“The Effectiveness of Acapulco (Senna Alata) Plant extract as Antihyperglycemic

Agent”

Chapter 1

THE PROBLEM AND IT’S BACKGROUND

Background of the study

Diabetes is a lifelong disease that can affect both children and adults. Type one

diabetes, also known as insulin dependent diabetes mellitus, usually occurs in people less

than thirty years of age, but it also may appear at any age. On the other side type 2 diabetes,

the common type of diabetes, occurs most often in middle-aged and older people. Diabetes

is a very serious disease with many life threatening consequences, but if it is taken care of

properly, diabetics can live a normal life.

Diabetes is a disease that occurs when the blood glucose or blood sugar level is too

high (hyperglycemia). Blood glucose is the main source of energy that comes from the

food we eat. Insulin, a hormone made by the pancreas, helps glucose from food get into

the cells to be used for energy. Sometimes the body does not make enough insulin or does

not use insulin well. Glucose then stays in the blood and does not reach the cells. Over

time, having too much glucose in the blood can cause health problems.

Metformin is a biguanide antihyperglycemic agent that is used for treating non-

insulin-dependent diabetes mellitus (NIDDM). It improves glycemic control by decreasing

hepatic glucose production, decreasing glucose absorption and increasing insulin-mediated

glucose uptake.
 The use of metformin is associated with modest weight loss. When used alone,

metformin does not cause hypoglycemia; however, it may potentiate the hypoglycemic

effects of sulfonylureas and insulin. Its main side effects are dyspepsia, nausea and

diarrhea. Metformin should be avoided in those with severely compromised renal function,

acute/decompensated heart failure, and severe liver disease.

Considering the adverse effects of the existing antihyperglycemic agent, nature

provides an abundant source of medicinal plants which are known to be used in the

treatment of a wide range of diseases, alternative herbal medicine from natural origin can

help to get the new molecular lead as a hope towards the better efficacious and safe

antihyperglycemic agent. Many plants have been investigated as to their medicinal

properties. One such extensively studied plant is Senna alata, more commonly known as

akapulko, wherein it can be found as ornamental plants in almost everywhere; its leaves

are known for their medicinal purposes (laxative, intestinal parasites expellers, and

fungicide property).

Hence, the researchers endeavored or prompted in to know the antihyperglycemic

effect of (Senna alata) akapulko as an antihyperglycemic agent. And so, the researchers

thought of utilizing akapulko as the primary raw ingredient for an alternative agent.

Moreover, attempted to prove that (Senna alata) akapulko may be acting on the extrinsic

cascade that could lead into the development of antihyperglycemic with optimized efficacy

and reduced side effects.

Statement of the Problem

The study aims to determine the effectiveness of akapulko (Senna alata) as

antihyperglycemic agent.

Specifically, it seeks to answer the following problems:

1. How effective is (Senna alata) akapulko plant as an antihyperglycemic agent?

2. Is there a significant difference between the effectiveness of the plant extract and

the commercial antihyperglycemic in terms of:

a. Effectiveness,

b. Cost effectiveness?

Significance of the Study

Considering the adverse effects of the existing antihyperglyvcemic agents and the

growing rate of people suffering from Diabetes. The study endeavored to know the

antihyperglycemic effect of (Senna alata) akapulko as an antihyperglycemic agent. The

essential results and findings of this study could benefit the following:

The people and society. This study would benefit the community since akapulko

is abundant throughout the country which can help people to have much more affordable

and organic antihyperglycemic agents – akapulko (Senna alata) extract.

Medical Implications. With further research and improvements, the akapulko

extract as antihyperglycemic aside from antihyperglycemic functions could be a treatment

for high blood pressure, heart attacks, stroke, atherosclerosis and other diseases caused by

high sugar level.

 Environment. The leaves and flower remains after extraction could be used as

organic fertilizer which could address problems related with poor crop production and soil

toxicity caused by the use of inorganic fertilizer. Thus, it will help preserve our

environment.

Future researchers. The ideas presented may be used as reference data in

conducting new researches or in testing the validity of other related findings. This study

would also served as their cross-reference that will give them a background or an overview

of the effectiveness of akapulko (Senna alata) as antihyperglycemic agent.

Scope and Delimitation of the study

This study aims to determine if the the effectiveness of akapulko (Senna alata) as

antihyperglycemic agent.

The akapulko leaves and flowers extract will be from the grasslands in Concepcion.

This study will be limited to determining the effect of the candle bush as an

antihyperglycemic agent: comparison of its effectiveness.

Specifically, the study will be describing the effectiveness of Senna alata as

antihyperglycemic agent. And lastly the extrinsic cascade that could be a hope towards

development of antihyperglycemic with optimized efficacy and reduced side effects.

 Chapter 2

REVIEW OF RELATED LITERATURE AND STUDIES

This chapter presents a review of Related Literature and research studies which that

give insights and directions to the present study.

Related Literature

Diabetes and Hyperglycemia

Diabetes is a chronic, incurable disease that occurs when the body doesn’t produce

any or enough insulin, leading to hyperglycemia (an excess of sugar in the blood). Insulin

is a hormone, produced by the pancreas, which helps the cells of the body use the glucose

(sugar) in food. Cells need this energy in order to function properly.

There are three common forms of diabetes: type 1 diabetes (body cells fail to

produce insulin due to a compromised immune system), type 2 diabetes (the commonest

type of diabetes when there is low production of insulin by the body cells or the body), and

gestational diabetes (happens when there is a development of high blood sugar level in

pregnant women not previously diagnosed of diabetes).

Eventually, the high blood sugar caused by excessive amounts of glucose in the

blood leads to a variety of complications, particularly for the eyes, kidneys, nerves, heart

and blood vessels. (Quebec Health Professionals, 2014)

The normal blood sugar levels for humans are less than 100 mg/dL after not eating (fasting)

for at least eight hours. And they're less than 140 mg/dL two hours after eating. For animals

during the day, levels tend to be at their lowest just before meals. For most
 animals without diabetes, blood sugar levels before meals hover around 70 to 80

mg/dL. For some, 60 is normal; for others, 90 is the norm.

Metformins

Metformin (a biguanide derivative), by controlling blood glucose level decreases

hyperglycemia, it is also the first line therapy for type 2 diabetes. Metformin works by

helping to restore the body's response to insulin. It decreases the amount of blood sugar

that the liver produces and that the intestines or stomach absorb. Metformin, other than

hypoglycemic activity, has been taken with diet and exercise changes to prevent diabetes

in people who are at high risk for becoming diabetic. It is also used in women with

polycystic ovarian syndrome. (Scheen AJ and Paquot N. 2013)

Metformin was first synthesized and found to decrease the blood glucose level in

the 1920s; however, it was not used for a long time. The use of metformin was rekindled

in 1957, when the results of a clinical trial were published confirming its effect on diabetes.

Metformin is now widely prescribed as an anti-diabetic drug; however, there have been

serious concerns about its adverse effects, especially ketoacidosis. Recently, not only some

implications have been discovered for metformin, Its main side effects are dyspepsia,

nausea and diarrhea. Metformin should be avoided in those with severely compromised

renal function, acute/decompensated heart failure, and severe liver disease. (Scarpello JH,

Howlett HC, 2008)

Senna alata

Akapulko (Senna alata) is widespread in the Philippines in disturbed areas in low

and middle altitudes. It is also cultivated for its ornamental and medicinal properties.

‘Akapulko’ is pantropic in distribution, originally introduced from tropical America.

Akapulko also known as empress candles sticks, ringworm bush or akapulko, is

one of the medicinally important plants in the Philippines. It has been used to cure

poisonous bites and venereal eruptions. The leaves are antiherpetic, purgative, and cure for

ringworm and other skin diseases. A decoction of the leaves and flowers is used as

expectorant for bronchitis, asthma, and also as a mouthwash in stomatitis (inflammation of

the mouth). The seeds are also used as vermifuge. The bioactive substances in ‘akapulko’

include chrysophamic acid and tannin found in the leaves and oxymethyl anthraquinone in

fruits. (stuartxchange.org)

Shrub, up to 3 m or more tall. The leaves are pinnate, up to 60 cm long. The leaflets

are 16 to 28, oblong, 5 to 15 cm long, rounded having a short point at the apex. The terminal

and axillary inflorescences are up to 50 cm long. The flowers are yellow, about 4 cm in

diameter, and are at the axils of yellow, oblong concave bracts which are 2.5 to 3 cm long.

The pod is rather straight, dark brown or black when ripe, about 15 x 15 cm wide. The pods

are winged on both sides, running their entire length, each containing 50 to 60 seeds.

(National Museum Collection of the Philippines, 2014)

Related Studies

According to Godofredo (2017), Senna alata seed are used to treat intestinal

parasitisim, tincture from it leaves are reported to be purgative which are used for
ringworm, scabies, eczema, tinea infections, itches, insect bites and herpes. The pod and

the wole plant are said to be anthelmintic and anti-pyretic.

In the study of Christine L. et al. (2011) the findings showed C. fistula and S. alata

are significant and are found to effectively reduce the body weight and weight of

parametrial fat in mice due to their tannin contents. Both plants present as potential sources

of anti-obesity, hypoglycemic and hypolipidemic compounds.

Phytochemical studies of S. alata have claimed that it contains variety of secondary

compunds including anthraquinones, flavonoids, sterols, tannins, triterpenoids, saponins,

fatty acids and the potential inhibition of α-glucosidase activities. Thus British researchers

believes that Senna alata may have the potential efficacy in treating diabetes.

Data accrued from the study of John E. and Mustafa R. (2013) clearly indicate that

the methanolic extract of the leaves at 500 mgkg−1 dose exhibited significant carbohydrate

inhibition and antilipidemic activity than at low dose (250 mgkg−1) in the STZ-

nictotinamide-induced DM rats. These extracts also showed improvement in parameters

glycosylated hemoglobin and insulin profile as well as regeneration of betacells of pancreas

and so might be of value in DM treatment.

The oral effectiveness of the bark and leaf extract on streptozotocin-induced

hyperglycemia in rats has been studied and the results were compared with glybenclamide.

While the extract has no effect on glucose levels in normoglycemic animals, it reduced the

blood sugar value in streptozotocin-induced hyperglycemic animals. (Palichamy, 2012)

 According to Okrenta (2013) one of the possible antidiabetic mechanisms of action

of S. alata is by inhibiting carbohydrate digestion. This is the first report on α-glucosidase

activity of an antioxidant kaempferol 3-O-gentiobioside.

Justification of the study

The researchers utilized candle bush (Senna alata Linn.) as antihyperglycemic

agent. Senna alata is similar to the current researches contains wherein it anthraquinones,

flavonoids, sterols, tannins, triterpenoids, saponins, fatty acids and potential inhibition of

α-glucosidase activity of the plant. The research determines the bioactive constituents of

some medicinal plants or ornamental plants and their effectiveness in the area of

pharmaceutical and medicinal fields.

The idea of utilizing akapulko (Senna alata Linn.) is not a duplication of the

previous studies that were conducted related to it. The researcher found it to be a good

scheme to utilize the leaves and flower extracts of the plant as it would attempt to provide

an antihyperglycemic agent to prove the (Senna alata) akapulko as antihyperglycemic with

optimized efficacy and reduced side effects.