OBJECTIVE: The prevalence of diabetes has increased dramatically in recent years1. Gymnema sylvestre is an Indian herb used in Ayurveda, the ancient Hindi medicine system of India. Its primary application was for adult-onset diabetes (NIDDM), a condition for which it continues to be recommended today in India. The gradual hypoglycemic action of Gymnema leaves, first documented in the 1930, differs from the rapid effect of many prescription hypoglycemic drugs.2 Gymnema leaves raise insulin levels, according to research in healthy volunteers2 possibly due to regeneration of the b-cells in the pancreas.3 The leaves are also noted for lowering serum cholesterol and triglycerides.4 A water-soluble acidic fraction of the leaves provides hypoglycemic actions, possibly gymnemic acid.5 Its action in the reduction of intestinal glucose uptake has also been noted.6 The purpose of this work was to investigate the acute effects of supplementing the diet with Gymnema sylvestre (Beta Fast GXR®) in regards to it’s glucose lowering thereby reducing the HbA1c and therefore the complications from diabetes.
By reducing the HbA1c (Average Blood Glucose) 1%, the DCCT7 study showed Type 1 diabetics could reduce the complications of Retinopathy by 38%, Nephropathy by 28% Neuropathy by 35%. The UKPDS8 showed that reducing the HbA1c in Type 2 diabetics by 0.9% could reduce any diabetic end point by 12%, reduce any microvascular end point by 25%, reduce MI by 16%, reduce retinopathy by 21% and reduce microalbuminurea at 12 years by 34%. The UKPDS also showed that Postprandial (1-2 hours after eating) glucose is a better indicator of glycemic control than fasting glucose levels9. Treatment of postprandial hyperglycemia is critical to achieving optimal outcomes in type 2 diabetes10.
METHODS: Sixty-five (65) patients (37male/28 female) completed the study. Their pre-study average fasting glucose (163 mg/dl) and postprandial blood glucose (212 mg/dl), and a base HbA1c (8.8) were taken. Patients were instructed to take two (2) tablets per day, one in AM, one in PM for 90 days. They continued to monitor fasting and postprandial blood glucose through the study period. At the conclusion of the 90-day period, their levels were measured.
RESULTS: Sixty-five participants completed the study. After the 90 days of the Gymnema sylvestre (Beta Fast GXR®) supplementation, mean daily preprandial plasma glucose concentrations were 11% lower (161 vs 144 mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation also lowered the 2-hour post prandial plasma glucose concentrations, by 13% (207 vs 180mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation lowered HbA1c from 8.8% to 8.2% (0.6% decrease).
In the sub set of participants whose pre-study HbA1c was 9% or above the results were more profound. Mean daily preprandial plasma glucose concentrations were 15 percent lower (191 vs 161 mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation also lowered the 2-hour postprandial plasma glucose concentrations, by 21 percent (250 vs. 199 mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation lowered HbA1c from 10.1% to 9.3% (0.8% decrease).
In the poorest controlled patients, those with a starting HbA1c of 10% or greater, mean daily preprandial plasma glucose concentrations were 18 percent lower (216 vs 178 mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation also lowered the 2-hour postprandial plasma glucose concentrations by 28 percent (295 vs 212 mg/dl). The Gymnema sylvestre (Beta Fast GXR®) supplementation lowered HbA1c from 11.1% to 9.9% (1.1% decrease). In addition 11 patients (16%) had a decrease in prescription medicine intake.
White bars represent readings pre-Beta Fast use. Black bars represent post-Beta Fast use.
CONCLUSIONS: As can be seen from the data above, the use of Gymnema sylvestre (Beta Fast GXR®) supplementation in all patients with diabetes has a positive result. In addition the use of Gymnema sylvestre (Beta Fast GXR®) supplementation in patients with the poorest control is even more critical. It appears that the largest effect occurs from decrease of post-prandial glucose levels, which is consistent with the mechanisms of action stated. Gymnema sylvestre (Beta Fast GXR®) supplementation appears to improve glycemic control in patients with type 2 diabetes. Reducing postprandial blood glucose significantly caused a decrease of HbA1c, therefore reducing the complications from diabetes.7,8,9,10
- Beckles GLA et al. Diabetes Care. 1998;21:1432-1438.American Diabetes Association. Diabetes Care. 1998;21(Suppl 2).Colwell JA. Ann Intern Med. 1996;124(1pt2):131- 135.Abraira C et al. Diabetes Care. 1992;15:1560-1571.Klein R et al. Am J Epidemiol. 1987;126:415-428.Cowie CC et al. Diabetes in America. 2nd ed.vol. 44, November 2001.
- Mhasker KS, Caius JF. A study of Indian medicinal plants. II. Gymnema sylvestre R.Br. Indian J Med Res Memoirs 1930;16:2–75.
- Shanmugasundaram KR, Panneerselvam C, Sumudram P, Shanmugasundaram ERB. Insulinotropic activity of G. sylvestre, R.Br. and Indian medicinal herb used in controlling diabetes mellitus. Pharmacol Res Commun 1981;13:475–86.
- Shanmugasundaram ERB, Leela Gopinath K, Radha Shanmugasundaram K, Rajendran VM. Possible regeneration of the islets of Langerhans in streptozotocin diabetic rats given Gymnema sylvestre leaf extracts. J Ethnopharmacol 1990;30:265–79.
- Bishayee A, Chatterjee M. Hypolipidemic and antiatherosclerotic effects of oral Gymnema sylvestre R.Br. leaf extract in albino rats fed on high fat diet. Phytother Res 1994;8:118–20.
- Gymnema. Lawrence Review of Natural Products Aug 1993 (monograph). Fushiki T, Kojima A, Imoto T, et al. An extract of Gymnema sylvestre leaves and purified gymnemic acid inhibits glucose-stimulated gastric inhibitory peptide secretion in rats. J Nutr 1992;122:2367–73. 1995.
- The New England Journal of Medicine -- September 30, 1993 -- Vol. 329, No. 14-DCCT research group, Diabetes 95;44:969-983;
- Hawaii Med J 2000 Jul;59(7):295-8, 313; BMJ. 2000 Aug 12;321(7258):405-12.
- Harris et al. Diabetes Care. 1994.
- De Veciana et al. N Engl J Med. 1995;333:1239