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   Jul 29

Anti-diabetic Activity of Ayurveda Herbs – A Review

Abstract

Ayurveda is an ancient system of health and life, originated in India. A couple of well documented texts are
available containing information regarding the fitness, longevity of life and for the treatment of various diseases.
Diabetes mellitus (DM) is the commonest endocrine disorder that affects more than 100 million people worldwide
(6% of the population)(WHO/Acadia, 1992). It is caused by the deficiency or ineffective production of insulin by
pancreas which results in increase or decrease in concentrations of glucose in the blood. It is found to damage many
of the body systems, particularly the blood vessels and nerves. Many herbal plants with hypoglycemic prop­erties
are known from across the world. Ayurveda refers the term “Madhumeha” for the Diabetes. Diabetes is an important
human ailment afflicting many from various walks of life in different countries. In India it is proving to be a major
health problem, especially in the urban areas. Major texts of Ayurveda the Charaka Samhita, Sushruta Samhita and
Ashtang Sangraha refers anti diabetic herbs.

Although there are a number of hypoglycemic agents available, but they don’t span a total control over the blood
glucose levels over long periods of time and are accompanied by many side effects. Along with it, there are various
approaches to reduce the ill effects of diabetes and its secondary complications, herbal formulations are preferred
due to lesser side effects and low cost. Researches conducted in the last few decades on plants, mentioned in ancient
literature or used traditionally for diabetes, have shown anti­diabetic property.Trigonella foenumgraecum, Momor­
dica charantia, Tinospora cordifolia, Enicostema littorae, Gymnema sylvestre, Azadirachta indica, Syzigium cumini
are some of the most effective and the most commonly studied Indian plants in relation to diabetes. Based on
possible mechanism of action, antidiabetic plants reported in Ayurveda have been classified and described in this
article.

One of the etiologic factors implicated in the development of diabetes and its complications is the damage induced
by free radicals and hence an anti­diabetic compound with antioxidant properties would be more beneficial.
Therefore information on antioxidant effects of these anti diabetic medicinal plants is also included. Further to,
attempt has been made to explore the scientific evidences with the available references which may prove that the
ancient Acharyas were very advance for the uses of herbs for the health care.
Keywords: Ayurveda, Diabetes mellitus; hypoglycemic; ant diabetic plants; Active chemical constituents;
pharmacognosy. Havisha, Dakshaprajapati

Introduction

The word diabetes was coined by the Greek physician Aerestaeus in the first century A.D. In the 17th century,
Willis observed that the urine of diabetics as wonderfully sweet as if imbued with honey or sugar. The presence of
sugar in the urine of diabetics was demonstrated by Dobson in 1755 (Satoskar, 1999).

Diabetes mellitus has been known since ages and the sweetness of diabetic urine has been mentioned in Ayurveda by
Charaka and Sushruta. Ayurveda named the Diabetes as the term Madhumeha under the chapter of 20 types of
Prameha, means “Presence of Sugar in Urine”. (Charak Samhita)

In the last few years there has been an exponential growth in the field of herbal medicine and these drugs are
gaining popularity both in developing and developed countries because of their natural origin and less side effects.
Many traditional & complementary medicines in use are derived from medicinal plants, minerals and organic
matter. (Grover J.K, et all. 2002) A number of medicinal plants refers Ayurveda from the time immemorial named
Rasayana, whichare said good for the longevity of life and to develop immunity of human body. (Scartezzini P.,
Sproni E, 2000 ) In Indian systems of medicine most practitioners formulate and dispense their own recipes. The
World Health Organization (WHO) has listed 21,000 plants, which are used for medicinal purposes around the
world. Among these 2500 species are in India, out of which 150 species are used commercially on a fairly large
scale. India is the largest producer of medicinal herbs and is called as botanical garden of the world. (Seth S.D.,
Sharma B., 2004)

Diabetes mellitus

Diabetes is a chronic disorder of carbohydrate, fat and protein metabolism characterized by increased fasting and
post prandial blood sugar levels. The global prevalence of diabetes is estimated to increase, from 4% in 1995 to
5.4% by the year 2025. WHO has predicted that the major burden will occur in developing countries? Studies
conducted in India in the last decade have highlighted that not only is the prevalence of diabetes high but also that it
is increasing rapidly in the urban population. WHO has predicted that the major burden will occur in developing
countries? Studies conducted in India in the last decade have highlighted that not only is the prevalence of diabetes
high but also that it is increasing rapidly in the urban population. It is estimated that there are approximately 33
million adults with diabetes in India. This number is likely to increase to 57.2 million by the year 2025.

Diabetes mellitus is a complex metabolic disorder resulting from either insulin insufficiency or insulin dysfunction.
(Ramachandran A., Snehalatha C., Viswanathan V, 2002 ) Type I diabetes (insulin dependent) is caused due to
insulin insufficiency because of lack of functional beta cells. Patients suffering from this are therefore totally
dependent on exogenous source of insulin while patients suffering from Type II diabetes (insulin independent) are
unable to respond to insulin and can be treated with dietary changes, exercise and medication. Type II diabetes is the
more common form of diabetes constituting 90% of the diabetic population.

Symptoms for both diabetic conditions may include: (a) high levels of sugar in the blood; (b) unusual thirst; (c)
frequent urination; (d) extreme hunger and loss of weight; (e) blurred vision; (vi) nausea and vomiting; (f) extreme
weakness and tiredness; (g) irritability, mood changes etc. Though patho­physiology of diabetes remains to be fully
understood, experimental evidences suggest the involvement of free radicals in the pathogenesis of diabetes and
more importantly in the development of diabetic complications. (Oberlay L.W. & Lipinski B., 2001)

For the development of diabetic complications, the abnormalities produced in lipids and proteins are the major
etiologic factors. In diabetic patients, extra­cellular and long lived proteins, such as elastin, laminin, collagen are the
major targets of free radicals. These proteins are modified to form glycoproteins due to hyperglycemia. The
modification of these proteins present in tissues such as lens, vascular wall and basement membranes are associated
with the development of complications of diabetes such as cataracts, microangiopathy, atherosclerosis and
nephropathy.
(Glugliano D., Ceriello A., 1996 )

There are also multiple abnormalities of lipoprotein metabolism in very low density lipoprotein (VLDL), low
density lipoprotein (LDL), and high density lipoprotein (HDL) in diabetes. Lipid peroxidation is enhanced due to
increased oxidative stress in diabetic condition. Apart from this, advanced glycation end products (AGEs) are
formed by non­enzymatic glycosylation of proteins. AGEs tend to accumulate on long­lived molecules in tissues and
generate abnormalities in cell and tissue functions. (Brownlee M. 1996, Elgawish A., Glomb, et all, 1999)
In addition, AGEs also contribute to increased vascular permeability in both micro and macrovascular structures by
binding to specific macrophage receptors. This results in formation of free radicals and endothelial dysfunction.
AGEs are also formed on nucleic acids and histones and may cause mutations and altered gene expression. As
diabetes is a multifactor disease leading to several complications, and therefore demands a multiple therapeutic
approach. Patients of diabetes either do not make enough insulin or their cells do not respond to insulin. In case of
total lack of insulin, patients are given insulin injections. Whereas in case of those where cells do not respond to
insulin many different drugs are developed taking into consideration possible disturbances in carbohydrate­
metabolism. Although several therapies are in use for treatment, there are certain limitations due to high cost and
side effects such as development of hypoglycemia, weight gain, gastrointestinal disturbances, liver toxicity etc. (Dey
L., Anoja S.A., Yuan C­S, 2002)

Based on recent advances and involvement of oxidative stress in complicating diabetes mellitus, efforts are on to
find suitable anti­diabetic and antioxidant therapy. Medicinal plants are being looked up once again for the treatment
of diabetes. Many conventional drugs have been derived from prototypic molecules in medicinal plants. The World
Health Organization Expert Committee on diabetes has recommended that traditional medicinal herbs be further
investigated, including Ayurveda, Chinese system of medicine, etc. Major hindrance in amalgamation of herbal
medicine in modern medical practices is lack of scientific and clinical data proving their efficacy and safety. There
is a need for conducting clinical research in herbal drugs, developing simple bioassays for biological standardization,
pharmacological and toxicological evaluation, and developing various animal models for toxicity and safety
evaluation. It is also important to establish the active component/s from these plant extracts.
Although from a clinical standpoint this may be true, our increasing knowledge of the pathophysiology of the
syndrome, together with the mechanisms of long­ term complications, has placed diabetes research at the frontier of
immunology and molecular biology (Debra­Haire­Joshu, 1991).

There are different approaches to the treatment of diabetes, like insulin treatment in type 1 diabetes: Sul­
phonylureas, which release insulin from pancreas by blocking the ATP­sensitive potassium channels (Aslam, 2002);
Biguanides, which decrease the insulin resis­tance; Thizaolidinediones, which increase the insulin sensitivity; alpha­
glucodase inhibitors like acarbose, which decrease glucose absorption from intestine, the­reby decreasing
postprandial hyperglycemia; metigli­nides like repaglimide and nateglamide, which are insu­lin secretogogues.

Herbal Remedies & Importance of Ayurveda Herbs

Many of the herbs and spices used by humans to season food yield useful medicinal compounds (Lai & Roy, 2004).
. The use of herbal medicines in the right way provides effective and safe treatment for many ailments. The
effectiveness of the herbal medicines is mostly subjective to the patient. The potency of the herbal medicines varies
based on the genetic variation of the herbs, growing conditions of the herbs, timing and method of harvesting of the
herbs, exposure of the herbs to air, light and moisture, and type of preservation of the herbs. Herbal medicines can
be used for healing purposes and to promote wellness.

Herbal medicines are often used as therapeutic remedies in combination with allopathic drugs (Ramesh, 2003). Most
of the doctors did not report any complication, but nausea, vomiting, gastric problems were the common adverse
effects reported with PHFs (Poly­herbal formulations). Usually ayurvedic drugs are being used due to their
minimum toxicity (Babara, 1993).

As per ancient literature, more than 800 plants are reported to have anti­diabetic properties (Eddouks M, Maghrani
M. , 2004 ) . Ethnopharmacological surveys indicate that more than 1200 plants are used in traditional medicine for
their alleged hypoglycemic activity (Kesari A N,et all, 2007) . Medicinal plants, since times immemorial, have been
used in virtually all cultures as a source of medicine. A study of ancient literature indicates that diabetes was fairly
well known and well conceived as an entity in ancient India. The knowledge of the system of diabetes mellitus, as
the history reveals, existed with the Indians since prehistoric age. Its earliest reference (1000 BC in the Ayurvedic
literature) is found in mythological form where it is said to have originated by eating Havisha, (Latha M, Pari L,
2003) a special food, which used to be offered at the times of yagna organized by Dakshaprajapati. The basis
prescription of Ayurvedic drugs was mainly found to be past experience of the patients.

In present paper is an attempt made to explore the Ayurveda plants which show inhibitory effect of glucose
utilization and are in use as anti­diabetic agents. Hence, the present study was performed with the aim of producing
an inventory of the plants used to treat diabetes, simultaneously also included those plants which are scientifically
justified as anti­ diabetic agents.

Ayurveda medicinal plants with anti­diabetic and other beneficial properties

Plant Name

Ayurvedic/common Anti­diabetic and other beneficial effects proved References
name/
scientifically

Acacia arabica: Babbul Hypoglycemic effect by initiating release of ( Wadood A., et all, 1989 )
insulin from pancreatic beta cells
Aegle , Bael or Bilva Hypoglycemic activity (Karunanayake E.H. et all,
marmelos 1984)
Aloe vera  Gwarpatha Hypoglycemic activity
and  or Ghritkumari Azadirachta Neem Anti­diabetic activity, apart from this plant also (Biswas K., et all, 2002 )
Aloe indica: has anti­bacterial, antimalarial, antifertility,
barbadensis hepatoprotective and antioxidant effects
Annona Sitaphal Hypoglycemic and antihyperglycemic activities (Kaleem M. et all, 2006 &
squamosa of ethanolic leaf­extract, Increased plasma insulin Gupta R K, et all, 2005)
level

Artemisia
pallens
Davana
Areca catechu Pugi/Supari
Hypoglycemic, increases peripheral glucose (Subramonium A., et all,
utilization or inhibits glucose reabsorption 1996 )
Hypoglycemic (Chempakam B. 1993 )
Boerhavia
diffusa
Punarnava
Increase in hexokinase activity,decrease in
glucose­6­phosphatase and fructose bis­
phosphatase activity, increase plasma insulin
(Pari L.,2004 & Sateesh M A
2004)
level, antioxidant
Bombax ceiba Semul or Shalmali Hypoglycemic

Palasha
(Saleem R.,et all, 1999 )
Hypoglycemic
(Somani R., et all, 2006 )
Butea
monosperma
Avartaki Antihyperglycemic (S. J. Surana, et all, 2008 )
Capparis Karir or Kair Hypoglycemic, antioxidant, hypolipidaemic (Agarwal V.,
decidua
Chauhan B.M. 1988 )
Coccinia Bimbi Hypoglycemic (Kamble S.M.,et all,
Cassia
auriculata Linn
indica
Emblica
officinalis
1998)
Amla, Dhatriphala, Decreases lipid peroxidation, antioxidant,
a constituent of
Hypoglycemic
herbal formulation,
“Triphala”

1.  Bhattacharya
A, et all
1999,b.
Kumar K C S
, et all, 1999,
c.
Bhattacharya
A, et all,
1995)
Enicostema Krimihrita
littorale
Increase hexokinase activity, Decrease glucose 6­ (a) Maroo J., et all,
phosphatase and fructose 1,6 bisphosphatase
2003, b. Vijayvargia
activity. Dose dependent hypoglycemic activity R. et all, 2000)
Eugenia Indian gooseberry, Antihyperglycemic effect, Inhibits insulin (Acherekar S., et all,
jambolana jamun, Jambu
activity from liver and kidney 1991)
Ficus Vat/ Burgad (Augusti K.T., et all,
Hypoglycemic, antioxidant
bengalenesis 1994)

Gymnema
sylvestre
Gudmar
or Meshashringi
Anti­hyperglycemic effect, hypolipidemic

1.  Chattopadhyay
R.R, 1999, b.
Preuss H.G.,
et all, 1998)
Hemidesmus
Sariva/Anantamul Anti snake venom activity, anti­inflammatory,
(Alam M.I., Gomes
A. 1998)

indicus Hypoglycemic
Hibiscus rosa­ Gudahal or Japa Initiates insulin release from pancreatic beta cells (Sachadeva A.,
sinesis Khemani L.D, 1999)
Hypoglycemic activity
Hollarhena (P. Chandar – 2006)
antidisentrica Kutaj
Momordica Karela Hypoglycemic, hypolipidemic
cymbalaria
(Rao B.K. et all,
1999)
Murraya Curry patta, Hypoglycemic, increases glycogenesis and
(Khan B.A.,, et all,
koenigii Meetha Neem decreases gluconeogenesis and glycogenolysis
1995)
Swertia Chiraita Stimulates insulin release from islets
chirayita
(Saxena A.M., et all,

1993)
Syzygium Shaha ­ jira Hypoglycemic and antihyperglycemic
alternifolium
(Rao B.K., Rao C.H.,

2001 )
Terminalia Behada Antibacterial, Hypoglycemic
belerica
(Sabu M.C., Kuttan

R, 2002 )
Terminalia Haritaki or Harad Antibacterial, Hypoglycemic
chebula
(Sabu M.C., Kuttan

R., 2002)
Vinca rosea Sadabahar Anti­hyperglycemic
(Chattopadhyay S.R,

et all, 1991 )
Withania Ashvagandha, Hypoglycemic, diuretic and hypocholesterolemic (Adallu B., Radhika
somnifera Winter cherry
B. , 2004 )

CONCLUSION

All the Ayurveda Herbs discussed in this review have exhibited significant clinical & pharmacological activity. The
potency of herbal drugs is significant & they have negligible side effects than the synthetic anti­diabetic drugs.

There is increasing demand by patients to use the natural products with anti­diabetic activity.

In recent times there has been renewed interest in the plant remedies. Plants hold definite promises in the
management of Diabetes mellitus. Isolation & identification of active constituents from these plants, preparation of
standardized dose & dosage regimen can play a significant role in improving the hypoglycemic action. Thus, it can
be concluded that the herbs for diabetes have been followed all over the World successfully. Herbs are used to
manage Type 1 and Type II diabetes and their complications. The above­mentioned plants have been considered for
their possible hypoglycaemic actions and the researchers have carried out some preliminary investigations.

Scientific validation of several Ayurveda plant species has proved the efficacy of the botanicals in reducing the
sugar level. However, there are numerous other plants still await scientific inquiry, which have mentioned in the
Ayurveda A large number of plants, screened for their anti­diabetic effect, have yielded certain interesting leads as
mentioned above, but till to date no plant­based drug has reached such an advanced stage of investigation or
development as to substitute or reduce the need for the currently­available oral synthetic drugs.

However, the interest in herbal drug research continues with an expectation that some day or the other, the mankind
would be able to bring a safer and more effective compound with all the desired parameters of a drug, that could
replace the synthetic medicines for the treatment of Diabetes.

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Source: Food Consumer

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