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Nutrimartus
ANTI-DIABETIC
GYMNEMA SYLVESTRE
Written by Dr. Kumar Pati
Courtesy extracted from Herbal World
According to Dr. Baskaran and Dr. Ahamath, of the Department of
Biochemistry, Post-Graduate Institute of Basic Medical Sciences, Madras,
India, the therapeutic properties of Gymnema sylvestre, 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. Gymnema sylvestre, (400 mg/day) was administered for 18-20 months
as a supplement to the conventional oral drugs.
During Gymnema sylvestre supplementation, the patients showed a
significant reduction in blood glucose, glycosylated haemolglobin 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
Gymnema sylvestre alone. These data suggest that the beta cells may be
regenerated/repaired in Type-2 diabetic patients on Gymnema sylvestre
supplementation. This is supported by the appearance of raised insulin
levels in the serum of patients after Gymnema sylvestre supplementation.
Type-2 NIDDM, (non-insulin dependent) diabetes mellitus, is among the most
common disorders in developed and developing countries, which report that
abnormalities of beta cell function and secretion exist in patients with
non-insulin.
Control of blood glucose on a 24-hour basis is the desired goal in the
management of diabetes mellitus, so as to prevent or delay the onset of
the secondary complications of diabetes mellitus. Dieting, physical
exercise and inclusion of dietary fibre have been used with limited
success.
Oral anti-hyperglycaemic drugs play an important role in the treatment of
Type-2 diabetes mellitus. There are two groups of oral anti-hyperglyceamic
agents available for clinical use, i.e. the sulfonylureas and biguanides.
The sulfonylureas are reported to regulate blood glucose homeostasis by
stimulating pancreatic secretion of insulin. Both have a characteristic
profile of side effects.
Many investigations of the oral anti-hyperglycemic agents of plant origin
used in traditional medicine have been conducted. One such preparation
proven effective in diabetes mellitus is an extract of the leaves of
Gymnema sylvestre.
Sushruta (6th Century B.C.) and practitioners of Ayurveda in ancient India
have recommended the use of the leaves of the 'sala saradi' group and it
has been described in Indian Medicinal Plants.
GS, an extract from Gymnema sylvestre, has been shown to regenerate the
islets of Langerhans, especially the beta cells, in both streptozotocin
and alloxan-treated rats.
GS, the water-soluble acidic fraction of an ethanol extract of the leaves
of Gymnema sylvestre, was tested by oral administration (400 mg/day,
packed in a hard gelatin capsule) to 22 Type-2 diabetic patients.
"Because of many clinical trials,
Gymnema sylvestre is used today
all over India
for treating diabetes mellitus."
Patients were enlisted for GS therapy after informed consent, and were
enlisted at various stages. All had been on conventional therapy by the
time the present study was instituted. The 22 patients were instructed to
take their conventional therapy in addition to GS capsules.
The patients were in the age group of 40 to 62 years and 3 were on
tolbutamide. The duration of diabetes varied from 1 to 12 years and the
average was 4.6 years. Blood glucose was adjusted to prevent hypoglycaemic
episodes.
Blood and urine analysis were made periodically in both groups. Venous
blood samples were drawn under fasting conditions from the patients into
tubes containing the disodium salt of ethylene diamine tetraacetic acid (EDTA)
as anticoagulant. Plasma was separated by decantation after centrifugation
of blood and sugar for the assay of glycosylated plasma proteins.
Serum insulin assay was conducted using 15 healthy adults, 15 cases of
NIDDM after 18-20 months of GS supplementation. Eight volunteers provided
a second sample 90 minute after their usual breakfast providing 600-650
calories and this was labelled in the post-prandial sample.
To assess the effectiveness of GS as an instant blood glucose lowering
agent, 12 adult healthy volunteers were administered 200 mg GS under
fasting state, after blood sampling in the morning. Blood samples were
collected 45 minutes after GS administration and blood glucose was assayed
in both samples.
"Five out of the 22 NIDDM
patients on GS supplementation
were able to discontinue
their conventional drugs
after GS supplementation."
Most of the patients reported a sense of well-being and better alertness
and less exhaustion during work, during GS supplementation. The female
patients reported that the nagging pain in their limbs disappeared within
4 weeks of GS supplementation. The blood glucose, glycosylated haemoglobin
and glycosylated plasma proteins were significantly lower after GS
supplementation. Five out of the 22 NIDDM patients on GS supplementation
were able to discontinue their conventional drugs after GS supplementation
and were able to maintain their blood glucose homeostasis with GS alone.
Blood urea, uric acid and haemoglobin levels remained in the normal range
during GS supplementation, suggesting the absence of hepato or
nephrotoxicity for GS.
It can be observed that serum insulin levels are lower than normal in
NIDDM patients on conventional drugs in both fasting and in the post-prandial
state, which provides data on glucose induced insulin release. However,
when the group on GS supplementation is compared with those on
conventional therapy alone, there is a significant elevation of serum
insulin in both the fasting and post-prandial state.
Because of many clinical trials, Gymnema sylvestre is used today all over
India for treating diabetes mellitus. In layman's language, it is called
GUR MAR. Gur means sugar and Mar means kill. So it is a powerful herbal
sugar killer for diabetes mellitus patients. In order to reduce the
symptoms of glycosuria, the dried leaves are used in various forms such as
hot tea in daily doses of three to four grams continuously. HW
