February 18, 2007

Gymnema sylvestre: A well-proven treatment for Type 1 and Type 2 diabetes

Written by Kevin Flatt

Studies show that Gymnema Sylvestre helps control both type 1 diabetes and type 2 diabetes. Gymnema is a well-proven treatment for diabetes, and it has been used for this purpose for over 2,000 years and has proved to be very effective in type 1 diabetes.

In human studies, the most common doses of Gymnema sylvestre used for blood sugar control were 400 mg to 600 mg per day. Gymnema sylvestre is commonly added to many different herbal combination products, but the majority of studies used GS4, a standardized product that contains only gymnema sylvestre. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. (DrugDigest).

Doses of 400 mg to 600 mg per day correlates to about 8 to 12 grams per day of the dried herb in tablet form. Therefore taking 4 grams in tablet form two to three times a day would give a total daily dose of 8 to 12 grams. Some practitioners find Gymnema works best when taken before meals.

A WebMD Medical News article (9 October 2000) related the story of a 71-year-old woman whose doctor had prescribed a widely used drug glyburide (Micronase) used to stimulate the pancreas to make insulin, which can help control blood sugar in a person with type 2 diabetes. According to the woman she was frequently hitting blood sugar highs and lows. She had been using the drug for six years but fours years prior to the abovementioned report she had dumped glyburide and started taking the herbal product Beta Fast GXR which contains the herb Gymnema without her doctor’s knowledge for three of those years. She said her doctor may not have noticed the change because her blood sugar checks always turned out so well. The woman also watches her diet and tests her blood sugar daily. (WebMD Medical News 9/10/2000).

So what is Gymnema?

Gymnema (Gymnema sylvestre) is a climbing plant that grows in open woods and bushland at an altitude of m in India, China, Indonesia, Japan, Malaysia, Sri Lanka, Vietnam and South Africa. Gymnema is also known as gurmar, gurmabooti, periploca of the woods, and meshasringi (ram’s horn). The Hindu word gurmar best describes the primary use of gymnema.

“Gurmar” translates in English as “sugar destroyer”. The translation is literal: When Gymnema is applied to the mouth, it prevents the taste buds from perceiving sweet tastes. Chewing chocolate is like chewing butter. Grains of sugar are like grains of sand. But it is more that just a fantastic party trick. Gymnema is a well-proven treatment for diabetes, and it has been used for this purpose for over 2,000 years. In my own clinical experience, I have found Gymnema to be the best herb available for treating this condition and controlling excessive blood sugar levels. (Kerry Bone, FNIMH, FNHAA, Nutrition and Healing Newsletter, January 2002).

It is best known for its apparent ability to lower blood sugar levels. Results from case reports and studies in humans and animals suggest that it may work in several ways to help control both type 1 and type 2 diabetes. First, the acids contained in gymnema sylvestre seem to decrease the amounts of sugar that are absorbed from foods. As a result, blood sugar levels may not increase as much as usual after meals. Secondly, gymnema sylvestre may promote the production of insulin by the body. It is possible that gymnema sylvestre may even prompt the pancreas to develop more beta cells - the source of insulin. It may also make body cells more responsive to the insulin that is available. (DrugDigest).

The first scientific confirmation of Gymnema’s effects on glucose in human diabetics was in 1926 when it was demonstrated that the leaves of Gymnema reduced urinary glucose. (K.G. Gharpurey, Indian Medical Gazette 1926; 61: 155).

Four years later it was shown that GS (Gymnema sylvestre) had a blood glucose lowering effect when there was residual pancreatic function, but was without effect in animals lacking pancreatic function, suggesting a direct effect on the pancreas. Despite the promise of these initial results, scientific inquiry into the effect of GS on diabetics was not seriously resumed until 1981 when it was again demonstrated that oral administration of the dried leaves of GS brings down blood glucose and raises serum insulin levels, recorded during an oral glucose tolerance test in diabetic animals and healthy human volunteers. (Parenting Naturally).

An unusual attribute of Gymnema sylvestre of great interest is its ability to lower blood sugar by increasing insulin output by apparently regenerating beta cells which are the cells that manufacture and secrete insulin. As abnormalities in beta cell number and/or function are directly related to both Type 1 and Type 2 diabetes, it appeared that Gymnema sylvestre was a major discovery in the battle against one of the most common disorders in the world.

In 1990 researchers at the University of Madras in India orally administered Gymnema extract to on group of diabetic rats while another group acted as controls and were not given Gymnema. A toxic agent was used to chemically destroy the insulin producing beta cells in the pancreas of each rat thereby causing diabetes. In the group of rats receiving Gymnema leaves in any form, whole or extracted, their fasting blood glucose levels returned to normal within 20 to 60 days. In addition, their insulin levels rose toward normal levels and the number of beta cells in the pancreas (the cells that manufacture and secrete insulin) increased. Their findings were published in the Journal of Ethnopharmacology. (J Ethnopharmacol. 1990 Oct;30(3):265-79).

Another 1990 study by researchers at Kobe University School of Medicine, Japan, and published in the journal Diabetes Research and Clinical Practice, concluded that gymnema is useful in the treatment of type 2 diabetes.

Diabetic rats were divided into two groups and fed either a normal diet or one supplemented with an extract of Gymnema. After four weeks the rats supplemented with the Gymnema extract showed reduced glucose levels in the “fed state” and an improvement in glucose tolerance. (Diabetes Res Clin Pract. 1990 May-Jun; 9(2): 143-8).

Of course, what works well in test animals may not work in the same way or at all in humans, but this is not the case with Gymnema sylvestre. There have been numerous human clinical trials that have all had positive results.

In a 1990 study, researchers at the University of Madras in India, 22 patients with type 2 diabetes who were non-insulin-dependent were given 400 milligrams of Gymnema extract daily, in two divided doses, in addition to their normal dose of oral hypoglycemics for 18 to 20 months. Ages ranged from 40 to 62 years and disease duration from 1 to 12 years. Over the duration of treatment, Gymnema significantly lowered fasting blood glucose levels (average of 174mg/dl to 124mg/dl). Participants in the Gymnema group also had a significant reduction in hemoglobin A1c. (Hemoglobin A1C is tested to monitor the long-term control of diabetes and is increased in the red blood cells of persons with poorly controlled diabetes. From this test clinicians can estimate the average blood glucose level during the preceding two to four months. The target for most people is below 7).

Twenty-one of the 22 patients were able to reduce their intake of drugs, while five patients were able to stop their conventional drugs completely, maintaining normal glucose levels with the Gymnema supplements alone. Also, their Insulin levels increased significantly compared to those on drugs alone. The authors suggested that this increase in insulin levels was probably due to regeneration or repair of beta cells facilitated by Gymnema.

All of the above contrasts significantly to the diabetic group on drugs alone. Their fasting glucose and hemoglobin A1c had elevated slightly and their drug doses either stayed the same or rose over the trial period. (J. Ethnopharmacol. 1990 Oct; 30(3): 295-300).

The above study demonstrates that the use of Gymnema may result in the need for smaller doses of oral diabetes drugs to control the disease. However, it is important that people with this disease don’t abandon proven ways to manage it, from a healthy diet to regular exercise and medications when needed.

In another study in 1990 carried out by the same research group at the University of Madras, India, 27 participants with insulin-dependent type 1 diabetes, ages from 10 to 50 years and with varying disease duration, were supplemented with 400 milligrams of Gymnema extract daily in two divided doses. All were using daily insulin injections. After 6 to 8 months of treatment with the Gymnema extract the average insulin requirements were decreased from 60 to 45 units per day and fasting blood glucose levels were lowered. In fact, one patient with a disease duration of 10 years and another with a lesser duration were able to discontinue insulin usage completely. These improvements continued through out the trial till its completion. One has to find it remarkable that, compared to conventional treatment, patients with type 1 diabetes for 25 years responded equally as well as those who had been diagnosed for only one year when given the Gymnema extract supplement. So, there appears to be no time limitation on Gymnema use to still receive benefits.

This contrasts significantly to the diabetic group not taking Gymnema and receiving insulin alone for a year. Their insulin requirements either remained the same or increased and their average insulin usage was almost double that of the Gymnema group. Also, the drop in fasting blood glucose was statistically insignificant in this group.

In addition, cholesterol levels also returned to near normal levels and triglycerides were lowered in the group taking Gymnema. (J. Ethnopharmacol. 1990 Oct; 30(3): 281-94).

In 1997 Japanese researchers at the Nippon Veterinary and Animal Science University, Tokyo, Japan, decided to test Gymnema inodorum, since it has an advantage that it does not suppress sweetness nor is it bitter in taste. They conclusions, published in The Journal of veterinary medical science, was that their studies suggested Gymnema inodorum inhibits the increase in the blood glucose levels by interfering with the intestinal glucose absorption process. (J Vet Med Sci. 1997 Sep; 59(9): 753-7).

In a study, published in the Diabetes In Control Newsletter (30/10/2001), conducted by Diabetes Educators, under the protocols established by Diabetes in Control and Informulab of Omaha, NE, the makers of Beta Fast GXR®, Gymnema Sylvestre was found to lower HbA1c from 10.1% to 9.3%. HbA1c or Hemoglobin A1C is tested to monitor the long-term control of diabetes and is increased in the red blood cells of persons with poorly controlled diabetes. From this test clinicians can estimate the average blood glucose level during the preceding two to four months. The target for most people is below 7.

The study included 65 participants with type 2 diabetes, some diet controlled others insulin dependent, ages 18 to 73 and was conducted for a ninety day period. Patients were given Beta Fast GXR® brand of Gymnema Sylvestre containing 400mg leaf extract per tablet twice daily.

An interesting observation made by the researchers was that the higher the participants initial HbA1c values (and therefore the less controlled their diabetes) the more significant the results. In the group of participants that started with an HbA1c above 10% the Gymnema Sylvestre supplementation lowered HbA1c from 11.1% to 9.9% (1.2% decrease) compared with the group that started at 9% or above, HbA1c was lowered from 10.1% to 9.3% (0.8% decrease). (Diabetes In Control Newsletter, Issue 76 (1) : 30 Oct 2001).

The reduction of HbA1c in this study is of great importance as an improvement in glycemic control reduces the risk of complications from diabetes.

Glycemic control is a medical term referring to the typical levels of blood sugar (glucose) in a person with diabetes type 2. Much evidence suggests that many of the long-term complications of diabetes, especially the microvascular (smaller blood vessels) complications, result from many years of hyperglycemia (elevated levels of glucose in the blood). Good glycemic control, in the sense of a “target” for treatment, has become an important goal of diabetes care. (From Wikipedia, the free encyclopedia).

In 2003 researchers, reporting in the journal Pharmacological Research, found that Oral administration of 200 mg of Gymnema montanum extract per kg of body weight to diabetic rats for 3 weeks resulted in a significant reduction in blood glucose levels and an increase in insulin levels. There was also a decrease in free radical formation in the blood of the diabetic rats. Supplementing with Gymnema montanum resulted in an increase in glutathione (which has many functions in a cell include activating certain enzymes and destroying toxic compounds and chemicals that contain oxygen). Vitamin C and vitamin E levels were also increased thereby clearly showing the antioxidant properties of Gymnema montanum.

These effects were compared with glibenclamide, an anti-diabetic drug (Diabeta®, Glynase® Micronase® Daonil®, Semi-Daonil® Euglucon®. Also sold in combination with metformin under the trade name Glucovance®.) The researchers concluded that the results suggest that Gymnema montanum extract was more effective than the drug glibenclamide. (Pharmacological Research. 2003 Dec; 48(6): 551-6).

Why is this antioxidant activity of Gymnema so important in diabetes management?

The above study shows that Gymnema appears to recycle available vitamin C and E.

The prevalent long term depletion of vitamin C, common in diabetes, may contribute to depressed immune function, compromised wound healing ability and reduced blood vessel integrity. These and other related aliments can possibly be arrested and reversed by vitamin C supplementation. (Dr. Brian Jakes, Jr. Diabetes In Control July 2002).

C-reactive protein is linked to cardiovascular disease in people with diabetes. “Having both diabetes and an elevated C-reactive protein (CRP) level compounds one’s risk of developing cardiovascular disease, for which people with diabetes are at particularly high risk,” scientists writing in the American Journal of Nursing report in their review. (Life Extension Foundation Daily News 10/04/06).

Vitamin C supplements can reduce levels of C-reactive protein, a marker of inflammation and chronic disease risk in humans, according to a new study led by researchers at the University of California, Berkeley. Participants who took about 500 milligrams of vitamin C supplements per day saw a 24 percent drop in plasma C-reactive protein (CRP) levels after two months. “C-reactive protein is a marker of inflammation, and there is a growing body of evidence that chronic inflammation is linked to an increased risk of heart disease, diabetes and even Alzheimer’s disease,” said Gladys Block, UC Berkeley professor of epidemiology and public health nutrition and lead author of the study. The researchers say that long-term adverse health effects occur when inflammation persists at low levels. This chronic inflammation, with persistent elevated levels of CRP, has been found among smokers and Type 2 diabetics, as well as among overweight or obese persons. The researchers noted that in other studies, higher doses of vitamin E produced lower CRP levels among Type 2 diabetics and healthy individuals. (Sarah Yang, Media Relations, University of California, Berkeley, 12/4/2004).

Recent clinical trials confirm the uses of typical antioxidants alone or in combination with other natural supplements may delay or even prevent the normal progression of diabetic complications.

Importantly, none of the participants in these studies reported any adverse side effects, although many patients developed hypoglycemia (low blood glucose) and required a lowering of their dose of conventional oral medication or insulin. Therefore, any diabetic that uses GSE must carefully monitor blood glucose levels and adjust their medication, in consultation with their physician, to maintain desired blood glucose levels. This is because improved insulin production and release during GSE supplementation may result in over-medication, and therefore low blood glucose levels, unless the dosage of conventional oral medication or insulin is lowered. Since most diabetics monitor their blood glucose levels on a daily basis, this shouldn’t present a problem.

Japanese researchers conducted a study in 2004 using both male and female rats to determine Gymnema sylvestre toxicity. One group of rats was fed a normal diet, the other group supplemented with Gymnema at increasing doses for 52 weeks. The researchers concluded there were no toxic effects in rats treated with Gymnema sylvestre at up to 1.00% in the diet for 52 weeks. This equated to an average of 504 mg/kg/day for male rats and 563 mg/kg/day for female rats daily intake over the period. (Shokuhin Eiseigaku Zasshi. 2004; 45(1):8-18).

What dose size is required to reduce blood glucose in humans efficiently?

This can vary widely depending on numerous factors including the specific type of herb used and the patient being treated.

Gymnema can work quite quickly to control blood sugar levels. Used on its own, it will not drop blood sugar so far as to cause hypoglycemia. However, there is the risk this could happen if it is used together with insulin or anti-diabetic drugs. So in these cases, Gymnema should only be taken under professional supervision. (Kerry Bone, FNIMH, FNHAA, Nutrition and Healing Newsletter, January 2002).

If you live in Australia you can buy gymnema at Xtreme Herbs Australia.

Aside from lowered blood sugar and increased effects of anti-diabetic drugs following chronic use of gymnema, no significant adverse effects have been reported with the herb, in several studies up to 20 months long. Caution is advised in patients with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, and medication adjustments may be necessary. (MedlinePlus).

Signs that blood sugar may be too low include shakiness, sweating, confusion, distorted speech, and loss of muscle control.

References

Shanmugasundaram ER, Gopinath KL, Radha Shanmugasundaram K, Rajendran VM. Possible regeneration of the islets of Langerhans in streptozotocin-diabetic rats given Gymnema sylvestre leaf extracts. J Ethnopharmacol. 1990 Oct;30(3):265-79.

Okabayashi, Y : Tani, S : Fujisawa, T : Koide, M : Hasegawa, H : Nakamura, T : Fujii, M : Otsuki, M. Effect of Gymnema sylvestre, R.Br. on glucose homeostasis in rats. Diabetes Res Clin Pract. 1990 May-Jun; 9(2): 143-8.

Baskaran, K : Kizar Ahamath, B : Radha Shanmugasundaram, K : Shanmugasundaram, E R. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J. Ethnopharmacol. 1990 Oct; 30(3): 295-300.

Shanmugasundaram, E R : Rajeswari, G : Baskaran, K : Rajesh Kumar, B R : Radha Shanmugasundaram, K : Kizar Ahmath, B. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J. Ethnopharmacol. 1990 Oct; 30(3): 281-94.

Shimizu, K : Ozeki, M : Tanaka, K : Itoh, K : Nakajyo, S : Urakawa, N : Atsuchi, M. Suppression of glucose absorption by extracts from the leaves of Gymnema inodorum. J Vet Med Sci. 1997 Sep; 59(9): 753-7.

Ananthan,-R; Baskar,-C; NarmathaBai,-V; Pari,-L; Latha,-M; Ramkumar,-K-M. Antidiabetic effect of Gymnema montanum leaves: effect on lipid peroxidation induced oxidative stress in experimental diabetes. Pharmacol-Res. 2003 Dec; 48(6): 551-6.

Joffe DJ, Freed SH. Effect of extended release gymnema sylvestre leaf extract (Beta Fast GXR) alone or in combination with oral hypoglycemics or insulin regimens for type 1 and type 2 diabetes. Diabetes In Control Newsletter 2001;76 (1).

Ogawa Y; Sekita K; Umemura T; Saito M; Ono A; Kawasaki Y; Uchida O; Matsushima Y; Inoue T; Kanno J. Gymnema sylvestre leaf extract: a 52-week dietary toxicity study in Wistar rats. Shokuhin Eiseigaku Zasshi. 2004; 45(1):8-18.


Copyright 2007 KevinFlatt. Disclaimer: The information contained in this article is presented for information purposes only and is in no way intended to replace professional medical care or attention by a qualified practitioner. It cannot and should not be used as a basis for diagnosis or choice of treatment.

 
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