CHEMISTRY BEHIND THE HYPOGLYCEMIC EFFECT OF BERGENIA CILIATA

HAW. (PAKHANBED)

Dr. Bimala Subba

Diabetes mellitus (DM) is a chronic disease caused by inherited or acquired deficiency in insulin
secretion and by decreased responsiveness of the organs to secreted insulin. Such a deficiency
results in increased blood glucose level, which in turn can damage many of the body’s systems,
including blood vessels and nerves. DM is currently one of the most costly and burdensome
chronic diseases and is a condition that is increasing in epidemic proportions throughout the
world. Diabetes affects about 5% of the global population and the management of diabetes
without any side effects is still a challenge to the medical system.
One therapeutic approach for treating diabetes is to decrease the post-prandial
hyperglycemia. This is done by retarding the absorption of glucose through the inhibition of the
carbohydrate-hydrolysing enzymes a-glucosidase and a-amylase in the digestive tract. A-
Glucosidase enzymes, located in the brush-border surface membrane of intestinal cells, catalyze
the hydrolysis of the a-glycosidic bond of oligosaccharides to liberate the monosaccharide units
from dietary sources. Hence, a-glucosidase inhibitors can delay the liberation of D-glucose of
oligosaccharides and disaccharides from dietary complex carbohydrates and retard glucose
assimilation, reducing postprandial plasma glucose levels. The inhibitors delay, but do not
prevent, the absorption of ingested carbohydrates, reducing the postprandial glucose and insulin
peaks. Therefore, it is a method of choice to control elevated glucose level in blood to treat
diabetes and prevent other cardiovascular complications.
Many natural resources have been investigated with respect to the suppression of glucose
production from carbohydrates in the gut or glucose absorption from the intestine. In many
developing countries like Nepal, traditional medicine, in particular herbal medicine is sometimes
the only affordable source for healthcare. As for the developed countries, the use of herbal
medicine by the suffers of chronic disease is encouraged because there is concern about the
adverse effects of chemical drugs and treatment using medicines of natural origin appears to
offer more gentle means of managing such disease. Herbal drugs are prescribed widely because
of their effectiveness, fewer side effects and relatively low cost.
A number of herbs found in Nepal have remarkable anti diabetic potential. Several
Nepalese herbal plants contain significant antidiabetic potential although Nepalese medicinal
herbs are presently limited only in traditional ayurvedic treatment. Many natural resources have
been investigated with respect to suppression of glucose production from carbohydrates in the
gut or glucose absorption from the intestine. Therefore, effective and nontoxic inhibitors of a-
amylase and a-glucosidase have long been wanted.

Figure 1. Pakhanbhed

The Nepalese herb, Pakhanbhed one of the traditional remedies used for diabetes since
prehistoric times (Fig. 1). The scientific name of plant is Bergenia ciliate belongs to famlily
‘Saxifragaceae’. The root powder or extract is used as a hypoglycemic agent. B. ciliata is
distributed in Afghanistan, Northern India, Bhutan, Northern Tibet, Western China, and Northern
Myanmar. In Nepal, it is found throughout the country at 1300 - 3000 m in moist rocky places.

Scientifically, antidiabetic properties of Bergenia ciliata had been investigated by

Bhandari et al (2008). B. ciliata is used in traditional ayurvedic medicine for the treatment of
several diseases. The inhibitory effects of a methanol extract from B. ciliata on a-glucosidase and
a-amylase had been investigated. The crude methanolic extract of B. ciliata showed strong
inhibitory activity for both a-glucosidase and a-amylase. Extraction and fractionation of the
active methanol extract lead to the isolation of two active compounds, (-)-3-O-galloylepicatechin
and (-)-3-O-galloylcatechin (Fig. 2). These isolated compounds demonstrated significant dose
dependent enzyme inhibitory activities against rat intestinal a-glucosidase and porcine pancreatic
a-amylase. This valuable herb was not previously investigated for its anti-diabetic activity.
However, their study clearly established the anti-diabetic potential of B. ciliata and revealed that
the active principles responsible for this activity are (-)-3-O-galloylepicatechin and (-)-3-O-
galloylcatechin, and these were reported from this plant species for the first time. These isolated
compounds were abundantly found in tea. Flavonoids, like antioxidants, may prevent the
progressive impairment of pancreatic beta-cell function due to oxidative stress and may thus
reduce the occurrence of type 2 diabetes. In their study Kao, Chang, Lee, and Cheng (2006) have
reported that these tea catechines, especially (-)-epigallocatechine gallate (EGCG) appears to
have antiobesity and antidiabetic effects and they have suggested that tea- and EGCG-based folk
medicine may be utilised in the treatment of obesity, diabetes and other chronic disease including
cancer. Similarly, Sabu, Smitha, and Kuttan (2002) have also reported the antidiabetic and
antioxidant activity of tea polyphenols such as gallocatechin (GC), epigallocatechin (EGC),
epicatechin (EC), epigallocatechin gallate (EGCG) and epicatechin gallate (ECG). It has been
hypothesized that a higher intake of catechin-rich food by diabetic patients may provide some
protection against the development of the long-term complications of diabetes.

Figure 2. Structure of compounds isolated from Bergenia ciliata: [1] (-)-3-O-galloylepicatechin, [2] (-)-3-O-galloylcatechin.

This study was the first to report a potential mode of action of B. ciliata and suggests that the
glucose lowering effect of this plant is due to the inhibition of digestive enzymes, a-glucosidase
and a-amylase.
In conclusion, the results from this study give scientific support to the use of B. ciliata in folklore
medicine for the treatment of diabetes and show, for the first time, the potential role of a-
glucosidase and a-amylase inhibition in its activity. This study would be helpful to explain the
pharmacological mechanism and also to develop medicinal preparations, nutraceuticals or
functional foods for diabetes and related symptoms.

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