Gymnema

Gymnema sylvestre is a woody climbing plant that grows in the tropical forests of central and southern India. The leaves are used in herbal medicine preparations. It has been used for thousands of years within the Indian Ayurvedic tradition for adult-onset diabetes. It is also a part of the botanical traditions of African cultures. It has been called gur-mar (“sweet destroyer”) because of its reputation for neutralizing one’s ability to taste sweet foods. Other ailments treated with this plant include dyspepsia, liver disorders, and tissue fluid retention.

Clinical Applications

• Diabetes mellitus Type I (insulin-dependent)
  • Prolonged oral Gymnema therapy has been demonstrated to
    • Reduce insulin requirements
    • Improve blood glucose homeostasis as indicated by reduced hemoglobin A1c and glycosylated serum proteins
    • Improve hyperlipidemia associated with diabetes
    • Reduce serum amylase activity
    • Increase serum C peptide, suggesting increased beta-cell activity.
• Diabetes mellitus Type II (non-insulin dependent)
  • Gymnema has demonstrated the ability to reduce blood glucose, glycosylated hemoglobin, and glycosylated plasma proteins in patients with non-insulin-dependent diabetes. It also allowed them to reduce the dosage of conventional diabetes drugs. Some were even able to discontinue conventional medicines. An elevation in insulin levels suggests to researchers a restoration of more normal function among the beta-cells of the pancreas.
• This botanical can be an important component of a multi-faceted diet modification and supplement protocol for diabetes. The restorative action of Gymnema is gradual and may require 18-24 months to manifest its full benefit to the patient.
• Obestiy

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How Gymnema Works

Insulin

• In vitro studies on extracts of Gymnema indicate that this plant induces an increase in insulin release from beta-cells in the islets of Langerhans of the pancreas. The mechanism seems to involve an increase in cell membrane permeability.
• Gymnema extracts have demonstrated the ability to increase insulin secretion in rats induced to be diabetic by streptozotocin damaging of pancreatic islet tissue. Histological study revealed the mechanism of healing that included the repair or re-generation of insulin-secreting beta cells.

Hyperglycemia

• Gymnema attenuates hyperglycemia in normal and mildly diabetic rats when given before the oral administration of glucose.
• The injection of anterior pituitary extract into rats induces an elevation in blood glucose, ostensibly due to increased gluconeogenesis and the inhibition of peripheral glucose utilization. The administration of oral Gymnema to these animals significantly reduces blood sugar, with little effect on blood sugar in normal controls.
• Gymnema extracts ameliorate moderate hyperglycemia in rats chemically-induced to be moderately diabetic. In addition, it has increased significantly longevity in rats with moderate or severe diabetes.
• In glucose fed hyperglucemic rats, the leaf extract significantly reduced the glycogen content of the tissues. The effect was enhanced when both exogenous insulin and Gymnema extract were administered.
• Based on studies with chemically-induced diabetic rabbits, Gymnema enhances the activity of enzymes involved in the utilization of glucose along insulin-dependent pathways. The following results, beneficial to diabetics, have been observed:
  • Decreased fasting glucose levels.
  • Increased glycogen storage in the liver and muscle tissue.
  • Increased protein content in tissues typically laden with lipids in diabetics.
  • Decreased encumbrance of tissues with lipid deposition.
  • Increased activity of the enzymes glyceraldehydes-3-phosphate dehydrogenase, glycogen synthesis, and glusoce-6-phosphate dehydrogenase.
• Gastric-inhibitory polypeptide (GIP) is a hormone released by the duodenal mucosa to control the dumping of food from the stomach into the small intestine and to stimulate an anticipatory release of insulin into the blood stream. The release of GIP is stimulated by glucose reaching duodenal receptors. The leaf extract and gymnemic acid interact with these receptors in a fashion that inhibit the release of GIP in rats.

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Hypoglycemia

• Beryllium compounds are known for a toxicity that induces, in humans and animals, dramatic decreases in blood glucose and damage to hepatocytes. Gymnema has demonstrated a modulating effect on beryllium–caused hypoglycemia in rats.

Taste Sense for Sweetness

• The gurmarin constituent in Gymnema is known to selectively suppress the sucrose responses of the chorda tympani nerve in rats and mice. In addition, saliva contains gurmarin binding proteins. Reduced preference for sucrose in animals on gymnmeic acid regimen is probably caused by gurmarin. Subsequent restoring of sucrose preference may be due to "suppression of the effect of gurmarin by salivary gurmarin-binding proteins induced by the gymnema diet" used during these studies.
• Extracts applied to taste buds on the tongue effectively neutralizes the gustat5ry stimuli to the brain for the taste quality of sweetness.

Cholesterol

• Saponin constituents of plants are well known for their ability to increase fecal excretion of cholesterol and other neutral steroids. The saponins of Gymnema are no exception. In a dose dependent manner, extracts increase fecal excretion of cholesterol, total neutral steroids, and bile acids in rats.

Lipid Absorption

• Gymnemic acid strongly inhibits the absorption of oleic acid from the intestines of rats in a dose-dependent, reversible fashion. This effect is similar to Gymnema’s effect on glucose absorption. The glycosides do not have this effect. These effects may help to clarify the clinical application of Gymnema to diabetes and obesity.

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Dosage

400-600 mg of a Gymnema extract per day, standardized to 25% gymnemic acids, in divided doses.

Side Effects

• Although used safely in Ayurveda for centuries, Gymnema has not been thoroughly studied for safety in animals and humans. Nevertheless, studies of efficacy have reported little, if any, toxicity from the plant directly at recommended doses.
• Due to its ability to reduce blood sugar in hyperglycemic patients, careful monitoring of those using blood-sugar lowering agents, including insulin, is critical. Blood sugar levels should be checked regularly and conventional medicines adjusted as Gymnema begins to lower hyperglycemia.
• Gymnema is not considered to be a viable insulin substitute in patients whose hyperglycemia must be controlled by insulin.
• As with many medicines, there have been no formal studies to ascertain safety during pregnancy and lactation.

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