Diabetes Anhang

 

http://ir.dut.ac.za/bitstream/handle/10321/1534/MALAPERUMAL_2016.pdf?sequence=1&isAllowed=y

[Veshara Malapermal]

1.2.1

Characterisation of diabetes mellitus

Diabetes is one of the most common metabolic disorders worldwide (Wild et al.2004), characterised by a loss of glucose homeostasis with disturbances in

carbohydrate, fat and protein metabolism resulting from defects in insulin secretion, insulin action, or both (Katzung et al. 2009).

Without adequate insulin, body tissues, in particular the liver, muscular and adipose tissues fail to take up and use glucose from the blood circulation.

The resultant elevated blood glucose level is known as hyperglycaemia (Jarald et al.2008).

 

Hyperglycaemia

Adiposetis sue, increased Lipolysis Brain,

Neurotransmitter

Dysfunction

Isletalphacel, In creased glucagonsecretion

M

u

s

c

l

e

,

D

e

c

r

e

a

s

e

d

p

e

r

i

p

h

e

r

a

l

g

l

u

c

o

s

e

u

p

t

a

k

e

P

a

n

c

r

e

a

s

,

D

e

c

r

e

a

s

e

d

i

n

s

u

l

i

n

s

e

c

r

e

t

i

o

n

S

t

o

m

a

c

h

,

C

a

r

b

o

h

y

d

r

a

t

e

i

n

t

a

k

e

L

i

v

e

r

,

I

n

c

r

e

a

s

e

d

h

e

p

a

t

i

c

g

l

u

c

o

s

e

p

r

o

d

u

c

t

i

o

n

a

n

d

d

e

c

r

e

a

s

e

d

h

e

p

a

t

i

c

g

l

u

c

o

s

e

u

p

t

a

k

e

K

i

d

n

e

y

s

,

I

n

c

r

e

a

s

e

d

g

l

u

c

o

s

e

r

e

a

b

s

o

r

p

t

i

o

n

D

i

g

e

s

t

i

v

e

s

y

s

t

e

m

,

D

e

c

r

e

a

s

e

d

i

n

c

r

e

t

i

n

e

f

f

e

c

t

Figure

1

:

Factors causing hyperglyc

a

emia

Source:

Katzung

et al.

2009

Diabetes

occurs predominantly in

two

forms, namely

:

Type 1 and T

ype 2

.

T

hese

two forms

dif

fer

in terms of

pathogenesis but produce

essentially

similar metabolic derangements

(

Nowak and Handford 2004

)

.

On the basis of

aetiology

, the term Type 1 is widely used to

describe insulin dep

endent diabetes mellitus (IDDM)

(

Nowak and Handford 2004).

This type is the more severe of the two forms, which typically is picked up at a young age, and is less common.

It develops following viral infection, exposure to environmental chemicals, abuse of and/or exposure to therapeutic drugs or a strong genetic predisposition leading to antigen alteration and subsequent

immune attack, causing Beta-cell (β-cell)

destruction and

leading to

zero functioning of the

β

-

cells

,

therefore resu

lting in no secretion of insulin

(

Katzung

et al.

2009

)

.

T

ype 2 diabetes mellitus, formerly known as non

-

insulin dependent diabetes mellitus

(NIDDM),

is

characterise

d

by chronic

hyperglyc

a

emia

as a consequence of insulin deficiency

caused by insufficient synthesis or se

cretion of insulin from the

β

-

cells

, however many

contributing factors remain uncertain

(Figure 2)

(

Nowak and Handford 2004)

ype 2 diabetes

is by far the most co

mmon form

of diabetes

(

Hannan

et al.

2006

)

,

account

ing

fo

r more than 90

% of population cases

(

Nguyen

et al.

2011

)

.

This form of diabetes

has

a slow

progression or development of symptom

;

often years will pass

without the victim being

aware of any change

(

Nowak and Handford 2004

)

.

I

nsulin therapy is required

less often in

this

t

ype

of diabetes

, with

the exception

being

patients that fail to

achieve

proper

glycaemic

control

,

during

severe

bacterial

infections, ketoacidosis,

during pregnancy

and in patients

with impaired renal or hepatic function

(

Mizuno

et al.

2008

)

.

A minority of cases

of

Type 3

and Type 4 are due to various specific metabolic or genetic causes

presented in Figure 3

(

Bastaki 2005

).

1.2.2

Complications of

diabetes mellitus

Patients with diabetes experience significant morbidit

y and mortality from micro

-

and/or

macrovascular complications

(

Tayyab

et al.

2012

)

.

Microvascular disease is defined as

damage to the small blood vessels

while

macrovascular disease is damage to the

larger

arteries

(

Nowak and Handford 2004

)

. The relationship between

glycaemic

control and

diabetic microvascular disease has been established in both Type 1 and Type 2 diabetes.

Acute complications include diabetic ketoacidosis co

mmon

to

Type 1

diabetic

patients, and

non

-

ketotic hyperosmolar coma, common in Type 2

diabetic

patients

(

Tayyab

et al.

2012

)

.

Regardless of

common

diabetic treatment reg

imens,

chronic

hy

perglyc

a

emia

has been

implicated

as

the

main cause

of the adverse effects experienced by patients such as

polydipsia

,

polyphagia

and

lingering

complications

over a significant period

(

McCue

et al.

2005

)

.

The

resultant

long

-

term complications

are caused

by

damage

to

organs

including the

eyes, kidneys, nervous system and blood vessels

, causing various

patholog

ies

such as

a

therosclerotic vascular disease

(

Gan

et al.

1999

;

Bastaki 2005

)

,

k

etoacidosis,

n

ephropathy,

6

|

P a g e

n

europathy,

u

lceration,

eye complications including r

etinopathy (

most common cause of

blindness

)

,

‘diabetic foot’ and

l

imb

amputation

(

Bastaki 2005

;

Lewis

et al.

2010

)

.

Oxidative stress induced by chronic hyperglycaemia

(

Kil

et al.

2004

)

has been shown to be a

major underlying mechanism for the

formation of harmful byproducts tha

t accumulate and

contri

bute to development of

the

long

-

term complication

s

associated with diabetes

(

Neri

et

al.

2005

)

.

Oxidative stress reflect

s

an imbalance between the systemic

manifestations

of

reactive oxygen

species

(ROS)

constantly

formed in the human

body

and the quantities of

antioxidant products required to restore balance,

causing vasoconstriction

(

Kuyvenhoven and

Meinders 1999

)

. E

xcess production of ROS leads to the impairment of equilibrium between

pro

-

oxidants and antioxidant systems

(

Sharma and Kar 2014

)

.

The

a

ctivation of a number of

metabolic pathways induced by chronic hyperglycaemia

produce

end products

that

co

ntribute

to the development of long

-

term complications associated with diabetes

(

Kuyvenhoven and

Meinders 1999

)

. For example

,

the activation of the

polyol pathway

causes

decreased nitric

oxide and p

rostaglandin

synthesis, which results

in

endothelial dysfunction and

hypertension

.

I

ncreased polyol pathway activity

can

induce retinopathy and neuropathy. Similarly,

increased

protein k

inase C (PKC) pathway activity and

the formation of non

-

enzymatic

glycation of proteins

can

lead

to

the

increased risk of

developing

nephro

pat

hy, neur

opathy

and retinopathy.

In addition, i

ncreased

hexosamine pathway

activity

can

potentiate

macromolecular

damage

.

P

roper

glycaemic

control, blood pressure management and lipid

modification are

important to consider as t

hey

may

independently slow the progression of

diabetic related micro

-

and macrovascular complications, and thus reduce the rates of

diabetic

retinopathy, neuropathy, nephropathy, diabetic foot infections,

atherosclerosis and other

associated cardiovascular events

, including dyslipidaemia, hypertension, hypercoagulability

and obesity

(

Ratner 2001

;

Mizuno

et al.

2008

)

.

1.2.3

Incidence of

diabetes

mellitus

Diabetes

is a major health problem with its frequency increasing every day

from

most

developed and developing countries (Wild

et al

. 2004). In SA

, the prevalence is between 4

%

and 6%. The global prevalence was

estimated at 2.8% in 2000 (171 million people affected)

(

Wild

et al.

2004

)

, 382 million people in 2013 and is estimated to reach 592 million people

by the year 2035,

with a prevalence of 8.3%

(Guariguata

et al

. 2014)

.

The World Health

Organisation

(

WHO) predicts that diabe

tes will be the 7

th

leading cause of death by 2030

(

WHO 2011

)

.

associated with

urbanis

ation

, modernisation

(

Hamdan and Afifi 2004

)

, growth of aged

population, i

ncreasing trends towards obesity, unhealthy diet, and sedentary lifestyles

(

Hannan

et al.

2006

)

.

Hypertension, coronary heart disease, stroke, genetics and various

forms of cancer are amongst the reasons for the global rise in diabetes

(

Omran 1983

;

Reddy

et al.

1998

)

.

The WHO

emphasise

d

the rise over a projected time frame

of

non

-

communicable diseases

worldwide

(

WHO 2011

)

. Many countries, including SA, are undergoing health and

epidemiological transition that pose significant threats

involving

the emergence of

debilita

ting diseases and their associated long

-

term complications

(

Omran 1983

)

, and will

increase with or without the impact of HIV/AIDS

in SA

(

Molle

n

tze and Levitt 2005

)

.

The

prevalence of diabetes and obesity is an increasing concern affecting the developing countries

t

o a greater extent than the developed world

(

Wild

et al.

2004

)

. Obesity is a major concern

because it indirectly affects or exacerbates the incidence of diabetes, worsening the severity

of side effects or accelerating the incidence of diabetic relate

d complications

(

Molle

n

tze and

Levitt 2005

;

National

Department of Health 2006

)

. These data show

s

that reliable, cost

saving therapy is necessary to lower the global

rise

of diabetes

(

Chiha

et al.

2012

)

. Medicinal

plants contain enormous pote

ntial

to provide

alternative medi

cines

for treating diabetes

,

but it

is

necessary that their effectiveness is

researched and

substantiated.

1.2.4

Treatment and

management of diabetes mellitus

Over the years, concerted efforts

to treat

diabetes have evoked breakthrough discoveries,

which have facilitated

suitable

management.

The primary aim

is to save a life and alleviate

diabetic

symptoms

and

secondary aims are to prevent long

-

term diabetic complications which

encompass a variety of me

tabolic abnormalities.

Insulin replacement therapy is

the mainstay

for patients with T

ype 1 diabetes while diet and lifestyle modifications are considered the

foundation

for

t

he treatment and management of T

ype 2 diabetes

(

Bastaki 2005

)

.

If diet and

exercise fail to control blood glucose at the desired level, phar

macological treatments such as

insulin or oral hypogly

caemic drugs for management of T

ype 2 diabetes are then evoked

.

Yet, due to the

rise and

progress

of the disease, and modernisation of

lifestyle,

opinion

is

divided

regarding

the primary use of

conventional hypoglycaemic agents

(

Wadkar

et al.

2007

;

Mizuno

et al.

2008

)

. In addition, patients placed on

restricted diets and instructed to

exercise

in order to lose weight

,

do not

always comply

(

Jarald

et al.

2008

)

.

8

|

P a g e

Proposed goals

of

treatment intervention have been

to improve

β

-

cell function to increase

pancreatic insulin decreas

e

hepatic glucose production, increas

e

glucose uptake peripherally

and reduc

e

absorption of carbohydrates

(

Houghton and Raman 1998

)

.

In addition, novel

treatment strategies suggest prescribi

ng according to the individual’s genetic pathogenic

profile

(

Bastaki 2005

;

van Huyssteen 2007

)

.

The overall treatment of diabetes depends on the severity of hyperglycaemia a

nd the lifestyle

of the patien

t

.

Oral

administered hypoglycaemic drugs

e.g., sulfonylureas

, metformin,

thiazolidinediones (TZDs), meglitinides and α

-

glucosidase inhibitors are prescribed first,

either alone or in combination. Often

medical professionals are inclined to suggest

combination ther

apy for patients failing to achieve normal glucose levels

(

South African

Medical Association 2005

)

.

The most common comb

ination is sulfonylurea plus metformin.

However, if combination therapy fails to attain glycaemic control,

patients are placed on

insulin monothera

py or combined

with oral hypoglycaemic agents

(

Mizuno

et al.

2008

)

.

Common

mechanistic class

es of hypoglycaemic drugs

in use exert their glucose lowering

effects

by means

of

:

(1) E

nhancement of insulin secretion by pancreatic

β

-

cells (insulin

secretagogues) (

sulfonylureas and potassium

-

ATP channel stimulators)

;

(2)

D

ecreasing

hep

atic glucose production

through

inhibition of gluconeogenesis

and promoting

insulin

-

stimulated glucose uptake in muscle

and changes lipid metabolism by decreasing plasma

triglycerides

and

free fatty acids

(metformin, a biguanide);

(3)

Increase muscle and a

dipose

tissue glucose uptake by potentiating insulin action

;

PPARү activates genes that regulate

insulin action, glucose

uptake and energy expenditure

(

thiazolidinediones (

TZDs));

(4)

Incr

ease β

-

cell insulin secretion (m

eglitinides

); and (5)

I

nhibition of intestinal glucose

digestion and absorption (α

-

glucosidase inhibitors such as acarbose and migitol competitive

inhibitors

of intestinal α

-

glucosidases)

(

Appendix

1)

(

Bastaki 2005

)

.

M

odern antidiabetic drugs pose many limitations

(

Mizuno

et al.

2008

)

.

The

main

drawback

of insulin is that it has to be administered by

injection

(

Wadkar

et al.

2007

)

and research

shows that most of the oral hypoglycaemic agents cannot maintain normal levels of blood

glucose for an extended period

(

Mizuno

et al.

2008

)

. For example, glibenclamide is effective

for

patients

that

do not lack endogenous

insulin

but the

side effects of this drug are

hypoglycaemia with increased cardiovascular

risk, especially

in the elderly and patients

with

renal problems, and weight gain

(

R

eid

et al.

2012

)

. In addition,

gastrointestinal (GI)

disturbances (severe lactic acidosis) are associated with metformin; weight gain, GI

disturbances and liver injury with thiazolidine

diones; GI disturbances, weight

gain and

9

|

P a g e

hypersensitivity reactions

with

meglitinides. G

iven the association

of

obesity

and insulin

resistance, weight gain is problematic,

pa

rticularly

in

that

that

are

overweight

to start with

(

Mizuno

et al.

2008

)

. In pregnancy

-

induced diabetes, synthetic agents are vigorously

used

,

however

, continuous use is prohibited

due to the development of

hypoglycaemi

a, weight

gain, GI disturbances

and liver toxicity

(

Swarnalatha

et al.

2012

)

.

Therefore, prolonged use

of such ag

ents can

cause

serious long

-

term complications.

The

current mainstay of treatments

fail

to alter the course of diab

etic complications,

do not restore glucose homeostasis and pose

risks of high secondary failure rates

(

Mizuno

et al.

2008

)

.

Drug

compliance and accurate

regulation of blood glucose is a difficult

to

control

(

Rang

et al.

2003

)

. It is therefore essential

to look for other means of treatment that will be as efficacious in the mechanism of action

(MOA)

as synthetic agents but

with minimal side effects and

which

can

delay

the

chronic

complications associ

ated with diabetes.

Apart from the

current

therapeutic options, many

herbal medicines have been

proposed for the treatment of

diabetes

(

Jarald

et al.

2008

)

.

The

use of m

edicinal p

lants

are

part of traditional practice

in many countries and cultures

(

Soumyanath 2006

)

including

South Africa

(

van de Venter

et al.

2008

)

,

because of their

availability,

effectiveness,

minimal

side effects and low co

st

.

I

nvestigation

into

antidiabetic

agents from traditional medicinal plants

is a major dr

iver of

research

(

Palatty

et al.

2013

)

.

1.3

The use of traditional medicine in

the

treatment of diabetes

In Africa, many plants are traditionally used for the management and control of various

ailments

(

Baynes 2006

)

including

diabetes

(

Kavishankar

et al.

2011

)

.

Globally,

approximately 85,000

medicinal

plant

species (sp.)

are

reported as medicinally useful

(

Liu

and Wang 2008

)

;

however

,

few have received scientific scrutiny despite medical and

scientific recommendation from the WHO

(

WHO 2007

)

.

In

South Africa

,

victims

of chronic diseases are turning to herbal medicine

s

as alternative

source

s

of treatment

as recommended by

the

National Department of Health (2006)

. This

renewed inte

rest in

plant medicines as

alternative

therapy

to restore he

alth or treat disease

s

is

believed to be motivated by

factors such as their

effectiveness

, that they

are more specific and

that they

contain diverse secondary metabolites

which

pr

ovide numerous he

alth benefits. T

he

orchestra of chemical compounds within the plants

work together synergistically

allow

ing

active compounds

to be available

to produce maximal therapeutic effi

ciency that

are

less

toxic

than high doses of individual components

(van Huyssteen 2007).

Traditional medicine (

TM

)

may

provide an effective solution to the threat

of

diabetes

worldwide, thus

help

ing

to

reduc

e

chronic disease

complications and deaths

(

Fang 2011

)

.

World ethnobotanical i

nformation on medicinal plants has

reported up to 800 plants used for

the treatment

of

d

iabetes

(

Udayakumar

et al.

2009

)

.

N

umerous medicinal plants offer

sustainable

management of the sugar levels among diabetic patients

and

validated for their

hypoglycaemic potential using experimental animal models

(

Yeh

et al.

2003

)

.

Plants such as

Momordica charantia

and

Eugenia jambolana

have been

shown to ameliorate diabetic

complications such as neuropathy, nephropathy, fructose

-

induced insulin

resistance,

and

cataract

s

in experimental animals

(

Premila and Conboy 2007

)

.

Diabetes i

s thus a common

disease

for investigation

using

natural product

s

.

However,

the

mechanism of action a

nd/or the

comp

onents

that specifically exert blood glucose lowering effects on tissues or organs remain

unknown

(

Prabhakar and Doble 2011

;

Palatty

et al.

2013

)

. Diabetic research on the

therapeutic effectiveness of natural

plant

product

s

of

S

A

is

limited

(

Afolayan and Sunmonu

2010

)

,

therefore, this study is aimed at improving

the

management of diabetes by

investigating

novel

compounds and the synergistic action of medicinal plants, marking a

promisi

ng future and better usage of South Africa’s

medicinally important

plants.

 

2.1

The link between

n

anotechnology

and

p

hytotherapy

in

the

treatment of

diabetes

I

ndividuals with diabetes and other debilitating diseases have been treated

via

t

raditional folk

medicine with a variety of plant extracts

from

many years

(

Barnes

et al.

2007

)

.

Natural

medicinal drugs are rec

laiming their

position

as

the primary source of treatment

as compared

to

the current and main forms of synthetic treatment

(

Mizuno

et al.

2008

)

. The most popular

antidiabetic

plants studied

belong to the

following

families

:

Anacardiaceae, Alliaceae,

Asphodelaceae

,

Asteraceae

, Apocynaceae, Bombacaceae, Caesalpiniaceae, Combretaceae,

Cucurbitaceae,

Fabaceae

,

Hypoxydaceae

, Lamiaceae

, Lauraceae,

Linaceae, Liliace

ae

,

Menispermaceae,

Moraceae,

Myrtaceae

,

Pedaliaceae

, Piperaceae,

Rutaceae and

Zin

giberaceae

(

Appendix

es

2

-

4

).

In

the

quest

for

innovative

and

eco

-

friendly healthcare,

nano

bio

technology is

now

an active

field

of research,

concentrating

on th

e rapid biosynthesis of benign

Nps

using highly

acclaimed

antidiabetic

medicinal plants possess

ing

active compounds

that serve as natural

reducing agent

s

(

Rao

et a

l.

2013

)

.

This has led to many

researchers developing newer and

more efficient green methods

of

synthesis

of biocom

patible and inert

Nps

(

Ramte

ke

et al.

2013

)

.

Chemical, physical and microbial methods

of

synthesising

gold

(Au)

, silver

(Ag),

palladium (Pd),

platinum

(Pt),

indium oxide (In

2

O

3

), magnetite

(Fe

3

O

4

)

and zinc oxide (ZnO)

Nps

curren

tly exist

(

Iravani 2011

;

Naik 2002

)

,

however, the

se methods

are

toxic,

costly, time

consuming

and

difficult

,

especially

in relation to

preserv

ing

microbial

cultures

(

Jayapriya and

Lalitha 2013

)

.

In light of this,

nanomedicine is making use of the vast reserves of

phytotherapy

to

syn

thesise

Nps

us

ing

various

noble metals such as gold, silver

and palladiu

m

in nanoform.

2.1.1

Green synthesis of metal

Nps

using

medicinal

plants

The b

iosynthesis of silver and gold

Nps

using

medicinal

plants

has

received

considerable

attention as a suitable alternative to

using

hazardous

chemical and physical

techniques

(

Iravani 2011

)

.

Plants are

being exploited for their unique metal tolerance and effective

production

of

metal

Nps

.

A single medic

inal plant

contains

an orchestra of chemical elements

16

|

P a g e

(e.g.

proteins, vitamins,

enzymes,

amino acids

, polysaccharides

and

organic compounds) that

are

“environmentally benign, yet chemically complex”

(

Iravani 2011

)

and

therefore

serve as

ideal tools f

or

enhanced medicinal applications

.

It is reported that p

olyol

s

such as terpenoids,

polysaccharides and flavones

take part

in the bio

-

reduction,

stabilisation

and

bio

-

capping

mechanisms

to form

stable

silver

(

Huang

et al.

2007

)

,

gold

(

Shankar

et al.

2003

)

and

bimetallic

Nps

(Shankar

et al

. 2004)

.

The importance of plant constituents

have

been

shown

in the bio

-

reduction of Ag ions to AgNps using

an aqueous (aq.) preparation of

C

innamon

zeylanicum

bark

which

is rich in

terpenoids such as linalool, methyl chavicol and eugenol

as

well as

cinnamaldehyde, ethylcinnamate

and β

-

caryophyllene

.

Prot

eins

from

C. zeylanicum

bark capped and further

stabilis

e

d

the particles

of

free amine

groups

and/

or cysteine

residues

(

Sathishkumar

et al.

2009

)

.

Phenolic compounds play an important role in the

bio

-

reduction

and

stabilisation

of metal

Nps

.

P

henols/p

henolics are a class of

compounds

comprising

a

hydroxyl functional group (

-

OH) attached to an aromatic hydrocarbon group

(

Harborne

1998

)

.

Recent

interest

in phenolic compounds

is

because of

their potential

antioxidant action

against oxidative damage

related

diseases such as diabetes, cancer, coronary heart disease and

stroke

. Phenolic compounds

have

a

high

affinity

with

chelating

metals

that

may inactivate

iron ions by chelating and supressing the superoxide driven Fenton reaction, which is

the sole

source of ROS

(

Iravani 2011

)

.

Therefore

, plants with high content of phenolic c

ompounds

such as

Ocimum

sp.

are suitable

candid

ates for nanoparticle synthesis.

Specific characteri

stic

s

such as size, morphology,

physi

c

o

chemical

properties

(charge

interaction and surface properties)

and dispersity play

significant role

s

in improving th

e

st

ability and compatibility of

Nps

(

Song and Kim 2009

)

.

B

y controlling

the

metal

nanoparticle

structure

at a precise

nanoscale level

measure

d in nano

metre

s

(

one billionth

of a

metre

)

, a standard control and modification can be set to

change

their sur

face layer for

enhanced aq.

solubility, biocompatibility or

bio

-

conjugatio

n

(

Grace

and Pandian 2007

)

.

This

enables

greater

biological

activity due to their relative

ly

high surface area to volume ratio

s

compared to

their larger counterparts

(

Mubarak

et al.

2011

)

. For example, remarkable size

-

dependent properties

were

presented

in

the

facile green synthesis of

AuNps, with a size range

of 15

-

25

nm, using the

antidiabetic

plant

Cassia auriculata

(

Gan

esh

et al

.

2011

)

; a

similar

nanorange was reported by

Arunachalam

et al.

(2013)

forming biocompatible Ag

Nps

and

AuNps from

Memecylon umbellatu.

Bimetallic Au core

-

Ag shell

s

Nps

was reported by

Sheny

et al.

(2011)

,

with a

size range below

10

nm

synthesised

from

Anacardium occidentale

,

and

a size range of 50

-

100

nm was achieved using Neem (

Azadirachta indica

) with

a

large

percentage of

Au

Nps

exhibiting

remarkable

flat, platelike morphology

(

Shankar

et al.

2004

)

.

The medical application

s

of Ag

Nps

,

AuNps

and bimetallic Nps

synthesised

by living plants

has advanced dramatically, focusing on

improving diagnosis, treatment, drug development

and

targeted

drug delivery systems

(

Raman

et al.

2012

;

Adekoya

et al

.

2014

)

.

The

applications

have

huge potential for t

reating major diseases such as c

ancer

(Anand

et al.

2015)

, d

iabetes

(

Daisy and Saipriya 2012

)

and

HIV/

AIDS

(

Raman

et al.

2012

)

in the near

future.

Recent

tren

ds in diabetic research suggest the potential

antidiabetic

activity of

Nps

synthesised

using

antidiabetic

plants as the reducing and

stabilis

ing

agent

s

(

Ganesh

et al.

2011

)

and

raise the question of their

potential

for

improving drug delivery

of ex

isting

synthetic

drugs

for

enhanced

anti

diabetic

treatment

(

Subramania

et al.

2012

)

.

In this study

the

properties of

metal

N

ps

synthesised

from

O. sanctum

(

Philip and Unni 2011

)

and

O.

basilicum

(

Sivaranjani and Meenakshisundaram 2013

)

will be

further extended to investigat

e

their

possibly

enhanced

antidiabetic activity.

2.1.2

In vitro

inhibition of c

arbohydrate

metabolising

enzymes

A range of

in vitro

models

is

available to study the potential

antidiabetic

activity of plant

extracts. B

oth α

-

amylase and α

-

glucosidase enzyme models

can be used to explain

many

reported herbal interactions

(

Kim

et al.

2005

)

.

The enzyme

α

-

amylase

is present in pancreatic juice and saliva and its main role

is to

start

the

breakdown of dietary carbohydrates (a major constituent of the human diet) in the

gastrointestinal tract (GIT) via hydrolysis of dietary polysaccharides, to produce

oligosaccharides and disaccharides

(

McCue

et al.

2005

)

. The resulting disaccharides are

further hydrolysed to produce glucose and other monosaccharides (fructose and galactose)

by

the enzymatic action of α

-

glucosidase

(

Sudha

et al.

2011

)

. After digestion the liberated

glucose and other resulting monosaccharides

are

absorbed

through the small intestine into the

hepatic portal vein

and

this

result

s

in an elevated blood glucose level

s

known as

PPHG

.

Glucose is now available for the body cells to

use

it for energy

(

Nowak and Handford 2004

)

.

Even though

the

a

etiology

of

diabetes

does not relate to the metabolism of carbohydrates

(

L

ebovit 1998

)

,

the in

hibition of α

-

amylase activity

(

Funke an

d Melzig 2006

)

and inhibition

of α

-

glucosidase activity

and other key enzymes

(Table

1

)

(

Akkarachiyasit

et al.

2010

)

have

18

|

P a g e

long been targeted as potential avenues for better glycaemic control in type 2 diabetic patients

or a

s

alternative

treatment

choice

for many borderline patients

(

Subramanian

et al.

2008

).

 

Table 1:

The role of selected carbohydrate metabolising enzymes in the digestion and absorption of carbohydrates

Enzyme                                              Catalytic function

Alpha amylase                                   Produced in the pancreas this enzyme hydrolyses dietary starch into disaccharides and trisaccharides.

Alpha glucosidase                             Present in the brush border of the small intestines, this membrane bound enzyme hydrolyses oligosaccharides, tri-and disaccharides to glucose and

                                                           other monosaccharides.

Hexokinase (glucokinase)                  First enzyme to change glucose during the energy investment phase of glycolysis, allows glucose to remain in the cells.

Glucose-6-phosphatase (G-6-P)        Plays a role in homeostatic regulation of blood glucose levels.

Hydrolyses G-6-P to glucose and inorganic phosphate.

Source: (Akkarachiyasit et al. 2010/Ugochukwu and Babady 2003/Udayakumar et al. 2009)

 

Currently i

n

the market

there are

several established enzyme

inhibitors

which

are

conventionally used

to manage

diabetes, including

m

iglitol,

v

oglibose,

n

ojirimycin, 1

-

d

eoxynojirimycin and

a

carbose,

commercially k

nown as Glucobay

®

(

South African Medical

Association 2005

;

Nickavar and Yousefian 2009

)

. However

,

studies have proven that many

of

these drugs

possess

limitations, are non

-

specific, produce serious side

effects and fail to

alleviate diabetic complications

(

McCue

et al.

2005

;

Bhat

et al.

2011

)

.

For example, long

-

term repercussions of

acarbose

include

GIT side effect

s

,

such as

bloating, abdom

inal

pain

/discomfort, diarrhoea,

flatulence

and

abdominal bacterial fermentation of undigested

carbohydrates in the colon

(

Bhat

et al.

2011

;

Sudha

et al.

2011

)

.

Research

shows that

certain

plant sources show prominent α

-

amyla

se and α

-

glucosidase

inhibition

and are

ab

le to mimic the MOA of standard commercial agents such as

acarbose

and

provide better inhibition

without the

associated

side

effects

(

Kim

et al.

1999

)

,

in

particular those possess

ing

important natural producing

hypoglycaemic

bioactive compounds

(Appendix 5

)

(

Kim

et al.

2005

;

McCue

et al.

2005

;

Mogale

et al.

2011b

)

.

Several

chemical

compounds exhibit α

-

amyla

se and α

-

glucosidase inhibition

(

Subramanian

et al.

2008

)

,

namely

:

alkaloids; stilbenoids

(polyphenol); triterpene

; phytosterol; myoinositol;

flavonoids;

flavonolig

nans; anthraquinones; anthrones;

xanthones;

feruloylglucosides; flavanone

glucosides; acetophenone glucosides; glucopyranoside derivatives

; genine derivatives;

flavonol

and anthocyanin

(

Benalla

et al.

2010

)

.

Thus

,

diabetic studies

are ongoing with the

aim of

obtain

ing

clinically useful enzyme inhibitors

in order to

better control

diabetes

(

Jung

et al.

1996).

 

2.1.3

Antidiabetic potential of Ag

Nps

and Au

Nps

synthesised

via the green route

One of the first attempts

at

assessing the antidiabetic activity of AgNps was demonstrated

using

Sphaeranthus amaranthoides

extract

as

a

natural reducing

agent

, the results of which

showed

a dose

-

response inhibitory activity on α

-

amylase and an IC

50

result lower than the

standard drug

acarbose

(

Swarnalatha

et al.

2012

)

. Biogenic AgNps

synthesised

by

Halymenia

poryphyroides

show

ed

significant

in vitro

an

tidiabetic efficacy

in

a

dose

-

dependent

manner

with

an

increase in the percentag

e inhibitory activity against α

-

amylase enzyme, at

a

concentr

ation of 1.0

mg/ml,

91.30

%

± 0.02

% inhibition, similarly

a significant

increase in

percentage inhibitory activity against α

-

glucosidase enzyme at

a

c

oncentr

ation of 1.0

mg/ml

with

89.10

%

± 0.01

%

inhibition

(

Vishnu and Murugesan 2013

)

.

More recently,

Vishnu and

Murugesan (2014)

repo

rted the biological green

synthesis of AgNps from marine algae

Colpomenia sinuosa

that displayed

in vitro

α

-

amylase and α

-

glucosidase inhibitory activity.

The

high biological

activity

can be explained by the properties of

the metal

Nps

.

F

or

example, AgNps possess a

high surface

area

to volume ratio

plus the charge they carry

is

useful in catalytic studies, a

s they

can easily

interact

with

protein molecules

(

Swarnalatha

et

al.

2012

)

.

As mentioned ROS is

a major

potentiating

factor

in

diabetic related complications

(Iravani

2011)

.

Barathmanikanth

et al

.

(2010) found that

AuNp

s displayed prominent anti

oxidant

properties, inhibiting the formation of ROS

and

scavenging free rad

icals,

therefore

increasing

the anti

oxidant enzymes

and

creating a sustained control over hyperglycaemic conditions

revealing

the potential of biocompatible

AuNps as a safe

therapeutic form of treatment for

diabetes and its associated complications.

The main

functionalis

ed propert

y

associated with

AuNps is that they bind readily to a large range of biomolecules such as proteins/

enzymes,

DNA, amino acids, and expose

a

large surface area for the

immobilisation

of ions of such

bi

omolecules (Ganesh

et al

.

2011).

The

biomedical applications

of AuNps

include diagnostic

assays, thermal ablation, radiotherapy enhancement, gene

therapy

an

d

improving

drug

delivery

systems

. They

are increasingly

being

researched

due to their low toxicity in human

s,

ease of biodegradability,

and

chemical stability as evidenced by

Anand

et al.

(2015

)

.

However, there is a lack of catalytic studies testing the antidiabetic potential

for

AuNps

and

bimetallic

Nps

.

In relation to carbohydrate

metabolising

enzymes

, the exact

mode of the

binding of nanoscale molecules to α

-

amylase and α

-

glucosidase

(

Hamdan

et al.

2004

)

and

the

consequent inhibition

requires

further investigation.

20

|

P a g e

Studies of the

biological applications of metal

have focused mainly

on

how matter behaves at

a

nanoscale level.

T

he limitation

of

these studies is

that they have not addressed the question

of

how

Nps

will react in the human body

(

Vishnu and Murugesan 2014

)

. The current study

investigates the

in vitro

effect

of bimetallic (Au

-

Ag)

Nps

and

AgNps

against α

-

amylase

(derived from porcine) and

B. stearothermophilus

α

-

glucosidase

that mimic

s

the

catalytic

activity

of the human pancreatic α

-

amylases (HPA) and intestinal brush border α

-

glucosidases

.

The

rationa

le for the synthesis of bimetallic (Au

-

Ag)

Nps

were

twofold: (1) to

combine AuNps

(

chemically

inert

and less toxic

ity

)

with AgNps (high

er

bio

active

properties), (2)

incre

ase the surface phenomenon

in the reduction reaction (higher surface

area

to volume

ratio) to achieve

greater biological activity in the enzyme assay.

2.2

Anti

bacterial

screening:

i

nfectious diseases

2.2.1

Diabetic related infections

Diabetic induced infections are increasing globally

at

an alarming rate, adding to associated

complication

s

and wo

rsening the effects of the disease

(

Reid

et al.

2012

)

.

Previously,

diabetes was treated as a single disease

;

now medical professionals are aware that diabetes

covers a wide range of heterogeneous diseases and

is itself an

environmental factor that lead

s

to the development of a wider range of disorders

(

Bastaki 2005

;

Mizuno

et al.

2008

)

. In both

developed and developing countries,

the disabling complications

from

diabetes are rapidly

draining

health care

resources

.

A

dmissions for diabetic

foot

-

related complications

is t

he

most

common r

eason for hospital bed occupancies

in this

patient population

(

Tudhope 2008

)

.

In sub

-

Saharan Africa

,

the

increased incidence of infections in diabetic patients

(

van

Huyssteen 2007

)

is

indirectly affected by the

increased incidence of

HIV/AIDS, and TB,

where up to 22.9 million people are infected with HIV/AIDS

(

Reid

et al.

2012

)

.

This

increase

is attributed to

several

factors, including

the growing

incidence of

antimicrobial

resistance

to

hospital

-

acquired and community

-

acquired

infections,

poorer

soc

ioeconomic

condition

s

,

inaccessibility to modern health care

needs especially

in rural a

reas

,

and poorly controlled

diabetic cases

(

Shankar

et al.

2005

)

.

Management of

infections in diabetic patients

is more

complex and therefore of greater

concern

compared

to infections in non

-

diabetic patient

s

(

La

rkin

et al.

1985

)

.

Immunological deficiency in diabetic patients is triggered

because

of poor

glycaemic control

.

Defects in the

ir

defence system may

increase the risk and severity of

developing

diabetic

21

|

P a g e

induced

infections

(

Larkin

et al.

1985

)

.

I

nfections of the skin

(

particularly

staphylococcal

)

,

periodontal disease, post

operative infections,

pneumonia caused by

Staphylococcus aureus

or

Klebsiella pneumonia

,

urinary tra

ct infections (UTIs)

and

foot infections

can further result in

immunological deficiency in t

he diabetic patient population.

Diabetic peripheral neuropathy

(polyneuropathy) among

all the

other associated co

-

morbid diabetic conditions is reported to

be the p

rim

ary

reason

underlying the

severity of

bacterial

related

diabetic foot trauma and

ulceration

.

D

elayed recognition of symptoms

due to lack of sensation

because of

neuropathy

together

with poor peripheral circulation

may delay healing and encourage

opportunistic

infection

s

(

Shankar

et al.

2005

)

.

T

he worst outcome

of infection

gangrene which

may lead

to

amputation of the foot or

limb

and even death

if prompt treatment is not

instituted

(

Hall

et al.

2011

)

.

In a study by

Shankar

et al.

(2005)

diabetic poly

neuropat

hy was found to be common, with

the incidence of Gram negative (predominant in chronic

diabetes

)

induced

infections being

higher than Gram positive (predominant in acute

diabet

es

)

induced

infections.

In

addition,

p

olymicrobial infections caused by

combination

s

of bacteria such as

Staphylococcus, E. coli,

P. aeruginosa

, and/or

Methicillin

-

resistant

Staphylococcus aureus

(

MRSA

)

in diabetic foot

infections

are increasing

ly

becoming a problem

in patients previously

hospitalised

.

Despite the existence o

f conventional

antimicrobial

agents on the market, resistant stra

ins are

continuously surfacing

(

Adwan

et al.

2010

)

.

Multidrug

resistance is developed due to the

indiscriminate use of

antimicrobial

drugs. In addition,

there are

side effects

of

antimicrobials

including

hypersensitivity, immune

-

suppression and/or

allergic reactions (

Sánchez

-

Borges

et

al.

2013

).

Ever since

hu

mankind

suffered

from

infectious

diseases, herbal

medicine

has been

pursued

as

an effective

source of

treatment

.

N

ew research

is ongoing in the

fight

against

the

constant

mutation and

upgrading of bacteria

(

Adwan

et al.

2010

)

.

A major

emphasis

of industrial

antibiotic production is to

ward

screening programmes for new potent antimicrobial producing

agents.

Plants or natural products still appear to be the most promising source of future

antimicrobials

because of their

availability and chemical diversity

(

Ahmad and Beg 2001

)

.

Historically, plants have created a platform

to create

new biological

ly

active components

,

specifically

focusing on the isolation and

characteris

ation

of unknown compounds expressing

interesting properties

regarding

their

antimicrobial

activity.

 

2.2.2

Antimicrobial potential

of AgNps and AuNps

synthesised

via the green route

Plant extract

s

mediated synthesis of AgNps and

their

antimicrobial

a

ctivity against clinically

isolated pathogens

has

been reported

on

in relation to

most prevalent and pathogenic

Gram

positive

,

Gram negative

bacterial

and fungal

microorganism

s

(

Ramteke

et al.

2013; Rout

et

al.

2012

)

.

Medically,

silver

is

commonly

incorporated in

to

many t

opic

al ointments and

creams

.

T

his

antimicrobial

agent prevent

s

infections caused by burns or open wounds

(

Singhal

et al.

2011

)

. Improving the properties of

silver

by

alter

ing

their

physicochemical

properties (charge interaction, surface properties and size i.e. nanorange

)

nanomedicine has

generated the facile green synthesis of

biocompatible

AgNps

which

are reported

to possess

anti

fungal,

antibacterial

,

antiinflammator

y

, anti

angiog

enesis, anti

platelet

and

anti

viral

properties

, thus

amplifying the existing medicinal properties of

silver

ions.

The

AgNps

formed f

rom

Phyllanthusniruri

sp.

displayed

antibacterial

properties against

Staphylococcus

sp.,

Salmonella

sp

., Proteus

sp

.

and

Bacillus

sp

.

(

Krishnamoorthy and Jayalakshmi 2012

)

;

AgNps

from

Artocarpus heterophyllus

Lam.

s

eed

displayed potent

antibacterial

activity

toward

s

B. cereus, B. subtilis, S. aureus

and

P. aeruginosa

(Jagtap and Bapat 2013)

;

AgNps

from

O.

sanctum

and

Vitex negund

o

,

showed

enhanced

antibacterial

activity against

S.

aureus, E. coli

and

P. aeruginosa

(Ramteke

et al

2013)

and anti

fungal properties against

C.

albicans, C. kefyr

and

A. niger

(Rou

t

et al.

2012)

;

AgNps from

Andrographis paniculata

has

shown prominent

antifungal properties

(Kotakadi

et al.

2014)

.

A

study by

Singhal

et al.

(2011)

found that

AgNps from

O. sanctum

displayed

greater

activity against

E. coli

and

S.

aureus

than silver nitrate and st

andard antibiotic ciprofloxacin

and a st

udy by

Sivaranjani and

Meenakshisundaram

(

2013

) found that

AgNps derived from

O.

basilicum

displayed h

igh

antibacterial

activity against

P.

aeruginosa

.

Antimicrobials

are produced

naturally

by bacteria, fungi, actinomycete

s, algae, lichens and

green plants

(

Peláez

2006

). Thousands of

antimicrobials

have been identifie

d, but

few

natural

sources

have

been commercially used to treat human diseases

(Hackl

et al.

2004

)

. Plant

communities are among the most complex, diverse and important assemblages of chemical

compounds in the biosphere

and

participate in various biological activities.

They

are an

important source

material in

the search

for

novel

antimicrobial

agents and molecules with

biotechnological im

portance (Hackl

et al.

2004).

Together with nanomedicine t

he rich

abundance of

plant

s

in

Africa and

South Africa

makes it a promising

avenue for

investigation

and discovery of

therapeutic drugs.

 

xxxx

 

 

The reasons for this global rise have been linked to changes in lifestyle

 

http://ir.dut.ac.za/bitstream/handle/10321/1534/MALAPERUMAL_2016.pdf?sequence=1&isAllowed=y

 

[Mauritius Fortier-Bernoville]

All the acids have in their pathogenesis a common symptom clearly marked. It is the debility i.e. to say a persistent sense for weakness which is very often seen clinically in a number of chronic cases.

This debility often characterizes the diabetic patient. Not only the patient who has slight or transitory diabetes but also the patient who suffers from important, durable and irremediable glycosuria.

To these patients who are always weak, always fragile, suit the acids. Moreover we must not forget that the acids will act preventively against acidosis which is the greatest danger of diabetes.

Other morbid states + diabetes, when it persists for a long time (for years) these are dyspepsias. We have already shown the value of acid in dyspeptic patients (hypochondria), due to butyric

fermentation. These diabetic dyspeptics will have more often important symptoms that will indicate the acids.

These acids are

a) The most important Acet-lac. Bor-ac. Lac-ac. Ph-ac.

b) Less frequently indicates Carb-ac. Fl-ac. Nit-ac. Pic-ac.

Acet-ac.:

Great weakness, frequent swooning. Persons with flaccid fibres, loose muscles, pale lady colour of the skin. Emaciation.

Great thirst.

Tendency to oedema.

Frequent dyspeptic troubles, burning in the stomach, by peracidity, gastric fermentation. Salivation.

Burning pain in the stomach followed by the sensation of coldness of the skin and cold sweets of forehead.

Am-c.: compared with Acet-ac.; Glycosuria, profuse sweats, weakness and swooning, weaker than Acet-ac.

Bor-ac.:

It suits to diabetics with urinary troubles, dry cracked tongue, red.

Gushes of heat during menopause Like Lachesis.

Tendency to oedema of the face (eyelids).

Sensation of intense coldness.

Cold salivation.

Lac-ac.:

Diabetes with marked polyuria.

The remedy is interesting to study in its action, because we know that the muscles which while working products lactic acid while they become tired, rather Sarcolactic acid which does not differ from real Lactic acid but by its polarimetric rotation. This the game which is chased than the muscles very stiff because of the formation of Sarcolatic acid. This fact denotes in Homoeopathy great muscular weakness some types of influenza.

Useful in some cases of dyspeptic conditions with copious salivation, nausea, > eating acid eructations or still in rheumatising condition with weakness and trembling by the last effort.

Naturally it will suit to diabetics who will have the above symptoms.

Ph-ac.:

Great physical and mental debility.

One of the best remedies of diabetes; suits to the grave conditions, weakening diabetes of children.

Profuse urination, frequent, watery or milky, nocturnal pollauria.

Debility, muscular, sexual, censorial. Amblyopia.

Somnolence, profuse sweat at night and in the morning.

Vertigo in the evening while walking or while standing.

Face pale, dry and lips cracked.

Carb-ac.:

Diabetes with bad conditions tendency to paralysis, weakness of the heart and of the pulse, respiratory troubles, tendency to prostrational and stupor.

Desire for stimulants.

Anorexia.

Tendency to burning eruption with vesicles and ulcerations.

Fl-ac.:

Diabetes with circulatory troubles of the lower extremities, atony or venous blood vesicles and of capillaries Tendency to ulcers.

Diabetes associated with syphilis, acquired or hereditary.

Nit-ac.:

Tendency to fissures to different ulcerations of the skin which bleeds easily and are painful as if due to multiple needle pricks.

Sweats of palms and arm-pits.

Pic-ac.:

A remedy of the degeneration of nerves, specially of the nerves of the marrow, with paralysis. Acts specially on he lumbosacral, marrow, goes towards paraplegia.

Very important in case or nervous debility.

Great weakness of the lower limbs with sensation of drawing and heaviness of the legs. < exercise.

Irritation of the lower part of the marrow determines in Picric acidum the sexual excitation, prolonged eructation and seminal emission during sleep, followed by great weakness.

2. The Metals

Generally the (heavy) metals used often for the treatment of prolonged chronic disease, + deep troubles and definite lesions (often the case in diabetics).

The metals used: Aurum and Argentum the two precious metals; Uranium and Vanadium among rare metals; Plumbum and Cuprum among the common metals.

Aur-met.:

Like Fl-ac. sits to cases of diabetes associated with old acquired and hereditary syphilis.

Exaggerated appetite and thirst.

Tendency to paralysis.

Diplegic, hemianopia sees only the upper half of a n object, mental and physical depression; periodic hopelessness;desire for suicide.

Tendency to general and partial paralysis with hypertension.

Aur-m.: should be preferred to Aur-met. everytime when the tendency to sclerosis is accentuated.

Arg-met.:

Polyuria; turbid and profuse urine with sweetest smell.

Emaciation. Seminal loss without sexual excitation.

Arg-n.:

Trembling, sexual weakness, paralysis of the extremities with numbness for which walking becomes difficulty. All sorts of polyneuritis.

Uran-n.:

Excessive thirst, voracious appetite, abdominal distention, polyuria.

Sexual weakness.

The liver is attacked, and goes towards generation and hypertrophic cirrhosis.

Cartier, after a first phase of congestion.

The arterial tension is often high.

Vanad-met.:

Degeneration of the liver and of arteries, arteriosclerosis fatty heart, fatty degeneration of the liver.

Plb-met.:

Diabetes with paralytic tendency. Skin troubles, asthenia, hyposthenia, tendency to coma or convulsion.

Possible ocular lesions, optic neuritis, paralyses of the external muscles of the eyes.

Paralysis of the lower extremities, abolition of rotulian reflexes raid and marked muscular atrophy.

Plb-i.:

This remedy is preferred to Plb-met. in diabetes with urine of high density, of foetid smell like onion, specially when there is acetonuria.

Acidosis and in the tendency to acenominia which causes coma.

Cupr-m.:

Uremia with the tendency to spasm and convulsion of legs and claves.

3. Other Minerals,.

The other metals or metalloids used generally as ground remedies or as remedies of morbid temperament.

The first three the three remedies of burning sensation are united by classical relations.

1. Ars.:

The intoxication by Arsenic is at the same time so intense, so varied and so deep that it may be called one of our great polycrests. In diabetes it is indicated by weakness and prostration

if the latter # or + restlessness the periodicity of troubles.

Often thirst, for small quantity of cold water rarely repeated or there may be no thirst.

The diabetes + digestive troubles, periodic diarrhoea of blackish stools having foetid smell; or paralysis, polyneuritis with jerkings, heaviness and trembling. the skin is dry and desquamated.

Diabetes with tendency to gangrene; grave humid gangrene with pain and horrible putrid smell.

Ars-br.:

It is used in diabetes with great tendency to cutaneous eruptions, acne, furuncles or anthrax.

Sulphur.:

Less important than Ars. The individual drinks much, eats less. Sensation of weakness and of goneness (in the stomach towards 11 h.) obliging the patient to eat something for amelioration.

Profuse and less colored urine.

Tendency to cutaneous eruptions.

 

Sulphur should be used always prudently in diabetic patients, because its repeated use (in high dilutions), may produce some abscesses, furuncles, or anthrax which are always dangerous.

In this case, better use Psorinum in he place of Sulphur, specially if the patient is chilly, weak and forced to put on multiple under garments.

Very often Hepar, Sulphur are to be used every time when it is indicated by suppurations.

 

Phos.:

It is very important remedy of diabetes.

Deep action not only on the liver, but also on the pancreas. A remedy of all lofts of degeneration.

Diabetes complicated with digestive troubles; Exaggerated hunger which reappears just after meals, unquenchable thirst for cold drinks.

1. debilitating Diarrhoea without pain 2. great weakness after stools. Sexual troubles, impotence after an exaggerated desire, with lascivious dreams and involuntary seminal loss; Nervous troubles;

Motor paralysis with weakness, trembling by the least exercise. Sensation of numbness; eye troubles; Cataract amblyopia. diplopia,. paresis of the motor muscles of the eyes of grave lesions of the

retina and of the optic nerve.

 

Whatever may be its indications, it is the remedy that should be well understood and should be prescribed uniquely, from a synthetic point of view of similar pathological troubles observed in the

individual than by its key symptoms. the characteristics of Phosphorus are almost always of the field of anatomy-pathology as well as of pure pathogenesis.

 

Sil.:

By its supportive tendency Silicea will very often be indicated with Hep. in diabetes who have pancreas, and furuncles.

In all these cases all the remedies of suppuration of septicemia may be indicated; Ars., Echi., Pyrog. in very grave cases. Lach., Apis, Bell., Ferr-p., Arn. Sil. may sometimes favour the suppuration dangerously. Hep. is better in acute cases, will stop menacing suppuration the latter on the contrary. Sil. suits to chronic suppuration which are weakening and with fistula.

 

[http://bestonhealth.com/diabetes-2/]

[http://bestonhealth.com/homeopathy-home/]

Homeopathy treats the total, taking the total symptom picture of the patient into consideration, not just the metabolic disorder. It also modifies your temperament so that you react appropriately

to stressful situations. The homeopathic medicines influence and balance a person’s neurological, hormonal and immune systems. Homeopathic treatment aims to cure the disease of the patient

by stimulating the vital force (power of resistance) of the sick person. But if this power of resistance weakened by damaging influences of toxic and infective agents (chronic miasm- fundamental

cause of chronic diseases), then H. advised to remove these obstruction to eliminate chronic miasm so that no interference may come in the way of cure.

Deficiency of insulin is the chief obstruction to cure diabetes mellitus. Therefore, where insulin deficiency (Type 1 diabetes) is present and cannot be stimulated by homeopathic medicines then it

should be given simultaneously to remove the obstruction to cure.

In the light of Hahnemannian principles the homeopathic remedies may be divided into three categories:

I. Homeo-miasmatic remedies: These remedies are similar to the damaging influences, toxins and infecting agents that derange the power of resistance (vital force) of the patient. These damaging

miasms (miasm are infectious, excessively minute agents causing diseases, these were first discovered by H. which cause diabetes of three types:

 Acute uncured miasm like influenza, whooping cough, diphtheria etc. (Remedies which may help are: Infl. Pertussin, Diph.

 Suppressed influences like effects of suppressed emotions like anger, grief (Remedies which may help are: Ign. Nat-m. Nux-v. Staph. Aur-met. Lach. Lyc. Psor.

 Chronic miasms (chronic infective agents): Remedies which may help are: Psor. Tub. Thuj. Syph. Med. Sulph. Merc.

II. Homeo-constitutional remedies: These remedies are similar to the personality of the patient. To select these remedies homeopathic physician must carefully assess your entire symptom picture,

figure out your personality, hopes and fears, family history, and put it all together to come up with the single individual remedy that best fits your picture.

Important homeo-constitutional remedies incl. Arg-met. Acet-ac. Ars. Bor-ac. Bov. Caus. Grap. Hep. Helon. Lac-ac. Lyc. Nat-m. Nit-ac. Op. Ph-ac. Phos. Plb-met. Sec. Sil. Sulph. Tarent-h. Van-met.

III. Specific Homeopathic remedies: These medicines have symptoms similar to the symptoms of diabetes and are therefore specific for this condition.

These remedies include: Adren. Ars. Anthrac. Cupr-ars. Glyc. Insulin. Lac-ac. Lecithin, Pancreatin. Nat-s. Phloridizin, Ph-ac. Uran-n. Syzyg.

Even though Homeopathy may not be able to cure diabetes completely, the above remedies help in:

 Stimulating the resistance power of the patient thereby controlling the disease.

 Fighting against the weakness.

 Maintain the patient in a state of equilibrium (both mentally and physically).

 Checking and managing the complications of diabetes.

 

[W. Karo]

Diabetes mellitus

Usually starts much earlier than the patients become aware of it. The first symptoms are vague and general to such a degree that they may be applied to other diseases (of the digestive organs).

Consequently we have to examine the urine in all cases whatsoever, before giving any advice or any treatment. Not to do, I must say, would be an inexcusable mistake.

Diabetes mellitus begins with disorders of the digestive organs. The patient at first complains of uneasiness, painful sensations and tightness in the region of the liver and of the stomach, + irregular opening of the bowels, sometimes by acid eructation and vomiting of a brownish, very bitter tasting liquid. The patient complains of headache, sleeplessness, intense fatigue, giddiness, buzzing in the ears, eyes weak, palpitation of the heart, burning sensations in the heads and feet; simultaneously the mental condition of the patient gets entirely altered.

Certainly all these symptoms are of an entirely general nature and may be found also in many other diseases. But if the disease progresses, we get confronted with a very characteristic symptoms, i.e. the strikingly increased thirst, especially after eating and during the night.

Naturally the patient is constantly seeking to allay it, and the quantity of liquid consumed is proportional to the amount of urine passed.

According to the increased secretion of urine the patient has to urinate very often (at night), again and again interrupting the patients sleep. As a rule the average quantity of the urine during 24 hours amounts to 3-5 pints. But there are cases in which the quantity may be much greater. I remember patients secreting nearly 12 pints urine daily. The urine is usually clear, pale in colour, has a sweet taste and is of high specific gravity (1030 to 1050).

When diabetic urine is boiled with cupric salt, which has a bluish of green color, the latter is reduced to a cuprous salt having a brown or yellow colour, and a process depending upon this chemical reaction from the usual method of recognizing and estimating the amount of sugar present in the urine. The sugar can also be tested by measuring the amount of carbonic acid gas set free on fermentation by yeast and by the extent to which a specimen of the urine rotates the pane of polarized light. The quantity of sugar passed in twenty-four hours may vary from a few ounces to several pounds, and it is, of course, markedly increased after sugary or starchy food has been taken. In light cases of diabetes the urine contains only 2 – 1% sugar, in the most serious cases 10% or even more; in these serious cases there is also albumen in the urine. In such serious cases the urine contains two other components, i.e. acetone and acetone-acetic acid; their presence in the urine we may conclude already from the winy smell of the urine or from the patients breath.

If the patients breath has the characteristic unpleasant pomaceous smell, we may be sure that acetone and acetone-acetic acid are not only in the breath, but also in the urine of the patient. Whoever has repeatedly perceived that smell will always recognize it, hence it is called the acetone-smell.

As a rule the skin of the diabetic patient is dry and harsh with a peculiar papery consistency. Owing to the poor vitality of the tissues, various skin eruptions appear, boils and carbuncles being especially common and, in the fact, sometimes giving the first signs of the presence of the disease. The sugar deposited from the urine is very liable to cause itching about the groins and eczema of various parts of the body is set up by the presence of sugar in the sweat. There is a special tendency to gangrene of the skin of the feet, commencing with the toes, and this from is a very serious complication of diabetes and a not uncommon from of fatal issue.

Regarding the nervous symptoms I have already mentioned the general symptoms as there are a certain feebleness, exhaustion, dislike of physical or intellectual work, great weakness after the slightest exertion, sensation of formication and numbness in the limbs, headache, depression. But one symptom of the nervous system is a very characteristic one, i.e. the typical neuralgia, especially frequently affecting the sciatic nerve, usually called ischias or sciatica.

Whenever it affects both sides, it may be an early symptom of the diabetes; besides the sciatica there are also cases with neuralgia in the occiput or in the face as well as cases of a specific migraine (sick headache). In other cases of diabetes we find paralysis of the limbs.

The most serious symptom of the disease is the so-called diabetic coma; it usually begins with some slighter general nervous symptoms as there are headache, nausea, a certain unrest, oppression and anguish, very soon increasing and aggravating. the patient gets delirious, jumps out of the bed and gets excited to such a degree that he behaves as raving mad. As soon as the excitation has passed away,

a characteristic enervation and somnolence sets in, aggravating in the most serious cases up to complete unconsciousness and to that deathlike sleep, called coma. The patients breathe extremely deeply and noisily, their faces get bluish red, cyanotic, the pulse is very much accelerated and low, the temperature decreasing.

Such a coma may continue for several days, but in the majority of cases it starts like an apoplexy. In any case the coma always is the most alarming and the most fateful symptom, it is due to a self-poisoning as a result of the absorption of the waste products of metabolism or of the products of decomposition within the intestine. In nearly all cases the coma is the consequence of inappropriate nourishment, especially of too much meat and eggs. The patient overloads the digestive organs with nourishment which cannot be digested, slags remain, poisoning the central nervous system.

Diabetes, as a rule, advance comparatively slowly, except in the case of young people, in whom its progress is apt to be rapid. Indeed, in a general way, it is more serious, the younger the subject of the disease. Various complications arise in its course; some of them I have already mentioned; as one of the most alarming complication I will call attention to the cataract, followed by dimness and loss of sight, furthermore to inflammatory chest affections, of which pulmonary consumption is the most common and is a frequent termination of diabetes. Occasionally death occurs from exhaustion or from the coma diabeticum spoken of above. But the majority of cases continue suitable diet and treatment for many years without materially getting worse, and in a great number of cases complete cure apparently takes place. The most unfavorable cases are those in children, also cases in which the disease has already become of severe character, and has established before it has been recognized.

There is no other disease in which diet is of such a decisive importance as it is in diabetes. It would be a serious mistake to prescribe schematically the same diabetic diet for all cases; each case has to be treated individually according to the age, weight and activity of the patient as well as to the stage reached by the diabetes. The amount of energy that must be supplied by the food in order to carry on the vital processes of life, such as body warmth, the action of the heart, he such as body warmth, the action of the heart, the movements of the chest, in breathing, and the chemical activities of the secreting glands, is, for an adult of about 140 lbs. in weight, approximately 1,600 calories daily. For a patient, lying quietly in bed, little more is needed; for sedentary occupations such a patient requires about 2,000 calories, while if he is doing muscular work, the equivalent of 3,000 calories is needed. I desist from discussing that problem thoroughly, though it is of the greatest importance.

Generally speaking the diabetic diet ought to be composed of albumen. green vegetable and fats. Uncooked food ought to be the main constituent; especially I call the attention to uncooked fermented cabbage, plentifully containing vitamins, mineral salts and an insulin-like body; I usually prescribe 1 to 2 lbs. daily. Furthermore, once or twice weekly, the patient ought to take only fruit, especially berry fruits; owing to their abundance of bases, they alkalize the acids and diminish the demand for albumen. Green vegetables, especially green beans, salads, onions, horseradish, celery, carrots, radish, potatoes baked in their jackets, fresh cucumbers, nuts, especially walnuts, oatmeal porridge, old and very well toasted rye-bread, cream cheese, fresh butter, daily one to two large spoons of walnut oil and the yolk of an egg, mixed with lemon juice, are of the greatest value for the patients. For, generally speaking, vegetable albumen is more wholesome to the diabetic patient than animal albumen; at least sausage ought to be prohibited.

Regarding the beverages I must call the attention to the wholesome effect of the various herbal teas, as there are hips, leaves of bilberries, bean-skins, dandelion; furthermore we ought to give berry fruit juices, lemon, mineral waters, sea-water preparations, buttermilk. I am giving to all my patients, as I have already mentioned in my paper on goitre (No. 4 of the journal), the Adinolan tea; due to its constituents it has the best effect on the metabolism. it purifies the whole body and stimulates the vital reactions of the patient.

Before discussing the Homoeopathic treatment of diabetes, I call attention to yeast as to a remedy of the greatest importance. It is indeed a tonic roborant as well as a remedy for the whole constitution of the patient; also, in serious cases its effect is such a striking one that no homoeopath ought to slight it. By giving 20-30 gr. daily we may, even in serious cases, save insulin, Insulin is the principal remedy not only in allopathy, but it is also used by a great number of homoeopaths. I refer only to Stiegele, the most prominent German homoeopath, who is of the opinion that Homeopathy is not able to replace the insulin; but, as the effect of the insulin is only a short one, Homoeopathy has supplement it. Certainly, a great many homoeopaths refuse insulin at all. I will not discuss thoroughly all the pros and cons of the insulin question. In my opinion, we so not need it in light cases, but I would not like to miss it in serious cases (coma); the homoeopath, who in coma cases would not given insulin, would be responsible for the patients death. Furthermore, we dare not to stop insulin entirely at once in patients who up to the beginning of the homoeopathic treatment have been using insulin for a long time. I remember such a tragedy.

The homoeopathic treatment of diabetes has to be based on the fact that the glycosuria is only symptom of the disease; to find the most suitable drug for the patient we have to keep in mind the whole constitution of the patient; i.e. we have to consider not only the physiological cases we have to treat the constitution of the patient rather than the glycosuria. That point is very important, especially here are far reaching points of view.

 

Sulph.: a constituent of the insulin-molecule, having far reaching connections with the metabolism (oxidizing process); it provokes symptoms on the skin and in the links, so frequently in diabetic patients; furthermore, there is the same psychical irritability, voracious or loss of appetite, sleeplessness.

Nat-s.: hydrogenoid constitution/tongue is brownish coated, dry; bitter taste; mouth and pharynx very dry, disorders of the liver, gall bladder and bowels; Dropsy., oedema.

Phos.: connected with the metabolism of the fats and with the storing of glycogen; especially in cases, complicated by gout, tuberculous and other diseases of the bronchial ways or the lungs. Instead of Phosphorus itself we may give Kali-p. Ferr-p. Calc-p.

Ph-ac.: nervous symptoms are to be considered first, especially in cases, due to grief, care and trouble, indifferent, unconcerned about their family; there is a great mental and physical weakness, loss of appetite, but extremely increased thirst. Many furuncles. Urine very much increased, much sugar, many phosphates; the urine has a pale, milky colour. Before the micturition anguish, after it burning. Especially indicated in diabetic children, suffering from stomach troubles, or having grown up too quickly.

Acet-ac.: suffering from great anaemia and weakness, polyuria, face emaciated, salivation, burning thirst, vomiting after each meal, pyrosis, increased acidity in the stomach; burning pains in the stomach. Suitable to serious cases, especially to patients suffering from the stomach, burning pain, burning thirst, pyrosis, vomiting after each meal, salivation; anaemia of a high degree, greatest weakness, skin very dry, sweat, face emaciated, wax-coloured; polyuria, urine very light and pale.

Iod.: increased appetite, skin very dry, many nervous symptoms, disorders of the glandular system and of the liver metabolism.

Sec.: Emaciation, gangrene of the toes, extremities cold; worse by heat.

Bry.: Very thirsty, lips very dry, bitter taste the patients are weakened, peevish, sad, appetite normal, disorders of the liver.

Uran-n.: Suitable to cases due to disorders of the assimilation, characterized by disposition to ascites or to general dropsy, great weakness, indigestion, urine increased, acid, very much sugar in the urine, burning sensation in the urethra, very thirsty, mouth dry, emaciation in spite of good appetite.

Syzyg.: improves the general condition of the patient, decreases the quantity of the sugar of the blood as well as of the urine; suitable to patients suffering from thirst, great weakness and emaciation; furunculosis; specific gravity of the urine very high.

Plb-met.: Hering: one off the most important remedies, especially suitable to patients suffering from nervous troubles and constipation.

Ars.: very thirsty; emaciation; especially for cases of gangrene.

Lac-ac.: suffering from disorders of the liver and of the whole digestive system, very thirsty, appetite very much increased, nausea vomiting; urine in profusion, clear yellow, sweetishly smelling.

Podo.: Bitter taste, tongue white coated, disorders of the liver, better by pressing the region of the liver.

Arg-met.: Polyuria, urine cloudy, sweetishly smelling, micturition frequent and abundant.

Arg-n.: great longing for sweets, though they are making worse all troubles; disorders of the stomach, eructation; feet very cold. Better by eructation, fresh air, cold and pressure.

Chion.: Sensation of great dryness, not improved by water, pinching pains in the umbilical region, enlargement of the liver, jaundice, constipation, stools

whitish grey, mellow; diseases of the pancreatic and other glands. Urine bilious with very much sugar high specific gravity, dark brown colour.

Lyc.: Suitable to the well-known Lycopodium constitution; I have learned by my own practice, that at least 40% of the diabetic patients have very characteristic Lycopodium symptoms; in all these cases Lycopodium, especially given alternating with Natrum sulfuricum , improved the diabetic condition of the patients very quickly.

 

In cases of coma diabeticum we my give drugs like Echinacea, Belladonna, Helleborus niger, Hyoscyamus, Cuprum met, Opium or Acidum muriaticum. But I must repeat: I would not dare to rely upon the homeopathic drugs alone in such serious cases, but would rather give high doses of insulin.

 

[Farokh J. Master]

What is the Homoeopathic approach to control Diabetes Mellitus

Homoeopathic approach for Diabetes mellitus is strictly individualizing every single case, analyzing the physical as well as mental constitutional symptoms and selecting single homoeopathic remedy. During constitutional homoeopathic treatment diabetes mellitus we usually advice investigations periodically on an average 3 months and I some cases early also.

Following are the common tests:

a) Plasma glucose concentration (Fasting and Post Prandial).

b) Glycosylated hemoglobin, to measure long term glyceamic control.

c) Plasma lipid levels to rule out increase level of triglycerides and low density lipoproteins.

d) Routine urine for albumin to rule out early evidence of diabetic nephropathy.

e) Serum creatine levels.

f) Regular eyes check up to detect early diabetic retinopathy.

g) Weekly measurement of blood pressure to rule out hypertension which is so frequently associated with diabetes mellitus.

The following homoeopathic medicine has been extremely useful in my practice.

a) Cod.: when there is excessive skin irritation (Itching due to diabetes mellitus).

b) Ph-ac.: when diabetes mellitus starts after some nervous exhaustion, working too hard or disappointment in relationship.

c) Remedies like Gun. Staphcoc. Melal. extremely useful for diabetic carbuncle and gangrene.

d) Remedies like Urea pura. Ampe. extremely useful for diabetic nephropathy.

The treatment for diabetes mellitus in homoeopathy is extremely effective but people do not come to us in early state and hence once the pathology is advanced we cannot cure but only palliate the condition. On an average in my Homoeopathic Health Centre I receive approximately 20-30 new patients every month with high creatine level and uncontrolled diabetes mellitus. There patients have been advised dialysis but with my experience of last 20 years I am able to prevent dialysis in majority of these people with the help of constitutional treatment and proper diet control. I have been successful to arrest the further progress of diabetic nephropathy. In our clinic we give advice for diabetic diet:

a) Fruit and leaves of drumsticks (saijan ki phalli) and patola (= Luffa.) very useful for the diabetic patient.

b) Fenugreek (methi/= Foenm-g.) seeds, when given in varying doses of 25 grams to 100 grams daily, diminishes reactive hyperglycemia in diabetic patient. Soak 10-12 fenugreek (methi) seeds in one-fourth cup of water overnight and have both the seeds and the water, next day in the morning with a glass of water. This is beneficial for people with diabetes. You can also powder the methi seeds and take one teaspoonful of this powder with low fat milk daily for at least two months. This will keep the blood sugar level under control.

c) The diabetics should take two raw string beans (runner beans or French beans) daily.

d) Have bhindi (okra/= Hibiscus esculentus) soup daily, this will keep the diabetic patient healthy.

Recipee:

Take 6-7 raw bhindis and wash them thoroughly. Slit them lengthwise (do not cut the bhindi into two halves, just slit them). Boil them in one litre of water till the water is reduced to half. Strain this liquid and drink it plain or with salt and pepper if you so desire. You mat throw away the boiled bhindi, do not squeeze the bhindis while straining.

Having bhindi water is also useful, the method is wash and cut 3-5 bhindis lengthwise in two pieces or in two halves and soak them overnight in some water. The next morning, remove the bhindis from the water and drink that water. Doing this regularly will make the sugar level normal within a couple of months.

                                               Diabetes mellitus associated with

- Cardiac failure

- Constipation

- Dropsy

- Dyspepsia

- Hepatic dysfunction

- Impotency

- Prostration

 

[Henriette Kress]

 

 

[Anthroposofisch.]

Der menschliche Organismus entfaltet durch alle seine Glieder hindurch Tätigkeiten, die ihre Impulse allein in ihm selber haben können. Was er von außen aufnimmt, muss entweder bloß die Veranlassung dazu sein, dass er eine eigene Tätigkeit entwickeln kann; oder es muss so im Körper wirken, dass die Fremdtätigkeit sich nicht von einer inneren Tätigkeit des Körpers unterscheidet, sobald sie in diesen eingedrungen ist.

Die notwendige Nahrung des Menschen enthält z. B. Kohlehydrate. Diese sind zum Teil stärkeähnlich. Als solche sind sie Substanzen, die ihre Tätigkeit in der Pflanze entfalten. In den menschlichen Körper gelangen sie in dem Zustande, den sie in der Pflanze erreichen können. In diesem Zustande ist die Stärke ein Fremdkörper. Der menschliche Organismus entwickelt keine Tätigkeit, die in der Richtung dessen liegt, was Stärke, in dem Zustande, in dem sie in den Körper kommt, als Tätigkeit entfalten kann. Was z. B. in der menschlichen Leber als stärkeähnlicher Stoff entwickelt wird (Glykogen), ist etwas anderes als pflanzliche Stärke. Dagegen ist der Traubenzucker eine Substanz, die Tätigkeiten erregt, welche von gleicher Art sind wie Tätigkeiten des menschlichen Organismus selbst. Stärke kann daher in diesem nicht Stärke bleiben. Soll sie eine Wirkung entfalten, die in dem Körper eine Rolle spielt, so muss sie verwandelt werden. Und sie geht, indem sie vom Ptyalin der Mundhöhle durchsetzt wird, in Zucker über. Eiweiß und Fett werden vom Ptyalin nicht verändert. Sie treten zunächst als Fremdsubstanzen in den Magen ein. In diesem werden die Eiweißstoffe durch das von ihm abgesonderte Pepsin so verwandelt, dass die Abbauprodukte bis zu den Peptonen entstehen. Sie sind Substanzen, deren Tätigkeitsimpulse mit solchen des Körpers zusammenfallen. Dagegen bleibt Fett auch im Magen unverändert. Es wird erst von dem Absonderungsprodukt der Bauchspeicheldrüse so verwandelt, dass Substanzen entstehen, die sich aus dem toten Organismus als Glycerin und Fettsäuren ergeben.

Nun aber geht die Verwandlung der Stärke in Zucker durch den ganzen Verdauungsvorgang hindurch. Es findet auch eine Umwandlung der Stärke durch den Magensaft statt, wenn diese Umwandlung nicht schon durch das Ptyalin stattgefunden hat.

Wenn die Umwandlung der Stärke durch das Ptyalin stattfindet, so steht der Vorgang an der Grenze dessen, was sich im Menschen im Bereich dessen abspielt, das in dem Kapitel II die Ich- Organisation genannt worden ist. In deren Bereich geht die erste Umwandlung des von außen Aufgenommenen vor sich. Traubenzucker ist eine Substanz, die im Bereich der Ich-Organisation wirken kann. Er ist dem Geschmack des Süßen entsprechend, der in der Ich-Organisation sein Dasein hat.

Entsteht aus dem Stärkemehl durch den Magensaft Zucker, so bedeutet dies, dass die Ich- Organisation in den Bereich des Verdauungssystems eindringt. Für das Bewusstsein ist dann der Geschmack des Süßen nicht da; aber, was im Bewusstsein - im Bereich der Ich-Organisation - vorgeht, während «süß» empfunden wird, das dringt in die unbewussten Regionen des menschlichen Körpers, und die Ich-Organisation wird dort tätig. In den uns unbewussten Regionen hat man es nun im Sinne von Kapitel II zunächst mit dem astralischen Leib zu tun. Es ist der astralische Leib da in Wirksamkeit, wo im Magen die Stärke in Zucker verwandelt wird.

Bewusst kann der Mensch nur sein durch dasjenige, was in seiner Ich-Organisation so wirkt, dass diese durch nichts übertönt oder gestört wird, so dass sie sich voll entfalten kann. Das ist innerhalb des Bereiches der Fall, in dem die Ptyalinwirkungen liegen. Im Bereich der Pepsinwirkungen übertönt der Astralleib die Ich-Organisation. Die Ich-Tätigkeit taucht unter in die astralische. Man kann also im Bereich des Materiellen die Ich-Organisation an der Anwesenheit des Zuckers verfolgen. Wo Zucker ist, da ist Ich- Organisation; wo Zucker entsteht, da tritt die Ich-Organisation auf, um die untermenschliche (vegetative, animalische) Körperlichkeit zum Menschlichen hin zu orientieren.

Nun tritt der Zucker als Ausscheidungsprodukt auf bei Diabetes mellitus. Man hat es dabei mit dem Auftreten der Ich-Organisation an dem menschlichen Organismus in einer solchen Form zu tun, dass diese Organisation zerstörend wirkt. Sieht man auf jede andre Region des Wirkens der Ich-Organisation, so stellt sich heraus, dass diese untertaucht in die astralische Organisation. Zucker unmittelbar genossen ist in der Ich-Organisation. Er wird da zum Veranlasser des Süß-Geschmackes. Stärke genossen und durch das Ptyalin oder den Magensaft in Zucker verwandelt, zeigt an, dass in der Mundhöhle oder im Magen der astralische Leib mit der Ich-Organisation zusammenwirkt und die letztere übertönt.

Zucker ist aber auch im Blute vorhanden. Indem das Blut Zucker enthaltend durch den ganzen Körper zirkuliert, trägt es die Ich-Organisation durch diesen. Überall da aber wird diese Ich-Organisation durch das Wirken des menschlichen Organismus in ihrem Gleichgewicht gehalten. In dem Kapitel II hat sich gezeigt, wie außer der Ich-Organisation und dem astralischen Leib in der menschlichen Wesenheit noch der ätherische und der physische Leib vorhanden sind. Auch diese nehmen die Ich- Organisation auf und halten sie in sich. So lange dies der Fall ist, sondert der Harn keinen Zucker ab. Wie die Ich-Organisation, den Zucker tragend, leben kann, das zeigt sich an den an den Zucker gebundenen Vorgängen im Organismus.

Beim Gesunden kann der Zucker im Harn nur auftreten, wenn er zu reichlich, als Zucker, genossen wird, oder wenn Alkohol, der unmittelbar, mit Übergehung von Verwandlungsprodukten, in die Körpervorgänge sich hineinzieht, zu reichlich aufgenommen wird. In beiden Fällen tritt der Zuckerprozess als selbständig, neben den sonstigen Vorgängen im Menschen auf.

Bei Diabetes mellitus liegt die Tatsache vor, dass die Ich-Organisation beim Untertauchen in den astralischen und ätherischen Bereich so abgeschwächt wird, dass sie für ihre Tätigkeit an der Zuckersubstanz nicht mehr wirksam sein kann. Es geschieht dann durch die astralischen und ätherischen Regionen mit dem Zucker dasjenige, was mit ihm durch die Ich-Organisation geschehen sollte.

Es befördert alles die Zuckerkrankheit, was die Ich-Organisation aus der in die Körpertätigkeit eingreifenden Wirksamkeit herausreißt: Aufregungen, die nicht vereinzelt, sondern in Wiederholungen auftreten; intellektuelle Überanstrengungen; erbliche Belastung, die eine normale Eingliederung der Ich-Organisation in den Gesamtorganismus verhindert. Das alles ist zugleich damit verbunden, dass in der Kopforganisation solche Vorgänge stattfinden, die eigentlich Parallelvorgänge der geistig-seelischen Tätigkeit sein sollten; die aber, weil diese Tätigkeit zu schnell oder zu langsam verläuft, aus dem Parallelismus herausfallen. Es denkt gewissermaßen das Nervensystem selbständig neben dem denkenden Menschen. Das aber ist eine Tätigkeit, die das Nervensystem nur im Schlafe ausführen sollte.

Beim Diabetiker geht eine Art von Schlaf in den Tiefen des Organismus dem Wachzustande parallel. Es findet daher im Verlaufe der Zuckerkrankheit eine Entartung der Nervensubstanz statt. Diese ist die Folge des mangelhaften Eingreifens der Ich-Organisation.

Eine andere Begleiterscheinung sind die Furunkelbildungen bei Diabetikern. Furunkelbildungen entstehen durch ein Übermaß in der Region der ätherischen Tätigkeit. Die Ich-Organisation versagt da, wo sie wirken sollte. Die astralische Tätigkeit kann sich nicht entfalten, weil sie gerade an einem solchen Orte nur im Einklange mit der Ich-Organisation Kraft hat. Die Folge ist das Übermaß der ätherischen Wirksamkeit, die sich in der Furunkelbildung zeigt.

In alle diesem sieht man, wie ein Heilungsvorgang für Diabetes mellitus nur eingeleitet werden kann, wenn man die Ich-Organisation bei dem Diabetiker zu kräftigen imstande ist.

 

[Anderson]

NewScientist.com news service

Just ½ a teaspoon of cinnamon a day significantly reduces blood sugar levels in diabetics, a new study has found. The effect, which can be produced even by soaking a cinnamon stick your tea, could also benefit millions of non-diabetics who have blood sugar problem but are unaware of it.

The discovery was initially made by accident, by Richard Anderson at the US Department of Agriculture's Human Nutrition Research Center in Beltsville, Maryland.

"We were looking at the effects of common foods on blood sugar," he told New Scientist. One was the American favourite, apple pie, which is usually spiced with cinnamon. "We expected it to be bad. But it helped," he says.

Sugars and starches in food are broken down into glucose, which then circulates in the blood. The hormone insulin makes cells take in the glucose, to be used for energy or made into fat.

But people with Type 1 diabetes do not produce enough insulin.

Those with Type 2 diabetes produce it, but have lost sensitivity to it. Even apparently healthy people, especially if they are overweight, sedentary or over 25, lose sensitivity to insulin.

Having too much glucose in the blood can cause serious long-term damage to eyes, kidneys, nerves and other organs.

Molecular mimic

The active ingredient in cinnamon turned out to be a water-soluble polyphenol compound called MHCP. In test tube experiments, MHCP mimics insulin, activates its receptor, and works synergistically with insulin in cells.

To see if it would work in people, Alam Khan, who was a postdoctoral fellow in Anderson's lab, organised a study in Pakistan. Volunteers with Type 2 diabetes were given one, three or six grams of cinnamon powder a day, in capsules after meals.

All responded within weeks, with blood sugar levels that were on average 20% lower than a control group. Some even achieved normal blood sugar levels. Tellingly, blood sugar started creeping up again after the diabetics stopped taking cinnamon.

The cinnamon has additional benefits. In the volunteers, it lowered blood levels of fats and "bad" cholesterol, which are also partly controlled by insulin. And in test tube experiments it neutralised free radicals, damaging chemicals which are elevated in diabetics.

Buns and pies

"I don't recommend eating more cinnamon buns, or even more apple pie - there's too much fat and sugar," says Anderson. "The key is to add cinnamon to what you would eat normally."

The active ingredient is not in cinnamon oils. But powdered spice can be added to toast, cereal, juice or coffee.

Anderson's team were awarded patents related to MHCP in 2002. But the chemical is easily obtained. He notes that one of his colleagues tried soaking a cinnamon stick in tea. "He isn't diabetic - but it lowered his blood sugar," Anderson says.

The group now plans to test even lower doses of cinnamon in the US, and also look at long-term blood sugar management with the spice.

 

 

Vorwort/Suchen Zeichen/Abkürzungen                                   Impressum