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“Acute Antihyperglycemic Effect of Moringa

oleifera Leaves on Postprandial Blood Glucose
Excursions among Normoglycemic Subjects”

Albert M. Hutapea1
Louisa E. Ottemoesoe1
Ezra Tampubolon1
Brightness T. A. Y. Siringoringo1
Dwight M. M. Hutapea2
1Faculty of Life Sciences
Universitas Advent Indonesia, Bandung, Indonesia
2Department of Nursing

STIKes Rajawali, Bandung, Indonesia

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Moringa oleifera
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Moringa oleifera
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Background
• Chronic hyperglycemia can be a serious health problem.
including heart disease (Micha et. al., 2017).
• Moringa oleifera is a plant that has been praised for its health
benefits for thousands of years and it is very rich in healthy
antioxidants and bioactive plant compounds (Mbikay, 2012; Sujatha &
Patel, 2017).
• Leaves of Moringa oleifera is scientifically supported to give
health benefits:
• Very nutritious (Teixeria et. al., 2014; USDA, 2016)
• Rich in antioxidants (Kuswaha et. al., 2012; Sreelatha & Padma, 2009)
• May lower blood glucose levels (Mbikay, 2012; Waterman et. al., 2015)
• May protect against arsenic toxicity (Chattapadhyay et. al., 2012; Sheikh et. al., 2014)
• May reduce inflammation (Libby, 2002; Sulaiman et. al., 2008)
• Can lower cholesterol (Mbikay, 2012; Chumark et. al., 2008)
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Background
• So far, scientists have only investigated a fraction of the many
reputed health benefits of Moringa oleifera that include control
of hyperglycemia.
• Results of several studies have shown that Moringa oleifera
may help lower blood glucose levels. However, most of the
evidence is based on animal studies. The human studies are few
(Irfan et. al., 2017).
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Research Objective

The aim of the study is to investigate the acute effect of Moringa

oleifera leaves on the postprandial blood glucose hyperglycemic
excursions among healthy normoglycemic subjects.
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Method
• Thirty participants (random selection)
• Students of Universitas Advent Indonesia (UNAI)
• Eligibility criteria: normal fasting blood glucose, good health
and physical condition, and normotensive.
• Constrol: Standardized glucose tolerance test: 75 grams of food-
grade D-(+)-monohydrate glucose diluted in 250 ml of warm
water.
• Treatment: 6 grams of pulverized dried leaves of Moringa
oleifera dissolved in 250 ml of hot water.
• Tool: blood glucose test kit (Accu-Chek Performa®) that has an
accuracy of ± 1%.
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Profile of Participants
Blood Pressure Fasting
BMI
(mmHg) Blood
Heart Glucose
Weight Height Age Height
No. Gender Rate (mg/dL)
(kg) (cm) (y) (cm)
Value Category b/min Systo. Diast.

1 Male 50 164 18.59 Normal 20 164 70 113 86 76

Below
2 Female 48 163 18.07 22 163 86 88 59 85
Average
3 Male 66 168 23.38 Normal 22 168 66 138 88 82

30 Female 55 150 24.4 Normal 19 150 76 98 66 99

Mean 56.3 162.8 21.2 20.9 162.8 79.8 115.0 80.8 86.8
Normal
SD 9.2 8.0 2.9 1.8 8.0 12.9 14.4 11.5 8.3
 Method

Exp. I. Control: Glucose

BG0 BG1 BG2 BG3 BG4

Fasting
0 30 60 90 120
Minutes

Glucose
 Method

Exp. II. Treatment

BG0 BG1 BG2 BG3 BG4

Fasting
0 30 60 90 120
Minutes

Glucose MO leaves
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Results

Group Time (min)

(n = 30) 0 30 60 90 120
Control 90.8 ± 1.88 142.5 ± 5.17 144.7± 4.24 125.9 ± 4.05 110.9 ± 3.85
Treatment 93.6 ± 1.92 161.3 ± 7.91 128.2 ± 5.39 101.1 ± 4.18 84.4 ± 3.11
p .319 .047 .005 .000 .000
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Results
Blood Glucose Excursions
180.0 Glucose Control
Treatment
160.0
Blood Glucose (mg/dL)

140.0
120.0
P = 0.047
100.0 P = 0.005
80.0
p = 0.000
60.0
p = 0.000
40.0
20.0
0.0
0 min 30 min 60 min 90 min 120 min
Time
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Discussion
• Pulverized dried leaves of Moringa oleifera attenuated
hyperglycemia in treatment group at 60, 90 and 120 minutes
postprandial.
• The antihyperglycemic effect was not evident at 30 minutes
postprandial where blood glucose of the subjects was
significantly higher than that of control.
• The molecular mechanism of the antihyperglycemic property of
MO leaves have not been elucidated.
• Hypoglycemic effect of MO leaf supplementation was not due
to increased insulin secretion (William et. al.,1993)
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Discussion
• However, a model of the mechanism has been proposed to be to
be insulin sensitizer because it has been indicated that dark
chocolate polyphenols (Grassi et al., 2005) and other
polyphenols (Al-Awwadi et al., 2004; Moharram et al., 2003)
are responsible for antihyperglycemic activity.
• MO leaves are potent source of polyphenols, including
quercetin-3-O-β-D-glucoside, rutin, kaempferol glycosides, and
other polyphenols (Ndong et al., 2007; Amaglo et. al., 2010;
Kasolo et. al., 2010).
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Discussion
• Flavanols, a subclass of flavonoids that is richly represented in
natural cocoa beans, increase NO production by cultured human
vascular endothelial cells (Leikert et. al., 2002) and improve
endothelium-dependent vasorelaxation (NO-dependent) in
finger (Fisher et. al., 2003) and brachial (Engler, et. al., 2004)
arteries of healthy humans.
• Because insulin sensitivity is, at least in part, dependent on NO
availability, ie, on insulin-stimulated NO production (Hsueh &
Quinones, 2003; Konopatskaya et. al., 2003).
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Conclusion
• There is a significant efficacy of the MO leaves in attenuating
the postprandial blood glucose excursions among healthy
normoglycemic subjects.
• The result of this study show that MO leaves have higher
efficacy in attenuating postprandial hyperglycemia than when
taken before or simultaneously with glucose load
(observation).
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Recommendation
Moringa oleifera leaf powder holds some therapeutic potential
for chronic hyperglycemia and hyperlipidemia. However, before
it is advocated in any formulation for the treatment of these
metabolic disorders in humans, state-of-the art clinical studies
must be conducted to establish the consistency of its medicinal
efficacy and the safest modalities of its administration.