Background: Type 2 diabetes mellitus results from defects in insulin secretion and/or insulin action or both.
Objectives: The present study was conducted to investigate the hypoglycemic effects of Allium cepa in patients with type 2 diabetes mellitus. &nbsp;
Results: In type 2 diabetic patients (n=21) the administration of crude Allium cepa (100g) markedly reduced fasting blood glucose levels by 40 mg/dl 4 hours later, compared to glibenclamide (81 mg/dl). Also Allium cepa significantly reduced the induced hyperglycemia (GTT) after ingestion of 75 grams dextrose by 159 mg/dl in the test subgroup (n=7) of type 2 diabetic patients to a point below that produced in the negative control group after 4 hours.
Conclusion: Crude Allium cepa produced hypoglycemic effects, thus it could be used as a dietary supplement in management of diabetes

Ahmed, Elhadi M.

HM, Abd Elwahab

Taj Eldin, Imad M.

English

Journals Of University Of Gezira

EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2)   CLINICAL HYPOGLYCEMIC EFFECTS OF ALLIUM CEPA (RED ONION) IN TYPE 2 DIABETIC PATIENTS  Imad M. Taj Eldin 1* , Elhadi M. Ahmed 2 , &  Abd Elwahab HM 3 1. Department of Pharmacology, Faculty of Pharmacy, University of Gezira, Sudan. * Corresponding author. 2. Department of Chemistry and Pharmacognosy, Faculty of Pharmacy, University of Gezira, Sudan 3. Department of Pharmacology and Toxicology, Medicinal and Aromatic Plant Research Institute, National Center for Research, Sudan.   ABSTRACT Background: Type 2 diabetes mellitus results from defects in insulin secretion and/or insulin action or both. Objectives: The present study was conducted to investigate the hypoglycemic effects of Allium cepa in patients with type 2 diabetes mellitus.   Results: In type 2 diabetic patients (n=21) the administration of crude Allium cepa (100g) markedly reduced fasting blood glucose levels by 40 mg/dl 4 hours later, compared to glibenclamide (81 mg/dl). Also Allium cepa significantly reduced the induced hyperglycemia (GTT) after ingestion of 75 grams dextrose by 159 mg/dl in the test subgroup (n=7) of type 2 diabetic patients to a point below that produced in the negative control group after 4 hours. Conclusion: Crude Allium cepa produced hypoglycemic effects, thus it could be used as a dietary supplement in management of diabetes.  Key words: Allium cepa, hypoglycemia, type 2 diabetes EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2)  INTRODUCTION   Diabetes mellitus is generally classified into 3 classifications: type 1, type 2 and gestational (occurring during pregnancy).[1] The chronic hyperglycemia that characterized type 2 diabetes mellitus results from both defects in insulin secretion, insulin action or both coupled with resistance to the effects of insulin.[2] Some of patients with type 2 diabetes are obese. Indeed, obesity itself, in particular central adiposity, can confer some degree of insulin resistance.[3] Although the hyperglycemia symptoms of type 2 diabetes tend to develop gradually, patients with chronically elevated blood glucose levels are at increased risk of developing micro-and macrovascular complications. Nevertheless, the risk of developing complications can be reduced significantly through tight glycemic control.[5] In some patients, glycemic control can be achieved with weight reduction, exercise and/or antidiabetic agents that promote insulin secretion or lower insulin resistance.[1] Over time, however, the beta-cell function of most patients will progressively decline, requiring treatment with combination therapy consisting of oral agents and/or exogenous insulin.[4] Plants remedies are the mainstay of treatment in underdeveloped regions and may provide valuable clues for the development of new oral hypoglycemic agents.[6-8] This has caused an increase in the number of experimental and clinical investigations towards the validation of the antidiabetic properties which empirically attributed to these remedies. Over 400 traditional plant treatments for diabetes have been reported, although a small number of these have received scientific and medical evaluation to assess their efficacy and safety.[9] Of these, ginseng species, Momordica Charantia (Bitter Melon), cloves, cinnamon, Trigonella foenum graecum (Fenugreek) and Allium cepa (onion) have been used for taste and flavour development in food preparations.[10]  The use of plants especially vegetables by the population as antidiabetic remedies have added interest of joining two basic diabetes mellitus control factors: food and medication. [6-8] Plants from the genus Allium, particularly onions (Allium cepa) have been consumed for their putative nutritional and health benefits for centuries.[11-14]  reports indicated that Allium cepa is rich in sulphides, flavonoids and cysteine phytoconstituents which were known to have hypoglycemic, hypocholesterolemic and antibacterial potentials,[15-17] and antioxidant activity with beneficial effects on cardiovascular and immune systems, inflammatory conditions and cancer prevention.[18-20] The present study was conducted to investigate the hypoglycemic effects of Allium cepa in patients with type 2 diabetes mellitus.   EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2) MATERIAL AND METHODS  Ethical approval  The ethical approval for this study was obtained from the Ethical Committee/ University of Gezira/ Gezira State, Ministry of Health, Wad Medani-Sudan. Consent forms were signed by participants, being interested in joining the study completely voluntary bearing in mind that Allium cepa is safe vegetable especially in the administered dose. Plant material Fresh and recently cropped Allium cepa harvested at the optimal maturity was purchased from the local market in Wad Medani city, Central Sudan. The fresh onion was cut into small slices to be taken orally by type 2 diabetic patients. Criteria for selecting patients For patients with type 2 diabetes mellitus, the following criteria of selection were considered: age ≤ 50 years, the duration of diabetes was between 2-5 years. Patients who are taking medicines for other health condition, taking vitamins or other supplements, smoking or consuming alcohol and those suffering from any of diabetes complications were excluded from the study. Type 2 diabetic patients Two groups of type 2 diabetic patients were used in this clinical trial to assess the hypoglycaemic effects of Allium cepa. Participants of the first group (n=21) of both sexes were subjected to fasting blood glucose levels determination and subdivided into three subgroups each consisted of 7 registered patients. Subgroup I participants were considered as negative control and received drinking water, while those in subgroup II were administered standard positive control treatment of glibenclamide (5mg). Subgroup III received 100g of the crude fresh slices of Allium cepa as a test or investigational group.   2.2.6.3 Determination of fasting blood glucose levels in type 2 diabetic patients For subgroup I, II and III, as designed and after administration of water or glibenclamide (5mg) and/or the fresh slices of Allium cepa (100g), fasting blood glucose levels were determined at 0, 1, 2 and 4 hours, using electronic glucometer. (Table 1) 2.2.6.4 Determination of glucose tolerance tests in type 2 diabetic patients   Another group of 21 type 2 diabetic patients were subjected to glucose tolerance tests (GTT). They received 75 grams dextrose dissolved in water orally. As designed in all subgroups and after administration of water or glibenclamide (5mg) and/or fresh slices of Allium cepa (100g), blood glucose levels were determined at 0, 1, 2 and 4 hours, using electronic glucometer. (Table 2) EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2) Statistical Analysis All the data were expressed as means ± standard error of means (SEM) and analyzed by analysis of variance (ANOVA). Comparisons with the control group were made using One-way ANOVA. Differences were considered significant if P < 0.05.  RESULTS AND DISCUSSION  Determination of fasting blood glucose levels in type 2 diabetic patients Heterogeneous group of twenty one diabetic individuals of type 2 were used for this study. As shown in Table 1 and Figure 1 fasting blood glucose levels in the tested patients with type 2 diabetes were determined. The administration of 100g of Allium cepa markedly reduced the fasting blood glucose levels in subgroup III diabetic patients (test group) by 40 mg/dl after 4 hours.  Four hours after oral administration of glibenclamide (5mg) a significant reduction in fasting blood glucose levels in subgroup II diabetic patients by about 81 mg/dl was observed, as glibenclamide acts by direct induction of insulin release from the pancreatic beta cells, such a significant reduction in glucose levels was evident.[21]  The hypoglycemic activity of Allium cepa has been demonstrated in many clinical studies, presenting that, the addition of raw onion to the diet of non-insulin-dependent diabetic subjects decreased the dose of antidiabetic medication required to control the disease. [22] The probable mechanism of the hypoglycemic action of onion may be mainly due to extra-pancreatic activities on the liver, muscle etc. by enhancing the utilization and consumption of glucose peripherally.[23]     Table 1: Fasting blood glucose levels in type 2 diabetic patients receiving water (5ml), glibenclamide (5mg) and Allium cepa (100g) P. value Blood glucose level (mg/dL, mean±S.E.M) Preparations 4 h 2 h 1 h 0 h 0.001 148.67±8.67 162.33±19.1 175±22.26 164.33±18.5 Water 0.003 100.38±6.41 131±7.5 157.5±11.25 181±11.71 Glibenclamide 0.005 115.5±15.46 150.25± 17.73 165±26.41 155±25.29 Allium cepa  EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2)  Figure 1: Fasting blood glucose levels in type 2 diabetic patients receiving water (5ml), glibenclamide (5mg) and Allium cepa (100g)  Determination of glucose tolerance tests (GTT) in type 2 diabetic patients Twenty one of type 2 diabetic individuals of both sexes were involved in this part of study. It was noticed that, the administration of 75g dextrose caused an increase in the blood glucose levels in all subgroups after one hour (hyperglycemic peak). Among the three groups, those who had received Allium cepa demonstrated the highest peak compared to others, due to glucogenic effect of Allium cepa [24], nevertheless its administration significantly reduced the blood glucose levels in the test subgroup of type 2 diabetic patients to a point below that produced in the negative control group after 4 hours (Table 2; Figure 2). The observed increase in fasting blood glucose levels during the first hour and after ingestion of Allium cepa which attributed to the glucogenic effects of cysteine present in Allium cepa can counteract the common side effect (hypoglycemia) of antidiabetic agents currently used if Allium cepa is taken concurrently as food supplement. The oral administration of glibenclamide (5mg) showed a significant reduction in the induced hyperglycemia in the positive control group by 157 mg/dl after 4 hours, compared to water, since it is known to act by direct induction of insulin release from the pancreatic beta cells.   Blood glucose level(mg/dL)Time (hours)waterGlibenclamideAllium cepaEDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2) Table 2: Glucose tolerance test (GTT) in type 2 diabetic patients receiving water (5ml), glibenclamide (5mg) and Allium cepa (100g) P. value Glucose level (mg/dL, mean±S.E.M) Preparations 4 h 2 h 1 h 0 h 0.004 265±8.67 290±19.1 320±22.26 190±18.55 Water 0.001 163.2±15.46 203.8±17.73 277±26.41 185.6±25.29 Glibenclamide 0.002 213±14.11 249± 13.2 372.5±11.25 204.63±11.7 Allium cepa     Figure 2: Glucose tolerance test curves in type 2 diabetic patients receiving water (5ml), glibenclamide (5mg) and Allium cepa (100g).  Although the number of study group is small to reach concrete conclusions, it was evident that, Allium cepa has hypoglycemic effects that may be beneficial in management of diabetes in addition to its other nutritional values.   REFERENCES  1. American Diabetes Association (2001). Reports of the Experts Committee on the Diagnosis and Classification of Diabetes Mellitus. Diabetes Care. 23:S4-S19. 2. American Diabetes Association (2001). Hyperglycemic crises in patients with diabetes mellitus. Diabetic Care. 24: S83-S90 3. Carey, V, WE and Colditz, G (1997). Body fat distribution and risk of non-insulin dependent diabetes mellitus in women: The nurse Health Study. American  Journal of  Epidemiology. 145: 614-619. 4. Turner, RC; Cull, CA; Frighi, V and Holman, RR (1999). Glycemic control with diet, sulphonylureas, metformin or insulin in patients with type 2 diabetes mellitus: progressive requirement for multiple therapies (UKPDS 49). UK Progressive Diabetes Study (UKPDS) Group. Journal of American Medical Blood glucose level(mg/dL)Time (hours)waterGlibenclamideAllium cepaEDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2) Association, JAMA. 281: 2005-12 5. United Kingdom Progressive Diabetes Study Group (1998). Intensive blood glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). UK Progressive Diabetes Study (UKPDS) Group. Lancet. 352:837-853 6. Bordia, M and Verma, SK (1980). Effects of garlic feeding on regression of experimental atherosclerosis in rabbits. Artery 7, 428-437. 7. Ali, M and Thomson, B (1995). Consumption of a garlic clove a day could be beneficial in prevention thrombosis. Prostaglandins Leukotrienes & Essential Fatty Acids 53 (3): 211-212. 8. Dorant, E; Van den, B; Dorant, PA and Goldbohm, RA (1995). Allium vegetable consumption, garlic supplement intake, and female breast carcinoma incidence. Breast Cancer Res Treatment 33, 163-170. 9. Bailey, CJ (1988). Metformin revisited: its action and indications for use. Diabet Med ;5:315-320. 10. Khan, A; Mahpara, S and Mohamed, M (2003). Cinnamon Improves Glucose and Lipids of People With Type 2 diabetes. Diabetes care, 26: 3215-3218 11. Reaven, E; Wright, d; Mondon, CE; Solomon, R; Ho, H and Reaven, GM (1983). Effects of age and diet on insulin secretion action in the rat. Diabetes 32, 175-180.  12. Ide, N; Nelson, AB and Lau, BH (1997). Aged garlic extract and its constituents inhibit Cu(2+)-induced oxidative modification of low density lipoprotein. Planta Med 63, 263-264. 13. Smith, TJ and Yang, CS (2000). Effect of organosulfur compounds from garlic and cruciferous vegetables on drug metabolism enzymes. Drug Metabolism & Drug Interaction 17, 23-49. 14. Slowing, K; Ganado, P; Sanz, M; Ruiz, E and Tejerina, T (2001). Study of garlic extract and fractions on cholesterol plasma levels and vascular reactivity in cholesterol-fed rats. Journal of Nutrition, 131 994S-999S. 15. Griffiths, G; Trueman, L; Crowther, T and Thomas, B (2002). Onions: a global benefit to health. Phytotherapy Research 17 (7), 603-615.  16. Kumari, K and Augusti, KT (2002). Antidiabetic and antioxidant effects of S-methyl cystiene sulfoxide isolated from onion (Allium cepa Linn) as compared to standard drugs in alloxan diabetic rats. Indian Journal of Experimental Biology 40, 1005-1009. 17. Augusti, KT (1996). Therapeutic values of onion (Allium cepa L.) and garlic (Allium sativum L.). Indian Journal of Experimental Biology 34, 634-640. 18. Hatono, S; Jimenez, A andWargovisch, M, (1996). Chemoprotective effects of S-allylcystiene and the relationship to the detoxification enzyme glutathione S-transferase. Carcinogenesis 17 (5): 1041-1044 19. Chisty , M; Zuddus, R; Islam, B and Khan, B, (1996). Effects of onion extract on immune response in rabbits. Bangladesh Med. Res. 22: 82-85  20. Kindler, BS (1987). Garlic (Allium sativum) and onion (Allium cepa): a review of their relationship to cardiovascular disease. Prev. Med. 16 (5): 670-685. 21. Katzung, GB (2001). Basic and clinical pharmacology. Pancreatic hormones and antidiabetic drugs. The McGraw-Hill, New Yourk, 8th edition, 41, 711-334. 22. Bhushan, S (1984). Effect of oral administration of raw onion on glucose tolerance test of diabetics: a  23. comparison with tolbutamide. Current medical practice, 28:712–715. 24. Shukia, R; Sharma, SB; Puri, D; Prabhu, KM and Murthy, PS (2000). Medicinal plants for treatment of diabetes mellitus. Indian Journal of Clinical Biochemistry Sciences, volume 15 B-164, Sector 14, 201 30. Schepartz, B (1973). Regulation of Amino Acid Metabolism in Mammals, W. B. Saunders Co., Philadephia. Clinical chemistry, 20 (3): 405EDITORIAL  Gezira Journal Of Health Sciences 2009 vol.5(2)   Gezira Journal Of Health Sciences 2009 vol.5(2)  

CLINICAL HYPOGLYCEMIC EFFECTS OF ALLIUM CEPA (RED ONION) IN TYPE 2 DIABETIC PATIENTS

http://journals.uofg.edu.sd/index.php/gjhs/article/download/440/481

CLINICAL HYPOGLYCEMIC EFFECTS OF ALLIUM CEPA (RED ONION) IN TYPE 2 DIABETIC PATIENTS

Abstract

Similar works

Full text

Available Versions

Journals Of University Of Gezira