The document outlines various foods that can act as medicinal treatments for diabetes mellitus types 1 and 2, including ingredients such as bitter gourd, knol khol, fenugreek, and millets, which have been shown to lower blood sugar levels and improve glycemic control. Specific studies highlight the mechanisms of action for these foods, such as increased insulin sensitivity, improved glucose tolerance, and inhibition of glucose absorption. Additionally, other foods like mango and guava leaves, milk thistle, and garlic are also discussed for their potential antidiabetic effects.

2. FOODS WHICH ARE MEDICINE FOR
DIABETES MELLITUS(1&2)
• Bitter gourd
• Knol khol
• Fenugreek
• Ivy gourd
• Okra/ladies finger
• Brassica oleracea
• Millets (foxtail millet, finger millet ,proso
millet)

3. • Plant leaves ( mango, guava, insulin plant,
mulberry, parijatha leaves, yekke leaf etc)
• Onion and its leaf
• Milk thistle
• Cinnamon
• Garlic cloves
• Green tea
• Cayenne pepper
• capsicum

5. • Bitter gourd contains a lectin that has
hypoglycemic effect. Which develops after
eating bitter gourd by acting peripheral tissue
and suppressing the appetite, its similar to
insulin’s effect in the brain.
• 2000mg/day of bitter gourd significantly
reduced the blood glucose level in T2DM
patients(journal of ethno pharmacology
jan2011).
• In march 2018 study bitter melon increased
cellular uptake of glucose & improved glucose
tolerance.

6. • According to one research by Saeed MK et al &
Tan MJ et al, constituents of bitter melon which
are responsible for the antidiabetic effects are
triterpene, proteid, steroid, alkaloid, inorganic,
lipid & phenolic compounds.
• Momordicine 2 and 3-hydroxycucurbita-5, 24-
dien-19-al-7, 23-di-O-beta-glucopyranoside were
extracted as saponin form from the BM showed
significant insulin activity in MIN6 beta cells
(Kellar AC et al).
• The major compounds that have been isolated
from bitter melon and identified as hypoglycemic
agents are charantin, polypeptide-p, vicine.

7. Possible mode of action of M.charantia & its
extracts
a) Stimulation of peripheral & skeletal muscle
glucose uptake.
b) Inhibition of adipocyte differentiation.
c) Suppression of key gluconeogenic enzymes.
d) Stimulation of key enzymes of HMP pathway
e) Preservation of islet beta cells and their
functions.

9. Knol khol extract proved that it has hypoglycemic
effect and antioxidant activity in diabetic rats.
A researcher Andallu B noticed that
Knol khol
Polyphenols, tannins, ascorbic acid
Significantly improved gylicemic control
& also reduced the lipid peroxidation in
erythrocytes(33%), plasma (21%), urine (16%)

10. • A study by Dr Selvakumar showed significant
reduction in blood sugar level after 120min.
No immediate effect (30min) on DM Type 2.

11. • A study in 2015 by Indumati sharma et al,
revealed that the administration of brassica
oleracea extracts in wistar rats significantly
reduced FBS by 64% within 7 days of treatment.
Additionally this extract was also observed
normalize the diabetic rats’ lipid profile and
HbA1c. Protection of kidney and liver functions
also noted.
• The polyphenolic isothiocynates are felt to be
responsible for hypoglycemic activity.

13. • Fenugreek seeds are rich in soluble dietary fibers
( can slow the absorption of sugar and control its
level in blood)
• A research on role of fenugreek in the
prevention of type 2 DM in prediabetic by Arpan
Gaddam et al, concluded that dietary
supplementation of 10g fenugreek/day in
prediabetics lower the conversion into type 2
DM.
• They found that it increased the b-cell function
and insulin sensitivity by HOMA IR assessment.
So the FBS will reduce. And proved fenugreek
seeds has hypoglycemic effect on both T1 & T2
DM

14. Fenugreek seeds
Soluble fiber
Combines with bile
TG, LDL, Cholesterol levels.
Insulinotropic effect- fenugreek seeds acts as
insulin secretor. 4 hydroxy isoleucine (a. a)
present in fenugreek is responsible for
insulinotropic action & for extra pancreatic
insulin – sensitizing.

16. • Both the leaves and vegetables are advised for
diabetes mellitus.
• A study conducted in srilanka, “blood sugar
lowering effect of coccinia grandis J Voigt:
Path for a new drug for DM.
• In this study they noticed FBS has not
effected, but PPBS reduced significantly after
1 hour and 2 hour.

17. Ivy gourd leaf
Suppression of glucose-6-phosphatase
Increase the activity of glycogen synthesis
Partly responsible for reducing PPBS.
Ivy gourd increases the glucose tolerance.

19. • Khosorozadeh M et al in 2016, proved abelmoschus
esulentus has positive effect on DM.
• Tomoda et al. 1989, reported that okra
polisaccharide possesses hypoglycemic activity in
normal mice.
• Ramachandan et al.2013 has reported antidiabetic
and antihyperlipidemic potential of okra peel & seed
powder on rats.
• Water soluble fraction of fruit of okra is studied to
check the absorption of oral glucose as well as
metformin from the GI tract in the long Evan rats.

20. • It showed significant reduction in absorption of
glucose as studies in 24hrs fasting rats, has
reported the presence of 2 major
flavonoglucosides named isoqercetin and
quercetin-3-O-beta-glyucopyransoyl-(1”-6”)-
glucoside in okra seeds which are alpha-
glucosidase inhibitors (Thankosai &
Phuwapraisirisan 2013).
• These 2 compounds inhibited the rat intestinal
sucrase, maltase and in which isoqercetin was
more potent (subrahmanyam et al 2011).

21. • Effect of a okra fruits on ALP, AST & ALT
activities on diabetic rats were also
investigated. Serum glucose levels and activities
of these 3 enzymes decreased significantly after
the administration of okra extract (Uraku A et al
2011).
• Recent study 2013 by S, et al also showed the
significant effect of okra on blood sugar level
and serum lipid.
• Okada et al 2010, indicating that okra may
major role in the regulation of glucose & lipid
metabolism.

22. • In a study, (Sabitha et al 2011) demonstrated
the antidiabetic activities of okra peel and
seed extracts, 100-200 mg/kg dose in diabetic
rats. Decreased in Blood glucose level,
increased in body weight, decreased HbA1c,
SGPT had seen.

23. On diabetic mice added
millet proteins can increase
insulin sensitivity & reduce
blood sugar level as well as
TG level (Nishizaha et al
2009)

24. • The millets are classified as positive & neutral &
negative(not there). Positive millets has more
dietary fibers (8-12.5%) compared to neutral. So
for DM positive millets are well suited.
• Compared to other cereal crops such as wheat
& maize, millets are high in nutritional content,
gluten free, low GI (Abdalla et al 1998).
• They provide high energy, high dietary fiber,
protein with balanced a.a profile, many
essential minerals, some vitamins &
antioxidants (FAO, 1995; Lestiene et al, 2005;
Suma & Urooj 2012)

25. Foxtail millet
• A study - T2 DM fed with foxtail millet for 90
days showed improved glycemic control as well
as other improvements (Jali et al, 2012).
• May be due to the presence of dietary fiber
content in foxtail millet which is slowly digested
& absorbed in the intestine.
• [Foxtail based diabetic diet- GI is 49.54%.
80grms of this powder is given/day/patient for
90 days.]

26. • A study (Shobana et al, 2010) demonstrated
that ragi may help to reduce cataract when
T2DM mice were fed with added finger millet
seeds coat.
• In this experiment she also observed the
reversal of hypercholesterolemia &
hypertrglycerolemia associated DM.
• Rats also showed significant reduction in weight
.

27. • A study in 2008 stated that proso millet &
foxtail millets improved the HDL concentration
as well as reduced insulin & plasma glucose
concentration.

29. • Mango leaf possesses pharmacological effects, that is
antioxidant, antidiabetic, antimicrobial, anticancer, anti
inflammatory.
• A study shows mango peels & mango seed extracts had
potential to inhibit alpha - glucosidase more than alpha
amylase. The leaf extracts inhibited alpha glucosidase.
• Mango leaf extract and its active compound, mangiferin
showed in vitro inhibitory potential on key enzymes
involving glucose metabolism that is, alpha amylase &
alpha glucosidase (Aunyachulee Ganogpichayagrai et al,
2017).

30. • A previous study compared potential of mature
and tender mango leaf aqueous methenolic
extracts.
Mature mango leaf Tender mango leaf
More potential to More potential to
Inhibit a-glucosidase inhibit a-amylase

31. • Deguchi et al, demonstrated that GvEx inhibited
the in vitro activities of maltase, sucrase &
alpha-amylase.
• Wang et al, found that the aqueous leaf extract
from guava leaf inhibited both sucrase &
maltase activities in the small intestinal mucosa
of D mice.
• Human trial:- Single ingestion of guava leaf tea
reduced PPBG elevation at 30,90,120 min.

32. • A crossover clinical trial involving 20 hospitalized
patients with T2DM
160mg/dl PPBS
guava leaf voglibose
143mg/dl 133mg/dl

33. • Improvement of diabetic symptoms &
hyperlipidemia. Ingestion of
GvEx(250mg/kg/day) for 7 weeks improved
T2DM , D neuropathy, significantly reduced,
significant reduction in the thickness index of
the glomerular measangial matrix in the kidney,
HbA1c (Deguchi et al).
• Recently Shen et al, have reported the effect of
the aqueous extract from guava leaves on T2D
rats. They showed that long-term feeding of the
extracts significantly reduced blood glucose
level, increased plasma insulin level in an oral
GTT.

34. • On humans also they studied they gave 12
weeks intervention for 7 patients found
significant reduction in FBS. 5 of them also
showed reduction in HbA1c. Also the levels of
insulin, C-peptide, HOMA-IR significantly
reduced in all the subjects. Serum TG levels
reduced in the subjects with
hypercholesterolemia.
• Even they conducted study on
hypercholesterolemia patients separately and
got the positive results.

35. • A study by Akhila J Shetty, effect of insulin
plant ( Costus igneus) leaves on
dextramethasone- induced hyperglycemia,
showed significant reduction in FBS, PPBS
which is comparable with that obtained from
Glibenclamide.
• The hypoglycemic action may be due to
release of insulin, insulin - sensitizing action or
combination of both.

36. • A research paper “ Hypoglycemic effect of
Caltropis gigantea Linn. Leaves and flowers in
Steptozotocin – induced Diabetic rats by Nanu R
Rathod et al concluded that chloroform extract
of Cg flowers and leaf is effective in lowering
blood sugar level.
• According to the older evidences it may be
possible that the presence of flavonol
glycosides may be responsible for the observed
anti-diabetic activity.

37. • A study “ Hypoglycemic effect of Nyctanthes
arbor- tristis leaf extract on Alloxon induced
Diabetic rabbits” by Chaitali pattanayak et al.
stated that presence of flavonoids has been
reported in NALE and flavonoids are frequently
implicated as having antidiabetic effect.
• The possible mechanism by which NALE brings
about its hypoglycemic action may be by
potentiating the insulin effect by increasing the
pancreatic secretion of insulin from B-cells

38. • Flavonoids of NALE + Sulfonylurea receptors in
Plasma membrane of P-B-cell
Closure of K+ ATP channels
Membrane depolarization
Stimulation of Ca++ influx
Promote insulin secretion.

39. • The findings suggests that flavonoids in the
plant extract may regenerate the damaged B-
cells & increased insulin sensitizing.
• However NALE (400mg/kg) was not able to
restore the blood glucose level to the baseline
value. So it indicates that it can be used as a
alternate medication with hypoglycemic diet
or antidiabetic drugs.

40. • A research on “ Hypoglycemic & Hypolipidemic
activation of aqueous extraction of flower from
Nyctanthes arbor- tristis in male mice”, by
Bramanaga Sachini Rangila et al, concluded that
results of this study indicated that AEF possess
hypoglycemic & hypolipidemic properties.
Therefore AEF could be used as an alternative
medicine in management of DM.
• The hypoglycemic activity observed in present
study can be attributed to presence of
flavonoids iridoide 6 beta- hydroxylonganin in
parijatha flowers.

41. • AEF had a gummy viscous appearance which
suggested process of fiber (Agnihotri MA et al)
• In vitro study had confirmed.
Glucose bonds + dietary fibers
(even low glucose level)
Bound glucose are incapable of binding to
specific transport protein for transportation
This inhibit the glucose uptake from GI tract.

42. • This inhibition of the glucose uptake from GI
tract may be also due to improved intestinal
Na+ - glucose- co- transporter as reported
with synthetic phlorizin derivatives
(flavonoid).
• AEF also showed α-amylase inhibiting activity.

44. • Mulberry leaf reported to be anti
hyperglycemic, anti hyperlipidemic.
• A study by Yao Sheng et al, showed that
mulberry leaf decreased the FBG and HbA1c,
ameliorated the blood lipid levels and
improved the insulin sensitivity in rats.
• They stated that flavanols and polyphenols in
it are responsible for anti diabetic activity.

45. • A study named “Influence of Mulberry leaf
extract on the blood extract on the blood glucose
& breath hydrogen response to ingestion of 75g
sucrose by T2 DM & control subjects” By Mitchell
Mudra et al.stated that co- ingestion of mulberry
extract with 75g sucrose significantly reduced the
increased blood glucose observed over the initial
120 min of testing in control & T2 DM subjects
• The mulberry – induced reduction in blood
glucose presumably reflects the ability of
mulberry to inhibit intestinal sucrase. The
increased H2 observed with mulberry indicates
that this supplement induced sucrose
malabsorption.

47. • Christos E et al, in his paper “ The therapeutic
potential of Milk Thistle in diabetes” concluded
that milk thistle contain flavonoids like Silbin A
an isoform of silbin , isoform 3 has been
demonstrated to possess partial PPAPɣ agonist
effects.
• Silbin has also demonstrated beneficial effects
on several diabetic complications including
diabetic neuropathy, d nephropathy etc.
• The mechanism behind this is-

48. • Glucose Sorbitol
Prevention of tissue damage
Hence the treatment for cataract/ D neuropathy.
• Researchers also showed silbin decrease
dihydroxyacetone (DHA) gluconeogenesis by 33% & also
decrease glycolysis. Furthermore silbin inhibits glucose-6-
phosphate. But no effect on fructose pathway.
Aldose
reductase
(in organs which
are not
dependent on
insulin for
glucose
transport
Silbin
inhibit
s

50. • A research paper by Zhang S, et al 2017 “
Capsaicin reduces blood glucose by increasing
insulin levels & glycogen contest better than
capsiate in streptozotocin – induced diabetic
rats”.
• In this study they investigated which flavonid in
these 2 are having hypoglycemic action.
• Both increased glycogen & inhibited intestinal
absorption of glucose.
• But the capsaicin increased the insulin levels
too

52. • It is also having hypoglycemic effect due to the
presence of capsaicin.
• Scientists at mahidol university in 2013,
Thailand investigated the effect of chili pepper
on plasma glucose levels & metabolic rates in
healthy Thai women. Scientists observed that
those in the chili pepper group had
significantly lower blood glucose levels, 30
min after ingestion compared with those who
didn’t have chili pepper.

54. • A paper by “Cinnamon improves glucose and
lipids of people with Type 2 Diabetes” by Alam
Khan et al. concluded that intake of 1, 3, or 6g
of cinnamon/day reduces serum glucose,
triglyceride, LDL cholesterol & total cholesterol
in people with T2D and suggest that the
inclusion of cinnamon in the diet of people with
type 2 diabetes will reduce risk factors
associated with diabetes and cvs disorder.
• Extracts of cinnamon activated glycogen
synthase , glucose uptake, and inhibited
glycogen synthase kinase-3beta.

55. • Extracts of cinnamon also activated insulin
receptor kinase and inhibited
dephosphorylation of the insulin receptor,
leading to maximal posphorylation of insulin
receptors. All there increased the insulin
sensitivity.
• A study by Justin A et al. “ The effect of
Cinnamon on A1c Among Adolescents with
Type 1 Diabetes”. Concluded that cinnamon is
not effective for improving glycemic control in
adolescents with T1D.

57. • A study “ effect of garlic supplement in the
management of T2DM: A meta analysis of
RCT”, By Juan Wang et al. states that the
antidiabetic effect of garlic reported in the
studies would be concluded as rapid &
sustained mechanisms and among the form of
garlic allicin - a major bioactive compound
found in T1D animal studies.
• The rapid effect of insulin secretion as well as
release from pancreatic beta cells.

58. • Song et al. reported that C- peptide in garlic
group was significantly higher than baseline &
control later.
• C- peptide & insulin are both secreted by beta-
cell & they come from a same precursor:
proinsulin.

60. • There was a study “ Effect of green tea on blood
glucose levels and serum proteomic patterns in
diabetic mice and on glucose metabolism in
healthy humans” by Tsuneki et al.
• This study provides evidences that green tea has
antidiabetic effect.
• Here they found that after administration of
green tea the serum proteins decreased hence
decreased the diabetic state.
• This is the first report demonstrating that a
certain serum proteins may be involved in the
antihyperglycemic effect of green tea.
• They also proved green tea increases glucose
metabolism

62. • Mohammad asif did study on this. Some good
things in fruits & vegetables are vitamins,
flavanoids (antioxidants), saponins,
polyphenols, carotenoids, isothiocynates,
dietary fibers. Reduces inflammation.
• The American Diabetes Association advices that
any fruit is fine to eat for a person with
diabetes.
• A meta- analysis published in 2014 in the British
medical journal found higher fruit intake was
significantly associated with a lower risk of
T2DM.

63. • Fresh & frozen fruits are better than processed
include dried fruits & fruit juices.
• In fruit juices the dietary fibers are removed.
• While processing the fruits it loose its vitamins
and some of key nutrients.
• Many fruits are filling because of their water
contents and high fibers so reduce the risk of
obesity and hence T2DM.
• The united states guidelines recommended that
people fill half of their plate with fruits and
vegetables.
• On one serving medium sized one fruit , if small
fruits one bowl, ½ if processed (juice), 2 table
spoon if dried fruits.

67. • While making the diet protocol for diabetic
easy way to select the foods is.
a) Select low glycemic index food
b) Diabetes means chapathi is not a only one
option
c) 2 varies of vegetables and 3 varieties of fruits
atleast should be there.
d) Calories must range from 1500-1800/day .
e) 60:20:20= carbs : proteins : fat.

68. we
ek
7a
m
8am 8:30am 10
/11
am
12:30/1:30pm 2/3p
m
5/6
pm
7/8 pm Option
al
either L
or D
MO
N
AGJ Grape
s
Ragi ganji /
indly+BV
BW
/cu
Foxtail millet
+BV+fruits(F)+B
M
½ MJ Nuts
and
seeds
Chapathi
+BV+BM/
SP
Fruit
salad
TUS AGJ Apple Idly+BV BW
/cu
Methi rice+
BV+F+BM/SP
½
KKJ
Nuts
&
seeds
Ragi
dosa+
BV+BM/S
P
Slimme
r salad
WE
D
AGJ guava Dosa + BV BW
/cu
Ragi ball/
rotti+F+BM/SP
½
MMJ
Nuts
&
seeds
Chapathi
+BV+BM/
SP
Super
salad
TH
U
AGJ ½
mang
o
Kichadi with
more
vegetables
BW
/cu
Proso millet +
BV+ F+ BM/SP
½
KKJ
Nuts
&
seeds
Foxtail
dosa+BV+
BM/SP
Summe
r
retreat
FRI AGJ banan
a
Any millet
item+ BV
BW
/cu
Pulav+pachadi+
F+BM/SP
½
OJ/
LHJ
Nuts
&
seeds
Chapathi
+BV+BM/
SP
Plantai
n pith
salad
SAT AGJ mm Upma/ poha BW
/cu
Broken
wheat+BV+F+
½
KKJ
Nuts
&
Proso
dosa+BV+
Carrot
apple