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Hypoglycemic effect of fenugreek seeds in Non-insulin-dependent diabetic subjects

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Abstract

Fenugreek seeds (Trigonella foenum graecum), a commonly used condiment in Indian homes, were evaluated for hypoglycaemic property. In a metabolic study, 15 non-insulin dependent diabetic patients were given randomly, in a cross over design, diets with or without 100 g of defatted fenugreek seed powder, each for 10 days. Incorporation of fenugreek produced a significant fall in fasting blood glucose levels and an improvement in glucose tolerance test. Insulin responses were significantly reduced. There was a 64% reduction in 24 hr urinary glucose excretion with significant alterations in serum lipid profile. Serum total cholesterol, LDL and VLDL cholesterol and triglyceride levels decreased without any alteration in HDL cholesterol fraction with fenugreek diet.Incorporation of fenugreek seeds for 20 days in the diets of 5 diabetic patients resulted in similar changes of higher magnitude in all the above parameters.

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... However, not all trials have reported the same results. As such, several human trials have demonstrated the beneficial effects of fenugreek supplementation on anthropometric indices and lipid profiles (Fedacko et al., 2016;Gholaman, 2018;Moosa et al., 2006;Rafraf et al., 2014); however, other studies have found no beneficial effects of this plant on the aforementioned parameters (Bordia et al., 1997;Chevassus et al., 2009aChevassus et al., , 2009bGaddam et al., 2015;Gupta et al., 2001b;Sharma and Raghuram, 1990;Shen et al., 2013;Yousefi et al., 2017). ...
... Twenty full-text articles were excluded due to the following reasons: did not report data of interest (n = 10), same population (n = 3), or combination along with other herbs (n = 7). Finally, a total of 12 eligible RCTs with 14 arms met all inclusion criteria (Bordia et al., 1997;Chevassus et al., 2009aChevassus et al., , 2009bFedacko et al., 2016;Gaddam et al., 2015;Gholaman, 2018;Gupta et al., 2001b;Moosa et al., 2006;Rafraf et al., 2014;Sharma and Raghuram, 1990;Shen et al., 2013;Yousefi et al., 2017) and were included in the statistical analysis. The PRISMA flow diagram is depicted in Fig. 1. ...
... Overall, 560 participants were randomly assigned to and completed the studies. Of the 12 trials used in the present metaanalysis, two trials were conducted in men only (Chevassus et al., 2009a(Chevassus et al., , 2009b, and one trial was conducted in women only (Gholaman, 2018), whereas most of the trials (8/12) were conducted in both sexes (Fedacko et al., 2016;Gaddam et al., 2015;Gupta et al., 2001b;Moosa et al., 2006;Rafraf et al., 2014;Sharma and Raghuram, 1990;Shen et al., 2013;Yousefi et al., 2017). Moreover, one trial did not outline sex composition (Bordia et al., 1997). ...
Article
Ethnopharmacological relevance: Fenugreek is a traditional herbal medicine that has been used for centuries to treat hyperglycemia, muscle spasms, gastritis, constipation, edema, and other metabolic disorders. Recently, lipid-lowering effects of fenugreek have been identified. Aim of the study: The aim of this systematic review and meta-analysis was to determine and clarify the impact of fenugreek supplementation on anthropometric indices and serum lipid levels. Materials and methods: We searched PubMed, Scopus, ISI Web of Science, Cochrane Library, and Google Scholar from inception to June 2019 using relevant keywords. All randomized controlled trials (RCTs) investigating the effects of fenugreek on anthropometric indices and plasma lipids in adults were included. A random-effects model was used for quantitative data synthesis. A sensitivity analysis was conducted using the leave-one-out method. Results: A meta-analysis of 12 RCTs (14 arms) with 560 participants suggested a significant decrease in plasma concentrations of total cholesterol (WMD = -9.371 mg/dL; 95% CI: -15.419, -3.323, p = 0.002), triglycerides (WMD = -13.776 mg/dL; 95% CI: -26.636, -0.916, p = 0.036), and low density lipoprotein cholesterol (WMD = -6.590 mg/Dl; 95% CI: -13.042, -0.137, p = 0.045), as well as an increase in plasma high density lipoprotein cholesterol (WMD = 3.501 mg/dL; 95% CI: 1.309, 5.692, p = 0.002), while body weight (WMD = 0.223 kg; 95% CI: -0.509, 0.955, p = 0.551) and body mass index (WMD = 0.091 kg/m2; 95% CI: -0.244, 0.426, p = 0.596) were not altered. Conclusion: Fenugreek supplementation improved lipid parameters in adults. However, to confirm these results, more studies, particularly among hyperlipidemic patients, are needed.
... However, the subjects with Type 2 diabetes with altered glucose metabolism. A study by Sharma and Raghuram (1990) found that 5 g of fenugreek gum significantly reduced postprandial blood glucose in normal subjects, when given with a large dose (100 g) of glucose [10] . The amount and type of carbohydrates consumed are largely responsible for postprandial blood glucose and insulin responses to meals and large amounts of fat or protein (> 50 g) are needed to significantly impact the glucose and insulin response to a meal [11] . ...
... However, the subjects with Type 2 diabetes with altered glucose metabolism. A study by Sharma and Raghuram (1990) found that 5 g of fenugreek gum significantly reduced postprandial blood glucose in normal subjects, when given with a large dose (100 g) of glucose [10] . The amount and type of carbohydrates consumed are largely responsible for postprandial blood glucose and insulin responses to meals and large amounts of fat or protein (> 50 g) are needed to significantly impact the glucose and insulin response to a meal [11] . ...
... Therefore, it would be interesting to investigate whether fenugreek fiber flakes would have significant effects on postprandial blood glucose in response to a larger meal or high energy meal or subjects with high BMI. The postprandial insulin AUC was decreased with the addition of 10 g of fenugreek fiber powder, which is in line with other studies, which have found decreased insulin response with fiber [12] , and a previous study showing that fenugreek gum can lower postprandial insulin response [10] . During the study, a single incidence of nausea and vomiting was reported by a subject which was mild in nature and assessed by investigator as not related to the IP. ...
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Fenugreek in form of flakes has shown to benefit with normal glucose metabolism. Subjects who wants to diet without changes in metabolism can look at this option
... (Fabaceae) (fenugreek) has ancient traditional uses in the treatment of diabetes. Fenugreek possesses a broad spectrum of pharmacological and therapeutic properties including anti-hyperlipidemic, antidiabetic, anticancer, anti-arthritic, antioxidant, antimicrobial, antinociceptive and antiinflammatory potential [41][42][43][44][45][46][47]. Fenugreek plays a vital role in the prevention of heart, liver, kidney and spleen diseases [48][49][50][51][52][53]. ...
... Fenugreek plays a vital role in the prevention of heart, liver, kidney and spleen diseases [48][49][50][51][52][53]. Several investigators have reported the hypocholesterolemic and anti-diabetic potential of defatted fenugreek seed [43,54]. Studies carried out by various researchers have reported the anti-diabetic potential of fenugreek in an array of animal models [41,42,55] as well as in human subjects [43,54]. ...
... Several investigators have reported the hypocholesterolemic and anti-diabetic potential of defatted fenugreek seed [43,54]. Studies carried out by various researchers have reported the anti-diabetic potential of fenugreek in an array of animal models [41,42,55] as well as in human subjects [43,54]. These effects are related to the presence of constituents such as alkaloid (Trigonelline) and amino acid (2S,3R,4S, 4-hydroxyisoleucine (4-HI)) [56][57][58][59]. ...
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Objective: To assess the safety and efficacy of herbal formulation rich in standardized fenugreek seed extract (IND-2) add-on therapy in type 2 diabetes mellitus (T2DM) patients who were on insulin treatment in prospective, single arm, open-label, uncontrolled, multicentre trial. Methods: T2DM patients (n=30) with aged 18-80 years who were stabilized on insulin treatment with fasting blood sugar (FBS) level between 100-140 mg/dL received IND-2 capsules (700 mg, thrice a day) for 16 weeks. The primary endpoints were an assessment of FBS at week 2, 4, 6, 8, 12 and 16. Secondary end-points include post-prandial blood sugar level, glycosylated Hb (HbA1c), reduction in the dose of insulin and number of hypoglycemic attacks, and improvement in lipid profile at various weeks. Safety and adverse events (AEs) were also assessed during the study. Results: Study was completed in twenty T2DM patients, and there was no significant reduction in FBS and post-prandial blood sugar level after addon therapy of IND-2. However, add-on therapy of IND-2 significantly reduced (P
... Safety of curcumin was investigated in rats showing that an overdose or long-term intake of curcumin could result in oxidative stress, inflammation, and metabolic disorders, which induced liver injury [37]. Fenugreek has been studied in several human RCTs as a treatment for diabetes [38][39][40]. One RCT has shown that fenugreek improves glycemic control by lowering HbA1c levels and improve insulin sensitivity [38]. ...
... One RCT has shown that fenugreek improves glycemic control by lowering HbA1c levels and improve insulin sensitivity [38]. In another RCT significant decreased blood glucose levels and serum insulin levels were measured after a diet with powder of fenugreek seeds [39]. Short term ingestion of fenugreek seeds as 30 grams/day in divided doses for 8 weeks, significantly decreased HbA1C levels in patients with uncontrolled diabetes mellitus [40]. ...
... There were no significant side effects reported. The adverse effect of the bitter taste can be solved by making bread of fenugreek [39,41]. A toxicology study in animals with Trigonella foenum-graecum seed extract concluded this plant to be safe for the treatment of diabetes mellitus type-2 [42]. ...
Article
Background The objective of this systematic review was to assess available scientific data on the efficacy and safety of medicinal food plants for the treatment of impaired glucose tolerance. Methods We included randomized controlled trials (RCTs) with a minimum follow-up period of 6 weeks. The diagnosis was determined by fasting plasma glucose values after two-hour oral glucose tolerance testing (OGTT). Two authors independently extracted data and evaluated bias. The Cochrane tool of risk of Bias Tool was used. Results This review included ten trials. Most studies were highly biased as data were incomplete or reporting was selective. The two-hour fasting plasma glucose after the curcumin extract intervention showed statistical significance after 3, 6 and 9 months: p<0.01. Also, glycosylated haemoglobin levels A1c (HbA1c) values after curcumin extract intervention showed statistical significance after 3, 6 and 9 months: p<0.01. Insulin resistance (HOMA-IR) after curcumin extract intervention showed statistical significance after 6 months and after 9 months: p<0.05 and p<0.01. Conclusions Curcumin has shown the confident results to be effective for the treatment of impaired glucose tolerance. Fenugreek and flaxseed may also be effective, but due to low quality of these studies the results must be interpreted with caution.
... But several hypotheses have been put forward in this respect. In a recent study, the reductions of TC, TG, and LDL-C levels and increase in HDL-C level by Trigonella foenum-graecum seed powder solution might be hypostasized due to crude fiber and saponin content in Trigonella foenum-graecum seed and estrogenic constituent, indirectly increasing thyroid hormone [28]. Trigonella foenum-graecum seed increased fecal bile acid and cholesterol excretion. ...
... Trigonella foenum-graecum seed increased fecal bile acid and cholesterol excretion. This may be secondary to a reaction between the bile acids and fenugreek-derived saponins causing the formation of micelles too large for the digestive tract to absorb [28]. Trigonella foenum-graecum seed powder solution may delay the absorption of glucose and fatty acids, thus providing less substrate for the synthesis of triglycerides [29]. ...
Article
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Background. Many drugs are commercially available for use in the management of diabetes. However, their side effects and high costs underscore the need for herbal alternative drugs. Trigonella foenum-graecum is one of the medicinal plants which are important in the management of diabetes mellitus. This study investigated the effect of Trigonella foenum-graecum seed powder solution on the lipid profile of newly diagnosed type II diabetic patients. Methods. A total of N=114 newly diagnosed type II diabetic patients without any significant diabetes complication were selected. They were grouped into two groups: the treatment group (n=57) consumed 25 g Trigonella foenum-graecum seed powder solution orally twice a day for one month and the second group is the control (n=57) which receives metformin. Blood sample was collected from each participant by a medical technologist/technician before and after the study. Lipid profile was analyzed by using Mindray BS 200E fully automated clinical chemistry analyzer. Result. By the end of the intervention period, the treatment group showed significantly lower total cholesterol level by 13.6% as compared with the baseline level (219.1±35.51 vs. 189.29±29.06, P
... It is in the Fabaceae family and cultivated as a spice, supplement for foods and vegetables. Leaves and seeds of fenugreek are preferred for medicinal purposes, especially for the treatment of diabetes (Sharma and Raghuram, 1990;Basch et al. 2003;Fernández-Aparicio et al. 2008). ...
Article
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This study was carried out to determine the effects of sulphur doses on the nutrient contents of safflower (Carthamus tinctorius L.) cultivars under irrigated conditions in the 2011- and 2012-years spring periods. Field trials were conducted with a randomized complete block split-plot design with three replications in the experimental area of Van Yuzuncu Yıl University, Faculty of Agriculture. As a factor, three different sulphur doses (0, 25, 50 kg ha-1) and three safflower cultivars were used. In the study, macro and micronutrient element contents of safflower seed were investigated. It was determined that wasn't affected significantly by nutrient element contents such as K, Mg, Zn, and Cu except for Ca, Fe, and Mn contents of seed by sulphur applications. In addition, statistically significant differences were found among safflower varieties in terms of the nutrient content of K, Ca, Fe, Mn, and Zn, except for Mg and Cu.
... It is in the Fabaceae family and cultivated as a spice, supplement for foods and vegetables. Leaves and seeds of fenugreek are preferred for medicinal purposes, especially for the treatment of diabetes (Sharma and Raghuram, 1990;Basch et al. 2003;Fernández-Aparicio et al. 2008). ...
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Background: In this study, the effects of deficit irrigation (DI) (normal=control, ½ reduced and 3/4 reduced) and some beneficial rhizobacteria (Azospirillum lipoferum, Bacillus megaterium) and microalgae (Chlorella saccharophilia) on some physiological and biochemical parameters of fenugreek (Trigonella foenum-graecum) were investigated. Methods: The experiment was carried out in a fully controlled climate cabinet with 4 replications in factorial order according to the completely randomized plot trial design. Fenugreek (Trigonella foenum-graecum) plant was used as material. The study aims to investigate the effects of different deficit irrigation treatments (normal (control), 1/2 reduced and 3/4 reduced) and some rhizobacteria (Control= R0, Azospirillum lipoferum= R1, Bacillus megaterium= R2) and microalgae (Chlorella saccharophilia= R3) on the growth and development of fenugreek plants. Result: Relative water content and membrane durability index values of leaf tissues decreased due to deficit irrigation applications, while ion leakage in leaf tissues, MDA and total phenolic substance content increased in leaf tissues. However, it was determined that they had positive effects on ion leakage in leaf tissues, total phenolic and flavonoid substance amounts of rhizobacteria and microalgae applications, but, membrane durability index in leaf tissues and MDA contents were affected as negative compared to the control.
... It is in the Fabaceae family and cultivated as a spice, supplement for foods, and vegetables. Leaves and seeds of fenugreek are preferred for medicinal purposes, especially in the treatment of diabetes (Sharma and Raghuram, 1990;Basch et al., 2003;Fernández-Aparicio et al., 2008). Although fenugreek's significance, benefits, and usage in the medicinal and other field have been searched by many, understanding its adaptation to abiotic stress and drought condition is among the major research objects. ...
Article
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In this study, the effects of deficit water (DW) (normal=control, ½ reduced and 3/4 reduced) and some beneficial rhizobacteria (Azospirillum lipoferum, Bacillus megaterium) and microalgae (Chlorella saccharophilia) on some growth and physiological parameters of fenugreek (Trigonella foenum-graecum L.) were investigated. The experiment was carried out in a fully controlled climate cabinet with 3 replications in factorial order according to the Random Plots Trial Design. Fenugreek (Trigonella foenum-graecum L.) plant was used as material. The study aims to investigate the effects of different deficit water treatments (normal=control, ½ reducedand 3/4 reduced) and some rhizobacteria (Control=R0, Azospirillum lipoferum=R1, Bacillus megaterium=R2) and microalgae (Chlorella saccharophilia=R3) on the growth and development of fenugreek. The effects of deficit irrigation practices on stem length, root fresh and dry weight, stem fresh and dry weight, and leaf area were found to be statistically significant. As the deficit irrigation doses increased, all growth parameters decreased. Root length, root age and stem weight were statistically significantly affected in rhizobacteria and microalgae applications. The highest stem length (19.32 cm) and root wet (1.34 g) and dry (0.18 g) weight were obtained from Bacillus megaterium applications.
... Fenugreek leaves and seeds have been used extensively to prepare extracts and powders for medicinal uses (Basch et al. 2003). Its utility has been proved experimentally in diabetic humans (Sharma and Raghuram 1990). ...
Chapter
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Fenugreek (Trigonella foenum-graecum L.) belongs to the botanical family Papilionaceae, and its native geographic range is the area extending from Iran to Northern India, but it is presently cultivated also in other regions of the world. Historically, fenugreek has been used as an important traditional, multipurpose medicinal herb in Iranian, Indian, Chinese, and Tibetan Medicinal Practices for several centuries. The most important compositions of fenugreek seeds are neutral detergent fiber, protein, gum, moisture, lipids, starch, and ash. Fenugreek seeds and leaves are anti-cholesterolemic, anti-inflammatory, anti-tumor, carminative, demulcent, deobstruent, emollient, expectorant, febrifuge, galactogogue, hypoglycemic, laxative, parasiticide, restorative, and uterine tonic and useful in burning sensation. Traditional uses of fenugreek seeds around the world are in bone and muscles, respiratory system, gastrointestinal system, female reproductive system, cardiovascular system, endocrinology, and hepatic. The most important modern health benefits of fenugreek are in appetite suppressant and weight loss, reduce cholesterol, reduce cardiovascular risk, control diabetes, a good relief for sore throats, it cures acid reflux or heartburn, relieves constipation, prevents colon cancer, good for kidney trouble, good for skin infection, increases milk production, reduces menstrual discomfort, and it minimizes symptoms of menopause. Integrative use of modern science and traditional medicine with novel technologies and discoveries will secure production of medicinal herbs and promote sustainability in a long-term and a wide-range. Treatment with natural medicine especially barberry as non-synthetic drug is recommended.
... Kassain et al., (2009) demonstrated that administration of water-soaked fenugreek seeds (in 11 subjects) and that mixed in yoghurt (in 7 subjects) for 8 weeks significantly reduced the levels of FBG, TG and VLDL. Similar studies report that administration of fenugreek seeds to diabetic patients for 10 days ameliorates GTT levels and results in significant reduction of FGB, TG and VLDL levels (Sharma et al., 1990a). Apart from stimulating the secretion of insulin from pancreatic beta cells (Table 1, Nimesh et al., 2019) fenugreek also helps to modulate gluconeogenic enzymes (glucose-6-phosphatase and fructose-1,6-bisphosphatase activities) in liver and kidneys of diabetic rats (Gupta et al., 1999). ...
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It is about the collection of information on plants and their uses in different aspects of India.
... To extend the study, the same type of therapy was used for next 20 days in 5 patients with type 2 diabetes. At the end of the study, changes in patients were observed that had not occurred before, but with a greater severity for the parameters tested [28]. ...
Article
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Fenugreek has a long tradition of use as a medicine and also has been commonly used as food in many countries. This plant is well known, especially in Asia. In Europe, fenugreek seeds are regarded as a traditional herbal medicine consumed in case of loss of appetite and in confirmed skin inflammations. Trigonella foenum-graecum seeds contain wide spectrum of different biologically active constituents which affect the properties of preparations produced from this plant. Numerous preclinical studies confirm the use of fenu-greek as a hypolipidemic and lowering blood glucose level drug. Unfortunately, there are not many clinical studies on fenugreek seeds in this area. Published studies often significantly differ in the amount and type of fenugreek seed preparation used. However, results of available scientific research are promising and suggest the possibility of using fenugreek seeds in metabolic syndrome therapy. Undoubtedly, further research is required to confirm such properties of Trigonella foenum-graecum.
... After 8 weeks, FBG, TG and VLDL significantly decreased in cases which received the seeds in soaked form (Kassaian et al., 2009). Similarly, addition of T. foenum-graecum seeds (100 g) to diets of patients with T2D for 10 (15 subjects) or 20 (15 subjects) days improved GTT and led to significant decrease in FBG, TG and LVDL levels (Sharma, Raghuran, 1990a). Plants are commonly cultivated throughout India. ...
Chapter
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Azolla is an aquatic fern having high biomass production rate and in association with Anabaena it fixes atmospheric nitrogen. It can be used as green manure, biofertilizer for increasing crop productivity, soil fertility and reduce environment contaminants. Chemical analysis of Azolla at Bihar Agricultural University, Sabour showed that Nitrogen, phosphorus and potassium in Azolla on dry weight basis was 4.1, 1.8 and 2.62 per cent. Due to its high nutritional value and protein content, Azolla is suitable for feed supplement for variety of animals like fish, ducks, cattle, poultry etc. to reduce feed cost. Azolla, can be used as a potential source in methane sink potential within agricultural system. In flooded rice ecosystem, Azolla dual cropping reduces methane emission by 40 per cent than did urea alone and improve the activity of methane oxidizing bacteria such as methanotrophs. Azolla is a good nitrogen fixer with nitrogen fixing potential of 30 to 60 kg N ha-1, which designates it as an important biological N source for agricultural crops, which reduces the use of chemical fertilizer leading to a step towards sustainability. Azolla also have high bioremediation potential of Cadmium, Chromium, Copper and Zinc and thus, can reduce heavy metal pollution. Because of the multifaceted uses of Azolla, it would be ideal and ecofriendly to promote the use Azolla-Anabaena system for sustainable agriculture and climate change mitigation.
... CANE alone or in combination with glibenclamide reduced triglycerides in alloxan induced diabetic rabbits and may be prevent the progression of CHD. Sharma, et al have found higher levels of serum lipids in both insulin dependent diabetes mellitus (IDDM) and non insulin dependent diabetes mellitus (NIDDM)[24].CANE used alone or in combination with glibenclamide may be used to counter the high serum lipids produced by the above conditions.The antihyperlipaemic effect of CANE may be due to the down regulation of NADPH and NADH a cofactor in fat metabolism. When glycoly sis slows down because of cellular inactivity, the pentose phosphate pathways still remains active in liver to breakdown glucose that continuously provides NADPH which convert acetyl radicals into long fatty acid chains. ...
Research
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Extracts of various plants material capable of decreasing blood sugar have been tested in experimental animal models and their effects confirmed. Neem or Margose (Azadirachta Indica) is an indigenous plant believed to have antiviral, antifungal, antidiabetic and many other properties. In this paper deals with a comparative study of effect of aqueous Neem leaves extract alone or in combination with glibenclamide on alloxan diabetic rabbits. Administration of crude aqueous Neem extract (CANE) alone (1.5 ml/kg/day) as well as the combination of CANE (1.5 ml/kg/day) with glibenclamide (0.25 mg/kg/day) significantly decreased (P<0.05) the concentrations of serum lipids, blood glucose and lipoprotein VLDL and LDL but significantly increased (P<0.05) the concentration of HDL. The change was observed significantly greater when the treatment was given in combination of CANE and glibenclamid than with CANE alone.
... greek was due to the saponin-rich subfraction (Gupta et al., 1986;Sauvaire, Ribes, Baccou, & Loubatieères-Mariani, 1991 reduce TC level (Chen et al., 2017). In addition fenugreek contain a gel-like dissolvable fiber which react with bile acids and produces overlarge micelles which cannot be absorbed easily by digestive tract and brings down the TG and LDL levels (Renuka et al., 2009;Sharma & Raghuram, 1990). Fenugreek seed may also reduce the amount of primary substrate for TG synthesis (Renuka et al., 2009). ...
Article
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Various studies have shown that Trigonella foenum‐graecum (fenugreek) supplementation has lipid‐lowering activity. This meta‐analysis was performed to evaluate the effect of fenugreek supplementation on human serum lipid profile. Data sources were PubMed, EMBASE, Scopus, and Coherence library which were searched systematically from January 2000 up to December 2019. Inclusion criteria were randomized clinical trial (RCT) study design, at least one of lipid profile components (triglyceride [TG], total cholesterol [TC], low‐density lipoprotein cholesterol, and high‐density lipoprotein cholesterol) levels measured before fenugreek use and one of the lipid components level reported as result. The pooled weighted mean difference (MD) and its 95% confidence interval (CI) were calculated and pooled using a random‐effect model. Only articles published in English were considered. Fifteen RCTs involving 281 cases consumed fenugreek and 255 control cases in controlled group (11 articles) and 136 cases in uncontrolled group (4 articles) were analyzed in our study. Pooled data of indicated a significant impact of fenugreek supplementation on lowering TC (−1.13 [−1.88, −0.37]; p = .003), low‐density lipoprotein (LDL) (−1.26 [−2.09, −0.43]; p = .003), and TG (−1.07 [−1.82, −0.33]; p = 0.005) and increasing the high‐density lipoprotein (HDL) level (0.70 [0.07, 1.34]; p = .03) compared with the control group. There were no significant differences in TC, TG, and LDL between pre‐ and post‐fenugreek studies in the noncontrolled studies however, the result of combination of four studies without control group showed a significant increase in mean HDL (0.81 [0.33,1.29]; p‐value = .001). The results of subgroup analysis showed that the fenugreek reduced the TG and LDL and increases HDL levels in diabetic subjects more effectively. Fenugreek supplementation significantly improved lipid profile (LDL, TG, TC, and HDL). It could be considered as an effective lipid‐lowering medicinal plant. Further high‐quality studies are needed to firmly establish the clinical efficacy of the plant.
... It was reported that hypertriglyceridemia, hypercholesterolemia and reduced HDL level were commonly seen in diabetes [5,37] . It has been suggested that either the removal of triglycerides from the circulation or its entry into the circulation or both was impaired in non-insulin-dependent diabetics [38] . The present results showed high significant increases in plasma TL, TG, cholesterol, LDL and VLDL, also a decrease in HDL level (Table 1), and this is in agreement with those found in alloxan-diabetic rats [5] . ...
Article
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The present study was carried out to investigate the hypoglycemic effect of barley (Hordeum vulgare L) and some of its components such as amino acids (L-leucine and L-glutamine) and chromium picolinate on some biochemical and immunological parameters of alloxan induced diabetic rats. Alloxan-diabetic rats were treated with barley water (10% w/v) at a dose 10 ml Kg-1 b.wt., chromium picolinate at 15 µg Kg-1 b.wt., L-leucine plus L-glutamine at 4.5 mg & 15 mg Kg-1 b.wt., and/or the combination of barley plus chromium plus L-leucine and L-glutamine at the same previous doses in the same water volume, respectively. Rats received the treatments in their drinking water for four weeks. The levels of glucose, immunoglobulin G (IgG), total lipids (TL), cholesterol, triglycerides (TG), low-density lipoprotein (LDL) and very low-density lipoprotein (VLDL) were significantly (P
... After 8 weeks, FBG, TG and VLDL significantly decreased in cases which received the seeds in soaked form (Kassaian et al., 2009). Similarly, addition of T. foenum-graecum seeds (100 g) to diets of patients with T2D for 10 (15 subjects) or 20 (15 subjects) days improved GTT and led to significant decrease in FBG, TG and LVDL levels (Sharma, Raghuran, 1990a). Plants are commonly cultivated throughout India. ...
Chapter
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Salinity is a major abiotic stress that limits the growth and productivity of plants in many areas of the world. It is caused by weathering of rocks, heavy irrigation with saline water, the entry of sea water into freshwater areas, poor water management, high evaporation and regular use of chemical fertilizers. Plant adaptation or tolerance to salinity is basically of three distinct types: osmotic stress tolerance, Na+ exclusion and tissue tolerance. Salinity tolerance involves complex physiological traits, metabolic pathways and molecular or gene networks. A comprehensive understanding on how plants respond to salinity stress at different levels is imperative for the development of salt-tolerant varieties of plants suitable for salt-affected areas. Recent research has shown that plants develop various physiological and biochemical mechanisms such as ion homeostasis and compartmentalization, ion transport and uptake, biosynthesis of osmoprotectants and compatible solutes, activation of antioxidant enzymes and synthesis of antioxidant compounds, synthesis of polyamines, generation of nitric oxide (NO) and hormone modulation in order to survive in soils with high salt concentration. A better understanding and elucidation of the complete physiological, biochemical and molecular mechanisms will enable plant breeders to produce new salt tolerant plants for the future.
... Fenugreek seeds and leaves (given for 3 weeks) produced a significant reduction in serum cholesterol level in diabetic subjects in addition to a beneficial effect on blood glucose and serum insulin responses. The hypocholesterolemic and hypotriglyceridemic effect of fenugreek seeds has been demonstrated in both insulindependent and noninsulin-dependent diabetic subjects as well as in diabetic rats [42][43][44]. Dietary fenugreek seeds not only improved insulin sensitivity in rats maintained on a high-fat/high-sucrose (HFS) diet, but also distinctly reduced triglyceride, cholesterol, and phospholipid levels in the liver [45]. ...
Chapter
Evidences from exhaustive research in experimental animal models as well as in human subjects indicate that high cholesterol concentration in circulation, especially of LDL-associated cholesterol, lowered HDL-associated cholesterol, high blood pressure, thrombotic tendency and oxidative stress in the myocardium are the major risk factors for the etiology of CVD. Liberal consumption of dietary fibre and antioxidant phytochemicals are advocated for the prevention of CVD. A few spices when consumed through food, exert hypocholesterolemic property and hence anti-atherogenic and cardioprotective influence. The anti-thrombotic influence, antioxidant potential – particularly in cardiac tissue and suppression of low-density lipoprotein (LDL) oxidation, anti-obesity/thermogenic influence, and anti-hypertensive influence exerted by specific spices also play a significant role in their cardio protective attribute. The antioxidant property of a few spices are of particular interest in view of the importance of oxidative modification of LDL in the development of atherosclerosis. Recent animal studies have suggested that the cardio protective influence of a combination of fenugreek seeds and garlic is higher than their individual effect. Similarly, the combination of fenugreek seeds and onion offers higher amelioration of the cardiac damage accompanying diabetes.
... [29] It is worth mentioning that the dose is an important determinant of the effect, and in the present study, for safety reasons, a dose of 3 gm daily of cinnamon was used while in a similar study a range of doses of 3, and 6 gm was used. [15] For fenugreek, the dose used in the present study was 15 gm while in other studies 5 gm [30] , 15 gm, [31] and up to 100 gm [32] were used. Cinnamon or fenugreek is safe apart from one patient on cinnamon complained from gastric discomfort, and two participants in fenugreek group had diarrhea for two days. ...
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Background: People often seek care from multiple sources outside the formal traditional health care system. One of these sources is the use of Complementary and Alternative Medicine (CAM) including herbal medications. Diabetic patients are found 1.6 times more likely to use CAM than non diabetic patients. Aim: To investigate the effectiveness of cinnamon, fenugreek and their combination in type 2 diabetic patients not well controlled by oral antidiabetic drugs. Methodology: Fifty four diabetic patients who were on oral hypoglycemic drugs were randomly divided into 4 groups. Group 1, 2, 3 and 4 were treated with bran, cinnamon (3 gm), fenugreek (15 gm), and the combination of fenugreek and cinnamon. HbA1C and 2 h postprandial glucose (PPG) were measured at baseline and 40 days of treatment. Results: HbA1C level and 2 h (PPG) were significantly declined from baseline with 40 days placebo treatment. Significant reduction in HbA1C was noticed with 40 days cinnamon treatment (9.37 ± 2.1% to 8.76 ± 1.9%). This effect was paralleled with reduction of 2 h-PPG from 291± 99 mg/100ml at baseline to 233 ± 61 mg/100ml after 40 days treatment. The same changes in HbA1C and 2 h PPG were noticed with fenugreek and even more with the combination of fenugreek and cinnamon. Conclusions: daily supplementation with cinnamon, fenugreek or their combination to patients not achieving glycemic control with oral antidiabetic medications and diet is effective in lowering HbA1C and 2 h PPG in type 2 diabetic patients.
... [29] It is worth mentioning that the dose is an important determinant of the effect, and in the present study, for safety reasons, a dose of 3 gm daily of cinnamon was used while in a similar study a range of doses of 3, and 6 gm was used. [15] For fenugreek, the dose used in the present study was 15 gm while in other studies 5 gm [30] , 15 gm, [31] and up to 100 gm [32] were used. Cinnamon or fenugreek is safe apart from one patient on cinnamon complained from gastric discomfort, and two participants in fenugreek group had diarrhea for two days. ...
Article
Background: People often seek care from multiple sources outside the formal traditional health care system. One of these sources is the use of Complementary and Alternative Medicine (CAM) including herbal medications. Diabetic patients are found 1.6 times more likely to use CAM than non diabetic patients. Aim: To investigate the effectiveness of cinnamon, fenugreek and their combination in type 2 diabetic patients not well controlled by oral antidiabetic drugs. Methodology: Fifty four diabetic patients who were on oral hypoglycemic drugs were randomly divided into 4 groups. Group 1, 2, 3 and 4 were treated with bran, cinnamon (3 gm), fenugreek (15 gm), and the combination of fenugreek and cinnamon. HbA1C and 2 h postprandial glucose (PPG) were measured at baseline and 40 days of treatment. Results: HbA1C level and 2 h (PPG) were significantly declined from baseline with 40 days placebo treatment. Significant reduction in HbA1C was noticed with 40 days cinnamon treatment (9.37 ± 2.1% to 8.76 ± 1.9%). This effect was paralleled with reduction of 2 h-PPG from 291± 99 mg/100ml at baseline to 233 ± 61 mg/100ml after 40 days treatment. The same changes in HbA1C and 2 h PPG were noticed with fenugreek and even more with the combination of fenugreek and cinnamon. Conclusions: daily supplementation with cinnamon, fenugreek or their combination to patients not achieving glycemic control with oral antidiabetic medications and diet is effective in lowering HbA1C and 2 h PPG in type 2 diabetic patients.
... A clinical trial has found that seeds of this plant improved FBG levels without any noticeable adverse effects (Sharma and Raghuram, 1990). ...
Chapter
Diabetes mellitus is an expeditiously growing health problem in developed as well as developing countries that either arises from insulin deficiency or resistance to insulin. The disease is marked by hyperglycemia which leads to glycation of many proteins including human serum albumin. Glycation is a nonenzymatic reaction between free amino groups and sugars (mainly glucose) resulting in formation of a diverse class of irreversible heterogenous compounds, collectively termed advanced glycation end products (AGEs). These AGEs are known to contribute to the pathogenesis of diabetes and its associated complications that include atherosclerosis, diabetic retinopathy, diabetic neuropathy, wound healing, etc. Various plant extract and phytocompounds are known to exhibit antidiabetic properties and are used traditionally as well. In this chapter, we have presented an overview of the complications associated with diabetes due to AGEs along with the biochemical mechanism involved in glycation, highlighting the therapeutic potential of common herbal medicine/plant products in the management of diabetes.
... Fenugreek has been used in traditional therapy as a remedy for diabetes (Miraldi et al., 2001;Basch et al., 2003;Fernandez-Aparicio et al., 2008). Also, its effects as an anti-diabetic and anti-atherosclerotic have previously been well documented (Ajabnoor and Tilmisany, 1988;Sharma and Raghuram, 1990). ...
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Fenugreek ( Trigonella foenum-graecum L.) is a valuable medicinal plant, which is widely distributed throughout the world. It has been known that plant growth promoting rhizobacteria (PGPR) have positive effects on the quality and quantity of medicinal plants under different soil water levels. For this reason, a factorial experiment was conducted on the basis of a randomized complete block design (RCBD) to evaluate PGPR effects on the morphophysiological and phytochemical traits of fenugreek under different soil water levels. This study was conducted in two separate experiments: after the six-leaf stage and after the flowering stage. In the experiments, the treatments were plant growth promoting rhizobacteria (PGPR) including the control, Sinorhizobium meliloti , Pseudomonas fluorescens , a combination of S. meliloti and P. fluorescens , and different soil water levels (i.e. 100, 80, 60 and 40% of field capacity (FC) in three replications. The results showed that the highest seed weight per plant was obtained by inoculation with the S. meliloti and P. fluorescens combination at 100% FC after the two developmental stages. The maximum concentrations of nicotinic acid and trigonelline were observed for the combination of S. meliloti and P. fluorescens at the soil water content of 40% FC after the six-leaf stage and for S. meliloti at the soil water content of 40% FC after the flowering stage. The correlation and stepwise regression analyses showed positive effects of PGPR application on the morphophysiological and phytochemical traits of fenugreek plants under different soil water levels.
... Hypersensitivity reactions like fainting, rhinorrhea, and wheezing have been reported after inhaling fenugreek seed powder (Ohnuma et al. 1998) or facial angioedema using fenugreek paste for curing dandruff (Patil et al. 1997). It is highly recommended to monitor blood glucose level after starting supplementation due to possibility of hypoglycemia (Sharma and Raghuram 1990). Other side effects of fenugreek are bleeding risk (Lambert and Cormier 2001), decrease in severity of bone marrow cell proliferation or increase of fetal mortality rate (Araee et al. 2009), dyspepsia and mild abdominal distention , rapid respiration, mild central nervous stimulation and tremors (Abdel-Barry et al. 1997) using fenugreek at high dose or concentration. ...
Chapter
Fenugreek (Trigonella foenum-graecum L.) is an important forage, spice legume herb of Fabaceae family. It is well known for its medicinal uses due to high nutraceutical and pharmaceutical properties for curing diseases or disorders in Ayurvedic, Chinese, and Tibetan medication since ancient times. Currently it is a cultivated crop in most parts of the world with major focus on the isolation of its important secondary metabolites rather than its use as edible plant. Both seeds and leaves of fenugreek are of immense importance as they contain medicinally important phytochemicals like alkaloids, carbohydrates, steroidal saponins, amino acids and other important organic as well as inorganic compounds and minerals. Fenugreek seeds and leaves can be used as spice, food additive, flavoring agent, preservative, or directly as vegetable. Great efforts are spent on its improvement using traditional breeding programs or modern biotechnological tools because of the increasing demand of phytochemicals like disogenin and trigonelline extracted from this herb. In spite of its high medicinal value it is still considered as an underutilized plant. There is dire need to focus on the development of new cultivars in order to exploit its full potential as an edible plant along with its medicinal value. This study highlights its botanical features, distribution, genetic resources, possibilities for trait improvement and edible uses together with data on its pharmaceutical and nutraceutical characteristics, adverse effects as well as role in the functional food industries.
... fenugreek is grown as a spice and a vegetable crop and also have been used as a traditional therapy for the remedy of diabetes (miraldi et al., 2001;Smith, 2003;fernández-Aparicio et al., 2008). Its effect as an antidiabetic and antiatherosclerotic have been documented (Ajabnoor and Tilmisany, 1988;Sharma and Raghuram, 1990). fenugreek's leaves are a rich source of iron, calcium, β-carotene and other vitamins and its seeds contain tannic acid, diosgenin, trigocoumarin, alkaloids trigonelline, trigomethyl coumarin, gitogenin and vitamin A (Warke et al., 2011). ...
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Bacteria that colonize plant roots and promote plant growth are referred to as plant growth-promoting rhizobacteria (PGPR). For a long-serving period, the PGPRs have been applied as biofertilizers in crops culture. Recent studies indicated the importance of PGPR for controlling the water deficit. The present study investigates the effects of two different PGPRs on some morpho-physiological characteristics in fenugreek under water deficit stress. The first factor was application of four PGPR levels including (1. Sinorhizobium meliloti, 2. Pseudomonas fluorescens, 3. combination of S. meliloti and P. fluorescens and 4. control without bacterial inoculation) and four levels of soil water content including 40%, 60%, 80% and 100% of field capacity (FC) was considered as second factor. The results showed that, leaf area, shoot fresh and dry weight, nitrogen, phosphorus and potassium content, and water use efficacy (WUE) were significantly improved by PGPR inoculation and individual use of PGPR was more effective. Decreasing of soil water content up to 0.40 FC and inoculation of two bacteria led to increase of secondary metabolites such as nicotinic acid and trigonelline. However seed yield was decreased in PGPR treated plants. © 2018 Bolandnazar S., Sharghi A., Naghdi Badhi H., mehrafarin A., Sarikhani m.R.
... Many of the botanical products and food components are not simply identifiable as nutrients but they are effective as pharmacological hypoglycaemic agents showing improvement in lipid metabolism, antioxidant status and capillary function in their clinical trials. These include fenugreek seeds (Trigonella foenum-graecum: powder 25-50 g twice a day), bitter melon (Momordica charantia: 57 g of juice/day or 15 g aqueous extract), spirulina (Arthrospira spp: 2 g/day), Soybean (Glycine max: 69 g/ day), flaxseeds (Linum usitatissimum: 40 g ground/day) curry leaves (Murraya koenigii), cinnamon (Cinnamomum cassia: 1, 3 or 6 g/day), Tulsi (Ocimum tenuiflorum: 2 g powder/day), Amla (Phyllanthus emblica: 35 g/day), etc. which have been clinically proved [9][10][11][12] and Panchratna juice (a juice containing Amla, Ginger, Mint, Tulsi and Turmeric) [13]. ...
Article
Objective To compare the clinical efficacy of Aegle Marmelos (L.) Correa (AMLC) leaf juice (supplementation (20 g/100 ml) for 60 days among type 2 diabetes mellitus subjects. Design Randomized-controlled trial. Setting Veraval. Gir-Somnath, Gujarat, India. Intervention Confirmed Type 2 diabetes mellitus subjects (n = 60), were randomly divided to experimental (n = 30) AMLC leaf juice supplementation (20 g/100 ml) and Control group (n = 30) for 8 weeks. Main outcome measures: body-mass-index (BMI), body-fat-percent (BF%), Systolic and Diastolic blood pressure (BP), Fasting blood Glucose, glycosylated hemoglobin and Post prandial bolld glucose (FBG, HbA1c and PPBG), Total, High, Low and Very low density Lipoproteins and Triglycerides (TC, HDL, LDL-cholesterol and TG), C-reactive protein (CRP), liver enzyme tests serum glutamate oxaloacetate transaminase and, serum glutamate pyruvate transaminase (SGPT and SGOT), kidney function tests (Creatinine), total protein (TP, Albumin, globulin) and Serum Ferric Reducing Antioxidant Potential (serum FRAP). Results At 4 weeks, significant reduction was recorded in blood pressure SBP- 6.45%; DBP- 4.6%, FBG & HbA1c-20%; PPBG-15%; Total Cholesterol (TC-8%), LDL-15%), Triglycerides (TG-11%), liver functions SGOT-19% and, SGPT-13%, increase in serum FRAP-18%) in the subjects of EG post supplementation compared to baseline. When compared to control group, it reduced BF%, FBG, HbA1c, cholesterol, TG, LDL-cholesterol, CRP and raised HDL-cholesterol as well as improved antioxidant activity. Conclusion AMLC leaf juice supplementation (20 g/100 ml) for 60 days showed improvement in all bio-chemical parameters of type 2 diabetes mellitus, with enhanced efficacy and negligible adverse-effects. This juice can therefore, be supplemented along with oral hypoglycemic drugs to keep the above parameters in control. AMLC leaf being easily available and low cost, can be used as complementary therapy in the management of diabetes possibly due to presence of active components, aegelin 2, scopoletin and sitosterol in the leaf. Trial Registration No: The study was approved by Ethics Committee of Department
... Hypoglycemia is an expected effect; therefore, care should be taken to monitor blood glucose [23]. Because fenugreek preparations can contain coumarin derivatives, there is a theoretical risk prothrombin time or the international normalized ratio might be increased, which, in turn, increases the risk of bleeding [24]. ...
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Background: The popularity of herbal medicine (HM) is increasing worldwide and its use is probably more frequent in patients undergoing surgery. The aim of our survey is to explore the use of HM in adult surgical patients. Materials and Methods: single-center prospective survey at department of anesthesiology of Mohammed V Training Military Hospital, Rabat, Morocco, over a period of 5 months. In addition to socio-demographic and herbal use data, other variables included types and the mode of HM consumption, the reasons of use, perceived side effects and perceived efficacy of HM. Results: A total of 800 eligible participants were approached preoperatively to complete the survey. The mean age of our patients was 49.02 +/- 16.81 years. Among those patients, (50.9%) were women and (49.1%) were men. 206 patients (25.8%) admitted to using HM and (13%) of the study population has consumed herbal medicine in the week prior to the consultation. The patients also consumed Oregano (29.7%), Fenugreek (16.1%), Verbena (10.2%), Rosemary (9.7%) and Chamomile (9.7%). The main source of information found in our study was family members with a rate of 34%, while cultural and religious beliefs are the main reasons for the consumption of medicinal plants Conclusion: A significant proportion of presurgical patients use HM in our survey. Because of the potential for side effects and drug interaction, it is important for anesthetists to be aware of their use.
... The seeds are commonly used in India and other oriental countries as a spice due to the characteristic aroma attributed to curry preparations (Acharya et al. 2008). The seeds are reported to stimulate digestive processes, have antiatherosclerotic effects, and are also used in the treatment of diabetes, high cholesterol, wounds, inflammation and gastrointestinal ailments (Acharya et al. 2008;Ajabnoor and Tilmisany 1988;Basch et al. 2003;Khosla et al. 1995;Miraldi et al. 2001;Sharma and Raghuram 1990;Zandi et al. 2015). The medicinal, nutraceutical and functional food values of fenugreek hold great promises and can be easily examined in normotensive and hypertensive subjects along with the subjects/patients suffering from acute and chronic dyslipidemia and functional disorders of hepatic tissues (cirrhosis of liver) and hepatic enzymes (Sudip Datta Banik, personal communication). ...
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In the days before the advent of science, human beings were completely dependent upon Mother Nature for every single aspect of their lives: be it food, shelter or health. Every aspect of natural resources including plants would prove useful to our pre-historic ancestors for the maintenance of their health. However, not enough useful information regarding the practise of medicine in the pre-historic age is available as the bodies were found to be almost completely destroyed at the time of excavations; so further investigation is necessary to unveil the mysteries of pre-historic medicine. But with the progress of human civilization, we come across drastic changes in this field of science. The ancient crude means of medication gave way to more rational drug therapies. Use of charms and amulets for driving out evil spirits off the body (looked upon as the cause for diseases) was overshadowed by modern scientific theories. From the writings in the papyrus or scientific treatises composed during the time of different civilizations of the world, one can clearly see the evolutionary steps taken by medical science. But nevertheless, nature has never been forsaken from the aspect of human health. Even with the invention of technologies used for synthesis of chemicals to be used in syrups or tablets, herbal products too have been an inseparable part of modern day medicine. This review will discuss the issues of plant-based phytonutrients such as nutraceuticals, functional foods and value-added food products: what they are and their applications in human health from a global perspective.
Article
Fenugreek seeds are used in numerous marketed herbal formulations having therapeutic benefits. Some of its bioactive components including 4-hydroxyisoleucine (4-HIL), trigonelline (TG), raffinose (RFO) and pinitol (PT) are reported to have potential therapeutic activity such as antibacterial, antidiabetic, stomach stimulant, anti-invasive, hyperandrogenism and other allied diseases including polycystic ovary syndrome (PCOS). A fully validated, selective and sensitive bioanalytical method for simultaneous rapid quantification of the above mentioned bioactive components has been developed using hyphenated liquid chromatography electrospray tandem mass spectrometry. Separation of the analytes was achieved within 5 minutes by gradient elution in C18 column at 0.5 mL/min flow rate. Plasma protein precipitation technique was employed to isolate the analytes from the samples. Oral pharmacokinetic profile of the four bioactive components in SD rats was then further evaluated using non compartmental analysis using Phoenix WinNonlin software.
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Metabolic syndrome (MetS) is a cluster of metabolic disorders with a heavy disease burden. Fenugreek was reported to be effective in some components of MetS. Therefore, a comprehensive review and meta-analysis of randomized controlled trials was conducted to study the effects of fenugreek on MetS indices. From the beginning until August 2022, PubMed, Embase, Scopus, and Web of science were searched. Data were analyzed using the random-effect model, and presented as weighted mean difference (WMD) and associated 95% confidence interval (CI). This meta-analysis comprised from a total of 29 eligible RCTs with 31 arms measuring fasting plasma glucose (FPG), Triglyceride (TG), high-density lipoprotein (HDL), waist circumference (WC), systolic blood pressure (SBP), and diastolic blood pressure (DBP). The results indicated significant improving effects of fenugreek on FPG (WMD: -16.75 mg/dL; 95% CI: -23.36, -10.15; P < 0.001), TG (-20.12 mg/dL; 95% CI: -34.238, -5.994; P < 0.001), HDL (WMD: 3.55 mg/dL; 95% CI: 1.98, 5.12; P < 0.001), WC (WMD: -2.51; 95% CI: -3.78, -1.24; P < 0.001) and SBP (WMD: -3.45 mmHg; 95% CI: -6.38, -0.52; P = 0.021); However the effect on DBP (WMD: 3.17; 95% CI: -5.40, 11.73; P = 0.469) and BMI (WMD: -0.40 kg/m2; 95% CI: -1.114, 0.324; P = 0.281) was not significant. Administration of fenugreek can meaningfully reduce FPG, TG, WC, and SBP and increase HDL. The overall results support possible protective and therapeutic effects of fenugreek on MetS parameters.
Chapter
Diabetes mellitus (DM), caused by either insulin resistance or abnormal insulin secretion, or both, continues to be one of the most prevalent endocrine disorders in the world. In fact, DM is the third most common cause of mortality and morbidity, next only to cancer and cardiovascular disorders. About 463 million people were said to have suffered from DM around the world in 2019. This number is soon to reach 548 million by the end of 2020 and is projected to be 700 million by 2045. Several studies have indicated that DM is found to be more prevalent in high-income countries and urban areas than in the rest. Typically characterized by multiple etiologies and a persistent state of hyperglycemia, DM is prone to cause multiple disorders, affecting several organs of the body. Its treatment, thus, proves to be quite tricky, requiring a multimodal approach. For instance, in order to manage the glucose levels of a DM patient, it is crucial to identify a whole host of individual factors that contribute toward the defective glycemic index. Of the many ways of effectively controlling and managing DM, several plant species and plant-based compounds play a pivotal role. It is against this backdrop that a review was conducted to ascertain the performance and characteristics of several plant-based bioactive compounds in the treatment of DM. It was found that the plant-based bioactive compounds exhibit a higher level of antidiabetic activity than that of non-plant-based hypoglycemic drugs. A compendious account of the review is provided here. It may be noted that though the review indicates the high level of antidiabetic activity of plant-based drugs such as polyphenols, alkaloids, flavonoids, coumarins, and terpenoids, attributing their derivatives to the corresponding plant structures, it does not include any discussion on structure-related activity.
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Dysglycemia is a disease state preceding the onset of diabetes and includes impaired fasting glycemia and impaired glucose tolerance. This review aimed to collect and analyze the literature reporting the results of clinical trials evaluating the effects of selected nutraceuticals on glycemia in humans. The results of the analyzed trials, generally, showed the positive effects of the nutraceuticals studied alone or in association with other supplements on fasting plasma glucose and post‐prandial plasma glucose as primary outcomes, and their efficacy in improving insulin resistance as a secondary outcome. Some evidences, obtained from clinical trials, suggest a role for some nutraceuticals, and in particular Berberis, Banaba, Curcumin, and Guar gum, in the management of prediabetes and diabetes. However, contradictory results were found on the hypoglycemic effects of Morus, Ilex paraguariensis, Omega‐3, Allium cepa, and Trigonella faenum graecum, whereby rigorous long‐term clinical trials are needed to confirm these data. More studies are also needed for Eugenia jambolana, as well as for Ascophyllum nodosum and Fucus vesiculosus which glucose‐lowering effects were observed when administered in combination, but not alone. Further trials are also needed for quercetin.
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RECURRENCE RATES AFTER MODIFIED LIMBERG FLAP PROCEDURE FOR THE TREATMENT OF PILONIDAL DISEASE VARY BETWEEN 0%-10%: WHY IS THERE SUCH A BIG DIFFERENCE WITHIN RECURRENCE RATES? Mehmet Eren Yüksel, Ankara Yıldırım Beyazıt University School of Medicine, Intensive Care Unit, Ankara, Turkey e-mail: doctormehmeteren@yahoo.com Abstract: Introduction: Modified Limberg flap technique is applied for the treatment of pilonidal disease. Aim: We aimed to determine recurrence rates after modified Limberg flap procedure. Method: A Pubmed search between 2009-2021 was performed in order to identify studies reporting complications and recurrence rates after modified Limberg flap procedure for the treatment of pilonidal disease. Nineteen studies were identified. Results: Recurrence rates after modified Limberg flap procedure were 5.4% (Can et al., 2010), 0.97% (Akin et al., 2010), 10% (Aren et al., 2010), 1.67% (Elshazly et al., 2011), 4.2% (Kaya et al., 2012), 0% (Karaca et al., 2012), 2.8% (Ahmed et al., 2013), 3% (Bessa et al., 2013), 3.3% (Shabbir et al., 2014), 0% (Yildiz et al., 2014), 6.8% (Bayhan et al., 2015), 6.5% (Tokac et al., 2015), 0.8% (Yoldas et al., 2015), 2% (Saydam et al., 2015), 4.5% (Sabuncuoglu et al., 2015), 2% (Sarhan et al., 2016), 3.7% (Kose et al., 2017), 3.3% (Sabry et al., 2018) and 7.4% (Abdelnaby et al., 2018), respectively (Table 1). Discussion and Conclusion: Recurrence rates after modified Limberg flap procedure for the treatment of pilonidal disease vary between 0%-10%. Dispersion of the pits in the gluteal sulcus, various flap sizes, hairiness of the gluteal region, prior wound infection within the operation field, different lateralization distances of the flaps from the midline, post-operative wound care, immunosuppression, underreporting and a short follow-up period may play role in the outcomes after surgical treatment. A drawing template which was recommended by Yuksel et al. in 2019 may help to standardize modified Limberg flap procedure in order to facilitate the comparison of end results accurately. Keywords: Flap, Limberg, Modified, Pilonidal, Recurrence
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Type 2 diabetes mellitus is the most common form of diabetes. Many efforts are made to control this disease. Diet therapy is a very powerful mean to complete and enhance drug therapy to control blood glucose levels in diabetic patients. Barley is a wonderful cereal grain. It is considered as a rich source of antioxidant and magnesium that acts as a cofactor for many enzymes involved in the glucose metabolism and insulin secretion. So, the present work aims to investigate the effect of new barley cultivars (barley Gemmiza & barley New valley) on some physiological parameters on streptozotocin-induced diabetic rats. STZ diabetic rats which were fed on diet mixed with 30% barley of the two hybrids for 30 days. Results showed that the use of 30% barley resulted in marked decrements in serum glucose, total cholesterol, triglycerides, LDL cholesterol and increased HDL cholesterol. More over the liver and kidney markers were also improved in the groups that treated with barley relative to its diabetic group. The obtained results might recommend that barley can be utilized as an essential part of the diabetic patient's diet.
Chapter
Most international guidelines advise reducing blood lipoproteins and blood glucose by diet and lifestyle changes before administering drug therapy. Many experts believe that beyond low-density lipoprotein (LDL) cholesterol, oxidized LDL and oxidation of other lipids are important in the pathogenesis of endothelial dysfunction, which leads to atherosclerosis. Oxidative stress and inflammation are also important in the pathogenesis of dysfunction of beta cells of the pancreas, adipocytes, hepatocytes, and neurons. There is a need to find a hypolipidemic agent that also has antioxidant effects to counteract these mechanisms of cardiovascular diseases and diabetes as well as of other chronic diseases. Fenugreek is rich in soluble fiber, saponins, polyphenolics, trigonelle, diosgenin, and 4-hydroxyisoleucine. Dietary fiber, flavonoids, and saponins may be responsible for hypoglycemic and hypolipidemic actions, and the beneficial effects may be due to decreased inflammation. In humans, fenugreek seeds acutely reduce postprandial glucose and insulin concentrations by decreasing oxidative stress. Several longer-term clinical trials showed reductions in fasting and postprandial glucose concentrations and glycated hemoglobin as well as blood lipoproteins without decline in high-density lipoprotein cholesterol. Experimental studies have shown that fenugreek seed extracts have the potential to slow enzymatic digestion of carbohydrates, reduce gastrointestinal absorption of glucose, and increase glucagon-like peptides. Fenugreek seeds are rich in polyphenolic flavonoids, such as quercetin, trigonelline, saponins (4%–8%), and phytic acid. The seeds of fenugreek also contain lysine and L-tryptophan-rich proteins, mucilaginous fiber, and other rare chemical constituents, such as coumarin, fenugreekine, nicotinic acid, folic acid, sapogenins, phytic acid, scopoletin, and trigonelline, which are thought to account for many of the presumed therapeutic effects that may inhibit cholesterol absorption and decrease blood sugar concentrations. Fenugreek seeds have no serious side effects except for a bitter taste, which can be reduced by defatting.
Chapter
Based on published information, potential health benefits of fenugreek (Trigonella foenum-graecum), one of the oldest medicinal plants, are reviewed in this chapter. The scientific data are summarized for potential health benefits including management of blood glucose in type II diabetics, cholesterol-lowering effect, effect on growth hormone leading to modulation of metabolic syndrome, antiinflammatory and anticancer effects, enhancement of milk production in new mothers, increase in male libido, safety, and toxicity. These benefits are analyzed in terms of the weight of evidence for efficacy, effective human dose, extrapolation of animal data to humans, and the safety margin at the projected clinical dose. Effects of not only the whole seed or plant but also the main active components, such as diosgenin, trigonelline, 4-hydroxyisoleucine, and galactomannan, are identified and summarized. The advantages of using the aqueous or alcoholic extract(s) instead of whole-seed powder, thus mitigating any coumarin-associated potential dermal or anticoagulation-related adverse effects, are also discussed. There appears to be strong preclinical-based evidence for most of the benefits listed here, but the clinical data appear to be not robust and need stronger evidence by conducting well-controlled clinical trials, as performed for human pharmaceuticals. Overall, the effective dose for the whole-seed powder is too high to be practical but does not pose a safety concern with respect to dose-limiting toxicity, even after repeated dosing. The use of fenugreek should be avoided during pregnancy until safety of the developing fetus is established based on quality (GLP) embryo/fetal developmental toxicity studies in appropriate animal species. Also, fenugreek, as a member of the Leguminoseae family, could be allergenic to some subjects, particularly those known to be allergic to peanuts. Further research for reducing the clinically effective dose has been proposed by using the bioactive components alone or in combination.
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Fenugreek (Trigonella foenum-graecum L.) native geographic range is the area from Iran to North part of India, but it is presently planted also in other regions of the world. Fenugreek has been used as a notable multipurpose medicinal and traditional herb in Iranian, Indian, and Chinese for several centuries. The most important composition of fenugreek seeds are protein, neural detergent fiber, gum, lipids, moisture, ash and starch. Fenugreek seeds and leaves are anticholesterolemic, anti-tumor, anti-inflammatory, carminative, demulcent, deobstruent, emollient, expectorant, galactogogue, febrifuge, laxative, hypoglycaemic, restorative, parasiticide and uterine tonic and useful in burning sensation. Traditionally, fenugreek seeds used around the world are in bone and muscles, respiratory system, gastrointestinal system, female reproductive system, cardio-vascular system, endocrinology and hepatic. The most outstanding modern health benefits of fenugreek are in appetite suppressant and weight loss, reduce cholesterol, reduce cardiovascular risk, control diabetes, a good consolation for sore throats, a remedy for acid reflux, constipation, colon cancer prevention, appropriate for kidney trouble, skin infection, increase milk production, reduce menstrual discomfort, and it reduces menopause symptoms. Both modern science and traditional medicine integration with novel technologies and discoveries will secure cultivation of medicinal herbs and promote sustainability in a long-term and a wide-range.
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Sainfoin (Onobrychis viciifolia Scop.) and fenugreek (Trigonella foenum‐graecum L.) are two legumes that are being developed as forage crops in Canada with potential benefits to animal and human health. Sainfoin, a perennial crop containing condensed tannins (CT), is gaining popularity in western Canada because of its benefits to cattle. Its condensed tannins makes the crop bloat‐free for grazing cattle while improving protein digestibility and reducing greenhouse gas emissions. The CT containing fenugreek is also considered a bloat‐free annual forage legume that was developed to serve in short–term crop rotations in western Canada. These crops are known to provide health and nutritional benefits to cattle with their high protein content and other beneficial nutraceuticals such as crude fiber, 4‐hydroxyisoleucine, steroid sapogenins and galactomannans. Some of these nutraceuticals have the potential to benefit human health, however, such attributes are not studied well to harness the full potential of these legume crops in Canada. Recent research suggests that legumes are a healthy substitute for meat. However, metabolite analysis of sainfoin is mostly limited to proteins and CTs. The CTs reported in sainfoin are involved in reduction of blood pressure, detoxification, and providing anti‐cancer properties in humans. Recent studies on fenugreek have highlighted the beneficial nutraceuticals associated with human health but, most of those claims are not backed by relevant clinical studies. In this article, we reviewed the nutritional quality attributes of sainfoin and fenugreek and assessed their potential as functional foods and nutraceuticals for animal and human health based on scientific evidence. This article is protected by copyright. All rights reserved
Chapter
The seeds of fenugreek (Trigonella foenum-graecum L.) have a long history of usage as spices and medicine that attributes to the diverse chemical composition of fragrant small molecules, amino acid derivatives (4-hydroxyisoleucine), alkaloids (trigonelline), galactomannan rich polysaccharides, phenolic compounds of both flavonoids and aromatic acids, and complex saponins. The diversity of pharmacological activities induced by the seeds powder, extracts and active components in diabetes and hyperlipidaemic models are astonishing. This chapter provides the mechanistic basis and potential applications for diabetes and a range of associated disorders by assessing data from in vitro, extensive animal models and human trials. The contribution of the active components individually and as a group in the seeds preparations is discussed. Improvement of insulin sensitivity, insulin release, regulation of lipid metabolism and antioxidant and anti-inflammatory mechanisms of organoprotective effects under diabetes pathology are among the discussion topics.
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Objective: The aim of this randomized controlled trial was to investigate the effects of a polyherbal compound consisting of Aloe vera, black seed, fenugreek, garlic, milk thistle, and psyllium on diabetic patients with uncontrolled dyslipidemia. Methods: Fifty patients with type 2 diabetes who had dyslipidemia in spite of statin therapy were randomly allocated to two groups: control group (n = 25) receiving a conventional therapy with hypolipidemic and hypoglycemic drugs and intervention group (n = 25) receiving both the conventional therapy and the herbal compound (one sachet twice daily) for 12 weeks. Each sachet contained 300 mg of Aloe vera leaf gel, 1.8 g of black seed, 300 mg of garlic, 2.5 g of fenugreek seed, 1 g of psyllium seed, and 500 mg of milk thistle seed. Results: The levels of serum triglyceride, total cholesterol, low-density lipoprotein, and HbA1c showed a significant in-group improvement in the intervention group. However, the effects of the herbal compound on fasting blood glucose remained insignificant. The compound had no unwanted effect on the kidney function parameters (urea, creatinine) and serum liver enzymes (alanine aminotransferase and aspartate transaminase). Conclusion: The tested herbal compound, as an add-on to statin therapy, was effective in lowering the serum lipids in diabetic patients with uncontrolled dyslipidemia.
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The annual sale of botanical products has grown to be a multimillion dollar business. Today we are witnessing a great deal of interest in the use of herbal remedies. Some consumers have become dissatisfied with conventional medicine. They perceive it as impersonal and expensive, and conventional drug therapy often has undesirable side effects. For many Americans, the medicinal use of plant extracts seems to be a more natural, less expensive way, and involving therapies that are more gentle and largely without side effects.
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Fenugreek is one of the oldest medicinal plants, originating in India and Northern Africa. The hypoglycemic effects of fenugreek have been attributed to several mechanisms. Under In vitro conditions, the amino acid 4-hydroxyisoleucine(4-OHIL) in fenugreek seeds increased glucose-induced insulin release in human and rat pancreatic islet cells. It was observed that 4-OHILextracted from fenugreek seeds has insulin tropic activity. This amino acid appeared to act only on pancreatic beta cells, since the levels of somatostatin and glucagon were not altered. Experimental: In order to separate amino acids from methanol extract of fenugreek seeds, ion exchange chromatography method containing 225H cationic resin was used. Five dipeptides were prepared from 4-OHILnamely; GLY-L-4-OHIL, ALA-L-4-OHIL, SER-L-4-OHIL, VAL-L-4-OHIL, THR-L-4-OHIL using cbZ-Cl in protecting step, DCC in peptide forming step and HBr in acetic acid in deprotection step. Results: Five dipeptides were confirmed by spectral data like IR, MASS, NMR and evaluated for anti-diabetic activity. The studies showed that only GLY-L-4-OHIL showed improved activity than the other derivatives and it is comparable with 4-OHIL. Conclusion: Remarkable anti diabetic activity was observed when compared with standard drug and the parent compound 4-OHIL.
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Purpose Purpose- Various studies suggest that some of natural agents create a specific action of hypocholesterolemic effect. Considering of this fact, this review work on describing selected natural agents that may reduce cholesterol concentrations by different mechanism of actions. Design/methodology/approach Design/methodology/approach-The advantages, phytochemical components and the mechanisms of the agents were reviewed and supported from findings of the in vitro, double-blind and clinical studies from published journals, books and articles. The journals used in this review, the studieswere published from 1985 to the 29th of November 2016, and are available from PubMed, ScienceDirect and Google Scholar. Findings Findings- Plants stanols and sterols, turmeric, fenugreek, avocado, tomato, artichoke, red yeast rice and garlic showed a positive effect in maintaining cholesterol levels by specific mechanisms or actions. These agents each had a specific action in creating a hypocholesterolemic effect either by inhibition of the enzyme significant to the synthesis process, disturbing the absorption of cholesterol, conversion of cholesterol to other related forms and through the reduction of the oxidative stress. The agents described in this review were appeared in various studies by a number of researchers in term of their benefits in hypocholesteremic effect. Research limitations/implications Limitations-However, this field still needs more studies as there isn't currently any detailed information regarding the main active ingredients responsible for the mechanism to reduce cholesterol levels in humans. Originality/value Originality- The review enlighten our understanding of some natural agents are potential to be used to control cholesterol.
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Background: Fenugreek (Trigonella foenum-graecum) seeds and onion (Allium cepa) are independently known to have antidiabetic effects through different mechanisms. The beeneficial influence of a combination of dietary fenugreek seeds and onion on hyperglycemia and its associated metabolic abnormalities were evaluated in streptozotocin-induced diabetic rats. Methods: Diabetes was experimentally induced with streptozotocin and diabetic rats were fed with 10% fenugreek or 3% onion or their combination for 6 weeks. Results: These dietary interventions significantly countered hyperglycemia, partially improved peripheral insulin resistance and impaired insulin secretion, reduced β-cell mass and markedly reversed the abnormalities in plasma albumin, urea, creatinine, glycated hemoglobin and advanced glycation end products in diabetic rats. These beneficial effects were highest in the fenugreek+onion group. Diabetic rats with these dietary interventions excreted lesser glucose, albumin, urea and creatinine, which were accompanied by improved body weights compared with the diabetic controls. These dietary interventions produced ameliorative effects on pancreatic pathology as reflected by near-normal islet cells, restored glycogen and collagen fiber deposition in diabetic rats. Conclusions: This study documented the hypoglycemic and insulinotropic effects of dietary fenugreek and onion, which were associated with countering of metabolic abnormalities and pancreatic pathology. It may be strategic to derive maximum nutraceutical antidiabetic benefits from these functional food ingredients by consuming them together.
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Diabetes has been recognized by ancient physicians and its main symptoms were known by the increased thirst, frequent urination, and tiredness. Medicinal plants were commonly used for treating these combined symptoms. In addition to several instructions for specific food consumption, a mild exercise was recommended. Currently, traditional medicine continues to be practiced in most Middle East, Asia, as well as developed countries. The current form of herbal medicine has historical roots in medieval Greco-Arab, ancient Egyptians, Chinese, and other ancient medicines. More than 800 plant species are reported as antidiabetic. Over 400 plants as well as 700 recipes and compounds have been scientifically evaluated for type 2 diabetes treatment. For instance, metformin, the most popular antidiabetic drug nowadays, was developed based on a biguanide compound isolated from French lilac. Medicinal herbs contain various bioactive compounds and thus can display multiple actions on insulin production as well as distinct insulin action mechanisms: insulin sensitizing, insulin mimicking, and inhibition of intestinal carbohydrate digestion and absorption. Herbal-derived insulin sensitizers act in a synergetic mechanism to increase glucose disposal and uptake by muscle, hepatic cells, and fat as well as those that control hepatic glycogen metabolism. This chapter provides a comprehensive overview on traditional herbal medicine including the historical background, medical innovations introduced by physicians and researchers, methods of therapies, and a state-of-the-art description of traditional herbal medicine.
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1. The effect of incorporating guar gum into predominantly single-component meals of carbohydrate, fat or protein on liquid gastric emptying and on the secretion of gastric inhibitory polypeptide (GIP), gastrin and motilin, was studied in healthy human volunteers. 2. Volunteers were given either 80 ml Hycal (carbohydrate meal), 150 g cooked lean minced beef (protein meal) or 200 ml double cream (fat meal) either with or without 5 or 6 g guar gum. Liquid gastric emptying was monitored in the fat and protein meals by taking 1.5 g paracetamol, consumed in water, with the meals and monitoring its appearance in circulation. 3. Postprandial insulin and GIP levels were both significantly reduced by addition of guar gum to the carbohydrate meal. Postprandial GIP secretion was also reduced by addition of guar gum to the protein meal, but protein-stimulated gastrin secretion was enhanced by guar gum. There was a significant negative correlation between peak circulating gastrin levels and the corresponding GIP levels. Postprandial GIP secretion and plasma motilin levels were unaffected by addition of guar gum to the fat meal. 4. 5 and 10 g guar gum/l solutions in water possessed buffering capacities between pH 2.75 and 5.5. 5. Guar gum at 5 g/l caused no detectable change in liquid gastric-emptying time. 6. The observed augmentation of gastrin secretion by guar gum following a protein meal could be due either to the buffering capacity of guar gum or to the attenuation of GIP secretion. It is possible that the chronic use of guar gum could be associated with changes in gastric acid secretion.
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The mechanisms of the hypocholesterolemic effect of polyunsaturated fats (PUSF) are not well understood. One possibility is that these fats uniquely reduce the cholesterol content of lipoproteins. The present study was carried out to determine specifically whether the ratio of cholesterol-to-protein (or apoB) in LDL (or other lipoproteins) is reduced by PUSF; also, lipoprotein composition was examined for other possible changes. Eight men and two women with different levels of plasma cholesterol were studied on the metabolic ward for 8 weeks. They were given a diet high in saturated fats (SF) for 4 weeks and another rich in PUSF for 4 weeks. On PUSF diets, mean plasma cholesterol decreased by 25% (SF = 296 +/- 27 (SEM) vs. PUSF = 223 +/- 21 mg/dl) as did total plasma apoB (155 +/- 8 vs. 116 +/- 13 mg/dl). LDL-Cholesterol decreased by 26%, and LDL-apoB fell by 29%. The mean ratio of cholesterol-to-apoB did not change significantly (SF = 1.52 +/- 0.04 vs. PUSF = 1.48 +/- 0.07). Likewise, HDL-cholesterol decreased by 15% (SF = 51 +/- 5 vs. PUSF = 43 +/- 4 mg/dl), and total plasma apoA-I was reduced by 19% (95 +/- 15 vs. 77 +/- 6 mg/dl); also, no change in the cholesterol-to-apoA-I in HDL was noted. Finally, there were no changes in cholesterol/apoB or triglyceride/apoB ratios in VLDL despite a 23% decrease in plasma triglycerides on PUSF. Thus, the hypocholesterolemic effect of PUSF was uniform for all lipoproteins and usually was accompanied by a corresponding decrease in concentrations of apoprotein constituents.
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The hypocholesterolaemic and hypotriglyceridaemic properties of fenugreek seed subfractions were studied in alloxan diabetic dogs. These subfractions were added to the diet of animals for 21 days. Subfraction a containing testa + endosperm (fibres 79.4%) induced a clear reduction in hyperglycaemia and in elevated plasma cholesterol levels. Subfraction b containing cotyledons + axis (proteins 52.8%, saponins 7.2%) caused a diminution in elevated plasma cholesterol and triglyceride levels. No beneficial effect was observed with subfraction P (proteins 70.50%). Subfraction S (saponins 22.2%) induced, like subfraction b, a reduction in hypercholesterolaemia and hypertriglyceridaemia of the diabetic dogs without inducing significant changes in HDL cholesterol concentrations. Our results show that the hypolipidaemic effects of fenugreek seeds are due to the fraction rich in fibres (hypocholesterolaemic effect) and to the fraction rich in saponins (hypocholesterolaemic and hypotriglyceridaemic effects).
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Fenugreek (Trifolium foenum graecum) a leguminous herb, is extensively cultivated in India, Mediterranean region and North Africa. It is used for culinary and medicinal purposes and also for fodder in various parts of the world. The hypoglycemic effect of fenugreek seeds and leaves was tested in normal and diabetic subjects. Six protocols A, B, C, D, E and F involved the acute administration (single dose of 25 g of seeds, 5 g of gum isolate and 150 g of leaves) of whole fenugreek seeds, defatted fenugreek seeds, gum isolate, degummed fenugreek seeds, cooked fenugreek seeds and cooked fenugreek leaves to healthy subjects. The rise in plasma glucose after a dose of glucose or meal was prevented by fenugreek seeds. The serum insulin levels were also modified (P<0.05). The reduction in area under glucose curve was greatest with whole seeds (42.4%), followed by gum isolate (37.5%), extracted seeds (36.9%), and cooked seeds (35.1%) in that order. The degummed seeds and fenugreek leaves showed little effect on glycemia. Fenugreek seeds were also administered for 21 days to diabetic subjects. A significant imporvement in plasma glucose and insulin responses was observed in these subjects. The 24 hr urinary glucose output and serum cholesterol levels were also reduced (P<0.05).
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The effect of obesity on the relationship between very low density lipoprotein (VLDL)-triglyceride (TG) production rate and concentration was studied in 80 subjects whose TG concentrations ranged from 41-1315 mg/100 ml and whose relative weight varied from 0.74-1.46. There was a positive correlation between VLDL-TG production rate and plasma TG concentration in all 80 patients (r = 0.78), which was highly statistically significant (p less than 0.001). Both male and female subjects were subdivided into quartiles on the basis of relative weight; the relationship between VLDL-TG production rate and plasma TG concentration was found to be comparable in all subgroups. These observations suggest that moderate degrees of obesity do not affect VLDL-TG kinetics in patients whose plasma TG levels vary over an extremely wide range.
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The effects of high-carbohydrate, high plant fiber (HCF) diets on glucose and lipid metabolism of 20 lean men receiving insulin therapy for diabetes mellitus were evaluated on a metabolic ward. All men received control diets for an average of 7 days followed by HCF diets for an average of 16 days. Diets were designed to be weight-maintaining and there were no significant alterations in body weight. The daily dose of insulin was lower for each patient on the HCF diet than on the control diet. The average insulin dose was reduced from 26 +/- 3 units/day (mean +/- SEM) on the control diets to 11 +/- 3 (P less than 0.001) on the HCF diets. On the HCF diets, insulin therapy could be discontinued in nine patients receiving 15 to 20 units/day and in two patients receiving 32 units/day. Fasting and 3-hr postprandial plasma glucose values were lower in most patients on the HCF diets than on the control diets despite lower insulin doses. Serum cholesterol values dropped from 206 +/- 10 mg/dl on the control diets to 147 +/- 5 (P less than 0.001) on the HCF diet; average fasting serum triglyceride values were not significantly altered on the HCF diets. These studies suggest that HCF diets may be the dietary therapy of choice for certain patients with the maturity-onset type of diabetes.
Article
A parameter of peripheral insulin activity (A = 10(4)/IpGp) can be obtained after oral glucose loading by simple calcuation using insulin and glucose levels at the glucose peak. In combination with a glucose-independent parameter of beta-cell function (CIR = 100. I/G(G-70) a parameter of glucose tolerance (GT = A-CIR) is defined. The parameters allow one to separate the contributions of beta-cell function and peripheral insulin resistance to the glucose tolerance observed after glucose loading. Examples, based on the literature and our own work, illustrate the increase of A and GT by cortisone acetate premedication as well as long-term oral contraceptive medication.
Article
From the dose-response relations between glucose and insulin after oral glucose loading, a reproducible parameter for beta-cell response was deduced. The main advantage of this parameter -corrected insulin response, defined as CIR = I- 100/G(G-70)- lies in it independence from the initial or reached glucose level.
Article
Studies done on dietary fiber (DF) over the past five years are presented in this Review. The involvement of dietary fiber in the control of plasma glucose and lipid levels is now established. Two dietary fiber sources (soybean and fenugreek) were studied in our laboratory and are discussed herein. These sources were found to be potentially beneficial in the reduction of plasma glucose in non-insulin dependent diabetes mellitus subjects. They are shown to be acceptable by human subjects and are easy to use either in a mixture of milk products and in cooking. The mechanism by which dietary fiber alters the nutrient absorption is also discussed. The effect of DF on gastric emptying, transit time, adsorption and glucose transport may contribute to reducing plasma glucose and lipid levels. DF was found to be effective in controlling blood glucose and lipid levels of pregnant diabetic women. Dietary fiber may also be potentially beneficial in the reduction of exogenous insulin requirements in these subjects. However, increased consumption of DF may cause adverse side effects; the binding capabilities of fiber may affect nutrient availability, particularly that of minerals and prolonged and high DF dosage supplementation must be regarded cautiously. This is particularly true when recommending such a diet for pregnant or lactating women, children or subjects with nutritional disorders. Physiological effects of DF appear to depend heavily on the source and composition of fiber. Using a combination of DF from a variety of sources may reduce the actual mass of fiber required to obtain the desired metabolic effects and will result in a more palatable diet. Previously observed problems, such as excess flatus, diarrhea and mineral malabsorption would also be minimized.
Article
We have previously shown that the antidiabetic property of fenugreek seeds (Trigonella foenum graecum L.) is associated with the defatted seed material which is rich in fibers, saponins, and proteins. In the present work this defatted preparation was divided into two subfractions: subfraction "a" which contains the testa and endosperm and is rich in fibers (79.6%); and subfraction "b" which contains the cotyledons and axes and is rich in saponins (7.2%) and proteins (52.8%). We investigated the effects of each subfraction on hyperglycemia and the levels of pancreatic hormones when chronically administered to alloxan-diabetic dogs. Each subfraction was studied separately and was given to the dogs per os (mixed with the two daily meals), in addition to the insulin treatment (which was kept the same throughout the experiment) for a period of 21 days. The addition of subfraction "a" to insulin treatment resulted in a clear decrease of hyperglycemia and glycosuria accompanied by a reduction of the high plasma glucagon and somatostatin levels in diabetic dogs. The treatment also decreased the hyperglycemic response to the oral glucose tolerance test. In contrast the chronic administration of subfraction "b" had no effect on hyperglycemia or on the levels of pancreatic hormones in diabetic dogs. Our results show that the antidiabetic properties of fenugreek seeds are contained in the testa and endosperm. Although this subfraction is rich in fibers (high viscosity; 115 cP), it is not possible to exclude the existence of one or more unknown active pharmacological compounds in this subfraction of the seed.
Article
The effect of fenugreek on postprandial glucose and insulin levels following the meal tolerance test (MTT) was studied in non-insulin dependent diabetics (NIDDM). The addition of powdered fenugreek seed (15 g) soaked in water significantly reduced the subsequent postprandial glucose levels. The plasma insulin also tended to be lower in NIDDM given fenugreek but without a statistical difference. Fenugreek had no effect on lipid levels 3 h following the MTT. Fenugreek may have a potential benefit in the treatment of NIDDM.
Article
The hypoglycemic effects of a decoction and an ethanol extract of Trigenolla foenum graceum seeds on the serum glucose levels of normal and alloxan diabetic mice were studied. A single 0.5 ml oral dose of 40-80% decoctions to normal as well as alloxanized mice was followed by hypoglycemia developed over a 6-h period. Reduction in blood glucose concentration was highly significant, was maximum at 6 h and was dose-dependent. The hypoglycemia caused by the ethanol extract (200-400 mg/kg) in alloxanized mice was also dose-dependent and 200 mg/kg was comparable in effect to 200 mg/kg tolbutamide.
Article
The major alkaloids of T foenum graecum and Lupinus termis seeds were tested for hypoglycemic activity in normal and alloxan diabetic rats. This study was stimulated by popular folk belief referring to these seeds as 'antidiabetic' and by the fact that Yemenites and Bedouins add the seeds to their diabetic diet. Extracts from Trigonella seeds exert a mild hypoglycaemic effect, and so does their major alkaloid component, trigonelline. Another Trigonella component, nicotinic acid, displayed, like nicotinamide, a much more profound hypoglycaemic activity than did trigonelline, but their effect persisted for a short period only. Coumarin, another Trigonella component, caused the most severe degree of hypoglycemia, lasting for 24 hr in alloxan diabetic rats. The only alkaloids active in non diabetic rats were nicotinic acid as a short acting drug, and coumarin, exerting a prolonged effect. Some borderline hypoglycemic activity was noticed in normal rats with high doses of scopoletine. Lupinus seed extract produced a mild and transient hypoglycemia in diabetic rats, most probably due to 2 of its major alkaloids, sparteine and lupanine. No hypoglycaemic effect was noticed in non diabetic rats. Coumarin and sparteine were the only 2 major components of both types of seeds to exert anti diuretic activity. Labelled nicotinic acid injected I.V. into non diabetic rats was concentrated mainly in the kidney and liver, and to a lower extent in the pancreas, thus permitting the conclusion that nicotinic acid and coumarin, but not trigonelline, are the major hypoglycemic components of trigonella seeds. The acute and sub chronic toxicity of the major alkaloids of the 2 seeds were determined in rats.
Article
The effects of insulin on the synthesis of sterols and fatty acids and on the activity of 3-hydroxy-3-methylglutaryl coenzyme A reductase (EC 1.1.1.34), a rate-limiting enzyme for sterol synthesis, were studied in mammalian cells grown in culture. While in some established cell lines sterol synthesis was not affected significantly by the hormone, in the nonpermanent human and animal cells the synthesis of lipids, especially that of sterols, as well as the activity of the reductase were stimulated following an incubation with insulin in a medium containing serum albumin for a few hours or longer. These effects of insulin were also demonstrable in the presence of solvent-extracted serum, which itself increases sterol synthesis and reductase activity. In medium containing whole serum insulin was ineffective. Addition of glucose decreased sterol synthesis as well as reductase activity. The effects of insulin were prevented by cycloheximide and are probably due to an increased synthesis of 3-hydroxy-3-methylglutaryl CoA reductase or of a protein that regulates its activity.
Article
Fractions of fenugreek seed were added to the diet of normal or diabetic hypercholesterolaemic dogs for 8 days. The effects on levels of blood glucose, plasma glucagon and plasma cholesterol were investigated. The lipid extract had no effect. The defatted fraction which is rich in fibres (53.9%) and contains 4.8% of steroid saponins significantly lowered basal blood glucose (P less than 0.02), plasma glucagon (P less than 0.01) and plasma cholesterol (P less than 0.02) levels in normal dogs. The addition of this fraction to the food of diabetic hypercholesterolaemic dogs caused a decrease of cholesterolaemia (P less than 0.02) and reduced hyperglycaemia. In conclusion, the defatted portion of fenugreek seed induces a hypocholesterolaemic effect.
Article
The components of fenugreek seeds were separated and analyzed to determine which fraction of the seed had hypoglycemic activity. These fractions were administered orally to normal or diabetic dogs for 8 days. The effect on blood glucose and pancreatic hormones was studied in normal dogs. The lipid extract had no effect; the defatted fraction (50.2% fibers: gum 17.7%, hemicellulose 22%, cellulose 8.3%, lignin 2.2%) lowered basal blood glucose level, plasma glucagon and somatostatin levels and reduced the orally induced hyperglycemia. The addition of this fraction to the insulin treatment resulted in a decrease of hyperglycemia and glycosuria in diabetic dogs. The results indicate that the defatted part is responsible for the antidiabetic action. However, the present study does not permit one to know whether the effects are caused by an unknown pharmacological compound or by the gastrointestinal action of fibers.
Article
A direct method for the quantitative determination of total serum cholesterol is described. The procedure consists of adding a reagent containing sulfuric acid, acetic acid, and ferric chloride to a 0.1 ml. sample of serum. The sensitivity achieved is several times that of current procedures and the time required for a single determination is in the order of minutes. Precision and reproducibility are demonstrated as well as the absorption characteristics of the purple color produced through the spectral range of 400 to 700 mμ. Finally, the method is compared with samples in which total cholesterol is determined by the Kingsley-Schaffert and Schoenheimer-Sperry procedures.
Article
A microprocedure for the direct determination of triglyceride concentrations in biologic specimens is presented. The method depends on the quantitative removal of phosphatides from the sample and the subsequent determination of esterified glycerol. The procedure has been tested on whole blood and plasma.
Diabetes mellitus: Some aspects of aetiology and management of non-insulin dependent diabetes
  • Mann
I. Mann J. Diabetes mellitus: Some aspects of aetiology and management of non-insulin dependent diabetes.
Fiber and diabetes — new perspectives
  • Peterson
Peterson DB. Fiber and diabetes -new perspectives.
High-fiber diets for obese diabetic men on insulin therapy: Short-term and long-term effects
  • Anderosn
Anderosn JW. High-fiber diets for obese diabetic men on insulin therapy: Short-term and long-term effects.
Hypoglycaemic effect of Trigonella foenum graecum and Lupinus termis (leguminosae) seed and their major alkaloids in alloxan-diabetic and normal rats
  • Shani
Hypocholesterolemic and hypotriglyceridemic effects of subfraction from fenugrek seeds in alloxan diabetic dogs
  • Ribes