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Abstract
Diabetes mellitus (DM) was an annual disease characterized by parennials of blood glucose levels exceeding
normal and impaired metabolism of carbohydrates, fat and protein caused by defficiency of insulin hormone
relative as well as absolute. Management of patients with DM can be done by some effort, among others
was consume an antidiabetic drug or antidiabetics herbal medicine. Antidiabetic herbal medicine were
consisting of bitter, brotowali, salam leaf, and AAI (analegtic, antiinflamation, and immunomodulator).
The resesarch aimed to know the influence of antidiabetic herbal medicine to decrese blood glucose levels
in patient with DM at The Hortus Medicus Scientification of Jamu Clinic, Tawangmangu, Karanganyar.
The method was quasi experimental with one group pre-post test. The samples were 37 people of the
patients with DM diagnose with purposive sampling technique methode. The research report that among
37 respondents, 32 (86.5%) of respondent got a decreased blood glucose levels. The mean value of blood
glucose level before consuming antidiabetic herbal medicine was 290.30 mg/dl and the mean value after
consuming the herbal medicine was 241.78 mg/dl with difference of the mean value before and after
consuming the herbal medicine was 48.52 mg/dl. There were influence of antidiabetic herbal medicine
to decrease blood glucose levels of diabetes mellitus patients at the clinic with p-value=0.00 (p<0.05).
Key words: Blood glucose, brotowali, diabetes mellitus, herbal medicine, salam leaf, sambiloto
Kata kunci: Brotowali, daun salam, diabetes mellitus, jamu, kadar glukosa, sambiloto
Correspondence: Nutrisia A. Sayuti, S.Farm., M.Sc., Apt., Department of Jamu, Health Polytechnic of Surakarta,
Klaten, Indonesia, email: nutrisayuti@gmail.com
Received: 17th September 2015, Accepted: 10th January 2016, Published: 1st March 2016
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Indonesian Journal of Clinical Pharmacy Volume 5, Issue 1, March 2016
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design with one group pre-post test design research and meet the inclusion criteria as
that tests conducted on a group without a many as 37 people.
control group, however it made by the first The data in this research is secondary data.
measurements (pretest) was the measurement The data obtained from the medical records
of blood glucose levels before taking of the patient in the form of the status of the
antidiabetic herbal medicine that allows name, address and age of the patient as well
the test for changes occurred after the as data from clinical laboratories in the form
consumption of antidiabetic herbal medicine of blood glucose levels of patients at the time
form blood glucose levels that were lower or before and after taking antidiabetic herbal
higher than before. The study was conducted medicine. The data collection tool was the
in The Hortus Medicus Scientification of data recapitulation sheet.
Jamu Clinic Tawangmangu Karanganyar on Early research conducted by the orientation
February to April, 2014. of the existing problems then conducted a
Population of this research was all patients preliminary study of literature and to develop
who seek treatment at the Hortus Medicus a research proposal. Proposals repairment
Scientification of Jamu Clinic Tawangmangu was necessary for the perfection of the study
who have been diagnosed with diabetes and and received approval for a seminar. The
checking blood glucose levels in clinical study was conducted after obtaining research
laboratories. The average number of patients permission. Permission was got from the
with diabetes who checked blood glucose Hortus Medicus Scientification of Jamu
levels were 64 patients of month based on the Clinic in this case is submitted to the Director
recapitulation: a) 74 patients on December of Medicinal Plant and Traditional Medicine
2013, b) 61 patients on January 2014 and c) Research and Development Center (Balai
57 patients in February 2014. Besar Penelitian dan Pengembangan Tanaman
Sample of the research were patients Obat dan Obat Tradisional/B2P2TOOT),
with diabetes who meet the following Tawangmangu, Karanganyar. The first study
inclusion criteria: a) It have been diagnosed was to determine the description of research
with diabetes mellitus, b) It has conducted location and observation of antidiabetic
measurements of blood glucose levels before herbal formulas are given. Second study was
taking antidiabetic herbal medicine, c) they the medical records observation of patients
have been taking antidiabetic herbal medicine with a diagnosis of DM in accordance with
for a month , and d) they have done blood the predetermined inclusion criteria. Data
glucose level checks every month. The was collected to study the characteristics of
sampling technique was purposive sampling respondents by age, sex, and blood sugar
that be done in order to get the number of levels of patients before and after taking
samples in accordance with the purpose of antidiabetic herbal medicine.
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Once the data was obtained and then the test analysis using Paired Sample T-test
processing and analysis can be done for the showed p-value=0.00 (p <0.05) so that it
data in a way to reexamine the validity of data. can be concluded that there was antidiabetic
The data encodes for each data classification effect ot the herbal on reducing blood glucose
and enter into a computer database for simple levels in diabetic patients of the clinic.
frequency distributions. At last, data was
grouped such that the data was aggregated and Discussions
compiled to be presented and analyzed in the
form of the master table. Analysis of the data The Hortus Medicus Scientification of
was the bivariate analysis, a paired sample Jamu Clinic is type A clinic under the agency
T-test with a level of confidence of 95%. of Medicinal Plant and Traditional Medicine
Research and Development Center (Balai
Results Besar Penelitian dan Pengembangan Tanaman
Obat dan Obat Tradisional/BBPPTOOT),
Characteristics of respondents by age can be Tawangmangu, Karanganyar. The clinic is
seen in Table 1. Characteristics of respondents an implementation of the regulation of the
by sex can be seen in Table 2. Risk factors for Minister of Health No. 003/Menkes/Per/2010
diabetes is not based on those genders, but on saintifikasi Jamu in research-based health
based on genetic opportunities derived by care through research and development
parents or relatives. from upstream to downstream of the safe,
The effect of antidiabetic herbal medicine quality and efficacious herbs. Research
to decrease blood glucose in diabetic patients and development of herbal medicine from
at The Hortus Medicus Scientification of upstream to downstream was started from
Jamu Clinic, Tawangmangu analyzed by exploration, aquaculture, post-harvest, pre-
bivariate test and presented in Table 3. clinical research, clinical research to the
The effect of antidiabetic herbal medicine formulation and preparation technology.
to decrease blood glucose levels can be seen Since April 20, 2012, the clinic into the new
from the difference between the mean value building as a preclinical trials and equipped
of blood glucose levels before and after by the inpatient facility. The developments
consuming antidiabetic herbal medicine was have been done since 2009. It showed an
equal to 48.52 mg/dl. The results of bivarate interest and appreciation of the greater
Table 3 The Effect of Antidiabetic Herbal Medicine to Decrease Blood Glucose of Respondents
Mean Value p
The blood glucose levels of respondents before taking antidiabetic herbal medicine 290.30 mg/dL
The blood glucose levels of respondents after taking antidiabetic herbal medicine 241.78 mg/dL 0.00
The difference of mean values 48.52 mg/dL
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community for service program that outcome insulin release. Ca2 cytosolic increasing
by Scientification of herbal medicine. The because of Ca2 extracellular uptake simulation
number of patients was increasing year by and efflux inhibition of Ca2 cytosolic.6
year. Initially in 2007, the number of patients Bay leaf water extract that insoluble ethanol
less than 10 persons a day and in 2014 at a dose of 700 mg/kg of bodyweight to
reached more than 150 patients a day. male white mice strains showed the effect
Clinicals activity includes research- of lowering blood glucose concentration
based clinical services to patients consisting to normal mice and lowers blood glucose
of two patients, ie patients as research concentration alloxan-induced diabetic mice
subjects and patients generally. General and accelerate glucose tolerance in diabetic
patient care was given after the patient get mice induced by alloxan.6
an explanation from the clerk and signed In antidiabetic herb medicine, turmeric is
informed consent and request consent. All of used as an anti-inflammatory. Essensial oil
herbal formulas that been used were listed in turmeric consisting of cynnamyl tiglate,
on the Saintifikasi Jamu Vademecum or eucalypton, metylol pinene and bicylo. The
upon the recommendation of the National compounds can inhibit the release of 1L1-
Commission of Saintifikasi Jamu. Diagnosis and TNF- in joint inflammation.7 Curcuma
was established based on the conventional rhizome can be used as an analgesic.
diagnosis equipped with laboratory analysis. Curcuma can reduce the occurrence of peptic
Antidiabetic herbs that be used in The ulcer at gastric mice that have induced by
Hortus Medicus Scientification of Jamu Indomethacin. The content of the active
Clinic consists of a crude drug preparation ingredient in turmeric which gives as an
or capsule containing bitter, brotowali, analgesic effects of curcumin and essential oil
salam/Indonesian bay leaf and herbs is mainly flavonoids that work by inhibiting the
formula for analgesic, anti-inflammatory, cyclooxygenase enzyme so that the conversion
immunomodulatory (AAI) which comprises of arachidonic acid to prostaglandins
of turmeric, curcuma, and meniran. did not happen and did not cause pain.8
Sambiloto or bitter have andrographolid Pre-clinical study to test the activity of
as antidiabetic compounds. The research meniran are conducted on rats and mice to
with male and female rats that given oral determine the safety and immunomodulatory
suspension with bitter leaf powder of 2 g/kg characteristics. The results showed that the
of bodyweight, bitter leaf ethanol extract of meniran extract can modulate the immune
2.4 g/kg of bodyweight, and andrographolide system through the proliferation and activation
of 3 g/kg of bodyweight did not give a toxic of T and B lymphocytes, the secretion of
effect 6. Bitter was combined with brotowali some cytokines such as interferon-gamma
and bay leaves for interact synergistically to specific, tumor necrosis factor alpha and some
hypoglycemic effect. interleukins, activation of the complement
Infusion with levels of 10% w/v brotowalis system, activation of phagocytic cells such
rod that given to rabbit due parenteral as macrophages and monocytes. Cytotoxic
administration can decrease blood glucose cells such as natural destruction of cells
levels compared with glibenclamide. The natural killer cells increased. The results
insulinotropic mechanism of brotowali studied of clinical trials to see immunomodulating
in vitro using insulin secreting clonal -cell effects in patients with certain conditions it
line, HIT T15. The Water extract sensitated is concluded that the extract meniran can be
cells on Ca2 intracellular and increased used as adjuvant therapy (support) for several
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