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Using ​Moringa oleifera​ (​Malunggay​) as a

Supplement for ​Insulin​ Used by Type 2 Diabetic


Patients
Castro, J., Choachuy, E., Chua, K., Garapan, K., Rubic, M., Plando, T.
Senior High School Unit – High School Department
Sacred Heart School – Ateneo de Cebu
H. Abellana St., Canduman, Mandaue City

Abstract urination, high blood pressure, nausea, blurred vision and


Medication in our economy today is not cheap. Here etc. Insulin is a hormone produced by the body’s pancreas,
in the Philippines, where poverty is on the rise, good medication the use of insulin is to help the body maintain a healthy
is not available to every one because of poor financial resources. level of blood sugar. A way to help understand how insulin
It is already hard enough to get by but because of an unhealthy works is to think of it as a key that unlocks our cells so that
environment and poor working conditions, majority of the the cells can use the glucose as a source of energy. There is
population are now in dire need of expensive medication which a man made version of insulin because there are two types
they could never afford. It is also evident that there is a
of diabetes that can affect the body. Type 1 diabetes is when
continuous rise of diabetic patients around the country that need
a daily dose of Insulin shots to maintain their blood sugar levels the function of the pancreas to make more insulin for the
normal. body because the pancreas is not able to produce anymore.
Type 2 diabetes is more about diet patterns and exercise
The research group has made a research proposal that
levels; this condition happens when the body is consuming
proposes a cheaper and more available supplement to the public.
With the use of the local plant Malunggay (Moringa oleifera), too much sugar for it to be able to control. When the sugar
the researchers have made a model to test the effectiveness of levels rise the amount of insulin the pancreas needs to
Moringa oleifera as a supplement to Insulin, a drug used by produce also increases. However, if there will be too much
patients with Diabetes. The researchers conducted an experiment sugar and not enough insulin is produced it leads to type 2
with the use of Wistar rats to predict the glucose metabolic rate. diabetes. This research will focus more on trying to treat
The Wistar were divided into three groups with the first group of type 2 diabetes because this type is more on health habits
Wistar Rats to be incorporated with only Moringa oleifera, the
and what the individual eats. In 2014, a survey was
second group with only Insulin, and the third group with both
Moring oleifera and Insulin. After all the groups have been conducted by International Diabetes Federation to see how
divided and prepared they will be induced with diabetes using a many people have type 2 diabetes, with an estimate of 3.2
chemical called Alloxan monohydrate. million people having this disease. The cost of the
medication during 2013 was at 205 dollars, which is too
Index Terms​--Supplement, Type II Diabetes, Moringa
Oleifera, Insulin, Effectiveness. much for most people [10]. With this in mind the research
group wanted to find a natural remedy that does not only
help the chances of blood sugar levels decrease but also a
natural remedy that can be used as an alternative to insulin.
If there already is a man made version of insulin, why are
I. INTRODUCTION
we still trying to look for a natural alternative to insulin?
Diabetes is becoming a greater health risk with every day We are looking for an alternative because the long term
that passes by. People today have gained access to fast food effects of insulin can increase the mortality rates of a
chains that sell foods that are very high in sugar, person. A common side effect of insulin is hypoglycemia or
cholesterol, trans fat and etc. Diabetes is a condition that low blood sugar which can cause headache, hunger,
affects an individuals blood sugar levels, mostly with the fainting, seizures and etc. This research would focus on the
level becoming to high for the body to tolerate. This will healing properties of Moringa oleifera (locally known as
eventually lead to complications in the body like constant Malunggay). There have been many claims as to what
Moringa oleifera is capable of doing in the medical field.
Moringa oleifera is said to have antidiabetic activity, after 3
hours of consumption there is a clear significance in the
C. Significance of the Study
decrease of the blood sugar levels. With this information,
The findings of this study will benefit the patients of type 2
the research group will conduct their study with Moringa
diabetes. Considering that this a common disease among the
oleifera.
Filipino people, this will benefit the Philippines by
recommending Moringa Oleifera to the Filipinos as a
A. Aims and Objectives
natural substitute for the relatively expensive insulin. This
(EDIT) This study aims to (1) establish whether Moringa
study serves as a benefit since the researchers chose one of
Oleifera is effective as a treatment of type 2 diabetes, (2) to
the most common diseases that affect the Filipino people
establish whether Moringa Oleifera is a practical alternative
(Diabetes), coupled with one of the most common plants
for insulin and (3) use the findings of the study to
that can be found in tropical countries such as the
recommend Moringa Oleifera over insulin as a treatment for
Philippines. If proven to be an effective supplement for
diabetic patients in not only the Philippines but in
insulin, it can benefit the Philippines by recommending a
developing countries that cannot afford expensive
supplement which is abundant and can result to lowering
medication. In order to achieve these aims, the researchers
the rate of diabetes in the country. Aside from this Moringa
will be conducting lab experiments (specifically the
Oleifera is also a safer supplement as it does not possess the
oral-glucose tolerance test) on streptozotocin-induced rats
negative side-effects of insulin and instead introduces
which will be divided into an independent and experimental
multiple positive side-effects extending further than
group differing in the treatment consumption. Fasting Blood
glycemic properties. When an individual uses insulin
glucose will be measured and will serve as the result
therapy the required dosage is only increased as the time
indicator for the effectiveness of Moringa Oleifera in
goes on, this would also increase the rate of which the
treating type 2 diabetes. From this, the researchers will
patient will have complications due to hypoglycemia [12],
compare the effectiveness of both insulin and Moringa
which would mean that a higher cost is needed to support
Oleifera and check if they differ significantly. From this
the medication of the patient. Additionally, the abundance
comparison, a recommendation will be made on the usage
of Moringa Oleifera and its lower cost provides more
of Moringa Oleifera as a substitute for insulin. (EDIT)
convenience and accessibility to the Filipino people. Aside
from the benefits it has for diabetes patients and the lack of
B. Scope and Limitations negative side-effects, Moringa Oleifera, often called a
In this study, the purpose is to treat diabetes in a natural “superfood” possesses countless positive health benefits.
way and to establish the supplementary effect of Moringa
D. Hypothesis Draft
Oleifera as it is paired with insulin for hypoglycemic
The research conducted will solve the question:
effects.. The locale for this study is the Science laboratory at
the 5th floor of the institution of Sacred Heart School - How well can ​Moringa Oleifera serve as a supplement to
Ateneo de Cebu in Brgy. Canduman, Mandaue City. The insulin in treating type 2 diabetes? The researchers
researchers chose this place because it was an appropriate presumed that Moringa oleifera will have a significant
location for the study since this could provide them impact on the blood levels of the rats, thus, the researchers
applicable tools and equipment and is available at the hypothesized that the independent variable, the amount of
Science laboratory of the said educational institution. The Moringa oleifera and the dependent variable, the fasting
study is also done with the help of advisors from San Carlos blood glucose of the rats will have an inversely proportional
University. Some of the most hindering limitations that relationship. This means that the if higher amounts of
were encountered by the researchers included the lack of Moringa oleifera are fed to the rats, then the lower the
time to pursue ethical approval for animal laboratory use, fasting blood glucose is for the rats. From this, we believe
the lack of experience (in researchers’ part) in dealing with that Moringa oleifera will serve as a practical natural
Wistar rats (including proper blood sampling techniques, supplement for insulin.
proper restrainment methods, etc.), and the lack of time to
conduct the experiment proper as a whole. As a I. REVIEW OF RELATED LITERATURE
compromise, the researchers have decided to forego the
experiment proper, and will instead, use secondary data A. Type 2 Diabetes Mellitus
from similar related secondary sources to be subjected to Diabetes may be known to many as the mere
data analysis in order to formulate predictions and to possession of high blood levels and while this characteristic
establish the conclusions for this study. may only serve as the indicator or a side-effect to the
disease, it can cause multiple complications within the
human body which can ultimately prove to be fatal. As of areas of India, it raises alarm because it was concluded that
today, Type 2 Diabetes Mellitus serves as a serious, yet their knowledge in terms of Diabetes was very poor.
common problem as stated in the research of (L.Olokoba, Another similar study by (Hamoudi, Ayoubi, Sharbatti &
A.Olokoba, Obateru, 2012) wherein an estimate of 366 Shirwaikar, 2012) measured the awareness of 235
million people were diagnosed with type 2 DM which participants from UAE, where the disease is quite prevalent.
caused 4.6 million deaths in the year 2011. In addition to According to the research, the results state that the
this, 80 percent of type 2 DM patients belong to developing knowledge about hypoglycemic symptoms and its
countries and the number of patients will be an estimated regulation is low and are not very aware of the severe
439 million by the year 2030. These numbers are truly a complications that may occur among diabetics, and have
subject for concern and implies that Type 2 DM is a very low awareness of the different aspects of diabetes and
common disease. L Olokoba, A. Olokoba and Obateru also motivation to check for blood levels (indicators for
mentions that while there is still no accepted cure for Type diabetes.), however it was concluded that the knowledge
2 DM, treatments can range from the regulation of weight among the respondents is just sufficient. Additionally, a
(treating obesity), changes in habits/lifestyle or the intake of study conducted by (Mansour, Al-Maliky,
medication such as oral hyoglycemic agents, biguanide Kasem,Jabar,Mosbeh, 2014), showed that out of 5,445
(reduce resistance of insulin), insulin sensitizers, adults in Iraq, 8.7 percent has already been diagnosed with
non-sulfonylurea secretagogues, thiazolidinediones, alpha diabetes while 11 percent had “undiscovered diabetes”
glucosidase inhibitors and insulin. Type 2 Diabetes can be (have diabetes, unaware of it.) Also, they were able to
caused by multiple factors that can either be from birth such conclude that one of five adults in Basrah, Iraq is affected
as our genetics, race and age, or could come from our own by the prevalence of diabetes. Most of these researches are
habits such as our diet, physical activites and other activities mutually conducted in developing countries and this could
as metioned in the review of (Sami, Ansari, Butt, Hamid, be a possible contributing factor to the lack of knowledge
2017). Their research also highlights the connection and awareness. However, one characteristic that makes
between Type 2 DM and complications wherein more than diabetes even more potentially dangerous is the symptoms
50 percent of patients die from cardiovascular diseases such which are relatively less obvious, and there is the possibility
as heart stroke and other primary heart diseases and causes of “undiscovered diabetes”, according to the study of
other complications such as diabetic retinopathy that causes (Ramachandran, 2014), A lot of people overlook the signs
blindness among patients and the increased risks of limb and symptoms of diabetes because of the progression of the
amputation. From this, we can hypothesize that Type 2 DM disease in which the effects of hyperglecemia are not
is truly a pressing problem since, as mentioned above, there immediate, however, the damage starts years before the
is still no “true cure” for Type 2 DM, and the disease is symptoms are noticeable. This makes recognition of
quite common and can be dangerous due to the symptoms and the prevention much more difficult. The
complications it may cause that has proven to be fatal for factors such as the lack of awareness and knowledge about
some. While Type 2 DM can be prevented through various diabetes among some areas of developing countries, paired
means, the process of prevention and treatment can be with the lack of clear, immediate symptom indicators and
tricky, considering that the awareness towards DM is low the possibility of the disease remaining undiscovered makes
for both regular people and the lack of awareness is even the disease all the more dangerous.
present for those who are already diagnosed with Type 2
DM. This is best described by multiple researches, a study B. Moringa oleifera
by (Muninarayana, Balachandra, Hiremath,Iyengar &Anil, Moringa Oleifera (MO) belongs to ​Moringacea ​family,
2010) conducted in India interviewed 311 adults in the age which accounts 14 species. It is a highly valued plant which
group of 30 to 45 years old and measured their awareness is commonly found in many countries mostly in the tropics
levels about diabetes mellitus, from their results a mere 45 and subtropics. [1] It is highly valued herb in most countries
percent were aware of the risks of diabetes and 16 percent due to its impressive medicinal usage which is tested and
of 31 diabetics did not have any knowledge about the risks trusted for a lot of years.
of their own disease. Additionally 75 percent of the In the field of medicine, it is claimed that there are
respondents did not know the long-term effects and therapeutic potentials of ​Moringa oleifera ​in antibiotic,
complications of diabetes while among the diabetics, a mere antiulcer, antitrypanosomal, hypertensive, antispasmodic,
74.2 percent were aware of the complications they can antiulcer, anti-inflammatory, hypocholesterolemic, and
possibly face. The most surprising data presented by their hypoglycemic activities. It contains vitamins and minerals
research was that only 50.8 percent of the respondents knew specifically Vitamins A and C, Calcium, Iron, potassium
about the condition of diabetes, implying another 49.2 and that of proteins. [2] Thus it is really beneficial in
percent, almost half, of respondents not knowing what treating diseases and in healing sicknesses, most especially
diabetes is. While this study was conducted in the rural in lowering blood sugar levels or in chronic hyperglycemia
which is an indicator of diabetes mellitus that is used in this the hypoglycemic properties of Insulin as common
study. Also​, Moringa oleifera does not only help in treating knowledge as it is regularly being used in the field of
diabetes but also help in the diet or have what we call medicine, especially in diabetes treatments.) From this, two
“hypocholesterolemic” activity or agent. It was then found studies were chosen as secondary sources for secondary
that ​Moringa oleifera ​along with high-fat diet has helped in data- “Hypoglycaemic effect of Moringa Oleifera ​and
decreasing the high-fat diet-induced which increases the Azadiractha Indica ​in Type 2 ​Diabetes Mellitus” ​[30] and
serum, liver and kidney cholesterol levels.[3] This means “​Blood Sugar Lowering Effect of Moringa Oleifera Lam in
that this will help in reducing diabetes since high Albino Rats”​ [31]
cholesterol foods will actually increase the blood sugar
levels.
Taking these effects into consideration, Moringa Oleifera is B. Study 1: ”Hypoglycaemic effect of Moringa
considered to be truly beneficial as compared to insulin Oleifera ​and ​Azadiractha Indica i​ n Type 2 D
​ iabetes
since, taking into account the difficulty of detecting Mellitus” ​[30]
immediate symptoms in DM (as mentioned above), insulin
This research, conducted by D. Jalaja Kumari,
can only be taken when a patient recognizes the presence of
was designed in order to establish and investigate the
Diabetes in his/her body. Also, considering that insulin is
hypoglycemic effects of both Moringa Oleifera and
merely a treatment, which is not even a recognized cure, it
Azadirachta Indica ​seeds powder. In order to conduct this,
can only be used as means of improvement of blood levels.
they selected 55 type 2-diabetic patients and divided them
Compared to Moringa Oleifera, which possesses numerous
into an experimental (46 people) group which is subdivided
positive effects, it can act as both a medicine/supplement
into the Moringa Oleifera group, which takes a total of 8
and as a complement to food diets. Considering diets are
grams of Moringa Oleifera leaves powder in 3 doses per day
closely linked to the cause of diabetes (mentioned above),
for a total of 40 days, and the Azadirachta indica group,
Moringa Oleifera can act as both a treatment for Type 2
which takes a total of 6 grams of Azadirachta indica seeds
Diabetes and a means of prevention through its integration
powder in 3 doses per day for a total of 40 days. The control
into our diets. Not only does MO act as a possible “cure/
group (9 people) on the other hand, did not receive any form
treatment”, it can also be considered as prevention since the
of any treatment. In their research, the supposed impact of
intake of MO as food can help the present diabetics and can
the herbal powders on blood glucose and cholesterol levels
help prevent other non-diabetics obtain the disease.
were measured through the BMI (body mass index), the
(mean) blood glucose values (in their case, the fasting and
II. METHODOLOGY postprandial levels were initially measured and estimated
and then analyzed again at the end of each trial of each
As stated earlier in the scope and limitations
respective herbal powder.) and the (mean) blood lipid levels
portion, due to the limitations in animal handling experience
(specifically, serum levels of Cholesterol, Triglyceride,
and time, the researchers will not be relying on any kind of
LDL cholesterol and HDL cholesterol) were measured.
primary data from experimentation, but will instead, use
After the experiment proper, the comparison between the
secondary sources to gather secondary data to formulate
mean blood glucose levels and the mean blood lipid levels
data analysis.
of the experimental groups relative to the levels of the
control group was used in order to formulate the conclusion.
A. Gathering of Secondary Data
As a means for finding secondary sources related C. S ​ tudy 2: “​Blood Sugar Lowering Effect of Moringa
to the research, databases such as EBSCO and Google Oleifera Lam in Albino Rats”​ [31]
Scholar were used to search for the available materials
(journals) that shared similarities to the study. In the This research, conducted by Edoga C. O., Njoku O. O.,
researchers’ case, the overall purpose and abstract of the Amadi E. N. & Okeke J. J., aims to investigate the effects of
research were placed into consideration and was a key Moringa oleifera on the blood sugar levels of Albino rats. In
factor in the selection of sources. In essence, the study order to conduct this, the researchers began by harvesting
revolves around the supplementary effect of Moringa Moringa Oleifera leaves which were then dried and then
Oleifera as a pair for insulin in the treatment of type 2 pounded into powder form. For a day, this was then spread
diabetes, however, due to the unavailability of sources into a 1% solution of sodium metabisulphate. This was then
regarding the pairing of insulin and an herbal medicine in sieved, acetone was added to the extract until precipitation,
supplements, the researchers will instead, use sources that wherein the precipitate was recovered and dried. Standard
establish the hypoglycemic properties of Moringa Oleifera solution was made using the “Tween” 80 solution. After the
and have similar methods of measurement. (and will assume creation of the plant, the researchers gathered commercial
Glucose, tolbutamide. sodium ethlyenediaminetetracetate, study may differ in the usage of diabetic patients instead of
ortho-toluidine, glacial acetic acid, trichioroacetic acid, the usual laboratory rat model, the experiment generally
alloxan monohydrate and thiourea. After the collection of showed that Moringa Oleifera was quite effective in
these materials, the researchers then gathered Albino rats decreasing mean blood glucose values, post prandial blood
(number not specified, probably _>30 obtained from “5 glucose levels, and the mean blood lipid levels relative to
groups of 6 animals each”), kept them in standard condition Azadirachta indica seeds powder and that there is a
for 14 days. After this, hyperglycemia was induced on consistent hypoglycemic effect that can be found in the
Albino rats through the induction (injection) of Alloxan Moringa Oleifera powder. The 2nd study on the other hand,
(120mg/kg body weight). After the induction, blood levels [31] “Blood Sugar Lowering Effect of Moringa Oleifera
were constantly checked and monitored through the Lam in ​Albino R ​ ats “ did not only re-establish the
tail-tipping method and only animals with glucose levels of hypoglycemic effects of Moringa Oleifera, it also compared
100mg/dl (hyperglycemic) were used. First off, Normal rats its effect relative to tolbutamide. Tolbutamide, just like
were split into groups of 5 with 6 rats per group, with the insulin, can be used as a drug for type 2 diabetes patients,
1st group receiving normal saline(2ml/kg body weight) just like insulin, it also has a strong hypoglycemic effect.
(sodium chloride plus water), 2nd group receiving Hypothetically, Moringa Oleifera extracts would have a
tolbutamide (200mg/kg body weight) while groups 3, 4 and weaker effect than a drug like insulin, in the same manner
5 received 100,200 and 300mg/kg(body weight) relative to tolbutamide. This was shown in the results
(respectively) of the Moringa aqueous extracts. This wherein Moringa Oleifera displayed its hypoglycemic
procedure was repeated once again, this time using the activity once again. On page 89, it was shown that in the
diabetic rats (induced with Alloxan) with the same case of diabetec/ Alloxan-induced rats, for 100 mg/kg dose
procedure. Blood samples were then taken at the original of MO aqueous extract taken, blood glucose level decreased
point, an hour, 2hours and 6 hours after each of the from (mg/kg) 105.05±6.90, to 98±5.80 in one hour, 81±5.6
respective group’s intake. Comparing the results between in three hours, 72.25±3.4 in six hours with a maximum
tolbutamide and the MO aqueous extracts were then able to reduction of 31.22%. Increasing doses of MO aqueous
guide the researchers into formulating their conclusion. extract also showed an increase in effectiveness as well, for
300mg/kg does of MO aqueous extract taken, blood glucose
level decreased from 103.70± 0.84, 1h:93.3±1.17, 3h:82±
1.53 and 6h:57.08 ±1.11 with a maximum reduction of
III. DATA ANALYSES
44.96%. A dose of 200mg/kg tolbutamide proved to be
While both experimental studies are mutually related with more effective however, with blood glucose level
their usage of Moringa Oleifera, the 1st study, [30] decreasing from 106.30±3.01, 1h:83±3.01 , 3h:64.69±6.72
”Hypoglycaemic effect of Moringa Oleifera a​ nd and 6h:56.60± 6.90 with a maximum reduction of 46.75%.
Azadiractha Indica ​in Type 2 ​Diabetes Mellitus” ​clearly Both extracts however, were proven effective in their own
shows the hypoglycemic activity of Moringa Oleifera, degree, relative to the control group which were merely
whether if it is in comparison with Azadiractha Indica, or on given 2(Ml/Kg) Normal Saline with blood glucose levels
its own. According to the data of D. Jalaja Kumari, the negligibly hovering around the 117-115 mg/kg levels with a
group of diabetics which administered Moringa Oleifera maximum reduction of 2.26%. This table potentially shows
leaves powder showed a decrease in fasting blood glucose a similar (probable) table if insulin was used instead of
levels significantly at one percent levels, and a decrease in tolbutamide, one probability however, as shown in the table
post prandial blood glucose level at one percent levels. for the effect of the different extracts on non-diabetic rats
From (table 4, pg 213), it can be seen that in the which showed reductions of blood glucose levels lower than
Experimental group for Moringa Oleifera, fasting blood normal glucose levels, thus the possibility of
glucose levels (measured in mg/dl) decreased from initial (hypoglycemia) or low blood levels, thus, this must be kept
level of 162±9.0 (mg/dL) to 117±21.3(mg/dl) with a t-value into consideration for those seeking an insulin treatment
of 5.94**(significant at one percent) and post prandial backed with a hypoglycemic diet.
blood glucose levels decreased from 219±77.4 (mg/dl) to
163±49.4(mg/dl) with t value at 2.9* (significant at five
IV. CONCLUSION
percent). The control group, on the other hand, had a
constant value for fasting blood glucose from 159.5±6.8 to From the earlier re-establishment of the hypoglycemic
159±7.4 and for post prandial blood glucose which even effects of ​Moringa Oleifera, i​ t can be concluded that
moved up from 224 ±3.7 to 251±59.0. Additionally, the Moringa Oleifera best serves as a mere supplement to
mean blood lipid levels showed a similar trend, consistently insulin, considering that its hypoglycemic effect is
decreasing Serum total cholesterol levels, Serum lower/less effective compared to drugs for Type II diabetes
triglycerides, HDL-C levels and VLDL-C levels. While the patients such as insulin or tolbutamide. Additionally,
Moringa Oleifera is also not a drug in itself, it can be easily The researchers would like to show their gratitude
incorporated into diets or into medicinal food supplements towards the following advisors who have helped them
as well. Moringa Oleifera would most likely, in most throughout the research process and for helping them
situations, e​ nhance the hypoglycemic effect of insulin with accomplish this study:
a smaller effect of its own, adding to the overall effect, thus
Mr. Jomar Abellana, their research adviser, for proactively
enhancing the entire hypoglycemic effect of the diet.
helping the research group and constantly teaching new
However, this must always be kept with strict regulation
techniques, (especially in our weak points, statistic
and cannot be used to dramatically, miraculously decrease
tests) to help enhance the effectiveness of tests and
glucose levels, for instance, incorporating MO supplements
experimentation for the research, for helping the
with insulin for patients with a less serious case of Diabetes,
research group pursue and reignite inspiration to carry
or with slightly elevated blood levels could eventually
on and finish the research from the past adviser and for
progress to become hypoglycemia (low blood levels), on the
tirelessly assisting the group throughout the different
other hand, the combination of both should not also be used
phases of the research proper.
to dramatically lower blood glucose instantaneously, but
Mr. Stephen Flores, ​their past research adviser, for initially
must be properly incorporated in a diet, wherein blood
guiding the researchers through the brainstorming
levels can be kept to optimal, with respect to the other
processes, the idea formulation and the initiation of the
components of a person’s holistic diet.
research proposal. He has also tirelessly worked to
improve the research papers and has proactively taught
in research classes to improve the overall effectiveness
RECOMMENDATIONS and quality of the research.
Ms. Joyce Rodriguez, ​their work immersion adviser, who
Through the analysis of the secondary sources, the
has helped the research change certain directions for the
secondary data to the implications and conclusions, the
better, for patiently bearing with the research group’s
researchers have devised a few recommendations for those
limitations of time and for constantly encouraging new,
choosing to pursue a similar path with this research:
more effective and more innovative ways to proceed
with the research proper.
1. That the future researchers should be more
experienced and/ or more willing to learn the
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