Complementary Alternative Medicine: Turmeric and the Effects on Type 2 Diabetes Mellitus

Transcription

1 Complementary Alternative Medicine: Turmeric and the Effects on Type 2 Diabetes Mellitus

2 1 Table of Contents Introduction Description...2 Background/history Modern uses, doses Review of literature Effectiveness, efficacy Nutrition facts Drug nutrient interactions or side effects Discussion Conclusion Reference List

3 2 Introduction Turmeric is widely used throughout Southeast Asia as an aromatic spice in cooking and as a medicinal instrument in complementary health practices for over 6000 years. Western medical practitioners and researchers recognize the importance and health benefits that turmeric may offer in the treatment of chronic illnesses (diseases of the eye, cancer, osteoarthritis, ailments of the digestive system, inflammation, cardiovascular disease, and diabetes) as evidenced by the over 3,000 research studies and publications. The focus of this paper will be to provide current research information on the potential scientifically demonstrated functions of turmeric concerning its effectiveness on preventing type 2 diabetes (T2DM) and impeding its devastating complications. Description Turmeric is extracted from the rhizome of the plant Curcuma Longa; a rhizome is an underground stem from which roots grow (Kumar, 2013). The rhizomes are boiled in water, drained, dried, and grounded into turmeric powder the form in which it is often used (Thomas- Eapen, 2009). Turmeric has a warm, bitter taste. Dried turmeric rhizomes yields 1.5-5% of essential oils, which are responsible for its aromatic taste and smell (Prasad, 2014). The yellow color of the spice is derived from the curcumin, which is the most active component of the spice and it makes up two to five percent of the spice (Gupta, 2013). Background/History Turmeric was regarded as the herb of the sun because of its purifying yellow-orange color, like the fire element which is symbolic for eliminating impurities (Reddi, 2013). Based on Hindu culture, turmeric is viewed as scared because of its healing properties that it led to the

4 3 belief that the plant was sent from the heaven (Reddi, 2013). Turmeric has been traditionally recognized as a therapeutic agent in both the Indian and Chinese systems of medicine (Gupta, 2013). In Traditional Chinese Medicine (TCM), turmeric has been historically used in herbal formulas to treat conditions including flatulence, liver problems, menstrual difficulties, bloody urine, hemorrhage, toothache, bruises and sores, chest pain and colic (Kumar, 2013). Ayurveda is the ancient medical practice of the Indian system of medicine and turmeric has been documented as a therapeutic agent to treat all kinds of disease states: acne, psoriasis, dermatitis, rash, ulcers, and wounds (Kumar, 2013). Because of the Ayurveda principle that turmeric carries medicinal properties, a pinch of turmeric is added to most of the foods cooked in India (Thomas-Eapen, 2009). Turmeric is a major ingredient in many curry powders and it is added as a flavoring agent to vegetables, lentils, beans, meat, fish, and buttermilk (Thomas-Eapen, 2009). In addition to the use of turmeric in Indian cuisine, turmeric paste is applied on the face and skin as a facial to improve skin appearance and to remove unwanted hair and as a facial for good complexion (Kumar, 2013). It is also worn as an amulet or charm to ward off evil spirits, and used during weddings as a nuptial necklace and other religious ceremonies where a yellow and deep-red powder are present at the altar (Reddi, 2013). Modern uses, Doses Complementary and alternative medicine (CAM) application for diabetes mellitus is receiving increased attention within the mainstream medical community (Elder, 2004). More than 65 human clinical trials have proven the potential of curcumin against a number of human ailments and more than 35 other clinical trials are under way to further evaluate its efficacy.

5 4 Curcumin is now marketed in several countries including the United States, India, Japan, Korea, Thailand, China, Turkey, South Africa, Nepal, and Pakistan in the form of capsules, tablets, ointments, energy drinks, soaps, and cosmetics (Gupta, et. Al, 2013). Preliminary findings suggest that Meriva, a lecithinized formulation of curcumin has been useful in the management of diabetic microangiopathy (Choudhary, 2013). Because curcumin is insoluble in water, it is poorly absorbed into the bloodstream therefore Super Bio-Curcumin was formulated which can absorb curcumin up to seven times better than conventional supplements, and achieved twice greater peak blood levels of curcumin than conventional supplements. Each 400 mg capsule of Super Bio- Curcumin is equivalent to 2,772 mg of a typical 95% curcumin extract. Several clinical reports states that curcumin even at a high dose of mg/day does not produce any harmful effect on human body (Choudhary et. al., 2013). Review of Literature Effectiveness, Efficacy Turmeric s effectiveness focuses mainly from its compounds. Curcumin has been found to possess anti-inflammatory and antidiabetic properties. In Chuengsamarn s et al. (2012) study, which was conducted in Thailand at HRH Princess Maha Chakri Sirindhorn Medical Center of Srinakharinwirot University, two hundred forty patients participated in a randomized, double blind experiment. Patients were subjected to either a curcumin capsule or a placebo for nine months. Curcumin intervention showed significant results in preventing T2DM in a pre-diabetic population. Results indicated improved beta-cell function, prevented beta-cell degradation, and reduced inflammation by lowering C-peptides and by down regulating inflammatory cytokines (Chuengsamarn et al., 2012).

6 5 In another study by Li-Xin Na et al. (2013), 100 overweight and obese T2DM patients, who were between 18 to 65 years of age participated in a randomized, double-blind, placebo controlled study for three months in Hospital of Harbin Medical University in China to study the effectiveness of a mixture of curcuminoids on T2DM. Curcuminoids capsule supplementation in overweight and obese T2DM patients presented significant reduction in fasting blood glucose and insulin resistance. Moreover, it led to major decreases in serum total free fatty acids (FFA), triglycerides, and an increase in LPL (lipoprotein lipase) activity. There were no detrimental effects on the kidney and liver (Na et al., 2013). This study suggests that curcuminoids supplementation induces a glucose-lowering effect in T2DM patients, which may be a result from a more efficient utilization of FFA (free fatty acid) in the body. Nutrition Facts Nutritional analysis showed that 100 g of turmeric contains 390 kcal, 10 g total fat, 3 g saturated fat, 0 mg cholesterol, 0.2 g calcium, 0.26 g phosphorous, 10 mg sodium, 2500 mg potassium, 47.5 mg iron, 0.9 mg thiamine, 0.19 mg riboflavin, 4.8 mg niacin, 50 mg ascorbic acid, 69.9 g total carbohydrates, 21 g dietary fiber, 3 g sugars, and 8 g protein. Turmeric is also a good source of the ω-3 fatty acid and α-linolenic acid. Commercial curcumin contains approximately 77% curcumin, 17% demethoxycurcumin, and 3% bisdemethoxycurcumin (Zhang, 2012). Drug Nutrient Interactions/Side Effects Overall current clinical trials report that turmeric has few adverse reactions; although, there are several possible drug interactions that individuals need to be aware of if they plan to or

7 6 are consuming turmeric supplements. Individuals with type 2 diabetes and taking hypoglycemic medications should be very cautious when taking turmeric. Studies have shown that turmeric may have the ability to lower blood sugar levels, and in combination with hypoglycemic medications it could cause dangerous blood sugar episodes. Turmeric should not be used in combination with blood thinning medications such as warfarin, Plavix, or aspirin as it may cause the effects of the drugs to become stronger and could result in the risk of bleeding. It may also interfere with the function of drugs that are used to reduce stomach acid by increasing the production of stomach acid. Discussion Turmeric can be effective in preventing the risk of developing type 2 diabetes mellitus. From Chuengsamarn s et al. (2012) study, pre-diabetic patients who were given curcumin did not develop type 2 diabetes, while some patients who were given the placebo developed T2DM. Curcumin intervention inhibited beta-cell death, improved beta-cell secretion of insulin, and thus, reduced insulin resistance. In another study by Li-Xin Na et al. (2013), curcuminoid supplementation enhanced fatty acid oxidation and reduced serum free fatty acids (FFA) in the tissues. A buildup of free fatty acids will interfere with insulin signaling and prevent glucose uptake by the cell (Na et al., 2013). If free fatty acids are reduced by curcuminoids, then it is possible to prevent and treat insulin resistance. On the other hand, the poor bioavailability of curcumin is dependent on other curcuminoids of turmeric for stability; therefore, limiting the effectiveness of curcumin. The main components of turmeric extract are curcumin, demethoxycurcumin, and bisdemethoxycurcumin; which would increase the bio potency when administered.

8 7 Also, the amount of curcuminoids that was used in the clinical human studies cannot be simply added to meals, as it would change how the food looks and tastes; therefore, in order to achieve the same effect, it should be taken as a supplement. Turmeric has the effect to influence blood glucose levels and help pre-diabetes and diabetes populations due to its natural antiinflammatory and antioxidant properties, turmeric should be taken in a capsule or supplement form. Conclusion Based on the clinical studies, curcumin has demonstrated beneficial effects on obese and overweight populations who are prone to developing type 2 diabetes. Results ranged from reducing serum levels of FFA, TAGs, inflammation, and decreasing insulin resistance to increasing LPL-activity and beta-cell secretion of insulin all ensure a promising future in T2DM research. Curcumin poses no harmful effects on the human body even at high doses at 1,000 to 2,000 mg per day; however, as with any medication, supplement, or herb it is important that individuals consult their physicians before adding them to their health regimen. Though turmeric is mainly prevalent in Southeast Asian countries, these outcomes suggest that adapting turmeric into the Western s food cultures may be beneficial for our overall health. Lastly, turmeric may not be the end all, be all elixir for treating T2DM, but it is one piece in solving that puzzle.

9 8 Reference List Choudhary, Neeraj, and Bhupinder Singh Sekhon. "Potential Therapeutic Effect of Curcumin - an Update." Journal of Pharmaceutical Education and Research, 3.2 (2012): 64. Chuengsamarn, S., Rattanamongkolgul, S., Luechapudiporn, R., Phisalaphong, C., & Jirawatnotai, S. (2012). Curcumin extract for prevention of type 2 diabetes. Diabetes Care, 35(11), Gupta, S., Kismali, G., & Aggarwal, B. (2013). Curcumin, a component of turmeric: From farm to pharmacy. BioFactors (Oxford, England), 39(1), Gupta, S., Sung, B., Kim, J., Prasad, S., Li, S., et al. (2013). Multitargeting by turmeric, the golden spice: From kitchen to clinic. Molecular Nutrition & Food Research, 57(9), (Gupta, 2013) Elder, Charles. "Ayurveda for Diabetes Mellitus: A Review of the Biomedical Literature." Alternative Therapies in Health and Medicine, 10.1 (2004): Khan, Ikhlas A., and Abourashed, Ehab A. Leung's Encyclopedia of Common Natural Ingredients Used in Food, Drugs and Cosmetics (3rd Edition). Hoboken, NJ, USA: John Wiley & Sons, ProQuest ebrary. Web. 10 October Kumar, K., Asish, G., Sabu, M., & Balachandran, I. (2013). Significance of gingers (zingiberaceae) in Indian system of medicine - ayurveda: An overview. Ancient Science of Life, 32(4), Na, L., Li, Y., Pan, H., Zhou, X., Sun, D., et al. (2013). Curcuminoids exert glucose-lowering effect in type 2 diabetes by decreasing serum free fatty acids: A double-blind, placebocontrolled trial. Molecular Nutrition & Food Research, 57(9), Prasad, S., Gupta, S., Tyagi, A., & Aggarwal, B. (2014). Curcumin, a component of golden spice: From bedside to bench and back. Biotechnology Advances, 32(6), Reddi, P. (2013). A touch of turmeric: Examining an ayurvedic treasure. Advances in Anthropology, 3(2), Thomas-Eapen, N. (2009). Turmeric: The intriguing yellow spice with medicinal properties. Explore-the Journal of Science and Healing, 5(2), Zhang, J. A. (2012). Mechanisms mediating antidiabetic effects of serviceberry extracts, curcumin, and stilbenes. (Order No , Auburn University). ProQuest Dissertations and Theses, 178.