Natural resources in the treatment of diabetes mellitus

Despite all the therapeutic advances, diabetes remains a significant cause of mortality and morbidity worldwide. There are many substances available to maintain and cure diabetes, but no complete recovery from diabetes has been reported.

By Maria Daud*1̽, Wafa Majeed1, Ambreen Mehmood Awan1, Mahnoor syed1,

Introduction:

Different synthetic substances such as medicinal herbs with hypoglycemic activity are identified all over the world, which has aroused great interest among researchers in this regard to study various plants with medicinal properties. Generally, pharmacological therapy for diabetes mellitus incorporates insulin and a hypoglycemic substance taken by mouth. There is a growing need for the production of antidiabetic agents and other dietary modulators with antidiabetic potential. This tendency is due to the fact that insulin cannot be used orally and its repeated infusions have serious adverse effects.

Additionally, some oral hypoglycemic agents are not potent in controlling diabetes in patients with chronic conditions. Thus, ethnobotanicals reported about 800 therapeutic plants used to control diabetes mellitus. Various plants including vegetables are normally eaten in India and different parts of the world; many of them are said to have anti-diabetic potential. Many plants such as Allium sativum, Momordica charantia, Ocimum sanctum and Azadirachta indica are said to have antidiabetic potential. These plants have a strong hypoglycemic activity; however, their impact on oxidative stress in diabetes mellitus has not been fully investigated (Chandra et al., 2007).

Plants, the primary source of carbohydrates, proteins, amino acids, minerals and other essential vitamins, are not only used as food, but also a source of fiber and raw materials for industry. Along with this, plants are also important for their medicinal value. Since ancient times, approximately 40,000 to 100,000 plants have served humans for medicinal purposes (Aasim et al., 2018).

Plants have always been an exemplary source of medicines and many of the medicines currently available are derived directly or indirectly from them (Grover et al., 2002). Of the reported benefits for the curative uses of plants, their efficacy, ease of access, health benefits, and economy are the most notable. And because of these benefits, herbal medicines are actively used by practitioners in their daily medical practices (Parakesh et al., 2005). These beneficial medicinal effects of plant materials generally result from the combinations of secondary products present in the plant (Pattanayak et al., 2010). of interest has been developed in conventional medicine to treat diabetes.

WHO Exploration:

The WHO declared in 1980 that new ways of treating diabetes should be explored (Al-Hader et al., 1993). About 800 plants have been reported by World Ethnobotanical Information to relieve and manage diabetes (Alarcon-Aguilara et al., 1998). The history of the treatment of diabetes with medicinal plants is very old and originates from the Ebers papyrus of 1550 BC (Kumar et al., 2011). A large number of herbs and other plant materials are reported worldwide for the treatment of diabetes (Bailey et al., 1989). The hypoglycemic agents present in these medicinal plants are a powerful source for developing new therapeutic avenues and a dietary complement to existing ones (Kumar et al., 2011). The anti-diabetic potential of a few herbs has been supported by scientific data, showing that in different societies herbal treatments have been used to treat diabetes since the past (Edoga et al., 2013).

Rising cases of diabetes mellitus worldwide, there has been targeted use of plant-derived polyphenols to prevent the onset and development of diabetes mellitus and its associated complications. Aspalathus linearis, commonly known as rooibos, is a rare glycosylated herb containing polyphenols with different functions including curing diabetes mellitus (Saski et al., 2018).

A number of plants have been used as traditional medicine for the treatment of various diseases since ancient times. Medicinal plant Curcuma longa, the common name of the plant is turmeric, used as a spice, belonging to the Zingiberaceae family. Piper nigrum also used as a spice commonly known as black pepper belonging to the family Piperaceae. Dates belonging to the Arecaeae family, scientifically known as Phoenix dactylifera, are all known for their effect on glucose regulation among all the activities they perform (Khaliq et al., 2016).

Diabetes is the most life-threatening and non-infectious prevalent metabolic disease. Ocimum sanctum extract increases intracellular calcium levels in pancreatic beta cells and improves insulin secretion (Rao et al., 2013). Most plants contain terpenoids, alkaloids, carotenoids, glycosides, flavonoids and have hypoglycemic potential. Hypoglycemic substances improve pancreatic functions and increase insulin discharge from pancreatic beta cells (Kooti et al., 2016). Sixty percent of the total population using therapeutic herbs and a specific number of therapeutic herbs reported to have anti-diabetic potential. These therapeutic herbs include Allium sativum, Momordica charantia, Phyllanthus amarus, Eugenia jambolana, Withania somnifera, Pterocarpus marsupium, Ocimum sanctum, Tinospora cordifolia and Trigonella foenum graecum (Pal et al., 2016).

Dietary supplement:

Many herbs and nutritional supplements that have been used to treat DM are vanadium, l-carnitine, chromium, and vitamin E. The mode of action of these compounds in lowering glucose includes activating the glycogenesis, hepatic glycolysis, potassium channel blocking action of pancreatic beta cells. , modulation of glucose uptake from the intestine and activation of cyclic AMP (Gubta et al., 2017). The Tabernaemontana divaricata plant is a coomon shrub found in tropical regions and previously reported to have medicinal properties. Ethnobotanical studies have shown its pharmacological activities due to the presence of alkaloid and non-alkaloid constituents. Due to the presence of these phytochemical constituents, the T.divaricata plant is said to have antioxidant, anti-inflammatory, antitumor, analgesic, and cholinergic properties. This plant would have a therapeutic potential against Alzheimer’s disease and myasthenia gravis (Pratchayasakul et al., 2008).

After a few years, the plant T. divaricata reported antimicrobial activity against infections caused by wounds or burns (Ashikur et al., 2011). Plant extract tested against gram negative and gram positive bacteria including Klebsiella species, Staphylocoocus aureus, E.coli and Bacillus cereus (Thombre et al., 2013). The anti-fertility activity of T. divaricata was reported in 2009 and this study found that the plant is used for family planning. In previous literature, the presence of phytosterols, alkaloids, flavonoids, amino acids, conophyllin 17-beta estradiol has been reported. Phytochemical analysis of the ethanolic extract of the plant showed the presence of glycosides, flavonoids, alkaloids, tannins, carbohydrates and steroids. Significant estrogenic activity was monitored in the control group when rats gained uterine weight (Jain et al., 2010).

Future outlook:

Hundreds of indigenous plants have been used for the treatment of many diseases and according to WHO data, eighty percent of the world’s population uses herbal treatments. People living in developing countries cannot take advantage of modern pharmaceutical treatments because they are very expensive. Treatment with herbal medicines is always famous for people who want cost-effective therapies. In the United States, approximately twenty-five percent of modern drugs have been derived from botanical origin. The antidiabetic and cytotoxic potential of the plant T. divaricata was reported in 2011 as the plant significantly lowered blood glucose levels and showed low cytotoxic potential in mice (Rahman et al., 2012).

Authors: Maria Daud*1̽, Wafa Majeed1, Ambreen Mehmood Awan1, Mahnoor syed1,

1Institute of Pharmacy, Physiology and Pharmacology, University of Agriculture, Faisalabad, Pakistan

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