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GHANA HERBS FOR DIABETES II -RESEARCH FINDINGS

4. Discussion

The adoption of a Western lifestyle and urbanization is cited as a major cause for the tremendous increase in metabolic diseases such as diabetes mellitus in Africa, including Ghana [183]. Currently, there is no known cure for diabetes mellitus despite the availability of various classes of pharmacological agents for management of diabetes mellitus. Currently, issues related to efficacy, safety, and affordability of existing pharmacological agents for management of diabetes are driving patients to turn to complementary and alternate medicine (CAM), including plant medicines for the management of diabetes mellitus. Indeed, it has been estimated that up to one-third of diabetic patients use CAM to manage their condition. A growing number of phytomedicines and their chemical constituents have been studied in the treatment of diabetes mellitus. Despite the increased use of phytomedicines, with over 70% of the world’s population using some form of it, according to WHO [184] many still lack thorough experimental investigation data to support their use.
Plant medicine remains an important means by which humans have treated ailments, prevented diseases, and maintained health for centuries. Traditional knowledge and use of plant-based medicines remain important in Ghana because Traditional Medical Practice (TMP) is readily available and is affordable to rural communities in Ghana. Various plants are used for managing diabetes mellitus in Ghanaian Traditional Medicine Practice [14, 17, 18, 21, 185] but not much is known about the plants used.
Of the plants discussed Aloe vera has the highest evidence supporting its use in diabetes mellitus, with multilateral level of support from in vitro, animal, and clinical studies and elucidation of active principle and testing in an animal model [103, 111, 143, 185]. Other findings also support its use in the treatment of various complications that arise from diabetes mellitus demonstrating broad clinical utility. Thus Aloe vera remains the hallmark of phytomedicine for diabetes mellitus though there are minor concerns over toxicity. Momordica charantia and Zingiber officinale offer the next most extensive evidence for use in managing diabetes mellitus with preclinical studies in animal models, with human studies showing clinical efficacy.
In this review, information on Ghanaian medicinal plants used for diabetes mellitus has been compiled (Tables 2 and 3). The information gathered demonstrates that some of these plants and/or their preparations show promise in managing diabetes mellitus. The review provides information on pharmacological mechanisms of some of the plants. The study shows that some of the plants and their bioactive compounds (Figure 1) act by reducing glucose absorption through inhibition of the action of enzymes such as sucrase, α-glucosidase, and maltase. Others act through cellular mechanisms such as regeneration of pancreatic β-cell by inhibiting the atrophy of pancreatic islet tissue. Some medicinal plants have also been shown to suppress accumulation of fat and dyslipidemia through the enhancement of energy expenditure enzymes such as carnitine palmitoyl-transferase1 and acyl CoA oxidase and also attenuating enzymes involved in fatty acid synthesis that occurs in the liver. Furthermore, some of the plants have antioxidant and anti-inflammatory potentials and thus may be playing a central role in acting against diabetes associated with metabolic disorders of liver and kidney. Others reduce hepatic glucose output and enhance glycolysis, glycogenesis, and reduction in glycogen breakdown and gluconeogenesis.
This review has also identified various experimental studies that have examined the efficacy of antidiabetic medicinal plants. Results obtained from clinical trials revealed that using medicinal plants notably improves levels of biochemical indices of people with diabetes. Moreover, some principles isolated from these plants indicated antidiabetic activity with better efficacy than orthodox oral hypoglycemic agents. This piece provides scientific evidence of the effectiveness and efficacy of phytomedicines in the management of diabetes mellitus. Most of these studies did not reveal any major adverse effects consequent to the use of these medicinal plants suggesting that they are generally safe.

5. Concluding Remarks and Future Direction

Ghana is bestowed with abundance of plant biodiversity; several are used in managing diabetes mellitus in Traditional Medicine Practice. This review indicates that there is substantial preclinical evidence and some clinical data to support the usefulness of some of these herbs as antihyperglycaemic agents. The provision of information on medicinal plants used for the management of diabetes mellitus in Ghana in this narrative can serve to promote a more rational medicinal use of these plants. These can also offer evidence-based data for clinical development of many of these potential medicinal plants. Further phytochemical elucidation and pharmacological research should be carried out on many ethnomedicinal plants used in Ghana to standardize these traditional medicines with definite antidiabetic or antihyperglycaemic activity. Ultimately, in giving credibility to the preclinical data, clinical trial studies ought to be carried out in order to validate their medicinal usefulness in people with diabetes mellitus. It is believed that, this way, the pharmacotherapeutic potential of these plants could be harnessed towards a possible all-inclusive integration into the healthcare system.

Conflicts of Interest

The authors declare that there are no conflicts of interest.

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