Document Type : Original Article

Authors

1 Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

2 Department of Physiology, Persian Gulf Physiology Research Center, Medical Basic Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

3 Department of Endocrinology and Metabolism, Health Research Institute, Diabetes Research Centre, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

Abstract

 
 Background: A multifactorial metabolic disorder, diabetes mellitus (DM) is characterized by chronic hyperglycemia. According to the International Diabetes Federation (IDF), this condition is expected to be among the most critical global health concerns in 2045. Despite the recent developments in medications for patients living with type 2 diabetes (T2D), there is still no definitive cure. As nearly all medications have their own complications, some herbs seem beneficial as alternatives. From this perspective, the present study investigated the effects of the coadministration of Eryngium billardieri (EB) and Boswellia serrata (BS) extracts on biochemical indices in patients with T2D.
Methods: Sixty patients with T2D, aged 35–55, were selected and randomly assigned to two groups: experiment and control. For four weeks, the experimental group was given a combination of the EB (14 cc) and BS (7 cc) extracts in addition to the routine medications. However, the controls only received routine care and medications.
Results: A significant reduction was observed in fasting blood sugar (FBS), homeostatic model assessment for insulin resistance (HOMA-IR), and triglyceride (TG) levels. There was a substantial upsurge in disposition index (DI), homeostasis model assessment of β-cell function (HOMA-β), and quantitative insulin sensitivity check index (QUICKI) levels in the patients in the experimental group. The serum insulin levels showed no major changes.
Conclusion: The study results revealed that the EB and BS coadministration could be a therapeutic approach or a supplement for patients with DM.

Keywords

Main Subjects

  1. Tan SY, Mei Wong JL, Sim YJ, et al. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes Metab Syndr. 2019;13(1):364-72. doi: 10.1016/j.dsx.2018.10.008
  2. Afshari M, Mohammadshahi M, Malayeri AR, Zaheri L. Antidiabetic, Hepato-Protective and Hypolipidemic Effects of Eryngium Caucasicum Extract in Streptozotocin-Nicotinamide Induced Type 2 Diabetes in Male Rats. Iraq Medical Journal. 2019;3(1).
  3. Ahangarpour A, Oroojan AA, Khorsandi L, Shabani R, Mojaddami S. Preventive effects of betulinic acid on streptozotocinnicotinamide induced diabetic nephropathy in male mouse. J Nephropathol. 2016;5(4):128. doi: 10.15171/jnp.2016.24
  4. WHO. "Diabetes Fact sheet N°312" 2013. Archived from the original on 26 August 2013. Retrieved 25 March 2014.
  5. IDF (2019) International Diabetes Federation DIABETES ATLAS 9th edition; 2019.
  6. Papatheodorou K, Banach M, Bekiari E, Rizzo M, Edmonds M. Complications of Diabetes 2017. J Diabetes Res. 2018;2018:3086167 doi : 10.1155/2018/3086167
  7. Stein SA, Lamos EM, Davis SN. A review of the efficacy and safety of oral antidiabetic drugs. Expert Opin Drug Saf. 2013;12(2):153-75. doi : 10.1517/14740338.2013.752813
  8. Afshari M, Malayeri AR, Mohammadshahi M. Effects of Eryngium caucasicum extract on testosterone, inflammation and oxidative status of nicotinamide-streptozotocin induced type-2 diabetes in male rats. Journal of Contemporary Medical Sciences. 2019;5(2). doi : https://doi.org/10.22317/jcms.v5i2.568
  9. Ahangarpour A, Sayahi M, Sayahi M. The antidiabetic and antioxidant properties of some phenolic phytochemicals: A review study. Diabetes Metab Syndr. 2019;13(1):854-7. doi : 10.1016/j.dsx.2018.11.051
  10. Khani S, Abdollahi M, Asadi Z, et al. Hypoglycemic, hepatoprotective, and hypolipidemic effects of hydroalcoholic extract of Eryngium billardieri root on nicotinamide/streptozotocin-induced type II diabetic rats. Res Pharm Sci. 2021;16(2):193-202. doi : 10.4103/1735-5362.310526
  11. Hasanbeiglu S, Hosseini K, Molavi O, Asgharian P, Tarhriz V. Eryngium billardieri Extract and Fractions Induces Apoptosis in Cancerous Cells. Anticancer Agents Med Chem. 2021. doi : 10.2174/1871520621666211201151736
  12. Zarei A, Changizi-Ashtiyani S., Hamidizadeh S, The study of the effects hydro-alcoholic extract of Eryngium billardieri on lipid profiles levels and liver and renal functions tests in hypercholesterolemic rats. J Chem Pharm Res. 2015;2:200-6.
  13. Daneshzadeh MS, Abbaspour H, Amjad L, Nafchi AM. An investigation on phytochemical, antioxidant and antibacterial properties of extract from Eryngium billardieri F. Delaroche. Journal of Food Measurement and Characterization. 2020;14(2):708-15 doi :10.1007/s11694-019-00317-y
  14. Şahin T. A Review: Some Plants Used for Stomach Ailments in Turkey Traditional Medicine. Central European Journal of Botany. 2022:27. doi : 10.13187/cejb.2022.1.20
  15. Ahangarpour A, Heidari H, Fatemeh RAA, et al. Effect of Boswellia serrata supplementation on blood lipid, hepatic enzymes and fructosamine levels in type2 diabetic patients. J Diabetes Metab Disord. 2014;13(1):1-5. doi: 10.1186/2251-6581-13-29
  16. Rezakhani S, Sedigh B, Pardakhty A, Shafiee K. Effects of Boswellia serrata on Improvement of Memory Impairment in Patients with Mild Cognitive Impairment: A Double-blind, Randomized, Placebo-controlled Study. Journal of Kerman University of Medical Sciences. 2020;27(4):348-355. doi.org/10.22062/jkmu.2020.91021
  17. Gupta M, Verma SK, Singh S, et al. Anti-proliferative and antibacterial activity of oleo-gum-resin of Boswellia serrata extract and its isolate 3-hydroxy-11-keto-β-boswellic acid. Journal of Herbal Medicine. 2022;32:100546. doi :10.1016/j.hermed.2022.100546
  18. Mehrzadi S, Tavakolifar B, Huseini HF, Mosavat SH, Heydari M. The Effects of Boswellia serrata Gum Resin on the Blood Glucose and Lipid Profile of Diabetic Patients: A Double-Blind Randomized Placebo-Controlled Clinical Trial. J Evid Based Integr Med . 2018;23:2515690X18772728. doi: 10.1177/2515690X18772728
  19. Kavitha JV, Rosario JF, Chandran J, Anbu P, Bakkiyanathan. Hypoglycemic and other related effects of Boswellia glabra in alloxan-induced diabetic rats. Indian J Physiol Pharmacol. 2007;51(1):29-39.
  20. Sharma R, Singh S, Singh GD, Khajuria A, Sidiq T, Singh SK, et al. In vivo genotoxicity evaluation of a plant based antiarthritic and anticancer therapeutic agent Boswelic acids in rodents. Phytomedicine. 2009;16(12):1112-8.
  21. Twaij HA, Al-Dujaili EA. Evaluation of the antidiabetic and anti-ulcer properties of some Jordanian and Iraqi medicinal plants; a screening study. JMED Research. 2014;2014
  22. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care. 2003;26(12):3215-8. doi: 10.2337/diacare.26.12.3215

23.Ahangarpour A, Belali R, Bineshfar F, Javadzadeh S, Yazdanpanah L. Evaluation of skin absorption of the Citrullus colocynthis in treatment of type II diabetic patients. J Diabetes Metab Disord. 2020;19(1):305-9. doi: 10.1007/s40200-020-00509-0

  1. Russell-Jones D, Cuddihy RM, Hanefeld M, et al. Efficacy and safety of exenatide once weekly versus metformin, pioglitazone, and sitagliptin used as monotherapy in drug-naive patients with type 2 diabetes (DURATION-4): a 26-week double-blind study. Diabetes Care. 2012;35(2):252-8. doi : 10.2337/dc11-1107
  2. DeFronzo RA, Ferrannini E, Groop L, et al. Type 2 diabetes mellitus. Nat Rev Dis Primers2015;1:15019. doi : 10.1038/nrdp.2015.19
  3. Shirazi M, Monajemi R, Shahanipoor K. Comparison of aqueous and alcoholic extracts of Eryngium billardieri fruit with metformin in the treatment of type 2 diabetes in male Wistar rats. New Cellular and Molecular Biotechnology Journal. 2020;10(40):51-64.
  4. ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, Bruemmer D, et al. Summary of Revisions: Standards of Care in Diabetes—2023. Diabetes Care. 2022;46(Supplement_1):S5-S9.
  5. Briet C, Ilie MD, Kuhn E, et al. Changes in metabolic parameters and cardiovascular risk factors after therapeutic control of acromegaly vary with the treatment modality. Data from the Bicêtre cohort and review of the literature. Endocrine. 2019;63(2):348-60. doi: 10.1007/s12020-018-1797-8
  6. Ahangarpour A, Akbari F, Ramezani A, et al. The effect of Boswellia serrata on blood glucose, insulin level and insulin resistance in type 2 diabetic patients. Daneshvar Medicine. 2020;20(6):11-8.
  7. Jyothi Y, Kamath JV, Asad M. Effect of hexane extract of Boswellia serrata oleo-gum resin on chemically induced liver damage. Pak J Pharm Sci. 2006;19(2):125-9.
  8. Marefati N, Beheshti F, Etemadizadeh P, Hosseini M, Anaeigoudari A. Gum resin extract of Boswellia serrata attenuates lipopolysaccharide-induced inflammation and oxidative damage in hepatic and renal tissues of rats. Asian Pacific Journal of Tropical Biomedicine. 2022;12(1):20-5. doi : 10.4103/2221-1691.333210