ICMR says rigorous research needed to prove efficacy of herbal drugs for diabetes

New Delhi: There should be rigorous research proving the efficacy of herbal drugs prescribed under Ayurveda, Homeopathy and Unani before relying on them for the treatment of diabetes, the Indian Council of Medical Research (ICMR) has pointed out.

ICMR last week issued draft guidelines for the treatment and management of type-2 diabetes in India, in which the apex research body has debated the efficacy of indigenous drugs offering treatment of diabetes.

“Many people with diabetes in our country use indigenous drugs from other systems of medicine like Ayurveda, Homeopathy, and Unani. Several herbal products have been advocated for the treatment of diabetes such as Pterocarpus marsupium, Gymnema sylvestre, Mormordica chirantica, and Eugenia jambolana,” the draft guidelines state.

“These drugs by themselves or in combination do have blood glucose lowering effects. Their exact mechanism of action is still not clear. There is a common belief that all herbal drugs are safe and non-toxic, which is not necessarily true,” the guidelines state.

“In view of the widespread use of these indigenous medicines, physicians should be aware of the herb-drug interactions. There is ample scope for research and careful evaluation of these agents needs to be done in the management of diabetes,” they say.

Type-2 diabetes is a metabolic-cum-vascular syndrome characterised by predominant insulin resistance with varying degrees of insulin secretory defect. It is a progressive disease often associated with central obesity, dyslipidaemia and hypertension.

Interestingly, the ICMR has advocated the use of yoga in management of diabetes and stress management. According to the guidelines, stress management is essential and could take the form of meditation, yoga, a long outdoor walk, exercise and trying out hobbies like reading, gardening, and painting. Practice of yoga is our traditional Indian system, which has therapeutic value in controlling our physical and mental health. It should be done under the guidance of an expert, the guidelines state.

However, modern medicine practitioners have always been at loggerheads with the alternative medicine systems in claiming any relief or treatment with yoga or herbal drugs. “Interestingly and rightly so, yoga has been mentioned under management of stress. There is a greater role of yoga; almost equivalent to aerobic physical activity, in diabetes; however, firm data and systematic review are needed to ascertain this. Till then, yoga could be practiced after full quota of daily physical activity is completed,” said Anoop Misra, chairman, Fortis C-DOC Centre for Diabetes, and vice president of the Diabetes Foundation of India.

“While there is increasing research on local herbs and neutraceuticals in treatment of diabetes; long-term robust data on their safety and efficacy is certainly required. Commercially made bhasmas or similar remedies of questionable significance should be avoided. However, use of home cooked vegetables (karela, methi) does no harm and could be taken to increase fibre intake,” said Misra.

The International Diabetes Federation estimates that there were 72.9 million people with diabetes in India in 2017. This is projected to rise to 134.3 million by 2045. The prevalence of diabetes has increased in urban India, especially in metropolitan cities and the rural areas are also fast catching up.