An Experimental Randomized Clinical Study Of Efficacy Of Homoeopathic Plant Remedy Cephalandra Indica Q In Management Of Diabetes Mellitus Type 2

NEED FOR STUDY

Type 2 diabetes now presents as one of the great pandemics of the 21st Century. In some population more than half of adults either already have the disease or are at high risk with evidence of impaired glucose tolerance, impaired fasting glycaemic or metabolic syndrome. It affects all people particularly some of our rapidly developing groups. India already faces a grave problem with the largest number of subjects with diabetes is expected to escalate further, with the number increasing to 70 million in the year 2025 and over 80 million by the year 2030. Treatment of diabetes mellitus with synthetic drugs often fails to provide desired results and comes with a lot of side effects. Homoeopathy is one of the most widespread systems of medicine which seeks to cure in accordance with natural laws of healing and uses medicine made of natural substance. Plants serve as a raw material or drug for approximately 80 percent of the medicines used in homoeopathy. There are many plants available that provide various alkaloids and phytochemicals that act as a potent inhibitor of glucose. Cephalandra is one amongst them with antihyperglycemic properties. A study conducted by Central Council for Research in Homoeopathy in the past on Albino rat model showed pancreatic beta cell- regeneration, inhibition in the uptake of glucose and reduction of blood sugar levels with the mother tincture of Cephalandra indica. This medicine lacks a thorough proving on human subjects. In homoeopathy, more detailed evidence based clinical study of Cephalandra indica is required on diabetes mellitus especially to bring down glucose levels with the help of mother tincture.

Hence, this study is an attempt to highlight the efficacy of Cephalandra indica Q in maintenance of blood sugar levels in human subjects suffering from diabetes mellitus type 2.

REVIEW OF LITERATURE

Diabetes Mellitus

Definition:

Diabetes mellitus is a group of metabolic diseases characterized by hyperglycaemia resulting from defects in insulin secretion, insulin action, or both. The chronic hyperglycemia of diabetes is associated with long term damage, dysfunction, and failure of various organs, especially the eyes, kidneys, nerves, heart, and blood vessels.

Prevalence:

The prevalence of diabetes is alarmingly high in India, so much so that it is referred to as the world’s diabetes capital. Presently, an estimated 40 million Indian citizens are diabetic, a figure that is predicted to surge to approximately 70 million by 2025. Consequently, it’s implied that by that period, one out of every five diabetics worldwide would be an Indian.

Types of Diabetes:

1 Diabetes Mellitus

2 Diabetes Insipidus

3 Gestational diabetes

4 Impaired glucose tolerance Borderline diabetes

Type 1 diabetes typically arises from an autoimmune response that destroys the insulin-producing beta cells in the pancreas, resulting in a significant lack of insulin. On the other hand, type 2 diabetes is characterised by a reduced responsiveness to insulin’s action, combined with a failure to generate enough insulin to compensate for this insulin resistance.

Causes:

The causes of Diabetes Mellitus Type I are believed to include factors such as genetic susceptibility, the hygiene hypothesis, and stress, while the causes of Type II Diabetes Mellitus are often tied to lifestyle changes like inadequate diet and obesity.

Symptoms:

The symptoms of diabetes mellitus can vary widely among individuals, with common symptoms being linked to high blood sugar levels, leading to excessive urination, increased thirst, and increased

hunger. Type 2 diabetes mellitus clinical features are Polyuria, thirst, weakness or fatigue, polyphagia with weight loss, recurrent blurred vision, vulvovaginitis or pruritus, peripheral neuropathy, nocturnal enuresis. In Type 2 Diabetes, symptom progression can lead to various Microvascular and Macrovascular Complications.

Diagnosis:

A fasting blood glucose level equal to or over 126 mg per dL after an 8 hour fast indicates diabetes.

An oral glucose tolerance test result showing a blood glucose level equal to or over 200 mg per dL two hours after consuming a drink containing 75 grams of glucose dissolved in water.

A random blood glucose level of 200 mg per dL or higher, taken at any time during the day.

A postprandial blood sugar measurement equal to or more than 200 mg per dl taken 2 hours after the meal.

HBA1C Test: The A1C test measures your average blood sugar level over the past 2 or 3 months. An A1C OF 6.5 percent or higher indicates diabetes.

Urine analysis test- Benedict test.

Management:

In new cases of diabetes, adequate glycaemic control can be obtained by diet and lifestyle advice alone in some. some people will need oral anti- diabetic medication, and some will require insulin. Homoeopathy is a system of Medicine that was first put into use by Samuel Hahnemann. For the better good of the mankind he introduced this system of medicine and it has served its purpose. Homoeopathy has long been in use for the treatment of diabetes. With its wide range of medicines to treat diabetes it can play an important part in the treatment. Plants serve as a raw material or drug for approximately 80 percent of the medicines used in homoeopathy. There are many plants available that provide various alkaloids and phytochemicals that act as a potent inhibitor of glucose. However, in this review we have tried to concentrate our gaze on one plant which is used in the homoeopathic treatment of diabetes Cephalandra indica. Others are: Syzygium jambolanum, Gymnema sylvestre.

Cephalandra indica

Cephalandra indica commonly known as Ivy gourd, little gourd, Kovai belongs to family Cucurbitaceae. It is used for hypoglycaemic and anti diabetic activities in homoeopathy and other system of traditional medicine. It contains an enzyme with amylolytic properties, a hormone and traces of an alkaloid and it produces reduction of sugar in the blood and urine of patients suffering from glycosuria. The present review attempts to encompass the available literature on Cephalandra indica with respect to its morphological characters, phytochemistry, summary of its various pharmacological activities and traditional and homoeopathic uses.

Introduction:

The World Health Organization estimated near about 80 percent of world population both in developing and developed countries use herbal drugs for various ailments. This plant is one of the tremendous plants of Homoeopathy system. Cephalandra indica is widely used for hypoglycemic and anti-diabetic activities in ayurvedic system of medicine. The whole plant of Cephalandra indica having pharmacological activities like Anti diabetic, Antibacterial, Antitussive, Antimicrobial, Antioxidant, Anti inflammatory, Hyperlipidemic, Hepatoprotective, Chemoprotective. Synonym: Coccinia grandis, Coccinia cordifolia, Coccinia Indica, Physedra, Staphylosyce.

History and distribution:

In India Cephalandra indica grows in large quantities and widely distributed in Andhra Pradesh, Tamil Nadu, Kerala and Lakshadweep.

Scientific Classification:

Kingdom Plantae

Botanical name Cephalandra indica naud

Order: Cucurbitales Family Cucurbitaceae

Synonyms Coccinia cordifolia Telakucha

Description

1. It is a perennial creeping herb

2. Leaves Deep green leaves, alternate, palmately lobed, palmi veined, exstipulate

3. Flowers white, appear in July

4. Fruit A smooth cylindrical berry.

5. Root Long, tapering, tuberous

Part used The fresh green leaves

Phytochemical Constituent:

Cephalandra indica contains

Alkaloids, flavonoids, fatty acids, as major chemical constituents. Aspartic acid, Glutamic acid, Asparaginase, Tyrosine, Histidine, Phenylalanine, Threonine, Valine.

Pharmacological Profile:

Cephalandra indica exhibits following pharmacological activities.

Antidiabetic activity

Anti-inflammatory and analgesic activity

Antibacterial activity

Hepatoprotective activity

Anti Hyper lipidemic activity

Antiulcerogenic activity

Indications:

Diabetes mellitus with skin affections

Intolerable burning sensation in body

Profuse micturition, polyuria, sugar in urine

Dryness of mouth with great thirst

Boils, abscess, carbuncles

Over-sensitive to noise and external impression