Hypoglycemic Effect of Bitter Gourd (Momordica charantia L) among Pre Diabetics in India: A Randomized Placebo Controlled Cross Over Study
Keywords:Hypoglycemia, pre diabetes, bitter gourd, diabetes, cross-over design
AbstractHigh prevalence of pre diabetes observed in many South Asian countries highlights a potential indicator of further progression of the diabetic epidemic in the region. Average expenditure related to diabetes per person in India is higher. Unless appropriate action is taken, this will place an economic burden, hence a food based approach was planned to reduce the incidence of pre diabetes. The main aim of the study was to investigate the hypoglycemic effect of bitter gourd (Mormordica charantia L.)among pre diabetics. A single blinded, placebo-controlled, randomized, cross-over designed intervention study was conducted with freeze dried bitter gourd powder (2.5 g) to find out its hypoglycemic effect. In the first phase Group 1 (AB) started the bitter gourd juice (A) intervention followed by placebo (B), while the Group 2 (BA) started the supplementation with placebo (B) followed by bitter gourd (A). The intervention continued for a period of eight weeks. Between the two arms, 4 weeks were left as wash-out period to minimize the carry-over effect of one phase to the other. Cross over was done after the washout period. The mean initial fasting blood glucose level of pre diabetics in AB group was 110.66 mg/dl which reduced significantly (p<0.01) to 99.86 mg/dl at the end of intervention. In case of BA group the placebo treatment did not bring any appreciable change in FBG where as the bitter gourd treatment was found to have a significant (p<0.01) impact. No serious adverse effects were observed. The present study proved that the consumption of bitter gourd juice prepared with 2.5 g freeze dried bitter gourd powder (50g of the vegetable) reduced the fasting blood glucose and total cholesterol level among the pre diabetics.
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Anjana, R.M., Pradeepa, R., Deepa, M., Datta, M., Sudha, V. and Unnikrishnan, R. ICMR– INDIAB Collaborative Study Group Prevalence of diabetes and prediabetes (impaired fasting glucose and/or impaired glucose tolerance) in urban and rural India: Phase I results of the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Diabetol., 2011, 3022-3027.
Jayawardena, R., Ranasinghe, P., Byrne, N.M., Soares, M.J., Katulanda, P. and Hillse t, A.P. Pre valence and trends of the diabete s epidemic in South Asia: a systematic review and meta-analysis. BMC Pub. Health, 2012, 380 (12), 1-11.
Poudel, R. and Adhikari, B. Diabetes in the Himalayas: Psychosocial barriers and solutions.
J. Social Health Diab., 2013, 1, 66.
Tabish, S.A. Complementary and Alternative Healthcare: Is it Evidence-based? Int. J. Health Sci., 2008, 2(1), V–IX.
Ocvirk, S., Kistler, M., Khan, S., Talukder, H.S. and Hauner, H. Traditional medicinal plants used for the treatment of diabetes in rural and urban areas of Dhaka, Bangladesh – An ethnobotanical survey. J.Ethnobiol. Ethnomed., 2013, 9(43), 1-8.
Habicht, D., Kind, V., Rudloff, S., Borsch, C., Mueller, A.S., Pallauf, J., Yang, R. and Krawinkel, M.B. Quantification of antidiabetic extracts and compounds in bitter gourd varieties. Fd. Chem., 2011, 126, 172-176.
Fuangchan, A., Sonthisombat, P., Seubnukarn, T., Chanouan, R., Chotchaisuwat, P. and Sirigulsatien, V. Hypoglycemic effect of bitter melon compared with metformin in newly diagnosed type 2 diabetes patients. J.Ethnopharmacol., 2011, 134(2), 422-428.
Mohan, V., Deepa, R., Deepa, M., Somannavar, S. and Datta, M. A simplified Indian Diabetes Risk Score for Screening for Undiagnosed Diabetic subjects.J.Assoc. Phys.Ind., 2005, 53 (7), 59-63.
American Diabetes Association. Standards of medical care in diabetes. Diab. Care, 2014, 37(1), S14–S80.
Tsai, C.H., Chen, E.C.F. and Tsay, H.S. Wild bitter gourd improves metabolic syndrome: A preliminary dietary supplementation trial. Nutr. J., 2012, 11, 4.
Wellek, S. and Blettner, M. On the proper use of the crossover design in clinical trials Part 18 of a Series on evaluation of scientific publications, Deutsches Arzteblatt International, 2012, 109 (15), 276-281.
Report of the Technical Group [11th Five Year Plan: 2007-12] on Estimation of urban housing shortage,Government of India, Ministry Of Housing and Urban Poverty Alleviation, pp-13. http://mhupa.gov.in/ministry/housing/HOUSINGSHORTAGE-REPT.pdf
Booth, F.W., Roberts, C.K. and Laye, M.J. Lack of exercise is a major cause of chronic diseases. Compr. Physiol., 2012, 2(2), 1143–1211.
Banerjee, S. The rise of the nuclear family behaviors increase risk of cardiovascular disease mortality in men. Med. Sci. Sports Exer., 2010, 42, 879–885
www.ehow.com/info_8308329_eating-habits-indian-culture.html-last accessed on 13.06.2014.
National Institute for Health and Care Excellence. PH35. Preventing type 2 diabetes: Population and community-level interventions. London, 2011.
Neufeld, L.M., Jones-Smith, J.C., Garcia, R. and Fernald, L.C. Anthropometric predictors for the risk of chronic disease in non-diabetic, non- hypertensive young Mexican women.Pub. Health Nutr., 2008, 11(2), 159 - 167.
Browning, L.M., Hsieh, S.D. and Ashwell, M. A systematic review of waist-to-height ratio as a screening tool for the prediction of cardiovascular disease and diabetes: 0·5 could be a suitable global boundary value. Nutr. Res. Rev., 2010, 23, 247-269.
Waheed, A., Miana, G.A., Sharafatullah, T. and Ahmad, S.I. Clinical investigation of hypoglycemic effect of unripe fruit on Momordica charantia in type-2 (NIDDM) diabetes mellitus. Pak. J. Pharmacol., 2008, 25, 7-12.
Singh, J., Cumming, E., Manoharan, G., Kalasz, H. and Adeghate, E. Medicinal chemistry of the anti-diabetic effects of Momordica Charantia: active constituents and modes of actions.Open Medic. Chem. J., 5 (Supple 2-M2), 2011, 70-77.
Rahman, U., Bashir, M., Salman, M., Idrees, M. and Khan, M.I. Bitter melon (Momordica Charantia) reduces serum sialic acid in Type2 Diabetics: Evidence to delay the process of atherosclerosis. Chin. Med., 2011, 2, 125-129.
Mohammady, I., Elattar, S., Mohammed, S. and Ewais, M. An evaluation of anti-diabetic and anti-lipidemic properties of Momordica charantia (Bitter Melon) fruit extract in experimentally induced diabetes.Life Sci. J., 2012, 9(2), 364-373.
Singh, N. and Gupta, M. Regeneration of beta cells of pancrease of alloxan diabetic rats by acetone extract of M. charantia fruits. Ind. J. Expt. Biol., 2007, 45, 1055-1062.
Sridhar, M., Vinayagamoorthi, R., Suyambunathan, V.A., Bobby, Z. and Selvaraj, N. Bitter gourd (Momordica charantia) improves insulin sensitivity by increasing skeletal muscle insulinstimulated IRS-1 tyrosine phosphorylation in high-fat-fed rats. Brit. J.Nutr., 2008, 99, 806–812.
Nerurkar, P.V., Lee, K.Y. and Nerurkar, R.V. Momordica charantia (bitter melon) inhibits primary human adipocyte differentiation by modulating adipogenic genes.BMC Compl. Alt.Med., 2010, 10-34.
Parmer, K., Patel, S., Patel, J., Patel, B. and Patel, M.B. Effects of bittergourd (Momordica Charantia) fruit juice on glucose tolerance and lipid profile in Type ll diabetic rats., Int.J.Drug Dev. Res., 2011, 3(2), 139-146.
Hasan, I. and Khatoon, S. Effect of Momordica charantia (bitter gourd) tablets in diabetes mellitus: Type 1 and Type 2. Prime Res. Med., 2012, 2(2), 72–74.
Veghari, G., Sedaghat, M., Joshaghani, H., Banihashem, S., Moharloei, P, Angizeh, A., Tazik, E., Moghaddami, A., Tilaki, K.H. and Pasha, Y.Z. The association of fasting blood glucose (FBG) and waist circumference in northern adults in Iran: a population based study. J. Diab. Metab. Disorders, 2014, 13, 2-6.