Comprehensive Evaluation of the Clinical Efficacy of an Anti-Diabetic Polyherbal Formulation

Authors

DOI:

https://doi.org/10.24925/turjaf.v11i10.1905-1916.6212

Keywords:

Polyherbal formulation, hyperglycemia, Fasting glucose, 2 hours PP glucose, Insulin., HbA1c

Abstract

Background: There are several clinical studies examining the health advantages of several single medicinal herbs utilized in traditional blood glucose-lowering treatments. But very few or no studies on herbal formulations were made as Polyherbal for the same goal. As a result, it is now necessary to confirm that patients with hyperglycemia can benefit from such Polyherbal medicines as Dolabi. Methods: This prospective open-label, herbal coded test drug-controlled, randomized trial was conducted at the Munshiganj and Dhaka area in Bangladesh. We enrolled 108 male and 104 female patients of 30-70 years with primary and moderate hyperglycemia. They were recruited from the OPD of an Unani & Ayurvedic hospital in Munshiganj and different Unani clinics in Dhaka, Bangladesh after fulfilling the inclusion criteria. Patients were randomly assigned to receive metformin hydrochloride 500 mg two times daily and 2 tablets of Dolabi two times daily by using a random numbers table with the help of an assistant. Blood samples, height, weight, blood pressure, and personal data were recorded—laboratory results were obtained at the study baseline, after 1.5 months and after 3 months of intervention. Results: In the case of the test drug, results showed a significant decrease in blood glucose level between the baseline and after 3 months, in males, it was from 9.83±1.17 to 7.72±1.06 mg/dL for fasting glucose, from 16.60±2.35 to 8.23±1.17 mg/dL for 2 hours PP glucose, from 9.33±1.17 to 7.45±2.03 percent for HbA1c and for Insulin it reduces from 183.10±27.59 to 168.10±29.59 pmol/ L. The control drug metformin hydrochloride also showed a significant decrease in blood glucose level between baseline and after 3 months, in the case of males it was from 9.99±2.52 to 6.97±1.76 mg/dL for fasting glucose, from 17.43±5.05 to 7.89±2.42 mg/dL for 2 hours PP glucose, from 10.43±2.36 to 6.87±1.18 percent for HbA1c and for Insulin it reduces from 198.75±30.61 to 183.75±30.61p mol/L. In the case of females the test drug showed a significant reduction in fasting glucose, 2 hours PP glucose, HbA1c and Insulin between the baseline and after 3 months, it was from 10.02±1.11 to 7.78±0.93 mg/dL, from 16.88±2.21 to 8.16±1.11 mg/dL, from 9.84±1.04 to 7.45±1.03 percent and from 199.47±30.90 to 173.47±30.90 mg/dL respectively. In the case of females, the control drug showed a significant reduction in fasting glucose, 2 hours PP glucose, HbA1c and Insulin between baseline and after 3 months, it was from 10.18±1.92 to 6.71±1.59 mg/dL, from 18.70±3.88 to 7.60±3.74 mg/dL, from 10.58±1.08 to 6.98±1.08 percent and from 200.00±31.83 to 188.00±31.83 mg/dL respectively. Conclusions: We can infer the following from the present study’s findings: The polyherbal formulation Dolabi is able to reduce the blood glucose level. It can be an effective drug for primary hyperglycemic patients.

References

Al-Masri, AA, Ameen, F Davella, R Mamidala E. 2023. Antidiabetic effect of flavonoid from Rumex vesicarius on alloxan induced diabetes in Male Albino Wistar rats and its validation through in silico molecular docking and dynamic simulation studies. Biotechnology and Genetic Engineering Reviews, 1-16.

Austin, M A Hokanson J E. 1994. Epidemiology of triglycerides, small dense low-density lipoprotein, and lipoprotein (a) as risk factors for coronary heart disease. Medical Clinics of North America, 78(1), 99-115.

Baskaran, K Ahamath, BK Shanmugasundaram, KR Shanmugasundaram ERB. 1990. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. Journal of ethnopharmacology, 30(3), 295-305.

Bhattacharya SK. 1995. Shilajit attenuates streptozotocin induced diabetes mellitus and decrease in pancreatic islet superoxide dismutase activity in rats. Phytotherapy Research, 9(1), 41-44.

Brown MS, Goldstein JL. 1983. Lipoprotein receptors in the liver. Control signals for plasma cholesterol traffic. The Journal of clinical investigation, 72(3), 743-747.

Cdc.gov. 2023, Last Reviewed: April 18, 2023 Source: Centers for Disease Control and Prevention https://www.cdc.gov/ diabetes.

Centers for Disease Control and Prevention National Diabetes Fact Sheet: National Estimates and General Information on Diabetes and Prediabetes in the United States, 2011. Atlanta, GA, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, 2011

Chehade JM, Mooradian AD. 2000. A rational approach to drug therapy of type 2 diabetes mellitus. Drugs, 60, 95-113.

DeFronzo, RA Goodman, AM Multicenter Metformin Study Group. 1995. Efficacy of metformin in patients with non-insulin-dependent diabetes mellitus. New England Journal of Medicine, 333(9), 541-549.

Diabetes-Overview. n.d. Retrieved from https://www.who.int/ health-topics/diabetes#tab=tab_1

Diabetes, 2023 (https://www.who.int/news-room/fact-sheets/ detail/diabetes)

Efendić S, Enzmann F, Nylen A, Uvnäs-Wallensten, K Luft R. 1979. Effect of glucose/sulfonylurea interaction on release of insulin, glucagon, and somatostatin from isolated perfused rat pancreas. Proceedings of the National Academy of Sciences, 76(11), 5901-5904.

Franco RR, Alves VHM, Zabisky LFR, Justino AB, Martins MM, Saraiva AL. Espindola, F. S. 2020. Antidiabetic potential of Bauhinia forficata Link leaves: a non-cytotoxic source of lipase and glycoside hydrolases inhibitors and molecules with antioxidant and antiglycation properties. Biomedicine & Pharmacotherapy, 123, 109798.

Gaurav, Zahiruddin S, Parveen B, Ibrahim M, Sharma I, Sharma S, Ahmad S. 2020. TLC-MS Bioautography-based identification of free-radical scavenging, α-amylase, and α-glucosidase inhibitor compounds of antidiabetic tablet BGR-34. ACS omega, 5(46), 29688-29697.

Geiss LS, Pan L, Cadwell B, Gregg EW, Benjamin SM, Engelgau MM. 2006. Changes in incidence of diabetes in US adults, 1997–2003. American journal of preventive medicine, 30(5), 371-377.

Gharpurey KG. 1926. Gymnema sylvestre in the treatment of diabetes. The Indian Medical Gazette, 61(3), 155.

Gholap S, Kar A. 2003. Effects of Inula racemosa root and Gymnema sylvestre leaf extracts in the regulation of corticosteroid induced diabetes mellitus: involvement of thyroid hormones. Die Pharmazie-An International Journal of Pharmaceutical Sciences, 58(6), 413-415.

Ghosal, S Lata, S Kumar, Y Gaur, B Misra, N Soumya L. 1995. Interaction of Shilajit with biogenic free radicals. INDIAN JOURNAL OF CHEMISTRY SECTION B, 34, 596-602.

Global Burden of Disease Collaborative Network. Global Burden of Disease Study 2019. Results. Institute for Health Metrics and Evaluation. 2020 (https://vizhub.healthdata.org/gbd-results/).

Goyal, AK Middha SK, Usha T, Sen A. 2017. Analysis of toxic, antidiabetic and antioxidant potential of Bambusa balcooa Roxb. leaf extracts in alloxan-induced diabetic rats. 3 Biotech, 7, 1-11.

Groth DH. 1980. Carcinogenicity of beryllium: review of the literature. Environmental Research, 21(1), 56-62.

Grover, JK Yadav, S Vats V. 2002. Medicinal plants of India with anti-diabetic potential. Journal of ethnopharmacology, 81(1), 81-100.

Gupta SS. 1961. Inhibitory effect of Gymnema sylvestre (Gurmar) on adrenaline-induced hyperglycemia in rats. Indian journal of medical sciences, 15, 883-887.

Gupta SS. 1966. Experimental Studies On Pituitary Diabetes. V. Effects Of Shilajit Ficus Bengalensis And Anterior Pituitary Extract On Glucose Tolerance In Rats. Indian Journal of Medical Research, 54(4), 354.

Gupta SS, Seth CB. 1962. Experimental studies on pituitary diabetes. II. Comparison of blood sugar level in normal and anterior pituitary extract-induced hyperglycaemic rats treated with a few Ayurvedic remedies. The Indian journal of medical research, 50, 708-714.

Hill CA, Forti P. 1997. Cave minerals of the world: National Speleological Society. Huntsville, Alabama, 163-176.

Hossain MB, Khan MN, Oldroyd JC, Rana J, Magliago DJ, Chowdhury EK, Islam RM. 2022. Prevalence of, and risk factors for, diabetes and prediabetes in Bangladesh: Evidence from the national survey using a multilevel Poisson regression model with a robust variance. PLOS Global Public Health, 2(6), e0000461.

International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels. Belgium: 2019. https://www.diabetesatlas.org, accessed 18 November 2020: 2019

Joffe DJ, Freed SH. 2001. Effect of extended release gymnema sylvestre leaf extract (Beta Fast GXR) alone or in combination with oral hypoglycemics or insulin regimens for type 1 and type 2 diabetes. Diabetes in Control Newsletter, 30.

Khare AK, Tondon RN, Tewari JP. 1983. Hypoglycaemic activity of an indigenous drug (Gymnema sylvestre,'Gurmar') in normal and diabetic persons. Indian J Physiol Pharmacol.

Khare AK, Tondon RN, Tewari JP. 1983. Hypoglycaemic activity of an indigenous drug (Gymnema sylvestre,'Gurmar') in normal and diabetic persons. Indian J Physiol Pharmacol.

Kraus-Friedmann N. 1984. Hormonal regulation of hepatic gluconeogenesis. Physiological reviews, 64(1), 170-259.

Lyssenko V, Almgren P, Anevski D, Perfekt R, Lahti K, Nissén M. Botnia Study Group. 2005. Predictors of and longitudinal changes in insulin sensitivity and secretion preceding onset of type 2 diabetes. Diabetes, 54(1), 166-174.

Macharla SP, Goli V, Santhosha D, Ravinder NA. 2012. Antdiabetic activity of bambusa arundinaceae stem extracts on alloxan induced diabetic rats. Journal of Chemical, Biological and Physical Sciences (JCBPS), 2(2), 832.

Mainigi KD, Bresnick E. 1969. Inhibition of deoxythymidine kinase by beryllium. Biochemical Pharmacology, 18(8), 2003-2007.

Makaryus AN, Akhrass P, McFarlane SI. 2009. Treatment of hypertension in metabolic syndrome: implications of recent clinical trials. Current Diabetes Reports, 9(3), 229-237.

Medicinal Plants and Herbs for Diabetes (n.d). Retrieved from https://diabetesaction.org/medicinal-plants-and-herbs

Meigs JB, Cupples L.A, Wilson PW. 2000. Parental transmission of type 2 diabetes: the Framingham Offspring Study. Diabetes, 49(12), 2201-2207.

Mhaskar KS, Caius JF. 1930. A Study oí Indian Medicinal Plants. II. Gymnema sylvestre, Br. Indian Medical Research Memoirs, (Memoir No. 16).

Nazamuddin M, Wadud A, Ansari AH, Alam T, Perveen A, Iqbal N. 2014. Concept of diabetes in Unani system of medicine: an overview. Medical Journal of Islamic World Academy of Sciences, 109(1567), 1-6.

Nazreen S, Kaur G, Alam MM, Haider S, Hamid H, Alam MS. 2011. Hypoglycemic activity of Bambusa arundinacea leaf ethanolic extract in streptozotocin induced diabetic rats. Pharmacologyonline, 1, 964-972.

Nguyen QM, Srinivasan SR, Xu JH, Chen W, Berenson GS. 2008. Changes in risk variables of metabolic syndrome since childhood in pre-diabetic and type 2 diabetic subjects: the Bogalusa Heart Study. Diabetes care, 31(10), 2044-2049.

Ohrnberger D. 1999. The bamboos of the world: annotated nomenclature and literature of the species and the higher and lower taxa. Elsevier.

Pickoff AS, Berenson GS, Schlant RC. 1995. Introduction to the symposium celebrating the Bogalusa Heart Study. The American Journal of the Medical Sciences, 310, S1-2.

Prakash AO, Mathur S, Mathur R. 1986. Effect of feeding Gymnema sylvestre leaves on blood glucose in beryllium nitrate treated rats. Journal of ethnopharmacology, 18(2), 143-146.

Prakash AO, Mathur S, Mathur R. 1986. Effect of feeding Gymnema sylvestre leaves on blood glucose in beryllium nitrate treated rats. Journal of ethnopharmacology, 18(2), 143-146.

Prasad SK, Kulshreshtha A, Qureshi TN. 2009. Antidiabetic activity of some herbal plants in streptozotocin induced diabetic albino rats. Pak J Nutr, 8(5), 551-557.

Shanmugasundaram ERB, Gopinath KL, Shanmugasundaram KR, Rajendran VM.1990. Possible regeneration of the islets of Langerhans in streptozotocin-diabetic rats given Gymnema sylvestre leaf extracts. Journal of ethnopharmacology, 30(3), 265-279.

Shanmugasundaram ERB, Rajeswari G, Baskaran K, Kumar BR, Shanmugasundaram KR, Ahmath BK. 1990. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. Journal of ethnopharmacology, 30(3), 281-294.

Shanmugasundaram KR, Panneerselvam C, Samudram P, Shanmugasundaram ERB. 1981. The insulinotropic activity of Gymnema sylvestre, R. Br. An Indian medical herb used in controlling diabetes mellitus. Pharmacological Research Communications, 13(5), 475-486.

Shigematsu N, Asano R, Shimosaka M, Okazaki M. 2001. Effect of administration with the extract of Gymnema sylvestre R. Br leaves on lipid metabolism in rats. Biological and Pharmaceutical Bulletin, 24(6), 713-717.

Shigematsu N, Asano R, Shimosaka M, OKAZAKI M. 2001. Effect of long term-administration with Gymnema sylvestre R. BR on plasma and liver lipid in rats. Biological and Pharmaceutical Bulletin, 24(6), 643-649.

Shimizu K, IINO A, NAKAJIMA J, TANAKA K, NAKAJYO S, URAKAWA N, YAMASHITA C. 1997. Suppression of glucose absorption by some fractions extracted from Gymnema sylvestre leaves. Journal of veterinary medical science, 59(4), 245-251.

Shumugasundaram KR. 1983. Enzyme changes and glucose utilization in diabetic rabbits, the effect of Gymnema sylvestre. J. Ethnopharmacol, 7, 205-234.

Singh VK, Umar S, Ansari SA, Iqbal M. 2008. Gymnema sylvestre for diabetics. Journal of herbs, spices & medicinal plants, 14(1-2), 88-106.

Srinivasan SR, Frontini MG, Berenson GS. 2003. Longitudinal changes in risk variables of insulin resistance syndrome from childhood to young adulthood in offspring of parents with type 2 diabetes: the Bogalusa Heart Study. Metabolism, 52(4), 443-450.

Sugihara Y, Nojima H, Matsuda H, Murakami T, Yoshikawa M, Kimura I. 2000. Antihyperglycemic effects of gymnemic acid IV, a compound derived from Gymnema sylvestre leaves in streptozotocin-diabetic mice. Journal of Asian natural products research, 2(4), 321-327.

Sun J, Ding ZQ, Gao Q, Xun H, Tang F, Xia ED. 2016. Major chemical constituents of bamboo shoots (Phyllostachys pubescens): Qualitative and quantitative research. Journal of agricultural and food chemistry, 64(12), 2498-2505.

Tablet Dolabi-Description (n.d). Retrieved from https://hamdard.com.bd/product-detail/tabletdolabi/

The International Diabetes Federation (IDF), Bangladesh. (n.d.) Retrieved from https://idf.org/our-network/regions-and-members/south-east-asia/members/bangladesh/

Tiwari P, Ahmad K, Hassan Baig M. 2017. Gymnema sylvestre for diabetes: from traditional herb to futures therapeutic. Current pharmaceutical design, 23(11), 1667-1676.

Trivedi NA, Mazumdar B, Bhatt JD, Hemavathi KG. 2004. Effect of shilajit on blood glucose and lipid profile in alloxan-induced diabetic rats. Indian journal of pharmacology, 36(6), 373.

Trivedi NA, Mazumdar B, Bhatt JD, Hemavathi KG. 2004. Effect of shilajit on blood glucose and lipid profile in alloxan-induced diabetic rats. Indian journal of pharmacology, 36(6), 373.

Wilson E, Rajamanickam GV, Dubey GP, Klose P, Musial F, Saha FJ, Dobos GJ. 2011. Review on shilajit used in traditional Indian medicine. Journal of ethnopharmacology, 136(1), 1-9.

Wilson PW, Meigs JB, Sullivan L, Fox CS, Nathan DM, D’Agostino RB. 2007. Prediction of incident diabetes mellitus in middle-aged adults: the Framingham Offspring Study. Archives of internal medicine, 167(10), 1068-1074.

Downloads

Published

24.10.2023

How to Cite

Sheikh, H., Alam, M. K., & Samad, M. A. (2023). Comprehensive Evaluation of the Clinical Efficacy of an Anti-Diabetic Polyherbal Formulation. Turkish Journal of Agriculture - Food Science and Technology, 11(10), 1905–1916. https://doi.org/10.24925/turjaf.v11i10.1905-1916.6212

Issue

Section

Research Paper