Author: Dr. Pradeep Jain, Kashiganga Hospital, Varanasi

1. Some medicinal plants and their
dpp4 inhibitory activity
A new dimension in the management of diabetes
Dr. Pradeep Jain
Kashiganga Nursing Home, Varanasi

2.  Diabetes mellitus(Madhumeha)is a major public health
challenge of 21st century.
 Medicinal plants play an important role in the management
of T2DM by delaying the development of disease,
complications and correcting metabolic abnormalities.

3.  Numerous mechanism of anti-diabetic actions have been
proposed for action of medicinal plants.
 One action is to stimulate insulin secretion.
 The DPP4 inhibitors not only stimulate insulin pancreatic
b-cells to secrete insulin but they also helps in
regeneration and differentiation of islet of b-cells.

4.  Incretin hormones like (GLP-1 and GIP) are
intestinal hormones that are released in response
to meal ingestion.
 But the problem is that both these hormones have
short half life (rapid degradation by DPP4
enzyme).

5. Administration of DPP4 inhibitors block the
enzyme and thereby prolongs the T½ life and
activity of GLP-1.

6. GLP-1 and DPP4 inhibitors
 Promote b-cell growth
 Increases insulin secretion
 Increases glycogenesis
 Reduces gastric empting thereby decreases
post prandial glucose spikes.

7. There are many medicinal plants which have
DPP4 inhibitory activity. Some of them are:
 Berberis aristata (Daru haridra)
 Terminalia arjuna (Arjuna)
 Commiphora mukul (Guggulu)
 Embelica Officinalis (Amalaki)
 Urena lobata (Bachita)

8. Commiphora mukul(Guggul)

10.  Family-: Burseraceae
 Gum resin (Z-guggulsterone, E-guggulsterone,
guggulsterols)
 DPP4 activity-:
 Commiphora mukul- 92.79 +- 8.45%
Sitagliptin- 84.67 +- 8.21%
Vildagliptin-90.42 +- 7.84%

11.  Vatshamak property(due to ushna virya) described in
brihatryee, Laghutryee
 Antidiabetic , hypolipidimic activity by Shiraji et.al.(2013)
 Bellam konda et.al.(2011) demonstrated C.mukul activity
against STZ induced diabetic oxidative stress.

12.  Rasa – tikta,katu
 Guna- Laghu, Ruksha,Vishad(Medohar and useful in meda avrit vata)
 Virya- Ushna(Vata-shamak)
 Vipaka- Katu
 Thus the qualities of Guggulu distrupts the dosha –dushya
saramchana of madhumeha which may be responsible for its anti
diabetic activity.

14. Embelica officinalis (Euphorbiaceae)
आमलकं वय:स्थापनानां

15.  Pramehaghna activity described in Brihatryee and
Laghutryee
 Fresh fruits 1% w/v hydroalcoholic extract was used.
 Nain et.al(2012)and various others researchers showed
anti-diabetic activity.
 DPP4 inhibitor activity-:
Embelica officinalis- 85.95 +- 7.16%
Sitagliptin- 84.67 +- 8.21%
Vildagliptin-90.42 +- 7.84%

16.  Rasa- panchrasa(except lavana)Amla predominant
 Guna- Guru,Ruksha,Sheeta
 Virya- Sheeta
 Vipaka- Madhur
 Vata-shamak- Amla rasa
 Pitta-shamak due to madhur and sheeta
 Kapha-shamak due to ruksha and kashaya

17. Active alkaloids:
 Gallic acid(hypoglycaemic and hypolipidimic action)
 Ellagic acid
 Phyllembin
 Tannins(aldose reductase inhibitor, alpha
glucosidase inhibitor)
 Chromium,zinc and copper

18. Terminalia arjuna

20.  Family-: Combretaceae
 Bark extract(Arjunetin, B sitosterol).Flavanoids present in Arjuna regenerate
the damaged b-cells.Polyphenolics and saponins present in the bark exhibit
SGLT-1 inhibitor activity.
 1% w/v hydro alcoholic extract was used.
DPP4 inhibitor activity-:
T.arjuna- 83.39 +- 7.58%
Sitagliptin- 84.67 +- 8.21%
Vildagliptin- 90.42 +- 7.84%
Antidiabetic (Madhumeha har) action in Kaidev nighantu, Raj nighantu,
Bhavaprakash nighantu.

21.  Difference between synthetic gliptins and natural gliptins
Synthetic Gliptins Natural Gliptins
High cost Economical
Pancreatitis Safe
Pancreatic cancer Safe
Thyroid cancer Safe
Angiodema Safe

22. Thus natural DPP4 inhibitors are safe,
economical and work according to Ayurvedic
principles also.