Diabetes also commonly known as “Diabetes Mellitus” is a cluster of metabolic diseases which is defined by high blood glucose or blood sugar levels caused either by the inadequate insulin production from the pancreas or due to the failure of the body cells in responding properly to the insulin produced or sometimes in both cases.
The symptoms include
- Frequent need to urinate
- Intense thirst and hunger
- Weight gain or unusual weight loss
- Slow healing of cuts and bruises
Diabetes is of 3 main types
- Type 1 Diabetes Mellitus/ Insulin-Dependent Diabetes Mellitus/ Juvenile Disease results from the inadequate production of insulin by the pancreas.
- Type 2 Diabetes Mellitus/ Non-Insulin Dependent Diabetes Mellitus/ Adult-Onset Diabetes results from the failure of the body cells in responding properly to the insulin produced.
- Gestational Diabetes results from high blood sugar levels during pregnancy without any prior history of diabetes.
Over 415 million people suffer from Diabetes worldwide, out of which 90% cases are of Type 2 Diabetes Mellitus.
According to the Indian heart association, more than 62 million Indians are affected by the disease, making India the diabetes capital in the world.
Anti-diabetic drugs are medications that help in stabilizing and controlling the blood sugar levels in diabetic patients. They are used in managing diabetes.
Types of Anti-Diabetic Medications include:
- Insulin sensitizers like Biguanides and Thiazolidinedione
- Secretagogues like Sulphonylureas and Non-sulphonylureas
- Alpha-glucosidase inhibitors etc
Curcumin is a yellow colored pigment which is a primary active curcuminoid of Turmeric (or Curcuma longa), commonly used as a spice in various Indian and Southern Asia cuisines and also in Ayurvedic medicines.
Curcumin possesses very powerful anti-inflammatory properties and is a strong anti-oxidant. It also has effective anti-microbial properties.
Glyburide is also referred to as Glibenclamide and is an oral anti-diabetic drug which comes under the class of Sulphonylurea medications. It helps in controlling the blood sugar level and is used in treating Type-2 Diabetes Mellitus.
However, this drug is the major cause of drug-induced hypoglycaemia (medication that causes abnormally low blood sugar level).
P-glycoprotein (P-gp) is also referred to as Permeability glycoprotein. It is a multi-drug resistance protein (MDRI) and is responsible for pumping all the foreign materials out of the cell.
It acts as a defense mechanism against harmful substance like toxins and chemicals produced by various drugs and hence jeopardize the success of the drug delivery to the target organs involved in the treatment.
The general precaution that is given with regards to curcumin supplements is that it should not be taken with anti-diabetic drugs as it has blood sugar lowering property and the combination of the two would lead to hypoglycemia or excessively low blood sugar. This study proves the contrary.
What happened in this study?
A study was conducted with the aim for determining the benefits of Curcumin capsules in lowering the lipid levels by acting as a permeability glycoprotein inhibitor (P-gp) and a P-gp substrate to the Glyburide drug in patients with Type-2 Diabetes.
8 patients with Type-2 Diabetes were taken in a clinical trial for the duration of 11 days and were given the Glyburide drug therapy. Blood samples were collected at the start and end of the study.
What were the results?
The blood samples collected on the 11th day of the trial, showed changes in the Glyburide concentrations during the second hour.
However, the amount of the drug in the blood circulation remained unchanged. It was observed that the glucose levels were reduced and no patient suffered from Hypoglycemia (abnormally low blood sugar levels often seen in diabetic patients due to increase in use of insulin).
It was also observed that the concentrations of Low-density Lipoproteins along the very low-density lipoproteins and triglycerides (known as bad types of cholesterol) were significantly reduced. The concentration of the High-density lipoproteins (good cholesterol) was found to be increased.
How did this occur?
Curcumin regulates its therapeutic properties by controlling the production of harmful substances like Cyclo-oxygenase-2 (COX-2), Inducible Nitric Synthase and Tumor Necrosis Factor (TNF) which cause inflammation.
It is known that inflammation is the major cause behind the development of Insulin resistance during progression of Type-2 Diabetes Mellitus.
Glyburide drug acts as a Permeable glycoprotein (P-gp) substrate (substance on which P-gp acts). It shows decrease in bioavailability as the P-glycoprotein binds with the drug and reduces its absorption and hence the drug is unable to reach the target area in sufficient amounts.
Hence it is unable to control blood sugar level and also leads to Hyperlipidemia (increase in cholesterol). Increasing the dose of Glyburide drug can cause Hypoglycemia (low blood sugar).
Curcumin can also inhibit P-gp and upon co-administering curcumin capsules with Glyburide drug, it is observed that the bioavailability of the glyburide is gradually increased.
It is because curcumin modifies the structural arrangement of P-glycoprotein by interacting directly with the drug or substrate binding sites of P-gp which allows the Glyburide drug to pass through the barrier and get absorbed. Thus, the therapeutic effects of the anti-diabetic drug are increased.
Curcumin also helps in reducing the cholesterol levels in patients Type-2 Diabetes Mellitus.
What does this mean?
Type-2 Diabetes is a chronic metabolic disorder where the body cells show reduced Insulin response leading to excess concentration of glucose in the bloodstream. It causes long term complications like heart, kidney and liver diseases.
Contrary to the common precautions of taking curcumin with anti-diabetic drugs, it is observed that curcumin works well with the Glyburide drug and increases the efficacy of the drug. Also it was found that curcumin did not cause hypoglycemia and also lowered the cholesterol levels.
Read paper here: http://www.ncbi.nlm.nih.gov/pubmed/25044423