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Journal of Integrative Medicine ›› 2014, Vol. 12 ›› Issue (4): 336-345.doi: 10.1016/S2095-4964(14)60031-5

• Review • Previous Articles     Next Articles

Clinical and experimental studies on polyherbal formulations for diabetes: Current status and future prospective

Ahmad Ghorbani   

  1. Pharmacological Research Center of Medicinal Plants, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
  • Received:2014-02-03 Accepted:2014-03-11 Online:2014-07-10 Published:2014-07-15

Diabetes is a leading cause of morbidity and mortality in the world. There is currently an active search for antidiabetic drugs with greater effectiveness with fewer and less adverse side effects. Although numerous individual herbs have been experimentally or clinically reported to possess antidiabetic effects, considerably less research has been conducted on polyherbal compounds. It is believed that herbal compounds containing multiple plant products have synergistic antidiabetic effects and could enhance the desired actions. Several polyherbal formulations have been studied as therapeutic agents in diabetes management. To describe the current state of research on polyherbal compounds in the treatment of diabetes, an extensive review of literature was undertaken on several major databases. This paper presents what is known about the efficacy of these polyherbal formulations and compare their antidiabetic effects with those of current oral hypoglycemic drugs as reference. The percent decrease in blood glucose, lipids and other biochemical parameters achieved by each product in diabetic animals and patients is reported. Also, the possible mechanisms responsible for hypoglycemic action of polyherbal formulations are discussed.

Key words: Diabetes mellitus, Hypoglycemic agents, Plants, Medicinal, Review

[1] Deshpande AD, Harris-Hayes M, Schootman M . Epidemiology of diabetes and diabetes-related complications[J]. Phys Ther, 2008,88(11):1254-1264
doi: 10.2522/ptj.20080020
[2] Lorenzati B, Zucco C, Miglietta S, Lamberti F, Bruno G . Oral hypoglycemic drugs: pathophysiological basis of their mechanism of action[J]. Pharmaceuticals, 2010,3(9):3005-3020
doi: 10.3390/ph3093005
[3] Ghorbani A . Best herbs for managing diabetes: a review of clinical studies[J]. Braz J Pharm Sci, 2013,49(3):413-422
doi: 10.1590/S1984-82502013000300003
[4] Ghorbani A, Shafiee-Nick R, Rakhshandeh H, Borji A . Antihyperlipidemic effect of a polyherbal mixture in streptozotocin-induced diabetic rats[J]. J Lipids, 2013,2013:675759
[5] Ghorbani A, Hadjzadeh MAR, Rajaei Z, Zendehbad SB . Effects of fenugreek seeds on adipogenesis and lipolysis in normal and diabetic rat. Pak[J] Biol Sci. 2014: 17(4):523-528.
[6] Shafiee-Nick R, Ghorbani A, Vafaee F, Rakhshandeh H . Chronic administration of a combination of six herbs inhibits the progression of hyperglycemia and decreases serum lipids and aspartate amino transferase activity in diabetic rats[J]. Adv Pharmacol Sci, 2012,2012:789796
[7] Park C, Lee JS . Natural ingredients for diabetes which are approved by Korean FDA[J]. Biomed Res, 2013,24(1):164-169
[8] Liu RH . Potential synergy of phytochemicals in cancer prevention: mechanism of action.[J] Nutr. 2004; 134(12 Suppl):3479S-3485S.
doi: 10.1093/jn/134.12.3479S
[9] Babu PS , Stanely Mainzen Prince P.Antihyperglycaemic and antioxidant effect of hyponidd, an ayurvedic herbomineral formulation in streptozotocin-induced diabetic rats[J]. J Pharm Pharmacol, 2004,56(11):1435-1442
doi: 10.1211/0022357044607
[10] Pari L, Saravanan G . Antidiabetic effect of Cogent db, a herbal drug in alloxan-induced diabetes mellitus[J]. Comp Biochem Physiol C Toxicol Pharmacol, 2002,131(1):19-25
doi: 10.1016/S1532-0456(01)00259-9
[11] Saravanan R, Pari L . Antihyperlipidemic and antiperoxidative effect of Diasulin, a polyherbal formulation in alloxan induced hyperglycemic rats[J]. BMC Complement Altern Med, 2005,5:14
doi: 10.1186/1472-6882-5-14
[12] Chang MS, Oh MS , Kim do R, Jung KJ, Park S, Choi SB, Ko BS, Park SK.Effects of okchun-san, a herbal formulation, on blood glucose levels and body weight in a model of type 2 diabetes[J]. J Ethnopharmacol, 2006,103(3):491-495
doi: 10.1016/j.jep.2005.08.039
[13] Mandlik RV, Desai SK, Naik SR, Sharma G, Kohli RK . Antidiabetic activity of a polyherbal formulation(DRF/AY/5001)[J]. Indian J Exp Biol, 2008,46(8):599-606
[14] Yadav H, Jain S, Prasad GB, Yadav M . Preventive effect of diabegon, a polyherbal preparation, during progression of diabetes induced by high-fructose feeding in rats[J]. J Pharmcol Sci, 2007,105(1):12-21
doi: 10.1254/jphs.FP0060092
[15] Thakkar NV, Patel JA . Pharmacological evaluation of “Glyoherb”: a polyherbal formulation on streptozotocin-induced diabetic rats[J]. Int J Diabetes Dev Ctries, 2010,30(1):1-7
doi: 10.4103/0973-3930.60001
[16] Gauttam VK, Kalia AN . Development of polyherbal antidiabetic formulation encapsulated in the phospholipids vesicle system[J]. J Adv Pharm Technol Res, 2013,4(2):108-117
doi: 10.4103/2231-4040.111527
[17] Yadav D, Chaudhary AA, Garg V, Anwar MF, Rahman MM, Jamil SS, Khan HA, Asif M . In vitro toxicity and antidiabetic activity of a newly developed polyherbal formulation(MAC-ST/001) in streptozotocin-induced diabetic Wistar rats[J]. Protoplasma, 2013,250(3):741-749
doi: 10.1007/s00709-012-0458-7
[18] Kesavanarayanan KS, Sathiya S, Kalaivani P, Ranju V, Sunil AG, Saravana Babu C, Kavimani S, Prathiba D . DIA-2, a polyherbal formulation ameliorates hyperglycemia and protein-oxidation without increasing the body weight in type II diabetic rats[J]. Eur Rev Med Pharmacol Sci, 2013,17(3):356-369
[19] Chan JY, Lam FC, Leung PC, Che CT, Fung KP . Antihyperglycemic and antioxidative effects of a herbal formulation of Radix Astragali, Radix Codonopsis and Cortex Lycii in a mouse model of type 2 diabetes mellitus[J]. Phytother Res, 2009,23(5):658-665
doi: 10.1002/ptr.v23:5
[20] Joshi CS, Priya ES, Venkataraman S . Hypoglycemic and antilipidperoxidative effects of a polyherbal formulation, Diakyur, in experimental animal models[J]. J Health Sci, 2007,53(6):734-739
doi: 10.1248/jhs.53.734
[21] Bangar OP, Jarald EE, Asghar S, Ahmad S . Antidiabetic activity of a polyherbal formulation(Karnim Plus)[J]. Int J Green Pharm, 2009,3(3):211-214
doi: 10.4103/0973-8258.56276
[22] Katiyar DK, Mehrotra A, Pant KK . Hypoglycemic and antioxidant effects of a polyherbal formulation in alloxan induced diabetic rats[J]. Ann Ayurvedic Med, 2012,1(4):134-139
[23] Lanjhiyana S, Garabadu D, Ahirwar D, Rana CA, Ahirwar B, Lanjhiyana SK . Pharmacognostic standardization and hypoglycemic evaluations of novel polyherbal formulations[J]. Der Pharm Lett, 2011,3(1):319-333
[24] Akhtar MS, Zafar M, Irfan HM, Bashir S . Hypoglycemic effect of a compound herbal formulation (Ziabeen) on blood glucose in normal and alloxan-diabetic rabbits. Diabetologia Croatica. 2012; 41(3); 87-94.
[25] Gray AM, Flatt PR . Insulin-releasing and insulin-like activity of the traditional anti-diabetic plant Coriandrum sativum(coriander)[J]. Br J Nutr, 1999,81(3):203-209
doi: 10.1017/S0007114599000392
[26] Hui H, Tang G, Go VL . Hypoglycemic herbs and their action mechanisms[J]. Chin Med, 2009,4:11
doi: 10.1186/1749-8546-4-11
[27] Shafiee-Nick R, Parizadeh SMR, Zokaei N, Ghorbani A . Effect of hydro-alcoholic extract of Vaccinium arctostaphylos on insulin release from rat-isolated langerhans islets[J]. Koomesh, 2011,12(4):447-452
[28] Shafiee-Nick R, Parizadeh SMR, Zokaei N, Ghorbani A . Effects of Ganoderma lucidum hydroalcoholic extract on insulin release in rat-isolated pancreatic islets[J]. Avicenna J Phytomed, 2012,2(4):206-211
[29] Abesundara KJ, Matsui T, Matsumoto K . α-Glucosidase inhibitory activity of some Sri Lanka plant extracts, one of which, Cassia auriculata, exerts a strong antihyperglycemic effect in rats comparable to the therapeutic drug acarbose[J]. J Agric Food Chem, 2004,52(9):2541-2545
doi: 10.1021/jf035330s
[30] Al-Romaiyan A, Liu B, Asare-Anane H, Maity CR, Chatterjee SK, Koley N, Biswas T, Chatterji AK, Huang GC, Amiel SA, Persaud SJ, Jones PM . A novel Gymnema sylvestre extract stimulates insulin secretion from human islets in vivo and in vitro[J]. Phytother Res, 2010,24(9):1370-1376
doi: 10.1002/ptr.v24:9
[31] Hannan JM, Ali L, Rokeya B, Khaleque J, Akhter M, Flatt PR, Abdel-Wahab YH . Soluble dietary fibre fraction of Trigonella foenum-graecum(fenugreek) seed improves glucose homeostasis in animal models of type 1 and type 2 diabetes by delaying carbohydrate digestion and absorption, and enhancing insulin action[J]. Br J Nutr, 2007,97(3):514-521
doi: 10.1017/S0007114507657869
[32] Vijayakumar MV, Singh S, Chhipa RR, Bhat MK . The hypoglycaemic activity of fenugreek seed extract is mediated through the stimulation of an insulin signalling pathway[J]. Br J Pharmacol, 2005,146(1):41-48
doi: 10.1038/sj.bjp.0706312
[33] Vijayakumar MV, Bhat MK . Hypoglycemic effect of a novel dialysed fenugreek seeds extract is sustainable and is mediated, in part, by the activation of hepatic enzymes[J]. Phytother Res, 2008,22(4):500-505
doi: 10.1002/(ISSN)1099-1573
[34] Arca M, Pigna G, Favoccia C . Mechanisms of diabetic dyslipidemia: relevance for atherogenesis[J]. Curr Vasc Pharmacol, 2012,10(6):684-686
doi: 10.2174/157016112803520864
[35] Ghorbani A, Varedi M, Hadjzadeh MR, Omrani GH . Type-1 diabetes induces depot-specific alterations in adipocyte diameter and mass of adipose tissues in the rat[J]. Exp Clin Endocrinol Diabetes, 2010,118(7):442-448
doi: 10.1055/s-0030-1247566
[36] Ghorbani A, Omrani GR, Hadjzadeh MA, Varedi M . Proinsulin C-peptide inhibits lipolysis in diabetic rat adipose tissue through phosphodiestrase-3B enzyme[J]. Horm Metab Res, 2012,45(3):221-225
doi: 10.1055/s-00000025
[37] Vijayaraghavan K . Treatment of dyslipidemia in patients with type 2 diabetes[J]. Lipids Health Dis, 2010,9:144
doi: 10.1186/1476-511X-9-144
[38] Karalis DG . The role of lipid-lowering therapy in preventing coronary heart disease in patients with type 2 diabetes[J]. Clin Cardiol, 2008,31(6):241-248
doi: 10.1002/(ISSN)0027-2507
[39] Ismail Khan A, Balaji V, Anne Williams A, Sathish S, Mayilvanan C, Balasubramanian K . A novel polyherbal preparation for the management of type-2 diabetes mellitus: a clinical study[J]. Int J Pharm Pharm Sci, 2012,4(3):495-500
[40] Kant S, Sahu M, Sharma S, Kulkarni KS . Effect of Diabecon(D-400), an Ayurvedic herbomineral formulation on diabetic retinopathy[J]. Indian J Clin Pract, 2002,12(9):49-56
[41] Yajnik VH, Acharya HK, Vithlani MP, Yajnik NV . Efficacy and safety of Diabecon(D-400), a herbal formulation, in diabetic patients[J]. Indian Pract, 1993,46(12):917-922
[42] Viswanathan V, Kesavan R, Kavitha KV, Kumpatla S . A pilot study on the effects of a polyherbal formulation cream on diabetic foot ulcers[J]. Indian J Med Res, 2011,134:168-173
[43] Said O, Fulder S, Khalil K, Azaizeh H, Kassis E, Saad B . Maintaining a physiological blood glucose level with ‘Glucolevel’, a combination of four anti-diabetes plants used in the traditional Arab herbal medicine[J]. Evid Based Complement Alternat Med, 2008,5(4):421-428
doi: 10.1093/ecam/nem047
[44] Ahmad N, Hassan MR, Halder H, Bennoor KS . Effect of Momordica charantia(Karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients[J]. Bangladesh Med Res Counc Bull, 1999,25(1):11-13
[45] Grover JK, Gupta SR . Hypoglycemic activity of seeds of Momordica charantia[J]. Eur J Pharmacol, 1990,183(3):1026-1027
[46] Sirvastava Y, Venkatakrishna-Bhatt H, Verma Y, Venkaiah K, Raval BH . Antidiabetic and adaptogenic properties of Momordica charantia extract: an experimental and clinical evaluation[J]. Phytother Res, 1993,7(4):285-289
doi: 10.1002/(ISSN)1099-1573
[47] Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH . Improvement in glucose tolerance due to Momordica charantia(karela)[J]. Br Med J (Clin Res Ed), 1981,282(6279):1823-1824
doi: 10.1136/bmj.282.6279.1823
[48] Waheed A, Miana GA, Sharafatullah T, Ahmad SI . Clinical investigation of hypoglycemic effect of unripe fruit of Momordica charantia in type-2(NIDDM) diabetes mellitus[J]. Pak J Pharmacol, 2008,25(1):7-12
[49] Inayat-ur-Rahman, Malik SA, Bashir M, Khan R, Iqbal M . Serum sialic acid changes in non-insulin-dependant diabetes mellitus(NIDDM) patients following bitter melon(Momordica charantia) and rosiglitazone(Avandia) treatment[J]. Phytomedicine, 2009,16(5):401-405
doi: 10.1016/j.phymed.2009.01.001
[50] Ghorbani A . Phytotherapy for diabetic dyslipidemia: evidence from clinical trials[J]. Clin Lipidol, 2013,8(3):311-319
doi: 10.2217/clp.13.26
[51] Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, Shanmugasundaram ER . Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients[J]. J Ethnopharmacol, 1990,30(3):295-305
doi: 10.1016/0378-8741(90)90108-6
[52] Joffe DJ, Freed SH . Effect of extended release Gymnema sylvestre leaf extract alone or in combination with oral hypoglycemics or insulin regimens for type 1 and type 2 diabetes[J]. Diabetes Control Newsl, 2001,76(1):1-4
[53] Shanmugasundaram ER, Rajeswari G, Baskaran K, Rajesh Kumar BR, Radha Shanmugasundaram K, Kizar Ahmath B . Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus[J]. J Ethnopharmacol, 1990,30(3):281-294
doi: 10.1016/0378-8741(90)90107-5
[54] Verma S, Singh SP . Current and future status of herbal medicines[J]. Vet World, 2008,1(11):347-350
[55] Tiwari Ashok K, Madhusudana Rao J . Diabetes mellitus and multiple therapeutic approaches of phytochemicals: present status and future prospects[J]. Curr Sci, 2002,83(1):30-38
[56] Pal SK, Shukla Y . Herbal medicine: current status and the future[J]. Asian Pac J Cancer Prev, 2003,4(4):281-288
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