The Efficacy of Gymnema Sylvestre in cases of Type-II Diabetes Mellitus along with Auxiliary Treatment

Abstract

Gymnema sylvestre is a staple plant medicine of Homoeopathy. It is traditionally used for supporting balanced sugar levels along with daily exercise. Gymnema is fascinating in that it works a multifaceted path towards maintaining healthy blood sugar. By working directly on the level of blood insulin, it helps balance the blood sugar level. The present study described the plant of Gymnema sylvestre medicinal potential effect along with daily exercise.

Introduction

My purpose of studying TYPE II DM as a topic for a survey and its management with homoeopathic medicine is because it is an increasingly medical and public health issue. Could lead to severe complications like myocardial infarction, ischemic heart disease, other cardiovascular diseases, renal failure, retinal degeneration, infertility with impotency etc…

The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over 134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for the majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influenced by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioural habits in addition to genetics and family history. Good control of blood sugar, blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India.

• “As per the WHO, diabetes mellitus is defined as a heterogeneous metabolic disorder characterised by common features of chronic hyperglycemia with disturbance of carbohydrate, fat and protein metabolism.” 

Classification Diabetes Mellitus:

1. TYPE-I Diabetes Mellitus (IDDM) / Juvenile-Onset Diabetes

• Type-IA DM: Immune-Mediated
• Type-IB DM: Idiopathic 

1. TYPE-II DIABETES MELLITUS (NIDDM)
2. GESTATIONAL DM 

TYPE-II DM / NIDDM:

• This type comprises about 80% cases of DM.
• It was previously called maturity-onset diabetes or NON-INSULIN DEPENDENT DM.

Major Risk factor:

• • Family H/O type 2 DM
  • Obesity
  • Habitual physical inactivity
  • Impaired glucose tolerance(02-03)
  • H/O gestational DM
  • Dyslipidemia
  • PCOS

• H/O vascular disease 

Pathogenesis of Type-II Dm: The basic metabolic defect in type-2 DM is either delayed insulin secretion relative to glucose load (IMPAIRED INSULIN SECRETION) or the peripheral tissue is unable to respond to insulin (INSULIN RESISTANCE).

• Genetic factors:

• • • There are 80% chances of developing diabetes in identical twins.
    • Parent with type-2 DM the risk in offspring is rises to 40%

• Constitutional factors:

• • • Obesity
    • Hypertension
    • Sedentary lifestyle

• Insulin resistance:

• • • One of the most prominent metabolic features of type-2 DM is the lack of responsiveness of peripheral tissue to insulin, especially skeletal muscle.

• Obesity in particular is strongly associated with insulin resistance and hence type-2 DM.

• Mechanism of hyperglycemia in these cases explained as under:

• Resistance to action of insulin impairs glucose utilization and hence hyperglycemia. 
• There is increased hepatic synthesis of glucose.
• Hyperglycemia in obesity is related to high levels of free fatty acids and cytokines affect peripheral tissue sensitivity to respond to insulin. (02-03)

Impaired Insulin Secretion:

In type-2 DM insulin resistance and insulin secretion are interlinked:

Early in the course of disease, in response to insulin resistance there is compensatory increased secretion of insulin in attempt to maintain normal blood glucose level.

Eventually however there is failure of β-cells function to secrete adequate insulin.

Clinical Feature of Type II Dm:

• Urinating more often than usual, particularly at night.
• Feeling very thirsty.
• Feeling very tired.
• Unexplained weight loss.
• Itchiness around the genital area, or regular bouts of thrush (a yeast infection)
• Cuts or wounds that heal slowly.
• Blurred vision – caused by the lens of the eye becoming dry 

Homoeopathic Management of Type-II DM: Gymnema Sylvestre 

Pharmacological action:

• It may act by enhancing insulin secretion through an increased number of pancreatic β-cells and through improved cell function.

• Gymnema Sylvestre regulates blood sugar by stimulating insulin secretion and inhibiting absorption of sugars in the intestine. 

• The plant has diuretic and cardiac stimulant activities. 

• The mode of action of the drug is through stimulation in insulin secretion from pancreas 

• It also exerts a similar effect by delaying the glucose absorption in the blood.

Clinical feature:

• Almost specific for diabetes mellitus

• Diminishes sugar in urine

• Patient puts on flesh & weight

• Improve appetite

• Prolongs Diabetic patient life

• Profuse micturition loaded with sugar

• Extreme weakness after large quantity of urine

• Sexual power almost lost (01)

Auxiliary Management In Type-II Diabetes mellitus

• Help the body use insulin better by increasing insulin sensitivity   
• Give you energy and help you in develop good sleep (02)
• Help your joints and flexibility 
• Help your mind as well as your body – exercise releases endorphins, which you could think of as happy hormones. 
• Being active is proven to reduce stress levels and improve low mood.   
• Help people with type 2 diabetes improve their HbA1c. In some cases, this can help people with the condition go into remission. (02)

Types of Exercise:

• Walking
• Cycling
• Jump rope
• Yoga
• Zumba
• Duration of exercise to control DM: It depends upon blood sugar level, life style, food habit, punctuality in exercise. On average daily 45 mins of exercise is useful to control diabetes with medicine

Conclusion:

• Considering the presence of bioactive compounds present in Gymnema sylvestre, this review is aimed to summarise the information of the chemical constituents and their antidiabetic activities and specially to detect the relation between antioxidants and antidiabetic compounds regarding blood sugar reduction in diabetes.

References

1. Boericke William; Pocket Manual Of Homoeopathic Materia Medica And Repertory; 11th Edition 2012; B. Jain Publisher (P) Limited; New Delhi.
2. Davidson Stanley; Davidson’s Principles & Practice Of Medicine, 21st Edition 2010; Churchill Livingstone Elvister; U.K.
3. Mohan Harsh; Text Book Of Pathology; 6th Edition 2010; Jaypee Brothers Medical Publishers (P) Ltd.; New Delhi.
4. Epidemiology of type 2 diabetes in India – PMC (nih.gov)