Metformin and Garlic Preparations for Hyperglycemia

  • Azra Saleem Associate Professor, Department of Pharmacology, SMBBMC, Pakistan.
  • Ashraf Memon Associate Professor, Department of Pharmacology, Islamabad Medical and Dental College, Islamabad, Pakistan
  • Khalid Niaz Assistant Professor, Department of Pharmacology, , Islamabad Medical and Dental College, Islamabad, Pakistan
  • Shahina . Associate Professor, Department of Biochemistry, Islamabad Medical and Dental College, Islamabad, Pakistan
  • Moosa Khan Professor, Department of Pharmacology, , Islamabad Medical and Dental College, Islamabad, Pakistan
  • Abdul Qudoos Assistant Professor, Department of Pharmacology, , Islamabad Medical and Dental College, Islamabad, Pakistan
  • Shah Murad HOD Pharmacology & Therapeutics Shaheed Zulfikar Ali Bhutto Medical University, Islamabad, Pakistan.
Keywords: Metformin, Biguanides, Diabetes Mellitus

Abstract

Background: Diabetes is a chronic disorder of carbohydrate, fat and protein metabolism characterized by increased fasting and post prandial blood sugar levels. The global prevalence of diabetes is estimated to increase, from 4% in 1995 to 5.4% by the year 2025. WHO has predicted that the major burden will occur in developing countries. Drugs used in treatment of diabetes mellitus type II include sulfonylureas, biguanides, meglitinides, thiazolidinediones, dipeptidyl peptidase IV inhibitors, and α-glucosidase inhibitors.  Due to low compliance of allopathic medicines patients are in search of medicinal herbs to treat their hyperglycemic state. Garlic is one of those herbs whose hypoglycemic effects are remarkable and accepted by cardiologists. 

Methods: We compared hypoglycemic potential of herbal hypoglycemic herb Garlic with Metformin. It was single blind placebo control research conducted at Jinnah Hospital Lahore-Pakistan from January 2016 to June 2016. Seventy-five diabetic type-II patients were selected for research. Hospital research counsel-approved and explained consent was taken from all patients. They were divided in three groups, 25 patients in each group. Group-1 patients were advised to take 250 mg Metformin thrice daily for two months. Group-2 patients were advised to take 10 grams of garlic in three divided doses for two months. Group-3 was on placebo therapy. Their base line fasting blood glucose level was taken and kept in record. They were advised to visit the lipid research clinic of the hospital fortnightly. They were also advised to check their fasting plasma glucose level daily at the morning by using Glucometer. 

Results: After two months’ trial when results were compiled and statistically analyzed by applying paired ‘t’ test, it was observed that Metformin decreased blood sugar level 28.4 mg/dl in 24 diabetic patients, which is highly significant change biostatistically. Garlic reduced fasting blood sugar 25.5 mg/dl in 22 diabetic patients, which is biostatistically highly significant change with p-value <0.001. 

Conclusions:  It was concluded from the study that garlic can decrease blood glucose level highly significantly, near to hypoglycemic effect of Metformin. 

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References

1. Young-Bum Kim, Lone -wall J, Skeram P, Furan T. Troglitazone but not metformin restores insulin-stimulated phosphoinositide 3-kinase activity and increases p110beta protein levels in skeletal muscle of type 2 diabetic subjects. Diabetes, 2012;12(4):333-40.
2. Schneider S, Copica R, Maqoli C. Metformin in Patients with Cardiovascular Diseases? Etho J Pharma, 2012;14(6):417-9.
3. Susan A Phillips, Kekan T, Molon Y, Uyforita C. Modulation of circulating and adipose tissue adiponectin levels by antidiabetic therapy. Diabetes, 2013;6(1):77-80.
4. Riccardo Vigneri, and Ira D Goldfine. Diabetes Mellitus: Disease or syndrome? Diabetes Care 2015 ;10(1): 118-122.
5. Hiromura M, Pasila J, Makorra M. Glucose lowering activity by oral administration of bis(allixinato)oxidovanadium(IV) complex in streptozotocin-induced diabetic mice and gene expression profiling in their skeletal muscles. Metallomics, 2010;12(3):344-6.
6. Torkamani A, Besakhy L, Huva F. Identifying New Genetic Markers for Metformin Response in Type 2 Diabetes. J Pharmacol, 2010;111(7):290-99.
7. Bailey CJ, Yokaal HT, Toma YU, Selara ER. Biguanides and NIDDM. Diabetes Care, 2014;12(5):213-9.
8. Dumas MA, Furkan M, Humilya T. How Does Metformin Affect Insulin Resistance? J Pharmacol, 2014;10(6):222-9.
9. Klip A, Leiter LA, Jawanu P, Semwa Y. Cellular mechanism of action of metformin. Diabetes Care 2012;13(6):696-704.
10. Haupt E, Knick B, Koschinsky T, Liebermeister H, Schneider J, Hirche H: Oral antidiabetic combination therapy with sulphonylureas and metformin. Diabete Metab. 2012;19(6):414-19.
11. Levy J, Cobas RA, Gomes MB: Assessment of efficacy and tolerability of oncedaily extended release metformin in patients with type 2 diabetes mellitus. Diabetol Metab Syndr. 2010;12(2): 16-10.
12. Donnelly LA, Morris AD, Pearson ER: Adherence in patients transferred from immediate release metformin to a sustained release formulation: a population-based study. Diabetes Obes Metab. 2012;14(4):616-9.
13. Giugliano D, De Rosa N, Di Maro G: Metformin improves glucose, lipid metabolism, and reduces blood pressure in hypertensive, obese women. Diabetes Care. 2011;16(&):1387-1390.
14. Wei Ting RZ, Szeto CC, Chan M, Ma K: Risk Factors of Vitamin B12 Deficiency in Patients Receiving Metformin. Arch Intern Med. 2014;170(3):2175-79.
15. Makola P, Hirsh H, Iliopoulos D, Tsichlis P, Stuh K: Garlic: A medicinal herb. Cancer Res. 2012;69 (19): 7507-7511
16. Sofati L, Zhuang Y, Miskimins W. Phytochemical studies of Garlic. Pharmacognosy J, 2014;9(2):222-8.
17. Mera T, Evans J, Donelly L, Ems.lie A. Chemical componds in Garlic and other herbs. BMJ. 2015; 330 (8): 1304-1305.
18. Kabi K, Libby G, Donnelly LA, Donnan PT. Different routes of administrations of garlic. Diabetes Care. 2009;32: 1620-1625.
19. Saqaviyu I, Wang J, Gallagher D, De Vito L. Mode of action of Allixin found in garlic. J Pharmacognosy, 2012;11(3):23-35.
20. Jelativove R, Godarzi MO, Brier-Ash M. Garlic contents and their body effects in diabetic patients. Diabetes Obes Metab. 2013;5 (1):654-665.
21. Faure P, Rossini E, Wiernsperger N, Jaiyawi U, Pawove T. An insulin sensitizer improves the free radical defense system potential and insulin sensitivity in high fructose-fed rats. Diabetes. 1999, 48: 353-357.
22. Kusaka I, Nagasaka S, Horie H, Ishibashi S: Metformin, but not pioglitazone, decreases postchallenge plasma ghrelin levels in type 2 diabetic patients: a possible rol.e in weight stability?. Diabetes Obes Metab. 2008, 10: 1039-1046.
23. Masoudi FA, Inzucchi SE, Wang Y, Havranek EP, Foody JM, Krumholz HM: Thiazolinediones, metformin, and outcomes in older patients with diabetes and heart failure. Circulation. 2005, 111: 583-590.
24. Krempf M, Parhofer KG, Steg G: National Cholesterol Education Program (NCEP) Expert Panel onDetection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection. Circulation. 2002, 106: 3143-3421.
25. Park M, Kinra S, Ward K, White B, Viner R: Metformin for obesity in children and adolescents: a systematic review. Diabetes Care. 2009, 32: 1743-1745.
26. Gottschalk M, Danne T, Vlajnic A, Cara J: Glimepiride Versus Metformin as Monotherapy in Pediatric Patients with Type 2 Diabetes.A randomized, single-blind comparative study. DiabetesCare. 2007, 30: 790-794
27. Gilbert C, Valois M, Koren G: Pregnancy outcome after first-trimester exposure to metformin: a meta-analysis. Fertil Steril. 2006, 86: 658-663. 10.1016/j.fertnstert.2006.02.098
28. Mannucci E, Ognibene A, Cremasco F: Effect of metformin on glucagon-like peptide 1 (GLP-1) and leptin levels in obese nondiabetic subjects. Diabetes Care. 2001, 24: 489-494. 10.2337/diacare.24.3.489.
29. Bailey CJ, Bagdonas A, Rubes J: Rosiglitazone-metformin fixed-dose combination compared with uptritrated metformin alone in type diabetes mellitus:a 24 week, multicenter, randomized, double-blind, parallel-group study. Clin Ther. 2005, 27: 1548-1561.
30. Turner RC, Cull CA, Frighi V, Holman RR: Glycemic control with diet, sulfonylurea, metformin, or insulin in patients with type 2 diabetes: progressive requirement for multiple therapies (UKPDS 49). JAMA. 1999, 281: 2005-2012.
31. Fantus IG, Brosseau R, Mucola J, Mucilo N. Mechanism of action of Garlic in type-II diabetic patients. J Clin Endocrinol Metab. 2013;67(4):1198-1200.
32. Canal JR, Torres MD, Romero A, Perez C. A. Active ingredients in Garlic. Acta Physiol Hung 2014;87(1):71-6.
33. Mukkerji V, Weber JA, Winter ML, Klein-Schwartz W, Hoffman M, Gorman SE, Stork CM, Krenzelok EP. Mode of action of garlic in DM type_II. Ann Pharmacother. 2012;34(12):1385-7.
34. Fenole T Y, Husain K, Mekanh P, Nosatuy N, Jantan I. Phytochemistry of garlic and its therpautic values. Alternat Med.
2014;115(2):5100-9.
Published
2017-03-18
How to Cite
1.
Saleem A, Memon A, Niaz K, . S, Khan M, Qudoos A, Murad S. Metformin and Garlic Preparations for Hyperglycemia. IABCR [Internet]. 18Mar.2017 [cited 18Jul.2019];3(1):77-0. Available from: https://iabcr.org/index.php/iabcr/article/view/126