Bitter Melon

Research indicates that bitter melon could be useful in the management of dyslipidemia. Still, there is disagreement concerning the findings. This systematic study was undertaken to clarify the impact of consuming bitter melon on lipid profile. The databases Web of Science, Cochrane Library, PubMed, and Scopus were queried from inception until February 9, 2023. The study assessed triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) levels. The effect sizes were calculated using weighted mean differences (WMDs) and 95% confidence intervals (CIs). Eight randomized controlled trials (RCTs) with a total of 423 participants were included. Bitter melon consumption resulted in a significant decrease in plasma concentrations of TC (WMD; -9.71 mg/dL; CI: -17.69 to -1.74, p = 0.01) and TG (WMD; -10.24 mg/dL; CI: -19.92 to -0.56, p = 0.03), while bitter melon did not significantly lower blood LDL-C (WMD; -8.66 mg/dL; CI: -19.83 to 2.50, p = 0.12) and HDL-C concentrations (WMD; 0.54 mg/dL; CI: -2.38 to 3.45, p = 0.71). Subgroup analysis showed a significant decrease in TC and LDL-C and an increase in HDL-C at a dose of ≤ 2000 mg/day and an intervention period of ≤ 8 weeks. Also, the greatest impact of LDL-C and HDL-C was seen in diabetic and prediabetic people. Bitter melon supplementation positively impacts TC and TG levels. The limitations of this study were short-term trials (less than 3 months). © 2024 John Wiley & Sons, Ltd.

There is controversial data on the impacts of bitter melon (Momordica charantia) supplementations on anthropometric indices. Thus, we aimed to clarify this role of bitter melon through a systematic review, and meta-analysis of the trials. All clinical trials conducted on the impact of bitter melon on anthropometric indices were published until August 2023 in PubMed, Web of Sciences, Scopus, Embase, and Cochrane Library web databases included. Overall, 10 studies with 448 individuals were included in the meta-analysis. Meta-analysis of 10 trials with 448 participants revealed no significant reductions in body weight (BW) (WMD: 0.04 Kg; 95 %CI: -0.16-0.25; P =0.651), body mass index (BMI) (WMD: -0.18 kg/m2; 95 %CI: -0.43-0.07; P =0.171), waist circumference (WC) (WMD: -0.95 cm; 95 % CI: -3.05-1.16; p =0.372), and percentage of body fat (PBF) (WMD: -0.99; 95 % CI: -2.33-0.35; p =0.141) following bitter melon supplementation. There was no significant impact of bitter melon supplementation on BW, BMI, WC, and PBF. More large-scale and high-quality RCTs are necessary to confirm these results.

Diabetes is a global health challenge, often managed with insulin therapy. However, the direct interactions of insulin receptor (IR)-binding macromolecules with IR remain poorly understood. In this study, we explored the hypoglycemic mechanisms of BG68, a 68-amino-acid polypeptide abundant in Momordica charantia, and its stable, gastro-resistant 9-amino-acid peptide (mcIRBP-9) in combination with insulin in a type 2 diabetes mouse model. We characterized the binding kinetics of BG68 and mcIRBP-9 to the IR/insulin complex using isothermal titration calorimetry (ITC) and hydrogen‑deuterium exchange mass spectrometry (HDX-MS). Functional assays, including Western blot and phosphoproteome analyses, were performed to assess IR phosphorylation. Our findings revealed that BG68 and mcIRBP-9 synergistically enhanced glucose clearance with insulin. HDX-MS analysis showed that mcIRBP-9 bound to IR at sites distinct from insulin, initially engaging the L1 and α-CT regions before extending to L2, FnIII-2, and FnIII-3 domains. ITC confirmed spontaneous binding to the IR/insulin complex with moderate affinity, while phosphoproteome analysis demonstrated that mcIRBP-9 significantly enhanced IR phosphorylation at Y1356 and Y1362, thereby amplifying IR kinase activity and promoting glucose clearance. In conclusion, our findings suggested that mcIRBP-9 provided a "second hit" to IR following insulin binding, further enhancing IR activation. This novel mechanism highlighted mcIRBP-9 as a promising candidate for improving the efficacy of insulin therapy and combating insulin resistance in type 2 diabetes.

INTRODUCTION: Acute pancreatitis associated with Pazopanib has been reported in the literature. Bitter Melon (Momordica Charantia) is traditionally used as a folk medicine in many regions. In this report, we describe a 65-year-old patient with a diagnosis of renal cell carcinoma, admitted to the hospital with symptoms of acute pancreatitis at the 8th year of pazopanib treatment. CASE REPORT: The patient diagnosed with renal cell carcinoma was admitted to the hospital with the complaint of abdominal pain, nausea, and vomiting in the 8th year of Pazopanib treatment. It was noticed from the patient's history that he had received Bitter Melon extract for 4 days prior to the beginning of his complaints (100-150 ml/day). Levels of serum amylase and lipase were measured as 9163 U/L and 14,206 U/L, respectively. MANAGEMENT & OUTCOME: Pazopanib drug was held. The patient was treated for acute pancreatitis. Pazopanib treatment was started again after the clinical condition of the patient had improved and levels of serum amylase and lipase had returned to normal levels. Levels of serum amylase and lipase did not increase again after re-administration of pazopanib treatment. DISCUSSION: It is thought that Bitter Melon extract and pazopanib interaction might have led to acute pancreatitis. To the best of our knowledge, this case is the first to highlight the interaction of Bitter Melon extract with pazopanib. The Drug Interaction Probability Scale indicates that there is a probable association between bitter melon and acute pancreatitis.

Increasing evidence shows that Traditional Chinese Medicine (TCM) has an obvious appeal for cancer treatment, but there is still a lack of scientific investigation of its underlying molecular mechanisms. Bitter melon or bitter gourd (Momordica charantia) is an edible fruit that is commonly consumed, and it is used to cure different diseases in various ancient folk medical practices. We report that a bioactive protein, MAP30, isolated from bitter melon seeds exhibited potent anticancer and anti-chemoresistant effects on ovarian cancer cells. Functional studies revealed that MAP30 inhibited cancer cell migration, cell invasion, and cell proliferation in various ovarian cancer cells but not normal immortalized ovarian epithelial cells. When administered with cisplatin, MAP30 produced a synergistic effect on cisplatin-induced cell cytotoxicity in ovarian cancer cells. When low doses of cisplatin and MAP30 were co-injected intraperitoneally, a remarkable reduction of tumor dissemination and tumor growth was observed in an ovarian cancer ascites mouse model. Notably, blood tests confirmed that MAP30 did not cause any adverse effects on liver and kidney functions in the treated mice. MAP30 activated AMP-activated protein kinase (AMPK) signaling via CaMKKβ and induced cell cycle arrest in the S-phase. MAP30 modulated cell metabolism of ovarian cancer cells via suppression of GLUT-1/-3-mediated glucose uptake, adipogenesis, and lipid droplet formation in tumor development and progression. MAP30 also induced an increase in intracellular Ca2+ ion concentration, which triggered ROS-mediated cancer cell death via apoptosis and ferroptosis. Collectively, these findings suggest that natural MAP30 is a non-toxic supplement that may enhance chemotherapeutic outcomes and benefit ovarian cancer patients with peritoneal metastases.

The pharmacology, clinical efficacy, adverse effects, drug interactions, and place in therapy of bitter melon are described. Bitter melon (Momordica charantia) is an alternative therapy that has primarily been used for lowering blood glucose levels in patients with diabetes mellitus. Components of bitter melon extract appear to have structural similarities to animal insulin. Antiviral and antineoplastic activities have also been reported in vitro. Four clinical trials found bitter melon juice, fruit, and dried powder to have a moderate hypoglycemic effect. These studies were small and were not randomized or double-blind, however. Reported adverse effects of bitter melon include hypoglycemic coma and convulsions in children, reduced fertility in mice, a favism-like syndrome, increases in gamma-glutamyltransferase and alkaline phosphatase levels in animals, and headaches. Bitter melon may have additive effects when taken with other glucose-lowering agents. Adequately powered, randomized, placebo-controlled trials are needed to properly assess safety and efficacy before bitter melon can be routinely recommended. Bitter melon may have hypoglycemic effects, but data are not sufficient to recommend its use in the absence of careful supervision and monitoring.

MAP30 is an antiviral protein from bitter melon (Momordica charantia). The enhancement of weak HIV antagonists, dexamethasone and indomethacin, by MAP30 has been examined by measuring the reduction in p24 expression in acutely infected MT-4 lymphocytes. In the presence of 1.5 nM MAP30 the IC50 dose of dexamethasone and indomethacin has been lowered, without concurrent cytotoxicity, at least a thousand-fold to 10(-7) M and 10(-8) M, respectively. This observation indicates that MAP30, a multifunctional antiviral plant protein capable of topological inactivation of viral DNA and specific cleavage of 28 S ribosomal RNA, may regulate HIV replication in concert with steroid and non-steroidal inhibitors of prostaglandin synthesis. The results suggest that use of MAP30 in combination with low pharmacological doses of dexamethasone and indomethacin may improve the efficacy of anti-HIV therapy.

Erratum in Int Wound J. 2024 Apr;21(4):e14875. doi: 10.1111/iwj.14875. This systematic review aimed to qualitatively synthesize recent randomized controlled trials (RCTs) regarding the effect of topical application and oral intake of herbal products on the healing of diabetic foot ulcer (DFU). Also, we sought to pool the obtained findings in a meta-analysis using a random-effects model, if RCTs were relatively comparable and homogenous. A comprehensive search was performed on five electronic data sources from their inception through 23 January 2024. The RCTs, without restriction on the country of origin, were included if they compared the effect of administering standard treatments and/or placebo (i.e. control condition) to applying standard treatments and/or herbal products in topical or oral routes (i.e. experimental condition). Out of 1166 retrieved records, 28 RCTs were included. Studies used different poly and single herbal formulations. Based on the meta-analysis, administration of standard care plus daily dressing of the ulcer site with olive oil for 28 days significantly increased the total ulcer healing score (3 RCTs; weighted mean difference [WMD] = 89.30; p < 0.001), raised frequency of complete ulcer healing (2 RCTs; risk ratio [RR] = 12.44; p = 0.039) and declined ulcer degree (3 RCTs; WMD = -22.28; p = 0.002). Also, daily use of the bitter melon leaf extract in oral form for 28 days significantly increased the total ulcer healing score (2 RCTs; WMD = 0.40; p = 0.001). Additionally, based on qualitative synthesis, the adjuvant use of herbal agents seems an intriguing choice to manage DFU. Nonetheless, considering the undesirable methodological quality of most studies and the high heterogeneity in administered herbal formulations, more robust trials are required to build a solid conclusion regarding the use of herbal products for healing DFU. © 2024 The Authors. International Wound Journal published by Medicalhelplines.com Inc and John Wiley & Sons Ltd. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. Hasani-Ranjbar S(1), Nayebi N, Larijani B, Abdollahi M. Author information: (1)Endocrinology a

9. World J Gastroenterol. 2009 Jul 7;15(25):3073-85. doi: 10.3748/wjg.15.3073. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesity. Hasani-Ranjbar S(1), Nayebi N, Larijani B, Abdollahi M. Author information: (1)Endocrinology and Metabolism Research

ETHNOPHARMACOLOGICAL RELEVANCE: Bitter gourd (Momordica charantia L.) is known for its ability to reduce parameters of diabetes, but its effects on prediabetic subjects have been scarcely studied. AIM OF THE STUDY: To assess the efficacy of Momordica charantia supplementation in a prediabetic population on markers of glucose homeostasis. METHODS: Two randomized controlled studies were conducted to assess the effect of bitter gourd supplementation in a prediabetic population. Study 1 was a 4-week cross-over intervention trial (n = 30), with freeze-dried bitter gourd (BG) fruit juice (2.4 g/day) or a cucumber-based control product (CC). Study 2 was a parallel trial (n = 38) lasting 12 weeks, with freeze-dried whole fruits (3.6 g/day) or a cucumber-based matched control supplement. Effects on fasting plasma glucose (FPG), insulin, HbA1c, fructosamine, postprandial glucose after an oral glucose tolerance test, and several safety biomarkers were also analyzed in both trials before and after the interventions. RESULTS: In Study 1, no significant differences were found between the bitter gourd and placebo interventions. However, a reduction in FPG in subjects with higher baseline values were found following bitter gourd supplementation, which was not observed in the control group. However, in Study 2, we observed significant reductions of FPG (p = 0.014), fasting insulin (p = 0.007), and HOMA-IR (p = 0.003) after a 12-week intervention with the bitter gourd supplement. In addition, between treatment analysis resulted in significant effects on FPG levels (p = 0.026) and HOMA-IR (p = 0.045) with no significant effects on other biomarkers related to glucose metabolism. On average, bitter gourd intervention reduced FPG by ∼0.05 mmol/L per week, whereas FPG remained unchanged following placebo. In both studies, there were no indications of health risks or side effects from consumption of the supplements. CONCLUSION: Results suggest that supplementation with bitter gourd fruit can have positive effects on fasting plasma glucose and insulin among prediabetic subjects when provided over an extended period of at least 12 weeks.

OBJECTIVE: The purpose of this study was to assess the impact of bitter melon extract supplementation on glycemia in individuals with prediabetes. METHODS: This was a 12-week randomized, parallel, placebo-controlled study where 75 adults with prediabetes were randomly allocated into the low-dose bitter melon (300 mg/day) (n = 26), high-dose bitter melon (600 mg/day) (n = 24), or control (n = 25) groups. RESULTS: At baseline and weeks 6 and 12, anthropometrics were measured, and fasting blood samples were obtained. The high-dose (1.05% ± 10.2%) and low-dose bitter melon (3.35% ± 13.2%) groups showed smaller increases in blood glucose levels at 12 wk, compared to the control group (11.0% ± 16.3%) (p < 0.05). A subgroup analysis of participants with age ≥ the median demonstrated a greater reduction in glycated hemoglobin at 12 wk in the high-dose bitter melon group (median change: -0.20%; IQRL: -0.20%, -0.05%) vs. the control group (median change: 0.00%; IQRL: -0.10%, 0.20%) (p = 0.017). Compliance with the interventions was >95%, and the study products were tolerated well. CONCLUSION: The bitter melon extract may help maintain a healthy level of glucose in adults with prediabetes.

BACKGROUND: Using functional foods in the prevention and treatment of type 2 diabetes mellitus (T2DM) has increased across the world owing to their availability, cultural acceptability, and lower side effects. The present study will aim to examine the impact of bitter almond (Amygdalus communis L. var. Amara) gum as a functional food on metabolic profile, inflammatory markers, and mental health in women with T2DM. METHODS: We will conduct a randomized, triple-blind, placebo-controlled trial. A total of 44 women with T2DM will be randomly allocated into two groups: an intervention group (n = 20) and a placebo group (n = 20). Patients will receive either 5 g/d of bitter melon gum or a placebo for 8 weeks. Clinical and biochemical outcome parameters which include glycemic indices, lipid profile, inflammatory markers, oxidative stress indices, tryptophan (Trp), kynurenine (KYN), cortisol, glucagon-like peptide 1 (GLP-1), leptin, adiponectin, ghrelin, peroxisome proliferator-activated receptor (PPAR) gene expression, brain-derived neurotrophic factor (BDNF), endothelial cell adhesion molecules, plasminogen, cluster deference 4 (CD4), cluster deference 8 (CD8), anthropometric indices, blood pressure, dietary intake, and mental health will be measured at the baseline and end of the study. Statistical analysis will be conducted using the SPSS software (version 24), and P value less than 0.05 will be considered statistically significant. DISCUSSION: The present randomized controlled trial will aim to investigate any beneficial effects of bitter almond gum supplementation on the cardio-metabolic, immune-inflammatory, and oxidative stress biomarkers, as well as mental health in women with T2DM. ETHICS AND DISSEMINATION: The study protocol was approved by the Ethical Committee of the Tabriz University of Medical Sciences (IR.TBZMED.REC.1399.726). TRIAL REGISTRATION: Iranian Registry of Clinical Trials ( www.irct.ir/IRCT20150205020965N7 ). © 2023. The Author(s).

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a major public health concern with growing prevalence with multiple debilitating complications. GlycaCare-II is a proprietary herbal formulation supplement for T2DM containing extracts of Cinnamomum cassia, Momordica charantia, Pterocarpus marsupium, Gymnema sylvestre, Salacia reticulata, Eugenia jambolana, and a bioavailability enhancer piperine from Piper nigrum. OBJECTIVE: The antihyperglycemic potential of GlycaCare-II was compared against metformin in a double-blind study. DESIGN: It was a randomized, two-arm design on prediabetic (N = 29; 12 in metformin and 17 in GlycaCare-II arm, respectively) and newly diagnosed diabetic (N = 40; 16 in metformin and 24 in GlycaCare-II) patients for 120 days. OUTCOME MEASURES: Changes in diabetic panel glycosylated hemoglobin (HbA1c), fasting blood sugar (FBS), and postprandial blood sugar (PBS) were the primary endpoints. Lipid profile, liver profile, thyroid-stimulating hormone, bilirubin and creatinine were the secondary endpoints. RESULT: Twice a day treatment for 120 days with GlycaCare-II led to a statistically significant change in HbA1c (p < 0.001), FBS (p < 0.001), PBS (p < 0.001) on both prediabetic and newly diagnosed diabetic patients. GlycaCare-II showed a similar potential as metformin in the treatment of T2DM. In the prediabetic group, both GlycaCare-II and metformin were comparable for all the hyperglycemic index parameters. In the case of newly diagnosed diabetic patients, GlycaCare-II showed a significantly better reduction for PBS (p = 0.026) as compared to metformin, while all other parameters in the diabetic panel were comparable. No adverse events were reported throughout the trial period. CONCLUSION: These results suggest that GlycaCare-II is effective in managing T2DM in both newly diagnosed diabetic and prediabetic patients. © 2021. The Author(s).

Though affecting many thousands of patients, myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) should be considered an orphan disease, since the cause remains elusive and no treatment is available that can provide complete cure. There is reasonable insight into the pathogenesis of signs and symptoms, and treatments specifically directed to immunological, inflammatory and metabolic processes offer relief to an increasing number of patients. Particular attention is given to the importance of co-morbidity requiring appropriate therapy. Promising results are obtained by treatment with Metformin, or possibly Momordica charantia extract, which will correct insulin resistance, with Meldonium improving the transportation of glucose into the mitochondria, with sodium dichloroacetate activating pyruvate dehydrogenase, and with nutraceutical support reducing oxidative and inflammatory impairment.

BACKGROUND: Bitter gourd (Momordica charantia L.) is a common tropical vegetable that has been used in traditional or folk medicine to treat diabetes. Wild bitter gourd (WBG) ameliorated metabolic syndrome (MetS) in animal models. We aimed to preliminarily evaluate the effect of WBG supplementation on MetS in Taiwanese adults. METHODS: A preliminary open-label uncontrolled supplementation trial was conducted in eligible fulfilled the diagnosis of MetS from May 2008 to April 2009. A total of 42 eligible (21 men and 21 women) with a mean age of 45.7 ± 11.4 years (23 to 63 years) were supplemented with 4.8 gram lyophilized WBG powder in capsules daily for three months and were checked for MetS at enrollment and follow-up monthly. After supplementation was ceased, the participants were continually checked for MetS monthly over an additional three-month period. MetS incidence rate were analyzed using repeated-measures generalized linear mixed models according to the intention-to-treat principle. RESULTS: After adjusting for sex and age, the MetS incidence rate (standard error, p value) decreased by 7.1% (3.7%, 0.920), 9.5% (4.3%, 0.451), 19.0% (5.7%, 0.021), 16.7% (5.4%, 0.047), 11.9% (4.7%, 0.229) and 11.9% (4.7%, 0.229) at visit 2, 3, 4, 5, 6, and 7 compared to that at baseline (visit 1), respectively. The decrease in incidence rate was highest at the end of the three-month supplementation period and it was significantly different from that at baseline (p = 0.021). The difference remained significant at end of the 4th month (one month after the cessation of supplementation) (p = 0.047) but the effect diminished at the 5th and 6th months after baseline. The waist circumference also significantly decreased after the supplementation (p < 0.05). The WBG supplementation was generally well-tolerated. CONCLUSION: This is the first report to show that WBG improved MetS in human which provides a firm base for further randomized controlled trials to evaluate the efficacy of WBG supplementation.

AIM OF THE STUDY: Momordica charantia Linn. Cucurbitaceae (MC), has been used to treat glycemic impairment in humans for centuries. The objective of this study was to determine the acute effect of MC on postprandial glucose levels, energy expenditure/fuel mixture and appetite in overweight men. MATERIALS AND METHODS: Five healthy overweight men were supplemented on three randomized conditions where (1) no MC (placebo), (2) 50 mg/kg body weight (MC50) or (3) 100 mg/kg body weight of freeze dried MC were administered orally prior to a 75 g oral glucose tolerance test (OGTT). Plasma glucose and insulin levels were measured before and during the OGTT. Energy expenditure as well as carbohydrate and lipid oxidation rates were measured by indirect calorimetry. Visual analogue scales were used to rate appetite profile. RESULTS: Plasma glucose and insulin levels significantly increased during the OGTT (p < or =0.05) but no significant difference was observed between experimental conditions. Energy expenditure, carbohydrate and lipid oxidation rates as well as appetite profile did not differ between experimental conditions. CONCLUSIONS: These results suggest that from an acute standpoint, a freeze dried MC extraction in its present dose form does not affect plasma glucose/insulin levels, energy expenditure, substrate mixture and appetite scores following an oral glucose load in non-diabetic overweight men.

There is considerable need for safe agents that can reduce risk for diabetes in at-risk subjects. Although certain drugs--including metformin, acarbose, and orlistat--have shown diabetes-preventive activity in large randomized studies, nutraceuticals have potential in this regard as well. Natural agents which slow carbohydrate absorption may mimic the protective effect of acarbose; these include: soluble fiber--most notably glucomannan; chlorogenic acid--likely responsible for reduction in diabetes risk associated with heavy coffee intake; and legume-derived alpha-amylase inhibitors. There does not appear to be a natural lipase inhibitor functionally equivalent to orlistat, although there are poorly documented claims for Cassia nomame extracts. Metformin's efficacy reflects activation of AMP-activated kinase; there is preliminary evidence that certain compounds in barley malt have similar activity, without the side effects associated with metformin. In supraphysiological concentrations, biotin directly activates soluble guanylate cyclase; this implies that, at some sufficient intake, biotin should exert effects on beta cells, the liver, and skeletal muscle that favor good glucose tolerance and maintenance of effective beta cell function. Good magnesium status is associated with reduced diabetes risk and superior insulin sensitivity in recent epidemiology; ample intakes of chromium picolinate appear to promote insulin sensitivity in many individuals and improve glycemic control in some diabetics; calcium/vitamin D may help preserve insulin sensitivity by preventing secondary hyperparathyroidism. Although conjugated linoleic acid--like thiazolidinediones, a PPAR-gamma agonist--has not aided insulin sensitivity in clinical trials, the natural rexinoid phytanic acid exerts thiazolidinedione-like effect in animals and cell cultures, and merits clinical examination. Other natural agents with the potential to treat and possibly prevent diabetes include extracts of bitter melon and of cinnamon. Nutraceuticals featuring meaningful doses of combinations of these agents would likely have substantial diabetes-preventive efficacy, and presumably could be marketed legally as

OBJECTIVE: To conduct a systematic review of the published literature on the efficacy and safety of herbal therapies and vitamin/mineral supplements for glucose control in patients with diabetes. RESEARCH DESIGN AND METHODS: We conducted an electronic literature search of MEDLINE, OLDMEDLINE, Cochrane Library Database, and HealthSTAR, from database inception to May 2002, in addition to performing hand searches and consulting with experts in the field. Available clinical studies published in the English language that used human participants and examined glycemic control were included. Data were extracted in a standardized manner, and two independent investigators assessed methodological quality of randomized controlled trials using the Jadad scale. RESULTS: A total of 108 trials examining 36 herbs (single or in combination) and 9 vitamin/mineral supplements, involving 4,565 patients with diabetes or impaired glucose tolerance, met the inclusion criteria and were analyzed. There were 58 controlled clinical trials involving individuals with diabetes or impaired glucose tolerance (42 randomized and 16 nonrandomized trials). Most studies involved patients with type 2 diabetes. Heterogeneity and the small number of studies per supplement precluded formal meta-analyses. Of these 58 trials, the direction of the evidence for improved glucose control was positive in 76% (44 of 58). Very few adverse effects were reported. CONCLUSIONS: There is still insufficient evidence to draw definitive conclusions about the efficacy of individual herbs and supplements for diabetes; however, they appear to be generally safe. The available data suggest that several supplements may warrant further study. The best evidence for efficacy from adequately designed randomized controlled trials (RCTs) is available for Coccinia indica and American ginseng. Chromium has been the most widely studied supplement. Other supplements with positive preliminary results include Gymnema sylvestre, Aloe vera, vanadium, Momordica charantia, and nopal.

10. Br Med J (Clin Res Ed). 1981 Jun 6;282(6279):1823-4. doi: 10.1136/bmj.282.6279.1823. Improvement in glucose tolerance due to Momordica charantia (karela). Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH. The effect of karela (Momordica charantia), a fruit indigenous to South America and Asia, on glucose and insulin concentrations was studied in nine non-insulin-dependent diabetics and six non-diabetic laboratory rats. A water-soluble extract of the fruits significantly reduced blood glucose concentrations during a 50 g oral glucose tolerance test in the diabetics and after force-feeding in the rats. Fried karela fruits consumed as a daily supplement to the diet produced a small but significant improvement in glucose tolerance. Improvement in glucose tolerance was not associated with an increase in serum insulin responses. These results show that karela improves glucose tolerance in diabetes. Doctors supervising Asian diabetics should be aware of the fruit's hypoglycaemic properties.