Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients

Antidiabetic potential of fenugreek (Trigonella foenum-graecum): A magic herb for diabetes mellitus

Fenugreek (Trigonella foenum-graecum) is a widely grown dietary herb in Asia, and its seeds are traditionally used for several diseases, including diabetes. The seeds and leaves possess a variety of compounds that play an important role in regulating their hypoglycemic effect. However, so far, no extensive systematic review exists on its antidiabetic effect, highlighting the molecular mechanisms and isolated compounds. The purpose of this review is to summarize the preclinical and clinical antidiabetic properties of fenugreek and its isolated compounds by focusing on underlying mechanisms. PubMed, Google Scholar, Science Direct, and Scopus databases were searched to retrieve articles until June, 2024. Preclinical studies demonstrated that the antidiabetic effect of fenugreek was mostly associated with enhanced glucose transporter type-4 (GLUT4) translocation and hexokinase activity, decreased glucose-6-phosphatase and fructose-1,6-bisphosphatase activities, inhibited α-amylase and maltase activities, protected β cells, and increased insulin release. Furthermore, few studies have reported its role as a glucagon-like peptide-1 (GLP-1) modulator, 5'-AMP-activated kinase (AMPK) activator, and dipeptidyl peptidase-IV (DPP-IV) inhibitor. Further clinical trials showed that fenugreek seeds improved blood glucose levels, insulin resistance, insulin sensitivity, and lipid profiles. This study highlights significant evidence of the antidiabetic effect of fenugreek and its isolated compounds; therefore, it could be a potential therapy for diabetes.

A randomized double blind placebo controlled trial to assess the safety and efficacy of a patented fenugreek (Trigonella foenum-graecum) seed extract in Type 2 diabetics

Background

Fenugreek plant (Trigonella foenum-graecum) constitutes a traditionally acclaimed herbal remedy for many human ailments including diabetes, obesity, neurodegenerative diseases, and reproductive disorders. It is also used as an effective anti-oxidative, anti-inflammatory, antibacterial, and anti-fungal agent. The seed of the plant is especially enriched in several bioactive molecules including polyphenols, saponins, alkaloids, and flavonoids and has demonstrated potential to act as an antidiabetic phytotherapeutic. A novel patented formulation (Fenfuro®) was developed in our laboratory from the fenugreek seeds which contained >45% furostanolic saponins (HPLC).

Objective

A placebo-controlled clinical compliance study was designed to assess the effects of complementing Fenfuro® on a randomized group of human volunteers on antidiabetic therapy (Metformin and sulphonylurea) in controlling the glycemic index along with simultaneous safety assessment.

Study methodology and trial design

In a randomized double-blind, placebo-controlled trial, 42 individuals (21 male and 21 female volunteers) in the treatment group (out of 57 enrolled) and 39 individuals (17 male and 22 female volunteers) in the placebo group (out of 47 enrolled), all on antidiabetic therapy with Metformin/Metformin with sulphonyl urea within the age group of 18-65 years were administered either 1,000 mg (500 mg × 2) (Fenfuro®) capsules or placebo over a period of 12 consecutive weeks. Fasting and postprandial glucose along with glycated hemoglobin were determined as primary outcomes to assess the antidiabetic potential of the formulation. Moreover, in order to evaluate the safety of the formulation, C-peptide and Thyroid Stimulating Hormone (TSH) levels as well as immunohematological parameters were assessed between the treatment and placebo groups at the completion of the study.

Results

After 12 weeks of administration, both fasting as well as postprandial serum glucose levels decreased by 38 and 44% respectively in the treatment group. Simultaneously, a significant reduction in glycated hemoglobin by about 34.7% was also noted. The formulation did not have any adverse effect on the study subjects as there was no significant change in C- peptide level and TSH level; liver, kidney, and cardiovascular function was also found to be normal as assessed by serum levels of key immunohematological parameters. No adverse events were reported.

Conclusion

This clinical compliance study re-instated and established the safety and efficacy of Fenfuro® as an effective phytotherapeutic to treat hyperglycemia.

Moroccan Antihypertensive Plants and their Mechanisms of Action

BACKGROUND

The use of herbal remedies, medicinal plants, and their derivatives for the treatment and control of hypertension is well-known and widespread throughout Morocco.

AIMS

The aim of the study was to review the antihypertensive and vasorelaxant medicinal plants of the Moroccan pharmacopeia.

OBJECTIVE

To date, no review on Moroccan medicinal plants exhibiting antihypertensive effects has been performed, and their mechanism of action has not been specified. The objective of this review was to collect, analyze, and critically assess published publications on experimental and clinical research that explored the blood pressure-reducing abilities of Moroccan medicinal plant extracts.

MATERIALS AND METHODS

This study collected, processed, and critically analyzed published studies related to experimental and clinical research that investigated Moroccan herbal derivatives' blood pressure-lowering abilities using a number of scientific databases, including ScienceDirect, Scopus, PubMed, Google Scholar, and others. Plantlist.org was used to validate the right plant names.

RESULTS

The results revealed 22 species of Moroccan medicinal plants belonging to 13 different groups with recognized antihypertensive properties. The species were abundant in a variety of chemical elements. Asteraceae (08 species), Lamiaceae (3 species), Apiaceae (2 species), and 1 species each from the following families: Parmeliaceae, Fabaceae, Cistaceae, Malvaceae, Polygonaceae, Brassicaceae, Myrtaceae, Rutaceae, Amaranthaceae, Rosaceae, and Lauraceae were the most frequently mentioned families for their antihypertensive properties. The most used parts were the leaves and the aerial parts. The two main methods of preparation among Moroccans were decoction and infusion. This study demonstrated the known antihypertensive and vasorelaxant properties of Moroccan medicinal plants in vivo and in vitro, as well as their mechanisms of action. Interestingly, phytochemicals can operate on blood vessels directly via a vasorelaxant impact involving a range of signaling cascades or indirectly by blocking or activating multiple systems, such as an angiotensin-converting enzyme (ACE), renin-angiotensin system (RAS), or diuretic activity.

CONCLUSION

The review of the available data reveals that more work needs to be done to examine all the Moroccan medicinal plants that have been suggested as antihypertensive in published ethnopharmacological surveys. A review of the literature in this area reveals that methodologies of the experimental study need to be standardized, and purified molecules need to be studied. In addition, mechanistic investigations, when they exist, are generally incomplete. In contrast, only a few advanced clinical investigations have been conducted. However, all studies fail to determine the efficacy/safety ratio.

Relevance of Indian traditional tisanes in the management of type 2 diabetes mellitus: a review

Background

Tisanes are a potential source of phytochemicals to reduce disease risk conditions and are used to protect from non-communicable diseases, globally. A few tisanes have gained more popularity than others depending on their chemical composition based on the geographical origin of the used herb. Several Indian tisanes have been claimed to have traits beneficial to people with or at a high risk of type 2 diabetes mellitus. Under the concept, the literature was reviewed and compiled into a document to highlight the chemical uniqueness of popular Indian traditional tisanes to be more informative and potent as per modern medicine to overcome type 2 diabetes mellitus.

Methods

An extensive literature survey was conducted using computerized database search engines, such as Google Scholar, PubMed, ScienceDirect, and EMBASE (Excerpta Medica database) for herbs that have been described for hyperglycemia, and involved reaction mechanism, in-vivo studies as well as clinical efficacies published since 2001 onwards using certain keywords. Compiled survey data used to make this review and all findings on Indian traditional antidiabetic tisanes are tabulated here.

Results

Tisanes render oxidative stress, counter the damage by overexposure of free radicals to the body, affect enzymatic activities, enhance insulin secretion, etc. The active molecules of tisanes also act as anti-allergic, antibacterial, anti-inflammatory, antioxidant, antithrombotic, antiviral, antimutagenicity, anti-carcinogenicity, antiaging effects, etc. WHO also has a strategy to capitalize on the use of herbals to keep populations healthy through effective and affordable alternative means with robust quality assurance and strict adherence to the product specification.

Application of botanical products as nutraceutical feed additives for improving poultry health and production

Poultry is one of the most consumed sources of animal protein around the world. To meet the global demands for poultry meat and eggs, it is necessary to improve their nutrition to sustain the poultry industry. However, the poultry industry faces several challenges, including feedstuff availability, the banning of antibiotics as growth promoters, and several environmental stressors. Therefore, there is a critical need to include available nutraceuticals in the diet to sustain the poultry industry. Nutraceuticals are natural chemical substances that positively influence animal physiological and productive traits. Botanical products (such as fenugreek seeds, ginger roots, and olive leaves) are among the most commonly used nutraceuticals and are gradually gaining popularity in the poultry industry due to their immense benefits in nutrition and therapeutic properties. They can be added to the diet separately or in combination (as a natural antioxidant and immunostimulant) to improve poultry health and production. Botanical products are rich in essential oils and essential fatty acids, which have multiple benefits on the animal's digestive system, such as activating the digestive enzymes and restoring microbiota balance, enhancing poultry health, and production. These nutraceuticals have been shown to stimulate the expression of several genes related to growth, metabolism, and immunity. In addition, the essential oil supplementation in poultry diets up-regulated the expression of some crucial genes associated with nutrient transportation (such as glucose transporter-2 and sodium-glucose cotransporter-1). Previous studies have suggested that supplementation of botanical compounds increased broiler body weight and hen egg production by approximately 7% and 15%, respectively. Furthermore, the supplementation of botanical compounds enhanced the reproductive efficiency of hens and the semen quality of roosters by 13%. This review article discusses the significant effects of some botanical products in the poultry industry and how they can benefit poultry, especially in light of the ban on antibiotics as growth promoters.

Effects of fenugreek supplementation on the components of metabolic syndrome: A systematic review and dose-response meta-analysis of randomized clinical trials

Metabolic syndrome (MetS) is a cluster of metabolic disorders with a heavy disease burden. Fenugreek was reported to be effective in some components of MetS. Therefore, a comprehensive review and meta-analysis of randomized controlled trials was conducted to study the effects of fenugreek on MetS indices. From the beginning until August 2022, PubMed, Embase, Scopus, and Web of science were searched. Data were analyzed using the random-effect model, and presented as weighted mean difference (WMD) and associated 95 % confidence interval (CI). This meta-analysis comprised from a total of 29 eligible RCTs with 31 arms measuring fasting plasma glucose (FPG), Triglyceride (TG), high-density lipoprotein (HDL), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The results indicated significant improving effects of fenugreek on FPG (WMD: -16.75 mg/dL; 95 % CI: -23.36, -10.15; P < 0.001), TG (-20.12 mg/dL; 95 % CI: -34.238, -5.994; P < 0.001), HDL (WMD: 3.55 mg/dL; 95 % CI: 1.98, 5.12; P < 0.001), WC (WMD: -2.51; 95 % CI: -3.78, -1.24; P < 0.001) and SBP (WMD: -3.45 mmHg; 95 % CI: -6.38, -0.52; P = 0.021); However the effect on DBP (WMD: 3.17; 95 % CI: -5.40, 11.73; P = 0.469) and BMI (WMD: -0.40 kg/m2; 95 % CI: -1.114, 0.324; P = 0.281) was not significant. Administration of fenugreek can meaningfully reduce FPG, TG, WC, and SBP and increase HDL. The overall results support possible protective and therapeutic effects of fenugreek on MetS parameters.

Advanced Practical Strategies to Enhance Table Egg Production

The global demand for table eggs has increased exponentially due to the growing human population. To meet this demand, major advances in hen genetics, nutrition, and husbandry procedures are required. Developing cost-effective and practically applicable strategies to improve egg production and quality is necessary for the development of egg industry worldwide. Consumers have shown a strong desire regarding the improvement of hens' welfare and egg quality. They also become interested in functional and designer foods. Modifications in the nutritional composition of laying hen diets significantly impact egg nutritional composition and quality preservation. According to previous scientific research, enriched egg products can benefit human health. However, producers are facing a serious challenge in optimizing breeding, housing, and dietary strategies to ensure hen health and high product quality. This review discussed several practical strategies to increase egg production, quality, and hens' welfare. These practical strategies can potentially be used in layer farms for sustainable egg production. One of these strategies is the transition from conventional to enriched or cage-free production systems, thereby improving bird behavior and welfare. In addition, widely use of plant/herbal substances as dietary supplements in layers' diets positively impacts hens' physiological, productive, reproductive, and immunological performances.

Revisiting Trigonella foenum-graecum L.: Pharmacology and Therapeutic Potentialities

Fenugreek (Trigonella foenum-graecum L.) is a medicinal plant that has been used as a food condiment as well as for its multiple therapeutic characteristics since ancient times. Fenugreek plant grows up to 60 cm in height, and its seeds are golden-yellow rhomboidal-shaped. Though fenugreek is more commonly known for its seeds, the leaves and stem have also been reported to have medicinal uses. These properties exhibited are due to the content of the secondary metabolites, also known as phytochemicals, in the fenugreek plant. Such metabolites are alkaloids, saponins, tannins, phenols, and many others. Fenugreek has been used traditionally for numerous indications, such as aid in labour, lactation stimulant, and laxatives. In modern research, there have been several animal and clinical studies that have shown therapeutic effects of fenugreek when taken orally. Fenugreek is a suitable plant candidate with a high prospect of being used as a credible medicinal plant to derive new drugs. This review aims to summarize the physical and chemical properties of fenugreek and its bioactive compounds that have been isolated for medicinal purposes and discusses the traditional and pharmacological uses of fenugreek.

Trigonella foenum-graecum seeds in treatment of metabolic syndrome

Fenugreek has a long tradition of use as a medicine and also has been commonly used as food in many countries. This plant is well known, especially in Asia. In Europe, fenugreek seeds are regarded as a traditional herbal medicine consumed in case of loss of appetite and in confirmed skin inflammations. Trigonella foenum-graecum seeds contain wide spectrum of different biologically active constituents which affect the properties of preparations produced from this plant. Numerous preclinical studies confirm the use of fenu-greek as a hypolipidemic and lowering blood glucose level drug. Unfortunately, there are not many clinical studies on fenugreek seeds in this area. Published studies often significantly differ in the amount and type of fenugreek seed preparation used. However, results of available scientific research are promising and suggest the possibility of using fenugreek seeds in metabolic syndrome therapy. Undoubtedly, further research is required to confirm such properties of Trigonella foenum-graecum.

A hairy-root transformation protocol for Trigonella foenum-graecum L. as a tool for metabolic engineering and specialised metabolite pathway elucidation

The development of genetic transformation methods is critical for enabling the thorough characterization of an organism and is a key step in exploiting any species as a platform for synthetic biology and metabolic engineering approaches. In this work we describe the development of an Agrobacterium rhizogenes-mediated hairy root transformation protocol for the crop and medicinal legume fenugreek (Trigonella foenum-graecum). Fenugreek has a rich and diverse content in bioactive specialised metabolites, notably diosgenin, which is a common precursor for synthetic human hormone production. This makes fenugreek a prime target for identification and engineering of specific biosynthetic pathways for the production of triterpene and steroidal saponins, phenolics, and galactomanans. Through this transformation protocol, we identified a suitable promoter for robust transgene expression in fenugreek. Finally, we establish the proof of principle for the utility of the fenugreek system for metabolic engineering programs, by heterologous expression of known triterpene saponin biosynthesis regulators from the related legume Medicago truncatula in fenugreek hairy roots.

Fenugreek seed extract ameliorates cognitive deficits in streptozotocin-induced diabetic rats

Background Natural medicinal plants have been the focus of current research for developing neuroprotective agents to be used in the diabetes-linked cognitive dysfunction. Trigonella foenum-graecum seeds (known as fenugreek, methi in Hindi), is a well-known traditional medicinal herb and possesses anti-diabetic, anti-oxidant, and anti-inflammatory properties. Purpose This study was undertaken to explore the ameliorative effects of T. foenum-graecum seed extract on diabetes-induced cognitive dysfunction. Methods Experimental diabetes was induced by administering a single dose of streptozotocin (60 mg/kg) through intraperitoneal dose. Cognitive function was assessed using a T-maze and the Morris water maze. Lipid peroxidation levels and oxidative stress in the hippocampus was measured. Quantification of hippocampal CA1 and CA3 regions was done using cresyl violet stain. Results Diabetic rats demonstrated learning and memory impairment, which was evident from poor performance in behavioral tasks, i.e. T-maze and Morris water maze tasks. Learning and memory impairment in diabetic animals is associated with increased blood glucose levels, increased oxidative stress in the hippocampus and decreased number of neurons in the CA1 and CA3 regions of the hippocampus. The diabetic rats administered with T. foenum-graecum showed improved performance in behavioral tasks, and these changes were associated with decreased blood glucose levels, decreased oxidative stress in the hippocampus, and decreased neuronal loss from the CA1 and CA3 regions of the hippocampus. Conclusion In conclusion, administration of T. foenum-graecum seed extract ameliorates diabetes-linked cognitive dysfunction in rats by decreasing blood glucose levels, reducing lipid peroxidation and oxidative stress in the hippocampus, and preventing neuronal loss from the hippocampus.

LC-MS/MS analysis and network pharmacology of Trigonella foenum-graecum - A plant from Ayurveda against hyperlipidemia and hyperglycemia with combination synergy

BACKGROUND

The seed of Trigonella foenum-graecum L. (Methika in Sanskrit) is a well known kaphahara (balancing kapha) herb in Ayurveda indicated in Prameha or early diabetes mellitus. It is also useful in obesity and reduces lipid level of blood.

PURPOSE

We aimed to explore the metabolites present in the plant extract and to establish the combination synergy and the network pharmacology along with the underlying the mechanism of action involved.

STUDY DESIGN

LC-MS/MS based metabolite screening followed by ADME screening and finally network pharmacology exploration of the mechanism of action involved against hyperlipidemia and hypolipidemia with neighbourhood based combination synergy approach.

METHODS

Ethanolic extract of Trigonella foenum-graecum L. (TFHE) was subjected to LC-MS/MS analysis to identify the active constituents. Oral bioavailability and drug likeness was screened for all the compounds. Databases- Binding DB, DAVID, KEGG and STRING were used to gather information to develop the networks. The networks were constructed using Cytoscape 3.2.1. Combination synergy analysis was performed with the help of Cytoscape network analyzer tool with neighbourhood approach.

RESULTS

The LC-MS/MS analysis identified 13 compounds which were found to be bio-available and drug like following the QED and Veber drug likeness parameters. The pathway analysis showed enrichment for different pathways like MAPK pathway (p-4.69E-07), JAK-STAT pathway (p-6.30E-05), Adipocytokine (p-0.00179), Type 2 Diabetes mellitus (0.00441), Insulin signalling pathway (p-0.0121), mTOR signalling pathway (p-0.000378), which are all connected to hyperlipidemia and hyperglycemia. The combination synergy network identified 23 targets interacting with 13 compounds based on a network neighbourhood approach.

CONCLUSION

The network pharmacology analysis strongly suggested the multimode evidences that TFHE largely works on the insulin signalling pathway and mainly based on its antioxidant potential due to its interaction with carbonic anhydrase. Various compounds were found to be interacting with key proteins that activates EGFR/AKT/mTOR signalling cascade which has therapeutic implication in hyperglycemia and hyperlipidemia. The combination synergy network analysis based on neighbourhood approach can help us in further understanding mechanism of multi-molecular fixed dose combinations.

A review of Algerian medicinal plants used in the treatment of diabetes

ETHNOPHARMACOLOGICAL RELEVANCE

Plants are traditionally used in Algeria to treat many disorders, including diabetes mellitus. Knowledge of the plants that are used may provide insight on their properties, for further exploration. This study reviewed all the available published and unpublished reports concerning the use of herbal medicines in the treatment of diabetes in Algeria.

AIM OF THE STUDY

To describe the plants used in Algeria to treat diabetes, as reported in the literature.

MATERIAL AND METHODS

Systematic review of ethnobotanical papers published in the medical literature, from literature databases (Pubmed, Web of Science), as well as Google, for English, French and Arabic -language publication, and a manual search of local libraries and bookshops, as well as the university repository of PhD and master's theses. The reference lists of the papers retrieved were also examined for further papers.

RESULTS

Many plants are cited in the ethnobotanical surveys, but only very few pharmacological studies were found. In the ethnobotanical surveys, 171 plants were reported, from 58 families of which the most often cited were Asteraceae, Lamiaceae and Apiaceae. The plants with the best evidence of use and activity are: Anabasis articulata (Forssk.) Moq., Trigonella foenum-graecum L., Centaurium erythraea Rafn, Artemisia herba-alba Asso, Marrubium vulgare L., Agathophora alopecuroides (Delile) Fenzl ex Bunge, Anabasis articulata (Forssk.) Moq., Hammada elegans (Bunge) Botsch., Helianthemum kahiricum Delile, Salsola baryosma (Schult.) Dandy, Salsola vermiculata L., Olea europaea L.

CONCLUSION

Traditional herbal medicines are still very much used in Algeria to control diabetes. However they are generally poorly characterized and none have been properly tested in man. There is a need for systematic evaluation of the more commonly used plants to confirm their antidiabetic activity, identify possible mechanimss of action, and recommend best use.

Diosgenin and Its Fenugreek Based Biological Matrix Affect Insulin Resistance and Anabolic Hormones in a Rat Based Insulin Resistance Model

Fenugreek is known since ancient times as a traditional herbal medicine of its multiple beneficial effects. Fenugreek's most studied and employed effect is its hypoglycemic property, but it can also be useful for the treatment of certain thyroid disorders or for the treatment of anorexia. The regulation of glucose homeostasis is a complex mechanism, dependent on the interaction of different types of hormones and neurotransmitters or other compounds. For the study of how diosgenin and fenugreek seeds modify insulin sensitivity, we used a rat insulin resistance model induced by high-fat diet. Diosgenin in three different doses (1mg/bwkg, 10mg/bwkg, and 50 mg/bwkg, respectively) and fenugreek seed (0.2 g/bwkg) were administered orally for 6 weeks. Insulin sensitivity was determined by hyperinsulinemic euglycemic glucose clamp method. Our research group found that although glucose infusion rate was not significantly modified in either group, the increased insulin sensitivity index and high metabolic clearance rate of insulin found in the 1 mg/kg diosgenin and the fenugreek seed treated group suggested an improved peripheral insulin sensitivity. Results from the 10 mg/kg diosgenin group, however, suggest a marked insulin resistance. Fenugreek seed therapy results on the investigated anabolic hormones support the theory that, besides insulin and gastrointestinal peptides, the hypothalamic-hypopituitary axis regulated hormones synchronized action with IGF-1 also play an important role in the maintaining of normal glucose levels. Both diosgenin and fenugreek seeds are capable of interacting with substrates of the above-mentioned regulatory mechanisms, inducing serious hormonal disorders. Moreover, fenugreek seeds showed the ability to reduce the thyroid hormone levels at the periphery and to modify the T4/T3 ratio. It means that in healthy people this effect could be considered a severe side effect; however, in hypothyroidism this effect represents a possibility of alternative natural therapy.

Low molecular weight galactomannans-based standardized fenugreek seed extract ameliorates high-fat diet-induced obesity in mice via modulation of FASn, IL-6, leptin, and TRIP-Br2

Background: Obesity is a complex, chronic metabolic disorder and its prevalence is increasing throughout most of the world. Low molecular weight galactomannans-based standardized fenugreek seed extract (LMWGAL-TF) has previously shown anti-diabetic and anti-hyperlipidemic potential. Aim: To evaluate the efficacy and mechanism of action of LMWGAL-TF in treating high fat diet (HFD)-induced obesity and hyperlipidemia in mice. Materials and methods: Male C57BL/6 mice were fed the HFD for 12 weeks and were co-administered with LMWGAL-TF (10, 30 and 100 mg kg-1, p.o.). Variables measured were behavioral, biochemical, molecular and histopathological. In a separate in vitro experiment, copper-ascorbate (Cu-As)-induced mitochondrial oxidative damage was evaluated. Results: The HFD-induced increase (p < 0.001) in body weight, fat mass, lean mass, adipose tissue (brown, mesenteric, epididymal and retroperitoneal) and liver weight was significantly attenuated (p < 0.001) by LMWGAL-TF (30 and 100 mg kg-1). The HFD-induced elevated levels of serum lipid, interleukins (ILs)-6 and leptin were significantly decreased (p < 0.001) by LMWGAL-TF (30 and 100 mg kg-1). Elevated fatty acid synthase (FASn), IL-6, leptin and transcriptional regulator interacting with the PHD-bromodomain 2 (TRIP-Br2) mRNA expression in brown adipose tissue (BAT), liver, and epididymal fat were significantly down-regulated (p < 0.001) by LMWGAL-TF (30 and 100 mg kg-1). Additionally, HFD-induced histological alterations in skeletal muscle, liver, white adipose tissue (WAT) and BAT were also reduced by LMWGAL-TF. Furthermore, the Cu-As-induced alteration in mitochondria oxidative stress (lipid peroxidation, protein carbonylation, glutathione, glutathione reductase, glutathione peroxidase, isocitrate dehydrogenase and α-ketoglutarate dehydrogenase) in skeletal muscle and BAT was significantly (p < 0.001) ameliorated by LMWGAL-TF (2, 4 and 6 mg mL-1) treatment. It also reduced the Cu-As-induced mitochondrial swelling. Conclusion: LMWGAL-TF showed its beneficial effect in reducing HFD-induced obesity via down-regulation of FASn, IL-6, leptin, and TRIP-Br2 in mice.

A small plant with big benefits: Fenugreek (Trigonella foenum-graecum Linn.) for disease prevention and health promotion

Plant-derived natural products have long-standing utility toward treating degenerative diseases. It is estimated that about two-thirds of world population depend on traditional medicine for primary medical needs. Fenugreek (Trigonella foenum-graecum Linn.), a short-living annual medicinal plant belonging to Fabaceae family, is used extensively in various parts of the world as herb, food, spice, and traditional medicine. Fenugreek is considered as one of the oldest medicinal plants and its health-promoting effects have been cited in Ayurveda and traditional Chinese medicine. The investigations into the chemical composition and pharmacological actions have seen a renaissance in recent years. Extensive preclinical and clinical research have outlined the pharmaceutical uses of fenugreek as antidiabetic, antihyperlipidemic, antiobesity, anticancer, anti-inflammatory, antioxidant, antifungal, antibacterial, galactogogue and for miscellaneous pharmacological effects, including improving women's health. The pharmacological actions of fenugreek are attributed to diverse array of phytoconstituents. The phytochemical analysis reveals the presence of steroids, alkaloids, saponins, polyphenols, flavonoids, lipids, carbohydrates, amino acids, and hydrocarbons. This review aims to summarize and critically analyze the current available literature to understand the potential of fenugreek for disease prevention and health improvement with special emphasis on cellular and molecular mechanisms. Current challenges and new directions of research on fenugreek are also discussed.

Ethnobotanical survey of medicinal plants used in the traditional treatment of diabetes in Chtouka Ait Baha and Tiznit (Western Anti-Atlas), Morocco

ETHNOPHARMACOLOGICAL RELEVANCE

In Morocco, diabetes mellitus is a major public health problem with more than 1.5 million cases in 2014. Medicinal plants are widely used by the Moroccan population to treat the illness.

AIM OF THE STUDY

The aim of this work is to make an inventory of plant species used in folk medicine for the management of diabetes in Chtouka Ait Baha and Tiznit provinces.

MATERIALS AND METHODS

The survey was carried out by means of semi-structured questionnaires. A total of 380 interviews were conducted with traditional health practitioners and knowledgeable villagers. The data were analyzed through use value (UV), fidelity level (FL) and relative frequency of citation (RFC).

RESULTS

In total, 48 plant species belonging to 25 families were reported. Lamiaceae, Asteraceae and Apiaceae were reported as the most represented families. Six plants are reported for the first time as used in traditional treatment of diabetes and one plant species was previously unknown for its medicinal use to treat diabetes in Morocco. The most frequently cited plant species are Allium sativum L., Salvia officinalis L., Marrubium vulgare L. and Lavandula dentata L. Leaves were the most cited plant part used, decoction is the preferred mode of preparation.

CONCLUSION

This study showed the importance of folk medicine in the healthcare system for the local people living in the study area. The current study represents a useful documentation, which can contribute to preserving knowledge on the use of medicinal plants in this region and to explore the phytochemical and pharmacological potential of medicinal plants.

Recent Update on the Role of Chinese Material Medica and Formulations in Diabetic Retinopathy

Diabetes mellitus is one of the most frequent endocrine disorders, affecting populations worldwide. Diabetic retinopathy (DR) is the most frequent microvascular complication of diabetes in patients aged 20 and over. Major complications of DR include intraocular neovascularization, inter-retinal edema, hemorrhage, exudates and microaneurysms. Therefore, timely medical attention and prevention are required. At present, laser-assisted therapy and other operational procedures are the most common treatment for DR. However, these treatments can cause retinal damage and scarring. Also, use of the majority of traditional medicines is not supported by clinical evidence. However, due to accumulating scientific evidence, traditional natural medications may assist in delaying or preventing the progression of DR. This review focuses on evidence for the role of traditional natural medicines and their mechanisms of action and pharmacological test results in relation to the progression of DR.

A simple dietary addition of fenugreek seed leads to the reduction in blood glucose levels: A parallel group, randomized single-blind trial

Introduction:

Diabetes is prevalent in India. This study was conducted to assess the impact of ingestion of fenugreek seed on fasting blood glucose levels and glycosylated hemoglobin (HbA₁C) levels in patients of Type 2 diabetes mellitus controlled with diet, exercise and oral hypoglycemic agents (OHAs) or insulin.

Aims:

Assessment of impact of ingestion of Trigonella foenum-graecum or fenugreek seed in patients with Type 2 diabetes controlled with OHAs and insulin on fasting blood sugar levels and HbA₁C levels.

Settings and Design:

Prospective, randomized control trial in a single center.

Materials and Methods:

Total sixty patients of Type 2 diabetes mellitus diagnosed at least 6 months prior and on OHAs and insulin were included in the study. Patients were randomized to receive 10 gm of fenugreek seeds soaked in hot water and another group was not. Strict dietary and exercise controls were followed as per the guidelines of American Diabetic Association protocols. The parameters assessed were demographic profile on the first visits and fasting blood sugar levels and HbA₁C every month till 6 months.

Results:

A total of sixty patients were enrolled in the study divided into two groups each containing thirty patients. One group of patients received 10 gm of fenugreek seeds soaked in hot water every day, while the second group did not received. Statistical analysis shows that there is significant reduction in fasting blood glucose levels in the 5^th month in the study group (P = 0.0421) while significant reduction in HbA₁C in the 6^th month (P = 0.0201).

Conclusion:

A simple complementary addition of fenugreek seeds can have a synergistic effect along with diet control and exercise on fasting blood glucose and HbA₁c but is of delayed occurrence.

Effects of fenugreek seed extract supplementation on growth performance, nutrient digestibility, diarrhoea scores, blood profiles, faecal microflora and faecal noxious gas emission in weanling piglets

This study was conducted to evaluate the effect of dietary fenugreek seed extract (FSE) on growth performance, apparent total tract digestibility (ATTD), diarrhoea scores, blood profiles, faecal microflora and faecal gas emission in weanling pigs. A total of 135 weanling pigs [(Yorkshire × Landrace)  × Duroc] with an average BW of (7.96 ± 1.03 kg; 28 days of age) were used in a 42-day study. Piglets were randomly allotted to three experimental diets with nine replicate pens and five pigs per pen. Dietary treatments were as follows: CON, basal diet; FSE1, basal diet + 0.1% FSE; FSE2, basal diet + 0.2% FSE. Pigs were fed with phase 1 (0-14 days) and phase 2 (14-42 days) diets in the form of mash. Average daily gain (ADG) was linearly increased (p = 0.031) by FSE supplementation compared with CON diet during days 0-14. From days 14-42, FSE2 diet had increased ADG and growth efficiency (G/F) compared with the CON diet (p = 0.014 and 0.026 respectively). Moreover, ADG and G/F were increased by FSE supplementation during days 0-42 (linear, p = 0.037 and 0.014 respectively). Energy digestibility was higher (linear, p = 0.030) by FSE supplementation at 6 weeks. On day 42, dietary supplementation of FSE linearly increased red blood cells (RBC) and immunoglobulin G (IgG) concentration (p = 0.042 and 0.038 respectively). Piglets fed FSE2 diet had higher (linear, p = 0.025) serum high-density lipoprotein cholesterol (HDL-C) concentration compared with those fed CON diet. However, piglets fed FSE2 diet had linearly reduced faecal ammonia (NH₃ ) and hydrogen sulphide (H₂ S) gas emission compared with those fed the CON diet (p = 0.018 and 0.010 respectively). In conclusion, FSE supplementation increased the performance and reduced faecal gas emission in weanling pigs.

Effect of Trigonella foenum graecum L on the Activities of Antioxidant Enzyme and Their Expression in Tissues of Alloxan-Induced Diabetic Rats

Diabetes is a life-threatening metabolic disorder. This study was undertaken to evaluate the antihyperglycemic and antioxidative potential of seed powder of Trigonella foenum-graecum L in alloxan (55 mg/kg) induced diabetic rats. The results obtained showed that extensive oxidative stress is generated in tissues of diabetic rats as evidenced by increased production of hydrogen peroxide, increased accumulation of malondialdehyde (MDA) and 4-hydroxynonanal (4HNE) and decreased activities of superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) in tissues of diabetic rats. It was observed that the transcription of genes of SOD, GPx, and CAT was also significantly decreased when compared with control. Treatment of Trigonella for 15 days to diabetic rats showed hypoglycemic effect and improved the altered levels of H2O2, MDA, and 4HNE, the activities of SOD, GPx, and CAT as well as transcription of these genes in the liver and the brain of diabetic rats.

Medicinal herbs and therapeutic drugs interactions

People mistakenly think that all herbs are safe, because of the fact that they are natural, and the use of herbal medication is growing. Aspects of the efficacy, safety, and quality of herbal or natural products are the subjects of on-going debates. Concurrent administration of herbs may interfere with the effect of drugs. Lack of knowledge of the interaction potential together with an underreporting of herbal use poses a challenge for health care providers and a safety concern for patients. A good understanding of the mechanisms of herb-drug interactions is also essential for assessing and minimizing clinical risks. Examples of herbal medicine-pharmaceutical drug interactions of commonly used herbs are presented. The potential pharmacokinetic and pharmacodynamic basis of such interactions is discussed, as well as the challenges associated with the identification and prediction of herb-drug interactions.

Effect of fenugreek (Trigonella foenum-graecum L.) intake on glycemia: a meta-analysis of clinical trials

Background and aim

Fenugreek is a herb that is widely used in cooking and as a traditional medicine for diabetes in Asia. It has been shown to acutely lower postprandial glucose levels, but the long-term effect on glycemia remains uncertain. We systematically reviewed clinical trials of the effect of fenugreek intake on markers of glucose homeostasis.

Methods

PubMed, SCOPUS, the Cochrane Trials Registry, Web of Science, and BIOSIS were searched up to 29 Nov 2013 for trials of at least 1 week duration comparing intake of fenugreek seeds with a control intervention. Data on change in fasting blood glucose, 2 hour postload glucose, and HbA1c were pooled using random-effects models.

Results

A total of 10 trials were identified. Fenugreek significantly changed fasting blood glucose by -0.96 mmol/l (95% CI: -1.52, -0.40; I² = 80%; 10 trials), 2 hour postload glucose by -2.19 mmol/l (95% CI: -3.19, -1.19; I² = 71%; 7 trials) and HbA1c by -0.85% (95% CI: -1.49%, -0.22%; I² = 0%; 3 trials) as compared with control interventions. The considerable heterogeneity in study results was partly explained by diabetes status and dose: significant effects on fasting and 2 hr glucose were only found for studies that administered medium or high doses of fenugreek in persons with diabetes. Most of the trials were of low methodological quality.

Conclusions

Results from clinical trials support beneficial effects of fenugreek seeds on glycemic control in persons with diabetes. However, trials with higher methodology quality using a well characterized fenugreek preparation of sufficient dose are needed to provide more conclusive evidence.

Effects of Trigonella foenum-graecum (L.) on retinal oxidative stress, and proinflammatory and angiogenic molecular biomarkers in streptozotocin-induced diabetic rats

The aim of the present study was to investigate the protective effects of Trigonella foenum-graecum Linn. (fenugreek) in Streptozotocin-induced diabetic rat retina. Fenugreek (100 and 200 mg/kg body weights) treatment was carried out for 24 weeks and evaluated for inflammatory [tumor necrosis factor (TNF)-α and interleukin (IL)-1β] and angiogenic [vascular endothelial growth factor (VEGF) and protein kinase C (PKC)-β] molecular biomarkers. Retinal oxidative stress was evaluated by estimating antioxidant (Glutathione, Superoxide dismutase, and Catalase) parameters. Fluorescein angiography was performed to detect retinal vascular leakage. Electron microscopy was performed to determine basement membrane thickness. In the present study, significant rises in the expressions of retinal inflammatory (TNF-α and IL-1β) and angiogenic (VEGF and PKC-β) molecular biomarkers were observed in diabetic retinae compared with normal retinae. However, fenugreek-treated retinae showed marked inhibition in the expression of inflammatory and angiogenic molecular biomarkers. Moreover, results from the present study showed positive modulatory effects of fenugreek on retinal oxidative stress. Fluorescein angiograms and fundus photographs obtained from diabetic retinae showed retinal vascular leakage. On the other hand, fenugreek-treated retinae did not show vascular leakage. Further, thickened BM was recorded in diabetic retina compared with normal retinae. However, fenugreek-treated retinae showed relatively lesser thickening of capillary BM. In conclusion, it may be postulated that fenugreek has great potential in preventing diabetes-induced retinal degeneration in humans after regular consumption in the specified dosage.

Tackling metabolic syndrome by functional foods

The metabolic syndrome is one of the most vibrant and widely prevailing health concerns worldwide. It is characterized by several metabolic abnormalities, which involve obesity, insulin resistance, dyslipidemia, enhanced oxidative stress; hypertension and increased pro-inflammatory state that ultimate contribute towards poor health. The prevalence of metabolic syndrome in Pakistan according to different definitions is reported to be from 18 % to 46 %. Fifty percent of Pakistani population is at high risk of metabolic syndrome as being hypertensive. In studying dyslipidemia in Pakistan, hypertriglyceridemia is found in 27-54 % of the population, whereas 68-81 % has low levels of high-density lipoprotein (HDL). Population likes to eat healthier diet without changing their fundamental dietary pattern. Nutrition science has moved on from the classical concepts of avoiding nutrient deficiencies and basic nutritional adequacy to the concept of positive or optimal nutrition. Many traditional food products including fruits, vegetables, flaxseed, oat, barley, whole grains, soy and milk have been found to contain component with potential health benefits. Nowadays, functional foods are used in the prevention and amelioration of several chronic diseases, such as the metabolic syndrome. The relation of the consumption of certain functional foods and the improvement in health status is regulated through health claims. This review focuses on the different features of the metabolic syndrome and the influence of functional foods on these aspects, involving dyslipidemia, improvement of insulin sensitivity, serum lipid profile, antioxidant status, anti-inflammatory status and weight management of humans.

Traditional Indian medicines used for the management of diabetes mellitus

Plants have always been a source of drugs for humans since time immemorial. The Indian traditional system of medicine is replete with the use of plants for the management of diabetic conditions. According to the World Health Organization, up to 90% of population in developing countries use plants and its products as traditional medicine for primary health care. There are about 800 plants which have been reported to show antidiabetic potential. The present review is aimed at providing in-depth information about the antidiabetic potential and bioactive compounds present in Ficus religiosa, Pterocarpus marsupium, Gymnema sylvestre, Allium sativum, Eugenia jambolana, Momordica charantia, and Trigonella foenum-graecum. The review provides a starting point for future studies aimed at isolation, purification, and characterization of bioactive antidiabetic compounds present in these plants.

Preventive and curative effect of Trigonella foenum-graecum L. seeds in C57BL/6J models of type 2 diabetes induced by high-fat diet

ETHNOPHARMACOLOGICAL RELEVANCE

Trigonella foenum-graecum L. (TFG) is traditionally used to treat diabetes in North Africa. we therefore tested the effects of the hydro-alcoholic extract of TFG seeds in a C57/BL6J mouse model of diabetes induced by a standardised high-fat diet (HFD).

MATERIALS AND METHODS

Plant extracts (2 g/kg daily) were administered orally by gavage at the start of HFD, or after confirmation of established diabetes (17th week), for 20 or 18 weeks, respectively, to male C57BL/6J mice. Animals were weighed; food intake and plasma glucose, lipid profile, insulin and insulin resistance were measured.

RESULTS

TFG extracts opposed the development of diabetes: compared with untreated HFD mice, TFG-treated HFD mice had lower mean (± SD) plasma glucose (129.3 ± 39.4 vs. 183.1 ± 19.1mg/dL, p<0.05), plasma insulin (1.3 ± 0.8 vs. 3.1 ± 1.8 ng/mL, p<0.05) and triglycerides (18.9 ± 12.9 vs. 48.9 ± 12.1mg/dL, p<0.05), and less insulin resistance as estimated by the homeostasis model assessment (HOMA: 9.7 ± 11.1 vs. 38.3 ± 26.6, p<0.05). In mice with established diabetes, TFG reduced fasting plasma glucose (170.4 ± 24.1 vs. 229.0 ± 20.8 mg/dL, p<0.05), plasma insulin (1.7 ± 1.3 vs. 3.3 ± 14.3 ng/mL, p<0.05) and insulin resistance (HOMA: TFG: 19.2 ± 15.7 vs. HFD control: 38.5 ± 30.3, p<0.05). In addition, administration of TFG extract also caused significant reduction in triglycerides (17.9 ± 9.7 vs. 62.8 ± 18.3 mg/dL, p<0.05) and total cholesterol (1.30 ± 0.20 vs. 1.80 ± 1.10 g/L, p<0.05), and an increase in HDL-cholesterol (1.6 ± 0.2 vs. 1.2 ± 0.1 g/L). The plant extract had no effect on calorie intake or body weight.

CONCLUSION

TFG extract opposed the development of experimental HFD diabetes in mice, and had an anti-diabetic effect in mice with established diabetes.

Meta-analysis of the effect of herbal supplement on glycemic control in type 2 diabetes

ETHNOPHARMACOLOGICAL RELEVANCE

A variety of herbs has been used in traditional medicine for the treatment of diabetes. However, evidence is limited regarding the efficacy of individual herbs for glycemic control. We performed a systematic review and meta-analysis to evaluate the effect of herbal supplement on glycemic control in type 2 diabetes.

MATERIALS AND METHODS

Randomized controlled trials were identified through electronic searches (MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials) up until February 2011, historical searches of relevant articles and personal contact with experts in the area. Studies were included in the meta-analysis if they were (1) randomized placebo-controlled trial of single herb aimed at assessing glycemic control in type 2 diabetes, (2) of at least 8 weeks duration, and (3) reporting HbA(1c). Treatment effect was estimated with mean difference in the final value of HbA(1c) and FBG between the treatment and the placebo groups.

RESULTS

Nine randomized, placebo-controlled trials (n = 487 patients) were identified. Ipomoea batatas, Silybum marianum and Trigonella foenum-graecum significantly improved glycemic control, whereas Cinnamomum cassia did not. The pooled mean differences in HbA(1c) were -0.30% (95% CI -0.04% to -0.57%; P = 0.02), -1.92% (95% CI -0.51% to -3.32%; P = 0.008), and -1.13% (95% CI -0.11% to -2.14%; P = 0.03), respectively, for Ipomoea batatas, Silybum marianum, and Trigonella foenum-graecum. The corresponding values for FBG were -10.20mg/dL (95% CI -5.32 mg/dL to -15.08 mg/dL; P<0.0001) and -38.05 mg/dL (95% CI -9.54 mg/dL to -66.57 mg/dL; P = 0.009), respectively, for Ipomoea batatas and Silybum marianum.

CONCLUSIONS

The current evidence suggests that supplementation with Ipomoea batatas, Silybum marianum, and Trigonella foenum-graecum may improve glycemic control in type 2 diabetes. Such effect was not observed with Cinnamomum cassia. Given the limitations of the available studies and high heterogeneity of the study results for milk thistle and fenugreek, further high quality, large controlled trials using standardized preparation are warranted to better elucidate the effects of these herbs on glycemic control in type 2 diabetes patients.

Diosgenin present in fenugreek improves glucose metabolism by promoting adipocyte differentiation and inhibiting inflammation in adipose tissues

In obesity, adipocyte hypertrophy and chronic inflammation in adipose tissues cause insulin resistance and type-2 diabetes. Trigonella foenum-graecum (fenugreek) can ameliorate hyperglycemia and diabetes. However, the effects of fenugreek on adipocyte size and inflammation in adipose tissues have not been demonstrated. In this study, we determined the effects of fenugreek on adipocyte size and inflammation in adipose tissues in diabetic obese KK-Ay mice, and identified the active substance in fenugreek. Treatment of KK-Ay mice with a high fat diet supplemented with 2% fenugreek ameliorated diabetes. Moreover, fenugreek miniaturized the adipocytes and increased the mRNA expression levels of differentiation-related genes in adipose tissues. Fenugreek also inhibited macrophage infiltration into adipose tissues and decreased the mRNA expression levels of inflammatory genes. In addition, we identified diosgenin, a major aglycone of saponins in fenugreek to promote adipocyte differentiation and to inhibit expressions of several molecular candidates associated with inflammation in 3T3-L1 cells. These results suggest that fenugreek ameliorated diabetes by promoting adipocyte differentiation and inhibiting inflammation in adipose tissues, and its effects are mediated by diosgenin. Fenugreek containing diosgenin may be useful for ameliorating the glucose metabolic disorder associated with obesity.

The effects of a commercially available botanical supplement on strength, body composition, power output, and hormonal profiles in resistance-trained males

BACKGROUND

Fenugreek (Trigonella foenum-graecum) is a leguminous, annual plant originating in India and North Africa. In recent years Fenugreek has been touted as an ergogenic aid. The purpose of this study was to evaluate the effects of Fenugreek supplementation on strength and body composition.

METHODS

49 Resistance trained men were matched according to body weight and randomly assigned to ingest in a double blind manner capsules containing 500 mg of a placebo (N = 23, 20 ± 1.9 years, 178 ± 6.3 cm, 85 ± 12.7 kg, 17 ± 5.6 %BF) or Fenugreek (N = 26, 21 ± 2.8 years, 178 ± 6 cm, 90 ± 18.2 kg, 19.3 ± 8.4 %BF). Subjects participated in a supervised 4-day per week periodized resistance-training program split into two upper and two lower extremity workouts per week for a total of 8-weeks. At 0, 4, and 8-weeks, subjects underwent hydrodensiometery body composition, 1-RM strength, muscle endurance, and anaerobic capacity testing. Data were analyzed using repeated measures ANOVA and are presented as mean ± SD changes from baseline after 60-days.

RESULTS

No significant differences (p > 0.05) between groups were noted for training volume. Significant group × time interaction effects were observed among groups in changes in body fat (FEN: -2.3 ± 1.4%BF; PL: -0.39 ± 1.6 %BF, p < 0.001), leg press 1-RM (FEN: 84.6 ± 36.2 kg; PL: 48 ± 29.5 kg, p < 0.001), and bench press 1-RM (FEN: 9.1 ± 6.9 kg; PL: 4.3 ± 5.6 kg, p = 0.01). No significant interactions was observed among groups for Wingate power analysis (p = 0.95) or muscular endurance on bench press (p = 0.87) or leg press (p = 0.61). In addition, there were no changes among groups in any clinical safety data including lipid panel, liver function, kidney function, and/or CBC panel (p > 0.05).

CONCLUSION

It is concluded that 500 mg of this proprietary Fenugreek extraction had a significant impact on both upper- and lower-body strength and body composition in comparison to placebo in a double blind controlled trial. These changes were obtained with no clinical side effects.

In vitro intestinal glucose uptake is inhibited by galactomannan from Canadian fenugreek seed (Trigonella foenum graecum L) in genetically lean and obese rats

Galactomannan, a soluble fiber, has been reported to reduce postprandial blood glucose response. Using this fiber, extracted from Canadian-grown fenugreek seeds (Trigonella foenum graecum L), we conducted an in vitro study to determine if galactomannan affects intestinal glucose uptake in genetically determined lean and obese rats. The segments of jejunum and ileum from these animals were incubated with labeled glucose (2 or 32 mmol/L) in the presence of different concentrations of galactomannan ranging from 0.1% to 0.5% (wt/wt). The uptake of low or high concentration of glucose was significantly and progressively reduced by increasing concentrations of galactomannan in both lean and obese rats. No significant difference was observed in the uptake of glucose between the 2 groups. The viscosity of various concentrations of galactomannan solutions was determined after stirring for 60 minutes at a temperature-controlled (37 degrees C) fixed sheer rate of 1.29 (1/s). The inhibitory effect of galactomannan on glucose uptake was found to be in parallel with the degree of viscosity of the fiber solutions. These results suggest that the galactomannan, because of its viscous property, has the potential to reduce intestinal absorption of low or high concentrations of glucose and hence for the benefit of blood glucose management.

Complementary and Alternative Medicines for the Treatment of Diabetes

There is a growing interest among diabetic patients in the role of complementary and alternative medicine (CAM) in controlling blood sugar and prevention of complications. It is being used among diabetic patients in addition to usual medical treatment and lifestyle modifications. Complementary and alternative medicine products are marketed for the treatment of diabetic complications and lowering of blood glucose, but the actual therapeutic role remains controversial due to lacking information regarding safety and efficacy. The majority of evidence for the use of CAM is as an adjunctive therapy to the patient’s current diabetic regimen. Trials have shown CAM to be effective for diabetes treatment, but further rigorous study is needed to establish safety, efficacy, and the exact mechanism of action. As the use of CAM increases among the diabetic population, there is a need for patients to communicate with health care professionals to educate them about the safety and efficacy of alternative therapy.

Fenugreek (Trigonella foenum-graecum L. Leguminosae): an evidence-based systematic review by the natural standard research collaboration

An evidence-based systematic review including written and statistical analysis of scientific literature, expert opinion, folkloric precedent, history, pharmacology, kinetics/dynamics, interactions, adverse effects, toxicology and dosing.

The Modifying Effects of Galactomannan from Canadian-Grown Fenugreek (Trigonella foenum-graecum L.) on the Glycemic and Lipidemic Status in Rats

Using high sucrose-fed male Sprague-Dawley rats, a study was conducted to determine the effects of feeding Galactomannan (GAL), a soluble dietary fiber extracted from Canadian-grown fenugreek seeds, on blood lipid and glucose responses. Rats (n = 8, 175-200 g) were randomly assigned to one of three high sucrose diets containing 10% cellulose (control), 7.5% cellulose + 2.5% GAL, and 5% cellulose + 5% GAL, respectively for 4 weeks. After 3 weeks, an oral glucose tolerance test (OGTT) was performed on each rat. A week later blood samples were collected to determine the effect on blood lipids. A significant reduction in glycemic response was observed only in 5% GAL group at 120 min following OGTT, when compared with that of control and 2.5% GAL groups. The plasma level of insulin was also significantly reduced (p<0.001) in 5% GAL-fed rats but at all times during OGTT. These animals also showed a reduction in body weight gain (p<0.05) in parallel with less food intake (p<0.05). All GAL-fed (2.5% and 5.0%) rats had significantly reduced plasma levels of triglycerides and total cholesterol in association with a reduction in epididymal adipose weight. Overall, this study demonstrated that feeding GAL from Canadian-grown fenugreek seeds has the potential to alter glycemic and lipidemic status and reduce abdominal fat in normal rats.