A Review of Clinical Trial Studies on Medicinal Plants in the Treatment of Diabetes

Fallah, Bahare; Mehrabbeik, Akram; Salmani, Naiire

doi:10.18502/ijdo.v14i2.9456

Volume 14, Issue 2 (5-2022) IJDO 2022, 14(2): 117-130 | Back to browse issues page

‎ 10.18502/ijdo.v14i2.9456

‎ 20.1001.1.20086792.2022.14.2.5.2

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Fallah B, Mehrabbeik A, Salmani N. A Review of Clinical Trial Studies on Medicinal Plants in the Treatment of Diabetes. IJDO 2022; 14 (2) :117-130
URL: http://ijdo.ssu.ac.ir/article-1-709-en.html

A Review of Clinical Trial Studies on Medicinal Plants in the Treatment of Diabetes

Bahare Fallah

, Akram Mehrabbeik

, Naiire Salmani ^*

Assistant Professor. Faculty of Nursing and Midwifery, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract: (1621 Views)

Objective: The use of medicinal plants in diabetic patients is rising, it is essential to increase knowledge about the effects of medicinal plants and subsequently perform evidence-based action, so, review studies are a helpful way for the present purpose. Current study was conducted to investigate the clinical trials of medicinal plants used in the treatment of diabetes in Iran.
Materials and Methods: Articles published online between 2010 - 2020 were googled in Magiran, SID, Scopus, and, Iran Medex with Persian keywords such as “type 2 diabetes”, “medicinal herbs”, “healing herbs” “herbs”, “medicinal plants” and “clinical trial”. The inclusion criteria for articles were conducting in the form of a clinical trial, conducting in Iran, publishing in Persian language and having at least a score of 3 based on the Jadad scale.
Results: 20 clinical trial studies were extracted. Five studies were conducted on cinnamon and two studies on cumin and the rest of the plants were examined just in one study. Although some trials showed positive effects of the medicinal plants on reducing fasting blood sugar (FBS) and glycosylated hemoglobin (HbA1c), some others demonstrated that medicinal plants had no effect on important variables in diabetes control.
Conclusion: Conclusions about the benefits of plants should be made with caution, safety and efficacy of plants in the treatment of diabetes should be investigated further. It is essential that patients take any herbal supplements under physician’s supervision and after receiving the necessary advice.

Keywords: Type 2 diabetes, Medicinal herbs, Healing herbs, Medicinal plants, Clinical trial

Full-Text [PDF 635 kb] (586 Downloads)

Type of Study: Research | Subject: Special
Received: 2021/12/18 | Accepted: 2022/03/12 | Published: 2022/05/20

References

1. Jafari S, Mehdizadeh A, Ghavamzadeh S. The effect of two different doses of cuminum cyminum extract on serum glycemic indices and inflammatory factors in patients with diabetes type II: a randomized double-blind controlled clinical trial. Journal of Ardabil University of Medical Sciences. 2016;16(2):200-10.(in Persian)

2. Fallah Tafti B, Vaezi AA, Moshtagh Z, Shamsi F. The assessment of barriers to the self-care behaviors in type 2 diabetic patients of Yazd province in 2014. Tolooebehdasht. 2016;15(3):115-29.(in Persian)

3. Esmaillzadeh A, Zakizadeh E, Faghihimani E, Gohari M, Jazayeri S. The effect of purslane seeds on glycemic status and lipid profiles of persons with type 2 diabetes: A randomized controlled cross-over clinical trial. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences. 2015;20(1):47.

4. Fallah B, Moshtagh Eshgh Z. The effects of basic conditioning factors on self-care behaviors of patients with type 2 diabetes referred to Yazd Research Center, 2014.Journal of Shahid Sadoughi University of Medical Sciences. 2018;25(10):770-9.(in Persian)

5. Abdul-Ghani MA, Williams K, Kanat M, Altuntas Y, DeFronzo RA. Insulin vs GLP-1 analogues in poorly controlled type 2 diabetic subjects on oral therapy: a meta-analysis. Journal of endocrinological investigation. 2013;36(3):168-73.

6. Farhadnejad H, Asghari G, Mirmiran P, Azizi F. Association of Dietary Approach to Stop Hypertension (DASH) diet with 3-year changes in body mass index and risk of obesity in adolescents: Tehran Lipid and Glucose Study. Iranian Journal of Endocrinology and Metabolism. 2017;18(5):325-33.(in Persian)

7. Zamani-nour N, Ahmadi A, Tahbaz F. Postprandial glucose and insulin responses to onion ingestion with breakfast in patients with type 2 diabetes. Journal of Shahrekord Uuniversity of Medical Sciences. 2012;13. 2012, 13(6): 19-26.(in Persian)

8. Dashtban R, Mansouri A. A Comparative Study on the Effect of Garlic and Cumin on Glycosylated Hemoglobin in Patients with Type II Diabetes. Journal of Diabetes Nursing. 2017 10;5(3):186-79.(in Persian)

9. Milajerdi A, Jazayeri S, Bitarafan V, Hashemzadeh N, Shirzadi E, Derakhshan Z, et al. The effect of saffron (Crocus sativus L.) hydro-alcoholic extract on liver and renal functions in type 2 diabetic patients: A double-blinded randomized and placebo control trial. Journal of Nutrition & Intermediary Metabolism. 2017;9:6-11. [DOI:10.1016/j.jnim.2017.07.002]

10. Ogbera AO, Dada O, Adeleye F, Jewo PI. Complementary and alternative medicine use in diabetes mellitus. West African journal of medicine. 2010;29(3). [DOI:10.4314/wajm.v29i3.68213]

11. Ghalavand A, Motamedi P, Delaramnasab M, Khodadoust M, Mahmoodkhani Koosskaki R. Cardiometabolic effects of urtica dioica in type II diabetes. Journal of Diabetes Nursing. 2017;5(1):59-69.(in Persian)

12. Al-Aboudi A, Afifi FU. Plants used for the treatment of diabetes in Jordan: A review of scientific evidence. Pharmaceutical biology. 2011;49(3):221-39. [DOI:10.3109/13880209.2010.501802]

13. Otoom SA, Al-Safi SA, Kerem ZK, Alkofahi A. The use of medicinal herbs by diabetic Jordanian patients. Journal of herbal pharmacotherapy. 2006;6(2):31-41. [DOI:10.1080/J157v06n02_03]

14. Karaman E, Erkin O, Senman S, Yildirim Y. The use of herbal supplements by individuals with diabetes mellitus. JPMA. The Journal of the Pakistan Medical Association. 2018;68(4):587-94.

15. Shahandokht N, Nojomi M, Moradilakeh M. The Common Herb In Self Herbal Medication In Diabetic Patients Refer To Diabetes Medical Health Center. Iranian Journal of Diabetes and Metabolism. 2014;13(5):413-24.(in Persian)

16. Rutebemberwa E, Lubega M, Katureebe SK, Oundo A, Kiweewa F, Mukanga D. Use of traditional medicine for the treatment of diabetes in Eastern Uganda: a qualitative exploration of reasons for choice. BMC international health and human rights. 2013;13(1):1-7. [DOI:10.1186/1472-698X-13-1]

17. Karaman E, Senman S, Yildirim Y, Erkin O. KAP Study. Journal Of Pakistan Medical Association. 2018;68(4).

18. Kesavadev J. Efficacy and safety concerns regarding Complementary and Alternative Medicine use among diabetes patients. JPMA. The Journal of the Pakistan Medical Association. 2017;67(2):316-9.

19. Mekuria AB, Belachew SA, Tegegn HG, Ali DS, Netere AK, Lemlemu E, et al. Prevalence and correlates of herbal medicine use among type 2 diabetic patients in Teaching Hospital in Ethiopia: a cross-sectional study. BMC complementary and alternative medicine. 2018;18(1):1-8. [DOI:10.1186/s12906-018-2147-3]

20. Hosseini SE, Tavakoli F, Karami M. Medicinal plants in the treatment of diabetes mellitus. Clinical Excellence. 2014 Sep 10;2(2):64-89.(in Persian)

21. Aliasgarzadeh A, Mobasseri M, Bahrami A, Zargami N, Tabrizi A. Effect of extract of Urtica dioica on insulin and C-peptide secretion from rats (RIN5F) pancreatic beta cells. African journal of pharmacy and pharmacology. 2012;6(29):2176-9. [DOI:10.5897/AJPP10.275]

22. Tarighat EA, Namazi N, Bahrami A, Ehteshami M. Effect of hydroalcoholic extract of nettle (Urtica dioica) on glycemic index and insulin resistance index in type 2 diabetic patients. Iranian journal of endocrinology and metabolism. 2012; 13(6):561-8.(in Persian)

23. Thippeswamy NB, Naidu KA. Antioxidant potency of cumin varieties-cumin, black cumin and bitter cumin-on antioxidant systems. European food research and technology. 2005;220(5):472-6. [DOI:10.1007/s00217-004-1087-y]

24. Parthasarathy VA, Chempakam B, Zachariah TJ. Chemistry of spices: Cabi; 2008. [DOI:10.1079/9781845934057.0000]

25. Froghi M, Ghatreh SK, Heidarian E, Nikokar M, Fazeli S. Study effects of resveratrol, cuminumcyminum, essence and vitamin C on blood sugar, lipid, insulin resistance and advanced glycatedend product (AGEs) in type2 diabetic patients. 2018;20(4):169-76.(in Persian)

26. Jarvill-Taylor KJ, Anderson RA, Graves DJ. A hydroxychalcone derived from cinnamon functions as a mimetic for insulin in 3T3-L1 adipocytes. Journal of the American College of Nutrition. 2001;20(4):327-36. [DOI:10.1080/07315724.2001.10719053]

27. Zahmatkesh M, Fallah Huseini H, Hajiaghaee R, Heidari M, Mehrafarin A, Tavakoli-Far B. The effects of Cinnamomum zeylanicum J. Presl on blood glucose level in patients with type 2 diabetes, a double-blind clinical trial. Journal of Medicinal Plants. 2012 10;11(41):258-63.(in Persian)

28. Baker WL, Gutierrez-Williams G, White CM, Kluger J, Coleman CI. Effect of cinnamon on glucose control and lipid parameters. Diabetes care. 2008;31(1):41-3. [DOI:10.2337/dc07-1711]

29. Mirfeizi M, Mehdizadeh Tourzani Z, Mirfeizi SZ, Asghari Jafarabadi M, Rezvani H, Shoghi M. Effects of cinnamon on controlling blood glucose and lipids in patients with type II diabetes mellitus: A double blind, randomized clinical trial. medical journal of mashhad university of medical sciences. 2014;57(3):533-41.

30. Zahedifar A, Khodashenas M, Bijari B, Zahedifar F. Effects of cinnamon on fasting blood sugar and hemoglobin A1C in patients with type II diabetes mellitus: A randomized clinical trial. Journal of Mazandaran University of Medical Sciences. 2018;27(156):80-8.(in Persian)

31. Khadem Hh, Farsad Na, Pourghassem Gb, Ali Aa, Nemati A. Effect Of Cinnamon On Glycemic Control And Insulin Resistance In Type Ii Diabetes Patients: A Randomized Clinical Trial. Journal of Ardabil University of Medical Sciences. 2010;10(4):295-302.(in Persian)

32. Hasanzade F, Tolyat M M, Emami A, Barakchi A, Emamimoghaadam Z. Effect of cinnamon on HbA1c in type 2 diabetes patients. Complementary Medicine Journal of faculty of Nursing & Midwifery. 2013;2(4):303-11.(in Persian)

33. Hosseinzadeh H. Saffron: a herbal medicine of third millennium. Jundishapur journal of natural pharmaceutical products. 2014;9(1): 1-2. [DOI:10.17795/jjnpp-16700]

34. Samarghandian S, Azimi-Nezhad M, Farkhondeh T. Crocin attenuate Tumor Necrosis Factor-alpha (TNF-α) and interleukin-6 (IL-6) in streptozotocin-induced diabetic rat aorta. Cytokine. 2016;88:20-8. [DOI:10.1016/j.cyto.2016.08.002]

35. Razavi BM, Hosseinzadeh H. Saffron as an antidote or a protective agent against natural or chemical toxicities. DARU Journal of Pharmaceutical Sciences. 2015;23(1):1-9. [DOI:10.1186/s40199-015-0112-y]

36. Grace A, Chan E, Giallauria F, Graham PL, Smart NA. Clinical outcomes and glycaemic responses to different aerobic exercise training intensities in type II diabetes: a systematic review and meta-analysis. Cardiovascular diabetology. 2017;16(1):1-0. [DOI:10.1186/s12933-017-0518-6]

37. Feinman RD, Pogozelski WK, Astrup A, Bernstein RK, Fine EJ, Westman EC, et al. Dietary carbohydrate restriction as the first approach in diabetes management: critical review and evidence base. Nutrition. 2015;31(1):1-3. [DOI:10.1016/j.nut.2014.06.011]

38. Rafraf M, Malekiyan M, Asghari-Jafarabadi M, Asgarzadeh AA, Pourmoradian S. Effect of Fenugreek Deeds on Serum Metabolic Factors and ICAM-1 (Intercellular adhesion molecule-1) levels in type 2 Diabetic Patients. Journal of Zanjan University of Medical Sciences and Health Services. 2015;23(96):11-21.(in Persian)

39. Bera TK, Ali KM, Jana K, Ghosh A, Ghosh D. Protective effect of aqueous extract of seed of Psoralea corylifolia (Somraji) and seed of Trigonella foenum-graecum L.(Methi) in streptozotocin-induced diabetic rat: A comparative evaluation. Pharmacognosy research. 2013;5(4):277. [DOI:10.4103/0974-8490.118840]

40. Hamden K, Mnafgui K, Amri Z, Aloulou A, Elfeki A. Inhibition of key digestive enzymes related to diabetes and hyperlipidemia and protection of liver-kidney functions by trigonelline in diabetic rats. Scientia pharmaceutica. 2013;81(1):233-46. [DOI:10.3797/scipharm.1211-14]

41. Yoshikawa M, Morikawa T, Kobayashi H, Nakamura A, Matsuhira K, Nakamura S, et al. Bioactive saponins and glycosides. XXVII. Structures of new cucurbitane-type triterpene glycosides and antiallergic constituents from Citrullus colocynthis. Chemical and Pharmaceutical Bulletin. 2007;55(3):428-34. [DOI:10.1248/cpb.55.428]

42. Benariba N, Djaziri R, Bellakhdar W, Belkacem N, Kadiata M, Malaisse WJ, et al. Phytochemical screening and free radical scavenging activity of Citrullus colocynthis seeds extracts. Asian Pacific journal of tropical biomedicine. 2013;3(1):35-40. [DOI:10.1016/S2221-1691(13)60020-9]

43. Zareei MA, Fallahhossini F, Sharifabady R, Nourouzzadeh A, Imani H, Ghoshouni H. The effect of Citrullus colocynthis extract on preventing/reducing streptozotocin-induced diabetes in rat. Kowsar Medical Journal. 2007;12(1):13-20.(in Persian)

44. Rahimi R, Amin G, Ardekani MR. A review on Citrullus colocynthis Schrad.: from traditional Iranian medicine to modern phytotherapy. The journal of alternative and complementary medicine. 2012;18(6):551-4. [DOI:10.1089/acm.2011.0297]

45. Yaghoobi MA, Miri-Moghaddam E, Navidian A, Nikbakht R, Mehrafarin A, Fallah Huseini H. Safety and Efficacy of Processed Citrullus colocynthis L. Fruit in Treatment of Hyperlipidemic Type II Diabetic Patients: A Randomized, Placebo-controlled Clinical Trial. Journal of Medicinal Plants. 2014;13(52):81-8.

46. Orak HH, Aktas T, Yagar H, Isbilir SS, Ekinci N, Sahin FH. Effects of hot air and freeze drying methods on antioxidant activity, colour and some nutritional characteristics of strawberry tree (Arbutus unedo L) fruit. Food Science and Technology International. 2012;18(4):391-402. [DOI:10.1177/1082013211428213]

47. Manzano S, Williamson G. Polyphenols and phenolic acids from strawberry and apple decrease glucose uptake and transport by human intestinal Caco‐2 cells. Molecular nutrition & food research. 2010;54(12):1773-80. [DOI:10.1002/mnfr.201000019]

48. Amani R, Moazzen S, Shahbazian H, Ahmadi Ankali K, Homayouni Rad A, Jalali M. Effects of freeze-dried strawberries on lipid profile and glycated hemoglobin in subjects with type 2 diabetes: a double blind randomized control trial. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(3):189-200.(in Persian)

49. Adab Z, Eghtesadi SH, Vafa MR, Heydari I, Shojaei A, Haqqani H, Khorraminia N. Effect of turmeric on body measurement indices, glycemic condition, and lipid profile in hyperlipidemic patients with type 2 diabetes. Iranian Journal of Nutrition Sciences & Food Technology. 2013;8(3):217-27. (in Persian)

50. Alappat L, Awad AB. Curcumin and obesity: evidence and mechanisms. Nutrition reviews. 2010;68(12):729-38. [DOI:10.1111/j.1753-4887.2010.00341.x]

51. Talaei B, MOZAFARI KH, Jalali B, Mahammadi SM, Najarzadeh A, Fallahzadeh H. The effect of ginger on blood glucose, lipid and lipoproteins in patients with type 2 diabetes: a double-blind randomized clinical controlled trial.Journal of Shahid Sadoughi University of Medical Sciences. 2012;20(3):383-95.(in Persian)

52. Aryaeian N, Arablou T, Sharifi F, Hosseini A, Valizadeh M. Effect of ginger consumption on glycemic status, insulin resistance, and inflammatory markers in patients with type 2 diabetes mellitus. Iranian Journal of Nutrition Sciences & Food Technology. 2014;9(1):1-0.(in Persian)

53. Kim MJ, Yoo KH, Park HS, Chung SM, Jin CJ, Lee Y, et al. Plasma adiponectin and insulin resistance in Korean type 2 diabetes mellitus. Yonsei medical journal. 2005;46(1):42-50. [DOI:10.3349/ymj.2005.46.1.42]

54. Bhathena SJ, Velasquez MT. Beneficial role of dietary phytoestrogens in obesity and diabetes. The American journal of clinical nutrition. 2002;76(6):1191-201. [DOI:10.1093/ajcn/76.6.1191]

55. Sáyago-Ayerdi SG, Arranz S, Serrano J, Goñi I. Dietary fiber content and associated antioxidant compounds in roselle flower (Hibiscus sabdariffa L.) beverage. J. of Agricultural and Food Chemistry. 2007;55(19):7886-90. [DOI:10.1021/jf070485b]

56. Mozaffari-Khosravi H, Afkhami Ardekani M, Jalali-Khanabadi BA, Fallahzadeh H. Comparison of the Effect of Green and Sour Tea on Blood Glucose and Lipids Profile in Patients with Type 2 Diabetes Mellitus. Tolooebehdasht. 2013;11(3):113-24.(in Persian)

57. Payahoo LA, Khaje-Bishak Y, Mobasseri MA, Ostadrahimi AL, Asghari-Jafarabadi M. The effects of Anethum graveolens L supplementation on the insulin resistance and inflammatory biomarkers in patients with type 2 diabetes. Journal of Isfahan Medical School. 2015;32(320):2473-83.(in Persian)

58. Kaur GJ, Arora DS. Bioactive potential of Anethum graveolens, Foeniculum vulgare and Trachyspermum ammi belonging to the family Umbelliferae-Current status. Journal of Medicinal Plants Research. 2010;4(2):087-94.

59. Kazemi S, Asgari S, Moshtaghian SJ, Rafieian M, Mahzooni P. Preventive effect of pumpkin (Cucurbita Pepo L.) on diabetic index and histopathology of pancreas in alloxan-induced diabetes in rats. Journal of Isfahan Medical School. 2011;28(117):1108-17.(in Persian)

60. Bayat A, Azizi-Soleiman F, Heidari-Beni M, Feizi A, Iraj B, Ghiasvand R,et al. Effect of Cucurbita ficifolia and probiotic yogurt consumption on blood glucose, lipid profile, and inflammatory marker in type 2 diabetes. International Journal of Preventive Medicine. 2016;7. [DOI:10.4103/2008-7802.175455]

61. Raja RR. Medicinally potential plants of Labiatae (Lamiaceae) family: an overview. Research journal of medicinal plant. 2012;6(3):203-13. [DOI:10.3923/rjmp.2012.203.213]

62. Patel DK, Prasad SK, Kumar R, Hemalatha S. An overview on antidiabetic medicinal plants having insulin mimetic property. Asian Pacific journal of tropical biomedicine. 2012;2(4):320-30. [DOI:10.1016/S2221-1691(12)60032-X]

63. Zarei A, Vaezi G, Malekirad AA, Abdollahi M. Effects of ethanol extract of Salvia hydrangea on hepatic and renal functions of streptozotocin-induced diabetic rats. Avicenna journal of phytomedicine. 2015;5(2):138-147.

64. Aqababa H, Chobineh MA, Zarei A, Changizi Ashtiyani S. The effect of ethanol extract of aerial parts of Salvia hydrangea L. on plasma biochemical factors in male rats with hypercholesterolemia. Qom University of Medical Sciences Journal. 2016;10(4):78-85.(in Persian)

65. Taleb AM, Qannadi F, Changizi-Ashtiyani S, Zarei A, Rezvanfar MR, Akbari A, et al. The effect of aqueous extract thymus kotschyanus boiss. Et hohen on glycemic control and dyslipidemia associated with type II diabetes: A randomized controlled trial. Iranian Journal of Endocrinology and Metabolism. 2017;19(4):234-43.(in Persian)

66. Shahdadi H, Mansouri A, Dashtban R. A Comparative Study On The Effect Of Garlic And Cumin On Blood Pressure In Patients With Type 2 Diabetes: A Clinical Double-Blind Trial. Nursing And Midwifery Journal. 2017;15(8):605-11.(in Persian)

67. Khademian-Ravandi R, Mozaffari-Khosravi H, Esteghamati A, Meysami A. The effect of garlic tablet on blood glucose, and lipid profile in type 2 diabetic patients: a double-blind randomized placebo controlled trial. Journal of Shahid Sadoughi University of Medical Sciences. 2015;23(7):621-30.(in Persian)

68. Sajjadi F, Baghbanian P, Asgari S, Naderi G, Alikhasi H, Mohammadi Fard N. The effect of hydroalcoholic extract of Salvia officinal on diabetic patients. International Journal Of Research In Medical Sciences. 2003;4(7):318-24.

69. Schnitzler P, Nolkemper S, Stintzing FC, Reichling J. Comparative in vitro study on the anti-herpetic effect of phytochemically characterized aqueous and ethanolic extracts of Salvia officinalis grown at two different locations. Phytomedicine. 2008;15(1-2):62-70. [DOI:10.1016/j.phymed.2007.11.013]

70. Jedinák A, Mučková M, Košt'álová D, Maliar T, Mašterová I. Antiprotease and antimetastatic activity of ursolic acid isolated from Salvia officinalis. Zeitschrift für Naturforschung C. 2006;61(11-12):777-82. [DOI:10.1515/znc-2006-11-1203]

71. Christensen LP. Ginsenosides: chemistry, biosynthesis, analysis, and potential health effects. Advances in food and nutrition research. 2008;55:1-99. [DOI:10.1016/S1043-4526(08)00401-4]