DOES PUMPKIN AFFECT GLYCEMIC CONTROL IN DIABETIC PATIENT. CASE REPORT AND LITERATURE REVIEW

Abstract

Pumpkin was reported to have hypoglycemic effect. It has been used in asia as traditional treatment for diabetes mellitus. Here we report 12 year old Saudi who is diagnosed as diabetes mellitus type 1. The pumpkin was fed once or twice daily. His blood HBA1C dropped from 10.8% to 8.5% within 2 months of onset of pumpkin introduction. Studies in our detailed literature review showed that pumpkin extract has positive effects on glycemic control and pancreatic β cells; however, most of the studies were done on animals and human study are needed in this field

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DOES PUMPKIN AFFECT GLYCEMIC CONTROL IN DIABETIC PATIENT. CASE
REPORT AND LITERATURE REVIEW
*Dr. Badi Alenazi, Dr. Asma Deeb, Amal Alrowaili, Abeer Alkhaldi and Muneerah alanazi
Article Received on 28/06/2017 Article Revised on 18/07/2017 Article Accepted on 08/08/2017
INTRODUCTION
diabetes mellitus is a metabolic disorder characterized by
chronic hyperglycemia due to defects in insulin
secretion, insulin action, or both. Diabetes can be
classified into two broad categories (type 1 diabetes,
which is characterized by an absolute deficiency of
insulin secretion; or type 2 diabetes, which results from a
combination of resistance to insulin action and an
inadequate compensatory insulin secretory response.
For many years, Cucurbita ficifolia (Cucurbitaceae)
known as pumpkin was used for management of diabetes
mellitus as traditional therapy in Asia.[1] however, the
mechanisms of antidiabetic action of this plant are
unknown.[2]
We presented a case report of diabetic child who had
mild improvement in glycemic control within two
months of pumpkin intake.
CASE REPORT
A 12 year old Saudi boy who is known case as diabetes
mellitus type one for one year. He was presented initially
with history of polyuria and polydepsaia and weight loss.
His initial HbA1C was 14 .4 upon admission. He was on
multiple daily injection (basal/bolus regimen) at total
daily dose of 1 unit /Kg/day. He was followed up
regularly in diabetes clinic. During follow up no noticed
improvement in spite of good compliance. He was a
product of term pregnancy and delivered by normal
spontaneous vaginal delivery. There was no
consanguinity between parents.
Vaccination was up to date. Developmental parameters
were appropriate for age. He was on family diet and not
on strict diabetic diet with average appetite.
On examination he was not dysmorphic, weight, height,
were at 25, 25 percentile respectively. Examination of
chest and cardiovascular system were normal. There was
no hepatosplenomegaly, no skin changes. Child had
normal muscle tone and power. No goiter and injection
site were not hypertrophied nor atrophied.
Investigations showed Hemoglobin 13.6g dl, white blood
cell (WBC) 8.9 x103/ L, Serum urea and electrolytes,
Liver function and Bone profile were normal. Celiac
disease profile was negative. Thyroid function test was
within normal range. Glutamic acid decarboxylase
antibodies were positive.
In october and november 2016 The family began to feed
him about 200 gram of pumpkin on daily basis up on
what they heard from the media. Raw pumpkin is placed
in the blender and administered before meals once or
twice daily. Every outpatient visit, Random blood sugar
and HBA1c have to be done prior to appointment. The
home blood glucose was monitored daily for two months
and we asked patient family to register quantity of
pumpkin consumed in meals for one month. By
comparing rates of blood sugar and HBA1c before and
after eating pumpkin. A mild improvement was noticed
after pumpkin introduction as shown in Table 1.
However, in February 2017. The child stopped eating
pumpkin. The last HbA1c was 11.3%. it done on 10 may
2017.
SJIF Impact Factor 4.161
Case Report
ISSN 2394-3211
EJPMR
EUROPEAN JOURNAL OF PHARMACEUTICAL
AND MEDICAL RESEARCH
www.ejpmr.com
ejpmr, 2017,4(9), 42-45.
*Corresponding Author: Dr. Badi Alenazi
Al Yamamah Hospital, Riyadh.
Mail ID: badi1300@gmail.com
ABSTRACT
Pumpkin was reported to have hypoglycemic effect. It has been used in asia as traditional treatment for diabetes
mellitus. Here we report 12 year old Saudi who is diagnosed as diabetes mellitus type 1. The pumpkin was fed once
or twice daily. His blood HBA1C dropped from 10.8% to 8.5% within 2 months of onset of pumpkin introduction.
Studies in our detailed literature review showed that pumpkin extract has positive effects on glycemic control and
pancreatic β cells; however, most of the studies were done on animals and human study are needed in this field.
KEYWARDS: Pumpkin, diabetes mellitus. Cucurbita ficifolia, Trigonelline.

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Table 1: home glucose reading and HBA1c before and after pumpkin introduction.
14-3-2016
admission
28-3-2016
outpatient visit
Before pumpkin
18-4-2016
outpatient visit
Before pumpkin
22-8-2016
outpatient visit
Before pumpkin
12-12-2016
outpatient visit
2 months after pumpkin
HbA1c
14.4
12
11.7
10.8
8.5
Random blood sugar
(hospital lab)
343 mg /dl
234 mg /dl
345 mg /dl
198 mg /dl
117 mg /dl
Average home
Prebreakfast
Blood glucose
265mg/dl
278 mg /dl
329 mg /dl
206 mg /dl
85 mg /dl
Average home
Pre lunch
Blood glucose
128mg/dl
308 mg /dl
109 mg /dl
188 mg /dl
123 mg /dl
Average home
Pre dinner
Blood glucose
480 mg /dl
132 mg /dl
87 mg /dl
112 mg /dl
166 mg /dl
DISCUSSION
Cucurbita ficifolia contain water (94%), fiber (3%),
vitamin B1 (0.03mg), calcium (17 mg), iron (0.6 mg),
and vitamin C (7 mg).[3] The chemicals within pumpkins,
which have hypoglycemic properties include
polysaccharides from the fruit pulp, oil from
ungerminated seeds and protein from germinated
seeds.[4,5,6]
Alloxan is an oxygenated pyrimidine derivative, which is
a toxic glucose analog and selectively destroys
pancreatic insulin-producing cells when administered to
animal species As a consequence, IDDM (Alloxan
Diabetes) is induced with resultant characteristics similar
to type 1 diabetes in humans.[7]
Yongjun Zhang et al. conducted a study to examine the
impact of the polysaccharide (PCE-CC) extracted from
the pumpkin on diabetic rabbits. The notion behind this
study was to observe the efficiency of PCE-CC on
reducing Blood Glucose (BG), Triglyceride (TG), Total
Cholesterol (TC) and Glycosylated Hemoglobin
(HbA1c) in diabetic rabbits. In addition, they also
wanted to examine the PCE-CC’s impact on the pancreas
islet cells. The subjects were rabbits female and male, the
rabbits were divided into 4 groups 6 rabbits each. The
first group was healthy rabbits and the rest of them were
injected with alloxan. The findings showed that the PCE-
CC had effective results on diabetic rabbits. The group
who was consuming PCE-CC had the most significant
decrease in the BG, TG, TC and HbA1c levels compared
to the negative group (diabetic), which had increased in
the BG, TG, TC and HbA1C levels. Moreover, The
impaired Pancreas in the alloxan-induced diabetic rabbits
was restored after consuming PCE-CC doses, which
concludes that islet cells could be regenerated due to the
PCE-CC consumption. Also, the PCE-CC group had
increased in body weight in contrast to the negative
group.[8]
Shuang Wang et al. conducted a study to test the
polysaccharide (PPs) impact on Blood Glucose (BG),
fasting serum insulin and hepatic glycogen and islet
cells. The subjects were male normal and alloxan-
induced diabetic mice, separated to 10 groups 5 mice
each. The results showed that the PPs had significant
lowering effects on BG in mice. Moreover, the
researchers observed the significant increase of liver-
glycogen and insulin level in alloxan-induced mice that
consumed PPs. Finally, researchers believe PPs could
regenerate pancreatic islet cells.[9]
Hui Jin et al. conducted a study to examine the
antidiabetic extraction from the pumpkin on mice. The
purpose of the study was to extract the polysaccharides
(PCE) from pumpkin powder then other chemicals were
extracted and purified. After extracting polysaccharides
from pumpkin powder, researchers purified PCE and
yield seven effective components (PCE- A, PCE-B,
PCE-C, PCE-D, PCE-E, PCE-F and PCE-G) in order to
inject them in the subjects. The mice were young adult
(male and female) normal and alloxan-induced diabetic,
they were separated in 20 groups, 10 mice in each. The
blood test was measured before and 4, 7 and 11 hours
after the injections. The finding showed that PCE with
dose 200mg/kg BW had significant effects on BG in
normal and diabetic mice. Moreover, PCE-C and PCE-F
both had an effective impact on BG level in both normal
and diabetic mice after 7 hours, however, the PCE-F kept
the low BG level after 11 hours.[10]
Orie YOSHINARI et al. experimented the impact of
pumpkin components especially Trigonelline (TRG) and
Nicotinic Acid (NA) on non-obese type 2 diabetic
(T2DM) rats. The researchers did two experiments, one
for pumpkin paste effects, and the other one was for
TRG and NA effects. They tested the subject’s glucose
tolerance, insulin resistance and the hemoglobin A1c,
insulin, fasting glucose and adipocytokine levels. The
subjects were male rats. They were divided into two
groups and five each in the first experiment, the second
they were three groups and six each. The finding showed
that pumpkin paste, TRG and NA had significant effects
on glucose tolerance in T2D rats and reduced HbA1c
levels. However, the TRG had more effective results
than NA. Moreover, both TRG and NA had positive

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effects on triglyceride. They concluded that TRG and
NA might have decreased the development of diabetic in
rats.[11]
R. Sharmin et al. conducted a study to examine the
impact of cucumber, white pumpkin, and ridge gourd
extractson Fasting Blood Glucose (FBG) and Lipid
Profile in diabetic rats. The subjects were female rats
divided into 6 groups, 5 of them were Alloxan induced
diabetic rats. The results showed that the cucumber,
white pumpkin, and ridge gourd extractions had positive
effects on FBG. The cucumber extraction had the most
significant effect on lowering blood sugar than the white
pumpkin. On the other hand, white pumpkin extraction
had the most significant effects on both total cholesterol
(TC) and serum triglyceride (TG). Moreover, the
cucumber extraction reduced the serum low-density
lipoprotein (LDL) efficiently first, then the pumpkin
extraction reduced it too. In conclusion, the researchers
believe that the cucumber, white pumpkin, and ridge
gourd extraction have a positive impact on FBG and
Lipid Profile. Also, they suggested adding these
extractions as natural treatments alongside the diabetes
treatment.[12]
Mohamed Makni et al. conducted a study to examine the
effects of flax seeds and pumpkin seeds on Alloxan
induced diabetes rats. The researchers tested the blood
glucose, insulin level and the Pancreases tissues. The
subjects were male rats divided into 3 groups. The results
showed that the rats which were fed the flax and
pumpkin seed mixture diet (DMS) had an excellent
decrease in blood glucose compared to the rats fed the
regular diet (DD). Moreover, the observation of the
Pancreatic tissues showed that the DMS tissues were
regenerated and were similar to the normal tissues. In
conclusion, the flax and pumpkin seeds have significant
effects on Pancreatic tissues, in addition to reducing
blood glucose in rats (3).
Zhiguo Jiang and Qizhen Du conducted a study to
understand the effects of Tetrasaccharide
Glyceroglycolipids from the pumpkin on decreasing
blood glucose. The subjects were mice divided into 5
groups. They extracted QGMG-2 and QGMG-3 from
Tetrasaccharide Glyceroglycolipids then they injected
them in Streptozotocin- and high fat diet-induced
diabetic mice. The results revealed that both QGMG-2
and QGMG-3 had an impact on lowering blood glucose.
However, QCMG-3 had a stronger impact on blood
glucose due to its chemical structure.[13]
LI QUANHONG et al. conducted a study to observe the
impact of the protein-bound polysaccharide (PBPP)
obtained by water extraction from pumpkin fruits on
Alloxan-induced diabetic rats. The subjects were divided
into 5 groups. The finding presented that the PBPP had a
major impact on lowering blood glucose. Moreover, this
study showed that having big doses of PBPP is more
effective.[14]
ZHU Hong-Yan et al. conducted a study to observe the
polysaccharides (PP) mechanism in protecting Pancreatic
islet cells from Streptozotocin (STZ). The researchers
removed the pancreas of the rats then they filtered the
islet cells and divide them into six groups. The groups
were a control group, negative group, positive group and
the rest were induced with (STZ) and treated with
different doses from PP. The results showed that STZ
toxicity could eliminate islet cell, however, the PP could
mostly protect the islet cell from these damage.[15]
IN CONCLUSION
Our case case demonstrate mild positive impact on
glycemic control over 2 months of eating daily pumpkin.
however, Studies showed that pumpkin extract has
positive effects on glycemic control and pancreatic β
cells; however, most of the studies were done on
animals. Due to the limited number of available studies,
more research, especially human study, are needed in
this field.
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