Sunday, December 15, 2013

          

Insulin is plays a key role in the control of glucose homeostasis. Lack of insulin affects carbohydrate, fat and protein metabolism. Diabetes mellitus is a metabolic disorder of non-communicable disease mainly which is characterized by chronic hyperglycemia or increased blood glucose levels with disturbances in carbohydrate, fat and protein metabolism resulting from absolute or relative lack of insulin secretion.

The number of diabetes mellitus cases has been increasing worldwide in recent years. In 2000, the world health organization estimated a total of 171 million of people with diabetes mellitus from the global population, and this report projected to increase to 366 million by 2030. With a long course and serious complications often resulting in high death rate, the treatment of diabetes consumed massive amount of resources including medicines, diets, physical training and so on in all countries. Management of diabetes without any negative side effects is still challenge to the medical community. In addition, in developing countries, where the per capita income is low, it is essential to search for affordable alternative therapies. Thus searching for a new class of compounds is essential to overcome diabetic problems.
Inhibition of ɒ-amylase and ɒ-glucosidase enzymes can be an important strategy in management of post prandial blood glucose level in type 2 diabetes patient. It was proposed that inhibition of the activity of such alpha-amylase and ɒ-glucosidase can delay the degradation of carbohydrate, which would in turn cause a decrease in the absorption of glucose, as a result the reduction of postprandial blood glucose level elevation.
Pancreatic ɒ-amylase is a key enzyme in the digestive system and catalyzes the initial step in hydrolysis of starch to a mixture of smaller oligosaccharides consisting of maltose, maltotriose, and a number of ɒ-(l-6) and ɒ-(1-4) oligoglucans. These are then acted on by a glucosidases and further degraded to glucose which on absorption enters the blood-stream. Degradation of this dietary starch proceeds rapidly and leads to elevated PPHG (post-prandial hyperglycemia). It has been shown that activity of HPA (human pancreatic a-amylase) in the small intestine correlates to an increase in post-prandial glucose levels, the control of which is therefore an important aspect in treatment of type two diabetes. Hence, retardation of starch digestion by inhibition of enzymes such as a-amylase plays a key role in the control of diabetes.
Inhibitors of pancreatic a-amylase delay carbohydrate digestion causing a reduction in the rate of glucose absorption and lowering the post-prandial serum glucose levels. Some inhibitors currently in clinical use are acarbose and miglitol which inhibit glycosidases such as a-glucosidase and aamylase while others such as and voglibose inhibit aglucosidase. However, many of these synthetic hypoglycemic agents have their limitations, are non-specific, produce serious side effects and fail to elevate diabetic complications. The main side effects of these inhibitors are gastrointestinal viz., bloating, abdominal discomfort, diarrhea and flatulence.
Herbal medicines are getting more importance in the treatment of diabetes as they are free from side effects and less expensive when compared to synthetic hypoglycemic agents. Ethnobotanical studies of traditional herbal remedies used for diabetes have identified more than 1,200 species of plants with hypoglycemic activity. A number of medicinal plants and their formulations are used for treating diabetes in the traditional Ayurvedic system as well as in ethnomedicinal practices.

References
  • Etoundi, C.B., Kuate, D., Ngondi, J.L., Oben, J. (2010). Anti-amylase, anti-lipase and antioxidant effects of aqueous extracts of some Cameroonian spices. Journal of Natural Products. 3,165-171.
  • R. Manikandan, A.Vijaya Anand and G. Durai Muthumani (2013). Phytochemical and in vitro anti-diabetic activity of methanolic extract of Psidium guajava leaves. International Journal of Current Microbiology and Applied Science. 2, 15-19.
  • Sudha, P., Smita, S., Zinjarde, Shobha, Y., Bhargava, Ameeta, R., Kumar. (2011). Potent a-amylase inhibitory activity of Indian Ayurvedic medicinal plants. Complementary and Alternative Medicine, 11, 5. 

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