Individualized homeopathic treatment in addition to conventional treatment in type II diabetic patients in Hong Kong - a retrospective cohort study.

OBJECTIVE: Glycaemic goals are not achieved in most patients with type II diabetes mellitus (T2DM), especially in those with long disease duration and taking multiple oral antidiabetic drugs (OAD). We aimed to investigate the effectiveness of individualized homeopathic treatment in glycaemic control. DESIGN: Retrospective cohort study. SETTING: At least 6 months of individualized homeopathic treatment at a private homeopathic centre in Hong Kong. PARTICIPANTS: Twenty-seven adults aged 37-84 years were treated with individualized homeopathic remedies between 2012 and 2015. Published data on 40 T2DM patients under standard conventional treatment in Hong Kong were used as a control. MAIN OUTCOME MEASURE: Change in fasting plasma glucose (FPG) and glycated haemoglobin (HbA1c) at 12-month or the last follow-up, whichever is earlier. RESULTS: Compared with the conventional treatment only group, the homeopathy group had higher baseline FPG (p = 0.044), and more patients had a long (>20 years) duration of diabetes (p = 0.006), and a history of cardiac events (p = 0.022). The mean difference in FPG in the homeopathy group was significantly greater than in the control after 12 months: -2.24 mmol/L (95% confidence interval [CI]: -3.47 to -1.01) vs 0.16 mmol/L (95% CI: -1.72 to 2.04), p = 0.001. The mean difference in glycated haemoglobin (HbA1c) was also significantly greater, -1.11% (95% CI: -2.17 to -0.05) vs 0.08% (95% CI: -1.37 to 1.53), p = 0.046. Poorer baseline glycaemic control was associated with better outcome (r = -0.750, p < 0.001), but not the duration of diabetes (r = 0.058, p = 0.772). The improvement was robust to sensitivity analyses. CONCLUSION: Individualized homeopathic treatment was associated with better glycaemic control compared with standard conventional treatment alone.

Effect of homeopathic preparations of Syzygium jambolanum and Cephalandra indica on gastrocnemius muscle of high fat and high fructose-induced type-2 diabetic rats.

BACKGROUND: Homeopathy is a holistic method of treatment that uses microdoses of natural substances originating from plants, minerals, or animal parts. Syzygium jambolanum and Cephalandra indica are used in homeopathy for treatment of type-2 diabetes. However, the molecular mechanisms responsible for such effects are not known. METHODS: Homeopathic preparations of S. jambolanum and C. indica in mother tincture, 6c and 30c were used to examine the molecular mechanism of antidiabetic effects in the skeletal muscle of rats with high fat and fructose-induced type-2 diabetes mellitus. After 30 days treatment, fasting blood glucose, serum insulin and insulin signaling molecules in the skeletal muscle (gastrocnemius) were measured. RESULTS: Diabetic rats showed a significant decrease in serum insulin and lipid profile as well as low levels of insulin receptor (IR), v-akt murine thymoma viral oncogene homolog (Akt), p-Akt(ser473) and glucose transporter-4 (GLUT4) protein expression (p < 0.05) with a significant increase in fasting blood glucose level (p < 0.05) compared to the control group. Treatment with homeopathic remedies significantly increased the serum insulin and expression of these proteins (p < 0.05) with a significant decrease in fasting blood glucose (p < 0.05) compared to diabetic rats. CONCLUSIONS: In the present study homeopathic preparations of S. jambolanum and C. indica, including ultramolecular dilutions exhibit antidiabetic effects, improving insulin action through activation of insulin signaling molecules in skeletal muscle of type-2 diabetic rats.

Interindividual variability in diabetic patients' response to opium poppy: an overview of impressive factors.

Diabetic patients always seek alternative treatments to lower their blood glucose level efficiently, because antidiabetic drugs produce adverse effects and many patients experience reduced response after a treatment period. Opium poppy (Papaver somniferum) is frequently consumed by diabetic patients for reduction of blood glucose level. Scientific studies found controversial results in the investigation of the blood glucose-lowering effects of opium poppy. In this regard, we explored the antidiabetic effect of opium poppy more closely. The antidiabetic or antihyperglycemic effect of P. somniferum alkaloids were reviewed. Next, opioid receptors and their role in diabetes were explored. In the final part origins of interindividual variabilities in opioid receptors and metabolizing enzymes' functions including genetic and epigenetic factors were reviewed.

Hypoglycemic effect of rosmarinic acid-rich infusion (RosCE) from Origanum vulgare in alloxan-induced diabetic rats.

Origanum vulgare, known for its medicinal value, is officially accepted in many countries. The flowers and leaves are used globally in homeopathy. In Brazilian folk medicine, O. vulgare has been used to treat diabetes mellitus. This study evaluated the hypoglycemic activity of an infusion extract (RosCE) of commercially available O. vulgare leaves in alloxan-induced diabetic rats. Oral administration of RosCE resulted in the reduction of blood glucose levels after the first day of treatment, compared to the diabetic control group. These results showed that RosCE displays hypoglycemic activity, which may be due to the combined effect of rosmarinic acid, and other minor compounds. Reversed phase-high performance liquid chromatography-diode array detection was used to identify and quantify the major constituents of RosCE. This study presents evidence that supports the folkloric use of O. vulgare for the treatment of hyperglycemia, confirming the use of its infusion as an antidiabetic herbal medicine.

Prevalence and association of co-morbidities in diabetic patients along with prescription patterns in Delhi-NCT, India.

BACKGROUND: Diabetes is rising at an alarming rate in India and the national capital forms a significant part of the nation's diabetic population. The metabolic disorder is no more a disease specific to the rich countries but has also markedly spread its roots in middle-income countries. OBJECTIVE: To ascertain the prevalence of associated co-morbidities in the diabetic population of Delhi, a metropolitan city in India. Moreover, this study was conducted to help with adding information to the limited shreds of evidence of diabetes prevalence in Delhi along with the usually preferred therapies. MATERIALS AND METHODS: A cross-sectional, observational, survey-based study was conducted on people (n = 798) of different age groups (18 years and above) belonging to different regions of Delhi. All subjects were enrolled after obtaining oral consent. Detailed information about clinical, demographic and metabolic profiles was obtained with the help of a pre-structured, open-ended questionnaire. The data were analyzed, and the correlation between diabetes and several other fields was drawn. RESULTS: Out of the 798 diabetic patients 458 (57.39%) were males and 340 (42.60%) were females. The presence of diabetes was higher in the age group of 50-60 years irrespective of the gender. CO-MORBIDITIES: 54.13% of patients suffered with additional co-morbidities which is significantly high. The associated co-morbidities found in the survey included Hypertension, Hypothyroidism, Dyslipidemia, Obesity, Coronary Artery Diseases etc. About 30.57% of patients suffered from hypertension making it the most commonly associated co-morbidity. The other diseases included hypothyroidism (11.52%), Dyslipidemia (10.27%), Obesity (9.27%) etc. MEDICATION: Majority of patients i.e about 60.65% received oral hypoglycemic agents (including patients receiving both insulin and oral hypoglycemic agents). About 19.92% of patients were prescribed with insulin. 14.16% of patients were found to be following diet control and yoga with about 3.13% more females the males. A small percentage of patients (5.25%) were also following alternative systems (Ayurvedic/Unani/Homeopathic) of treatment. Overall, amongst oral hypoglycemic agents, the combination of metformin and DPP4 inhibitors (Vildagliptin, Sitagliptin) was being prescribed majorly i.e 16.41%. CONCLUSION: The number of diabetic population is high in Delhi. It was evident that a significant percentage of diabetic patients suffered from additional diseases that may lead to worsening of the health conditions. Thus, there is an urgent need to educate and spread awareness amongst the masses about the potential benefits of lifestyle modifications like the incorporation of a healthy diet and physical activities. Additionally, continuous and regular tests should be taken to avoid further complications.

Use of complementary and alternative medicine in children with type 1 diabetes mellitus - prevalence, patterns of use, and costs.

BACKGROUND: Complementary and alternative medicine (CAM) is increasingly used in adults and children. Studies on CAM in diabetes have mainly focused on the adult population and its use among children with type 1 diabetes has not been well characterized. OBJECTIVES: This study determines prevalence, parental reasons and motivations, perceived effectiveness, costs, and communication of CAM use. Moreover, caregiver-related variables associated with the use of CAM were investigated. METHODS: A self-completed anonymous questionnaire was administered to parents of children with type 1 diabetes in four pediatric diabetes centers in Germany (Leipzig, Berlin, Stuttgart, and Bonn). RESULTS: Two hundred and twenty eight (65.9%) of 346 families completed the survey. Mean age of the diabetic patients was 11.9 +/- 3.8 yr. Forty two (18.4%) received one or more types of CAM, with the most common types being homeopathy (14.5%), vitamins and minerals (13.7%), modified diet (12.9%), aloe vera (7.3%), and cinnamon (5.6%). Users had a significantly higher family income and parental tertiary education (p < 0.05) and stated a significantly stronger interest in self-care (p < 0.01). Parents' motivations for using CAM were the hope for an improved well-being (92.1%), to try everything (77.8%), and assumption of fewer side effects (55.2%). Costs for the entire treatment varied between less than euro100 and up to euro5000, with mostly no reimbursement. CONCLUSIONS: Use of CAM in children with type 1 diabetes is less common than that documented for adults. Parents using CAM do not question the need for insulin. When using CAM, improved well-being and quality of life are important considerations where CAM can have a role.

Evaluation of antihyperglycemic potential of homeopathic medicines Insulinum, Pancreatinum and Uranium nitricum in Streptozotocin Induced diabetic rats

IntroductionDiabetes Mellitusis an emerging endocrine and metabolic disorder which has affected millions of people globally. Homeopathic system of medicine uses ultra-molecular doses for treatment of Diabetes Mellitus. Homeopathic medicines are prepared from plant, mineral, sarcodes,nosodes and animal parts. Insulinum 6 CH, Pancreatinum 6CH and Uranium nitricum 6 CHareused in homeopathy for treatment of Diabetes Mellitus. However,no preclinical studies have been investigated for the anti-diabetic effect and its safety.MethodsHomeopathic medicines Insulinum 6CH, Pancreatinum 6CHandUranium nitricum6CH(1012)dilution factor were used to examine antihyperglycemic effects in streptozotocin induced diabetic rats. After 28 daysoftreatment,bodyweight, Hematology, Biochemistry (serum glucose, urea, creatinine, SGPT, SGOT, ALP, Triglyceride and HDL-cholesterol), Oral Glucose Tolerance Test, HbA1C with histopathologyof (Liver, Kidney, Pancreas) weremeasured.ResultsAfter Streptozotocin induction, the animals have shown significant increase in the fasting blood glucose level (p<0.01) as compared to normal control animals. Treatment with homeopathic medicine Insulinum 6CH, Pancreatinum 6CHandUranium nitricum6CHpotency showed significant decrease in levels of Glucose (p<0.05), OGTT, Total protein (P<0.001), ALP (P<0.05), Cholesterol (P<0.001), SGPT (P<0.001), SGOT (p<0.01), Urea, HbA1C as compared to diabetic animal.ConclusionsIn the present study homeopathic medicine Insulinum 6CH, Pancreatinum 6CH andUranium nitricum6CHpotency exhibitantihyperglycemic effects in streptozotocin induced diabetic rats.(AU)

[Clinical report of 60 cases of diabetic cardio-vascular autonomous neuropathy by stasis removing treatment of combined traditional and Western medicine].

OBJECTIVE: To study the treatment of diabetic cardio-vascular autonomous neuropathy (DCVAN) by TCM-WM following the principle of promoting blood circulation to remove blood stasis. METHODS: Sixty patients with DCVAN were randomly divided into two groups, the treatment group (30 patients) were treated with combined TCM-WM therapy. Based on the control of blood sugar by WM effectively, then use TCM-Tangxinshen ([symbol: see text], TXS) with the function of supplementing the Qi and nourishing Yin, promoting blood circulation to remove blood stasis. Thirty cases of the control group were treated with WM alone. The course of treatment was three months. RESULTS: The total effective rate of the treatment group and the control group was 77.3% and 33.4% respectively, which were significantly different statistically (P < 0.005). CONCLUSION: The therapeutic effect of TCM-WM was better than that of WM.

[A study on the action of tang niao kang decoction].

Experiments have verified that Tang Niao Karg (a preparation from Chinese medicinal herbs) taken orally does not decrease the blood sugar of empty stomach in mice, but markedly helps lower high levels of blood sugar and lipid induced by epinephrine and glucose in mice. For rat models of diabetes induced by 4-o-pyrincidine Tang Niao Kang can significantly lower the content of blood sugar, raise the insulin level of blood serum, and enhance the tolerance to sugar.

Antihyperglycemic drug Gymnema sylvestre also shows anticancer potentials in human melanoma A375 cells via reactive oxygen species generation and mitochondria-dependent caspase pathway.

OBJECTIVE: Ethanolic extract of Gymnema sylvestre (GS) leaves is used as a potent antidiabetic drug in various systems of alternative medicine, including homeopathy. The present study was aimed at examining if GS also had anticancer potentials, and if it had, to elucidate its possible mechanism of action. METHODS: We initially tested possible anticancer potential of GS on A375 cells (human skin melanoma) through MTT assay and determined cytotoxicity levels in A375 and normal liver cells; we then thoroughly studied its apoptotic effects on A375 cells through protocols such as Hoechst 33258, H2DCFDA, and rhodamine 123 staining and conducted ELISA for cytochrome c, caspase 3, and PARP activity levels; we determined the mRNA level expression of cytochrome c, caspase 3, Bcl2, Bax, PARP, ICAD, and EGFR signaling genes through semiquantitative reverse transcriptase polymerase chain reaction and conducted Western blot analysis of caspase 3 and PARP. We also analyzed cell cycle events, determined reactive oxygen species accumulation, measured annexin V-FITC/PI and rhodamine 123 intensity by flow cytometry. RESULTS: Compared with both normal liver cells and drug-untreated A375, the mortality of GS-treated A375 cells increased in a dose-dependent manner. Additionally, GS induced nuclear DNA fragmentation and showed an increased level of mRNA expression of apoptotic signal related genes cytochrome c, caspase 3, PARP, Bax, and reduced expression level of ICAD, EGFR, and the anti-apoptotic gene Bcl2. CONCLUSION: Overall results indicate GS to have significant anticancer effect on A375 cells apart from its reported antidiabetic effect, indicating possibility of its palliative use in patients with symptoms of both the diseases.

Chlorophytum borivilianum: a white gold for biopharmaceuticals and neutraceuticals.

Chlorophytum borivilianum Santapau & Fernandes (Liliaceae) also known as 'Safed Musli' is a traditional rare Indian medicinal herb which has many therapeutic applications in Ayurvedic, Unani, Homeopathic and Allopathic system of medicine. Its roots (tubers) are widely used for various therapeutic applications. It is used to cure physical illness and weakness, as an aphrodisiac agent and revitalizer, as general sex tonic, remedy for diabetes, arthritis and increasing body immunity, curative for natal and postnatal problems, for rheumatism and joint pains, increase lactation in feeding mothers, as antimicrobial, anti-inflammatory, antitumor agent, also used in diarrhea, dysentery, gonorrhea, leucorrhea etc. It has spermatogenic property and is found useful in curing impotency, now it is considered as an alternative 'Viagra'. Its root contains steroidal and triterpenoidal saponins, sapogenins and fructans which act as therapeutic agents and play vital role in many therapeutic applications. It is a rich source of over 25 alkaloids, vitamins, proteins, carbohydrates, steroids, saponins, potassium, calcium, magnesium, phenol, resins, mucilage, and polysaccharides and also contains high quantity of simple sugars, mainly sucrose, glucose, fructose, galactose, mannose and xylose. The commercial exploitation of this plant and their secondary metabolites, germplasm conservation and in vitro production of secondary metabolites for quality control are some of the major prospects of this rare medicinal herb. The focus of the present review is to galvanize the potential of therapeutic and nutritive values of this herb and production of their secondary metabolites. The in vitro tuber induction, extraction, purification and characterization of saponins are also discussed in the present review.

Proliferation of the b -cells of pancreas in diabetic rats treated with Urtica dioica / Proliferación de las células b del páncreas en ratas diabéticas tratadas con Urtica dioica

This investigation was carried out to evaluate the effect of the extract of Urtica dioica leaves on hyperglycemia and quantitative changes of b-cells in streptozotocin-diabetic rats. Forty male Wistar rats were allocated in groups of normal, diabetic, treatment and protective. Hyperglycemia induced by administrating one dose of 80 mg/kg streptozotocin (STZ) intraperitoneally. Animals in treatment group received Urtica dioica (100 mg/kg/day) for 4 weeks intraperitoneally, one week after injection of STZ. In protective group animals received U. dioica (100 mg/kg/day) for 5 days before inducing diabetes. After five weeks the animals were sacrificed and whole pancreas removed. Pancreas specimens were used for quantitative morphometric analysis after Chromealum hematoxiline - phloxine staining. The mean +/- SE of b-cells in non hyperglycemic animals in protective group was higher than in hyperglycemic animals in the same group (54.33 +/- 2.4 versus 1.25 +/- 0.5, P<0.05). Hyperglycemia was improved in 6 (60 percent) of rats in protective group and 1 (10 percent) rat in treatment group OR=0.07 (CI 95 percent: 0.0-1.1, p=0.06). The logistic regression analysis showed an association between decrease of blood glucose, increase of number of b-cells and administration of Urtica before induction of diabetes. This study showed proliferation of b-cells when of the U. dioica leaves extract (100 mg/kg/day) administrated before induction of diabetes in animal model.

Este estudio evalúa el efecto del extracto de hojas de Urtica dioica sobre la hiperglicemia y de los cambios cuantitativos de células b en ratas diabéticas por estreptozotocina. Cuarenta ratas Wistar macho, fueron distribuidas en grupos normal, diabético, en tratamiento y protector. La hiperglicemia fue inducida, por vía intraperitoneal, a través de la administración de una dosis de 80 mg/kg de estreptozotocina (STZ) . Los animales del grupo en tratamiento recibieron Urtica dioica (100 mg/kg/día) durante 4 semanas por vía intraperitoneal, una semana después de la inyección de STZ. En los animales del grupo de protección recibieron U. dioica (100 mg/kg/día) durante 5 días antes de inducir la diabetes. Después de cinco semanas, los animales fueron sacrificados y se extirpó el páncreas. Muestras de páncreas se utilizaron para el análisis morfométrico cuantitativo después de la tinción hematoxilina/floxina. La media +/- SE de células b en los animales sin hiperglicemia y en el grupo de protección fue mayor que en los animales con hiperglicemia (54,33 +/- 2,4 frente a 1,25 +/- 0,5, p<0,05). La hiperglicemia mejoró en 6 (60 por ciento) de las ratas del grupo de protección y 1 (10 por ciento) de ratas en grupo de tratamiento OR=0,07 (IC 95 por ciento: 0,0-1,1, p=0,06). El análisis de regresión logística mostró una asociación entre la disminución de la glucosa en sangre, aumento del número de células b y la administración de Urtica antes de la inducción de la diabetes. Este estudio mostró una proliferación de las células b cuando el extracto de las hojas de U. dioica (100 mg/kg/día) administrado antes de la inducción de la diabetes en modelos animales.

Effect of insulin concentration on bioavailability during nasal spray administration.

The bioavailability of rapid-acting insulin administered as a nasal spray was studied in 6 type 1 (insulin-dependent) diabetic patients. They received long-acting bovine insulin (Ultratardum 40 U/ml, Organon) as basal treatment at 8 a.m. Rapid-acting insulin was also administered at 8 a.m., then at noon and 6 p.m, subcutaneously on day 1 as a 100 U/ml solution and intranasally by aerosol spray as a 100 U/ml and 500 U/ml with 1% (w/v) 9 lauryl ether solution on day 2 and day 3 respectively. On days 2 and 3, the dose of insulin was at least nine times higher than the subcutaneous dose on day 1. Free and total plasma insulin concentrations were assayed after the noon insulin administration. The peaks of the free and total plasma insulin levels were reached earlier and the return to basal levels was obtained earlier after nasal insulin administration than after insulin injected subcutaneously. The bioavailability of nasal spray insulin versus subcutaneous insulin with a 100 U/ml insulin solution was similar to that with a 500 U/ml insulin solution: 5.14 +/- 0.38% (m +/- SEM) and 4.64 +/- 0.46% according to the total plasma insulin level. This study suggests that the bioavailability of nasal spray insulin is not increased by increasing insulin concentration in our experimental conditions.

Modificaciones de la glucemia en conejos, con Cecropia sp / Blood glucose changes in rabbits with Cecropia sp

Existen una serie de vegetales en la Republica Mexicana que son enpleados empiricamente con fines farmacologicos por la poblacion rural. Es un compromiso de quienes se dirigen a la medicina experimental demostrar las funciones que estas plantas tienen en el organismo humano, ya que de comprobarse su utilidad su uso abaratara considerablemente los costos de la industria farmaceutica, en bien de la poblacion mas pobre del pais. En este caso el Guarumbo (Cecropia peltata, Cecropia mexicana o Cecropia obtusifolia) es mencionado continuadamente como util en algunos sintomas de la diabetes, cuya cualidad fue comunicada de manera verbal constantemente a medicos que realizaron su servicio social en regiones donde se encuentra dicho vegetal. El interes por el estudio de esta planta, se desarrollo en nosotros con objeto de esclarecer las relaciones farmacologicas existentes en pacientes con problemas de diabetes a los que se les administra la planta en forma de infusion, encontrandose que se conseguia la disminucion de la astenia y adinamia, asi como la normalizacion de la diuresis. Tomando en cuenta que dentro de la bibliografia conocida de Cecropia no existen informes de su probable actividad en esta estidad nosologica, resulta de gran importancia constatar a nivel de laboratorio si efectivamente contribuye a la regulacion homeostatica, escogiendo para analizar parametros de alteracion en la quimica sanguinea

Pancreatic beta-cell regeneration

Cephalendra indica (41//v/v alcoholic extract of the wild variety of Cephalendra indica Naud.), on regular administration in doses ranging from 25uml to 75uml/100g of body weight (gbw) by the oral or intraperitoneal (ip) route produced a significant fall in blood sugar level in alloxan-induced diabetic rats. Biochemical studies showed stabilization of blood sugar level in 70//of cases at fourteen to twenty days after withdrawal of the drug. Histopathological studies revealed regeneration of pancreatic B cells. The hypothesis is that the drug acts through the hypothalamo-hypophysial-pancreatic axis, producing selective regeneration of B cells. The drug may indirectly release inhibitory factors from hypothalamic neurons, inhibiting the secretion of growth hormone and triggering insulin secretions from B cells. The therapeutic action of the drug on pancreatic B cells and lack of acute and subacute toxicity may open up new prospects in the treatment of diabetes mellitus

Tratamiento farmacológico de la diabetes mellitus tipo 2 / Drug theraphy for the treatment of type 2 diabetes mellitus

El tratamiento farmacológico para los pacientes con diabetes mellitus tipo 2 se encuentra en su estado más maduro, con una base racional, con el principal objetivo de la prevención de la morbilidad y la mortalidad, lo que se encuentra considerado como el distintivo más importante en esta enfermedad. El tratamiento de los pacientes con diabetes mellitus tipo 2 con dieta ocurre en 12 por ciento, con hipoglucemiantes orales en 48 por ciento, con insulina en 36 por ciento, y 4 por ciento tienen un tratamiento combinado de hipoglucemiantes orales e insulina. Durante los últimos años ha habido una gran proliferación de nuevos medicamentos para el tratamiento de los pacientes con diabetes mellitus tipo 2. Estos productos ofrecen diferentes mecanismos de acción, lo que hace importante la individualización del tratamiento. Al momento de prescribir un hipoglucemiante oral debemos tener presente los efectos colaterales y las contraindicaciones

Nuevos retos del control de la hipertensión arterial en México / New challenges for the control of hypertension in México

Los nuevos lineamientos para el manejo de la hipertensión arterial plantean retos para nuestro sistema de salud. El primero referente a la cobertura del tratamiento hipertensivo, ya que sólo 21 por ciento recibe tratamiento antihipertensivo y de este porcentaje sólo 30 por ciento alcanza cifras < 140/90 mm Hg. El segundo consiste en mejorar las estrategias para su adecuada identificación, ya que existe un sobrediagnóstico que va de 16 a 26 por ciento. El tercero orientar el tratamiento a grupos de alto riesgo como los diabéticos y quienes ya presentaron alguna complicación cardiovascular, cuyas cifras de control deben ser < 130/85 mm Hg. El último reto es abatir el costo del tratamiento antihipertensivo. En el presente estudio se plantea resolver cada uno de estos retos y lograr la disminución de las complicaciones asociadas con la enfermedad