Abstract
BackgroundNearly 50% of diabetic patients worldwide use complementary medicines to treat or supplement their conventional diabetes treatment. Salacia reticulata (Kothala himbutu) is a woody climber used widely in the Ayurvedic system to treat diabetes and obesity.ObjectiveIn this review I critically analyze the evidence for using Salacia reticulata for treating type 2 diabetes and obesity. The available evidence is described in terms of in-vitro studies, animal studies and clinical trials.Results and conclusionsIn vitro studies demonstrate the ability of Salacia to inhibit intestinal alpha glucosidase. In mouse mesenteric fat it enhances the mRNA expression for hormone sensitive lipase (HSL) and adiponectin; thus increasing lipolysis and reducing insulin resistance respectively. In 3 T3-L-1 adipocytes lipogenesis factors are down regulated and lipolysis factors are up regulated with Salacia reticulata treatment. Animal studies and clinical trials are consistent in demonstrating improvement of glucose concentrations in the fasted and sucrose and maltose loaded states. Clinically significant reductions of HbA1C and plasma Insulin are reported with treatment of 6 weeks to 3 months. One clinical trial reported significant reduction of weight and BMI when Salacia is used in combination with vitamin D.Salacia reticulata effectively improves insulin resistance, glucose metabolism and reduces obesity. A larger evidence base is required from well-planned studies to confirm its efficacy and safety.
Highlights
50% of diabetic patients worldwide use complementary medicines to treat or supplement their conventional diabetes treatment
In vitro studies demonstrate the ability of Salacia to inhibit intestinal alpha glucosidase
In mouse mesenteric fat it enhances the mRNA expression for hormone sensitive lipase (HSL) and adiponectin; increasing lipolysis and reducing insulin resistance respectively
Summary
50% of diabetic patients worldwide use complementary medicines to treat or supplement their conventional diabetes treatment. Diabetes mellitus is a major cause of morbidity and mortality worldwide with an increasing prevalence. The WHO estimates a prevalence of 347 million people with diabetes worldwide in 2013 [1]. The prevalence is expected to double between 2005–2030 and the greater proportion of this increase would be in the low to middle income countries of Asia, Africa and South America [2]. Studies have been consistent in showing that diabetic patient adherence to current conventional treatment protocols are poor [3]. Complementary and alternative treatment systems have readily gained popularity in treating diabetes over the past few years [5]. Postprandial glucose value 240 mg/day None FBS HbA1C BMI.
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