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Medical Anthropology: Cross-Cultural
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Ethnobotanical treatments of
diabetes in Baja California Norte
Michael Winkelman a
a Lecturer in the Department of Anthropology, Arizona State
University, Tempe, AZ, 85287
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To cite this article: Michael Winkelman (1989): Ethnobotanical treatments of diabetes in Baja
California Norte, Medical Anthropology: Cross-Cultural Studies in Health and Illness, 11:3,
255-268
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Ethnobotanical Treatments of Diabetes
in Baja California Norte
Michael Winkelman
This paper provides a brief review of the current biomedical knowledge on some of the medicinal
plants used in the treatment of diabetes in Baja California Norte. In general there is very little
biochemical knowledge of the specific modes of action in the treatment of diabetes, but most of
the plants have been found to contain substances (e.g., glucosides, alkaloids) frequently impli-
cated as having anti-diabetic effects. Furthermore, clinical studies with animals indicate that most
of these plants do have hypoglycemic properties. This paper calls attention to the need for further
biochemical investigations into the plant constituents and invites collaboration in the develop-
ment of clinical field studies to assess the efficacy of herbalists' use of medicinal plants in the
treatment of diabetes in Baja California Norte or other U.S-Mexico border areas. Such research
can make an important contribution to the World Health Organization's plan of "Health for All by
the Year 2000" through establishing a scientific basis for traditional medicine.
INTRODUCTION
This paper provides a review of biomedical knowledge on some of the medicinal
plants used in the treatment of diabetes in Baja California Norte. The plants
considered here include those used for diabetes which were reported in a previous
study on frequently used medicinal plants of Baja California Norte (Winkelman
1986),
and includes other plants identified as treatments for diabetes in that research
project but not considered in previous publications. This paper reviews the known
biochemical and pharmacological research on these plants in order to suggest
specific areas in which biochemical, pharmacological and clinical research would
be most useful for an assessment of the effectiveness of plant medicines frequently
employed in the treatment of diabetes, and contributes to efforts to develop a
scientific base for the use of plant medicines in areas without access to biomedicine.
The use of plants for the treatment of illness has not been given wide considera-
tion in the traditional anthropological literature. However recent research (e.g.,
Ortiz de Montellano 1975; Browner and Ortiz de Montellano 1985; Ortiz de Mon-
tellano and Browner
1985;
Dominguez
1976;
Winkelman 1986) has examined the use
of medicinal plants from a biochemical and pharmacological point of view, and
demonstrated that many medicinal plants are likely effective in treating the dis-
eases for which they are used (see also
Journal
of
Ethnopharmacology).
The recogni-
tion that the plants employed in traditional medicine are likely effective in the
treatment of disease has several important implications. The efficacy of traditional
medicine provides justification for further examination of the conditions of its
MICHAEL
WINKELMAN
is a
Lecturer
in the
Department
of
Anthropology
at
Arizona State University, Tempe,
AZ
85287.
His
research
focus
is on
ethnomedicine, with
a
particular interest
in
Mesoamerica.
255
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256 M.
Winkelman
effectiveness so that medicinal plants can be effectively employed as primary
medical resources in areas without access to Western biomedicine. Integrating
traditional medicine into biomedicine through a scientific examination of the bases
for the effectiveness of traditional medicine is the means the World Health Organi-
zation is employing to achieve its goal of assuring "Health for All by the Year 2000."
Knowledge about the use of traditional plant remedies has important implica-
tions for Western biomedicine as well. Knowledge about traditional medicinal plant
use can contribute important information about new sources of biochemicals for the
treatment of disease. The research of Farnsworth and Kass (1981) indicates that
plant substances which are used as traditional medicines are more than twice as
likely to have anti-cancer activity than do randomly selected plants. As such,
ethnomedical research into traditional plant use can provide information about
likely sources of effective bioactive phytochemicals (Trotter and Logan 1985). The
physician must be knowledgeable about herbal remedies and their effects since
Mexican-Americans and other clients may make use of multiple systems of health
care simultaneously. Ignoring or discounting the potential efficacy of herbal medi-
cations may lead to serious treatment problems since traditional Mexican-American
remedies may be potentially toxic (e.g., see Huxtable 1983 and Riddker et al. 1985
on pyrrolizidine alkaloids; Winkelman 1986; Trotter 1985). Ignoring the effects of
medicinal plants could frustrate medical treatment since traditional remedies may
counteract biomedical remedies or compound their effects to dangerous levels. On
the other hand, acceptance of the potential efficacy of traditional remedies facili-
tates the establishment of doctor-patient rapport and increases the likelihood of full
disclosure and patient compliance.
MATERIALS AND METHODS
The plants identified here as those used in the treatment of diabetes were identified
as part of a general study of some of the frequently used medicinal plants employed
by herbalists in Baja California Norte (BCN) (Winkelman 1986). These frequently
used plants were determined in informal consultation with three individuals who
worked in stores selling medicinal plants, who were asked to provide the names of
approximately 20 plants which they considered to be the most important ones
which they sold. These somewhat longer lists of plants were edited based upon (1)
the actual inventories of plants sold by ten herb stores in the area, and (2) the
presence of these species in Mexican botanical and herbal publications or English
language herbal publications. Eight herbalists working in herbal stores in Baja
California Norte were then interviewed as to the use of these plants. The plants
included in that list which were used for the treatment of diabetes are the subject of
this paper. Specimens were collected from medicinal plant stores in BCN and
voucher samples of these plants were identified1 and placed in the herbarium at the
Los Angeles State and County Arboretum. Table I provides the current botanical
nomenclature, scientific names, Spanish names, English translations or related
plants, and the part(s) of the plant used.
The following sections of this paper review the pathophysiology of diabetes, the
ethnobotanical treatment of diabetes in BCN, and the known biochemical and
pharmacological literature relevant to the treatment of diabetes for each of these
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Ethnobotanical Treatments
of
Diabetes
257
TABLE
I. Plants used to treat diabetes in Baja California Norte.
Genus, species, author and family. (Primary Spanish and other names reported by informants). [English
name or related species]. Part(s) of plant used.
Arctostaphylos
cf. pungens HBK. Ericaceae. (Pinguica, manzanita, pepioita, tepezquite, guayuba de
Mexico).
[Arctostaphylos
uvaursi (L.) Spreng. Ericaceae is bearberry]. Dried fruits.
Bidens pilosa
L. Asteraceae. (Aceitilla, acahuale, saetilla, and rosilla). [Beggar ticks, Spanish needles].
Leaves and stems.
Calea zacatechichi
Schlecht. Asteraceae. (Prodigiosa). [Mexican calea, Dog's grass, Bitter grass]. Leaves,
stems and flowers.
Cecropia peltata
Hemsl. Urticaceae. (Guarumbo). [Pumpwood or trumpet
tree].
Leaves and stems.
Equisetum spp. Equisetaceae. (cola de caballo, limpia plata, platero, and equiseto). [Shave Grass,
Horsetail].
Stalk, stem, leaves.
Hintonia latiflora
(Moc. et Sess.) Bullock fide Martinez, 1979, Rubiaceae. (Copalquin, copalchi, cam-
panillo, palo amargo, quina). [Copalchi
Bark].
Bark.
Larrea tridentata
(Sesse
&
Mox. ex DC.) Cov. Zygophyllaceae. (Gobernadora, hediondilla, falsa alcaparra,
& guamis). [creosote bush, chaparral]. Leaves.
Psacalium decompositutn
A. (Gray) Rob. & Brett. Asteraceae. syn.
Cacalia decomposita
A. Gray. (Matarique,
maturi). Roots.
Rhantnus purshiana
DC fide Martinez 1979 Rhamnaceae. (Cascara sagrada). [Sacred bark, chittem bark,
purshiana
bark].
Reddish and grey bark.
Tecoma
cf.
starts
(L.) HBK. Bignoniaceae. (Tronadora, lluvia de oro, trompetilla, retama, hierba de San
Nicolas, Flor de San Pedro, huachacata, kano, tulasochil and Minona). [Trumpet Bush, Yellow Bells].
Leaves & stems.
Turnera
diffusa Willd. Turneraceae. (Damiana, pastorcita, hierba del venado, hierba de la pastora).
[Damiana].
Leaves.
plants. Identification of the chemical constituents of these plants and their effects
was based upon reviews of research on biochemical investigations and pharmaco-
logical effects of these plants or closely related species of the same genus. Major
references included herbal dictionaries (Duke
1985;
Duke and Ayensu
1985;
Ayensu
1978;
Boulos 1983; Martinez 1939), standard medical dictionaries (Thomas 1977),
indexes and encyclopedias of chemicals and drugs (Windholz et al. 1976) and texts
(Katzung 1984; Lewis and Elvin-Lewis 1977). It is emphasized that there is a need
for understanding much more about the conditions of the use of these plants, as
well as their biochemical and clinical properties, before an adequate assessment of
their efficacy may be made.
THE PATHOPHYSIOLOGY OF DIABETES
Assessment of the effects of the medicinal plants upon diabetes requires a general
understanding of the nature of the effects of diabetes upon the human system.
Diabetes, even Type II diabetes alone (adult onset versus Type II juvenile onset),
may be caused by a number of different factors, and therefore treatable through a
number of different mechanisms. This section reviews the general physiology of
diabetes, some of the body systems which affect diabetes and are affected by it, and
the classes of bioactive phytochemicals which have been implicated in the success-
ful treatment of diabetes. Recognition of the range of organs and systems involved
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258 M.
Winkelman
in the process of diabetes will allow for a more informed examination of the
effectiveness of these ethnobotanical remedies.
Diabetes mellitus is due to a number of factors which adversely influence the
individual's ability to adequately metabolize and utilize food consumed, specifi-
cally the sugar (glucose). Diabetes may be caused by: misfunction of the beta or
alpha cells of the pancreas, and the resultant lack of insulin; hyperfunction of the
adrenal or pituitary glands; or malfunction of the liver. Diabetes is most frequently
treated through weight and diet modification and insulin replacement. Although
some forms of diabetes are caused by a lack of insulin, others indicate an inability of
the body to utilize the insulin available, for example, resulting from the blockage of
insulin receptor sites.
Insulin, a hormone created by the pancreas, is necessary to convert glucose to
energy or store it in the muscle cell in the form of glycogen. If energy is not needed
and the glucose is not stored as glycogen, it is converted to triglycerides and stored
in fat cells. The conversion of glucose to triglycerides may occur in the liver from
which they are released into the bloodstream. In the diabetic, glucose levels in the
blood increase producing symptoms of thirst as the diabetic tries to flush the excess
glucose out through the kidneys. The pancreas also produces glucagon, which
converts glycogen (stored sugar) back into blood sugar, which then raises the levels
of blood sugar. Excessive levels of glucagon act as an insulin antagonist and can
result in diabetes.
The role of the liver in diabetes includes the conversion of glucose to triglycerides,
particularly when there is an excess of glucose. Substances which in general
improve liver functioning (e.g., antihepatotoxic, choleretic) may assist in dealing
with secondary problems from excessive workload placed upon the liver. The liver
produces bile, which aids in the process of digestion, and is a more important factor
than glucose in the regulation of the pancreas and the release of glucose. Thus,
factors influencing the liver may predispose to diabetes by stimulating the pancreas
to release more insulin or by restricting the release of glucose when blood sugar
levels are already high. One of the effects of high blood glucose and triglyceride
levels is arteriosclerosis, the fattening and hardening of the walls of the arteries
caused by deposits from the blood stream. Therefore, substances with anti-
atherogenic effects upon the liver would effectively deal with some of the secondary
problems of diabetes by counteracting the pathogenic process of arteriosclerosis.
Both the liver and the kidney function to remove insulin from circulation, and could
therefore regulate insulin deficient diabetes by reducing uptake (or the effects of
antagonists). The liver not only contains insulinase, a destructive factor for insulin,
but also produces insulinase-inhibitor, a factor capable of inhibiting the degrada-
tion of insulin. Diuretic substances may also affect diabetes by increasing renal
filtration and thus urination. This flushes the excess glucose out of the system
through the kidneys. However, diuretics may also contribute to hyperglycemia by
increasing the concentration of glucose through stimulating excretion of water.
Stress also affects the process of diabetes. Stress causes the release of certain
hormones (cortisol, glucagon and catecholamines) which not only inhibit insulin
secretion, but also increase production of glucose by the liver from glycogen
reserves. Therefore, substances which reduce stress would favorably affect the
progress of diabetes by arresting counterproductive processes that inhibit insulin
secretion and increase the production of glucose.
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Ethnobotanical Treatments
of
Diabetes
259
Reviews of the biochemical and pharmacological literature on plants with oral
hypoglycemic action illustrate that plants may intervene at a number of different
sites in glucose metabolism (e.g., see Oliver Bever 1980; Oliver Bever and Zahnd
1979).
Oliver Bever has suggested general classes of chemicals with frequently
recognized hypoglycemic action. In addition to insulin substitutes, a number of
other substances such as phytosterin glucosides, beta-sitosterin, triterpenes, fla-
vonoids, organic sulphur compounds, alkaloids, somatostatins, pituitary and sex
hormones, corticosteroids and prostaglandins have shown an ability to control
hyperglycemic problems. Some plants have been shown to act only in the presence
of beta cells, with their action mediated through the presence of insulin (e.g.,
Tecoma
stans), while others act in totally depancreatized animals.
Phytosterolglycosides (phytosterin glucosides) were found to be the active ingre-
dients in a number of plants with both pancreatic and extra-pancreatic action. The
phytosterin glucosides identified as active constituents in plants with hypoglyce-
mic action include steroid and triterpene glycosides, beta sitosterin-D-glucoside,
and triterpenes. Flavonoids are frequently found in plants with a hypoglycemic
action (Harborne, Marby, and Marby 1974), and the glucosides are frequently active
constituents, including the rhamnoglucosides. In addition to the anthocynanins,
leucoanthocynanins and catechols, flavonosides such as quercitin-, kaempferol-
and luteolin-glycosides are frequently found in hypoglycemia-inducing plants
(Oliver Bever 1980). Flavonoids also appear to act on the capillaries and help in the
•
recovery of the vascularization of the pancreas.
Organic sulphur compounds have been recognized as active hypoglycemics,
specifically allyl propyl disulphide (APDS) and allicin (diallyl disulphide oxide).
Their effectiveness is not surprising given that insulin is a disulphide protein. The
allicin produces significant drops in blood glucose levels and a rise in serum insulin
levels.
'APDS probably removed insulin-inactivating compounds by competing
with insulin for the SH-group in these compounds, thus producing an insulin-
potentiating effect which prevents the increase of free fatty acids on fasting" (Oliver
Bever 1980:121). Sulfonamide derivatives increase insulin secretion through direct
stimulation of the beta cells of the islets of Langerhans.
Hypoglycemic alkaloids (e.g., leurosine, vindoline, vindolinine, tecomine and
tecostanine) have been shown to have more potent action at equivalent doses than
standard drugs like tolbutamide; however, hypoglycemic alkaloids must be sepa-
rated from other alkaloids since many have cytotoxic action. Hypoglydns appear to
act through inhibition of the beta-oxidase enzymes "thus increasing anaerobic
glycolysis and decreasing gluconeogenesis, entailing an increased rate of transfer of
glucose from blood to tissue" (Oliver Bever 1980:126). Anthocyanosides are believed
to improve the vascularization of the pancreas thus counteracting the vascular
problems (diabetic angiopathy) which develop during diabetes.
The above discussion should serve to illustrate that a number of specific mecha-
nisms may be involved in the cause of diabetes and in the ethnobotanical treatment
of this disease. In the following sections, the BCN herbalists' treatment approaches
and knowledge about diabetes, and the biochemical and pharmacological proper-
ties of each of the plants in Table I are reviewed in order to illustrate their potential
contributions to the biomedical treatment of diabetes.
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260
M.
Winkelman
RESULTS
Examination of the information provided by the herbalists and the agreement
among them revealed some consistency in the ethnobotanical treatment of dia-
betes.
All of the herbalists in the study were aware of differences in types of
diabetes, making a distinction between juvenile onset diabetes ("diabetes juve-
nile") and adult onset diabetes ("diabetis de adultos"). This apparently corre-
sponds to the biomedical distinction between Type I diabetes (insulin-dependent,
juvenile onset) and Type II diabetes (adult onset). The remedies discussed here
were employed for treatment of adult onset diabetes (presumably Type II).
The BCN herbalists indicated that the cases of diabetes which they treated were
frequently patients who were diagnosed as having diabetes by medical doctors.
Patients then sought out herbal treatments; cost was thought to be a primary
consideration in their utilization of herbal medicine. However, the herbalists also
made diagnoses of diabetes, based upon the presence of a combination of a number
of symptoms including: (1) excessive appetite, hunger, thirst or poor digestion; (2)
obesity or loss of weight; (3) general debility or dizziness upon standing up; (4)
frequent urination, with a burning sensation, a fetid smell, and very obscure or
clear urination; (5) a sour or dry mouth; (6) an opaque color to the eyes; and (7) high
blood pressure.
Examination of the number of informants which mentioned each of the plants as
a treatment of diabetes indicated several patterns. One finding is that diabetes is
always treated by a combination of plants rather than a single plant. All of the
herbalists interviewed sold
"compuestas",
combinations of plants mixed together, as
their recommended treatment of diabetes. Initial inquiries into the specific compo-
nents of the
compuestas
evoked suspicious reactions from some herbalists, since the
compuestas
constitute a trade secret. Since the initial focus of the study was upon
frequently used medicinal plants, and not diabetes or
compuestas,
inquiry into the
nature of the
compuestas
was abandoned. However, some herbalists informed the
author that the plants identified here represent the range of plants typically in-
cluded in
compuestas
used for treating diabetes. Further studies of the herbal
treatment of diabetes should focus upon the combinations of plants present in the
compuestas,
their possible interactions, and their potential clinical efficacy.
Another point revealed by an examination of the number of informants which
mentioned each of the plants was that two of the plants,
Bidens pilosa
and
Tecoma
starts, were mentioned by essentially all of the informants as being used in the
treatment of diabetes. In addition, most informants mentioned either
Cecropia
peltata
or
Hintonia latiflora
as an additional plant remedy employed with
Bidens pilosa
and
Tecoma starts
in the treatment of diabetes; no other plant remedy listed in Table I
was mentioned by more than two informants as used in the treatment of diabetes.
Other plants not listed here were mentioned as used in the treatment of diabetes,
but are not discussed here since voucher specimens were not collected for identi-
fication.
The herbalists also had regular dietary recommendations to be followed in
conjunction with the plants employed in the treatment of diabetes. Herbalists were
quite uniform in recommending that foods such as the following be avoided by
diabetic patients: sugars, sweets, starches, breads, dark sodas, alcohols and wines,
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Ethnobotanical Treatments
of
Diabetes
261
coffee, fried foods, pork, irritants, spicy foods, chiles and chocolates. Such recom-
mendations are consistent with the kinds of dietary restrictions used in bio-
medicine in the treatment of diabetes. Herbalists also recommended that fresh
vegetables be included in the diet, which will favorably affect Type II diabetes since
fibrous roughage reduces glucose absorption.
The material that follows reviews the available literature on the biochemical and
pharmacological properties of each of the plants discussed in order to illustrate
their likely efficacy in the treatment of diabetes.
Arctostaphylos cf. pungens HBK. Ericaceae.
Arctostaphylos
pungens is recom-
mended for treatment of diabetes, as well as renal and gall bladder problems
("destapa canos de vejiga"), urinary tract infections, prostate problems and nephri-
tis.
Biochemical and pharmacological investigations on A. pungens are apparently
lacking, but the uses of A.
pungens
are quite similar to the uses of
Arctostaphylos
uva-
ursi (L.) K. Spreng. of Eurasia which is widely naturalized in North America.
Arctostaphylos uva-ursi
has therapeutic use in humans as a urinary and antiseptic,
and is used in veterinary medicine as a diuretic (Windholz et al. 1976).
Arctostaphy-
los
uva-ursi
contains arbutin (or ursin), quercitin, ericolin, ericinol, gallic acid, malic
acid and ursolic acid (a diuretic) (Duke 1985). The quercitin-glycosides are fre-
quently found in hypoglycemia-inducing plants (Oliver Bever 1980).
Arctostaphylos
uva-ursi also contains two glucosides, arbutoside and methylarbutoside, and the
catechin-tannins (Schauenberg and Paris 1977); arbutin is diuretic and catechin is
antihepatotoxic and antioxidant (Duke 1985). The antihepatotoxic effects may help
counteract potential liver damage from the excessive activity of the liver in the
transformation of glucose to triglycerides. The antioxidant effects may counteract
the progress of toxic effects of diabetes by preventing the deterioration of the oils
and fats. The strong diuretic agents ursolic acid (urson) and isoquercetin will
increase urination, as is desired by the herbalists in treating diabetes. Spoerke
(1980) suggested that the plant's diuretic action is likely due to hydroquinolone.
Duke (1985) reported that extensive and long-term use of A. uva-ursi can cause
chronic impairment of the liver, since it contains hydroquinone, which is toxic.
Bidens pilosa L. Asteraceae. Bidens pilosa and other Bidens species known as
aceitilla are principally used for the treatment of diabetes. Perez et al. (1984)
evaluated the hypoglycemic effect in rats of 21 Mexican plants and found Bidens
spp.
among the best antidiabetic plants in the study. The hypoglycemic effects of
Bidens pilosa
were examined in tests using CDa strain mice with alloxan-induced
diabetes. The mice were administered plant extracts and control substances both
intraperitoneally and orally; hypoglycemic activity was assessed by measurements
taken 5 hours after administration with the O-toluidine, Dextrostix tape, and
Nelson-Somogyi methods of blood samples taken from the tips of the tails of the
mice. Perez et al. (1984) found Bidens
leucantha
and Bidens
pilosa
among the best
antidiabetic plants in the study, but the relevant phytochemicals in the treatment of
diabetes are not known. However, B. pilosa contains polyacetylenes, phenylhep-
tatriyne and other substances which are phototoxic, antibiotic, fungicidal and
bactericidal (Duke and Ayensu 1985). The Bidens species of Hawaii contain the
polyacetylene thiophene (Marchant et al. 1984); however, the biochemical and
biological roles of acetylenes or their relationship to the treatment of diabetes are not
yet established.
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262 M.
Winkelman
Calea zacatechichi Schlecht. Asteraceae.
Calea zacatechichi
contains a wide range
of substances, including: glucoside-like bitter principles, acetylenes, polyacetyl-
enes,
germacrolides, sesquiterpene lactones, triterpenes, chromenes, flavonoids, a
crystalline alkaloid C21H26O8, and carbonic-, chlorhydric-, phosphoric-, salicylic-,
succinic- and sulphuric-acids (Duke 1985). Oliver Bever's (1980) reviews indicate
that glucosides, triterpenes, flavonoids, organic sulphur compounds and alkaloids
are frequently implicated in hypoglycemic effects from medicinal plants, but the
relevant substances or their effects have not been established for
Calea
zacatechichi.
Jui (1966) reports that
Calea zacatechichi
has anti-atherogenic effects in dogs and rats;
this may deal with the secondary effects of diabetes by counteracting the patho-
genic process of arteriosclerosis.
Cecropia peltata Hemsl. Urticaceae.
Cecropia
peltata is a widely distributed
species in the tropical Americas.
Cecropia dbtusiflora
extracts had significant anti-
atherogenic effects in lowering serum cholesterol levels of rats and dogs (Jiu 1966).
This would counteract increased circulation of fatty acids which accompanies
diabetes and counteract the pathogenic process of arteriosclerosis. Perez et al.
(1984) report that C.
dbtusiflora
was one of the most effective of 21 Mexican plants
they studied for hypoglycemic effects. Mellado-Campos and Lozoya-Meckes
(1984) also report significant hypoglycemic and hyperlipidemic activity with dogs
given hot water extracts of C.
obtusiflora.
However, no research is known which has
established the relevant fitochemicals in C.
dbtusiflora
or established the pharmaco-
logical effects of C. peltata.
Equisetum spp. Equisetaceae. A wide variety of Equisetum species (e.g., E.
fluviatile, E.
hyemale
L. var. affine [Engelm] A. A. Eat., E. giganteum L. and E.
myriochaetum
Hauke) (P£rez Gutierrez, Yescas Laguna, and Walkowski 1985) are
known in Mexico as
cola
de
caballo,
and used in the treatment of diabetes, problems
of the kidneys and infections of urinary tract. Perez Gutierrez, Yescas Laguna, and
Walkowski (1985) report that the various
Equisetum
species have significant diuretic
effects in mice; the E.
hiemale
var.
affine
was found to be a more effective diuretic
than the standard comparison drugs (hydrochlorothiazide, spironolactone and
furosemide). The Mexican species of
Equisetum
have established diuretic effects
(cf., Perez Gutierrez, Yescas, Laguna, and Walkowski 1985), but their biochemistry
is apparently not known; however, there is data available on the European E.
arvense
L.,
and the
Equisetum
genus, which has a long history of use in European herbalism.
Equisetum arvense contains many chemicals including isoquercitin, a diuretic
(Duke 1985). Schauenberg and Paris (1977) indicated that E.
arvense
contains kaemp-
ferol, a diuretic and a natriurteic, increasing the rate of sodium excretion in the
urine. Since diuretics increase secretion of urine and act on the kidney cells,
increasing permeability and circulation, it seems clear that
Equisetum
will intervene
in the functioning of the kidney systems and deal with some of the secondary
symptoms of diabetes such as retention of water and excessive blood glucose levels.
Equisetum
species also contain nicotine, and nicotinic acid has been shown to have
hypoglycemic action (Oliver Bever 1980). Kaempferol-, quercitin-, and luteolin-
glycosides are frequently found in plants with hypoglycemic properties (Oliver
Bever 1980) and have been implicated as the active agents in plants with hypoglyce-
mic action, suggesting that
Equisetum
species should have similar hypoglycemic
effects. E.
arvense
also contains beta-sitosterol, an antihypercholesterolemic (Duke
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Ethnobotanical Treatments
of
Diabetes
263
1985) which will likely reduce cholesterol levels and exercise hypoglycemic effects
(Oliver Bever 1980). However, the biochemical constituents of the Mexican Equi-
setum species and their clinical effectiveness in the treatment of diabetes have yet to
be investigated.
Hintonia latiflora (Moc. et Sess.) Bullock fide Martinez (1979) Rubiaceae (syn.
Coutarea latiflora
Moc. & Sesse).
Hintonia latiflora
is used in the treatment of diabetes,
liver problems and gall bladder problems. Hintonia
latiflora
reportedly contains an
alkaloid—copalchina, an unidentified glucoside, and a saponin (Garcia 1973).
Perez et al. (1984) reported that H.
latiflora
was one of the most effective of 21
Mexican plants tested for antidiabetic effects in mice, but the active substance was
not determined. However, Oliver Bever and Zahnd (1979) reviewed research which
indicates that Hintonia
latiflora
contains coutareoside (glucose and polyphenolic
methoxylated genin [hydroxycoumarin]), which is active in hyperglycemic rabbits;
coumarin is hypoglycemic (Duke 1985) and may be the means through which H.
latiflora
exercises its effects. Jiu (1966) reported that H.
latiflora
has antiatherogenic
and appetite suppressant (inhibition) effects in rats and dogs. The antiatherogenic
effects are likely to arrest the pathogenic process of arteriosclerosis which accom-
panies diabetes. The appetite suppressant effects may favor diabetes treatment by
reducing appetite and consumption of food. Although the antidiabetic effects of
Hintonia latiflora
have been established in animals, the biochemical basis for these
effects is not well investigated, nor are the effects upon diabetes of the biochemical
constituents such as quinidine and quinine (Duke 1985), or the effects of the
alkaloid, glucoside, and saponin components known.
Larrea tridentata (Sesse & Moc. ex DC.) Cov., Zygophyllaceae, (syn. Covilka
tridentata
Vail.)
Larrea tridentata
is used for the treatment of diabetes, as well as a
wide variety of other conditions, including treatment of kidney problems and gall
stones.
Larrea tridentata
contains arginine, which is diuretic (Duke 1985), therapeu-
tic in hepatic failure (Windholz et al. 1976) and initiates insulin and glucagon release
from the Islets of Langerhans (Arslanian and Virji 1984).
Larrea
tridentata also
contains a complex mixture of phenolics (flavonoids and lignans) and saponins
(triterpenoids) (Marby, Hunziker, and DiFeo 1977), as well as a range of amino acids
(Duke 1985). Flavonoids and triterpenoids are frequently found in hypoglycemic
plants (Harborne, Marby, and Marby 1974; Oliver Bever and Zahnd
1979).
The maj or
lignan is nordihydroguaiaretic acid, with many biocidal and anti-tumor effects
(Rodriguez 1985; Marby, Hunziker, and DiFeo 1977; Windholz et al. 1976).
Larrea
tridentata
is a plant rich in chemicals but in need of further pharmacological and
biological study to determine its modes of action and possible effectiveness in
treatment of the many diseases for which it is used.
Psacaliutn decontpositum A. (Gray) Rob. and Brett. Asteraceae (syn.,
Cacalia
decomposita
A. Gray).
Psacalium decontpositum
is used in the treatment of diabetes
and problems of the liver, kidneys and pancreas.
Psacalium decompositum
(reported
as
Cacalia decomposita)
contains an unknown alkaloid which effects the heart (Gar-
cia 1973); alkaloids are known for hypoglycemic action (Oliver Bever 1980). How-
ever,
Cacalia decomposita
contains toxic pyrrolizidine alkaloids (Huxtable 1983), and
may therefore not be an advisable treatment. The sesquiterpene compounds ca-
calol, maturinone and furanoeremophilane are also present (Inouye, Uchida and
Kakisawa 1977; Huxtable 1983). Triterpene glycosides have been identified as the
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264 M.
Winkelman
active constituents in plants with hypoglycemic action (Oliver Bever 1980). Perez et
al.
(1984) report that C.
decomposita
has significant hypoglycemic properties with
mice, but biochemical studies to determine active constituents are lacking.
Rhamnus purshiana DC. fide Martinez (1979) Rhamnaceae. The bark oiRhatnnus
purshiana
contains 6-9% anthraquinone glucosides and cascarsosides A, B, C., and
D (Spoerke 1980); the anthraquinone glucosides have therapeutic use as a cathartic
and laxative (Windholz et al. 1976).
Rhamnus purshiana
also contains cascarin (fran-
gulin, franguloside or avornin), consisting of two glucosides, frangulins A and B,
which are also cathartic (Windholz et al. 1976), as well as an unidentified hydrolytic
enzyme, which may be responsible for the positive effects in the treatment of
diabetes reported by users of
Rhamnus
purshiana.
However, the biochemical basis of
these effects, or whether these glucosides are antidiabetic agents, has not been
determined.
Tecoma
cf. stans (L.) HBK., Bignoniaceae.
Tecoma
stans is used in the treatment of
diabetes, liver problems and gastritis (inflammation of the stomach). The
Tecoma
genus contains coumarin, a hypoglycemic (Duke 1985).
Tecoma
stans contains
tecomanine (tecomine) and tecostanine (Lozoya-Meckes and Mellado-Campos
1985),
which possess hypoglycemic effects (Windholz et al. 1976). The hypoglyce-
mic alkaloids found in T. stans (tecomanine [tecomine] and tecostanine) probably
act only in the presence of a minimum amount of
B
cells and are mediated by insulin
(Oliver Bever
1980).
This suggests that
T.
stans functions in a manner similar to other
orally active hypoglycemic substances such as the sulphonylureas (Oliver Bever
and Zahnd 1979). Clinical studies of the effect of intravenous administration of
Tecoma
stans infusion to dogs indicate an initial hyperglycemic response, arterial
hypotension and a slow decrease in glucose blood values in normal dogs adminis-
tered T. stans infusion (Lozoya-Meckes and Mellado-Campos 1985).
Tecoma
stans
was one of the best antidiabetic plants in a sample of
21
Mexican plants surveyed for
such activity on mice (Perez et al. 1984), and T. mollis has effective antidiabetic
properties in the treatment of some diabetic patients (Colin 1927).
Tecoma
stans also
contains a variety of substances which affect the liver, including: chlorogenic acid
(Dohnal 1977), which provokes secretion of bile by the liver; coumaric acid (Dohnal
1977,
Sugumaran et al. 1975), which is hypoglycemic; f erulic acid (Sugumaran et al.
1975),
which is choleretic and hepatotropic; oleanolic acid (Dohnal 1977), which is
antihepatitic; and beta-sitosterol (Dohnal 1976,1977), which is antihypercholester-
olemic (Duke 1985) and identified as the active ingredient in plants with antihyper-
glycemic activity (Oliver Bever and Zahnd 1979).
Tecoma
stans will clearly affect
diabetes, and is an ideal candidate for clinical studies.
Turnera diffusa Willd., Turneraceae, (syn., T.
aphrodisiaca
Willd.) is used in the
treatment of diabetes.
Turnera diffusa
contains a range of substances which Oliver
Bever and Zahnd (1979) indicate as frequently known for the hypoglycemic effects
(e.g., terpenes, beta-sitosterol, cyanogenic glucosides, flavones [gonzalitosin 1 {5-
hydroxy-7',3',4'-trimethoxyflavone}], and the alkaloid damianin), as well as a
range of other substances (e.g., alpha and beta pinenes, p-cymene and the sesqui-
terpenes alpha-copaene, cadiene and calamenene) (Duke 1985). However, the po-
tential effects of these substances upon diabetes are apparently not known. Studies
by Perez et al. (1984) indicate that
T.
diffusa
was one of the most effective antidiabetic
hypoglycemics of 21 Mexican plants studied for their effects with mice. T. diffusa
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Ethnobotanical Treatments
of
Diabetes
265
also contains arbutin, a diuretic (Duke 1985). The diuresis produced by this sub-
stance is effective in dealing with the secondary symptoms of diabetes and is the
mode of action desired by BCN herbalists in the treatment of diabetes. Jiu (1966)
reports the presence of central nervous system depressants, which may be the
means through which T. diffusa favorably affects nervous problems, and thereby
potentially reducing the stress which could exacerbate the effects of diabetes.
However, the biochemicals which create the hypoglycemic and CNS depressent
effect have not been identified.
SUMMARY
The plants of this study which are used in the treatment of diabetes either have
been established as having hypoglycemic effects in animals, or have substances
(e.g., glucosides and alkaloids) widely recognized as having hypoglycemic action.
All of the herbalists recommended the treatment of diabetes with herbal combina-
tions which include plants all of which are clearly likely to be effective in the
treatment of diabetes. The effects and general class of substance found in the
various plants are shown in Table II. However, in most cases the relevant fitochemi-
cals have not been identified, and none of the plants can be said to contain
substances with commonly accepted therapeutic effects in the treatment of dia-
betes.
Biochemical, pharmacological and clinical studies necessary to evaluate the
TABLE
II.. Pharmacological effects and biochemical constituents of plants used
in the treatment of diabetes in Baja California Norte.
Plant Effects and constituents
Arctostaphylos
pungens Diuretic and antihepatotoxic. Contains glucosides (quercitin and catechin)
and numerous acids.
Bidens pilosa
Hypoglycemic. Contains polyacetylenes.
Calea zacatechichi
Antiatherogenic. Contains glucosides, triterpenes, flavonoids, sulphur
compounds and alkaloids.
Cecropia peltata
Hypoglycemic, hyperlipidemic and antiatherogenic. Relevant fitochemicals
not known.
Equisetum
spp. Diuretic, antihypercholesterolemic and hypoglycemic effects. Contains
kaempferol, isoquercitin, luteolin and beta-sitosterol.
Hintonia latiflora
Hypoglycemic, antiatherogenic and appetite suppressant effects. Contains
alkaloids, glucosides and coutareoside, an antihyperglycemic.
larrea tridentata
Initiates insulin and glucogen release, therapeutic in hepatic failure. Contains
flavonoids, saponins and triterpenoids.
Psacalium decomposition
Hypoglycemic. Contains pyrrolizidine alkaloids and sesquiterpene
compounds.
Rhamnus purshiana
Diuretic. Contains anthraquinone glucosides and cascarsosides A, B, C., and
D,
and cascarin glucosides and an unidentified hydrolytic enzyme.
Tecoma stans
Hypoglycemic, diuretic and antihypercholesterolemic. Contains alkaloids
and acholeretic substances, chlorogenic acid, coumaric acid, ferulic acid,
oleanolic acid and beta-sitosterol.
Turnera diffusa
Hypoglucemic, diuretic, CNS depressant effects. Contains terpenes, beta-
sitosterol, cyanogenic glucosides, flavones and the alkaloid damianin
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266 M.
Winkelman
empirical efficacy of these herbal medicines are lacking. In contrast, a previous
study of the frequently used medicinal plants in Baja California Norte (Wiñkelman
1986) indicated that the vast majority of plants had substances with recognized
therapeutic uses. This suggests there are fewer studies on plants used in the
treatment of diabetes than on plants used for other diseases. Given the high
incidence of diabetes among American Indian and Mexican-American popula-
tions,
and traditions of medicinal plant use in these populations, research on these
and other plants used in the treatment of diabetes is most important in permitting
effective utilization of plant resources by these and other groups. Clinicians and
researchers involved in studies of diabetes would make important contributions to
the study of its treatment by extending these findings in further studies on medici-
nal plants used in the treatment of diabetes, the make-up of these
compuestas
(herbal
combinations), their interaction effects, and their pharmacological and clinical
effects and modes of action in humans. Studies are also needed on the diagnostic
and treatment processes utilized and on the specific dose levels which are ideal in
the use of these substances.
ACKNOWLEDGMENTS
This research was initiated under a University of California Mexus grant to Duane Metzger, in collabora-
tion with Carole Browner, Eloy Rodriguez and Michael Winkelman. I wish to thank UC Mexus, and
these and numerous other individuals who have contributed to this research project. I owe much to
Abraham Esquivai, Eduardo Fonseca, Raúl Gamma, Francisco García, Victor Gonzales, Mauro Gutiér-
rez, German Morales and Antonio Quevada—the herbalists of Baja California Norte who provided me
with ethnographic data on the use of herbal medicines. Jim Bauml of the Los Angeles State and County
Arboretum provided essential assistance in the identification of the voucher specimens, determining
current nomenclature conventions, and the placement of the specimens in a medicinal plant collection at
LASCA.
NOTES
1.
These plants were identified by Jim Bauml, plant taxonomist at the Los Angeles State and County
Aboretum.
REFERENCES CITED
Arslanian, S. and M. Virji
1984 Arginine-induced Dispersion of Cells from Neonatal Rat Islets of Langerhans. Diabetes Re-
search 1(3):165-169.
Ayensu, E.
1978 Medicinal Plants of West Africa. Algonac, MI: Reference Publications.
Boulos, L.
1983 Medicinal Plants of Africa. Algonac, MI. Reference Publications.
Browner, C., and B. Ortiz de Montellano
1985 Herbal Emmenagogues Used by Women in Colombia and Mexico. In Plants in Indigenous
Medicine and Diet: Biobehavioral Approaches. N. Etkin, ed. Bedford Hills, NY: Redgrave.
Downloaded by [Arizona State University] at 04:43 05 April 2013
Ethnobotanical Treatments of Diabetes 267
Colin, G.
1927 Further Observations of the Anti-diabetic Properties of
Tecoma
mollis.
Journal of the American
Pharmaceutical Association 16(2):199-209.
Dohnal, B.
1976 Investigations on Some Metabolites of
Tecoma starts
Juss. Callus Tissue. II. Chromatographic
Analysis of Alkaloid and Quinone Compounds. Acta Societatis Botanicorum Poloniae 45:369.
1977 Investigations on some metabolites of
Tecoma
stans
Juss. Callus Tissue III. Chromatographie
Search for Iridoids, Phenolic Adds, Terpenoids and Sugars. Acta Societatis Botanicorum
Poloniae 46(2):187-199.
Dominguez, X.
1976 Aspectos Químicos de las Plantas Tóxicas y Medicinales del Noreste de México. In Estado
Actual del Conocimiento en Plantas Medicinales Mexicanas. X. Lozoya, ed. México: IMEPLAM.
Duke, J.
1985 Handbook of Medicinal Herbs. Boca Raton, FL.: CRC Press.
Duke, J., and E. Ayensu
1985 Medicinal Plants in China, 2 vols. Algonac, MI: Reference Publications.
Farnsworth, N., and C. Kass
1981 An Approach Utilizing Information from Traditional Medicine to Identify Tumor-inhibiting
Plants. Journal of Ethnopharmacology 3:85-99.
García, M.
1973 Manual de Botánica Medicinal. Guadalajara, México: Manual Garcia.
Harborne, J., T. Marby, and H. Marby
1974 The Flavonoids. London: Chapman and Hall.
Huxtable, R.
1980 Problems with Pyrrolizidines. Trends in Pharmacological Sciences. 1(11):299-303.
1983 Herbs Along the Western-American Border. Proceedings of the Western Pharmacology Society
26:185-191.
Inouye, Y., Y. Uchida, and H. Kakisawa
1977 Synthetic Proof for the Structures of Maturinone and Cacalol. Bulletin of the Chemical Society
of Japan
50:961.
Jiu, J.
1966 A Survey of Some Medicinal Plants of Mexico for Selected Biological Activities. Lloydia:
29:250-259.
Katzung, B.
1984 Basic and Clinical Pharmacology. Los Altos, CA: Lange Medical Publications.
Lewis, W., and M. Elvin-Lewis
1977 Medical Botany. New York: Wiley.
Lozoya-Meckes, M., and V. Mellado-Campos
1985 Is the
Tecoma
stans Infusion an Antidiabetic Remedy? Journal of Ethnopharmacology 14:1-9.
Marby, J. T., J. Hunziker, and D. DiFeo, eds.
1977 Creosote Bush, Biology and Chemistry of Larrea in New World Deserts. Stroudsburg, PA:
Dowden, Hutchinson and Ross.
Marchant, Y., F. Ganders, C. Wat, and G. Towers
1984 Polyacetylenes in Hawaiian Bidens. Biochemical Systematics and Ecology 12(2):167-178.
Martinez, M.
1939 Los Plantas Medicinales de México. México: Ed. Botas.
1979 Catálogo de Nombres Vulgares y Científicos de Plantas Mexicanas. México: Fondo de Cultura
Económica.
Mellado-Campos, V., and M. Lozoya-Meckes
1984 Effect of the Aqueous Extract of
Cecropia Obtusifolia
on the Blood Sugar of Normal Pancreatec-
tomized Dogs. International Journal of Crude Drug Research 22(1):11-16.
Oliver Bever, B.
1980 Oral Hypoglycemie Plants in West Africa. Journal of Ethnopharmacology 2:119-127.
Oliver Bever, B., and G. Zahnd
1979 Plants with Oral Hypoglycemie Activity. Quarterly Journal of Crude Drug Research 17(3-
4):139-196.
Downloaded by [Arizona State University] at 04:43 05 April 2013
268 M.
Winkelman
Ortiz de Montellano, B.
1975 Empirical Aztec Medicine. Science 188:215-220.
Ortiz de Montellano, B., and C. Browner
1985 Chemical Basis for Medicinal Plant Use in Oaxaca, Mexico. Journal of Ethopharmacology
13:57-88.
Pérez, R., A. Ocegueda, J. Muñoz, J. Avila, and W. Morrow.
1984 A Study of the Hypoglycemie Effect of Some Mexican Plants. Journal of Ethnopharmacology
12:253-262.
Pérez Gutierrez, R., G. Yescas Laguna, and A. Walkowski
1985 Diuretic Activity of Mexican Equisetum. Journal of Ethnopharmacology 14:269-272.
Ridker, P., S. Ohkuma, W. McDermott, C. Trey, and R. Huxtable
1985 Hepatic Venocclusive Disease Associated with the Consumption of Pyrrolizidine-containing
Dietary Supplements. Gastroenterology 88:1050-1054.
Rodriguez, E.
1985 Rubber and Phytochemical Specialities from Desert Plants of North America. In Plants for Arid
Lands. D. Goodwin, ed. Pp. 399-412. London: Royal Botanical Gardens.
Schauenberg, O., and F. Paris
1977 Guide to Medicinal Plants. New Canaan, Conn.: Keats.
Spoerke, D.
1980 Herbal Medications. Santa Barbara: Wadsworth.
Sugumaran, M., V. Mohan, G. Kishore, H. Sharma, and C. Vaidyanathan.
1975 Phenolic Acids of
Tecoma
stans. Indian Journal of Experimental Biology
13:93.
Thomas, C., ed.
1977 Taber's Cyclopedic Medical Dictionary. Philadelphia: Davis,
Trotter, R.
1985 Greta and Azarcón: A Survey of Episodic Lead Poisoning from a Folk Remedy. Human
Organization 44:64-72.
Trotter, R., and M. Logan
1985 Informant Consensus: A New Approach for Identifying Potentially Effective Medicinal Plants.
In Plants in Indigenous Medicine and Diet. Biobehavioral Approaches. N. Etkin, ed. Bedford
Hills, NY: Redgrave.
Windholz, M., S. Budavari, L. Stroumtsos, and M. Fertig, eds.
1976 Merck Index. Rahway, NJ: Merck and Co.
Winkelman, M.
1986 Frequently Used Medicinal Plants in Baja California Norte. Journal of Ethnopharmacology
18:109-131.
Downloaded by [Arizona State University] at 04:43 05 April 2013
