The Advantages of Herbal Alternatives to Conventional Drugs for Treating Diabetes

Heba El-Ahmad

His feet began to burn, but he saw nothing and concluded it must be nothing. His
symptoms progressively became worse, and the unrelenting burning sensation continued to
intensify until he could no longer walk on his feet. In those terrifying moments, years of neglect
towards his health accumulated into one terrifying jolt. Every year, 1.1 million people experience
a heart attack, and this year, Sam was one of them. After recovery, his doctor diagnosed him with
type two diabetes and prescribed drugs to lower his blood glucose levels. The medications then
began to cause indigestion and severe back pain. The severity of these unwanted side effects lead
him to Karta Purkh Singh Khalsa, a natural healing specialist. She diagnosed him with diabetic
neuropathy, damage to the nerves of the body from high blood sugar levels caused by diabetes.
She immediately began treating Sam with three main herbs; bitter melon, fenugreek seeds, and
gymnema leaves. He was also given a glycemic index eating plan, a strategy to help watch what
foods are ingested by labeling the sugar content of all foods on a scale from one to one hundred,
least to greatest sugar content. After one month of following Khalsas instructions, his blood
sugar was once again under control. Within six months the pain in his feet gradually decreased,
and after five years he was taken off the plan. He has now achieved normal body weight, his
symptoms have been resolved, he is no longer diabetic, and most importantly, he takes no
medication (Rubin). It is clear that herbal alternatives are safer and promise greater benefits
to diabetic patients than many commonly prescribed drugs.
One out of ten American adults has diabetes, and experts predict this number will only
increase. There are two types of diabetes (Liebman). Type-one diabetes is an auto- immune
disease. It occurs when the body mistakenly begins to attack insulin- producing cells, and insulin
ceases production (Facts about Diabetes and Insulin). Genetics or exposure to certain
environmental factors such as viruses may trigger the disease, though the exact cause is unknown

(Type One Diabetes). The affected person must then take periodic injections of insulin, an
important hormone in the body that acts like a key for glucose to enter the cell. Hormones are the
bodys chemical messengers, traveling through the blood stream and tissues in order to affect
different body processes (Facts about Diabetes and Insulin). After eating, the pancreas releases
insulin into the body. The pancreas is both an endocrine and exocrine gland. This means that the
pancreas can both secrete hormones like insulin into the blood (endocrine) and secrete enzymes
through ducts (exocrine). It produces insulin to maintain the balance of blood sugar in the body,
and without this, the body is susceptible to diabetes (Sargis). The Insulin produced then travels to
the receptors, proteins found in the cell membrane that respond to chemical signals on the cell
membranes. The receptors then signal the glucose transporters, mechanisms that regulate the
entry of solutes into the cell, to allow the glucose (sugar) to pass the membrane into the cell. It is
crucial for glucose to enter the cell in order for it to be turned into fuel or stored within the body
(Liebman). Glucose is oxidized within the cell, combining with six oxygen molecules, in a series
of biochemical reactions to produce six carbon dioxide molecules and Adenosine Triphosphate
(ATP) (What is Glucose Oxidization). ATP is the molecule cells use to store energy and
provides energy required by cellular processes in order to function. Glucose is the primary source
of energy for plants and animals, and when found in the human bloodstream, it is referred to as
blood sugar. The normal concentration of blood sugar is approximately 0.1% (Glucose). In
people developing type two diabetes (typically those with excess weight and physical inactivity)
the insulin struggles to open the door for the glucose to enter. The glucose transporters never
receive the message from the receptors to allow the glucose entry, leaving excess glucose in the
blood. This is insulin resistance, or impaired insulin sensitivity. Type-two diabetes results from
the bodys insulin resistance, leading to the inability to produce sufficient insulin needed to allow

the breakdown of glucose (Liebman). To make up for this, pancreatic islet beta cells, one of the
four types of cells in the islets (islands of cells distributed throughout the pancreas), begin to
create more and more insulin, but the pancreas eventually hits a point where it is unable to
compensate for the resistance (Kulkarni). This skyrockets the blood sugar levels, causing
diabetes (Diagnosis of Diabetes and Prediabetes). Diabetes can eventually lead to heart and
blood vessel diseases (increased threat of cardiovascular diseases), nerve damage, kidney
damage, eye damage, foot damage, hearing impairment, skin and mouth conditions, pregnancy
complications, and Alzheimers disease (Symptoms). There are 29 million adults in America
today living with diabetes, most of which are type two diabetic. With all the diabetes health
complications patients have to endure, they shouldnt have to suffer drug side effects as well
(Liebman).
Diabetes has 8 classes of drugs, one of which is Sulfonylureas. These stimulate beta cells
in the pancreas to release more insulin. These have been in use since the 1950s, and have first
and second-generation classes. Second-generation Sulfonylureas drugs such as glipizide,
glyburide, and glimepiride, are given in lower dosages than first generation Sulfonylurea like
Chlorpropamide. They are generally taken twice a day before meals. All Sulfonylurea drugs
lower blood glucose levels in a similar manner, but differ in side effects and interactions with
other drugs (What are my Options). A study in the journal of Diabetologia was conducted
concerning sulfonylureas and metformin, another drug also used to treat type two diabetes. The
study administered the treatments metformin only, sulfonylureas only, sulfonylureas added to
metformin, metformin added to sulfonylureas, and both drugs simultaneously to five different
groups. In the study those who were treated with sulfonylureas only or any combination of
sulfonylureas were at a higher risk of mortality and adverse cardiovascular outcomes (Evans).

Another class of drugs often used is the Biguanides. Metformin (Glucophage) is a common
biguanide. It is used to lower blood glucose levels by decreasing the rate of production of
glucose in the liver. Metformin also assists muscle tissue to become more sensitive to insulin,
increasing absorption of insulin into the cell. A side effect of Metformin in some people may be
diarrhea. Meglitinide drugs also stimulate beta cell production of insulin. Repaglinide (Prandin)
and nateglinide (Starlix) are meglitinides. Because Meglitinides and Sulfonylureas increase
production and release of insulin, high dosages may lower the blood sugar too much. This is
called hypoglycemia, a serious condition that could lead to seizures, loss of consciousness, and
death. The danger of prescribing a too high of a dosage of Meglitinides or Sulfonylureas poses a
very large risk for hypoglycemia. Thiazolidinediones are also another class of drugs that include
Rosiglitazone (Avandia) and Pioglitazone (ACTOS). Another group, troglitazone (Rezulin) was
removed from the market after showing to cause sever liver problems in some people, so both
rosiglitazone and pioglitazone are monitored for liver problems as a precaution. These drugs
increase insulin sensitivity in muscles and fat, and they also reduce glucose production in the
liver. Both drugs have been shown to increase risk of heart failure in some people, and it is
debated whether rosiglitazone increases risk for heart attacks (What are my Options). In a
study conducted on rosiglitazone, it was found that Rosiglitazone was associated with an
increase in myocardial infarction and death from cardiovascular disease. These drugs may help
lower blood sugar levels, what has been thought to be the main contributor to heart disease risk
in diabetes, but drugs usually have multiple effects on the body. Because of this, there has been a
debate about Avandias (and other drugs) worth in treating diabetes. This study brought a lack of
knowledge concerning drugs used for diabetes treatment to public attention. Glaxo, a consumer
health care company, has since submitted a meta- analysis (statistical method for combining

results from different studies to identify a pattern among the results) suggesting Avandia users
had a 30% higher risk of heart attack or blocked coronary artery (Nissen). DPP- 4 inhibitors,
sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), and alogliptin (Nesina),
improve blood glucose levels without causing hypoglycemia, but it is broken down quickly by
the body and ineffective when injected. Sodium- glucose transporter 2 (SGLT2) works to absorb
glucose in the kidneys, so the class of drugs, SGLT2 inhibitors, blocks this action allowing
glucose to leave the body in the urine. Because they increase urination, side effects can include
urinary tract and yeast infections. Alpha- glucosidase inhibitors, acarbose (Precose) and miglitol
(Glyset), block the breakdown of starches in the intestine so glucose is not released. This slows
the rise in blood pressure, but they may cause gas and diarrhea. Bile Acid Sequestrants (BAS)
such as colesevelam (Welchol) lowers cholesterol which then reduces blood glucose levels. BAS
may cause flatulence and constipation, and the method to which it lowers blood glucose level is
not well understood. The lack of knowledge present concerning drugs used to treat diabetes has
sparked an interest in a search for alternative treatments that abstain from drugs (What are my
Options).
Bitter Melon (Momordica charantia) has shown promising data involving its antidiabetic abilities. Various animal studies administering Momordica charantia (MC) have shown
suppressed postprandial hyperglycemic (exaggerated rise in blood sugar following a meal) and
glucose tolerance improvement in rats. MC extract has also been shown to enhance insulin
sensitivity and lipolysis (the breakdown of fats by hydrolysis, chemical reactions involving
water), comparing its effect to other commonly used oral medications such as tolbutamide,
chlorpropamide, and glibenclamide, all of which are sulfonylureas. Years of consumption of
bitter melon as a dietary supplement also suggest a high level of safety (Leung). A clinic study

showed Fenugreek to typically reduce fasting blood sugar levels and improve glucose tolerance
in type-one diabetic patients. Fenugreek seeds are rich in fiber, indigestible carbohydrates that
absorb water in the digestive system and ease bowel movement, and several studies have
suggested that subjects become more sensitive to insulin after adaptation to a high fiber diet.
Studies that have been done in animals also show fenugreek seeds to contain hypoglycemic
properties. The fenugreek administration also increased bile acids and neutral sterols in the feces,
depleting cholesterol stores in the body and thus proving to be beneficial to patients (Sharma).
Gymnema leaves have also been tested for anti diabetic properties. Patients showed a significant
reduction in blood glucose, glycosylated hemoglobin (proteins that transport glucose in the
blood) and glycosylated plasma proteins, giving the opportunity for conventional drug dosage to
be decreased. The appearance of raised insulin levels in the patients also suggested that beta cells
in the pancreas were able to regenerate and repair in the patients taking the supplement, and five
of the twenty two patients were able to completely discontinue their conventional drug use while
maintaining blood glucose homeostasis, or stability (Baskaran).
Diabetes is a hereditary and auto- immune disease that is the cause of many
complications within peoples lives. The drugs commonly administered to control the effects of
diabetes often inflict other ailments upon the patients as well. Herbs like fenugreek, gymnema,
and bitter melon would be more helpful alternatives to these drugs with less adverse effects.
There are many patients who are plagued with symptoms from many conventional drugs they are
forced to take to survive, so an alternative like this could improve their quality of life greatly and
take the one out of ten Americans who suffer from diabetes out of the discomfort of suffering
from their drugs too.

Works Cited
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http://diabetes.niddk.nih.gov/dm/pubs/diagnosis/#3
Evans, J.M. M., Ogston, S. A., Emslie-Smith, A., & Morris, A. D. (2006). Risk of mortality and
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http://www.nobelprize.org/educational/medicine/insulin/diabetes-insulin.html
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Biology, 36(3), 365-371.
Leung, L., Cuthbertson, S., Birtwhistle, R., Kotecha, J., & Hannah, S. (2009). Anti-diabetic and
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