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Orthosiphon Aristatus B.L. in Type 2 Diabetes Mellitus

Y. Myint1, K. Chit2, A. Than2; 1Yangon General Hospital, Institute of Medicine 1, Yangon, Myanmar, 2Medical Research, Pharmacology Research Division, Yangon, Myanmar.

Background and Aims: The problem of diabetes mellitus is growing and causing a burden to the health care delivery services of Myanmar. The plant Orthosiphon aristatus B.L. of the family Labiatae is cultivated locally and has been scientifically evaluated for its traditionally reputed activity of hypoglycaemic property. First, botanical identification of this plant and physico-chemical studies were conducted. The isolated compound was confirmed to be ƒ sitosteral. When aqueous extract of the leaf was tested on rabbit model, blood sugar lowering effect was observed on both adrenaline induced and glucose loaded models. In animal toxicity studies no toxicity was observed. If antidiabetic property of Orthosiphon aristatus B.L. is demonstrated, its use in type 2 diabetics in Myanmar would be cost effective. The aim is to determine the role of Orthosiphon aristatus B.L. in the management of type 2 diabetes mellitus in Myanmar.

Materials and Methods: This study was conducted in three phases,The first phase was to demonstrate the hypoglycaemic effect of Orthosiphon in thirteen healthy volunteers using 175 mL of Orthosiphon leaf decoction (175 mL = 25 g leaf) on glucose loaded models. Mean blood sugar levels of volunteers before and after Orthosiphon administration was compared. This was a cross over study design.In the second phase, the hypoglycaemic effect of Orthosiphon was assessed and compared to standard oral hypoglycaemic drug Metformin 500 mg and diet control alone with the aid of oral glucose tolerance tests in 19 type 2 diabetics. 180 mL of Orthosiphon decoction (25 g of dried leaves) was used in a single dose. This was a cross over study design. The third phase was to determine the combined effects of Orthosiphon with other oral hypoglycaemic drugs (metformin and sulphonylureas) in the management of 14 type 2 diabetics.

Results: The results of phase one trial showed that Orthosiphon decoction used on glucose loaded volunteers significantly reduced the mean blood sugar levels by 35% at half an hour when compared to their corresponding values during control phase without drug. (P=0.003). No untoward side effects in volunteers.In phase two trial, mean blood sugar levels were significantly lower in 19 diabetics receiving Orthosiphon decoction alone than those receiving diet alone (P<0.05). The effect of Orthosiphon was similar to Metformin but Orthosiphon had more blood sugar lowering effect. Significant blood sugar lowering effect was observed in all patients three hours afteradministration of plant decoction (P<0.05).In phase three, with the use of Orthosiphon raw leaves of 1" diameter length (250 mg leaf) together with oral hypoglycaemic drugs in 14 type 2 diabetics after three months, the average reduction of fasting blood sugar level was 37.14% (72.8 mg%) (P<0.001).The use of Orthosiphon resulted in omission of all oral hypoglycaemic drugs in 23.07%.

Conclusion: There is an important role for Orthosiphon aristatus in the management of type 2 diabetics either alone or in combination with oral hypoglycaemic drugs. The use of locally grown Orthosiphon plant in type 2 diabetics will be cost effective (89% reduction in cost) and will lessen the economic burden on both the patient and the country.

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Orthosiphon Aristatus B.L. in Type 2 Diabetes Mellitus