the most useful medicinal herbs to treat diabetes

14
DOI:10.15419/bmrat.v5i8.463 Review Article History: Keywords: Diabetes, Medicinal plants, Phytomedicine, Treatment Author for correspondence: Saber Abbaszadeh e-mail: [email protected] The most useful medicinal herbs to treat diabetes Behzad Moradi 1 , Saber Abbaszadeh 2,1 , Somayeh Shahsavari 3 , Mohsen Alizadeh 2,1 and Fatemeh Beyranvand 1 1 Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran 2 Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran 3 Biotechnology and Medicinal Plants Research Center, Ilam University of Medical Sciences, Ilam, Iran Biomed Press An Open Access Publisher © 2018 The Authors. Published by the BioMedPress under the terms of the Creative Commons Attribution License http://creativecommons.org/licenses/ by/4.0/, which permits unrestricted use, provided the original author and source are credited. Diabetes mellitus is a syndrome that is characterized by hyperglycemia, change in the metabolism of lipids, carbohydrates, and proteins, and in the long term, with eye, kidney, cardiovascular, and neurological complications. Plenty of plants from different regions of the world have been investigated for anti-diabetic effects. This review article was designed to report some of the most important medicinal plants with hypoglycemic properties according to reliable clinical and laboratory evidence, and also touched on the medicinal plants that are prescribed in Iranian traditional medicine, for the treatment of diabetes. The information in this review was obtained from the eligible articles retrieved using the search terms diabetes mellitus, medicinal plants, type 1 diabetes and medicinal plants, type 2 diabetes and medicinal plants, and the effect of extract and essential oil of medicinal plants affecting diabetized tissues in the human body indexed in databases such as Iran medex, Irandoc, ISI, PubMed, Scopus, SID, Magiran, Google Scholar, etc. Based on the results drawn in this review the plants, Urtica, Trigonella foenum-graecum, Allium sativum, Carthamus tinctorius, Ferula assa-foetida, Bauhinia, Gymnema sylvestre, Swertia, Combretum, Sarcopoterium, Liriope, Caesalpinia bonduc, Coccinia grandis, Syzygium cumini, Mangifera indica, Momordica charantia, Ocimum tenuiflorum, Pterocarpus, Tinospora cordifoli, Salvia officinalis, Panax, Cinnamomum verum, Abelmoschus moschatus, Vachellia nilotica, Achyranthes, Fabaceae, Mentha, Asphodelaceae, Andrographis paniculata L, Artemisia herba-alba, Artemisia dracunculus, Azadirachta indica, Caesalpinioideae, Pachira aquatic, Gongronema latifolium, Nigella Sativa, Tinospora cordifolia (guduchi), Chrysanthemum morifolium, Zingiber zerumbet, Symphytum, Cactaceae, Symplocos, Perilla frutescens, Terminalia chebula and Aloe vera are effective to controland treat diabetes. Abstract Received: 18 June 2018 Accepted: 15 July 2018 Published: 21 August 2018 Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551 Biomed. Res. Ther. 2018, 5(8): 2538-2551 2538

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Page 1: The most useful medicinal herbs to treat diabetes

DOI:10.15419/bmrat.v5i8.463

Review

Article History:

Keywords:

Diabetes, Medicinal plants,

Phytomedicine, Treatment

Author for correspondence:

Saber Abbaszadeh

e-mail:

[email protected]

The most useful medicinalherbs to treat diabetesBehzad Moradi1, Saber Abbaszadeh2,1,

Somayeh Shahsavari3, Mohsen

Alizadeh2,1 and Fatemeh Beyranvand1

1Razi Herbal Medicines Research Center, Lorestan

University of Medical Sciences, Khorramabad, Iran2Student Research Committee, Lorestan University of

Medical Sciences, Khorramabad, Iran3Biotechnology and Medicinal Plants Research Center,

Ilam University of Medical Sciences, Ilam, Iran

Biomed PressAn Open Access Publisher

© 2018 The Authors. Published by the BioMedPress under the terms of the

Creative Commons Attribution License http://creativecommons.org/licenses/

by/4.0/, which permits unrestricted use, provided the original author and

source are credited.

Diabetes mellitus is a syndrome that is characterized by hyperglycemia, change in the metabolism of lipids, carbohydrates, and proteins, and in the long term, with eye, kidney, cardiovascular, andneurological complications. Plenty of plants from different regions of the world have beeninvestigated for anti-diabetic effects. This review article was designed to report some of the mostimportant medicinal plants with hypoglycemic properties according to reliable clinical andlaboratory evidence, and also touched on the medicinal plants that are prescribed in Iraniantraditional medicine, for the treatment of diabetes. The information in this review was obtained from the eligible articles retrieved using the search terms diabetes mellitus, medicinal plants, type 1 diabetes and medicinal plants, type 2 diabetes and medicinal plants, and the effect of extract andessential oil of medicinal plants affecting diabetized tissues in the human body indexed in databases such as Iran medex, Irandoc, ISI, PubMed, Scopus, SID, Magiran, Google Scholar, etc. Based on the results drawn in this review the plants, Urtica, Trigonella foenum-graecum, Allium sativum, Carthamus tinctorius, Ferula assa-foetida, Bauhinia, Gymnema sylvestre, Swertia, Combretum, Sarcopoterium, Liriope, Caesalpinia bonduc, Coccinia grandis, Syzygium cumini, Mangifera indica, Momordica charantia, Ocimum tenuiflorum, Pterocarpus, Tinospora cordifoli, Salvia officinalis, Panax, Cinnamomum verum, Abelmoschus moschatus, Vachellia nilotica, Achyranthes, Fabaceae, Mentha, Asphodelaceae, Andrographis paniculata L, Artemisia herba-alba, Artemisia dracunculus, Azadirachta indica, Caesalpinioideae, Pachira aquatic, Gongronema latifolium, Nigella Sativa, Tinospora cordifolia (guduchi), Chrysanthemum morifolium, Zingiber zerumbet, Symphytum, Cactaceae, Symplocos, Perilla frutescens, Terminalia chebula and Aloe vera are effective to controland treat diabetes.

Abstract

Received: 18 June 2018 Accepted: 15 July 2018Published: 21 August 2018

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2538

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2539

Biomed. R

es. Ther. 2018, 5(8):2538-2551..............................................................

1. IntroductionDiabetes mellitus is a syndrome that is characterized by hyperglycemia, change in the metabolismof lipids, carbohydrates, and proteins [1]. Diabetes mellitus is the most common chronic andmetabolic disease characterized by an increase in glucose levels due to absolute or relativeinsulin deficiency. The disease is associated with eye, renal, cardiovascular, and neurologicalcomplications in the long term. This disease is also associated with symptoms such as polyuria,fatigue, weight loss, delayed wound healing, blurred vision, increases in urine glucose levels,etc. [2–4]. Destruction of beta-cells of the islets of Langerhans in the pancreas and consequentlydevelopment of insulin-dependent diabetes is one of the impairments of the regulation of theimmune system. Several environmental and genetic factors affect the immune system, leading tothe attack of lymphocytes, especially lymphocytes, and pancreatitis. This inflammatory responsemay cause insulitis and diabetes [5,6]. There are currently more than 150 million people withdiabetes across the globe, which seems to reach 300 million by 2025 [7]. In the absence ofproper treatment, cardiac, vascular, neurological, and renal damage and neuropathy may occur.Treatment includes diet, exercise, and medication [8]. Currently, the main and effective treatmentfor diabetes is the use of insulin and hypoglycemic drugs, but these compounds also have manyadverse side effects [9]. Medicinal plants have a long history of usage and today, they are beingextensively used for various diseases [10–14]. There are several reasons for increasing the useof medicinal plants. Many plants from different parts of the world have been investigated forantidiabetic effects. This review article reported some of the most important medicinal plants withhypoglycemic properties according to reliable clinical and laboratory evidence, and also touchedon the medicinal plants that are prescribed, in Iranian traditional medicine, for the treatment ofdiabetes.

2. Materials and methodsThe information in this review was obtained from the eligible articles retrieved using the searchterms diabetesmellitus, medicinal plants, type 1 diabetes and medicinal plants, type 2 diabetes andmedicinal plants, and the effect of extract and essential oil of medicinal plants affecting diabetized tissues inthe human body indexed in databases such as Iran medex, Irandoc, ISI, PubMed, Scopus, SID, Magiran,Google Scholar, etc.

3. ResultsBased on the results drawn in this review the studies, Urtica, Trigonella foenum-graecum, Allium sativum, Carthamus tinctorius, Ferula assa-foetida, Bauhinia, Gymnema sylvestre, Swertia, Combretum, Sarcopoterium, Liriope, Caesalpinia bonduc, Coccinia grandis, Syzygium cumini, Mangifera indica, Momordica charantia, Ocimum tenuiflorum, Pterocarpus, Tinospora cordifoli, Salvia officinalis, Panax, Cinnamomum verum, Abelmoschus moschatus, Vachellia nilotica, Achyranthes, Fabaceae, Mentha, Asphodelaceae, Andrographis paniculata L, Artemisia herba-alba, Artemisia dracunculus, Azadirachta indica, Caesalpinioideae, Pachira aquatic, Gongronema latifolium, Nigella Sativa, Tinospora cordifolia (guduchi), Chrysanthemum morifolium, Zingiber zerumbet, Symphytum, Cactaceae, Symplocos, Perilla frutescens, Terminalia chebula and Aloe vera are effective to control and treat diabetes. The names, families, and used parts of the medicinal plants are summarized in Tables 1, 2, 3, 4 and 5. The mechanism of the effect of these drugs is shown in Tables 6 and 7.

4. DiscussionDiabetes is a condition that is characterized by high blood sugar levels. Millions of peopleworldwide are affected by the disease. Research on diabetes is ongoing. When a person develops

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2539

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2540

. .............................................................

Tabl

e1.

Med

icin

alhe

rbs

and

ther

apeu

ticin

form

atio

nin

diab

etes

No.

Scie

ntifi

cN

ame

Part

of plan

tN

ame

Ori

gin

ofpl

ant

Cou

ntry

ofst

udy

Year

Res

ult

Ref

1U

RTI

CA

DIO

ICA

(U.

dioi

ca)

Leav

esU

rtic

acea

est

ingi

ngne

ttle

Itis

nati

veto

Euro

pe,A

sia,

nort

hern

Afr

ica

Bang

lade

shIn vivo

2009

Aqu

eous

extr

acto

fU.d

ioic

ale

afim

prov

edth

egl

ycem

iale

vels

inty

pe2

diab

etic

rats

,whi

chis

med

iate

dby

the

cent

rale

ffec

ton

the

func

tion

alst

atus

ofpa

ncre

atic

beta

-cel

ls.

[35]

2Tr

igon

ella

foen

umgr

aecu

m

Seed

Faba

ceae

fenu

gree

kIn

dian

Iran

In vivo

2005

15gr

ams

ofpo

wde

red

fenu

gree

kpr

escr

ibed

topa

tien

tsw

ith

type

IIdi

abet

esis

redu

ced

Dar

qndk

hvn

sens

e.[3

6]

3C

arth

amus

tinc

tori

usFl

ower

Com

posi

tae

Saffl

ower

Indi

a,th

eU

nite

dSt

ates

and

tonn

esan

dK

azak

hsta

n

Iran

In vivo

2016

The

hydr

oalc

ohol

icex

trac

tofC

.tin

ctor

ius

flow

erca

nbe

used

totr

eatt

ype

1an

dty

pe2

diab

etes

.The

phyt

oche

mic

alan

alys

esof

C.t

inct

oriu

sflo

wer

show

that

itis

ari

chso

urce

offla

vono

ids,

such

asqu

erce

tin

and

kaem

pfer

ol,t

hata

reth

eca

uses

ofan

tiox

idan

tand

hypo

glyc

emic

effe

cts

ofth

ese

com

poun

ds.

[37]

4Fe

rula

assa

-fo

etid

a

Gum

Api

acea

eA

safo

etid

aIr

anan

dA

fgha

nist

anIr

anIn vivo

2016

Due

toth

epr

esen

ceof

anti

oxid

antc

ompo

unds

,F.

assa

foet

ida

gum

can

redu

ceth

eam

ount

offr

eera

dica

lsin

the

cell

and

stim

ulat

eth

esy

nthe

sis

and

secr

etio

nof

insu

linin

type

2di

abet

es,a

ndhy

perp

lasi

aof

resi

dual

panc

reat

icce

llsan

dre

duce

gluc

ose

inth

ebl

ood.

[38]

5Ba

uhin

iafo

rfica

taLe

afLe

gum

inos

aeBr

azili

anor

chid

tree

Arg

enti

na,

Braz

ilan

dPe

r u

Indi

aIn vitr

o20

10

Aft

er31

days

oftr

eatm

entw

ith

deco

ctio

n,in

the

type

2di

abet

icgr

oup,

plas

ma

gluc

ose

and

urin

ary

gluc

ose

leve

lssi

gnifi

cant

lyde

crea

sed.

[39]

6G

ymne

ma

sylv

estr

eLe

afA

scle

piad

acea

eco

wpl

ant,

cent

ralI

ndia

and

SriL

anka

Indi

aIn vitr

o20

10

The

G.s

ylve

stre

crud

eex

trac

tsan

dth

eco

mpo

und

isol

ated

from

it,d

ihyd

roxy

gym

nem

ictr

iace

tate

,exh

ibit

hypo

glyc

emic

effe

ctin

rats

wit

hst

rept

ozot

ocin

-ind

uced

diab

etes

mel

litus

indo

se-a

ndti

me-

depe

nden

tman

ner.

[38]

Com

mon

Fam

ily

Nam

e

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2540

Biomed. R

es. Ther. 2018, 5(8):2538-2551

Page 4: The most useful medicinal herbs to treat diabetes

2541

Biom

ed.R

es.Ther.

2018,5(7):2349-2364

..............................................................

Tabl

e2.

Med

icin

alhe

rbs

and

ther

apeu

ticin

form

atio

nin

diab

etes

(Tab

le1

cont

inue

d)

No.

Scie

ntifi

cN

ame

Part

of plan

t

Com

mon

Nam

eO

rigi

nof

plan

tof stud

y

Res

ult

Ref

7Sw

erti

apu

nice

aW

hole

plan

t

Nam

e

Gen

tian

acea

e Sw

erti

am

uch

ofEu

rasi

aan

dw

este

rnN

orth

Am

eric

a

Indi

aIn vi

tro

2010

The

acti

onm

echa

nism

ofhy

pogl

ycem

icef

fect

ofS.

puni

cea

was

confi

rmed

byth

eim

prov

emen

tof

insu

linre

sist

ance

inth

em

ice

wit

hdi

abet

es.

[38]

8C

ombr

etum

Mic

rant

hum

Leav

esC

ombr

etac

eae

know

nas

kink

elib

ain

Beni

n,Se

nega

lan

dkn

own

as‘g

eza’

inH

ausa

Afr

ica

Indi

aIn vi

tro

2010

The

hypo

glyc

emic

acti

vity

ofth

ispl

ant’s

extr

act

was

test

edby

usin

ggl

ucos

eto

lera

nce

and

fast

ing

bloo

dsu

gar

asse

ssm

enti

nno

rmal

rats

.The

aque

ous

extr

acto

fC.m

icra

nthu

mle

afw

asha

spo

tent

iala

ntid

iabe

tic

prop

erty

for

both

type

1an

dty

pe2

diab

etes

mel

litus

.

[38]

9Sa

rcop

oter

ium

spin

osum

Roo

tR

osac

eae

S.sp

inos

umso

uthe

ast

Med

iter

rane

anre

gion

Indi

aIn vi

tro

2010

The

aque

ous

extr

acto

fS.s

pino

sum

root

may

prod

uce

anti

diab

etic

effe

cton

prog

ress

ive

hype

rgly

cem

iain

gene

tica

llydi

abet

icm

ice.

The

aque

ous

root

extr

acto

fthe

plan

tsho

ws

insu

lin-l

ike

acti

ons

inta

rget

sti

ssue

s.

[38]

10Li

riop

esp

icat

aLe

aves

Lilia

ceae

mon

key

gras

sEa

stA

sia

and

chin

aIn

dia

In vitr

o20

10

The

aque

ous

extr

acto

fthe

plan

tcau

sed

am

arke

dde

crea

seof

fast

ing

bloo

dsu

gar

leve

land

asi

gnifi

cant

impr

ovem

ento

fglu

cose

tole

ranc

ean

din

sulin

resi

stan

cein

stre

ptoz

otoc

in-i

nduc

edty

pe2

diab

etic

mic

e,co

nfirm

ing

its

hypo

glyc

emic

effe

cts.

[38]

11C

aesa

lpin

iabo

nduc

ella

Seed

sC

aesa

lpin

iace

aeG

ray

Nic

ker

indi

aIn

dia

In vitr

o20

07

The

aque

ous

and

50%

etha

nolic

extr

acts

ofC

.bo

nduc

ella

seed

show

edan

tihy

perg

lyce

mic

and

hypo

lipid

emic

acti

viti

esin

stre

ptoz

otoc

in-d

iabe

tic

rats

.Bot

hth

eaq

ueou

san

det

hano

licex

trac

tssh

owed

pote

nthy

pogl

ycem

icac

tivi

tyin

chro

nic

type

IIdi

abet

icm

odel

s.th

ean

tihy

perg

lyce

mic

acti

onof

the

seed

extr

acts

may

bedu

eto

the

bloc

kage

ofgl

ucos

eab

sorp

tion

.

[39]

12C

occi

nia

indi

caLe

aves

and

shoo

ts

Cuc

urbi

tace

aeG

ourd

Wor

ldw

ide

Indi

aIn vi

tro

2007

Ora

ladm

inis

trat

ion

of50

0m

g/kg

ofC

.ind

ica

leaf

prod

uced

sign

ifica

nthy

pogl

ycem

icef

fect

sin

allo

xan-

diab

etic

dogs

and

incr

ease

dgl

ucos

eto

lera

nce

inbo

thno

rmal

and

diab

etic

dogs

.

[39]

Cou

ntry

Yea

rFa

mil

y

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2541

Page 5: The most useful medicinal herbs to treat diabetes

2542

. .............................................................

Tabl

e3.

Med

icin

alhe

rbs

and

ther

apeu

ticin

form

atio

nin

diab

etes

(Tab

le1

cont

inue

d)

No.

Scie

ntifi

cN

ame

Nam

eO

rigi

nof

plan

tC

ount

ryO

fst

udy

Yea

rR

esul

tR

ef

13Sy

zygi

umcu

min

iSe

eds

Myr

tace

aeJa

mbo

lan

Indi

anSu

bcon

tine

ntan

dSo

uthe

ast

Asi

a

Indi

aIn vitr

o20

07

The

extr

acto

fjam

unpu

lpsh

owed

hypo

glyc

emic

acti

vity

inst

rept

ozot

ocin

-dia

beti

cm

ice

wit

hin

30m

inof

adm

inis

trat

ion

whi

leth

ese

edof

the

sam

efr

uitn

eede

d24

h.Th

ese

extr

acts

also

inhi

bite

din

sulin

ase

acti

vity

inth

eliv

eran

dki

dney

.

[39]

14M

angi

fera

indi

caLe

aves

Ana

card

iace

aem

ango

in Bang

lade

sh,

Indi

aan

dPa

kist

an

Indi

aIn vitr

o20

07

The

resu

lts

indi

cate

dth

ataq

ueou

sex

trac

tofM

.ind

ica

has

hypo

glyc

emic

acti

vity

.Thi

sm

aybe

due

toa

redu

ctio

nin

the

inte

stin

algl

ucos

eab

sorp

tion

.

[39]

15M

omor

dica

char

anti

aFr

uitp

ulp,

seed

,lea

ves

and

who

lepl

ant

Cuc

urbi

tace

aebi

tter

gour

dgr

own

inA

sia,

Afr

ica,

and

the

Car

ibbe

an

Indi

aIn vitr

o20

07

Etha

nolic

extr

acts

ofM

.cha

rant

ia(2

00m

g/kg

)sho

wed

anan

tihy

perg

lyce

mic

and

hypo

glyc

emic

effe

ctin

norm

alan

dst

rept

ozot

ocin

-dia

beti

cra

ts.

This

may

bebe

caus

eof

inhi

biti

onof

gluc

ose-

6-ph

osph

atas

ean

dfr

ucto

se-1

,6-b

ipho

spha

tase

inth

eliv

eran

dst

imul

atio

nof

hepa

tic

gluc

ose-

6-ph

osph

ate

dehy

drog

enas

eac

tivi

ties

.

[39]

16Sa

lvia

nem

oros

aAer

ialp

art

Lam

iace

as.

nem

oros

ace

ntra

lEu

rope

and

Wes

tern

Asi

a

Iran

In vitr

o13

87

Thes

eae

rial

part

sof

the

plan

ttha

tcon

tain

meg

asti

gman

egl

ycos

ide

and

salv

iono

side

caus

ea

sign

ifica

ntin

crea

sein

insu

linle

vels

indi

abet

icra

tsco

mpa

red

tohe

alth

yra

ts,a

ndis

also

resp

onsi

ble

for

inte

nse

insu

linac

tivi

ty.

[40]

17G

inse

ngR

oots

,sta

lk,

leav

es,a

ndbe

rrie

s

Ara

liace

aeA

sian

gins

eng

Nor

thA

mer

ica

and

inea

ster

nA

sia

Chi

naIn

vitr

o20

11G

inse

ngsi

gnifi

cant

lyde

crea

sed

insu

linre

sist

ance

and

fast

ing

bloo

dgl

ucos

e(F

BG)i

nT2

DM

pati

ents

.am

ong

30ca

ses

ofT2

DM

trea

ted

wit

hR

ensh

enta

ngta

i,an

inje

ctio

nco

ntai

ned

Gin

seng

poly

pept

ide

and

poly

sacc

hari

des;

86.7

%of

the

pati

ents

show

edap

prec

iabl

eef

fect

ondi

abet

icsy

mpt

oms.

[41]

18M

omor

dica

char

anti

aFr

uit

Cuc

urbi

tace

aebi

tter

mel

onA

sia

Chi

naIn

vivo

2011

Bitt

erm

elon

low

ered

fast

ing

and

post

pran

dial

seru

mgl

ucos

ele

vels

inT2

DM

pati

ents

.Bit

ter

mel

onex

erte

da

anti

hype

rgly

cem

icEf

fect

byin

hibi

tion

ofpr

otei

nty

rosi

neph

osph

atas

e1B

(PTP

1B),

acti

vati

onof

AM

PK,i

ncre

ase

ofgl

ucos

etr

ansp

orte

rty

pe4

(GLU

T4)e

xpre

ssio

n,pr

omot

ion

ofth

ere

cove

ryof

beta

cells

And

insu

lin-m

imic

king

acti

on.

[41]

Com

mon

Part

ofpl

ant

Fam

ily

Nam

e

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2542

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es. Ther. 2018, 5(8):2538-2551

Page 6: The most useful medicinal herbs to treat diabetes

2543

. .............................................................Ta

ble

4.M

edic

inal

herb

san

dth

erap

eutic

info

rmat

ion

indi

abet

es(T

able

1co

ntin

ued)

No.

Scie

ntifi

cN

ame

Part

ofFa

mil

yN

ame

Com

mon

Nam

eO

rigi

nof

plan

tC

ount

ryof stud

y

year

Res

ult

Ref

19Tr

igon

ella

foen

um-

grae

cum

Fenu

gree

kN

ear

East

and

Indi

an

Chi

naIn vi

vo20

11

Com

bine

dth

erap

yof

tota

lsap

onin

sof

Fenu

gree

kw

ith

sulf

onyl

urea

shy

pogl

ycem

icdr

uglo

wer

edth

ebl

ood

gluc

ose

leve

land

amel

iora

ted

clin

ical

sym

ptom

sin

46ca

ses

ofT2

DM

com

pare

dw

ith

23ca

ses

ofco

ntro

ls.

[41]

20A

llium

sati

vum

Bulb

Am

aryl

lidac

eaeGar

licce

ntra

lA

sia

Afr

ica,

and

Euro

pe

Chi

naIn vi

vo20

11

Gar

licha

dan

tihy

perg

lyce

mic

and

anti

hype

r-Li

pide

mic

Effe

ctin

T2D

Mpa

tien

ts.I

nth

e4-

wee

kdo

uble

-blin

ded

plac

ebo-

cont

rolle

dst

udy

in60

T2D

Mpa

tien

ts,G

arlic

low

ered

FBG

.Gar

licim

prov

edgl

ycem

icco

ntro

lthr

ough

incr

ease

din

sulin

secr

etio

nan

den

hanc

edin

sulin

sens

itiv

ity

[41]

21C

inna

mon

Who

lePl

ant

Laur

acea

eC

inna

mom

umve

rum

Asi

aan

dA

fric

aC

hina

Invi

vo20

11ci

nnam

onin

the

diet

ofpa

tien

tsw

ith

T2D

Mw

ould

redu

ceri

skfa

ctor

sas

soci

ated

wit

hdi

abet

esan

dca

rdio

vasc

ular

dise

ases

.Cin

nam

onlo

wer

edhe

mog

lobi

nA

1c(H

bA1C

)by

0.83

%co

mpa

red

wit

hus

ualc

are

alon

elo

wer

ing

HbA

1Cby

0.37

%in

pati

ents

wit

hT2

DM

ina

rand

omiz

ed,c

ontr

olle

dtr

ial.

[41]

22D

endr

obiu

mch

ryso

toxu

mae

rial

part

sor

chid

acea

eG

olde

n-bo

wD

endr

obiu

mna

tive

toSo

uthe

ast

Asi

a,

Chi

naIn vi

voan

din

vitr

o20

14

DC

alle

viat

edth

ein

crea

sed

1an

dph

osph

oryl

ated

p65,

IκB,

and

IκB

kina

se(I

KK

)in

diab

etic

rats

.The

refo

re,

DC

can

alle

viat

eD

Rby

inhi

biti

ngre

tina

linfl

amm

atio

nan

dpr

even

ting

the

decr

ease

ofti

ghtj

unct

ion

prot

eins

,su

chas

occl

udin

and

clau

din-

1.

[42]

23Z

ingi

ber

zeru

mbe

tro

otZ

ingi

bera

ceae

Bitt

ergi

nger

Asi

aan

din

dia

Taiw

anIn vi

tro

2015

Zin

gibe

rze

rum

bet’

rhiz

ome

etha

nole

xtra

cts

(ZZ

Rex

t)A

fter

thre

em

onth

sof

diab

etes

,the

wei

ghtg

ain

inST

Z-d

iabe

tic

rats

was

sign

ifica

ntly

less

whe

nco

mpa

red

wit

hno

rmal

rats

,and

the

bloo

dgl

ucos

ele

vels

wer

esi

gnifi

cant

lyhi

gher

The

redu

ctio

nin

body

wei

ghtw

asno

tobv

ious

inST

Z-d

iabe

tic

rats

rece

ivin

gZ

ZR

extd

urin

gth

eex

peri

men

talp

erio

d.

[43]

24K

aem

pfer

iapa

rvifl

ora

root

Z

ingi

bera

ceae

(KP)

or

Kra

chai

dum

belo

ngs

orTh

aigi

nsen

gs

in Thai

land

Thai

land

In vitr

o20

17

KP

(Kae

mpf

eria

parv

iflor

a)t

reat

men

tdem

onst

rate

da

sign

ifica

ntre

cove

ryof

sexu

albe

havi

our

and

seru

mte

stos

tero

nele

vels

indi

abet

icra

ts.

[44]

plan

t Le

aves

Faba

ceae

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2543

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es. Ther. 2018, 5(8):2538-2551

Page 7: The most useful medicinal herbs to treat diabetes

2544

. .............................................................Ta

ble

5.M

edic

inal

herb

san

dth

erap

eutic

info

rmat

ion

indi

abet

es(T

able

1co

ntin

ued)

No.

Scie

ntifi

cN

ame

Part

ofpl

ant

Nam

eN

ame

Ori

gin

ofpl

ant

Cou

ntry

Yea

rR

esul

tR

ef

25O

punt

iam

egac

anth

aleav

esC

acta

ceae

culin

ary

Sout

hA

fric

aan

dSo

uth

Am

eric

a

ofst

udy

Zim

babw

e1999

invi

tro

Adm

inis

trat

ion

ofth

ele

afex

trac

twas

also

asso

ciat

edw

ith

anin

crea

sed

GFR

inST

Z-d

iabe

tic

rats

.alt

houg

hth

era

tew

asun

alte

red

inno

n-di

abet

icra

ts.

[45]

26Sy

mpl

ocos

cocc

inea

Seed

and

leav

es

Sym

ploc

acea

een

dem

icto

Mex

ico

Indi

aIn

vitr

o20

14Bu

tSC

E(h

ydro

etha

nolE

xtra

ctof

Sym

ploc

osco

chin

chin

ensi

s)A

dmin

istr

atio

nre

sult

edin

alo

wer

plas

ma

leve

lofu

rea

and

crea

tini

nein

trea

ted

grou

psco

mpa

red

toth

edi

abet

icco

ntro

lgr

oup

This

Show

spr

otec

tive

prop

erty

ofSC

EA

gain

stre

nal

dam

age.

[46]

27pe

rilla

Leav

esLa

mia

ceae

"per

illa"

Am

eric

aan

dA

sia

and

Euro

peJa

pan

In vivo

2005

The

flavo

noid

lute

olin

from

peri

llalu

teol

intr

eatm

ent

prev

ente

dth

ede

velo

pmen

tofd

iabe

tic

neph

ropa

thy

bysi

gnifi

cant

lylo

wer

ing

BUN

and

crea

tini

nein

diab

etic

anim

als.

This

coul

dbe

expl

aine

dth

atth

ere

was

incr

ease

dcl

eara

nce

ofbl

ood

urea

and

crea

tini

neby

the

kidn

eyor

that

ther

ew

asde

crea

sed

prot

ein

degr

adat

ion.

Mor

eove

r,lu

teol

inal

sopr

even

ted

the

incr

ease

in24

-hur

eapr

otei

nin

diab

etic

rats

.

[47]

28A

llium

sati

vum

Seed

Am

aryl

lidac

eaeG

arlic

Chi

naan

dco

mm

onse

ason

ing

wor

ldw

ide.

Iran

Invi

tro

2016

Gar

licex

trac

thas

the

oppo

site

effe

cton

the

rena

lfun

ctio

nm

arke

rsan

dhi

stop

atho

logy

ofdi

abet

icra

ts.S

ince

hype

rgly

caem

iaca

uses

the

diab

etic

com

plic

atio

ns,c

ompo

unds

that

have

hypo

glyc

aem

icef

fect

sca

nbe

effe

ctiv

ein

redu

cing

ofdi

abet

icco

mpl

icat

ions

such

asre

nald

ysfu

ncti

on.

[48]

29Te

rmin

alia

cheb

ula

seed

sC

ombr

etac

eaec

hebu

licm

yrob

alanSo

uth

Asi

afr

omIn

dia

and

Nep

alea

stto

sout

hwes

tC

hina

Can

ada

Invi

tro

2006

T.ch

ebul

ais

mor

eef

fect

ivel

yin

hibi

ted

the

inci

denc

eof

diab

etic

neph

ropa

thy.

Dia

beti

cne

phro

path

yis

mai

nly

asso

ciat

edw

ith

exce

ssur

inar

yal

bum

inex

cret

ion,

abno

rmal

rena

lfun

ctio

nas

repr

esen

ted

byan

abno

rmal

ity

inse

rum

crea

tini

ne.

[49]

30A

loe

vera

.Bu

rm

leaf

Asp

hode

lace

aeA

loe

vera

arou

ndth

ew

orld

Turk

eyIn

vitr

o20

03th

efu

ncti

onan

dst

ruct

ure

ofki

dney

may

beaf

fect

edby

chan

ges

inth

ele

vels

ofin

sulin

Dia

beti

cki

dney

exhi

bits

char

acte

rist

icch

ange

sle

adin

tore

nali

nsuf

ficie

ncy

orco

mpl

ete

kidn

eyfa

ilure

.The

maj

oral

tera

tion

was

obse

rved

espe

cial

lyin

the

prox

imal

tubu

les

ofth

eki

dney

tiss

uein

the

diab

etic

anim

als.

The

rupt

urin

gof

the

brus

hbo

rder

,sho

ws

that

the

stru

ctur

alin

tegr

ity

ofth

em

embr

ane

was

disr

upte

d.

[50]

Fam

ily

Com

mon

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2544

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es. Ther. 2018, 5(8):2538-2551

Page 8: The most useful medicinal herbs to treat diabetes

2545

. .............................................................

Tabl

e6.

Ant

idia

betic

mec

hani

smac

tivity

ofm

edic

inal

herb

s

Scie

ntifi

cN

ame

Mec

hani

smR

ef.

UR

TIC

AD

IOIC

A(U

.dio

ica)

The

aque

ous

UD

extr

actp

lays

anim

port

antr

ole

byim

prov

ing

the

mor

phol

ogy

and

/or

func

tion

ofbe

tace

lls.P

reve

ntin

gda

mag

eto

beta

-cel

lcel

ls,r

epai

rda

mag

edbe

tace

lls,r

ebui

ldin

gne

wce

lls,a

ndst

imul

atin

gin

sulin

secr

etio

nin

func

tion

alce

llsis

one

ofth

em

echa

nism

sof

acti

onof

the

extr

acto

fthi

spl

ant

[35]

Trig

onel

lafo

enum

grae

cum

The

ther

apeu

tic

effe

ctof

fenu

gree

kse

edon

diab

etes

isat

leas

tpar

tly

due

toth

edi

rect

stim

ulio

fan

amin

oac

idca

lled

hydr

oxys

olec

uine

-4on

insu

linse

cret

ion

from

beta

cells

.Fol

low

ing

cell

dam

age,

the

acti

vity

ofC

aA

TPas

ean

dN

a/

KA

TPas

epu

mps

decr

ease

sth

eco

nsum

ptio

nof

fenu

gree

kse

eds

byre

duci

ngth

efr

eera

dica

ls,e

limin

atin

gth

ese

diso

rder

s.

[36]

Car

tham

usti

ncto

rius

The

rich

sour

ceof

flavo

noid

s,su

chas

quer

ceti

nan

dca

mph

orol

,is

linke

dto

its

anti

oxid

anta

ndhy

pogl

ycem

icac

tivi

ty.

[36]

Feru

laas

sa-f

oeti

daD

ueto

the

pres

ence

ofan

tiox

idan

tcom

poun

ds,g

umca

nre

duce

the

amou

ntof

intr

acel

lula

rfr

eera

dica

lsan

dst

imul

ate

the

synt

hesi

san

dse

cret

ion

ofin

sulin

orhy

perp

lasi

aof

the

rem

aini

ngbe

tace

llsin

the

panc

reas

.Ant

hocz

one

gum

may

redu

cebl

ood

gluc

ose

byst

imul

atin

gth

esy

nthe

sis

and

secr

etio

nof

insu

linan

dhy

perp

lasi

aof

the

rem

aini

ngbe

tapa

ncre

atic

beta

cells

.

[37]

Bauh

inia

forfi

cata

Itis

rich

inpo

lyph

enol

ican

tiox

idan

tcom

poun

ds,fl

avon

oids

,whi

chre

duce

bloo

dgl

ucos

eby

incr

easi

ngin

sulin

secr

etio

nan

din

duci

nggl

ucos

etr

ansf

erth

roug

hin

sulin

-dep

ende

ntpa

thw

ays.

[37]

Gym

nem

asy

lves

tre

Gym

nem

icac

idm

olec

ules

have

are

cept

oron

the

surf

ace

ofth

eou

ter

laye

rsof

the

inte

stin

eth

atpr

even

tsth

eab

sorp

tion

ofsu

gar

mol

ecul

esby

the

inte

stin

e,w

hich

lead

sto

ade

crea

sein

bloo

dsu

gar

leve

ls.

[38]

Swer

tia

puni

cea

The

mec

hani

smof

acti

onof

the

Swer

tia

Puni

cea

Glu

cose

Red

ucin

gEf

fect

byIm

prov

ing

Insu

linR

esis

tanc

e,w

hich

incr

ease

sth

eab

sorp

tion

and

secr

etio

nof

insu

lin.

[38]

Com

bret

umM

icra

nthu

mSt

imul

ates

the

synt

hesi

san

dse

cret

ion

ofin

sulin

orhy

perp

lasi

aof

the

rem

aini

ngbe

tace

llsin

the

panc

reas

.[3

8]

Sarc

opot

eriu

msp

inos

umT

hebl

ueex

trac

toft

hero

otof

the

Sarc

opot

eriu

msp

inos

umpl

ante

xhib

its

acti

vity

sim

ilar

toin

sulin

.[3

8]

Liri

ope

spic

ata

Incr

ease

sin

sulin

secr

etio

nan

dab

sorp

tion

,and

impr

oves

gluc

ose

tole

ranc

ein

the

body

.[5

0]C

aesa

lpin

iabo

nduc

ella

Incr

ease

sin

sulin

secr

etio

nfr

ompa

ncre

atic

isle

ts.T

hean

ti-h

yper

glyc

aem

icef

fect

ofth

epl

ant’s

extr

acts

may

bedu

eto

bloc

kage

ofgl

ucos

eup

take

[39]

Coc

cini

ain

dica

Thes

eex

trac

tslo

wer

edth

elip

opro

tein

lipas

e(L

PL)e

nzym

eac

tivi

tyan

dre

cons

titu

ted

gluc

ose

6-ph

osph

atas

ean

dla

ctat

ede

hydr

ogen

ase,

whi

chin

crea

sed

indi

abet

icpa

tien

tsw

itho

uttr

eatm

ent

[39]

Syzy

gium

cum

ini

The

cAM

Pco

nten

tinc

reas

esla

nger

hans

,whi

chis

asso

ciat

edw

ith

incr

ease

din

sulin

prod

ucti

on.T

his

role

play

sa

role

inco

nver

ting

peri

nsul

into

insu

linw

ith

incr

ease

dac

tivi

tyof

cate

psin

.Iti

ncre

ases

the

acti

vity

ofin

sulin

and

inhi

bits

the

acti

vity

ofN

a/

KA

TPas

efr

omth

epa

tien

t’ser

ythr

ocyt

es.

[39]

Man

gife

rain

dica

This

may

bedu

eto

decr

ease

din

test

inal

abso

rpti

onof

gluc

ose.

[39]

Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

Biomed. Res. Ther. 2018, 5(8): 2538-2551 2545

Biomed. R

es. Ther. 2018, 5(8):2538-2551

Page 9: The most useful medicinal herbs to treat diabetes

2546

. .............................................................

Tabl

e7.

Ant

idia

betic

mec

hani

smac

tivity

ofm

edic

inal

herb

s(Ta

ble

1co

ntin

ued)

Scie

ntifi

cN

ame

Mec

hani

smR

ef.

Mom

ordi

cach

aran

tia

Itin

hibi

tsgl

ucos

e6-

phos

phat

ase

inad

diti

onto

fruc

tose

-1,6

-bis

-sep

sfat

ase

inth

eliv

eran

dst

imul

ates

gluc

ose

6-ph

osph

ate

dehy

drog

enas

e[3

9]

Salv

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Moradi et al. Biomedical Research and Therapy 2018, 5(8): 2538-2551

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diabetes, insulin deficiency or the body’s inability to consume it causes the sugar to remain inthe blood instead of reaching the cells and producing energy. This excess amount of sugar in theblood causes the blood sugar level to exceed normal level.

Before the discovery of insulin and hypoglycemic drugs, diabetic patients were treated withmedicinal plants and traditional treatments. So far, the positive effects of over 1200 herbal drugs inreducing blood glucose levels or the complications due to hyperglycemia have been established.Each plant may have its own effective component to reduce hyperglycemia. However, theseplants have been shown to possess antioxidant activities [15–20]. Oxidative stress is involvedin development of diabetes and a lot of other diseases [19–24]. Therefore, these plants, at least inpart, impose their anti-diabetic activities through this mechanism. Because oxidative stress is thecause of a wide variety of other disease and these plants have antioxidant activity, hence, theymay have beneficial effects on other diseases, too [25–29]. It is noteworthy that these plants dueto their antioxidant activities and other mechanisms are able to reduce the toxic effects of toxicagents or other drugs [30]. However, they themselves may have toxic effects and might be usedwith caution [31]. More importantly a lot of other plans have antioxidant capacity [32–34].

5. ConclusionsHence, these plants may also have anti-diabetic activities and/or can reduce diabetescomplications.

6. Open AccessThis article is distributed under the terms of the Creative Commons Attribution License(CCBY4.0) which permits any use, distribution, and reproduction in any medium, provided theoriginal author(s) and the source are credited.

7. List of abbreviationsDiabetes: Diabetes mellitus

8. Competing interestsThe authors declare no conflict of interest.

9. Authors’ contributionsAll authors searched, studies, reviewed and contributed to the design of the research. All authorsreviewed, commented and approved the final draft.

10. AcknowledgmentsThe present study was supported by Lorestan University of Medical Sciences. We cordially thankof Lorestan University of Medical Sciences, Iran.

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