History of ethnomedicinal plants used

for the treatment of Diabetes

Diabetes is arguably the greatest public health problem in the world and has
been one for a long time now (1). It is widely considered as the silent epidemic
of the 21st century. Diabetes is a chronic disease that gradually affects many
different organs of the body. The disease progresses gradually and its
symptoms occur several years after the onset of disease. During this period,
serious and irreversible complications arise (2).

Before the discovery of insulin in 1921, diabetes controlling was referred to the
prevention of early death from the disease. Today, diabetes controlling is not
only to keep blood glucose, lipid and pressure levels within a normal range, but
also to prevent related complication and improve patient satisfaction and
quality of life.

People interested in herbal medicines, believe that the use of herbal medicines
dates back to the period when there were no modern medicine and no
information about the cellular and molecular function of body (3). Although
medicinal plants have a long history of use in the treatment of diseases
however, their acceptance and application in modern medicine need time (4).
However, this alternative medicine is still attractive for people (5-7). Type-2
diabetes treatment requires the lowering of the blood glucose and this effect
has claimed to have been shown by several herbs and spices. Pharmacological
researches and surveys have been carried out on this particular method of
treatment of diabetes by medicinal plants and it resulted in an increase in the
number of people who have been using these natural compounds to control
the aforementioned disease (8-9). Predating the discovery of insulin and other
blood glucose lowering agents, diabetes and other such diseases were treated
by traditional and herbal remedies. To date, more than 1200 medicinal plants
have been shown to possess anti-diabetic activities (10-11).
Pathophysiology

The pathophysiology of diabetes is rather very complex and is directly related

to the insulin levels within the body, and its ability to utilize the
aforementioned peptide hormone. Insulin is produced within the body by the
beta cells of the islets of Langerhans of the pancreas.

In type-1 diabetes, there is no involvement of insulin whatsoever. Type-1

diabetes (Diabetes Insipidus) is a disorder of salt and water in which the body
cannot regulate the flow of body fluids caused due to hormonal abnormalities
caused when the pituitary gland fails to secrete the hormone vasopressin.

However, when we talk about the type-2 diabetes, i.e., Diabetes Mellitus, the
effect of little to no secretion of insulin (depending upon the magnitude of the
diagnosis) comes into play. The peripheral tissues resist its effects. In a
perfectly healthy human being, whenever there is an increase in the blood
glucose concentrations, the beta cells released from the islets of Langerhans
release insulin due to an increase in blood glucose level. The human brain, in
order to perform normally and to function continually, requires glucose.
Hypoglycaemia, or low plasma glucose levels, is usually caused by the drugs
used in the treatment of diabetes, which includes insulin and oral anti-
hyperglycaemics. The pathophysiology of diabetes involves plasma
concentrations of glucose signalling the central nervous system to mobilize
energy reserves. It is based on cerebral blood flow and tissue integrity, arterial
plasma glucose, the speed that plasma glucose concentrations fall, and other
available metabolic fuels. Low plasma glucose causes a surge in autonomic
activity. Low plasma glucose levels are required for the diagnosis of
hypoglycaemia. Immediate treatment of type-2 diabetes involves the intake of
glucose in varying amount, based on requirement. The responses to
hypoglycaemia include decrease in insulin secretion, increase in the secretion
of glucose counter-regulatory hormones, such as glucagon and epinephrine, a
greater sympatho-adrenal response, related symptoms, and finally, cognitive
dysfunction, seizures, or coma. [12]

References/Citations:
1. Larijani B, Forozandeh F. Diabetes foot disorders. Iranian J Diabetes
Lipid. 2003;2(2):93–103.

2. Powers A. Diabetes Mellitus. In: Braunwold E, Fauci AS, Kasper DL, Hauser
SL, Long DL, Jameson JL. Harrisons’ Principles of Internal Medicine. 15th ed.
McGraw-Hill; 2007:2109-38

3. Bahmani M, Banihabib E, Rafieian-Kopaei M, Gholami-Ahangaran M.

Comparison of disinfection activities of nicotine with copper sulphate in water
containing Limnatis nilotica. Kafkas Univ Vet Fak Derg. 2015;21(1):9–11

4. Asadi-Samani M, Bahmani M, Rafieian-Kopaei M. The chemical composition,

botanical characteristic and biological activities of Borago officinalis: a
review. Asian Pac J Trop Med. 2014;7(Suppl 1):22–8.

5. Bahmani M, Zargaran A, Rafieian-Kopaei M, Saki M. Ethnobotanical study of

medicinal plants used in the management of diabetes mellitus in the Urmia,
Northwest Iran. Asian Pac J Trop Med. 2014;7(Suppl 1):348–54.

6. Delfan B, Bahmani M, Hassanzadazar H, Saki K, Rafieian-Kopaei M.

Identification of medicinal plants affecting on headaches and migraines in
Lorestan Province, West of Iran. Asian Pac J Trop Med. 2014;7(Suppl 1):376–9.

7. Bahmani M, Rafieian-Kopaei M, Hassanzadazar H, Saki K, Karamati SA,

Delfan B. A review on most important herbal and synthetic antihelmintic drugs.
Asian Pac J Trop Med. 2014;7(Suppl 1):29–33.
8. Saki K, Bahmani M, Rafieian-Kopaei M. The effect of most important
medicinal plants on two important psychiatric disorders (anxiety and
depression)-a review. Asian Pac J Trop Med. 2014;7(Suppl 1):34–42.

9. Bahmani M, Shirzad HA, Majlesi M, Shahinfard N, Rafieian-Kopaei M. A

review study on analgesic applications of Iranian medicinal plants. Asian Pac J
Trop Med. 2014;7(Suppl 1):43–53

10. Asadbeigi M, Mohammadi T, Rafieian-Kopaei M, Saki K, Bahmani M, Delfan

B. Traditional effects of medicinal plants in the treatment of respiratory
diseases and disorders: an ethnobotanical study in the Urmia. Asian Pac J Trop
Med. 2014;7(Suppl 1):S364–8. [PubMed] [Google Scholar]

11. Karamati SA, Hassanzadazar H, Bahmani M, Rafieian-Kopaei M. Herbal and

chemical drugs effective on malaria. Asian Pac J Trop Dis. 2014;4(Suppl 2):599–
601.

12. www.sciencedirect.com/science/article/pii/B9780128168646000031