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Role of Glyco-Persica® in Targeting Diabetes Type 2: an Integrative Approach
  • 비영리 CC BY-NC
  • 비영리 CC BY-NC
Role of Glyco-Persica® in Targeting Diabetes Type 2: an Integrative Approach
Diabetes , alternative therapy , integrative medicine , herbal medicine , TCAM
  • 1. Introduction

    Diabetes mellitus (DM) is a syndrome of chronic hyperglycemia due to a relative insulin deficiency, insulin resistance, or both. Diabetes is rampant in many parts of the world, with incidence rates increasing yearly. Many chemical agents are available to control and treat diabetes but overall protecting on against long-term complications requires much efforts and money. In addition, the side effects from using chemical hypoglycemic agents, to maintain euglycemia and avoid late-stage diabetic complications disgust most patients. Alternatives to these synthetic agents, plants, provide a potential source of hypoglycemic drugs and are widely used in several traditional systems of medicine to prevent diabetes. The actions of herbal medicines and nutraceuticals are commonly multi-target, multi-channel and synergistic, due to the variety of constituents within a single natural product. Owing to these properties, herbal medicines and nutraceuticals may be beneficial in dealing with diabetes itself, as well as with its complications, because various mechanisms are involved in diabetic vascular complications. [1]. However, because diabetes is a dangerous disease with many potential complications, alternative treatments for diabetes should not be attempted as a substitute for conventional medical care.

    The objectives of this study were to examine how an integrated approach to the treatment of type 2 diabetes mellitus could improve glycemic control, how immune-potentiating activities respond to oral hypoglycemic agents, and whether or not botanical compounds have an adjuvant effect among primary care patients.

    2. Materials and Methods

    Aqueous extracts of the experimental materials were obtained and mixed in a proper formula. (Table 1) Aqueous extract of all ingredients were purchased from Shanghai Wellong Medical Material CO., LTD. (Shanghai, China), and were identified by the Department of Authentication of Dubai Pharmacy College, Alternative Department.

    Astragalus membranaceus is an herb that has historically been used in traditional Chinese medicine, usually in combination with other herbs, to support and enhance the immune system. Some other studies found that Astragalus hypoglycemic activities in type 2 diabetic (T2DM) rats. Hypoglycemic effect of APS was investigatedregarding possible mechanism(s) underlying improvement of insulin resistance in vivo and in vitro. [2] In vivo studies on diabetic rats suggest that increasing peripheral glucose metabolism via Astragalus can alleviate type II diabetes induced by diet with oral doses of 400-700 mg/kg body weight in diabetic rats [3]. These effects are due to Astragalus Polysaccharides rather than the steroidal saponin content. [4]

    Rehmanniae Radix and Panax ginseng are plant has been used traditionally in Chinese medicine to treat diabetes, with similar claim to that of Astragalus [5-6]. Their combination is being looked at for wound healing in diabetics and the combination of the two is believed to be synergistically beneficial.

    The vegetable Momordica charantia L. is also known as bitter gourd, balsam pear, bitter melon. Bitter gourd extracts possesses antioxidant, antibacterial, antiviral, anti- hepatotoxic and anti-ulcerogenic properties as well as the ability to lower blood sugar. Animal and in vitro data support both insulin secretagogue and insulin-mimetic activity of the fruit. A polypeptide (p-insulin) produces hypoglycemic effects in humans and animals by subcutaneous injection, but oral activity are questionable. [7-10] Preliminary animal and human trials suggest possible hypoglycemic and anti-hyperlipidemic properties of oral fenugreek seed powder. In animal and several human trials, fenugreek seeds have been found to lower fasting serum glucose levels, both acutely and chronically. The hypoglycemic effects of fenugreek have been attributed to several mechanisms. [11-15]

    [Table. 1] Ingredients of the botanical compound used in this study


    Ingredients of the botanical compound used in this study

    The major constituents of Danshen include water-soluble phenolic acids and lipophilic Danshinones. Phenolic acids possesses antioxidant and anticoagulant activities, whereas Danshinones show antibacterial, antioxidant, and antineoplastic activities. [16] Danshinone enhanced the activity of insulin in Chinese hamster ovary cells and in adipocytes. Pathways through which Dihydrotanshinone- I might affect blood glucose were examined in cellular experiments. Inhibition of advanced glycation end products through alpha-glucosidase blockade by danshen was reported. [17-19]

    Some studies show that huanglian has cardiovascular effect. Intravenous injection of berberine at 0.1 to 6.0 mg/kg, lowered blood pressure in anesthetized dogs, cats and rats. The mechanism of blood pressure reduction is dilation of the blood vessels and inhibition of secretion from adrenal glands. Berberine also has antiarrhythmic actions. [20-21] The flavonoids and antioxidant phenols concentrated in Propolis are powerful antioxidants and have been shown to be capable of scavenging free radicals which can extensively interfere with normal cell metabolism. Active free radicals, together with other factors, are considered to be responsible for cellular ageing and degradation in conditions such as cardiovascular diseases, arthritis, cancer, diabetes, and neurodegenerative diseases [22-25].

    Chromium (Cr) is an essential element required for normal carbohydrate metabolism. A preliminary study found that treatment with corticosteroids caused increased loss of chromium in the urine [26]. Another preliminary study found that individuals with corticosteroid-induced diabetes could improve blood sugar control by taking chromium supplements [27]. Trivalent Cr, the form of Cr found in foods and nutrient supplements, is considered one of the least toxic nutrients. [28]

    Sample no. 1 was a 500-mg capsule of Glyco-Persica. Its ingredients are shown in Table1.

    Sample no. 2 was a 500-mg placebo capsule, filled with post-extracted washed fibers. Two capsules (1000 mg) were administered three times daily for 45 days.

    The inclusion criteria were age 24-70, fasting blood sugar > 200 mg /dl, 2 h postprandial blood sugar > 200 mg/dl, history of diabetes type 2 of more than one year and treated with allopathic medications.

    Exclusion criteria were pregnancy, severe heart failure, renal failure, liver failure and other complications. Patients with other primary diseases, such as diabetic ketoacidosis and who under taken corticosteroids or other medicines that affect blood sugar blood sugar were also excluded.

    We used double blind random selection to divide the patients who had been treated between March 2007 and November 2009 and who were willing to participate in this trial; according to their blood glucose into treatment and a control groups. A balanced test among all factors that might affect the course of disease such as medication, Type, gender and age, was done to avoid comparability between each two groups. All participants took medicine every day for 45 days. All indices were measured before and after intake of food. Safety indicators included general physical examinations:

    Detailed inquiries regarding participant’s mental condition, sleep routine, diet, urine and stool, body weight, blood pressure, and heart rhythm before the start of this study; complete blood count assessments: red blood cells, white blood cells and differentiation, and hemoglobin.

    Routine stool tests were done and included routine urine analysis: pH, white blood cell count (WBC), sugar, and ketones.

    Blood biochemical tests for serum total protein, albumin, alanine transaminase, aspartate transaminase, blood urea nitrogen, serum creatinine, blood glucose, total cholesterol, triglycerides, and high-density lipoproteins.

    Chest x-rays, electrocardiograms, abdominal sonograms were taken before the test. Finally, the side effects of medications were observed.

    Detailed inquiries were made about the participant’s history, diet, medications, and activities. In all cases, we determined the chief complaint such as polydipsia, polyuria, polyphagia, fatigue, etc., before and after food, and we divided the symptoms into three categories according to severe as 3, medium as 2 and mild as 1. We also observed symptom improvement. (Improvement of more than one for each symptom was considered effective.)

    Glucose tolerance tests were done before and 2 h after the consumption of 10 large dates or bread made from 100 gram of flour.

    Urine sugar and ketones were measured. Morning urine was measured on an empty stomach, and according to positive rate, the results were divided into - , ±, +, ++, +++, ++++ groups corresponding to 0, 0.5, 1, 2, 3, and 4 points, respectively. Before and after food, we statistically analyzed the integral values.

    Basic symptoms were considered to be reduced significantly in the treatment group when a significant difference in the fasting blood sugar or the 2-h post-prandial blood glucose existed between the treatment and the control groups or between the treatment group before and after treatment. A drop of ≥10 % compared to the pre-test blood sugar was considered a significant difference.

    Results are expressed as means ± standard errors. Paired sample t-tests, under the premise of homogeneity of variance, were compared using composition t-tests; otherwise, variables were transformed to satisfy homogeneity of variance, after which t-tests were used. If the variance was still missing, a Wilcoxon signed-rank test was used. Pearson’s chi-squared test (χ2) was used for efficiency.

    3. Result

    Double-blind observations were made. Capsule 1 was used for the treatment group, and capsule 2 for the placebo group. In general, the two groups were comparable(Table 2)

    Clinical symptom scoring and clinical symptoms with changes are shown in (Table 3) and 4, respectively. Clinical symptoms were compared between the treatment group before and after treatment and between the treatment and the control groups after treatment, and the differences were statistically significant (P < 0.05). In the treatment and the control groups, the symptoms were improved in 36 (69.23%) and 10 (19.23%) of 52 cases, respectively, a significant difference (P < 0.05) (Tables 3,4)

    Before treatment, the fasting blood sugar levels in the two groups were not significantly different (P > 0.05); neither were the fasting blood sugar levels in the control group before and after treatment (P > 0.05). However, the fasting blood glucose level in the treatment group after treatment compared with that before treatment and with that of the control group after treatment was significantly different (P < 0.05). After treatment, the blood glucose levels in the treatment and control groups were lower by 21.6 mg/dl (12.67% reduction) and 1.98 mg/dl (1.16% reduction), respectively, the difference being statistically significant (P <0.05) (Table 5)

    [Table. 2] General characteristics and conditions before treatment


    General characteristics and conditions before treatment

    [Table. 3] Clinical symptom scoring (integral value, mean ± SD)


    Clinical symptom scoring (integral value, mean ± SD)

    [Table. 4] Changes in clinical symptoms


    Changes in clinical symptoms

    Before treatment, the post-prandial blood glucose levels in the two groups were not significantly different (P > 0.05). In the control group, the levels before and after treatment were not significantly different (P > 0.05). However, in the treatment group, the level after treatment compared with that before treatment and with that of the control group after treatment was significantly different (P < 0.05). In the treatment and control groups, the levels were reduced by 20.88 mg/dl and 1.62 mg/dl, respectively, the difference being statistically significant (P < 0.05) (Table 6)

    In both the two groups, the urine glucose levels after treatment were not significantly different. Also, in the treatment and the control groups, the levels before and after treatment were not significantly different (P > 0.05). These results indicate that this botanical compound had no significant effect on glycosuria. Before and after treatment, Ketonuria was not detected (Table 7)

    Body weight, blood pressure, heart rate, routine blood and stool/urine checkups (except urine glucose), and biochemical tests showed no apparent changes. No significant adverse reactions occurred during evaluations. The Glyco-Persica medication caused no obvious damage to the body (Table 8)

    After 45 days of treatment, one case each in the groups was eliminated due to intermittent use the placebo and the herbal compound such that we could not determine a result. The final number of patients in each group was 52 (Table 9)

    [Table. 5] Fasting blood sugar levels before and after treatment (mg/dl, mean ± SD)


    Fasting blood sugar levels before and after treatment (mg/dl, mean ± SD)

    [Table. 6] Post-prandial blood glucose changes (mg/dl, Mean ± SD)


    Post-prandial blood glucose changes (mg/dl, Mean ± SD)

    [Table. 7] Evaluation of glycosuria and urine ketone before and after treatment (mean ± SD)


    Evaluation of glycosuria and urine ketone before and after treatment (mean ± SD)

    4. Discussion

    The results showed that Glyco-Persica significantly lessened the main clinical symptoms in diabetes type 2 patients (treatment group: 69.23%, control group: 19.23%). The fasting blood sugar in the treatment group after treatment was significantly different from that in the treatment group before treatment and from that in the control group after treatment (P < 0.05). In the treatment group, the reduction in the fasting sugar after treatment was significant compared to that in the control group (12.67% vs. 1.16%, P < 0.05). Also, the post-prandial sugar in the treatment group after treatment compared with that before treatment and with that in the control group after treatment was significantly different (8.98% vs. 0.69%, P < 0.05).

    5. Conclusion

    The results revealed that Glyco-Persica® had a significant hypoglycemic effect on the main clinical symptoms in diabetes type 2 patients, but body weight, blood pressure, heart rate, routine blood and stool/urine checkups, and biochemical tests showed no apparent changes. No significant adverse reactions were noted during evaluations.

    [Table. 8] Analysis of body weight, blood pressure, heart rate, routine blood, stool/urine and blood biochemical index before and after treatment (mean ± SD)


    Analysis of body weight, blood pressure, heart rate, routine blood, stool/urine and blood biochemical index before and after treatment (mean ± SD)

    [Table. 9] Trail screening rate


    Trail screening rate

  • 1. Liang YZ, Xie P, Chan K 2004 Quality control of herbal medicines [J Chromatogr B Analyt Technol Biomed Life Sci] Vol.812 P.53-70 google cross ref
  • 2. Mao XQ, Yu F, Wang N, Wu Y, Zou F, Wu K 2009 Hypoglycemic effect of polysaccharide enriched extract of Astragalus membranaceus in diet induced insulin resistant C57BL/6J mice and its potential mechanism [Phytomedicine] Vol.16 P.416-425 google cross ref
  • 3. Zou F, Mao XQ, Wang N, Liu J, Ou-Yang JP 2009 Astragalus polysaccharide alleviates glucose toxicity and restores glucose homeostasis in diabetic states via activation of AMPK [Acta Pharmacol Sin] Vol.30 P.1607-1615 google cross ref
  • 4. Zhao M, Zhang ZF, Ding Y, Wang JB, Li Y 2012 Astragalus polysaccharide improves palmitate-induced insulin resistance by inhibiting PTP1B and NF-κB in C2C12 Myotubes [Molecules] Vol.17 P.7083-7092 google cross ref
  • 5. Lau KM, Lai KK, Liu CL, Tam JC, To MH, Kwok HF 2012 Synergistic interaction between Astragali Radix and Rehmanniae Radix in a Chinese herbal formula to promote diabetic wound healing [J Ethnopharmacol] Vol.141 P.250-256 google cross ref
  • 6. Huang X, Tan H, Chen B, Deng C 2010 [Influence of astragalosides and Panaxnotoginsengsaponins compatibility on MMP-9 and TIMP-1 after cerebral ischemia-reperfusion in mice] [Zhongguo Zhong Yao ZaZhi] Vol.35 P.2187-2191 google
  • 7. Welihinda J, Arvidson G, Gylfe E, Hellman B, Karlsson E 1982 The insulin-releasing activity of the tropical plant Momordica charantia [Acta Biol Med Ger] Vol.41 P.1229-1240 google
  • 8. Garau C, Cummings E, Phoenix DA 2003 Beneficial effect and mechanism of action of Momordica charantia in the treatment of diabetes mellitus: a mini review [Int J Diabetes & Metabolism] Vol.11 P.46-55 google
  • 9. Welihinda J, Karunanayake EH 1986 Extra-pancreatic effects of Momordica charantia in rats [J Ethnopharmacol] Vol.17 P.247-255 google cross ref
  • 10. Welihinda J, Karunanayake EH, Sherilf MHR, Jayasinghe KS 1986 Effects of Momordica charantia on the glucose tolerance in maturity onset diabetes [J Ethnopharmacol] Vol.17 P.277-282 google cross ref
  • 11. Kaviarasan S, Ramamurty N, Gunasekaran P, Varalakshmi E, Anuradha CV 2006 Fenugreek (Trigonella foenum graecum) seed extract prevents ethanol-induced toxicity and apoptosis in Chang liver cells [Alcohol Alcohol] Vol.41 P.267-273 google cross ref
  • 12. Madar Z, Abel R, Samish S, Arad J 1988 Glucose-lowering effect of fenugreek in non-insulin dependent diabetics [Eur J Clin Nutr] Vol.42 P.51-54 google
  • 13. Bordia A, Verma SK, Srivastava KC 1997 Effect of ginger (Zingiber officinale Rosc.) and fenugreek (Trigonella foenumgraecum L.) on blood lipids, blood sugar and platelet aggregation in patients with coronary artery disease [Prostaglandins Leukot Essent Fatty Acids] Vol.56 P.379-384 google cross ref
  • 14. Sharma RD 1986 Effect of fenugreek seeds and leaves on blood glucose and serum insulin responses in human subjects [Nutrition Research] Vol.6 P.1353-1364 google cross ref
  • 15. Sharma RD, Sarkar A, Hazra DK, Mishra B, Singh JB, Sharma SK 1996 Use of fenugreek seed powder in the management of non-insulin dependent diabetes mellitus [Nutrition Research] Vol.16 P.1331-1339 google cross ref
  • 16. Wang X, Morris-Natschke SL, Lee KH 2007 New developments in the chemistry and biology of the bioactive constituents of Tanshen [Med Res Rev] Vol.27 P.133-148 google cross ref
  • 17. Jung SH, Seol HJ, Jeon SJ, Son KH, Lee JR 2009 Insulin-sensitizing activities of tanshinones, diterpene compounds of the root of Salvia miltiorrhiza Bunge [Phytomedicine] Vol.16 P.327-335 google cross ref
  • 18. Liu Q, Zhang Y, Lin Z, Shen H, Chen L, Hu L 2010 Danshen extract 15, 16-dihydrotanshinone I functions as a potential modulator against metabolic syndrome through multi-target pathways [J Steroid Biochem Mol Biol] Vol.120 P.155-163 google cross ref
  • 19. Ma HY, Gao HY, Sun L, Huang J, Xu XM, Wu LJ 2011 Constituents with α-glucosidase and advanced glycation end-product formation inhibitory activities from Salvia miltiorrhiza Bge [J Nat Med] Vol.65 P.37-42 google cross ref
  • 20. Xiao YL, Lu FE, Xu LJ, Leng SH, Wang KF 2005 [Protective effects of HuanglianJiedu decoction on vascular endothelial function in type 2 diabetic rats] [Zhongguo Zhong Yao ZaZhi] Vol.30 P.1767-1770 google
  • 21. Chen JK 2004 Chinese medical herbology and pharmacology P.1267 google
  • 22. Krol W, Czuba Z, Scheller S, Gabrys J, Grabiec S, Shani J 1990 Anti-oxidant property of ethanolic extract of propolis (EEP) as evaluated by inhibiting the chemiluminescence oxidation of luminal [Biochem Int] Vol.21 P.593-597 google
  • 23. Scheller S, Wilczok T, Imielski S, Krol W, Gabrys J, Shani J 1990 Free radical scavenging by ethanol extract of propolis [Int J Radiat Biol] Vol.57 P.461-465 google cross ref
  • 24. Velazquez C, Navarro M, Acosta A, Angulo A, Dominguez Z, Robles R 2007 Antibacterial and free-radical scavenging activities of Sonoran propolis [J Appl Microbiol] Vol.103 P.1747-1756 google cross ref
  • 25. Viuda-Martos M, Ruiz-Navajas Y, Fernandez-Lopez J, Perez-Alvarez JA 2008 Functional properties of honey, propolis, and royal jelly [J Food Sci] Vol.73 P.R117-24 google cross ref
  • 26. Ravina A, Slezak L, Mirsky N, Bryden NA, Anderson RA 1999 Reversal of corticosteroid-induced diabetes mellitis with supplemental chromium [Diabet Med] Vol.16 P.164-167 google cross ref
  • 27. Ravina A, Slezak L, Mirsky N, Anderson RA 1999 Control of steroid-induced diabetes with supplemental chromium [The Journal of Trace Elements in Experimental Medicine] Vol.12 P.375-378 google cross ref
  • 28. Mertz W, Abernathy CO, Olin SS 1994 Risk assessment of essential elements P.19-38 google
이미지 / 테이블
  • [ Table. 1 ]  Ingredients of the botanical compound used in this study
    Ingredients of the botanical compound used in this study
  • [ Table. 2 ]  General characteristics and conditions before treatment
    General characteristics and conditions before treatment
  • [ Table. 3 ]  Clinical symptom scoring (integral value, mean ± SD)
    Clinical symptom scoring (integral value, mean ± SD)
  • [ Table. 4 ]  Changes in clinical symptoms
    Changes in clinical symptoms
  • [ Table. 5 ]  Fasting blood sugar levels before and after treatment (mg/dl, mean ± SD)
    Fasting blood sugar levels before and after treatment (mg/dl, mean ± SD)
  • [ Table. 6 ]  Post-prandial blood glucose changes (mg/dl, Mean ± SD)
    Post-prandial blood glucose changes (mg/dl, Mean ± SD)
  • [ Table. 7 ]  Evaluation of glycosuria and urine ketone before and after treatment (mean ± SD)
    Evaluation of glycosuria and urine ketone before and after treatment (mean ± SD)
  • [ Table. 8 ]  Analysis of body weight, blood pressure, heart rate, routine blood, stool/urine and blood biochemical index before and after treatment (mean ± SD)
    Analysis of body weight, blood pressure, heart rate, routine blood, stool/urine and blood biochemical index before and after
treatment (mean ± SD)
  • [ Table. 9 ]  Trail screening rate
    Trail screening rate
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