Effect of oyster mushroom on glycemia, lipid profile and quality of life in type 2 diabetic patients

Abstract

Aims and objectives: The aim of the study was to evaluate efficacy of oyster mushroom (Pleurotus spp) on glycemic control, lipid profile and diabetic quality of life in type 2 diabetic patients. Material and method: Total 150 type 2 newly onset diabetics were recruited. After one month stabilisation period, 120 randomly selected patients were divided into three groups of 1, 2 and 3 given type A, B and C biscuits respectively by a dietician blindly. All three groups were given conventional treatment i.e. diet and exercise for 3 months. Anthropometric parameters, FBS and BP were recorded weekly and HbA1c, lipid profile, diabetic quality of life questionnaire were performed before and after treatment. After 3 months decoding was done and concluded that type A, B and C biscuits were ajwain, ajwain+mushroom and mushroom biscuits respectively. Results: After 3 months period blood sugar (225.41±3.35 to 113.83±4.03; p<0.005), HbA1c(8.47±0.17 to 7.27±0.14; p<0.02) and blood pressure reduced in ajwain+mushroom group as well as in mushroom group (fasting blood sugar 212.9±4.29 to 112±1.37; p<0.005; HbA1c8.00±0.13 to 6.99±0.12; p<0.05). Significant improvement in lipid profile was also observed in same groups (ajwain+mushroom group 190.69±4.39 to 166.83±2.47; p<0.001; mushroom group 186.77±3.43 to 157.39±2.32; p<0.05). Diabetes quality of life also improved significantly. No extra effect was observed due to supplementation of ajwain. Conclusion: Oyster mushroom (Pleurotus spp) consumption appears to be effective in controlling glycemic control, lipid profile and diabetic quality of life. Statistical method: Using ANOVA, confidential limit and correlation.

Full text

Australian Journal of Medical Herbalism 2010 22(2)
50 © National Herbalists Association of Australia 2010
Global dispensary
Introduction
Health is a birth right of every individual and there
is increasing evidence that the dietary habits of people
are important determinants of health. Proper dietary
substances can protect people from chronic diseases such
as coronary heart disease, cancer, obesity and diabetes
mellitus. Diabetes mellitus is a universal health problem
affecting human society at all stages of development
(Rai, Sohi 1998). Diabetes mellitus is a relatively
common disorder in India, which has been dened in
the genetically and clinically heterogeneous group of
disorders. It is primarily caused by degeneration and
inactivation of the β cells of islets of langerhans. There
is a serious defect of carbohydrate, fat and protein
metabolism in this disorder (Bahl 2000).
There are two major types of diabetes. Type 1 diabetes
known as insulin dependent diabetes mellitus (IDDM),
which is usually diagnosed in childhood. In this case
the body makes little or no insulin and daily injections
of insulin are required. Type 2 diabetes, known as non-
insulin dependent diabetes mellitus (NIDDM) which is
more common being about 90% of all diabetes cases and
usually occurs in adulthood. In this type of diabetes diet,
exercise or oral antidiabetic drugs may be sufcient to
control the increased blood sugar levels (Visanthamein,
Savita 2001).
Diabetes is a condition frequently controlled by
proper dietary management. In recent years studies
have indicated that a low glycemic index of food has a
signicant inuence on blood glucose levels.
Traditional medicines such as mushrooms are
very useful for treatment of certain health problems.
Mushrooms are an edible fungi which have been used as
an antidiabetic drug since ancient time. Mushrooms are
nutritive and are richer in protein then cereals, pulses,
fruits and vegetables on dry weight (Ghosh 1990). Due
to their low caloric value mushrooms can be consumed
by patients with hyperlipidemia (Bano 1982). They
are completely devoid of starch and are an excellent
inclusion in the diet of diabetic patients. Edible fungi
produce secondary metabolites which possess various
therapeutic properties. Mushrooms also contain ample
minerals such as calcium, phosphorous, potassium,
iron and copper. They have traditionally been used
in the treatment and prevention of diabetes, obesity,
heart disease, hyperacidity, constipation, cancer, blood
pressure and hypertension (Suguna 1995).
Mushrooms are extremely useful in the prevention of
diabetes mellitus due to the presence of polysaccharides
and their low glycemic index, lack sugar and starch.
This study was undertaken with the objective of
incorporating mushrooms into Indian food products so
that diabetic patients may get low fat, low calorie and
sugar free products. Extracts and powders of mushrooms
in the form of capsules or sugar coated tablets are being
marketed (Yang, Jong 1989). Active principles are said
to be immune stimulating polysaccharides strengthening
health and immunity. Research has also shown that the
maitake fraction may benet people with non insulin
dependent diabetes mellitus (King 1998).
Effect of oyster mushroom on glycemia, lipid
profile and quality of life in type 2 diabetic patients
*Agrawal RP, Chopra A, Lavekar GS, Padhi MM, Srikanth N, Ota S, Jain S
Diabetes Care and Research Centre, SP Medical College, Bikaner, Rajasthan, India 334003
*Corresponding author email: drrpagrawal@yahoo.co.in
Aims and objectives: The aim of the study was to evaluate efficacy of oyster mushroom (Pleurotus spp) on glycemic control, lipid
profile and diabetic quality of life in type 2 diabetic patients.
Material and method:
Total 150 type 2 newly onset diabetics were recruited. After one month stabilisation period, 120 randomly
selected patients were divided into three groups of 1, 2 and 3 given type A, B and C biscuits respectively by a dietician blindly. All three
groups were given conventional treatment i.e. diet and exercise for 3 months. Anthropometric parameters, FBS and BP were recorded
weekly and HbA1c, lipid profile, diabetic quality of life questionnaire were performed before and after treatment. After 3 months
decoding was done and concluded that type A, B and C biscuits were ajwain, ajwain+mushroom and mushroom biscuits respectively.
Results:
After 3 months period blood sugar (225.41±3.35 to 113.83±4.03; p<0.005), HbA1c (8.47±0.17 to 7.27±0.14; p<0.02) and
blood pressure reduced in ajwain+mushroom group as well as in mushroom group (fasting blood sugar 212.9±4.29 to 112±1.37;
p<0.005; HbA1c8.00±0.13 to 6.99±0.12; p<0.05). Significant improvement in lipid profile was also observed in same groups
(ajwain+mushroom group 190.69±4.39 to 166.83±2.47; p<0.001; mushroom group 186.77±3.43 to 157.39±2.32; p<0.05). Diabetes
quality of life also improved significantly. No extra effect was observed due to supplementation of ajwain.
Conclusion: Oyster mushroom (Pleurotus spp) consumption appears to be effective in controlling glycemic control, lipid profile and
diabetic quality of life.
Statistical method: Using ANOVA, confidential limit and correlation.

Australian Journal of Medical Herbalism 2010 22(2)
Global dispensary
51© National Herbalists Association of Australia 2010
Methods
A total of 150 type 2 newly onset diabetic patients
were recruited from the outpatient department of
Diabetes Care & Research Centre, SP Medical College,
Bikaner. The patients were advised to follow a strict diet
and exercise for one month. During this period frequent
self monitoring of blood sugar was done to maintain
euglycemic level. After one month of a stabilisation
period 120 patients were selected having blood sugar
levels 126-250 mg/dL. These 120 patients were randomly
divided into three groups: group 1 (n=40), group 2 (n=40)
and group 3 (n=40). Group 1 received biscuits of type A,
group 2 received biscuits of type B and group 3 received
biscuits of type C. Biscuits were given by a dietician who
was unaware of the nature of biscuits.
Standardisation was done of the oyster mushroom
before clinical trials.
Proximate composition of the Pleurotus sajor-ciju
Moist. Protein Fat CHO Fibre Ash Calories
90.2% 2.5% 0.2% 5.2% 1.3% 0.6% 35
Study design
The study was a randomised double blind study with
history and clinical examinations carried out for suitable
inclusion criteria. Dietary survey by 24 hour recall system
was done. Anthropometric parameters, fasting blood
sugar and blood pressure were recorded weekly and
HbA1c, lipid prole, diabetic quality of life questionnaire
(Rai 1988, 1998) were performed initially as well as after
3 months. Initial approval was from Ethics Committee,
SP Medical College, Bikaner.
After 3 months decoding by a statistician it was
concluded that type A biscuits were ajwain biscuit, type
B were ajwain + mushroom and type C were mushroom
biscuits. Patients were closely observed for any untoward
effect during the study period.
Inclusion criteria
• Subjects with a diagnosis of type 2 diabetes mellitus
(American Diabetes Association guidelines).
• Fasting blood sugar levels greater than 126 but less
than 250 mg/dL.
• Written consent showing willingness to participate in
the study.
Exclusion criteria
• Patients suffering from kidney disease, liver disease,
arthritis, pulmonary tuberculosis, malabsorption, or
alcoholism.
Anthropometry
Anthropometric measurements were taken viz height
in cm and weight in kg with the use of a digital machine
accessorised with a movable headboard. Participants
were shoeless and wore light clothing. Waist/hip ratio
was estimated; waist circumference was measured at the
mid point between the lower border of the rib cage and the
iliac crest. Hip circumference was measured at the level
of maximum prominence of the buttocks parallel to the
oor, the horizontal girth measured around the buttocks
at the level of greatest lateral trochanteric projectors.
• Blood pressure: by sphygmomanometer
• Fasting blood sugar: by glucose oxidase method
• Lipid prole: by auto analyzer
• HbA1c: by DS5 Drew Scientic machine (ion
exchange chromatography)
• Diabetes quality of life questionnaire was assessed
every month.
Statistical analysis
Data was presented as means ± SEM. Comparisons
between baseline characteristics of each group
were made by using ANOVA, condential limit and
correlation tests. At p value <0.05, differences were
considered signicant.
Results
The demographic and clinical proles of three groups
(ajwain, ajwain + mushroom and mushroom) were
studied for different variables in the beginning of the
study and there was no signicant difference in baseline
characteristics (Table 1).
After a 3 month period the blood sugar levels were
found reduced in the ajwain + mushroom group as well
as in the mushroom group (225.41±3.35 to 113.83±4.03;
p<0.005 and 212.9±4.29 to 112±1.37; p<0.005).
Systolic blood pressure was reduced in both the groups
(ajwain + mushroom 130.75±2.10 to 121.50±1.16;
p<0.05 and the mushroom group 126.8±1.73 to
121.65±1.3; p<0.05). Diastolic blood pressure was
reduced in the ajwain + mushroom group (85.00±1.31
to 79.70±0.70; p<0.05) and in the mushroom group
(82.00±0.96 to 79.95±0.79; p<0.05).
There was a signicant effect on glycemic control
(HbA1c) in both groups (ajwain + mushroom group
8.47±0.17 to 7.27±0.14; p<0.02; the mushroom group
8.00±0.13 to 6.99±0.12; p<0.05).
There was a signicant reduction in lipid prole
i.e. total cholesterol in the ajwain + mushroom group
(190.69±4.39 to 166.83±2.47; p<0.001) and the mushroom
group (186.77±3.43 to 157.39±2.32; p<0.05); HDL in the
ajwain + mushroom group (40.42±0.92 to 45.40±0.91;
p<0.005) and in the mushroom group (45.81±2.03 to
49.30±1.47; p<0.05); LDL in the ajwain + mushroom
group (110.05±2.55 to 98.21±1.38; p<0.05) and the
mushroom group (103.04±3.41 to 96.99±3.30; p<0.05);
VLDL in the ajwain + mushroom group (42.62±2.03
to 28.62±1.26; p<0.05) and in the mushroom group
(42.42±2.35 to 31.40±1.81; p<0.05); serum triglyceride in
ajwain + mushroom group (213.93±14.24 to 144.73±7.01;
p<0.05) and in the mushroom group (210.71±12.49 to
157.41±7.79; p<0.02); diabetes quality of life improved
signicantly. There was no signicant change in BMI and
waist hip ratio (Tables 2 and 3).

Australian Journal of Medical Herbalism 2010 22(2)
52 © National Herbalists Association of Australia 2010
Global dispensary
Table 1
Comparison of different clinical and biochemical parameters at baseline
Parameters Ajwain Mushroom
+ ajwain
Mushroom Anova Anova
Mean±SE
0 month
Mean±SE
0 month
Mean±SE
0 month
Ajwain v/s
mushroom +
ajwain
Ajwain v/s
mushroom
Age 52.5±1.22 49.95±1.2 51.10±1.32 NS NS
Sex (M:F) 28:13 24:6 31:9 - -
BMI (body mass index) 26.87±.86 26.15±.61 26.67±0.71 <.4 <0.4
Waist /hip ratio .95±.01 .94±.009 1.00±0.10 <.9 <0.8
FSB (fasting blood sugar) 225.65±4.32 225.41±3.35 212.9±4.29 <.8 <.02
BP (blood pressure) Systolic 131.25±1.90 130.75±2.10 126.8±1.73 <.1 <.05
Dialostic 83.55±1.31 85.00±1.31 82.00±0.96 <.1 <0.1
HbA1c 8.60±.12 8.47±.17 8.00±0.13 <.2 <0.2
S.Cholesterol 190.22±2.68 190.69±4.39 186.77±3.43 <.1 <0.1
HDL (high density lipoprotein 44.50±.87 40.42±.92 45.81±2.03 <.1 <0.1
VLDL (very low density lipoprotein) 39.52±.74 42.62±2.03 42.42±2.35 <.1 <0.5
LDL (low density lipoprotein) 99.39±1.35 110.05±2.55 103.04±3.41 <.1 <0.1
S.Triglyceride 195.70±5.32 213.93±14.24 210.71±12.49 <.1 <0.1
DQL (diabetes quality
of life)
Satisfactory 38.00±2.87 36.17±2.17 39.51±2.09 <.1 <0.1
Impact 44.83±4.11 35.07±2.89 42.50±2.98 <.2 <0.1
Worry 25.5±2.17 23.98±1.79 24.87±1.93 <.1 <0.1
Table 2
Effect of different treatment regimen on clinical and metabolic parameters
Parameters Ajwain Mushroom
+ ajwain
Mushroom
Mean±SE
0 month
Mean±SE
3 month
Anova Mean±SE
0 month
Mean±SE
3 month
Anova Mean±SE
0 month
Mean±SE
3 month
Anova
Age 52.5±1.22 NS 49.95±1.2 NS 51.10±1.32 NS
Sex (M:F) 28:13 - 24:6 - 31:9 -
BMI 26.87±.86 27.03±0.89 NS 26.15±.61 25.87±0.86 NS 26.67±0.71 26.3±0.65 NS
W/H Ratio .95±.01 0.94±0.01 NS .94±.009 0.93±0.009 NS 1.00±0.1 0.97±0.2 NS
FBS 225.65±4.32 310.33±3.13 <0.005 225.41±3.35 113.83±4.032 <0.005 212.9±4.29 112±1.37 <0.005
BP Systolic 131.25±1.90 138.15±2.21 <0.05 130.75±2.10 121.50±1.16 <0.05 126.8±1.73 121.65±1.34 <0.05
Dialostic 83.55±1.31 87.55±1.18 <0.05 85.00±1.31 79.70±0.70 <0.05 82.00±0.96 79.95±0.79 <0.05
HbA1c 8.60±.12 9.98±0.14 <0.005 8.47±.17 7.27±0.14 <0.02 8.00±0.13 6.99±0.12 <0.05
S.Cholesterol 190.22±2.68 251.45±4.01 <0.005 190.69±4.39 166.83±2.47 <0.001 186.77±3.43 157.39±2.32 <0.05
HDL 44.50±.87 36.82±0.46 <0.005 40.42±.92 45.40±0.91 <0.005 45.81±2.03 49.30±1.47 <0.05
VLDL 39.52±.74 55.2±0.69 <0.005 42.62±2.03 28.62±1.26 <0.05 42.42±2.35 31.40±1.81 <0.05
LDL 99.39±1.35 104.43±1.18 <0.02 110.05±2.55 98.21±1.38 <0.05 103.04±3.41 96.99±3.30 <0.05
S.Triglyceride 195.70±5.32 276.20±5.32 <0.02 213.93±14.24 144.73±7.01 <0.05 210.71±12.49 157.41±7.79 <0.02
DQL
Satisfactory 38.00±2.87 32.25±2.36 <0.05 36.17±2.17 40.87±1.42 <0.05 39.51±2.09 42.40±0.98 <0.001
Impact 44.83±4.11 41.5±1.22 <0.02 35.07±2.89 39.74±1.18 <0.05 42.50±2.98 44.4±1.68 <0.001
Worry 25.5±2.17 20.33±1.97 <0.05 23.98±1.79 18.78±2.88 <0.005 24.87±1.93 20.85±1.83 <0.001

Australian Journal of Medical Herbalism 2010 22(2)
Global dispensary
53© National Herbalists Association of Australia 2010
Parameters Ajwain Mushroom
+ ajwain
Mushroom Anova Anova
Mean±SE
3 month
Mean±SE
3 month
Mean±SE
3 month
Ajwain v/s
mushroom +
ajwain
Ajwain v/s
mushroom
Age 52.5±1.22 49.95±1.2 51.10±1.32 - -
Sex (M:F) 28:13 24:6 31:9 - -
BMI (body mass index) 27.03±.89 25.91±.56 26.3±.65 <.8 <.1
Waist /hip ratio .95±.01 .94±.009 0.97±.0.15 <.05* <.02*
FSB (fasting blood sugar) 310.33±3.31 113.83±4.02 112±1.37 <.001* <.001*
BP (blood pressure) Systolic 138.15±2.21 121.50±1.16 121.65±1.34 <.005* <.001*
Dialostic 87.55±1.18 79.70±.70 79.95±.79 <.005* <.02*
HbA1c 9.98±.14 7.27±.14 6.99±.12 <.02* <.005*
S. cholesterol 251.45±4.01 166.43±2.47 157.39±2.32 <.001* <.001*
HDL (high density lipoprotein 36.82±.46 45.42±.91 49.30±1.47 <.02* <.001*
VLDL (very low density lipoprotein) 55.20±.69 28.8±1.26 31.4±1.81 <.001* <.001*
LDL (low density lipoprotein) 104.43±1.18 98.21±1.38 96.99±3.30 <.05* <.001*
S. triglyceride 276.20±5.32 144.73±7.00 157.41±7.79 <.005* <.001*
DQL (diabetes quality
of life)
Satisfactory 32.25±2.36 40.87±2.42 42.40±.98 <.02* <.05*
Impact 36.5±1.23 39.74±1.18 44.4±1.68 <.05* <.05*
Worry 20.33±1.97 18.78±2.40 20.85±1.83 <.2 <.2
Table 3
Comparison of different clinical and biochemical parameters among different plans
Discussion
Oyster mushroom (Pleurotus spp) is known in the Indian
traditional system of medicine for its antihyperglycemic
and antihyperlipdemic potential. Mushrooms are edible
fungi conrmed to have denite human health properties
and nutrition. Oyster mushrooms have been demonstrated
to have benecial effects in animal and human studies
individually as well as in combination.
The present study was performed to observe the effect
of oyster mushroom (Pleurotus spp) on glycemic control,
lipid prole and diabetes quality of life.
We observed that blood sugar was reduced in the
ajwain + mushroom group and in the mushroom group.
There was signicant effect on glycemic control (HbA1c)
in both groups. The signicant fall in fasting blood sugar
and HbA1c may be attributed to the hypoglycemic
potential of the oyster mushroom supplement. It was
reported that mushroom signicantly reduced blood
glucose level in diabetic subjects (Khatun 2007).
Reduction in glycated hemoglobin in streptozotocin
diabetic mice after mushroom supplement was observed
(Swanston 1989).
In both the ajwain + mushroom group and the
mushroom group there was a signicant reduction in lipid
prole i.e. total cholesterol, HDL, LDL, VLDL and serum
triglyceride. Results of present study show that oyster
mushroom lowers blood lipid levels. Reduction in total
serum cholesterol, VLDL, LDL and serum triglyceride
and increased serum HDL was observed in the study. It
was found the cholesterol concentration was decreased
by more than 40%, the lipoprotein prole was upgraded
by the decrease of the cholesterol in both the low density
and very low density liproproteins in rats (Chorvathova
1993). Oyster mushroom signicantly reduced serum
triglyceride and serum cholesterol in diabetic subjects
(Khatun 2007). Oyster mushroom diet effectively
prevented the progress of hypercholesterolemia
(decreased by 38%) and cholesterol accumulation in liver
(decrease by 25%) that were induced by the cholesterol
diet in rats (Bobek 1995).
We observed slight reduction in mean BMI in the
ajwain + mushroom group and the mushroom group
although it was not statistically signicant. We also found
the W/H ratio was slightly decreased in the ajwain +
mushroom group and increased in the mushroom group.
This change was also not statistically signicant.
Both systolic and diastolic blood pressure decreased
signicantly in the ajwain + mushroom group and
mushroom group. Treatment of diabetic zucker fatty rats
with mushroom supplements resulted in lower systolic
blood pressure and maintained body weight compared
with control animals (Talpur 2003). Another study
concluded that the soluble fraction of maitake mushroom
lowers systolic blood pressure signicantly (Talpur 2002).
We observed that there was a statistically signicant
improvement in diabetes quality of life score, when
biscuits supplement was added along with usual care.

Australian Journal of Medical Herbalism 2010 22(2)
54 © National Herbalists Association of Australia 2010
Global dispensary
Despite the limited size of this study population
we were able to demonstrate a signicant association
between mushroom supplementation and gradual
reduction in hyperglycemia in type 2 diabetic subjects.
Further studies are needed to verify these observations.
In conclusion the results throw light on the potential use
of oyster mushroom for better glycemic control, positive
effect on lipid prole and better quality of life.
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