“Eye on diabetes” with herbs & vitamins

Introduction

November is in the air… It is the time of every year, on 14th November, millions of people around the world come together to raise awareness of this global campaign – World Diabetes Day. In conjunction with the month of diabetes, let’s take this opportunity to taking control on our own blood sugar levels and diabetes condition.

Diabetes has always been a major public health concern in Malaysia. The latest statistic has shown that the prevalence of diabetes has been increased which 1 out of 5 people adult aged 30 above is suffering from type 2 diabetes¹. The increase in the prevalence of diabetes is associated with the increase in overweight and obesity. In fact, 75% of diabetic patients have found to be obese².

Blood sugar management among diabetic patients in Malaysia has been become poorer than before, with only 22% of the patients achieving the healthy level (< 7%)^3,4.

Microvascular complications such as nephropathy, retinopathy, and neuropathy have been related to poor sugar management among diabetics⁵. Poor blood sugar management has been found to be the most significant factor contributes to the development and progression of diabetic retinopathy in individual with diabetes⁶. Therefore, maintaining a healthy sugar level is very important among them to prevent diabetic-related complications.

An herbal remedy consists of a unique formulation (gymnema leaf extract, fenugreek seed extract, holy basil whole plant extract and bitter melon fruit extract) has anti-diabetic properties. Gymnema (Gymnema sylvestre) is regarded as one of the plants with potent anti-diabetic properties. The active compound of the gymnema, known as gymnemic acids is able to help to delay glucose absorption in the blood, inhibit glucose absorption from the intestines and increase the enzyme activity responsible for glucose uptake and utilization⁷. On the other hands, fenugreek can help to stimulate insulin secretion from pancreatic beta cells and inhibit enzymes activities involved in carbohydrate metabolism⁸. Same goes for holy basil and bitter melon, both is able to help lowering blood sugar level in the body.

For the individuals with diabetes, they are always being reminded to control their blood sugar level in order to prevent from various complications. One of the complications is diabetic retinopathy, which caused by high blood sugar levels that damaging the microvascular in the retina. Those who diagnosed with diabetes for 20 years, nearly all with type 1 and at least 60% with type 2 diabetes have developed retinopathy⁹. Diabetic retinopathy is a disease that affecting the capillaries in the retina. Over a long period with uncontrolled blood sugar levels, the blood vessels become weak, blood leak out into retinal tissues and eventually bring impact on vision. Diabetic retinopathy does not cause noticeable symptoms until significant damage has occurred. It can eventually lead to blindness if left untreated.

Pycnogenol® can help to treat and prevent people with diabetic retinopathy. Pycnogenol® is a natural plant extract, extracted from the bark of the maritime pine tree which grows exclusively along the coast of south-west France. Pycnogenol® has been used for centuries for all kinds of ailments. It is produced are grown in unspoilt and natural forest environment.

The ability of Pycnogenol® in reducing capillary leakage and retinal edema is related to its free radical scavenging, anti-inflammatory and capillary protective activities¹⁰. Pycnogenol® is a potent antioxidant that can help to decrease oxidative stress in the eye. Pycnogenol® is standardized to 70%±5% procyanidins, which has been shown to have higher prevention over lipid peroxidation compare to lipoic acids, vitamin C and E, CoQ10, ginkgo biloba and grape seed extract. The Pycnogenol® strengthens capillary permeability by binding to collagens of defective blood capillaries, thereby preventing endothelial cell injury and membrane leakage. With this, Pycnogenol® is significantly proven in stopping the progression of diabetic retinopathy.

On the other hands, B vitamins are essential in glucose metabolism, which serve as coenzymes in cellular reactions involving utilization of glucose in our body. B vitamins such as Vitamin B1 and B6 is required for a healthy nerve function, its deficiency may further increase the risk of neuropathy among those having diabetes¹¹. In addition, studies have shown that patients with type 1 and type 2 diabetes are susceptible to vitamin B12 deficiency¹². Vitamin B12 is vital for red blood cell formation, neuro-cognitive and cardiovascular function, therefore diabetes patients need to ensure they have sufficient intake to prevent from having impaired memory, dementia, neuropathy, anemia and etc¹².

Having diagnosed with diabetes is not the end of the world, but what matters the most is how to manage the diabetes condition. “Eye on diabetes” and together we make a difference!

References

1. M. Feisul, “Current burden of diabetes in Malaysia,” in Proceedings of the 1st National Institutes of Health (NIH) Scientific Meeting, Selangor, Malaysia, June 2012.
2. Zaki, M., Robaayah, Z., Chan, S.P., Vadivale, M., and Lim, T.O., 2010. Malaysia Shape of the Nation (MySoN): a primary care based study of abdominal obesity in Malaysia. Med J Malaysia, 65 Suppl A:143-149
3. Mafauzy, M., Hussein, Z., Chan, S.P., 2011. The status of diabetes control in Malaysia: results of DiabCare 2008. Med J Malaysia, 66(3):175-181
4. Mohamed, M., Diabcare-Asia 2003 Study Group., 2008. An audit on diabetes management in Asian patients treated by specialists: the Diabcare-Asia 1998 and 2003 studies. Curr Med Res Opin,24(2):507-514. Abstract link at: http://www.ncbi.nlm.nih.gov/pubmed/18184454
5. Stolar, M., 2010. Glycemic control and complications in type 2 diabetes mellitus. Am J Med, 123(3 Suppl):S3-11. Abstract link at: http://www.ncbi.nlm.nih.gov/pubmed/20206730
6. Cade, W. T., 2008. Diabetes-Related Microvascular and Macrovascular Diseases in the Physical Therapy Setting. Physical Therapy, 88(11):1322–1335. Full text link at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2579903/
7. Kanetkar, P. et al. 2007. Gymnema sylvestre: a memoir. J. Clin. Biochem. Nutr., 41, 77-81.
8. Basch, E. et al. 2003. Therapeutic applications of Fenugreek, review. Alternative Medicine Review, 8(1), 20-27.
9. Fong, D.S. et al. 2004. Retinopathy in Diabetes. Diabetes Care, 27(suppl 1): s84-s87.
10. Spadea, L., and Balestrazzi, E., 2001. Treatment of vascular retinopathies with Pycnogenol. Phytother Res., 15(3):219-223. Abstract link at: http://www.ncbi.nlm.nih.gov/pubmed/11351356
11. Hammond, N., Wang,Yx., Dimachkie, M., and Barohn, R., 2013. Nutritional Neuropathies. Neurol Clin.,31(2): 477–489
12. Kibirige, D., and Mwebaze, R., 2013. Vitamin B12 deficiency among patients with diabetes mellitus: is routine screening and supplementation justified? Journal of Diabetes and Metabolic Disorders,:17. Full text link at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3649932/