Momordica charantia (Bitter melon) in Combination with Metformin Potentiates Hypoglycemic and Hypolipidemic Effects in Alloxan-induced Diabetic Rats

Abstract

The present study was designed to investigate the effects of bitter melon (Momordica charantia) in combination with a standard oral hypoglycemic agent metformin on alloxan induced diabetic rats (AIDRs). Both the plant extract and the drug, individually and in combination, were subjected in vivo for two weeks (short term) and four weeks (long term) treatment protocol to determine blood glucose level, lipid profile and liver glycogen level using Swiss Albino rats. In short term treatment protocol, bitter melon extract (BME) at a dose of 75, 150 and 300 mg/ kg body weight (bw) were administered in AIDRs by using oral gavages once daily and dose-dependent antihyperglycemic and antidyslipidemic effects were investigated. This short term study revealed that the most effective dose of BME was found as 300 mg/kg bw among the three doses. In long term treatment protocol, AIDRs in different groups received fixed dose monotherapy of BME (300 mg/kg bw) and metformin (15 mg/kg bw) and fixed dose BME (150 mg/kg bw) and metformin (7.5 mg/kg bw) combination therapy. The study showed that combination therapy significantly decreased the blood glucose level from 18.42 ± 0.95 to 6.80 ± 0.39 mmol/l in comparison to the control group after daily treatment for four weeks. In case of antidyslipidemic effect, combination therapy reduced total cholesterol (34.25%), triglycerides (11.92%) and LDL-cholesterol (57.73%) levels and increased HDL-cholesterol level (55.48%) in comparison with their respective control groups. Metformin, BME and their combination preserved the liver glycogen level by 35.21%, 22.54% and 49.01%, respectively in comparison to diabetic control group. These changes were significantly better than those of BME and metformin monotherapy. The results suggested that treatment with combination therapy was more effective than mono-therapy for preventing diabetes as bitter melon extract potentiates the effects of metformin on long term alloxan-induced diabetic rats.Bangladesh Pharmaceutical Journal 21(2): 109-117, 2018

Herbal medicine use in Thai patients with type 2 diabetes mellitus and its association with glycemic control: A cross-sectional evaluation

“…The major constituent of bitter gourd is charantin, which improves insulin sensitivity by increasing glucose uptake via glucose transporter-4 in skeletal muscle cells, resulting in cellular uptake and utilization of glucose [ 42 ]. This mechanistic finding was in line with an in vivo study where feeding mice with metformin (15 mg/kg) in combination with bitter gourd (300 mg/kg) showed synergistic hypoglycemic properties when compared to those that were fed with metformin or bitter ground alone [ 43 ]. However, the use of herbal medicine and higher doses of metformin was not found to be associated with good glycemic control in this study.…”

Exploration of Succinimide Derivative as a Multi-Target, Anti-Diabetic Agent: In Vitro and In Vivo Approaches

“…Following the administration of alloxan, the animals’ blood glucose levels were checked using a glucometer. According to the protocols, in the in vivo study, mice with elevated blood sugar concentrations were also utilized [ 52 ].…”

Potential Pharmacokinetics and Pharmacodynamics (PK-PD) Drug-Herbs Interactions (DHI) from Metformin and Traditional Medicines: A Literature Review

“…This study suggested that combination of both as treatment for diabetes mellitus was more effective than mono-therapy. 19,23 In type 2 diabetic patient, bitter gourd showed there is no difference for HbA1c levels from baseline and after 12 weeks treated by bitter gour standardized extract, while in placebo group, HbA1c levels showed significantly increased after 12 weeks of treatment compared to baseline. 24 Bitter gourd fruit juice could also reduce the enhanced fasting plasma glucose in patients with prediabetes.…”