Pharmacological Study: Synergistic Antidiabetic Activity of Cinnamon Bark and Zingiber Extract in Streptozotocin-Induced Diabetic Rats

Eva Nurinda; Nurul Kusumawardani; Ari Susiana Wulandari; Annisa Fatmawati; E. Emelda; Husnatun Nisa; Nurjani A. Hasan; Wahyu Fajar Iriyanti; Mardiatun Rohmah; Puji Lestari; Veriani Aprilia

doi:10.3889/oamjms.2022.9462

Authors

Eva Nurinda Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia https://orcid.org/0000-0002-2486-1505
Nurul Kusumawardani Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia https://orcid.org/0000-0003-3554-9039
Ari Susiana Wulandari Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia https://orcid.org/0000-0001-5391-8577
Annisa Fatmawati Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia https://orcid.org/0000-0002-8677-0932
E. Emelda Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Husnatun Nisa Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Nurjani A. Hasan Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Wahyu Fajar Iriyanti Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Mardiatun Rohmah Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Puji Lestari Department of Pharmacy, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia
Veriani Aprilia Department of Nutrition, Faculty of Health Sciences, Alma Ata University, Yogyakarta, Indonesia https://orcid.org/0000-0002-6231-6487

DOI:

https://doi.org/10.3889/oamjms.2022.9462

Keywords:

Insulin, Blood glucose, Hyperglycemic, Cinnamon, Ginger

Abstract

Background: Cinnamon has been widely used by Indonesian people as a complementary therapy to treat hyperglycemia such as in diabetes mellitus patients. While ginger is also used as a mixture in traditional anti hyperglycemia herb. There is not known how much antidiabetic effect of cinnamon ethanolic extract when combined with ginger, and not many studies have analyzed the correlation of lowering blood glucose levels associated with increasing of insulin of this combination.

Objectives: This study aimed to investigates antidiabetic activity of cinnamon extract, zingiber extract, and mixture on streptozotocin-induced diabetic rats.

Methods: This pharmacological study used Wistar strain male rats under hyperglycemia condition induced by streptozotocin at a dose of 45mg/kg. Sample were grouped with 6 animals in each where there was a positive and negative control group and also an intervention group given ethanol extract for 14 days.

Results: The result showed that all intervention groups experienced an increase in insulin levels and a decrease in blood glucose levels after 14 days. The One Way Anova test showed that the increase of insulin levels treated with combination of ethanolic extract cinnamon bark at the dose 150mg/200gr and ginger ethanolic extract at the dose 100mg/200gr was comparable to Glibenclamide (p=0.355), but the decrease in blood glucose levels between groups showed a difference that was not statistically significant. There was a relationship between insulin levels and blood glucose levels linearity with the equation Y (insulin level) = -5.261 + (-0.060) blood glucose level.

Conclusions: The combination of cinnamon and ginger showed beneficial synergistic anti-diabetic activity. It can increase insulin levels, making it possible to control blood sugar levels in high blood glucose conditions.

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References

Westman EC. Type 2 diabetes mellitus: A pathophysiologic perspective. Front Nutr. 2021;8:707371. http://doi.org/10.3389/fnut.2021.707371 PMid:34447776 DOI: https://doi.org/10.3389/fnut.2021.707371

Abdul M, Khan B, Hashim MJ, King JK, Govender RD, Mustafa H, et al. Epidemiology of type 2 diabetes-global burden of disease and forecasted trends. J Epidemiol Glob Health. 2020;10(1):107-11. http://doi.org/10.2991/jegh.k.191028.001 PMid:32175717 DOI: https://doi.org/10.2991/jegh.k.191028.001

Chen L, Magliano DJ, Zimmet PZ. The worldwide epidemiology of type 2 diabetes mellitus-present and future perspectives. Nat Rev Endocrinol. 2012;8(4):228-36. http://doi.org/10.1038/nrendo.2011.183 PMid:22064493 DOI: https://doi.org/10.1038/nrendo.2011.183

Purnamasari D, Soegondo S, Oemardi M, Gumiwang I. Insulin resistance profile among siblings of type 2 diabetes mellitus (preliminary study). Acta Med Indones. 2010;42(4):204-8. PMid:21063041

Cho NH, Shaw JE, Karuranga S, Huang Y, da Rocha Fernandes JD, Ohlrogge AW, et al. IDF diabetes atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. Diabetes Res Clin Pract. 2018;138:271-81. https://doi.org/10.1016/j.diabres.2018.02.023 PMid:29496507 DOI: https://doi.org/10.1016/j.diabres.2018.02.023

Ligita T, Wicking K, Francis K, Harvey N, Nurjannah I. How people living with diabetes in Indonesia learn about their disease: A grounded theory study. PLoS One. 2019;14(2):1-19. https://doi.org/10.1371/journal.pone.0212019 PMid:30794570 DOI: https://doi.org/10.1371/journal.pone.0212019

Li S, Wang J, Zhang B, Li X, Liu Y. Diabetes mellitus and causespecific mortality : A population-based study. Diabetes Metab J. 2019;43:319-41. https://doi.org/10.4093/dmj.2018.0060 PMid:31210036 DOI: https://doi.org/10.4093/dmj.2018.0060

Kasole R, Martin HD, Kimiywe J. Traditional medicine and its role in the management of diabetes mellitus: Patients and herbalists perspectives. Evid Based Complement Altern Med. 2019;2019:2835691. https://doi.org/10.1155/2019/2835691 PMid:31354852 DOI: https://doi.org/10.1155/2019/2835691

Adeniyi O, Washington L, Glenn CJ, Franklin SG, Scott A, Aung M, et al. The use of complementary and alternative medicine among hypertensive and type 2 diabetic patients in Western Jamaica: A mixed methods study. PLoS One. 2021;16(2):1-15. http://doi.org/10.1371/journal.pone.0245163 PMid:33556053 DOI: https://doi.org/10.1371/journal.pone.0245163

Gwarzo MY, Nwachuku VA, Lateef AO. Prevention of alloxan induced diabetes mellitus in rats by vitamin a dietary supplementation. Asian J Anim Sci. 2010;4(4):190-6. DOI: https://doi.org/10.3923/ajas.2010.190.196

Rao PV, Gan SH. Cinnamon: A multifaceted medicinal plant. Evid Based Complement Altern Med. 2014;2014:642942. https://doi.org/10.1155/2014/642942 PMid:24817901 DOI: https://doi.org/10.1155/2014/642942

Chou ST, Chang WL, Chang CT, Hsu SL, Lin YC, Shih Y. Cinnamomum cassia essential oil inhibits α-MSH-induced melanin production and oxidative stress in murine B16 melanoma cells. Int J Mol Sci. 2013;14(9):19186-201. https://doi.org/10.3390/ijms140919186 PMid:24051402 DOI: https://doi.org/10.3390/ijms140919186

Emelda E, Alfiana RD, Kusumawardani N, Yolanda Y, Widyarini S. The episiotomy effect of topical combination of cinnamon oil and red betel on skin wound healing mechanism. Adv Health Sci Res. 2021;40:144-51.

Prasad S, Tyagi AK. Ginger and its constituents: Role in prevention and treatment of gastrointestinal cancer. Gastroenterol Res Pract. 2015;2015:142979. https://doi.org/10.1155/2015/142979 PMid:25838819 DOI: https://doi.org/10.1155/2015/142979

Mao QQ, Xu XY, Cao SY, Gan RY, Corke H, Beta T, et al. Bioactive compounds and bioactivities of ginger (Zingiber officinale roscoe). Foods. 2019;8(6):1-21. https://doi.org/10.3390/foods8060185 PMid:31151279 DOI: https://doi.org/10.3390/foods8060185

Iqubale A, Singh AK, Singh SK, Ali M, Kumar A, Kumar R. Comparative nephroprotective effect of cinnamomum cassia and Zingiber officinal on Diabetic Rat. Indian J Appl Res. 2019;12:43-4.

Atta M, Jafari S, Moore K. Complementary and alternative medicine: A review on the effects of ginger, cinnamon and camellia sinensis leaf tea in diabetes. J Diabetes Mellit. 2019;9(3):126-36. DOI: https://doi.org/10.4236/jdm.2019.93012

Damasceno DC, Netto AO, Iessi IL, Gallego FQ, Corvino SB, Dallaqua B, et al. Streptozotocin-induced diabetes models: Pathophysiological mechanisms and fetal outcomes. Biomed Res Int. 2014;2014:819065. https://doi.org/10.1155/2014/819065 PMid:24977161 DOI: https://doi.org/10.1155/2014/819065

Widyasti JH, Widodo GP, Herowati R. The antihyperglycemic activity of ethanol extract of Trigonella foenum-graecum L. and its effect on the GLUT-2 expression of streptozotocinnicotinamide-induced rats. Indones J Pharm. 2018;29(1):10-5. DOI: https://doi.org/10.14499/indonesianjpharm29iss1pp10

Furman BL. Streptozotocin-induced diabetic models in mice and rats. Curr Protoc. 2021;1(4):1-21. https://doi.org/10.1002/0471141755.ph0547s70 PMid:26331889 DOI: https://doi.org/10.1002/cpz1.78

Nurinda E, Emelda E, Kusumawardani N. Correlation between the antioxidant capacity of plasma and blood glucose level. Pharm Educ. 2021;21(2):108-15. DOI: https://doi.org/10.46542/pe.2021.212.108115

Ashari A, Eva N, Annisa F. Improvement of wistar rat insulin levels male streptozotocin (STZ) inducted due to giving ethanol extract from brotowali stem. Peningkatan Kadar Insulin Tikus Wistar (Rattus norvegicus) jantan yang diinduksi streptozotosin akibat pemberian ekstrak etanol batang brotowali (Tinospora crispa L.). Indones Pharm Nat Med J. 2021;5(1):1. DOI: https://doi.org/10.21927/inpharnmed.v5i1.1653

Fatmawati A, Bachri MS, Nurani LH. Combination effects of Moringa oleifera leaf ethanol extract and Andrographis paniculata herb on blood glucose levels and pancreas histopathology of diabetic rats induced by streptozotocin. Maj Obat Tradis. 2019;24(2):85. DOI: https://doi.org/10.22146/mot.39401

Błaszczyk N, Rosiak A, Kałużna-Czaplińska J. The potential role of cinnamon in human health. Forests. 2021;12(5):1-17. DOI: https://doi.org/10.3390/f12050648

Medagama AB. The glycaemic outcomes of Cinnamon, a review of the experimental evidence and clinical trials. Nutr J. 2015;14(1):1-12. https://doi.org/10.1186/s12937-015-0098-9 PMid:26475130 DOI: https://doi.org/10.1186/s12937-015-0098-9

Noipha K, Ninla-Aesong P. Antidiabetic activity of Zingiber officinale roscoe rhizome extract: An in vitro study. HAYATI J Biosci. 2018;25(4):160-8. DOI: https://doi.org/10.4308/hjb.25.4.160

Otunola GA, Afolayan AJ. A review of the antidiabetic activities of ginger. Ginger Cultiv its Antimicrob Pharmacol Potentials. India: IntechOpen; 2020. p. 1-13.

Afshari AT, Shirpoor A, Farshid A, Saadatian R, Rasmi Y, Saboory E, et al. The effect of ginger on diabetic nephropathy, plasma antioxidant capacity and lipid peroxidation in rats. Food Chem. 2007;101(1):148-53. DOI: https://doi.org/10.1016/j.foodchem.2006.01.013

Son MJ, Miura Y, Yagasaki K. Mechanisms for antidiabetic effect of gingerol in cultured cells and obese diabetic model mice. Cytotechnology. 2015;67(4):641-52. http://doi.org/10.1007/s10616-014-9730-3 PMid:24794903 DOI: https://doi.org/10.1007/s10616-014-9730-3

Semwal RB, Semwal DK, Combrinck S, Viljoen AM. Gingerols and shogaols: Important nutraceutical principles from ginger. Phytochemistry. 2015;117:554-68. http://doi.org/10.1016/j.phytochem.2015.07.012 PMid:26228533 DOI: https://doi.org/10.1016/j.phytochem.2015.07.012

Bin SM, Bin MM, Razu BA, Hossain MT, Mahzabeen S, Unnoor N, et al. [6]-Gingerol, from Zingiber officinale, potentiates GLP-1 mediated glucose-stimulated insulin secretion pathway in pancreatic β-cells and increases RAB8/RAB10-regulated membrane presentation of GLUT4 transporters in skeletal muscle to improve hyperglycemia in Lepr db/db type 2 diabetic mice. BMC Complement Altern Med. 2017;17(1):395. https://doi.org/10.1186/s12906-017-1903-0 PMid:28793909 DOI: https://doi.org/10.1186/s12906-017-1903-0

Zhu R, Liu H, Liu C, Wang L, Ma R, Chen B, et al. Cinnamaldehyde in diabetes: A review of pharmacology, pharmacokinetics and safety. Pharmacol Res. 2017;122:78-89. http://doi.org/10.1016/j.phrs.2017.05.019 PMid:28559210 DOI: https://doi.org/10.1016/j.phrs.2017.05.019