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7, 285-289 (1993)
The hypoglycaemic properties of Mormodicu charuntiu (bitter gourd) water extract was tested on alloxan diabetic
rats experimentally. A fall of blood sugar after 3 week’s treatment with aqueous extract of fruits of the herb was
found to be significant @<0.01). The aqueous extract of fruit was more effective in diabetes (fall of blood sugar
54% after 3 week’s therapy) than the powder of the dried fruit (fall 25% nonsignificant). Hypoglycaemic effects
in diabetic patients were found to be highly significant @<0.01) at the end of the trial but were cumulative and
gradual, unlike that produced by insulin. Adaptogenic properties are indicated by the delay in the appearance of
cataracts, the secondary complications of diabetes and relief in neurological and other common symptoms even
before the hypoglycaemia occurred.
Keywords: Momordica charantia (bitter gourd) extract; hypoglycaemia; cataract (secondary complication of
diabetes); clinical evaluation.
Table3. Blood and urine sugar levels in clinical trial with aqueous extract of Momordica
churantiu
Case
Length of number Blood sugar (PPBS, mg%)
treatment 6 7 8 9 10 11 12
0 weeks 422 236 380 280 380 450 250
a++++ ++ ++++ +++ +++ +++ ++
2 weeks 200 170 191 225 200 191 175
++ + ++ ++ + ++ ++
3 weeks 142 151 - 180 160 150 140
trace nil + trace + nil
4 weeks 120 110 120 150 125 115 120
nil nil nil nil nil nil nil
7 weeks 97 99 118 - - 100 115
nil nil nil nil nil nil nil
Wrine sugar, qualitative.
Table 4. Glycosylated haemoglobin before and after the clini- Table6. Period of appearance of cataract in drug treated
cal trial diabetic rats and diabetic control rats
Glycosylated haemoglobin (mg%) Blood sugar (mg%l
mean+SD range after alloxan after Period of cata-
Diabetic Group Initial treatment 2 months ract development
before treatment 8.37k0.39 (8.0-9.0) Diabetic 64+16 290k44 305f61 93f16 days
Diabetic control
after treatment 6.95k0.46a (6.2-7.6) ( n = 10)
Diabetic 60+15 270k40 109+66' 146k30' days
*p<O.Ol,n=7.
treated (NS) (NS)
( n = 10)
well as pancreatic activity has been reported in rats and NS, Non significant (compared with control).
aSignificant pcO.01.
cats respectively (Lolitkar and Rajaram-Rao, 1962;
1966). Three nonsteroidal hypoglycaemic principles
have been isolated, from unripened fruits of bitter Simultaneously with blood sugar, a qualitative urine
gourd, different from the earlier reported principles, sugar level examination was carried out. Other trials
and named as kakra l b , kakra l l l a and kakra l l l b but with aqueous extract also showed an absence of sugar
their chemistry is unknown as yet. Kakra l b has been in urine when blood sugar registered within normal
reported to act by suppressing free fatty acid levels. limits. Urine sugar estimation was done just before and
Hypoglycaemic effects were evident in the glucose after a gap in the treatment of these subjects. The
tolerance test. Our findings are in agreement with the results expressed in Table 7 show that the sugar appears
earlier reports regarding hypoglycaemia caused by M. in urine in the absence of treatment but to a much
charantia. So far most workers have tried to isolate lesser extent compared with the initial urine sugar
active principles of the fruit, administered orally or by levels. This indicates that the reversal of the control of
injection (as is the case for insulin or oral hypoglycae- diabetes is not total and immediate, unlike other con-
mics) compared in terms of a reduction of blood sugar ventional treatments practised.
after a given number of hours. From the animal experi- Table 4 shows the levels of glycosylated haemoglobin
ments we found the response to aqueous extract of M. in patients before and after the clinical trial. The rate of
charantia fruit increased over a number of days of glycosylation is proportional to the concentration of
treatment indicating a time-related cumulative res- blood glucose (Cerami et al., 1979; Monnier and
ponse. Hence in the clinical trial, the blood sugar level Cerami, 1982). Blood sugar at the peak of the glucose
was monitored after 2, 3, 4 and 7 weeks until the level tolerance curve correlates with glycosylation (Koeing et
stabilized or returned to normal limits. In almost all al., 1976) and with the improvement glycaemic control,
cases it returned to normal limits. None of the earlier glycosylation of haemoglobin also decreases. Hence
published reports on M. charantia followed our criteria estimation of glycosylated haemoglobin is a well-
or an exactly similar plan of work. accepted parameter useful in the management and
prognosis of the disease (Bunn et al., 1978; Stevans et
al., 1977; Koeing et al., 1977; Chang and Noble, 1979).
Table5 Hypoglycaemia caused by powder of dried fruit of
Momordica charantia and aqueous extract
Length of Overall fall in blood Table 7. Urine sugar after gap in therapy
Preparation Dose trial sugar (PPBS) (%I
Initial Urine sugar Gap in Urine sugar
Powder of 15 glsubjectlday 3 weeks 25 Case blood sugar Urine after clinical therapy after gap
dried fruit in 3 equal doses number (mg%) sugar trial (days1 in therapy
of 5 g each 6 422 ++++ nil 1 +
Aqueous 100 g/100mL of 3 weeks 54 7 236 ++ nil 1 nil
extract of water, single 8 380 +++ nil 2 +
fruit standard dose 9 280 ++ nil 1 +
288 Y.SRIVASTAVA ET A L
The initial level of haemoglobin glycosylation in dia- treated with the aqueous extract of bitter gourd fruit for
betic subjects in the present study was 8.37k0.4. The 2 months. The average period of appearance of appar-
value was reduced to 6.1 after the control of glycaemia. ent sugar cataract in the control group was 3 months,
This finding is in agreement with earlier reports. while in the treated group it was 5 months. The delay in
Under normal physiological conditions glucose can cataract formation was significant ( ~ ~ 0 . 0 1The
) . results
react nonenzymatically with proteins to form covalent are presented in Table 6. It gives some indications of
adducts which form brown fluorescent pigments. In the adaptogenic properties of the herb, since herbs are
diabetes, this takes place at an accelerated rate causing known to have many principles antagonistic and syner-
structural and functional changes in physiologically gistic to each other but their combined result produces
active proteins leading to pathogenesis and diabetic the desired effect.
complications, viz., neuropathy (Cerami et al., 1979) The aqueous extract of M. charantia seems to induce
and neuropathic changes (Vlassora et a f . , 1981). In in a better adaptation against diabetes with control of
uiuo and in uitro studies of the crystalline lens, it was glycaemia as reflected by a delay in the appearance of
observed that glycosylated lens proteins cross-link by cataract. An inability to totally reverse glycosuria is
disulphide bonds to form high molecular weight form- evidenced by the gap in the treatment and the relief in
ing aggregates which display opalescence in solution symptoms such as polyphagia, polydypsia, burning in
similar to that observed in diabetic cataract (Monnier hands and feet, pain in calf muscle and generalized
and Cerami, 1982; Srivastava et a f . , 1987a, b). There is weakness at a stage of treatment before the control of
clinical recognition of cataract as a diabetic complica- hyperglycaemia. A hypothesis regarding the mode of
tion. Its incidence and severity increases with the action needs further study since the hypoglycaemic
advancement of diabetes. Of the groups of alloxan properties of this herb cannot be attributed to a single
diabetic rats one was used as control and the other was principle.
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