Herbal medicines are used in the treatment of diabetes, a metabolic disorder that poses a significant threat to public health worldwide. There are chemicals and biochemical agents that can help manage diabetes, but a permanent cure for the condition does not currently exist. Through extensive research, many traditional treatments for diabetes have been discovered. Compounds and extracts obtained from various natural sources, especially plants, have consistently served as a valuable tool in the management and treatment of diabetes and its associated complications. This review explains the importance of a variety of herbal and polyherbal formulations traditionally used for the treatment of diabetes.
Introduction
Diabetes mellitus is a non-infectious endocrine disorder that involves disruption of carbohydrate metabolism and is associated with hypoglycemia. It is associated with the development of various serious diseases such as microvascular (nephropathy, retinopathy, neuropathy) and macrovascular (peripheral vascular disease and coronary heart disease). Diabetes mellitus, also known as diabetes, was historically identified by the presence of "sweet urine" and muscle loss. Glucose levels in the blood are controlled by insulin, a hormone produced by the pancreas. When levels rise, the pancreas releases insulin to control glucose levels. In individuals with diabetes, there is little or no production of insulin, leading to high blood sugar levels (hyperglycemia). There are three types of diabetes mellitus: type 1, type 2 and gestational diabetes mellitus. Type 1 diabetes mellitus is also called insulin-dependent diabetes mellitus. This occurs when there is complete dysfunction of the β cells in the islets of Langerhans located in the pancreas. Type 2 diabetes mellitus is also called non-insulin dependent diabetes mellitus. It involves a temporary loss of β cell mass and is often associated with genetic predisposition.
This type of diabetes is usually seen in obese individuals and is associated with high blood pressure and increased cholesterol levels. The goal of treatment for type 2 diabetes is to reduce insulin resistance and boost insulin production. Gestational diabetes is a form of diabetes that involves high blood sugar levels in pregnant women. It usually occurs in 2-4% of pregnancies during the second or third trimester. Symptoms of diabetes include excessive thirst, frequent urination, increased appetite, fatigue, nausea, vomiting, erectile dysfunction in men, slow wound healing and blurred vision.
According to a survey conducted in 2016 by the International Diabetes Federation (IDF), diabetes is a condition that affects 415 million individuals globally, and this number is expected to increase to 642 million by 2040. According to Aroma World report, 61.3 million individuals in India are suffering from diabetes, with the population belonging to the age group of 20-79 years. This may almost double by 2030. India is known as the diabetes hub of the world, affecting individuals in both rural and urban areas. The incidence of diabetes is continuously increasing in urban India.
The incidence of diabetes in urban areas is approximately 6 times higher than that of the rural population. Decrease in physical activity, weight gain, changes in diet, malnutrition, alcohol consumption and viral infections have been the primary factors contributing to the increase in diabetes cases over the past two decades. The number of women with diabetes exceeds that of men with diabetes because of differences in how hormones and inflammation affect them. People with less education are more likely to have diabetes than people with higher education. Diabetes rates are highest in developing countries.
Diagnosis of Diabetes Mellitus
The diagnosis of diabetes can be determined by analyzing blood sugar levels. The blood sugar level in a healthy person is 80 mg/dl during fasting and can rise up to 160 mg/dl in the postprandial state. Various tests used to diagnose diabetes in a laboratory setting include finger prick blood sugar test, fasting blood sugar test, glucose tolerance diagnostic test, and glycohemoglobin test.
Pathophysiology of diabetes mellitus
The main factor in the pathophysiology of diabetes is oxidative stress. The formation of reactive oxygen species (ROS) and imbalance in the ability of enzymatic or non-enzymatic antioxidants is called oxidative stress. Reactive oxygen species (ROS) include free radicals such as superoxide, hydroxyl, peroxyl, hydroperoxyl, and non-radical species such as hydrogen peroxide. An antioxidant containing superoxide dismutase, glutathione reductase, vitamins A, C and E, carotenoids, glutathione and trace elements. Low density lipoprotein cholesterol is oxidized when reactive oxygen species are present. These oxidized lipoproteins are then taken up by scavenger receptors in macrophage cells, leading to the formation of foam cells and arterial plaques in a process called atherosclerosis. These ROS can activate various harmful pathways that play an important role in the development of diabetes.
The main pathways include the glucosamine pathway, the sorbitol aldose reductase pathway, the electron transport chain, and protein kinase C stimulation. Activation of these pathways and mechanisms of action can result in the development of atherosclerosis, apoptosis, oxidative damage to lipids, formation of advanced glycation end products (AGEs), amyloid deposition, and impaired pancreatic beta-cell function. It has been demonstrated that sequences specific for DNA binding factor (Nuclear Factor Erythroid Derivative Like 2) and its inhibitor (Kelch Like ECH Associated Protein 1) play important roles in protecting cells against oxidative stress.
Antidiabetic drugs
The onset of diabetes can be avoided by managing blood sugar levels by using various medications, engaging in various forms of physical activity or yoga therapy, and following a specific diet plan [9]. Currently, there are two main treatments for diabetes: insulin therapy for type 1 diabetes and oral hypoglycemic drugs such as sulfonylureas, thiazolidinediones, and peptide analogs for type 2 diabetes.
Herbal Remedy
Herbal treatments for diabetes are a topic of interest, as finding treatments without side effects remains a challenge for medical professionals. Based on global ethnobotanical research, 800 medicinal plants are used for the prevention of diabetes. It has been clinically proven that 450 medicinal plants have anti-diabetic properties, out of which 109 plants have a complete mode of action. In the past, doctors and non-professionals used traditional medicinal plants containing active components to treat conditions such as heart disease, cancer, and diabetes. There is a long history of the use of traditional plants for the management of diabetes in India and China. There are various books like Charaka Samhita and Sushruta Samhita which describe the phytopharmacology aspects of diabetes and its negative effects.
Synthetic drugs used to treat diabetes can cause a variety of side effects, including nausea, vomiting, diarrhea, redness due to alcohol consumption, headache, swelling, anemia, and dizziness. Herbal medicines are considered a better option than synthetic medicines due to their minimal side effects and adverse reactions. Herbal remedies can be obtained over the counter without requiring a prescription. These herbal medicines are used for serious diseases. These medicines are also used when synthetic medicines do not work in treating a condition. These are organic and safe medicines, for example: There are no harmful effects.
Herbal medicines provide a permanent cure for individuals and treat diseases effectively, whereas synthetic medicines do not provide long-lasting solutions to diseases. Herbal formulas contain natural herbs and extracts of fruits and vegetables that can help treat various ailments without any negative side effects. Chemical medicines are made artificially and may have side effects. Herbal formulas cost less than allopathic medicines. Herbal formulas are eco-friendly. Herbal formulas are made from natural ingredients, while allopathic medicines are made from chemical compounds and chemically altered natural substances. Herbal medicines can be purchased without a prescription, while allopathic medicines require a prescription.
