Vernonia amygdalina is in layman’s language called the bitter leaf. It is very famous and it is a plant found mostly in the parts of Africa and Asia. It is one of the most cultivated species of genus Vernonia and a prominent species in the Asteraceae family. It produces no seeds and it is cultivated through planting its stem in tropical areas (Ofori, Anjarwalla, Jamnadass, Stevenson, & Smith 2013). It has a bitter taste due to the presence of saponins, tannins, glycosides, and alkaloids hence making the leaves act as a bittering agent and also used as a hop substitute in controlling microbial contamination during the brewing of beer with no reduction of the malt’s quality. Its harvesting is done twice per month until the plant reaches seven years (Vasorelaxant Properties of Vernonia Amygdalina Ethanol Extract and Its Possible Mechanism 2017). These leaves have a lot of beneficial uses. It is mostly used for food and acts as a traditional medicine where before consumption, its bitter taste and odor are reduced through a lot of water or boiling it. It is used in treating malaria where medicine man from Uganda produces a greenish powder, packs it into sachets and then urges the patients to use them in preparing tea (Eddouks 2016). It is also used as soup and also used in the production of honey wine named Tei in Ethiopia. The decoctions of leaves and roots are used in ethnomedicine in the treatment of hiccups, fevers, kidney problems and also stomach disorders (Vernonia Amygdalina Protect Joints by Suppressing Chondrocyte Differentiation in Osteoarthritis Rat Model 2018). This plant contains diverse bioactive compounds such as flavonoids, saponins, phenolics, steroidal glycosides, tannins, triterpenoids and other types of sesquiterpene lactones. These bioactive compounds make Vernonia have different pharmacological properties. These properties are antimalarial, antioxidant, laxative, anti-fungal, antimicrobial, antithrombotic, cathartic, hypoglycemic, anticancer, antifertility, and others that make it too beneficial in curing various human conditions (Neffati, Najjaa, & Máthé 2017).
The leaves of V. amygdalina nutritional values are many. Its leaves, roots, and stem are enriched with amino acids, carbohydrates, vitamins, fibers, fats, and proteins. This composition varies from one location to the other due to geographical location, the plant’s ecology, the conditions of harvesting, genetic and also the surrounding environment. Their leaves are made up of carbohydrates, proteins, lipids, iodine, amino acids, glycine, hydrolysate, total oxalate, among others, (Hasibuan, Harahap, Sitorus, & Satria 2018).
The bioactive compounds named above inhibit the growth of the cells that result in breast cancer because it possesses antimicrobial and antitumoral properties. These properties lead to a significant activity of bactericidal against the gram bacteria, (Hasibuan, Harahap, Sitorus, & Satria 2018).
Their anti-inflammatory property is used in the treatment of gastrointestinal disorders Flavonoids, tannins and saponins in these leaves contain anti-oxidants and participate in strong antioxidant activities in the human body. The triterpenoids these plants contain can be used in functional foods, in cosmetics, in products of healthcare and are extracted from the leaf, root, and stems. Its extracts reduce malondialdehyde levels and scavenge free radical cells where they interfere with induced detoxification DNA binding in some factors of transcription. The extract also inhibits bleaching B – carotene and peroxidation.
The presence of phytochemicals, vitamins and various other nutrients in the extracts of these leaves gives them an antidiabetic effect. The antidiabetic effect involves reducing the level of blood glucose in people.
These leaf extracts possess protective effects against hepatotoxicity through its antioxidant mechanism of action and the presence of antioxidant bioactive compounds. Their action is also because of their early maturation where they release leucocytes and thus these leaves extracts act as an immune booster in various health conditions.
The toxicology effects of V. amygdalina are that it leads to a significant decrease in red blood cell count and increased dependence on its dose. The extracts are non-toxic, and this has been proven through conducting various tests using rats and chicken.
Pathophysiology of diabetes
Diabetes occurs as a result of the misbalance insulin’s demand and production. There are three types of diabetes namely diabetes type 1, diabetes type 2, and gestational diabetes.
Diabetes type 1 comes by when the immune system of the human body attacks and destroys the beta cells of the pancrease that produce insulin. When there comes this beta-cell deficiency, it follows a complete deficiency of insulin. Diabetes 1 is an autoimmune disease where there is the presence of anti-insulin cells in the blood. They lead to lymphocytic infiltration and pancrease islets destruction which. The onset of diabetes 1 takes place rapidly and one gets completely affected within the first one week (Boeder & Edelman 2019). There are autoimmune conditions associated with diabetes type 1 which include vitiligo and hypothyroidism. This type of diabetes needs therapy of insulin and does not respond to insulin stimulating oral drugs (Marchand, Garnier, Thivolet, Nicolino, & Fabien 2018).
Pathophysiology of diabetes type 2 is that it is a condition that comes by as a result of a relative deficiency of insulin in the human body. The body produces inadequate amounts of insulin and thus cannot meet the insulin needs. There is a deficiency of beta cells in the body followed by the resistance of peripheral insulin (STEVENS 2016). Peripheral insulin resistance, in this case, means that there is low blood sugar-also called hypoglycemia irrespective of high insulin levels in the blood. This is due to the changes in the receptors of insulin that cause insulin actions. The insulin resistance experienced is a result of obesity and to cure this condition, patients are administered insulin after oral drugs fail to stimulate adequate insulin release.
Gestational diabetes occurs during pregnancy (Petry 2014). It occurs when there are excessive counter hormones of insulin during the gestation period. This leads to insulin resistance state and high blood sugar levels in the expectant mother. Deceptive insulin receptors may be witnessed during this period.
The pathophysiology behind symptoms and complications of diabetes is that there is associated with high thirst as a result of increased blood glucose that makes blood very concentrated (Nair & Peate 2015). There is also associated with increased urination as a result of excess intake of fluids and urination induced by glucose. Patients suffer weight loss as a result of calories that are lost through frequent urination and increased hunger because the body is in a state of craving for more glucose due to excessive loss of glucose through urination. Also, patients experience poor healing of wounds and increased infections as a result of diminished immunity and good nutrition source of microbes due to high blood glucose. Patients may suffer heart disease due to large vessels of blood and eye damages as a result of fine retina blood vessels after their exposure to high levels of sugar. Another pathophysiology includes kidneys damage due to proteinuria and nerve damages that affects legs and arms and diabetic foot occurs as a result of damaged peripheral nerves and the affliction of blood vessels. Diabetic Ketoacidosis is brought about by type 1 diabetes due to the complete lack of insulin and the body’s reliance on fatty acids for energy. Non-ketotic hyperosmolarity is another sign and symptom pathophysiology brought about by increased blood sugar especially in type 2 diabetes where there is enough insulin that suppresses the synthesis of ketone (Nair & Peate 2015).
The epidemiology of diabetes
Diabetes is increasing at a very high rate in the globe day by day. The recent 8th edition by IDF Diabetes Atlas shows that within every seven seconds. A person dies out of diabetes or its associated complications (World Health Organization 2016). It is approximated that about 4 million people die per year due to this condition and 50% of those deaths are of people aged below 50 years of age. The global prevalence of diabetes is at a confidence interval of 95% at the standardized age of 20 to 79 in the globe in 2017. It is estimated that by the year 2045, the diabetes prevalence shall increase and one of the factors leading to this is that the majority of the individuals with this condition are undiagnosed especially in the developing countries. Due to the increased rate of people suffering from obesity, people have also increasingly suffered from multifactorial cardiovascular risk management and diabetes. Obesity is a pandemic of the entire globe, brought about by lifestyle habits of individuals (Hunter 2015). Some people are suffering from pre-stage diabetes called IGT (Impaired Glucose Tolerance) and according to the IDF atlas estimations, the figure identified in 2017 was 352.1 million which is expected to rise to 531.6 million by 2045. Overt diabetes can be prevented in several measures while the complications associated with diabetes include heart diseases, brain, kidneys, eyes and feet complications (Rockefeller 2015). On a global scale, diabetes affects mostly middle-aged people of 40 to 59 years and suffers very serious social and economic implications. In India, over 62 million people have been affected by diabetes mostly due to genetic factors, lifestyle standards, and increased obesity levels (Misra 2018).
The health effects of diabetes are both short and long term, which worsen as a result of poor glycemic control. Diabetes can be managed appropriately through the prescribed therapies, change of lifestyles, and diet can halt the progression of diabetes-associated symptoms, (“global prevalence of diabetes”).
The short term health effects of diabetes globally include hypoglycemia which is due to reduced blood sugar levels. This happens when the blood glucose is poorly managed by the use of high amounts of insulin, failure to consistently take meals or by behaviors such as consumption of alcohol. The symptoms of hypoglycemia include confusion, headache, loss of consciousness and increased heart rate (Shotliff 2018).
Another short term effect includes ketoacidosis which is caused by high levels of ketones. This comes from low insulin in the body to sufficiently draw glucose from the blood to refuel cells. In return, the body metabolizes fats into ketones. the symptoms of this condition include increased thirst, coma, vomiting and frequent urination. The other short term condition includes the hyperosmolar hyperglycemic state that is caused by illnesses or ineffective medications of diabetes. this condition is characterized by a very high blood glucose level that is over 40mmol/l which causes severe dehydration that needs too much fluid to treat. Its signs and symptoms include disorientation, thirst, frequent urination, nausea and susceptibility to complications.
The long term effects of diabetes include diabetic retinopathy that arises as a result of poorly managed type 2 diabetes. This results in a long period of high blood glucose which leads to damaged small blood vessels in the retina of the eye. This is what causes diabetic retinopathy. This disorder can cause blindness and its treatments are limited to VEGF injections in the eye and photocoagulation therapy. To prevent this condition, diabetes should be properly managed after its onset. Another long term effect includes cardiovascular disease. Cardiovascular disease is one of the biggest risks known globally, which is associated with diabetes (Santulli 2019). This happens due to inflammation, oxidation and various associative factors. inflammation and oxidation are triggered by high blood sugar levels(hyperglycemia) which then results in the onset of endothelial dysfunction. This can even lead to morbidity and mortality thus managing diabetes at its earliest stages is one of the best interventions.
Nephropathy is another long term effect of diabetes. This is a kidney disease brought about by hyperglycemia which makes the kidneys filter too much blood leading to filter damage. The filters may then leak little amounts of protein into the urine and if there is accompanied high blood sugar, large amounts of blood may leak to the bloodstream. The end-stage renal disease may display the symptoms of nephropathy which include insomnia, fatigue, upset stomach, and poor concentration.
Neuropathy is another long term condition that affects the nerve as a result of uncontrolled diabetes. this results from hyperglycemia which damages the small blood vessels that supply the nerves with essential nutrients. Neuropathy exists in motor, autonomic and sensory forms.
In the globe, people suffering from diabetes can take several measures to control the condition. They can reduce their blood sugar and also prevent the long term and short term health effects progression. One of those methods includes exercises that lead to improved cells insulin sensitivity, especially in type 2 diabetes. A healthy diet can lead is one of the well-rounded treatment protocol together with insulin therapy support. A glucose analyzer can be used to monitor therapy’s effect together with regular analytic measurements. Individual needs should be kept into consideration when managing this condition.
Globally, diabetes can be reduced through early detection and the use of preventive measures such as prediabetes disorder stage. POCT devices should always be used to quickly detect diabetes through analysis of levels of blood glucose, lactate levels, and glycated hemoglobin. Glycated hemoglobin is a marker for diabetes and is also used as a prognostic risk marker for cardiovascular heart disease.
There are three types of diabetes as discussed in this paper which include diabetes type 1, diabetes type 2 and gestational diabetes. Diabetes is a global phenomenon as discussed that mostly affects young people across the globe. Anyone can suffer from type 1 and type 2 diabetes while gestational diabetes is mostly found in the expectant women. Not every expectant mother suffers from diabetes and for those who experience the condition, it vanishes after giving birth. They are all associated with diverse signs and symptoms as earlier discussed, which can be controlled through therapy and change of lifestyle.
There are very many plants that can be used in curing diabetes. These include stinging nettle that originates from Europe, Asia, and Northern Africa. Another plant is fenugreek and safflower that originates from India, Asafoetida from Iran and Afghanistan, Brazilian Orchard tree from Argentina, Peru and Brazil, cow plant from central India and Srilanka (Saad, Zaid, Shanak, & Kadan 2017). There is also the bitter gourd whose fruit pulp, seed, leaves and the whole plant are used in managing diabetes and also the mango leaves whose origin is Asia and Africa as well as Bangladesh, India, and Pakistan respectively. Vernonia is another plant used in the curing of diabetes and also Coccinia indica, Syzygium cumin, Momordica charantia, Trigonella foenumgraecum and Azadirachta indica.
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