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Anti-diabetic drugs treat diabetes mellitus by lowering glucose levels in the blood. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Glucose (Glc a Monosaccharide (or simple Sugar) also known as grape sugar, is an important Carbohydrate in Biology. With the exceptions of insulin, exenatide, and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents or oral antihyperglycemic agents. Insulin is a Hormone with intensive effects on both metabolism and several other body systems (eg vascular compliance Exenatide ( INN, marketed as Byetta) is one of a new class of medications ( Incretin mimetics approved for the treatment of Diabetes mellitus type 2 Pramlintide acetate (Symlin is a relatively new adjunct treatment for diabetes (both type 1 and 2 developed by Amylin Pharmaceuticals. There are different classes of anti-diabetic drugs, and their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors.


Diabetes mellitus type 1 is a disease caused by the lack of insulin. Diabetes mellitus type 1 (Type 1 diabetes Type I diabetes T1D T1DM IDDM juvenile diabetes is a form of Diabetes mellitus. Insulin must be used in Type I, which must be injected or inhaled.

Diabetes mellitus type 2 is a disease of insulin resistance by cells. Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non - Insulin -dependent Diabetes mellitus (NIDDM or adult-onset diabetes is a metabolic Treatments include (1) agents which increase the amount of insulin secreted by the pancreas, (2) agents which increase the sensitivity of target organs to insulin, and (3) agents which decrease the rate at which glucose is absorbed from the gastrointestinal tract.

Several groups of drugs, mostly given by mouth, are effective in Type II, often in combination. The therapeutic combination in Type II may include insulin, not necessarily because oral agents have failed completely, but in search of a desired combination of effects. The great advantage of injected insulin in Type II is that a well-educated patient can adjust the dose, or even take additional doses, when blood glucose levels measured by the patient, usually with a simple meter, as needed by the measured amount of sugar in the blood.

Diabetes mellitus
Types of Diabetes
Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes

Pre-diabetes:
Impaired fasting glycaemia
Impaired glucose tolerance
Disease Management
Diabetes management:
•Diabetic diet
•Anti-diabetic drugs
•Conventional insulinotherapy
•Intensive insulinotherapy
Other Concerns
Cardiovascular disease

Diabetic comas:
•Diabetic hypoglycemia
•Diabetic ketoacidosis
•Nonketotic hyperosmolar

Diabetic myonecrosis
Diabetic nephropathy
Diabetic neuropathy
Diabetic retinopathy

Diabetes and pregnancy
Blood tests
Blood sugar
Fructosamine
Glucose tolerance test
Glycosylated hemoglobin

Contents

Insulin

Main article: insulin

Insulin is usually given subcutaneously, either by injections or by an insulin pump. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc Diabetes mellitus type 1 (Type 1 diabetes Type I diabetes T1D T1DM IDDM juvenile diabetes is a form of Diabetes mellitus. Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non - Insulin -dependent Diabetes mellitus (NIDDM or adult-onset diabetes is a metabolic Gestational diabetes (or gestational diabetes mellitus, GDM) is a condition in which women without previously diagnosed diabetes exhibit high blood Impaired fasting glycaemia (IFG is a pre-diabetic state of dysglycemia associated with insulin resistance and increased risk of cardiovascular pathology although of lesser risk than Impaired Glucose Tolerance (IGT is a pre- Diabetic state of dysglycemia that is associated with Insulin resistance and increased risk of cardiovascular pathology Diabetes is a Chronic disease with no cure As of 2008. It is associated with an impaired Glucose cycle, altering Metabolism. The diet most often recommended for people who suffer from Diabetes mellitus is high in Dietary fiber, especially soluble fiber but low in fat (especially Saturated fat Conventional insulinotherapy is a therapeutic regimen for treatment of Diabetes mellitus which contrasts with the newer Intensive insulinotherapy. Intensive insulinotherapy is a therapeutic regimen for Diabetes mellitus treatment Cardiovascular disease or cardiovascular diseases refers to the class of diseases that involve the Heart or Blood vessels ( arteries and Diabetic coma is a Medical emergency in which a person with Diabetes mellitus is Comatose (unconscious because of one of the acute complications Diabetic hypoglycemia describes a low blood glucose level occurring in a person with Diabetes mellitus. Diabetic ketoacidosis (DKA is a life-threatening complication in patients with diabetes mellitus Nonketotic hyperosmolar coma (nonketotic Hyperglycaemia) is a type of Diabetic coma associated with a high mortality seen in Diabetes mellitus type 2. Diabetic myonecrosis is a rare complication of Diabetes. It is caused by Infarcted Muscle tissue usually in the thigh Diabetic nephropathy ( nephropatia diabetica) also known as Kimmelstiel-Wilson syndrome and intercapillary glomerulonephritis, is a progressive Kidney Diabetic neuropathies are neuropathic disorders that are associated with Diabetes mellitus. Diabetic retinopathy is Retinopathy (damage to the Retina) caused by complications of Diabetes mellitus, which can eventually lead to Blindness For women with Diabetes mellitus, Pregnancy can present some particular challenges for both mother and child Blood sugar, used in a physiological context is a misnomer and misleading Fructosamine is a compound that can be considered the result of a reaction between Fructose and Ammonia or an Amine (with a molecule of water being released A glucose tolerance test in medical practice is the administration of Glucose to determine how quickly it is cleared from the blood Glycosylated (or glycated hemoglobin ( hemoglobin A1c Hb1c, or HbA1c) is a form of Hemoglobin used primarily to identify the average Insulin is a Hormone with intensive effects on both metabolism and several other body systems (eg vascular compliance An insulin pump is a medical device used for the administration of Insulin in the treatment of Diabetes mellitus, also known as continuous subcutaneous Research is underway of other routes of administration. In acute care settings, insulin may also be given intravenously. There are several types of insulin, characterized by the rate which they are metabolized by the body.

Sulfonylureas

Main article: Sulfonylurea

Sulfonylureas were the first widely used oral hypoglycemic medications. Sulfonylurea (UK Sulphonylurea derivatives are a class of Antidiabetic drugs that are used in the management of Diabetes mellitus type 2 ("adult-onset" Sulfonylurea (UK Sulphonylurea derivatives are a class of Antidiabetic drugs that are used in the management of Diabetes mellitus type 2 ("adult-onset" They are insulin secretagogues, triggering insulin release by direct action on the KATP channel of the pancreatic beta cells. A secretagogue is a substance which causes another substance to be Secreted. Beta cells ( beta-cells, β-cells) are a type of cell in the Pancreas in areas called the Islets of Langerhans. Eight types of these pills have been marketed in North America, but not all remain available. The "second-generation" drugs are now more commonly used. They are more effective than first-generation drugs and have fewer side effects. All may cause weight gain.

Sulfonylureas bind strongly to plasma proteins. Blood proteins, also called serum proteins, are Proteins found in Blood plasma. Sulfonylureas are only useful in Type II diabetes, as they work by stimulating endogenous release of insulin. They work best with patients over 40 years old, who have had diabetes mellitus for under ten years. They can not be used with type I diabetes, or diabetes of pregnancy. They can be safely used with metformin or -glitazones. The primary side effect is hypoglycemia. Hypoglycemia or hypoglycaemia is the medical term for a pathologic state produced by a lower than normal level of Glucose ( sugar) in the blood

Biguanides

Main article: Biguanide

Biguanides reduce hepatic glucose output and increase uptake of glucose by the periphery, including skeletal muscle. Tolbutamide is a first generation Potassium channel blocker, Sulfonylurea oral hypoglycemic drug sold under the brand name Orinase Acetohexamide ( Dymelor) is a first-generation Sulfonylurea Medication used to treat Diabetes mellitus type 2, particularly in people whose diabetes Tolazamide is an oral Blood glucose lowering drug used for people with Type 2 diabetes. Chlorpropamide is an example of a drug class called sulphonylureas used to treat type 2 diabetes mellitus Glipizide is an oral medium-to-long acting Anti-diabetic drug from the Sulfonylurea class Glibenclamide ( INN) also known as glyburide ( USAN) is an Anti-diabetic drug in a class of medications known as Sulfonylureas used Glimepiride is a medium-to-long acting Sulfonylurea Anti-diabetic drug. Gliclazide is an oral hypoglycemic ( Anti-diabetic drug) and is classified as a Sulfonylurea. Biguanide can refer to a molecule or to a class of drugs based upon this molecule Biguanide can refer to a molecule or to a class of drugs based upon this molecule The liver is a vital organ in the human body and is present in Vertebrates and some other animals Although it must be used with caution in patients with impaired liver or kidney function, metformin has become the most commonly used agent for type 2 diabetes in children and teenagers. The kidneys are complicated organs that have numerous biological roles Metformin ( INN; trade names Glucophage, Riomet, Fortamet, Glumetza, Obimet, Dianben, Diabex, Amongst common diabetic drugs, metformin, a biguanide, is the only widely used oral drug that does not cause weight gain.

Metformin should be temporarily discontinued before any radiographic procedure involving intravenous iodinated contrast as patients are at an increased risk of lactic acidosis. Iodine (ˈaɪədaɪn ˈaɪədɪn or /ˈaɪədiːn/ from ιώδης iodes "violet" is a Chemical element that has the symbol I and Atomic Contrast medium Radiocontrast agents (also simply contrast agents or contrast materials) are compounds used to improve the visibility of internal bodily structures

Metformin is usually the first-line medication used for treatment of type-2 diabetes. Initial dosing is 500 mg twice daily, but can be increased up to 1000 mg twice daily. It is also available in combination with other oral diabetic medications.

Meglitinides

Main article: Meglitinide

Meglitinides help the pancreas produce insulin and are often called "short-acting secretagogues. The meglitinide class of drugs treat Diabetes type 2 They bind to an ATP -dependent K + (KATP channel on the cell membrane of The meglitinide class of drugs treat Diabetes type 2 They bind to an ATP -dependent K + (KATP channel on the cell membrane of " Their mode of action is original, affecting potassium channels. In the field of Cell biology, potassium channels are the most widely distributed type of Ion channel and are found in virtually all living organisms [2] By closing the potassium channels of the pancreatic beta cells, they open the calcium channels, hence enhancing insulin secretion. [3]

They are taken with meals to boost the insulin response to each meal.

Adverse reactions include weight gain and hypoglycemia.

Thiazolidinediones

Main article: Thiazolidinedione

Thiazolidinediones (TZDs), also known as "glitazones," bind to PPARγ, a type of nuclear regulatory proteins involved in transcription of genes regulating glucose and fat metabolism. The Medication class of thiazolidinedione (also called glitazones) was introduced in the late 1990s as an adjunctive therapy for Diabetes mellitus (type The Medication class of thiazolidinedione (also called glitazones) was introduced in the late 1990s as an adjunctive therapy for Diabetes mellitus (type The Medication class of thiazolidinedione (also called glitazones) was introduced in the late 1990s as an adjunctive therapy for Diabetes mellitus (type Peroxisome proliferator-activated receptor gamma ( PPAR-gamma) These PPARs act on Peroxysome Proliferator Responsive Elements (PPRE [1]). The PPREs influence insulin sensitive genes, which enhance production of mRNAs of insulin dependent enzymes. The final result is better use of glucose by the cells.

As a result of multiple retrospective studies, there is a concern about rosiglitazone's safety, although it is established that the group, as a whole, has beneficial effects on diabetes. The greatest concern is an increase in the number of severe cardiac events in patients taking it. The ADOPT study showed that initial therapy with drugs of this type may prevent the progression of disease,[4] as did the DREAM trial. [5]

Concerns about the safety of rosiglitazone arose when a retrospective meta-analysis was published in the New England Journal of Medicine. [6] There have been a significant number of publications since then, and a Food and Drug Administration panel[7] voted, with some controversy, 20:3 that available studies "supported a signal of harm," but voted 22:1 to keep the drug on the market. Safety studies are continuing.

In contrast, at least one large prospective study, PROactive 05, has shown that pioglitazone may decrease the overall incidence of cardiac events in people with type II diabetes who have already had a heart attack. Pioglitazone is a prescription drug of the class Thiazolidinedione with hypoglycemic (antihyperglycemic antidiabetic action [8]

Alpha-glucosidase inhibitors

Main article: Alpha-glucosidase inhibitor

Alpha-glucosidase inhibitors are "diabetes pills" but not technically hypoglycemic agents because they do not have a direct effect on insulin secretion or sensitivity. Alpha-glucosidase inhibitors are oral Anti-diabetic drugs used for Diabetes mellitus type 2 that work by preventing the digestion of carbohydrates (such as Starch Alpha-glucosidase inhibitors are oral Anti-diabetic drugs used for Diabetes mellitus type 2 that work by preventing the digestion of carbohydrates (such as Starch These agents slow the digestion of starch in the small intestine, so that glucose from the starch of a meal enters the bloodstream more slowly, and can be matched more effectively by an impaired insulin response or sensitivity. These agents are effective by themselves only in the earliest stages of impaired glucose tolerance, but can be helpful in combination with other agents in type 2 diabetes. Impaired Glucose Tolerance (IGT is a pre- Diabetic state of dysglycemia that is associated with Insulin resistance and increased risk of cardiovascular pathology Diabetes mellitus type 2 or Type 2 Diabetes (formerly called non - Insulin -dependent Diabetes mellitus (NIDDM or adult-onset diabetes is a metabolic

These medications are rarely used in the United States because of the severity of their side effects (flatulence and bloating). Miglitol is an oral Anti-diabetic drug that acts by inhibiting the ability of the patient to breakdown complex carbohydrates into glucose Acarbose is an Anti-diabetic drug used to treat type 2 Diabetes mellitus and in some countries Prediabetes. They are more commonly prescribed in Europe.

They do have the potential to cause weight loss by lowering the amount of sugar metabolized.

Peptide analogs

Overview of insulin secretion
Overview of insulin secretion

Incretin mimetics

Incretins are insulin secretagogues. Incretins are a type of gastrointestinal hormone that cause an increase in the amount of Insulin released from the Beta cells of the A secretagogue is a substance which causes another substance to be Secreted. The two main candidate molecules that fulfill criteria for being an incretin are Glucagon-like peptide-1 (GLP-1) and Gastric inhibitory peptide (aka glucose-dependent Insulinotropic peptide or GIP). Glucagon-like peptide-1 (GLP-1 is derived from the transcription product of the Proglucagon gene Gastric inhibitory polypeptide ( GIP) also known as the glucose-dependent insulinotropic peptide is a member of the secretin family of Hormones Both GLP-1 and GIP are rapidly inactivated by the enzyme dipeptidyl peptidase-4 (DPP-4). The Enzyme Dipeptidyl peptidase-4 ( DPP-4) also part of the CD 26 surface region is associated with immune regulation Signal transduction

Glucagon-like peptide (GLP) analogs

GLP agonists bind to a membrane GLP receptor. [3] As a consequence of this, insulin release from the pancreatic beta cells is increased. Endogenous GLP has a half life of only a few minutes; thus an analogue of GLP would not be practical.

These agents may also cause a decrease in gastric motility, responsible for the common side effect of nausea, and is probably the mechanism by which weight loss occurs.

Gastric inhibitory peptide (GIP) analogs

DPP-4 inhibitors

Main article: Dipeptidyl peptidase-4 inhibitors

Dipeptidyl peptidase-4 (DPP-4) inhibitors increase blood concentration of the incretin GLP-1 (glucagon-like peptide-1) by inhibiting its degradation by dipeptidyl peptidase-4 (DPP-4). Inhibitors of Dipeptidyl peptidase 4, also DPP-4 inhibitors, are a new class of Oral hypoglycemics which block DPP-4 Inhibitors of Dipeptidyl peptidase 4, also DPP-4 inhibitors, are a new class of Oral hypoglycemics which block DPP-4 Incretins are a type of gastrointestinal hormone that cause an increase in the amount of Insulin released from the Beta cells of the Glucagon-like peptide-1 (GLP-1 is derived from the transcription product of the Proglucagon gene The Enzyme Dipeptidyl peptidase-4 ( DPP-4) also part of the CD 26 surface region is associated with immune regulation Signal transduction Examples are:

Amylin analogues

Amylin agonist analogues slow gastric emptying and suppress glucagon. Vildagliptin (previously identified as LAF237, trade name Galvus) is a new oral anti-hyperglycemic agent ( Anti-diabetic drug) of the new dipeptidyl Sitagliptin ( INN; previously identified as MK-0431, trade name Januvia) is an oral antihyperglycemic ( Anti-diabetic drug) of the dipeptidyl Amylin or Islet Amyloid Polypeptide (IAPP is a 37-residue Peptide hormone secreted by pancreatic β-cells at the same time as Insulin Glucagon is an important Hormone involved in Carbohydrate metabolism. As of 2007, pramlintide is the only clinically available amylin analogue. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Pramlintide acetate (Symlin is a relatively new adjunct treatment for diabetes (both type 1 and 2 developed by Amylin Pharmaceuticals. Like insulin, it is administered by subcutaneous injection. An injection is an infusion method of putting Liquid into the Body, usually with a hollow needle and a Syringe which is pierced through The most frequent and severe adverse effect of pramlintide is nausea, which occurs mostly at the beginning of treatment and gradually reduces. Nausea ( Latin: Nausea, Greek:, " Sea-sickness " also called wamble) is the sensation of unease and discomfort

Experimental agents

Many other potential drugs are currently in investigation by pharmaceutical companies. Some of these are simply newer members of one of the above classes, but some work by novel mechanisms. For example, at least one compound that enhances the sensitivity of glucokinase to rising glucose is in the stage of animal research. Glucokinase ( is an Enzyme that facilitates Phosphorylation of Glucose to Glucose-6-phosphate. Others are undergoing phase I/II studies.

Herbal extracts

The first registered use of anti-diabetic drugs was as herbal extracts used by Indians in the Amazon Basin for the treatment of type 2 diabetes, and today promoted as vegetable insulin although not formally an insulin analog. An insulin analog is an altered form of Insulin, different from any occurring in nature but still available to the human body for performing the same action as human insulin [11] The major recent development was done in Brazil around Myrcia sphaerocarpa and other Myrcia species. |utc_offset = -2 to -4 |time_zone_DST = BRST |utc_offset_DST = -2 to -5 |cctld Myrcia sphaerocarpa is native to the Amazon Basin of Latin America. Myrcia is a genus of the Flowering plant family Myrtaceae.;Selected species Myrcia albobrunnea

"Many countries, especially in the developing world, have a long history of the use of herbal remedies in diabetes (. . . ) STZ diabetic rats were also used to test Myrcia Uniflora extracts (. Streptozotocin ( Streptozocin, STZ, Zanosar) is a naturally occurring Chemical that is particularly toxic to the insulin-producing Beta cells . . ) ". [12]

The usual treatment is with concentrated (root) Myrcia extracts, commercialized in a 4 US dollar per kilogram packed rocks (~100 times cheaper than equivalent artificial drugs), named "Pedra hume de kaá". Phytochemical analysis of the Myrcia extracts reported kinds of flavanone glucosides (myrciacitrins) and acetophenone glucosides (myrciaphenones), and inhibitory activities on aldose reductase and alpha-glucosidase. [13]

A recent review article presents the profiles of plants with hypoglycaemic properties, reported in the literature from 1990 to 2000 and states that "Medical plants play an important role in the management of diabetes mellitus especially in developing countries where resources are meager. "[14] Animal studies on the possible role of walnut leaf, coriander and pomegranate preparations found supportive evidence only for the former of these,[15] while on testing fenugreek, onion and garlic only for the latter. [16]

Notes

  1. ^ Eurich DT, McAlister FA, Blackburn DF, et al (2007). "Benefits and harms of antidiabetic agents in patients with diabetes and heart failure: systematic review". BMJ 335 (7618): 497. doi:10.1136/bmj.39314.620174.80. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17761999.  
  2. ^ Rendell M (2004). "Advances in diabetes for the millennium: drug therapy of type 2 diabetes". MedGenMed 6 (3 Suppl): 9. PMID 15647714.   Free full text with registration at Medscape. Full text at PMC: 1474831
  3. ^ a b Helping the pancreas produce insulin. PubMed Central is a free digital database of full-text Scientific literature in biomedical and life sciences HealthValue. Retrieved on 2007-09-21. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1217 - The Estonian tribal leader Lembitu of Lehola was killed in a battle against Teutonic Knights.
  4. ^ Haffner, Steven M. (2007). Expert Column - A Diabetes Outcome Progression Trial (ADOPT). Medscape. Retrieved on 2007-09-21. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1217 - The Estonian tribal leader Lembitu of Lehola was killed in a battle against Teutonic Knights.
  5. ^ Gagnon, Louise (2007). DREAM: Rosiglitazone Effective in Preventing Diabetes. Medscape. Retrieved on 2007-09-21. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1217 - The Estonian tribal leader Lembitu of Lehola was killed in a battle against Teutonic Knights.
  6. ^ Nissen, Steven E. ; Wolksi, K (2007-06-14). "Effect of Rosiglitazone on the Risk of Myocardial Infarction and Death from Cardiovascular Causes (early web release)". N Engl J Med 356 (24): 2457–2471. doi:10.1056/NEJMoa072761. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17517853.  
  7. ^ Wood, Shelley (2007-07-31). Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 30 BC - Battle of Alexandria: Mark Antony achieves a minor victory over Octavian 's forces but most of his army subsequently FDA Advisory Panels Acknowledge Signal of Risk With Rosiglitazone, but Stop Short of Recommending Its Withdrawal. Heartwire. Retrieved on 2007-09-21. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1217 - The Estonian tribal leader Lembitu of Lehola was killed in a battle against Teutonic Knights.
  8. ^ Erdman, Erland; Dormandy, JA; Charbonnel, B; Massi-Benedetti, M;Moules, IK;Skene,AM (2007). "The Effect of Pioglitazone on Recurrent Myocardial Infarction in 2,445 Patients With Type 2 Diabetes and Previous Myocardial Infarction. Results From PROactive (PROactive 05)". J Am Coll Cardiol 49 (17): 1772–1780. doi:10.1016/j.jacc.2006.12.048. A digital object identifier ( DOI) is a permanent identifier given to an Electronic document. PMID 17466227.  
  9. ^ Cvetković RS, Plosker GL (2007). "Exenatide: a review of its use in patients with type 2 diabetes mellitus (as an adjunct to metformin and/or a sulfonylurea)". Drugs 67 (6): 935-54. PMID 17428109.  
  10. ^ Novo Nordisk A/S - R&D Pipeline: Liraglutide (NN2211). Novo Nordisk (2007). Novo Nordisk () manufactures and markets Pharmaceutical products and services Retrieved on 2007-09-30. Year 2007 ( MMVII) was a Common year starting on Monday of the Gregorian calendar in the 21st century. Events 1399 - Henry IV is proclaimed King of England. 1744 - France and Spain defeat the
  11. ^ Soumyanath, Amala(ed. ) (2005-11-01). Traditional Medicines for Modern Times, 1st Edition (in english), Taylor & Francis. ISBN 0-415-33464-0.  
  12. ^ McNeill, John H. (1999-02-01). Experimental Models of Diabetes, 1st Edition (in english), CRC Press, 208. ISBN 0-8493-1667-7.  
  13. ^ Matsuda, H; Nishida N, Yoshikawa M. (Mar 2002). "Antidiabetic principles of natural medicines. V. Aldose reductase inhibitors from Myrcia multiflora DC. (2): Structures of myrciacitrins III, IV, and V. ". Chem Pharm Bull (Tokyo) 50(3): 429-31.  
  14. ^ Bnouham M et al (2006). "Medicinal plants with potential antidiabetic activity - A review of ten years of herbal medicine research (1990-2000)". Int J Diabetes & Metabolism 14: 1-25.  
  15. ^ Jelodar G, Mohsen M, Shahram S (2007). "Effect of Walnut leaf, coriander and pomegranate on blood glucose and histopathology of pancreas of alloxan induced diabetic rats". African Journal of Traditional, Complimentary and Alternative Medicines 4 (3): 299-305.  
  16. ^ Jelodar GA, Maleki M, Motadayen MH, Sirus S (February 2005). "Effect of fenugreek, onion and garlic on blood glucose and histopathology of pancreas of alloxan-induced diabetic rats". Indian J Med Sci 59 (2): 64–9. PMID 15738612.  

References


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