Harnessing the potential clinical use of medicinal plants as anti-diabetic agents

Correspondence: Joan Campbell-Tofte Department of Clinical Biochemistry, Coordinating Research Unit, Frederiksberg University Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark Tel +45 38 16 34 48 Fax +45 38 16 47 19 Email joan.campbell-tofte@frh.regionh.dk Abstract: Diabetes is a metabolic disorder arising from complex interactions between multiple genetic and/or environmental factors. The characteristic high blood sugar levels result from either lack of the hormone insulin (type 1 diabetes, T1D), or because body tissues do not respond to the hormone (type 2 diabetes, T2D). T1D patients currently need exogenous insulin for life, while for T2D patients who do not respond to diet and exercise regimes, oral anti-diabetic drugs (OADs) and sometimes insulin are administered to help keep their blood glucose as normal as possible. As neither the administration of insulin nor OADs is curative, many patients develop tissue degenerative processes that result in life-threatening diabetes comorbidities. Several surveys of medicinal plants used as anti-diabetic agents amongst different peoples have been published. Some of this interest is driven by the ongoing diabetes pandemic coupled with the inadequacies associated with the current state of-the-art care and management of the syndrome. However, there is a huge cleft between traditional medicine and modern (Western) medicine, with the latter understandably demanding meaningful and scientific validation of anecdotal evidence for acceptance of the former. The main problems for clinical evaluation of medicinal plants with promising anti-diabetic properties reside both with the complexity of components of the plant materials and with the lack of full understanding of the diabetes disease etiology. This review is therefore focused on why research activities involving an integration of Systems Biology-based technologies of pharmacogenomics, metabolomics, and bioinformatics with standard clinical data, should be used for cost-effective validation of the safety and anti-diabetic efficacy of promising medicinal plants. The application of such approaches to studying entire mixtures of plant materials will ensure proper elucidation of novel therapies with improved mechanisms of action, as well as facilitate a personalized clinical use of medicinal plants as anti-diabetic agents.