A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes

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Introduction
The diabetes is one of the leading health problem in the world.
There are 425 million people around the world who have been
suffering from diabetes in 2017. The Chinese population has the
highest number of diabetic patients amounting to 114.4 million
individuals suffering from the disease. India has the second largest
number of diabetic patients, which are 72.9 million individuals during
2015. There has been around 50% increase in the diabetic patients in
India between 2005-2015. Diabetes is also a major health problem in
the USA, which consists of the third largest population (32.2 million)
of diabetic patients.1
The diabetic is a metabolic disorder characterized by
hyperglycaemia and glucose intolerance. The malfunctioning of
pancreas is the major cause of this metabolic disorder. This may be
due to lack of insulin production, defective insulin action or both.
The diabetes is four types depending on the aetiology and clinical
presentation. The insulin dependent diabetes mellitus (IDDM, Type
I) and non-insulin dependent diabetes mellitus (NIDDM, Type II).
The other types of diabetes include gestational diabetes, and other
specic types.2 The type I diabetes (IDDM) is an autoimmune disease
produced due to the destruction of β-cells of islets of Langerhans by the
body’s T lymphocytes leading to local inammation and suppression
of insulin secretion and this needs insulin replacement therapy.3 It is
more common in children than adults and has genetic predisposition
and its incidence is on the rise.4 Type II diabetes is characterized by
development of peripheral insulin resistance and impaired secretions
of insulin by pancreas. It is more prevalent than type I. The individuals
suffering from type II diabetes suffers from the intermediate stages
of impaired fasting glucose and impaired glucose tolerance and
therefore it is also known as prediabetes. Obesity is one of the leading
causes of development of type-II diabetes and 90% of the diabetic
patients belong to this category.5 The diabetes is the sixteenth leading
cause of mortality worldwide.6 Diabetes is characterized by blurred
visions, fatigue, hunger, excess thirst, polyurea and weight loss in the
diabetic patients.7,8 Several treatment modalities are available for the
treatment of both type I and II diabetes in the modern medicine. The
diabetes leads to various other disorders including, cardiomyopathies,
nephrotoxicity, neuropathy, cerebrovascular disorders and wound
healing disorders.9 The global burden of treatment cost of diabetes
is very high and alternative systems of medicine provide treatment
choices to diabetic patients. The ancient system of medicine, the
Ayurveda has also described its treatment and I am going to focus on
the use of Jamun, Syzygium cumini in the treatment of diabetes.
Jamun characteristics
Jamun, Syzygium cumini belongs to Family: Myrtaceae and is
also known as Eugenia cumini Druce; Eugenia caryophyllifolia
Lam., Eugenia jambolana Lam., Eugenia djouat Perr., Syzygium
caryophyllifolium (Lam.) DC., Syzygium jambolana (Lam.)
DC., Syzygium jambolanum DC, Calyptranthes oneillii Lundell,
Calyptranthes jambolana Willd. and Myrtus cumini L. (Figure 1). It is
an indigenous plant to Indian subcontinent and it is commonly grows in
India, Bangladesh, Ceylon, Pakistan, and Myanmar. Jamun is a rapidly
growing tree, which is 100 feet tall and start fruiting in summer.10,11
The fruits are produced in clusters and each cluster consists of a few
to 10 or 40 fruits. Jamun fruits are round to oblong in shape and 1/2
to 2” long (Figure 1). The Jamun fruits are green coloured and turns
from light to dark purple or even black after ripening.10,11 Their taste
is sweetish sour and eating of Jamun fruits makes the tongue purple.
The other names of Jamun are Indian blackberry, black plum, Duhat
Jambu, Jaman, Jambul, Jambool, Java plum, Portuguese or Malabar
plum.12,13 Jamun has several benecial effects on many ailments.11
Despite this fact, Jamun may have some adverse effects, if eaten in
excess or during certain conditions. Since it lowers blood sugar, it
should be avoided before one week and a minimum of two weeks after
surgery as it may have adverse effect on healing. Eating of Jamun
empty stomach and also after drinking of milk may produce adverse
effect. Breast feeding mothers and pregnant women should not eat
Jamun. Eating of Jamun in excess amount may lead to cough, sputum
accumulation in lungs, body ache and fever.11
Int J Complement Alt Med. 2018;11(2):91‒95 91
© 2018 Jagetia. This is an open access article distributed under the terms of the Creative Commons Attribution License, which
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A review on the role of jamun, syzygium cumini
skeels in the treatment of diabetes
Volume 11 Issue 2 - 2018
Ganesh Chandra Jagetia
Hiran Magri, India
Correspondence: Ganesh Chandra Jagetia, 10, Maharana
Pratap Colony, Sector-13, Hiran Magri,
Udaipur-313002, India, Email: gc.jagetia@gmail.com
Received: March 31, 2018 | Published: April 11, 2018
Abstract
The diabetes has been increasing throughout the globe with an alarming rate due to
lifestyle changes and it has become a global burden requiring attention of the most
populated countries, where its incidence is ever increasing. There are two major type
of diabetes type I which is an autoimmune disorder where the T lymphocytes are
involved in the destruction of β-cells of the pancreas and it has genetic predisposition.
Type I diabetes is quite common in the children and young population. The Type
II diabetes is highly prevalent and 90% of the world’s population is suffering from
this disease. It is due to obesity and development of peripheral resistance to insulin
accompanied by a malfunctioning pancreas. Several treatment options are available
for the treatment of diabetes in modern medicine, which are aimed to control the blood
sugar level. This review describes the use of different parts of Jamun, Syzygium cumini
in the treatment of diabetes to control blood sugar and cholesterol levels. In different
study systems
Keywords: Diabetes, Jamun, blood sugar, mice, rat, human
International Journal of Complementary & Alternative Medicine
Review Article Open Access

A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes 92
Copyright:
©2018 Jagetia
Citation: Jagetia GC. A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes. Int J Complement Alt Med. 2018;11(2):91‒95.
DOI: 10.15406/ijcam.2018.11.00374
Jamun as antidiabetic agent
Antidiabetic effect of Jamun has been indicated in Ayurvedic
pharmacopeia, which states that the seed powder of Jamun is effective
in controlling high blood sugar levels (Figure 1). Jamun has been
used to control blood sugar levels for more than 130 years in West
however, clinical studies are mixed results. Some of the patients
had shown control of blood sugar levels after they have been put on
Jamun therapy indicating a good response to the treatment, whereas
others did not show any improvement after the treatment.14 The
hypoglycaemic effect of different parts of Jamun to control diabetes
in preclinical models have been investigated by several investigators
who have shown that Jamun alleviates blood sugar levels (Table 1).
These preclinical studies are with mixed results as a few studies have
been negative where no hypoglycaemic effect of jamun was observed
in alloxan-induced diabetic rats.15 However, majority of the preclinical
reports have indicated that different parts of Jamun reduced blood
sugar levels in rodent models of diabetes and clinical setting. The
seed powder extracted in water has been shown to reduce blood sugar
level in diabetic rabbits.16 The administration of aqueous seed extract
of Jamun at a dose of 1 g/kg b. wt. in diabetic rats has been reported
to produce hypoglycaemic effect in the blood.17 Likewise, numerous
other studies on aqueous seed extract has been found to reduce blood
sugar in the diabetic rats.18–20 The lyophilized powder of aqueous
seed extract has been reported to decrease the blood glucose level
in diabetic mice and rats.21,22 Similarly, aqueous Jamun seed extract
consisting of gummy bres has been highly effective in controlling
diabetes in alloxan induced diabetes in rats. However, in contrast,
the aqueous extract devoid of gummy bre did not have any effect
ion blood sugar level.23 The alloxan-induced diabetic rats and rabbits
administered with ethanol extract of Jamun seeds showed a decline
in fasting blood glucose levels in an earlier study.24 Likewise, The
Jamun seed kernel extracted in ethanol reduced the blood glucose
level in the streptozotocin-induced diabetic rats and also restored
the activities of catalase, glutathione peroxidase and superoxide
dismutase enzymes accompanied by restoration of glutathione
concentration in liver and kidney of diabetic rats.25 Administration
of various doses of Jamun seed powder into streptozotocin-induced
diabetic rats has shown an attrition in the fasting glucose level.26
Likewise, treatment of streptozotocin-induced diabetic rats with
100mg/kg b. wt. seed kernel ethanol extract reduced the blood sugar
level, urea and cholesterol and led to a rise in the glucose tolerance
and decreased the glutamate oxaloacetate transaminase and glutamate
pyruvate transaminase activities.27 An alleviation in the blood glucose
level in the streptozotocin-induced diabetic rats have been reported
after treatment with mycaminose isolated from Jamun and ethyl
acetate and methanol extracts of Jamun seeds in an earlier study.28
The treatment of alloxan-induced diabetic mice and rats with Jamun
seed methanol extract has been reported to alleviate serum glucose
level earlier.29,30 The administration of ethanol extract of Jamun seeds
depleted the blood serum glucose levels in the streptozotocin induced
diabetic rats in some other studies.31,32 The sephadex gel separated of
active principles from the ethanol fraction of seed extract of Jamun
has been reported to decline the serum glucose level in the of alloxan-
induced mild and severe diabetes in rats.33 The administration of
streptozotocin-induced type –II diabetic rats with 400 mg/kg aqueous
Jamun seed extract of has been found to bring the glucose level to
almost normal level and it also increased the expression of PPARγ
and PPARα proteins in the rat liver.34 The aqueous Jamun seed extract
has been reported to decrease serum glucose levels in the alloxan-
induced diabetes in mice.35 Supplementation of Jamun seed powder
in human diabetic subject for 30 days reduced the fasting and post
prandial blood glucose levels.36 The aqueous and methanol extracts
of root, stem bark, leaf and seed extracts of Jamun has been reported
to lower serum glucose levels in alloxan-induced diabetes in male
Sprague Dawley rats.37 Recently, the administration of ethanol extract
of Jamun seeds and fruits for 60 days reduced serum glucose level in
hyperglycaemic/diabetic rats and the former was more effective than
the latter.38 In a study conducted on 60 Type -II diabetic individuals
who were given Jamun seed powder in different forms for 60 days
showed a signicant reduction in the serum blood glucose and relief
from the symptoms including fatigue, polyurea and tiredness.39 In a
double blinded control clinical trial, feeding of 10g of Jamun seed
powder up to 90 days to diabetic patients reduced the fasting blood
glucose levels by 9%, 18%, and 30% and post prandial glucose by
8%, 15%, and 22% after 30, 60, and 90 days, respectively.40
Table 1 The hypoglycaemic effect of different extracts of jamun, Syzygium
cumini in preclinical and clinical setting
S. No. Parts
used
Extract
type Species Reference
1 Seed
Aqueous
Powder
Rabbit
Rat
Mice
Humans
16
15, 17-
20,23,24,34
22,35
36,39,40
Ethanol Rat & Rabbit
Humans
25-28,31-33
38
Ethyl
acetate
Methanol
Rat and mice 29,30,37
2 Fruit Aqueous Rat 41-43
Methanol 44
3 Stem Ethanol Rat 37,45,46
4 Leaf Aqueous Humans 47
Ethanol Rat 48
Many studies conducted on the fruit pulp have also been found
effective in treating diabetes in rodent model of diabetes. The
treatment of streptozotocin-induced diabetic rats with the lyophilized
fruit pulp extract of Jamun did not deplete higher blood sugar levels
in a Brazilian study,41 whereas both aqueous and ethanol extracts of
Jamun fruit pulp did lower the blood glucose in the alloxan-induced
diabetic rats and the aqueous extract was superior than the ethanol
extract.42 The aqueous Jamun fruit pulp extract has also been reported
to lower the serum glucose level in streptozotocin-induced diabetes
female Wistar rats however, the combination of Jamun fruit extract
with the stem bark extract of Cinnamon zeylanicum was more effective
than the either treatment alone.43 The methanol extract of Jamun fruit
(pulp, seed, seed coat and kernel has been found to produce higher
antidiabetic effect recently.44
Apart from the seed and fruit, the extract of stem bark of Jamun
(Figure 1) was also found to be effective in reducing the blood glucose
levels in spontaneous diabetic rats.45 The ethanol extract of Jamun
bark has been also found to reduce blood glucose levels in rats.46 The
aqueous leaf extract of Jamun alleviated the adenosine deaminase

A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes 93
Copyright:
©2018 Jagetia
Citation: Jagetia GC. A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes. Int J Complement Alt Med. 2018;11(2):91‒95.
DOI: 10.15406/ijcam.2018.11.00374
activity and glucose level in the serum of diabetic patients.47 A recent
study on the oral administration of ethanol leaf extract of 100mg/kg b.
wt. of Jamun has been found to reduce insulin resistance and attenuate
the blood glucose level in dexamethasone-induced diabetes in rats.48
Figure 1 The images of various parts of jamun. Upper left: Jamun tree; Upper
right: Fruits; Lower left: Seeds and Lower right: Leaves.
Jamun as antihyperlipidemic agent
The diabetes is usually associated with hyperlipidaemia (high
cholesterol level) a consequence of insulin-resistant metabolic
disarray, which is the main cause of cardiovascular disorder. Use of
different parts of Jamun has been studied for their ability to attenuate
blood cholesterol in different systems (Table 2). The seed extract
of Jamun has been shown to cause an alleviation in the total serum
cholesterol (TC)/high density lipoprotein cholesterol (HDL-c) ratio,
amount of serum low density lipoprotein cholesterol (LDL-c) and the
activity of HMG-CoA reductase in alloxan-induced diabetic rabbits.24
The ethanol extract of Jamun seed kernel has been found to reduce
the (Low Density Lipoproteins) LDL and VLDL cholesterol levels
in streptozotocin-induced diabetic rats, which was accompanied
by an elevation in the HDL cholesterol.27 The aqueous Jamun fruit
pulp extract has been reported to attenuate triglycerides and total
cholesterol levels and elevate the HDL cholesterol level in the
streptozotocin-induced diabetic rats.43 The active principles isolated
by passing ethanol seed extract fraction of Jamun on sephadex gel
did decrease triglycerides and total cholesterol and raised the HDL
cholesterol level in the alloxan-induced diabetic rats.33 In another study
in mice the aqueous seed extract of Jamun has been found to reduce
the hyperlipidaemic effect after alloxan treatment as indicated by the
decline in the level of triglycerides and total cholesterol to normal level
accompanied by a rise in the HDL cholesterol.35 The ethanol extract of
seeds and fruits of Jamun has been found to reduce the higher levels
of triglycerides and LDL and increase the HDL cholesterol in rats fed
with high cholesterol diet.38 A study on human subject who were given
seed powder for 60 days showed hypocholesterolemic effect.
Table 2 The hypolipidemic effect of different extracts of jamun, Syzygium
cumini in preclinical models
S. No. Parts used Extract type Species Reference
1 Leaf Aqueous Humans
Rat
47
37
2 Seed Aqueous Rabbit 24
Ethanol Rat
Mice
27,33,38
35
3 Fruit Aquoeus Rat 42,
Ethanol Rat 38,43
Mice 35
The exact mechanism of action of Jamun in lowering the blood
sugar and cholesterol level is not known. The Jamun may have
employed several putative mechanisms to bring out its effects (Figure
2). The diabetes is triggered by induction of free radicals. Jamun may
have reduced free radicals and improved the functioning of β-cells of
pancreas reducing the sugar level. Jamun also stimulates the activation
of different enzymes like catalase glutathione peroxidase, glutathione-
s-transferase and increased synthesis of glutathione and depletes lipid
peroxidation that may have also helped to reduce the sugar cholesterol
levels in the blood. Jamun may have reduced the activity of α-amylase,
which is upregulated in the diabetes. The α-amylase activity has been
found to be reduced by Jamun.44,49,50 At molecular level presence
of Jamun may have upregulated the PPARγ and PPARα leading to
the suppressed activation of transcription factors including NF-κB,
nitric oxide synthase (iNOS), tumour necrosis factor-alpha (TNF-α)
and cyclooxygenases causing reduced inammation and protection
against diabetes and hyperlipidaemia. Apart from this Jamun may
have also upregulated the transcription of Nrf2 leading to increase in
the antioxidants that may have resulted in the proper functioning of
β-cells of pancreas.
Figure 2 Antidiabetic action of Jamun

A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes 94
Copyright:
©2018 Jagetia
Citation: Jagetia GC. A review on the role of jamun, syzygium cumini skeels in the treatment of diabetes. Int J Complement Alt Med. 2018;11(2):91‒95.
DOI: 10.15406/ijcam.2018.11.00374
Conclusions
The Jamun, Syzygium cumini belonging to family Myrtaceae
has been used in traditional medicine for treatment of diabetes.
The hypoglycaemic and hypolipidemic activities of Jamun may
be due scavenging of free radicals as diabetes is caused by excess
oxidative stress, elevated activities of catalase glutathione peroxidase,
glutathione-s-transferase and increased synthesis of glutathione
coupled with reduced lipid peroxidation. Jamun may have activated
PPARγ and PPARα genes that suppressed the transcription of NF-κB,
COX, iNOS, TNF- α and other inammatory cytokines followed by
the upregulation of Nrf2. However, there is need to systematically
evaluate the molecular mechanisms of action of Jamun in various
study systems.
Acknowledgment
None
Conict of interest
Author declares there is no conict of interest.
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DOI: 10.15406/ijcam.2018.11.00374
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