Abstract
Canadian Aboriginals, like others globally, suffer from disproportionately high rates of diabetes. A comprehensive evidence-based approach was therefore developed to study potential antidiabetic medicinal plants stemming from Canadian Aboriginal Traditional Medicine to provide culturally adapted complementary and alternative treatment options. Key elements of pathophysiology of diabetes and of related contemporary drug therapy are presented to highlight relevant cellular and molecular targets for medicinal plants. Potential antidiabetic plants were identified using a novel ethnobotanical method based on a set of diabetes symptoms. The most promising species were screened for primary (glucose-lowering) and secondary (toxicity, drug interactions, complications) antidiabetic activity by using a comprehensive platform of in vitro cell-based and cell-free bioassays. The most active species were studied further for their mechanism of action and their active principles identified though bioassay-guided fractionation. Biological activity of key species was confirmed in animal models of diabetes. These in vitro and in vivo findings are the basis for evidence-based prioritization of antidiabetic plants. In parallel, plants were also prioritized by Cree Elders and healers according to their Traditional Medicine paradigm. This case study highlights the convergence of modern science and Traditional Medicine while providing a model that can be adapted to other Aboriginal realities worldwide.
Highlights
Background on DiabetesDiabetes is a chronic metabolic disease that arises from a dysfunction in the body’s production of the anabolic hormone insulin, a reduction of the response of peripheral organs to the same hormone, or both [1,2,3]
There exist two predominant types of the disease; namely, type 1 diabetes (T1D) and type 2 diabetes (T2D) [2, 4, 5]. The former often affects younger individuals and is related to autoimmune responses against insulin or other components related to insulin production that lead to the destruction or severe dysfunction of pancreatic beta cells [2, 4, 5]
T1D is characterized by insulin insufficiency and is treated by exogenous insulin administration, its former definition as an insulin-dependentt type of diabetes
Summary
Diabetes is a chronic metabolic disease that arises from a dysfunction in the body’s production of the anabolic hormone insulin, a reduction of the response of peripheral organs to the same hormone, or both [1,2,3]. There exist two predominant types of the disease; namely, type 1 diabetes (T1D) and type 2 diabetes (T2D) [2, 4, 5] The former often affects younger individuals and is related to autoimmune responses against insulin or other components related to insulin production that lead to the destruction or severe dysfunction of pancreatic beta cells [2, 4, 5]. The pancreas decompensates, in good part because of a significant loss in the functional mass of beta cells This leads to a frank deregulation of blood glucose whereby it remains chronically elevated. Elevated blood glucose and lipids cause micro- and macrovascular lesions The former affects principally the kidney (diabetic nephropathy), peripheral nerves (diabetic neuropathy), and the retina (diabetic retinopathy). These are summarized because they reflect the relevant targets for medicinal plants stemming from Canadian Aboriginal Traditional Medicine that are the focus of the present paper
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