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1
Federal School of Medical Laboratory Science, Jos-Nigeria.
*Corresponding author: E-mail: uchejesoobeta@gmail.com;
Chapter 6
Print ISBN: 978-93-90516-25-4, eBook ISBN: 978-93-90516-33-9
Bitter Kola (Garcinia kola) as Herbal Remedy for
Diabetes
Nkereuwem S. Etukudoh
1
, Obeta M. Uchejeso
1*
and Ibanga I. Etim
1
DOI:
10.9734/bpi/ctmamr/v12/6013D
ABSTRACT
Bitter Kola (Garcinia kola) is highly valued in Herbal / African folk medicine because of its varied and
numerous uses which are social, economic and medicinal, thus making it an essential ingredient in
African medicine. The study reviews some related literature on the action of bitter kola on diabetes.
Medicinal plants such as Bitter kola are believed to be an important source of kolavirons and
flavonoids as phytochemical components with potential therapeutic benefits for diabetes and other
ailments. Bitter kola has antiinflammatory, analgesic, molluscidal, anti-atherogenic, antioxidant and
hepatoprotective properties and should not be totally ignored in medical conditions including diabetes.
From our published work, the serum glucose concentration of treated diabetic rats was significantly
reduced (P > 0.05) compared to the serum glucose concentration of untreated diabetic rats and that
of the controls. The reduced serum glucose concentration and that of concentrations of the lipid profile
parameters attributed to the anti-diabetic and anti-hyperlipidemic activities of the bitter kola seed
extract. The reduced glucose concentration could be due to the activity of bitter kola seed extract
against inflammation and reactive oxygen species (ROS) of free radical on the pancreatic beta cells.
This chapter shall be useful to researchers interested in authenticating the hidden truth which has not
been scientifically validated about bitter kola especially with regards to diabetes.
Keywords: Bitter kola; diabetes; herbal medicine.
1. INTRODUCTION
Garcinia kola, is generally known as Bitter Kola which belongs to the family Clusiacea or Guttiferae. It
can be grown using the seed cultivation and or with cuttings to a medium size and up to about 12m in
height. It can easily grow by the cutting method in the farm. The Bitter Kola seed is smooth and
elliptically shaped, with yellow pulp and brown seed coat (Fig. 1). Biter kola is highly valued in African
folk medicine because of its varied and numerous uses which are social, economic and medicinal,
thus making it an essential ingredient in African medicine. Medicinal plants such as Bitter kola are
believed to be an important source of flavonoids and chemical substances with potential therapeutic
benefits [1,2]. Ibanga etal., [1] described diabetes mellitus in line with WHO [3] as the commonest
endocrine disorder known to humans with estimate of 135 million people in the world affected with
diabetes currently and that it would rise to 380 million by 2025. WHO’s report also pointed out that low
and middle income countries shall increase the number with Africa contributing significantly to the
rise. Diabetes causes multi-organ complications that ultimately affect every system of the body with
an increased risk of coronary heart disease just like iron overload [4].
Not minding whether, type-1, type-2 or gestational diabetes; diabetes is associated with increased
glucose level in the blood of which the total cure has been a mirage. No wonder this Chapter as a
means to seeing a cure alternative from the conventional management drugs.
Current Topics in Medicine and Medical Research Vol. 12
Bitter Kola (Garcinia kola) as Herbal Remedy for Diabetes
62
2. BITTER KOLA AND PHYTOCHEMICAL COMPONENTS
Several studies have been carried out on the phytochemical components of Garcinia kola. Such
studies have shown that Garcinia kola contains alkaloids, saponins, tannins, flavonoids, glycosides,
sterols and phenols. The major constituents of the plant are kolaviron, garcinia biflavonoid (GB-1a-
glucoside, GB-1a, GB-1, GB-2), kolaflavonone, benzophenone, xanthone, coumarin, apigenin,
quercetin, and garcinoic acid [5-9].
Fig. 1. Bitter kola seed bought from Nsukka-Nigeria
Hexadecanoic acid, 9-octadecanoic acid, methyl ester, linoleic acid, heptadecane-(8)-carbonic acid,
formaldehyde, N, N-Diethyl, n-tetradecanoic acid amide; 3,4,8-trimethyl-2-nonenal were gotten from
the seed of Garcinia kola. Carbohydrates were separated from the seed. The mineral composition
of G. kola seeds extracts was also reported [10]. The seed contain enormous amount of potassium
and phosphorus. Other constituents include ash, crude protein, crude fiber, crude lipid, water-soluble
oxalate, terpenoids, and fat [11].
Gas-liquid chromatography and High-Performance Liquid Chromatography was used to study these
phytochemical contents of Garcinia kola. The seed oil was found to contain fatty acid and amino acid
derivatives, namely meristic, pentadecanoic, margaric, transpalmitoleic, cisvaccenic, cisoleic,
cislinoleic, α-linolenic, threonine, tyrosine, methionine, serine, histidine and alanine [12,13].
The medicinal importance of bitter kola is based mainly on the photochemical components of the
plants. Some of these components isolated include: oleoresin, tannin, saponins, and alkaloids. Other
components isolated from bitter kola seeds are bioflavonoid such as kola flavanone, and
hydroxyflavonoids. Bitter kola is highly valued in African ethnic medicine because of its varied and
numerous social and medicinal uses, thus making it an essential ingredient in folk medicine. Herbal
Medicine has been advocated as a major contributor to cure of many ailments [14] and Bitter kola is
believed to be an important source of flavonoids and chemical substances with potential therapeutic
benefits especially in treatment of diabetes [1].
3. COMPONENTS THAT CONTRIBUTE TO SUGAR AND LIPID REDUCTION
On chewing, bitter kola, the seed has a bitter astringent and resinous taste, somewhat resembling that
of raw coffee, followed by a slight sweetness. It can be deduced that bitter astringent properties may
be due to the presence of tannin. Garcinia kola can be said to possess several pharmacological
activities such as antiinflammatory, analgesic, molluscidal, anti-atherogenic, antioxidant and
hepatoprotective properties, which have been attributed to some of its phytochemical compositions
[12].
Current Topics in Medicine and Medical Research Vol. 12
Bitter Kola (Garcinia kola) as Herbal Remedy for Diabetes
63
Ekor, [15] points to the ability of kolaviron to regulate the blood glucose level in the rats better than GB
for the 3 weeks duration of their study. It is known that for every 1% drop in HbA
1c
value may lead to
35% reduction in the risk of microvascular complications, including myocardial infarction in type 2
diabetes [16].
The serum glucose concentration of treated diabetic rats was significantly reduced (P > 0.05)
compared to the serum glucose concentration of untreated diabetic rats and that of the controls. The
reduced serum glucose concentration could be attributed to the anti-diabetic and anti-hyperlipidemic
activities of the bitter kola seed extract. The reduced glucose concentration was due to the activity of
bitter kola seed extract against inflammation and reactive oxygen species (ROS) of free radical on the
pancreatic beta cells. Same study showed that the total cholesterol concentration of the treated
diabetic rats did not show significant increase (P < 0.05) but the values were significantly increased
(P<0.05) compared to the controls. Also, the TC concentration of the untreated diabetic rats was
significantly increased (P < 0.05) compared to the treated diabetic rats. There was significant increase
(P < 0.05) in the HDL-C concentrations of the controls compared to the treated diabetic rats. The
HDL-C has the ability to promote cholesterol efflux from cells, have reduced antioxidative and
vasorelaxant properties. There was increase in TG concentration of the untreated diabetic rats
compared to the treated diabetic rats. This increase is as a result of decrease adipose tissue and
muscle lipoprotein lipase activity in the liver and higher VLDLC-C production by the liver and their
decreased clearance. There was a marked decrease in the LDL-C concentration of the treated
diabetic rats compared to the untreated diabetic rats. The decrease in LDL-C and increase in HDL-C
demonstrates the effectiveness of the bitter kola seed extract against inflammation and reactive
oxygen species (ROS) of the free radicals [1].
4. ENCOURAGEMENT OF HERBAL REMEDIES IN DIABETIC MANAGEMENT
Medicinal plants play an important roles in the therapeutic exploits by humans. According to the
world health organization [17] over 80% of the world’s population, mostly in poor and less developed
countries depend on traditional medicines for their daily health care.
Historically, plants have proved to be a source of inspiration for the discovery of novel drug
compounds, as plant-based medicines have made tremendous contributions to human health and
well-being. In recent time, there was increased pharmacological evaluation of medicinal plants that
could be of benefit as diabetic cure herbs.
Globally, ethnopharmacology and drug discovery using plant-based products remain a pivot point in
health care delivery. Garcinia kola is considered a wonder plant as every part of it is of medicinal
importance. The plant is used in folklore remedies for the treatment of various ailments such as liver
disorder, diarrhea, laryngitis, bronchitis and gonorrhea. Extracts from the bark of the plant are also
used in traditional medicine for treatment of liver cirrhosis and hepatitis [18]. Given the enormous
relevance of G. kola in folkloric medicine, the present review focuses on the current experimental
research covering the phytochemistry, pharmacology and therapeutic studies on G. kola toward
identification of further research gaps.
Though, there is paucity of definitive and consistent data on efficacy and knowledge of exact
mechanism of actions of many herbal medicines helpful in the treatment of diabetes in Africa, India,
China and other countries of the world. Researchers [19,20] listed herbal / botanical products that
help in management of diabetes to include: Bitter lemon (Monodica charantia), Fenugreek (Trigonella
foenum-gracem), Gymnema or Gurmarin (Gymnema sylvestre), Hoodia (Hoodia gordonii), Prickly
pear cactus (Opuntia spp), Ginseng (Panax spp.), Cinnamon (Cinnamon cassia, verum and others),
Russian tarragon (Artermisia dracunculus L.), Garlic (Allivium sativum), Ginkgo (Ginkgo biloba), Ivy
gourd, and Aloe vera. The above listed products excluded bitter kola (Garcinia kola) of which this
chapter dwells more on the kola knowing that the mechanism of action to control diabetes may be as
a result of the inhibition of alpha glucosidase from two sources just like the acarbose [21].
Current Topics in Medicine and Medical Research Vol. 12
Bitter Kola (Garcinia kola) as Herbal Remedy for Diabetes
64
5. CONVENTIONAL AND NON-CONVENTIONAL APPROACH TO DIABETES
MANAGEMENT
Modern medicine has failed to reduce or prevent the rapid increase in Cardio-Metabolic Disorders
(CMDs) worldwide. According to experts at NIH/USA, the disease driven approach to healthcare, has
resulted in high costs, as well as an unreliable health system. Current Diagnostic methodologies
identify “at risk” patients at a point that is too late, to account for the damage already caused by
underlying pathologies. For instance, considering the type-2 diabetes (T2D) detection, monitoring
standards such as HbA1c, fasting blood glucose, help in identifying altered glucose metabolism in
circulating blood. However, using these markers would result in providing just palliative treatment of
the disease and its symptoms, whereas, the damage already done is not reversible. Non-traditional
approaches to the management of health care, which is called the integrative approach, emphasizes
prevention, health maintenance and early intervention, and utilizes all appropriate evidence-based
and personalized therapeutic approaches, to achieve optimal health and wellbeing across one’s
lifespan [22-24]. However, Developing Nations and resource poor countries bear much greater
economic burden in view of greater prevalence of this chronic metabolic disease. According the
International Diabetes Federation, 387 million people have diabetes worldwide; by 2035 this number
will rise to 592 million. The number of people with type-2 diabetes is increasing in every country. In
the Global Diabetic population, greater than 75% of Type-2 diabetes subjects live in resource poor
countries. The greatest numbers of patients with diabetes are between 40 and 59 years of age. Close
to 200 million people with diabetes are undiagnosed [25]. With over 65 million diabetics and an equal
number of pre-diabetics, Vascular complications related to diabetes accounts for the majority of
economic burden worldwide. About one half of the diabetics die prematurely due to cardiovascular
complications and a tenth due to renal failure. In spite of the fact that there is an increase in the
incidence of this disease worldwide, the major share of the morbidity and mortality is predicted to
occur in the resource poor countries [26]. Although these risks are modifiable or preventable, there
are very little efforts in progress in majority of the developing countries, to monitor or control them.
Globally, the generalised method for the detection of diabetes is measurement of fasting blood
glucose or impaired glucose metabolism or glycated hemoglobin (HbA1c). In developing countries,
there is no organized surveillance program or effective management programs for these cardio-
metabolic disorders. For instance in a country like India, which is considered the diabetes capital of
the world, there is no national platform to address these chronic diseases. In addition, in the absence
of health insurance, people do not go for regular annual checkups. Therefore, by the time they
discover that they have diabetes or impaired glucose tolerance/insulin resistance, they will have
already had considerable irreversible vascular damage. Therefore, we need to start management and
prevention of this disease with better maternal nutrition. We also need to address the nutrition of the
neonates as well as the adolescents. In addition, we need to find out the mechanisms by which
excess blood glucose and insulin levels modulate the patho-physiology and function of blood vessels.
Therefore, it is worthwhile to develop novel management strategies to prevent or reduce macro-
vascular complications [27] and such is not far from examining various herbs especially bitter kola.
6. CONCLUSION AND RECOMMENDATION
This Chapter discusses the use of bitter kola as part of practices regarding the use of medicinal plants
and traditional medicines in the management of diabetes. The chapter do not discourage the use of
bitter kola either alone or in with conventional medicines for the treatment and management of
diabetes and related diseases. Most of the traditional medicines were plant products that were
affordable and widely available locally. Although bitter kola as a traditional medicine have potential
benefits, we are not aware of its adverse effects. Some researchers have agreed on the use of herbal
products for management of various ailments [28-30] There is currently limited knowledge of the
physiological effects of most of the traditional medicines [31], bitter kola inclusive but further studies
can assess whether bitter kola has harmful effects as we generally eat it and also uses it to entertain
guests in our locality.
The chapter has shown that bitter kola (Garcinia kola) is no doubt a potential medicinal plant that
cannot be ignored in the management and treatment of diabetes with the exposition of the
phytochemical compositions that makes Garcinia kola very useful in the Pharmaceutical and Medical
Current Topics in Medicine and Medical Research Vol. 12
Bitter Kola (Garcinia kola) as Herbal Remedy for Diabetes
65
science to make drugs that can prevent and cure various diseases, diabetes as an example.
Research into herbal medicine had made great impact in the development of numerous
pharmaceutical products and drugs in the healthcare industry. This chapter shall be useful to
researchers interested in authenticating the hidden truth which has not been scientifically validated
about bitter kola.
COMPETING INTERESTS
Authors have declared that no competing interests exist.
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Biography of author(s)
Nkereuwem S. Etukudoh
Federal School of Medical Laboratory Science, Jos-Nigeria.
Research and Academic Experience: PhD Medical Physiology in Reproductive Endocrinology from the prestigious University
of Ibadan-Nigeria; Fellow, West African Post-Graduate College of Medical Laboratory Science (FWAPCMLS); Fellow Medical
Laboratory Science Council of Nigeria (FMLSCN) in Haematolgy / Blood Group Serology; MSc. Medical Physiology and
Associate of Institute of Medical Laboratory Science (AIMLS) in Chemical Pathology.
Research Area: Reproductive Endocrinology, Medical Laboratory Science, Medical Physiology, Chemical Pathology,
Heamatology and Blood Transfusion Science
Number of Published papers: Has published 20 peer reviewed articles in both International and Local Journals.
Special Award (If any): He has several awards and recognitions: Paul Harris Fellow, Rotary Club International; Ambassador
for Peace; Justice for Peace; Distinguished Fellow, University of Calabar Students Union; Distinguished Fellow, West Africa
Student Union; Patron, Interstate Drivers Association of Nigeria
Any other remarkable point(s): He is the Provost / CEO of Federal School of Medical Laboratory Science, Jos-Nigeria who
contributed immensely to the legalization and improvement of training of the institution. He has made a useful input towards
good regulation of Medical Laboratory Science Council of Nigeria (MLSCN) as a former Acting Registrar of the council.
Obeta M. Uchejeso
Federal School of Medical Laboratory Science, Jos-Nigeria.
Research and Academic Experience: MSc. Human Physiology (Endocrinology); Master of Public Administration [MPA];
Fellow of Chartered Institute of Human Resources Management [FCIHRM]; Nigeria; Bachelor of Medical Laboratory Science
[BMLS] with option in Chemical Pathology; Associate Member of Medical Laboratory Science Council of Nigeria [AMLSCN] and
Higher National Diploma [HND] in Physiology/Pharmacology.
Research Area: Reproductive Endocrinology, Medical Laboratory Science, Medicinal Plants, Human Resources Management
and Health Institutions Quality Improvement.
Number of Published papers: He has 55 reviewed articles in both International and Local Journals to his credit in the
research areas.
Special Award (If any): Member, Chartered Institute of Productivity and Quality Management [MCPQM]; Member, Institute of
Professional Managers and Administrators of Nigeria [MIPMA]; Member, International Association of Public Health Logisticians
[MIAPHL]; Member, African Society for Laboratory Medicine [MASLM].
Any other remarkable point(s): He is the Head, Department of Medical Laboratory Management, Federal School of Medical
Laboratory Science, Jos and has contributed to the development of the Department and quality training of the Institution.
Current Topics in Medicine and Medical Research Vol. 12
Bitter Kola (Garcinia kola) as Herbal Remedy for Diabetes
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Ibanga I. Etim
Federal School of Medical Laboratory Science, Jos-Nigeria.
Research and Academic Experience: He researches in Chemical Pathology and Endocrinology.
He has MSc. in Chemical Pathology, Postgraduate Diploma (PGD) in Chemical Pathology, Associate Medical Laboratory
Science Council of Nigeria (AMLSCN) and BSc. in Chemistry.
Research Area: Endocrinology, Diabetes management, Lipid metabolism and Carcinogenesis.
Number of Published papers: 18 published papers
Any other remarkable point(s): He is the Head of Department, Chemical Pathology, Federal School of Medical Laboratory
Science, Jos-Nigeria. He is a Laboratory Quality Manager and Laboratory Safety Expert. He is equally a Microsoft and CISCO
Certified Engineer.
_________________________________________________________________________________
© Copyright (2021): Author(s). The licensee is the publisher (Book Publisher International).
DISCLAIMER
This chapter is an extended version of the article published by the same author(s) in the following journal.
Journal of Biosciences and Medicines, 8:127-134,2020.
