What is Diabetes? Diabetes mellitus can be defined as a group of metabolic diseases characterized by chronic hyperglycemia resulting from defects in insulin secretion, insulin action or both, resulting in impaired function of carbohydrate, lipid and protein metabolism. As a result of this, the glucose in the blood cannot be absorbed into the cells of the body.
Two types of diabetes have been recognized:
Type 1
This type of diabetes develops when the body’s immune system destroys pancreatic beta-cells, the cells responsible for making the hormone insulin that regulates blood glucose. The result is a pancreas that produces little or no insulin. The mechanism of attack on the beta-cells is unknown but genetic, autoimmune, environmental and viral factors have been implicated.
The classical symptoms include thirst, polyuria, wasting / or keto-acidosis. This form of diabetes has been reported among children and young adults. They need several injections of insulin a day or an insulin pump to survive. This condition has been reported in 5-10% of all diagnosed diabetic cases.
Type 2
Type 2 diabetes can further be divided into non-obese, obese and maturity-onset diabetes of the young. This accounts for 90-95% of all diabetic cases. This is the most common form of diabetes.
Patients with Type 2 have two defects:
a. Abnormal insulin secretion [leading to insufficient insulin] b. Resistance to insulin action in target tissues [inability to utilize the insulin that is produced] In insulin deficient diabetes, the secretion of the hormone is either totally defective or severely impaired. The failure of the pancreatic beta-cells to secrete insulin probably involves genetic, viral and auto-immune processes among others. Viral infections are capable of damaging the pancreas. To become diabetic, an individual must not only be affected by viruses but must also develop antibodies to islets cells.
Type-2 diabetes is associated with obesity, older age (> 40 years), family history, physical inactivity, impaired glucose tolerance, prior history of gestational diabetes and certain races. It may present with classical symptoms but often is asymptomatic. Despite the presence of hyperglycemia, the concentration of ketone bodies in the blood and urine are low. Today this condition is increasingly being reported among children and adolescents.
Gestational diabetes
This condition has been reported among pregnant women and treated with insulin. It can have deleterious consequences for both the mother and the fetus. This condition is temporary and disappears after birth. However, women with this form of diabetes have a higher incidence of developing Type 2 diabetes later.
Insulin resistance
Every cell in our body requires energy in order to function. The body’s primary energy is derived when our body breaks down carbohydrates into glucose in the blood stream. The more carbohydrates are consumed, the higher the blood glucose levels. The glucose from the digested food circulates in the blood as a ready source of energy. The beta-cells of the pancreas produce a hormone called insulin whose function is to push the blood glucose into the various cells of the body.
On each cell surface are insulin receptors whose function is to regulate the inflow of glucose to provide the cells with energy. The insulin binds to the receptor site on the outside of cells and acts as a key to open into the cell through which glucose can enter. In a healthy individual, the pancreatic beta-cells produce exact amount of insulin needed to match the amount of food ingested. The controlled system of the body maintains and regulates the blood glucose. Blood glucose has to remain within normal limits i.e. between 70 to 120 mg / dl (milligrams per deciliter) after a heavy meal. In diabetes mellitus, this metabolic process is altered.
Due to factors identified (that includes life-style changes and high carbohydrate diet) and with so much insulin, these receptors begin to malfunction. Blood glucose builds up in the blood stream and the cells starve. With defects on the receptors, the body needs to produce more insulin to push the glucose into the cells. This process continues and eventually type 2 diabetes sets in. Once the blood glucose reaches a certain level, unused glucose naturally spills into the urine as the body’s natural response is to get rid of excess glucose. This results in frequent urination (polyuria) and unquenchable thirst (polydipsia) because of the continued removal of fluids to transport the extra glucose into the urinary bladder. The body then is forced to turn to other sources of energy in the body (polyphagia). It breaks down the stored fats for its glucose. A by-product of this is the ketone- bodies which builds up in the blood and may result in dangerous events. Keto-acidosis has been reported in 10% of diabetic deaths.
Long term complications of this disease affecting the vasculature, eyes, kidneys, nervous system and the probable development of drug dependency in a large number of patients are the two major sets of problems that are confronted all around the world.
The classical triad of diabetes is:
Polydipsia - The increased level of glucose in the blood leads to hyper-osmolarity and depletion of intra-cellular water. This triggers thirst centers in the brain leading to thirst.
Polyphagia - Insulin deficiency leads to catabolism of proteins and fat leading to a negative energy balance and increased appetite.
Polyuria - Increased blood glucose spills over into the kidney as well as promoting an osmotic diuresis leading to increased urination.
Consequences of high insulin elevation and insulin resistance
Weight gain Fat accumulation and storage leading to obesity Heart diseases Hardening of the arteries Increased blood cholesterol and triglyceride levels Kidney diseases Mineral and vitamin deficiencies
Warning signs and symptoms
Frequent thirst Frequent urination and urine is foamy Unexplained weight loss Increased hunger Lethargy and tiredness Weakness Frequent or recurring skin infections Extreme fatigue Wounds that don’t heal
COGENT db+
Formulation A medicinal formula in Ayurveda is always considered as being more than merely the sum of its parts. It is the overall balance or action of the formula that is important. This is based on the Ayurvedic philosophy that emphasizes the whole. The extracts of the herbs or parts are combined in such a way that their natural attributes synergistically enhance the action of the whole formula. Thus, an holistic approach to the treatment of a disease syndrome.
One such supplement that was formulated years ago and based on Ayurvedic principles is Cogent db+. The ingredients in the formulation have had conventional therapeutic and recorded use in Ayurvedic medicine for disorders of the kidney, cardiovascular system, liver and metabolism for thousand of years. The formulation has 2 distinctive properties:
1. Anti-diabetic, and 2. Acts as a prophylactic against diabetic complications.
Thus, this herbal supplement
1. Is able to lower high blood glucose levels (anti-hyperglycemic); 2. Does not compromise vital organs such as kidneys and liver; and 3. Can be prescribed for diabetic complications (therapeutic and prophylactic).
Based on evidences from the Ayurvedic literature, the supplement now has undergone extensive scientific and clinical evaluation for over 20 years in various medical institutions in Asia.
9 Herbs:The Synergy of Healing
Azadirachta indica (Margosa or Neem)
Available throughout India in deciduous forests and is also widely cultivated. It is a medium large sized tree 10-15 m in height with a clear bole of grayish to dark tuberculated bark; compound leaves, imparipinnate leaflets, sub-opposite, serrate and very obliques at base; flowers, cream or yellowish-white in auxillary panicles, staminal tubes, conspicuous, cylindrical, widening above, lobed at the apex. Fruits are one seeded drupes with woody endocarp, cotyledons thick, fleshy and oily. It is hardy, quick growing, ever green showy tree.
Clinical uses The herb has anti-septic, anti-inflammatory, anti-bacterial and anti-hyperglycemic (blood glucose lowering) properties. It is used in healing chronic wounds, diabetic foot and gangrene developing conditions. The hepato-renal protective activity and hypo-lipidemic effect has been recently published. It is a blood purifying agent and a prophylactic in micro-angiopathy.
Phyllanthus emblica (Indian gooseberry)
It is found growing throughout India in the deciduous forests and on hill slopes and cultivated in the plains. This is a small to medium sized deciduous tree, 8-18 m in height with thin light grey bark exfoliating in small thin irregular flakes. The leaves are simple, very many sub-sessile, closely set along the branchlets, districhous, light green having the appearance of pinnate leaves. The flowers are greenish yellow in axillary fascicles, unisexual, males numerous on short tender pedicles, females few, sub-sessile, ovary three celled. The fruits are globose, fleshy, plae-yellow with six obscure vertical furrows, enclosing 6 trigonous seeds in 2 seeded, 3 crustaceous cocci. The small leaves are set in pinnate fashion, very closely. Fruits are 1.5-2.5 cm in diameter.
Clinical uses Besides being a rich source of vitamin C, the herb is considered one of the best cardiac, neuro- hormonal and liver-tonic [hepato-protective]. It has been scientifically proven that it modifies hepato-toxic and reno-toxic effects. In Ayurveda, based on its anti-bacterial and anti-inflammatory activity it has been accredited as a prophylactic medicine for preventing ophthalmic problems (that includes retinopathy) and different diabetic conditions. It also has anti-ageing and rejuvenation properties. The herb has gained scientific acceptance that it supports the blood vessels, nerves at the cellular levels for improving the immunologic barrier as well as smooth maintenance of circulation and conduction of impulses.
Curcuma longa (Turmeric)
It is available throughout India and cultivated. It is a perennial herb, 60-90 cm in height with a short stem and tufts of erect leaves. The rhizome is cyclindrical, ovoid, orange-colored and branched. The leaves are very large, petioles as long as the blade, oblong, lanceolate, tapering to the base up to 45 cm long. The flowers are pale yellow in spikes concealed by the sheathing petioles. The flowering bracts are pale green. It is a fleshy rooted herbaceous plant.
Clinical uses It has antiseptic, anti-bacterial activity and anti-inflammatory properties. It is well-known as a powerful blood purifier. Helps in healing chronic wounds quickly particularly corneal wound healing. Recent research shows that it has atherogenesis prevention property [anti-atherosclerotic effect], is a good antioxidant, possesses immuno-modulatory and cytotoxic, activity, inhibits aggregation and alters eicosanoid metabolism in human blood platelets and also has hypolipidemic action. It is vascular supportive and useful in conditions where gangrene development is a possibility as in diabetic foot. Has a protective effect on liver damage. It has been prescribed since time immemorial in Ayurvedic medicine for controlling diabetic complications, Experimental evidence in rats show that it inhibits LDL oxidation and has hypocholesterolemic effect.
Trigonella foenum-graceum (Fenugreek)
It grows wildly in Kashmir, Punjab and upper Gangetic plains. It is also cultivated in many other parts of India as a pot-herb. It is an aromatic, erect, annual plant 30-60 cm in height. The leaves are pinnate, 3-6 folister while the leaflets are toothed. The flowers are white or yellowish white. The fruit pods are 5-7.5 cm long with long persistent beak, 10-20 per pod, greenish-brown along with a deep groove across one corner.
Clinical uses Trigonella has been known in Ayurveda to be the best known anti-hyperglycemic herb and has been in use for more than 2000 years. It has been recently proven that this herb possesses anti- hyperglycemic property. It is also a powerful anti-inflammatory herb with anti-bacterial activity. It is good in toxic conditions and disorders of the liver. It prevents tissue resistance and enhances intra-extra cellular transportation.
Rotula aquatica (Country borage)
It is available throughout India especially in the sandy and rocky beds of streams. It is a small shrub, much branched, 60-180 cm in height having numerous lateral, short and arrested branchlets, which often root. The leaves are simple, nearly rounded at the apex, more or less hairy, sessile and spatulate, crowded at the branches. The flowers are pink, having short pedicellate, single or couple together on short branches which s lateral. The fruits are sub-globose, orange and drupes which is tipped with the remains of the style.
Clinical uses Diabetic nephropathy is one of the commonest complications of tissue damage caused by diabetes. This herb is specially used for treating renal pathology such as diabetic nephropathy. The herb is also a powerful laxative and diuretic.
Syzygium cumini (black plum)
It is available throughout India. It is mostly seen in forests up to 1800 meters, usually on river banks and moist areas and also cultivated as shade trees. It is a medium to large sized tree, 20-30 cm in height, having smooth light grey bark with dark patches, simple leaves, opposite, variable in shape, 3cm broad, 10-15 cm long. The flowers are greenish-white or dull white, while the fruits are oblong or ovoid-oblong, dark purple with pinkish juicy pulp and one seeded. These seeds are round and strong. This is a tall and evergreen tree. The leaves are smooth, shining and long.
Clinical uses It is a powerful anti-inflammatory herb and good in toxic conditions and disorders especially affecting the liver. It has been used as an anti-microbial prophylactic in alleviating infections associated with chronic diabetes. It also exhibits hypolipidemic effect. It diminishes tissue resistance and improves intra-extra-cellular transportation.
Terminalia bellerica (Belleric myrobalan)
This is a genus of 250 species from tropical regions of which 12 are native in India. It is seen throughout India in deciduous forests up to an elevation of 900 meters. These are large trees.. It is a large buttressed, deciduous tree with thick, brownish grey-bark having shallow longitudinal fissures, simple leaves, alternate, long petioles, crowded at the extremities of the branches, broadly elliptic, margins entire, prominent mid-rib on both surfaces. Leaves are alternate or sub-opposite, often with glands on the petiole or on the lower part of the midrib beneath. The flowers are in axillary spikes, longer than petioles. The fruits are ovoid, grey drupes, obscurely s-angled, narrowed into a very short stalk. Plants are propagated by seeds.
Clinical uses This herb provides symptomatic relief of polydipsia and works as a prophylactic in diabetic retinopathy. It also arrests general debility. It possesses rejuvenating property particularly in arresting necrosis.
Terminalia chebula (Chebula myrobalan)
It is available throughout India in deciduous forests on dry slopes up to 900 meters. It is a moderate to a large sized tree, deciduous, rounded crown and spreading branches with ovate leaves. The flowers are elliptic or obovate and yellowish found in terminal spikes or short panicles. The fruits are glabrous, shining, ellipsoidal, the drupes are ovoid or obovoid, yellow to orange- brown in color, faintly angled, up to 4 cm long. The seeds are hard and yellow while the leaves are covered with hairs. The fruit have specific segments.
Clinical uses It is a prophylactic for diabetic neuropathy and retinopathy. It is an effective antidote for internal inflammatory conditions such as pancreatitis. It is considered rejuvenative and also reverses necrosis. Recent evidence shows that it has anti-oxidant, anti-bacterial, hypolipidemic and cardio- tonic activity. It has been demonstrated that it has anti-mutagenic activity in Salmonella typhimurium and reduces cholesterol induced atherosclerosis in rabbits.
Tribulus terrestris (land caltrop)
It is a trailing and spreading herb, densely covered with minute hair, compound leaves, in opposite pairs, 3-6 leaflets up to 8 cm long, usually silky flower, white or yellow, solitary, arising from the axils of leaves. The ovary is bristle, style short and stout. The fruits are globose, spinous or tuberculate and often cling to the bodies of animals. The trailing plant is common in sandy soil. The carpels of the fruits resemble a cloven hoof of the cow. It is an annual or perennial prostrate herb with many slender spreading branches.
Clinical uses It is a powerful diuretic, tonic and aphrodisiac. It reduces inflammations, edema, urinary complaints, impotence and painful micturition. It serves as a prophylactic for diabetic nephropathy and is supplementary in healing diabetes induced impotence.
CLINICAL AND EXPERIMENTAL EVIDENCE HAS SHOWN THAT Cogent db+ USED AS AN ADJUVANT THERAPY:
Is a potent anti-diabetic supplement as revealed by its blood and urinary glucose lowering effect, significant reduction in HBA1c, glycated hemoglobin and proteinuria.
Helps to normalize blood glucose
Enhances beta-cells response to insulin
Sustains energy by promoting effective utilization of glucose
Improves liver functions and restores liver enzymes
Improves kidney functions
Does not cause hepatotoxicity, nephrotoxicity or hematologiic toxicity
Has an ability to reduce cholesterol and triglycerides
Prevents diabetic complications
Reduces the risk of diabetic gangrene
Improves libido and general vitality
Rejuvenates the pancreas
Cogent db+ is
A natural product of herbal origin
Safe, efficacious and with no side effects
MANAGEMENT OF DIABETES USING COGENT db+
Visit your personal Physician to determine whether you are diabetic·
If you are already a confirmed diabetic check your glycosylated or glycated hemoglobin and blood glucose levels (base-line data)
Take 2 tablets of Cogent db+ after breakfast and 2 tablets of Cogent db+ after dinner (for those who are on oral diabetic tablets or even insulin –they need to be taken half an hour before meals)
Exercise and diet are very important – approach your dietician for a diet for you and recommended exercise by your Physician
Check your glycosylated hemoglobin at the end of three months
Your physician will guide you through a good control of your condition.
COGENT db+
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