycemic effect (p < 0.05) in NIDDM model rats. Chemical analysis showed that the major constituent of the SDF is a galactomannan. The results confirm the involvement of SDF in the hypoglycemic effect of T. foenum graecum seeds. However, compound(s) other than SDF is (are) also involved in the hypoglycemic activity.

American Herbal Products Association. Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997.

Baskaran K, Ahmath BK, Shanmugasundaram KR, Shanmugasundaram ERB. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol 1990 Oct;30(3):295-300.
Abstract: The effectiveness of GS4, an extract from the leaves of Gymnema sylvestre, in controlling hyperglycaemia was investigated in 22 Type 2 diabetic patients on conventional oral anti-hyperglycaemic agents. GS4 (400 mg/day) was administered for 18-20 months as a supplement to the conventional oral drugs. During GS4 supplementation, the patients showed a significant reduction in blood glucose, glycosylated haemoglobin and glycosylated plasma proteins, and conventional drug dosage could be decreased. Five of the 22 diabetic patients were able to discontinue their conventional drug and maintain their blood glucose homeostasis with GS4 alone. These data suggest that the beta cells may be regenerated/repaired in Type 2 diabetic patients on GS4 supplementation. This is supported by the appearance of raised insulin levels in the serum of patients after GS4 supplementation.

Bever BO, Zahnd GR. Plants with Oral Hypoglycaemic Action. Quart. J Crude Drug Res 1979 17:139-196.

Boyd JR. (ed.) Facts and Comparisons. St. Louis, MO: J.B. Lippincott Co., 1985.

Brinker F. Botanical Medicine Research Summaries. In: Eclectic Dispensatory of Botanical Therapeutics, Vol. II. Sandy, OR: Eclectic Medical Publications, 1995.

Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Institute, 1997.

Bruttomesso D, Biolo G, Inchiostro S, Fongher C, Briani G, Duner E, Marescotti MC, Iori E, Tiengo A, Tessari P. No effects of high-fiber diets on metabolic control and insulin-sensitivity in type 1 diabetic subjects. Diabetes Res Clin Pract 1991 Aug;13(1-2):15-21.
Abstract: The metabolic effects of a three-month treatment with a high-fiber diet (15 grams of guar-gum added to a standard diet) were investigated in seven type 1 diabetic subjects, with a moderately poor metabolic control. HbA1c levels, daily insulin requirement, cholesterol, triglyceride, amino acid and intermediate metabolite concentrations were evaluated before and following the high fiber diet, both in the postabsorptive state at euglycemia and during a euglycemic, hyperinsulinemic, hyperaminoacidemic clamp. Insulin-mediated glucose utilization, an index of insulin-sensitivity, was also measured during the clamp. Following the diet, no differences in HbA1c levels (7.6 +/- 0.7%----7.3 +/- 0.6%), daily insulin requirement (50 +/- 5----51 +/- 3 U/d), triglyceride, amino acid and intermediary metabolite concentrations in the basal, euglycemic state, were observed. Only cholesterol concentrations decreased significantly (from 165 +/- 12 to 142 +/- 12 mg/dl, P less than 0.01) after the diet. During the clamp, the concentrations of all measured substrates were comparable before and after high fiber treatment. Insulin-mediated glucose disposal was also unchanged by guar-gum treatment. Patients' body weights were not modified by the diet. In conclusion, our study shows that a high fiber diet, obtained with the addition of 15 grams of guar-gum to a standard diet, is of no benefit to IDDM either as regards the metabolic control or insulin sensitivity. Only cholesterol levels were decreased. Therefore, the costs and benefits of these diets in the treatment of IDDM should be reconsidered.

Briani G, Bruttomesso D, Bilardo G, Giorato C, Duner E, Ion E, Sgnaolin E, Pedrini P, Tiengo A. Guar-Enriched Pasta and Guar Gum in the Dietary Treatment of Type II Diabetes. Phytother Res 1987 1:177-179.

Cameron-Smith D, Habito R, Barnett M, Collier GR. Dietary guar gum improves insulin sensitivity in streptozotocin-induced diabetic rats. J Nutr 1997 Feb;127(2):359-364.
Abstract: Although dietary recommendations for diabetics stress the need for increased carbohydrate and dietary fiber, the effectiveness of dietary fiber in improving insulin sensitivity remains controversial. The aim of this study was to compare the effects of a soluble fiber (guar gum) and an insoluble fiber (wheat bran) on insulin sensitivity in streptozotocin-induced (STZ) diabetic rats. Consequently, the rats were divided into two groups and one half were rendered diabetic with streptozotocin. The STZ diabetic and nondiabetic rats were further randomized and fed a diet containing dietary fiber (7 g/100 g diet) from either guar gum or wheat bran. The hyperinsulinemic clamp technique, combined with infusion of the glucose analog, 2-deoxyglucose (2DG), was utilized to examine insulin sensitivity. Bran-fed STZ diabetic rats were significantly (P < 0.001) hyperglycemic, which was ameliorated by guar gum. Insulin-mediated glucose disposal was increased by the guar diet compared with the bran diet in both the STZ diabetic rats [17.7 +/- 2.2 vs. 11.8 +/- 2.4 mL/(kg x min), P < 0.05] and the nondiabetic rats [20.5 +/- 2.8 vs. 15.5 +/- 1.5 mL/(kg x min), P < 0.05]. The accumulation of 2DG in peripheral muscles reflected the changes in insulin sensitivity with a trend for increased 2DG uptake in the majority of analyzed tissues in rats fed the guar diet, both nondiabetic and STZ diabetic, compared with the bran-fed rats. Accompanying these alterations in insulin sensitivity, guar gum suppressed food intake in the hyperphagic diabetic rats by 20% (P < 0.001). The present results demonstrate the effectiveness of guar gum in improving insulin sensitivity in STZ diabetic rats and suggest that reduced food intake may be an important mechanism of action of guar in hyperphagic diabetic rats.

Day C, Cartwright T, Provost J, Bailey CJ. Hypoglycaemic effect of Momordica charantia extracts. Planta Med 1990 Oct;56(5):426-429.
Abstract: The hypoglycaemic effect of orally administered extracts of fruits of cultivated Momordica charantia (karela) was examined in normal and streptozotocin diabetic mice. In normal mice, an aqueous extract (A) lowered the glycaemic response to both oral and intraperitoneal glucose, without altering the insulin response. This aqueous extract (A) and the residue after alkaline chloroform extraction (B) reduced the hyperglycaemia in diabetic mice at 1 hour. Material recovered by acid water wash of the chloroform extract remaining after an alkaline water wash (D) produced a more slowly generated hypoglycaemic effect. The results suggest that orally administered karela extracts lower glucose concentrations independently of intestinal glucose absorption and involve an extrapancreatic effect. Two types of hypoglycaemic substances with different time dependent effects are indicated.

Fairchild RM, Ellis PR, Byrne AJ, Luzio SD, Mir MA. A new breakfast cereal containing guar gum reduces postprandial plasma glucose and insulin concentrations in normal-weight human subjects. Br J Nutr 1996 Jul;76(1):63-73.
Abstract: A new guar-containing wheatflake product was developed to assess its effect on carbohydrate tolerance in normal-weight, healthy subjects. The extruded wheatflake breakfast cereals containing 0 (control) or approximately 90 g guar gum/kg DM were fed to ten fasting, normal-weight, healthy subjects using a repeated measures design. The meals were similar in energy (approximately 1.8 MJ), available carbohydrate (78 g), protein (15 g) and fat (5.4 g) content. The guar gum content of the test meals was 6.3 g. Venous blood samples were taken fasting and at 15, 30, 45, 60, 90, 120, 150 and 240 min after commencing each breakfast and analysed for plasma glucose, insulin and C-peptide. The guar wheatflake meal produced a significant main effect for glucose and insulin at 0-60 min and 0-240 min time intervals respectively, but not for the C-peptide levels compared with the control meal. Significant reductions in postprandial glucose and insulin responses were seen following the guar wheatflake meal compared with the control meal at 15 and 60 min (glucose) and 15, 60, 90 and 120 min (insulin). The 60 and 120 min areas under the curve for glucose and insulin were significantly reduced by the guar gum meal, as was the 240 min area under the curve for insulin. Thus, it can be concluded that the use of a severe method of heat extrusion to produce guar wheatflakes does not diminish the physiological activity of the guar gum.

Farnsworth NR, Segelman AB. Hypoglycemic Plants. Tile Till, 57:52-56, 1971.

Gatenby SJ, Ellis PR, Morgan LM, Judd PA. Effect of partially depolymerized guar gum on acute metabolic variables in patients with non-insulin-dependent diabetes. Diabet Med 1996 Apr;13(4):358-364.
Abstract: Fourteen patients with non-insulin-dependent diabetes (NIDDM) attended the study centre on 4 mornings separated by at least 3 days, to receive in random order 75 g carbohydrate breakfast meals of control or guar breads with jam and butter. Guar gum flours of low, medium, and high molecular weight (MW) were incorporated into wheat bread rolls to provide 7.6 g guar per meal. Venous blood samples were taken via an indwelling cannula in a forearm vein at fasting and at eight postprandial times and then analysed for blood glucose, plasma insulin, C-peptide, and gastric inhibitory polypeptide (GIP). Guar gum bread significantly reduced the postprandial rise in blood glucose, plasma insulin, and, except for bread containing low MW guar gum, plasma GIP levels compared to the control. Thus, the partial depolymerization of guar gum does not diminish its physiological activity. No reductions in postprandial plasma C-peptide levels were seen after any of the guar bread meals. This suggests that guar gum attenuates the insulin concentration in peripheral venous blood in patients with NIDDM by increasing the hepatic extraction of insulin.

Gonzalez M, Zarzuelo A, Gamez MJ, Utrilla MP, Jimenez J, Osuna I. Hypoglycemic activity of olive leaf. Planta Med 1992 Dec;58(6):513-515.
Abstract: The hypoglycemic activity of olive leaf was studied. Maximum hypoglycemic activity was obtained from samples collected in the winter months, especially in February. One of the compounds responsible for this activity was oleuropeoside, which showed activity at a dose of 16 mg/kg. This compound also demonstrated antidiabetic activity in animals with alloxan-induced diabetes. The hypoglycemic activity of this compound may result from two mechanisms: (a) potentiation of glucose-induced insulin release, and (b) increased peripheral uptake of glucose.

Khosla P, Gupta DD, Nagpal RK. Effect of Trigonella foenum graecum (Fenugreek) on blood glucose in normal and diabetic rats. Indian J Physiol Pharmacol 1995 Apr;39(2):173-174.
Abstract: Trigonella foenum graecum (Fenugreek) was administered at 2 and 8 g/kg dose orally to normal and alloxan induced diabetic rats. It produced a significant fall (P < 0.05) in blood glucose both in the normal as well as diabetic rats and the hypoglycemic effect was dose related.

Landin K, Holm G, Tengborn L, Smith U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 1992 Dec;56(6):1061-1065.
Abstract: A double-blind, placebo-controlled, cross-over study was carried out in 25 healthy, nonobese middle-aged men to test the effect of guar gum on glucose and lipid metabolism, blood pressure, and fibrinolysis. Ten grams guar or placebo granulate was given three times a day for 6 wk with a 2-wk run-in before and a wash-out period after. Decreases in fasting blood glucose (P < 0.001), cholesterol (P < 0.001), triglycerides (P < 0.05), plasminogen activator inhibitor-1 activity (P < 0.01), systolic blood pressure (P < 0.01), and diastolic blood pressure (P < 0.001) were seen during guar treatment when compared with placebo. Insulin sensitivity, measured with the euglycemic-clamp technique, increased (P < 0.01), adipose tissue-glucose uptake measured in vitro increased (P < 0.001), and 24-h urinary excretion of sodium and potassium increased (P < 0.001) during guar treatment. Fasting plasma insulin, renin, aldosterone, and fibrinogen concentrations as well as skeletal-muscle electrolytes, urinary catecholamines, and body weight remained unaltered. These findings support a role for guar in the treatment of the metabolic syndrome in which insulin resistance seems to play a pivotal role.

Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH. Improvement in glucose tolerance due to Momordica charantia (karela). Br Med J (Clin Res Ed) 1981 Jun 6;282(6279):1823-1824.
Abstract: The effect of karela (Momordica charantia), a fruit indigenous to South America and Asia, on glucose and insulin concentrations was studied in nine non-insulin-dependent diabetics and six non-diabetic laboratory rats. A water-soluble extract of the fruits significantly reduced blood glucose concentrations during a 50 g oral glucose tolerance test in the diabetics and after force-feeding in the rats. Fried karela fruits consumed as a daily supplement to the diet produced a small but significant improvement in glucose tolerance. Improvement in glucose tolerance was not associated with an increase in serum insulin responses. These results show that karela improves glucose tolerance in diabetes. Doctors supervising Asian diabetics should be aware of the fruit's hypoglycaemic properties.

Lewis WH, Elvin-Lewis MPF. Medical Botany. New York: John Wiley and Sons, 1977.

Medon PJ, Thompson EB, Farnsworth NR. Hypoglycemic effect and toxicity of Eleutherococcus senticosus following acute and chronic administration in mice. Chung Kuo Yao Li Hsueh Pao 1981 Dec;2(4):281-285.

Mertz W. Interaction of chromium with insulin: a progress report. Nutr Rev 1998 Jun;56(6):174-177. (Review)

Mertz W, Roginski EE, Gordon WA, Harrison WW, Shani J, Sulman FG. In vitro potentiation of insulin by ash from saltbush (Atriplex halimus). Arch Int Pharmacodyn Ther 1973 Nov;206(1):121-128.

Newall C, Anderson L, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. The Pharmaceutical Press: London, 1996.

Ng TB, Wong CM, Li WW, Yeung HW. Insulin-like molecules in Momordica charantia seeds. J Ethnopharmacol 1986 Jan;15(1):107-117.
Abstract: Decorticated Momordica charantia seeds were extracted and processed by a method which was developed originally for the purification of insect and annelid insulins. Essentially, the method entailed HCl-ethanol extraction, neutralization with NH4OH, gel filtration on Sephadex G-50, ion exchange chromatography on CM Sepharose CL-6B and desalting on Sephadex G-10. Of the seven fractions collected, three fractions were obtained with antilipolytic and lipogenic activities in isolated adipocytes and one fraction with only lipogenic activity. The data indicate that molecules with insulin-like bioactivity are present in Momordica charantia seeds.

Perez RM, Ocegueda A, Munoz JL, Avila JG, Morrow WW. A study of the hypoglycemic effect of some Mexican plants. J Ethnopharmacol 1984 Dec;12(3):253-262.
Abstract: Diabetes mellitus is a disease that annually causes many deaths, and to date no really efficient remedy has been found. We studied a number of plants traditionally used in Mexico against diabetes, some of them since prehispanic times. Specimens of each species were collected and extracts from them were tested on CD1 strain mice with alloxan-induced diabetes. Hypoglycemic activity was determined by the O-toluidine and the Dextrostix tape methods. Several of the plants showed a marked hypoglycemic effect.

Perez S, Perez RM, Perez C, Zavala MA, Vargas R. Coyolosa, a new hypoglycemic from Acrocomia mexicana. Pharm Acta Helv 1997 Apr;72(2):105-111.
Abstract: From the methanol extract of the Arocomia mexicana root a new tetrahydropyrane compound was isolated. Its skeletal structure and relative stereochemistry were established by spectral analysis. Substituent effects have been determined with the hope of providing information about steric interactions and conformation of tetrahydropyran derivatives and carbohydrates. The extract showed a significant blood sugar lowering effect on normal and alloxan-diabetic mice when administered at 2.5 to 40 mg/kg i.p. doses, and exhibited a dose-dependent response in the mice models.

Platel K, Srinivasan K. Plant foods in the management of diabetes mellitus: vegetables as potential hypoglycaemic agents. Nahrung 1997 Apr;41(2):68-74. (Review)
Abstract: Vegetables are among the numerous plant adjuncts tried for the treatment of diabetes mellitus. A few vegetables that are commonly consumed in India have been claimed to possess antidiabetic potency. In recent years, there has been a renewed interest to screen such plant food materials, for a possible beneficial use. Considerable amount of work has been carried out in this regard with bitter gourd (Momordica charantia) and ivy gourd (Coccinia indica) both in experimental animals and human diabetic subjects. Majority of these studies have documented the beneficial effect of the fruit of bitter gourd and leaf of ivy gourd when administered orally as a single dose. The hypoglycaemic influence is claimed to be mediated through an insulin secretagogue effect or through an influence on enzymes involved in glucose metabolism. The limited number of studies on other vegetables such as cabbage (Brassica oleracia), green leafy vegetables, beans and tubers have shown the beneficial hypoglycaemic influence in both experimental animals and humans. There is scope for more extensive research in this area, especially to examine the long term beneficial effect of dietary vegetables, to identify the active principle, and to understand the mechanism of action, which is at present unclear. Since diet forms the mainstay in the management of diabetes mellitus, there is scope for exploiting the antidiabetic potency of vegetables to the maximum extent. Such plant food adjuncts possessing hypoglycaemic activity appear to hold promise as potential antidiabetic agents.

Roman-Ramos R, Flores-Saenz JL, Alarcon-Aguilar FJ. Anti-hyperglycemic effect of some edible plants. J Ethnopharmacol 1995 Aug 11;48(1):25-32.
Abstract: The anti-hyperglycemic effect of 12 edible plants was studied on 27 healthy rabbits, submitted weekly to subcutaneous glucose tolerance tests after gastric administration of water, tolbutamide or a traditional preparation of the plant. Tolbutamide, Cucurbita ficifolia, Phaseolus vulgaris, Opuntia streptacantha, Spinacea oleracea, Cucumis sativus and Cuminum cyminum decrease significantly the area under the glucose tolerance curve and the hyperglycemic peak. Brassica oleracea var. botrytis, Allium cepa and Allium sativum only decrease the hyperglycemic peak. The glycemic decreases caused by Psidium guajava, Brassica oleracea and Lactuca sativa var. romana were not significant (P > .05). The integration of a menu that includes the edible plants with hypoglycemic activity for the control and prevention of diabetes mellitus may be possible and recommendable.

Sadhukhan B, Roychowdhury U, Banerjee P, Sen S. Clinical evaluation of a herbal antidiabetic product. J Indian Med Assoc 1994 Apr;92(4):115-117.
Abstract: Sixty-seven diabetic patients and 12 normal subjects were selected for a clinical study with an indigenous herbal product. The study consisted of 2 phases. In phase 1 study out of 25 diabetics (both insulin dependent and non-insulin dependent) only those in the age group of 41-50 years ie, 11 cases showed lowering of mean high blood sugar level in all samples from 1/2 an-hour to 2 hours with the test drug containing guar gum, methi, tundika and mesha shringi. But in phase 2 study there was lowering of blood sugar level with the test drug and with 2 of its constituents ie, guar gum and methi when used separately in 42 non-insulin dependent diabetics. While there was some blood sugar level lowering effect with guar gum and methi when used separately in 12 normal subjects in phase 2 study, but that was not the same observed with the test drug. The results of this study indicate the efficacy of the product as an adjuvant.

Serraclara A, Hawkins F, Perez C, Dominguez E, Campillo JE, Torres MD. Hypoglycemic action of an oral fig-leaf decoction in type-I diabetic patients. Diabetes Res Clin Pract 1998 Jan;39(1):19-22.
Abstract: The effect of a decoction of fig leaves (Ficus carica), as a supplement to breakfast, on diabetes control was studied in insulin-dependent diabetes mellitus (IDDM) patients (six men, four women, age 22-38 years, body mass index (BMI): 20.8 +/- 3.0 kg/m2, HbA1c 7.6 +/- 0.9% with a mean duration of diabetes of 9 +/- 6.3 years). The patients were managed with their usual diabetes diet and their twice-daily insulin injection. During the first month, patients were given a decoction of fig leaves (FC) and during the next month a non-sweet commercial tea (TC). The patients were divided into two groups (n = 5) with random allocation and cross-over design. A standard breakfast was given at the beginning and end of each month-run. C-peptide, 2 h pre- and post-prandial glycemia, HbA1c, cholesterol, lipid fractions and hematology data, were analyzed during each visit. Glycemic profiles (7/day per week) were recorded by patients. Only two patients had intolerance dropout. Post-prandial glycemia was significantly lower during supplementation with FC 156.6 +/- 75.9 mg/dl versus TC 293.7 +/- 45.0 mg/dl (P < 0.001) without pre-prandial differences 145.0 +/- 41.5 and 196.6 +/- 43.2 mg/dl, respectively. Medium average capillary profiles were also lower in the two sub-groups of patients during FC 166.7 +/- 23.6 mg/dl, P < 0.05 and 157.1 +/- 17.0 mg/dl versus TC 245.8 +/- 14.2 mg/dl and 221.4 +/- 27.3 mg/dl. Average insulin dose was 12% lower during FC in the total group. The addition of FC to diet in IDDM could be of help to control postprandial glycemia.

Shanmugasundaram KR, Panneerselvam C, Samudram P, Shanmugasundaram ER. The insulinotropic activity of Gymnema sylvestre, R. Br. An Indian medical herb used in controlling diabetes mellitus. Pharmacol Res Commun 1981 May;13(5):475-486.

Shanmugasundaram KR, Panneerselvam C, Samudram P, Shanmugasundaram ER. Enzyme changes and glucose utilisation in diabetic rabbits: the effect of Gymnema sylvestre. R Br J Ethnopharmacol 1983 Mar;7(2):205-234.
Abstract: The administration of the dried leaf powder of Gymnema sylvestre regulates the blood sugar levels in alloxan diabetic rabbits. G. sylvestre therapy not only produced blood glucose homeostasis but also increased the activities of the enzymes affording the utilisation of glucose by insulin dependent pathways: it controlled phosphorylase levels, gluconeogenic enzymes and sorbitol dehydrogenase. The uptake and incorporation of [14C] glucose into the glycogen and protein are increased in the liver, kidney and muscle in G. sylvestre administered diabetic animals when compared to the untreated diabetic animals. Pathological changes initiated in the liver during the hyperglycemic phase are reversed by controlling hyperglycemia by G. sylvestre. G. sylvestre, a herb used for the control of diabetes mellitus in several parts of India, appears to correct the metabolic derangements in diabetic rabbit liver, kidney and muscle.

Shanmugasundaram KR, Panneerselvam C, Samudram P, Shanmugasundaram ER. Enzyme changes and glucose utilisation in diabetic rabbits: the effect of Gymnema sylvestre. R Br J Ethnopharmacol 1983 Mar;7(2):205-234.
Abstract: The administration of the dried leaf powder of Gymnema sylvestre regulates the blood sugar levels in alloxan diabetic rabbits. G. sylvestre therapy not only produced blood glucose homeostasis but also increased the activities of the enzymes affording the utilisation of glucose by insulin dependent pathways: it controlled phosphorylase levels, gluconeogenic enzymes and sorbitol dehydrogenase. The uptake and incorporation of [14C] glucose into the glycogen and protein are increased in the liver, kidney and muscle in G. sylvestre administered diabetic animals when compared to the untreated diabetic animals. Pathological changes initiated in the liver during the hyperglycemic phase are reversed by controlling hyperglycemia by G. sylvestre. G. sylvestre, a herb used for the control of diabetes mellitus in several parts of India, appears to correct the metabolic derangements in diabetic rabbit liver, kidney and muscle.

Sharma RD, Raghuram TC, Rao NS. Effect of fenugreek seeds on blood glucose and serum lipids in type I diabetes. Eur J Clin Nutr 1990 Apr;44(4):301-306.
Abstract: The effect of fenugreek seeds (Trigonella foenum graecum) on blood glucose and the serum lipid profile was evaluated in insulin-dependent (Type I) diabetic patients. Isocaloric diets with and without fenugreek were each given randomly for 10 d. Defatted fenugreek seed powder (100 g), divided into two equal doses, was incorporated into the diet and served during lunch and dinner. The fenugreek diet significantly reduced fasting blood sugar and improved the glucose tolerance test. There was a 54 per cent reduction in 24-h urinary glucose excretion. Serum total cholesterol, LDL and VLDL cholesterol and triglycerides were also significantly reduced. The HDL cholesterol fraction, however, remained unchanged. These results indicate the usefulness of fenugreek seeds in the management of diabetes.

Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care. 1995 Oct;18(10):1373-1375.
Abstract: OBJECTIVE: To investigate the effect of ginseng on newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM) patients. RESEARCH DESIGN AND METHODS: In this double-blind placebo-controlled study, 36 NIDDM patients were treated for 8 weeks with ginseng (100 or 200 mg) or placebo. Efficacy was evaluated with psychophysical tests and measurements of glucose balance, serum lipids, aminoterminalpropeptide (PIIINP) concentration, and body weight. RESULTS: Ginseng therapy elevated mood, improved psychophysical performance, and reduced fasting blood glucose (FBG) and body weight. The 200-mg dose of ginseng improved glycated hemoglobin, serum PIIINP, and physical activity. Placebo reduced body weight and altered the serum lipid profile but did not alter FBG. CONCLUSIONS: Ginseng may be a useful therapeutic adjunct in the management of NIDDM.

Vuorinen-Markkola H, Sinisalo M, Koivisto VA. Guar gum in insulin-dependent diabetes: effects on glycemic control and serum lipoproteins. Am J Clin Nutr 1992 Dec;56(6):1056-1060.
Abstract: We examined the effect of guar gum on glycemic control and serum lipid and lipoprotein profiles in mildly hypercholesterolemic patients with insulin-dependent diabetes. The study was done in a randomized, double-blind fashion with either guar gum or placebo added to the diet four times per day for 6 wk each. Fasting blood glucose and hemoglobin A1c decreased significantly during the guar-gum diet, whereas the diurnal glucose profile was unchanged. In addition, serum low-density-lipoprotein (LDL) cholesterol decreased by 20% and the ratio of LDL cholesterol to high-density-lipoprotein cholesterol by 28% during guar-gum therapy. No changes were seen in the placebo group. In conclusion, guar gum can improve glycemic control and decrease serum LDL-cholesterol concentrations in mildly hypercholesterolemic insulin-dependent diabetic patients and thus reduce risk factors for both micro- and macroangiopathic complications.

Welihinda J, Karunanayake EH, Sheriff MH, Jayasinghe KS. Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. J Ethnopharmacol 1986 Sep;17(3):277-282.
Abstract: Investigations were carried out to evaluate the effect of Momordica charantia on the glucose tolerance of maturity onset diabetic patients. The fruit juice of M. charantia was found to significantly improve the glucose tolerance of 73% of the patients investigated while the other 27% failed to respond.

Welihinda J, Arvidson G, Gylfe E, Hellman B, Karlsson E. The insulin-releasing activity of the tropical plant momordica charantia. Acta Biol Med Ger 1982;41(12):1229-1240.
Abstract: An aqueous extract from the unripe fruits of the tropical plant Momordica charantia was found to be a potent stimulator of insulin release from beta-cell-rich pancreatic islets isolated from obese-hyperglycemic mice. The stimulation of insulin release was partially reversible. It differed from that of D-glucose and other commonly employed insulin secretagogues in not being suppressed by L-epinephrine and in even being potentiated by the removal of Ca2+. This anomalous behaviour was not associated with general effects on the metabolism of the beta-cells as indicated by an unaltered oxidation of D-glucose. Studies of 45Ca fluxes suggest that the insulin-releasing action is the result of perturbations of membrane functions. In support for the idea of direct effects on membrane lipids, the action of the extract was found to mimic that of saponin in inhibiting the Ca2+/H+ exchange mediated by the ionophore A23187 in isolated chromaffin granules and release Ca2+ from preloaded liposomes.

Wichtl M. (ed.). Herbal Drugs and Phytopharmaceuticals. Boca Raton, FL: CRC Press, 1994.

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Hypoglycemic Herbs:
Adiantum capillus-veneris (Adiantum plant)
Allium cepa (Onion bulbs)
Allium sativum * (Garlic cloves)
Anacardium occidentale (Cashew leaves)
Arctium lappa (Burdock roots)
Argyreia cuneata (Rivea leaves)
Atriplex halimus (Salt bush leaves)
Bidens pilosa (Aceitilla plant)
Blighia sapida * (Akee apple seeds)
Brassica oleracia (Cabbage)
Catharanthus roseus (Madagascar periwinkle leaves)
Cecropia obtusifolia (Guarumo leaves and stem)
Coccinia grandis (Coccinia roots)
Coccinia indica (Ivy gourd)
Corchorus olitorius (Jute leaves)
Coutarea latiflora (Copalchi root bark)
Cucumis sativus (Cucumber fruit)
Cuminum cyminum (Cumin seed)
Eleutherococcus senticosus (Siberian ginseng)
Euphorbia prostrata
Ficus bengalensis * (Banyan stem bark)
Galega officinalis (Goat’s rue seeds)
Guazuma ulmifolia
Gymnema sylvestre (Gymnema leaves)
Hordeum vulgare (Barley sprouts)
Hygrophila auriculata (Barleria plant)
Lagerstroemia speciosa (Lagerstroemia leaves and ripe fruit)
Lepechinia caulescens
Lupinus albus (Lupin seeds)
Lycium barbarum (Box thorn leaves)
Lycopus virginicus (Bugleweed plant)
Momordica charantia (Bitter melon fruit)
Morus spp (Mulberry leaves)
Musa sapientum (Banana flowers and roots)
Nymphaea lotus (Lotus roots)
Ocimum sanctum (Sacred basil plant)
Olea europaea (Olive leaves)
Oplopanax horridum, also known as Fatsia horrida (Devil’s club root bark)
Opuntia spp. (Prickly pear stems and fruit)
Panax ginseng (Chinese Ginseng root)
Phaseolus vulgaris (Kidney bean, immature pods)
Polygonatum multflorum (Solomon’s seal root)
Psittacanthus calyculatus (Injerto flowers, leaves, and stem)
Rhizophora mangle
Rhus typhina (Staghorn sumach leaves)
Salpianthus arenarius (Catarinita flowers)
Sarcopoterium spinosum (Thorny burnet root bark)
Scoparia dulcis (Sweet broom plant)
Securinega virosa (Fluggea seeds)
Spinacea oleracea (Spinach leaves)
Syzygium jambolanum (Jambul seeds)
Taraxacum officinale (Dandelion plant)
Tecoma stans (Tronadora leaves)
Tinospora cordifolia (Gulancha plant)
Trigonella foenum-graecum (Fenugreek seeds)
Triticum sativum (Wheat leaves)
Turnera diffusa (Damiana leaves)
Urtica dioica (Stinging nettle plant)
Vaccinium myrtillus (Bilberry leaves)
Zea mays (Corn silk)
Note: * Indicates an herb having other side effects when taken alone in excessive doses.

(Adapted, with modifications derived from multiple source included above, from Brinker F. Herb Contraindications and Drug Interactions. pp. 104-105, 1997.)