Diabetes in insulin secretion, insulin action or both

Diabetes
mellitus (DM) is a metabolic disease with prevalence worldwide estimated to be
2.8% in 2000 and 4.4% in 2030 (Wild et al.,
2004) while in animals, especially dogs and cats, the prevalence was estimated
as 0.4 – 1.2% (Richard and Claudia, 2014). The rapidly increasing incidence of
DM globally poses a serious health risk in the 21st century. DM is rapidly becoming
a serious health issue in Nigeria with the prevalence of Type II DM, according
to the International Diabetes Foundation/WHO reports estimated to be over 3.4%
of 24 million Nigerian DM sufferers between the ages of 20-79 years and with
projected estimate of 3.9% rise in 2025 (Chikezie et al., 2015).

Diabetes
mellitus leads to metabolic abnormalities and is characterized by hyperglycemia
resulting from defects in insulin secretion, insulin action or both (Fonseca et al., 2000). This high blood sugar
produces symptoms of polyuria (frequent urination), polydipsia (increased
thirst) and polyphagia (increased hunger).

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Type
1 Diabetes results from impairment of insulin release by the pancreas leading to
reduced glucose uptake into muscles and adipose tissue. Type 2 diabetes is usually
seen in obese individuals with associated hypertension and dyslipidemia,
therefore, the treatment goals are basically reduction in insulin resistance
and stimulation of insulin secretion. Although, oral hypoglycemic agents and
insulin are majorly used in the treatment of diabetes, they have prominent side
effects and fail to significantly alter the course of diabetic complications
(Maghrani et al., 2004). The common
side effects associated with oral hypoglycemic agents are hypoglycemia, weight
gain, gastrointestinal disorders, peripheral oedema and impaired liver
function, in addition to the cost of treatment (Mallare et al., 2005).

Traditional
(herbal) medicine  is used for treatment
of diabetes in developing countries where the cost of conventional medicines is
a burden to the populace (Hongxiang et al.,
2009). Medicinal plants are readily available and have reduced side effects; many
of these plants have been found to be useful in the management of diabetes.
However, only a few have been subjected to detailed scientific investigation
due to a lack of mechanism-based available in
vitro assays (Hongxiang et al., 2009). Several herbs used in the management of diabetes have been
reported to possess hypoglycemic effects (Grover et al., 2002; Macedo and Ferreira, 2004; Djomeni et al., 2006) and it has been reported
that the array of anti-diabetic bioactive principles in these plants may act synergistically
to produce glycemic
control (Liu et
al., 2005). Among these plants is Momordica
charantia L Fam. Cucurbitaceae (African cucumber, bitter gourd, bitter
melon).