Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals

Abstract

The effect of cinnamon doses on blood serum glucose was studied in type 2 diabetic individuals for 60 days. Sixty type 2 diabetic individuals of both sexes and of age 48�6.5 years were divided into 6 groups; each group was having 10 individuals. Groups 1, 2 and 3 were assigned for 1g, 3g and 6g cinnamon doses/day respectively. Groups 4, 5 and 6 were assigned for 1g, 3g and 6g placebo doses/day respectively. The doses were equally distributed over the day. Cinnamon and placebo were given in the form of capsules with breakfast, lunch and dinner. The doses were given for 40 days and after 40 days; there was a 20 days blank period. Fasting blood samples were taken on days 0 (starting day of the experiment) 20, 40 and 60 and blood serums were separated. The blood serum glucose of both the cinnamon and placebo groups were determined. The mean fasting serum glucose levels for cinnamon doses on days 0, 20, 40 and 60 were 208.7, 189.1, 156.5 and 176.6 mg/dl for 1 g cinnamon dose/day; 206.2, 178.4, 170.3 and 177.8 mg/dl for 3 g cinnamon dose/day and 233.9, 183.2, 166.4 and 205.7 mg/dl for 6 g cinnamon dose/day respectively. The cinnamon doses significantly (P<0.05) reduced the mean fasting serum glucose levels while the placebo doses did not affect the serum glucose levels. In the light of this research, it is recommended that Type 2 diabetic individuals should use 1-3g cinnamon in their food preparations on regular basis. They can use cinnamon shakers for sprinkling of cinnamon powder on the curry in the plate. They can prepare cinnamon tea without sugar and can use it after meals. Also they can chew cinnamon bark after meals. This will keep their sugar level near to normal values.

Full text

Pakistan Journal of Nutrition 3 (5): 268-272, 2004
© Asian Network for Scientific Information, 2004
This project was funded by University Grants Commission/NWFP Agricultural University, Peshawar, Pakistan
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Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals1
Mahpara Safdar, Alam Khan, Muhammad Muzaffar Ali Khan Khattak and Mohammad Siddique
Department of Human Nutrition, NWFP Agricultural University, Peshawar, Pakistan
Abstract: The effect of cinnamon doses on blood serum glucose was studied in type 2 diabetic individuals
for 60 days. Sixty type 2 diabetic individuals of both sexes and of age 48±6.5 years were divided into 6 groups;
each group was having 10 individuals. Groups 1, 2 and 3 were assigned for 1g, 3g and 6g cinnamon
doses/day respectively. Groups 4, 5 and 6 were assigned for 1g, 3g and 6g placebo doses/day respectively.
The doses were equally distributed over the day. Cinnamon and placebo were given in the form of capsules
with breakfast, lunch and dinner. The doses were given for 40 days and after 40 days; there was a 20 days
blank period. Fasting blood samples were taken on days 0 (starting day of the experiment) 20, 40 and 60 and
blood serums were separated. The blood serum glucose of both the cinnamon and placebo groups were
determined. The mean fasting serum glucose levels for cinnamon doses on days 0, 20, 40 and 60 were
208.7, 189.1, 156.5 and 176.6 mg/dl for 1 g cinnamon dose/day; 206.2, 178.4, 170.3 and 177.8 mg/dl for 3
g cinnamon dose/day and 233.9, 183.2, 166.4 and 205.7 mg/dl for 6 g cinnamon dose/day respectively. The
cinnamon doses significantly (P<0.05) reduced the mean fasting serum glucose levels while the placebo
doses did not affect the serum glucose levels. In the light of this research, it is recommended that Type 2
diabetic individuals should use 1-3g cinnamon in their food preparations on regular basis. They can use
cinnamon shakers for sprinkling of cinnamon powder on the curry in the plate. They can prepare cinnamon
tea without sugar and can use it after meals. Also they can chew cinnamon bark after meals. This will keep
their sugar level near to normal values.
Key words: Cinnamon, blood glucose, diabetic
Introduction
Diabetes mellitus is a chronic disorder of glucose
metabolism resulting from dysfunction of pancreatic-
beta cells and insulin resistance. It is still a serious
health problem all over the world. Because the disease
prevails in both genders and all age groups so, the
general public has a concern about its control and
treatment.
Natural products like spices have been used for taste
and flavor development in food preparations. Some
spices have an additional benefit of having role in
carbohydrate metabolism (Khan et al., 1990 ). Marles
and Farnsworth (Marles and Fransworth, 1994) have
reported that one- to two-thirds of the 1123 plants that
affect blood glucose may be dangerous, and many of the
phytochemicals are hypoglycemic due to metabolic or
hepatic toxicity. However, medicinal plants have been
used for diabetes safely and with reasonable success
(Marles and Fransworth, 1994; Duke et al., 1998).
Botanical products can improve glucose metabolism
and over all condition of persons with diabetes not only
by hypoglycemic effect but also by improving lipid
metabolism, antioxidant status, and capillary function
(Broadhurst, 1997). A number of medicinal/culinary
herbs have been reported to yield hypoglycemic effects
in subjects with diabetes. These include cinnamon,
cloves, bay leaves, turmeric (Khan et al., 1990), bitter
melon (Srivastava et al., 1993; Raman and Lau, 1996),
gurmar (Basakaran et al., 1990; Shanmugasundaram et
al., 1990; Bishayee and Chatterjee, 1994), Korean
ginseng (Sotaniemi et al., 1995), onions and garlic
(Koch and Lawson, 1996), holy basil (Rai et al., 1997),
and flaxseed meal (Cunnane et al., 1993).
(Broadhurst et al.,2000) re-evaluated the extract of
cinnamon on insulin function in the insulin-dependent
utilization of glucose using a rat epiddymal adipocyte
assay . Cinnamon was the most bioactive product. The
glucose oxidation enhancing bioactivity was lost from
cinnamon by polyvinylpyrrolidone (PVP) treatment,
indicating that the active phytochemical were likely to be
phenolic in nature. They concluded that the extract of
cinnamon had improved the glucose and insulin
metabolism.
Khan et al., 1990 isolated an unidentified factor from
cinnamon and termed this factor as insulin potentiating
factor (IPF). They demonstrated that IPF increased the
activity of insulin 3 fold in glucose metabolism in rat
epididymal fat cells. (Anderson et al., 2001)
characterized this unidentified factor present in
cinnamon as methyl hydroxy chalcone polymers
(MHCP). They reported that MHCP found in cinnamon
increased insulin dependent glucose metabolism
roughly 20 fold in vitro. They explained that MHCP made
fat cells more responsive to insulin by activating the

Mahpara et al.: Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals
269
enzyme that causes insulin to bind to cells (insulin-dinner respectively. The individuals were told to take the
receptor-kinase) and inhibiting the enzyme that blocks
this process (insulin-receptor-phosphatase) leading to
maximal phosphorylation of the insulin receptor, which
is associated with increased insulin sensitivity.
However, those studies were conducted in vitro. There
is a general view that the results of animal studies may
not be applied to human. Therefore, this study was
designed to see the effect of cinnamon on blood
glucose in Type 2 diabetic individuals.
Materials and Methods
Location, sample size and criteria for registration of
the study: The study was conducted in the department
of Human Nutrition, NWFP Agricultural University
Peshawar, Pakistan. Sixty type 2 diabetic individuals of
both sexes and of age 40 years or older, who were
residing in Peshawar city and its vicinity, were registered
for the study. These diabetic individuals were registered
at different times and at different locations, because
diabetics were not available at one time. Only those
diabetic subjects, who were not on insulin therapy, were
not taking medicine for other health conditions and
whose fasting blood glucose were in the range of 140-
400mg/dl, were included in the study.
Preparation of cinnamon and placebo capsules:
Cinnamon and wheat flour were used for the preparation
of cinnamon and placebo capsules. The required
amount of cinnamon and wheat flour were purchased
from the local market and ground finely. The ground
cinnamon and wheat flour were given to Mehran
Traders, Pharmaceutical Suppliers, Khalid Market,
Charsadda Road, Peshawar for preparation of the
capsules. Capsules were prepared and each capsule
was having 500mg of cinnamon or wheat flour.
Packages of 40 (1g or 2 capsules/day for 20 days), 120
(3g or 6 capsules/day for 20 days) and 240 (6g or 12
capsules/day for 20 days) of both the cinnamon and
placebo capsules were prepared in plastic bags.
Protocol of the study: The study was conducted for 60
days. The 60 type 2 diabetic individuals were divided into
6 groups. Each group was having 10 individuals. Groups
1, 2 and 3 were assigned to cinnamon and groups 4, 5
and 6 were assigned to placebo. The individuals were
allowed to take their routine diet and usual diabetic
medicine. Groups 1, 2 and 3 were given 1g, 3g and 6g
cinnamon/day respectively for 40 days. From day 41 to
60, no dose of cinnamon was given. On similar pattern,
1g, 3g and 6g placebo/day were given to groups 4, 5 and
6 respectively for 40 days. The 1g doses of cinnamon
and placebo were spread over the day as 0.5g (1
capsule) at the time of lunch and 0.5g (1 capsule) at the
time of dinner. The 3g and 6g doses of cinnamon and
placebo were spread over the day as 1g (2 capsules)
and 2g (4 capsules) at the time of breakfast, lunch and
capsules immediate after breakfast and meals.
Collection of blood samples and biochemical analysis
Approximately 5ml fasting blood samples were taken
from each individual on day 0, 20, 40 and 60. Blood
samples were transferred to sterilized centrifuge tubes
and allowed for clotting at room temperature. The blood
samples were centrifuged for 10 minutes in a centrifuge
at 4000 rpm for serum separation. Serum samples were
stored in freezer at 0 ºC for later analysis of glucose.
These tests were done in the Main Laboratory, Hayat
Abad Medical Complex by using auto analyzer (Express
plus, Ciba corning USA).
Determination of Glucose: Glucose was determined by
the enzymatic calorimetric method of Trinder (Trinder,
1969). Auto analyzer (Express plus, Ciba corning USA)
and Elitech kit were used. In this method, the enzymatic
reaction is in two steps. In the first step, glucose is
oxidized to gluconic acid and hydrogen peroxide in the
presence of glucose oxidase enzyme. In the second
step, red quinone is formed in the presence of
peroxidase enzyme. The absorbance of this colored
substance is taken and the concentration of glucose is
calculated.
The enzymatic reactions are as follow:
Reagents:
Reagent 1:
Phosphate buffer, pH 7.40 100 mmol/l
Phenol 10 mmol/l
Reagent 2:
Glucose oxidase > 10 000 U/l
Peroxidase > 600 U/l
4-Amino antipyrine 270 µmol/l
Sample:
Serum free of hemolysis
Procedure: The working reagent was prepared by
dissolving reagent 2 in reagent 1. This working reagent
is stable for 1 month at 20-25 ºC and for 3 months at 2-8
ºC. The reagent reservoir was kept in the auto analyzer
chamber. The wavelength was adjusted at 546 nm and
the temperature was set at 37 ºC. Cuvette of 1cm light
path was used. Before using the auto analyzer, it was
calibrated and both normal and abnormal control ranges
were given. If the sample reading falls between these
two ranges and the auto analyzer shows the current
calibration, then it is in a position to work properly and to
give accurate results. 10 µl sample and 300 µl working
reagent was sucked and mixed automatically and the
analyzer gave the optical density (OD) after a short
incubation period.

Mahpara et al.: Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals
270
Table 1: Effects of Different Doses of Cinnamon on Blood Glucose
Group* of Diabetics Doses of Cinnamon (g/day) Mean Fasting Blood Glucose (mg/dl)**
---------------------------------------------------------------------------
Before Cinnamon Intake After Cinnamon Intake
1 1 208.7 172.8
a a
2 3 206.2 174.4
a a
3 6 233.9 174.8
a a
* = 10 individuals in each group, **= The figures in column No. 4 are the average of values on days 20 and 40. Means followed by
different letters in rows are significantly different at P < 0.05 as determined by analysis of variance and LSD test.
Fig. 1: Effect of cinnamon on blood glucose in diabetic mean fasting blood values of the diabetic individuals of
individuals the same groups at the start of the experiment (day 0).
Calculations: individuals of all the 3 groups were significantly (P<0.05)
Factor = n / OD lower, when they used cinnamon doses for 40 days,
n = Standard concentration than when they used cinnamon doses for 20 days,
n = 100 mg/dL showing that longer use of cinnamon was more
Glucose concentration = OD sample x factor beneficial than shorter use of cinnamon.
The calculations were done automatically. It should be pointed out that 40 days consumption of
Statistical Analysis: Two- way Analysis of Variance and therapy and many diabetic individuals may not like such
Randomized Complete Block Design was used forlong treatment. Cinnamon is not a medicine but a spice
statistical analysis (MSTAT-C). and is used in food preparations for flavor and taste. So
Results and Discussion
Effect of cinnamon on blood glucose: The effect of
various doses of cinnamon on the blood glucose levels
of diabetic individual is given in Fig. 1. The glucose
values on day 0 in Table 1 indicate the fasting blood
glucose of diabetic individuals before the start of
cinnamon capsules. So these glucose levels were
control values for the study.
On the starting day of the experiment (day 0), the mean
fasting blood glucose levels of the diabetic individuals of
the 3 groups, assigned for 1g, 3g and 6g cinnamon
dose/day, were 208.7 mg/dl, 206.2 mg/dl and 233.9
mg/dl respectively. When the diabetic individuals of
these groups used 1g, 3g and 6g cinnamon doses/day
for 20 days, their mean fasting blood glucose level
dropped to 189.1 mg/dl, 178.4 mg/dl and 183.2 mg/dl
respectively. The data demonstrated that cinnamon
doses had reduced the mean fasting blood glucose
level in all the 3 groups. However, this reduction in
glucose levels was not statistically significant (P<0.05)
from the mean fasting blood glucose values on day 0.
This was perhaps due to the large variability in the blood
glucose levels of individuals in each group (Table 1).
When the same individuals of the same groups used
1g, 3g and 6g cinnamon doses/day for another 20 days
(total 40 days), their mean fasting blood glucose further
dropped to 156.5 mg/dl, 170.3 mg/dl and 166.4 mg/dl
respectively. Consumption of the various doses of
cinnamon for 40 days significantly (P <0.05) lowered the
mean fasting blood glucose levels of diabetic individual
of all the 3 groups of cinnamon as compared to the
The mean fasting blood glucose levels of diabetic
cinnamon for treatment of diabetes is really a lengthy
it is a part of food and one would not be tired of its use.
The hypoglycemic effect of cinnamon is an additional
benefit of cinnamon and is particularly important for type
2 diabetic individuals. In the light of this research, it is
recommended that diabetic individuals should use
cinnamon in their food preparations on regular basis.
They can use cinnamon shakers for sprinkling of
cinnamon powder on the curry in the plate. They can
prepare cinnamon tea without sugar and can use it after
meals. Also they can chew cinnamon bark after meals.
This will keep their sugar level near to normal values.
The mean fasting blood glucose levels of the diabetic

Mahpara et al.: Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals
271
Fig. 2: Effect of placebo on blood glucose in diabetic
individuals
individuals of all the 3 groups on day 60 (when they were
not using cinnamon for the last 20 days) were 174.6
mg/dl, 177.8 mg/dl and 205.7 mg/dl respectively. The
mean fasting blood glucose levels of the diabetic
individuals of all the 3 groups on day 60 were
significantly lower (P<0.05) than the mean fasting blood
glucose levels of the diabetic individuals of all the 3
groups on day 0, but were non-significantly higher than
the mean fasting blood glucose levels of the diabetic
individuals of the 3 groups on days 20 and 40. This trend
was justified as cinnamon was potentiating the function
of insulin in carbohydrate metabolism and when
cinnamon was not present, then insulin was not
oxidizing glucose at the same rate as it was oxidizing it
in the presence of cinnamon. Khan et al., 1990 has
reported that an unidentified factor is present in
cinnamon that potentiates the action of insulin in
carbohydrate metabolism. They termed this factor as
insulin potentiating factor (IPF). Broadhurst et al., 2000
reconfirmed the presence of this factor in cinnamon.
This hypoglycemic effect of cinnamon may or may not be
like other hypoglycemic drugs.
The gradual increase in the mean fasting blood glucose
levels of the individuals, who were not taking cinnamon
doses for the last 20 days, indicated that cinnamon had
lasting hypoglycemic effect in diabetic individuals. The
cinnamon dose might have introduced some
biochemical change at the cellular level and as a result
the mean fasting blood glucose did not rise to the level
where it was at the start of the experiment (day 0). We
are not sure yet, but it seems that cinnamon might have
brought some biochemical/physiological changes in the
sites of resistance to insulin, transfer of glucose through
cell membrane, enzyme system of carbohydrate
metabolism and receptor sites. If the assumption of the
authors, that the biochemical/physiological changes in
the sites of resistance to insulin or other parameter is
true, then a permanent cure for diabetes mellitus is
present in cinnamon therapy.
Symptoms of insulin resistance include a decreased
stimulation of muscle glycogen synthesis, defects in
glycogen synthase activity, hexokinase activity and
glucose uptake (Cline et al., 1999). In addition, altered
enzymatic activities, such as an increased phosphatase
activity and/or seryl phosphorylation of the insulin
receptor substrate by glycogen synthase kinase 3 (GSK-
3), have also been shown to be involved in some cases
of type 2 diabetes mellitus (Begum et al., 1991; Nadiv et
al., 1994; Eldar and Krebs, 1997).
Dephosphorylation of the receptor $-subunit is
associated with the deactivation of its kinase activity and
therefore is associated with insulin signal down-
regulation (King et al., 1991). Jarvill-Taylor, et al., 2001
concluded from their study that methylehydroxy chalcone
polymers (MHCP) was an effective mimetic of insulin.
MHCP might be useful in the treatment of insulin
resistance and in the study of the pathways leading to
glucose utilization in cells.
Cinnamon extracts have also been shown to improve
insulin receptor function by activating insulin receptor
kinase and inhibiting insulin receptor phosphatase,
leading to increase insulin sensitivity (Imparl-
Radosevich et al., 1998). Khan et al., 1990 isolated an
insulin-potentiating factor (IPF) from cinnamon. This
unidentified factor increased the activity of insulin 3 fold
in glucose metabolism in rat epididymal rat fat cell.
Anderson et al., 2001 characterized this unidentified
factor present in cinnamon as methylehydroxy chalcone
polymers (MHCP). They explained that MHCP made fat
cells more responsive to insulin by activating the enzyme
that causes insulin to bind to cells (insulin-receptor-
kinase) and inhibiting the enzyme that blocks this
process (insulin-receptor-phosphatase) leading to
maximal phosphorylation of the insulin receptor, which
is associated with increased insulin sensitivity.
To verify that the drop in the mean fasting blood glucose
level was not due to psychological effect of the cinnamon
capsules, a parallel placebo trial where placebo
capsules were given to the groups of diabetic individuals
in the pattern of cinnamon trial. Blood samples were
collected and analyzed. The doses of placebo did not
affect the glucose level (Fig. 2).
The effect of different cinnamon doses on the mean
fasting blood glucose is given in Table 1. There was no
significant effect of cinnamon doses on the
concentration of glucose in type 2 diabetic individuals.
This indicated that small doses of cinnamon like 1-

Mahpara et al.: Effect of Various Doses of Cinnamon on Blood Glucose in Diabetic Individuals
272
3g/day were as good as 6g/day in reduction of glucoseJarvill-Taylor, K.J., R.A. Anderson and D.J. Graves, 2001.
level in diabetic individuals. The usual addition of
cinnamon as a spice to food preparations was sufficient
for the additional benefit of reducing glucose level in
diabetic individuals.
References
Anderson, R.A., C.L. Broadhurst, M.M. Polansky, W.F.
Schmidt, A. Khan, N.W. Schoene and D.J. Graves,
2001. Isolation and characterization of chalcone
polymers from cinnamon with insulin like biological
activities. Manuscript in preparation, 2001.
Basakaran, K., B.K. Ahmath, K.R. Shanmugasundaram
and E.R.B. Shanmugasundaram, 1990. Antidiabetic
effect of a leaf extract from Gymnema sylvestre in
non-insulin dependent diabetes mellitus patients.
J. Ethnopharm., 30: 295-305.
Begum, N., K.E. Sussman and B. Draznin, 1991.
Differential effects of diabetes on adipocyte and liver
phosphotyrosine and phosphoserine phosphatase
activities. Diabetes, 40: 1620-1629.
Bishayee, A. and M. Chatterjee, 1994. Hypolipidaemic
and antiastherosclerotic effects of oral Gymnema
sylvestre R. Br. Leaf extract in albino rats fed a high
fat diet. Phytother. Res., 8: 118-120.
Broadhurst, C.L., 1997. Nutrition and non-insulin
dependent diabetes from an anthropological
perspective. Alt. Med. Rev., 2: 378-399.
Broadhurst, C.L., M.M. Polansky and R.A. Anderson,
2000. Insulin-like biological activity of culinary and
medicinal plants aqueous extracts in vitro. J. Agri.
Food Chem., 48: 849-852.
Cline, G.W., K.F. Oetersen, M. Krssak, J. Shen, R.S.
Hundal, Z. Trajanoski, S. Inzucchi, A. Dresner, D.L.
Rothman and G.I. Shulman, 1999. Impaired
glucose transport as a cause of decreased insulin-
stimulated muscle glycogen synthesis in Type 2
diabetes. N. Engl. J. Med., 341: 240-245.
Cunnane, S.C., S. Ganguli, C. Menard, A.C. Liede, M.J.
Hamadeh, Z.-Y. Chen, T.M.S. Wolever and D.J.
Jenkins, 1993. A. High a-linoleic flaxseed (Linum
usitaissimum): some nutritional properties. Br. J.
Nutr., 69: 443-453.
Duke, J.A., S. Beckstrom-Sternberg and C. L.
Broadhurst, 1998. U.S. Department of Agriculture
Phytochemical and Ethnobotanical Data Base,
http://www.ars-grin.gov/~ngrlsb/.
Eldar-Finkelman, H. and E.G. Krebs, 1997.
Phosphorylation of insulin receptor substrate-1 by
glycogen synthase kinase 3 impairs insulin action.
Proc. Natl. Acad. Sci. USA, 94: 9660-9664.
Imparl-Radosevich, J., S. Deas, M.M. Polansky, D.A.
Baedke, T.S. Ingebrutsen, R.A. Anderson and D.J.
Graves, 1998. Regulation of phosphotyrosine
phosphatase (PTP-1) and insulin receptor kinase by
fractions from cinnamon: implications for cinnamon
regulation of insulin signaling. Hormone Res., 50:
177-182.
A hydroxy chalcone derived from cinnamon functions
as a mimetic for insulin in 3T3-L1 adipocytes. J.
ACN. 20: 327-336.
Khan, A., N.A. Bryden, M.M. Polansky and R.A. Anderson,
1990. Insulin potentiating factor and chromium
content of selected foods and spices. Bio. Trace.
Element Res., 24: 183-188.
King, M.J., R.P. Sharmr and G.J. Sale, 1991. Site-specific
dephosphorylation and deactivation of the human
insulin receptor tyrosine kinase by particulate and
soluble phosphotyrosyl protein phosphatases.
Biochem. J., 275: 413-418.
Koch, H.P. and L.D. Lawson, 1996. Garlic: The Science
and Therapeutic Application of Allium sativum L.
Related Species; Williams and Wilkins: Baltimore,
M.D.
Marles, R.J. and N.R. Fransworth, 1994. Plants as
sources of antidiabetic agents. Econ. Med. Plant
Res., 6: 149-187.
MSTAT-C with MGRAPH, Russell D. Freed, MSTAT
Director, Crop and Soil Sciences Department,
Michigan State University, Version 2.00.
Nadiv, O., M. Shinitzke, H. Manu, D. Hecht, C.T. Roberts,
D. LeRoith and Y. Zick, 1994. Elevated protein
tyrosine phosphatase activity and increased
membrane viscosity are associated with impaired
activation of the insulin receptor kinase in old rats.
Biochem. J., 298: 443-450.
Rai, V., U.V. Mani and U.M. Iyer, 1997. Effect of Ocimum
sanctum leaf powder on blood lipoproteins, glycated
proteins, and total amino acids in patients with non-
insulin dependent diabetes mellitus. J. Nutr.
Environ. Med., 7: 113-118.
Raman, A. and C. Lau, 1996. Antidiabetic properties and
phytochemistry of Momordica chantaria L.
(Cucurbitaceae). Phytomedicine, 2: 349-362.
Shanmugasundaram, E.R.B., G. Rageswari, K.
Baskaran, K.K. Rajesh Kumar and B.K. Ahmath,
1990. Use of Gymnema sylvestre leaf extract in the
control of blood glucose in insulin dependent
diabetes mellitus. J. Ethnopharm., 30: 281-294.
Sotaniemi, E.A., E. Haapakoski and A. Rautio, 1995.
Ginseng therapy in non-insulin dependent diabetic
patients. Diabetes Care, 18: 1373-1375.
Srivastava, Y., H. Venkatakrishna-Bhatt, Y. Verma, K.
Venkaiah and B.H. Raval, 1993. Antidiabetic and
adaptogenic properties of Momordica charantia
extract: an experimental and clinical evaluation.
Phytother. Res., 7: 285-289.
Trinder, P., 1969. Ann. Clin. Biochem., 6: 24.