Effect of Moringa Oleifera on Metformin Plasma Level in Type 2 Diabetes Mellitus Patients
Condition: Type 2 Diabetes Mellitus
MeSH terms: Diabetes Mellitus; Diabetes Mellitus, Type 2
Study type: Interventional

Summary: 
      Type 2 diabetes mellitus (T2DM) patients from our previous survey tend to co-administer
      various herbs with their oral hypoglycemic agents (OHA). Some of these herbs are known to
      possess antidiabetic activities. One of such is Moringa oleifera leaves.

      The present study evaluated the effects of seven days, twice-daily administration of hot
      water infusion of dried Moringa oleifera leaves on the steady state plasma concentrations of
      Metformin, one of the most widely used OHAs using T2DM patients who have been on Metformin
      for a period of not less than three months. The included patients had also been on Moringa
      supplementation but had terminated the use of Moringa at least a month to the start of the
      study.

      Patients who had other comorbidities such as heart diseases, renal or hepatic impairments
      were excluded from the study. The patients were recruited from Endocriniology clinic of the
      Obafemi Awolowo University Teaching Hospitals complex, a tertiary hospital from southwest
      Nigeria.

      Each patient served as his/her control.
    

Detailed description: 
      Background Plant parts of Moringa oleifera Lam. (Moringaceae) is known to lower blood glucose
      level and as a result, type 2 diabetes mellitus patients (T2DM) sometimes use it as herbal
      supplements. This study therefore sought to evaluate the effects of coadministration of
      Moringa oleifera tea on steady state concentration of metformin in ambulatory T2DM patients
      attending a tertiary health facility in Nigeria.

      Method This study used a non-randomized pre-test and post-test design to evaluate the effects
      of coadministration of Moringa tea and metformin on selected parameters in T2DM patients.
      Consented patients, aged 49 -77 years were stabilised on the same brand of metformin for
      seven days. On day 8 after an overnight fast, baseline fasting blood sugar (FBG) and 2-hour
      post prandial blood sugar (2-hPPBG) were determined using a glucometer. Blood samples were
      also collected at the appropriate times for evaluation of serum creatinine, trough and peak
      metformin plasma concentrations.

      Thereafter, patients were given fourteen sachets of pre-packed 400 g dried Moringa oleifera
      leaves for preparation of Moringa tea for seven days (twice daily) while on their normal
      doses of metformin. On day 15 after an overnight fast, a repeat of FBG and 2-hPPBG was done
      using a glucometer. At the appropriate times, blood samples were also collected for
      determination of serum creatinine, trough and peak metformin plasma concentrations.

      Serum was obtained from aliquots of the blood samples to determine serum creatinine for
      calculation of estimated glomerular filtration rate, eGFR. Plasma was obtained from the blood
      samples and were analysed using modified previously-validated HPLC method.

      The values of FBG, 2-hPPBG, trough and peak metformin plasma concentrations obtained were
      compared with the baseline values using Paired sample t-test at P<0.05 considered significant
      in order to evaluate the effect of Moringa tea on the parameters.
    

Intervention name(s): Moringa oleifera tea
Intervention type(s): Dietary Supplement
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Moringa Oleifera tea; Type 2 Diabetes Mellitus; Metformin Steady state concentrations; Herb-drug interaction