Nursing Pharmacology: Herbal Remedies and Medications for Diabetes Management

This article discusses the use of herbal remedies and medications for diabetes management in nursing pharmacology. It covers the effectiveness of cinnamon and ginseng, and the use of fenugreek and metformin. The article also provides insights into the risks and benefits of these remedies and medications.

Running head: NURSING PHARMACOLOGY
Response to 3 questions
Name of the Student
Name of the University
Author Note

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Response 1
The student is correct in stating that cinnamon is derived from the inner bark of a tree.
The use of cinnamon as a herbal remedy can be established by research evidences supporting
cinnamon’s role in increasing insulin sensitivity, and cellular absorption of glucose (Allen et al.,
2013). Several studies have been conducted that verify the fact that cinnamon reduces fasting
glucose levels. However, more research is needed to determine its effect on HbA1c levels
(Ranasinghe et al., 2012). The answer is also correct in mentioning about the herbal benefits of
ginseng (Lee & Ji, 2014). It has been proved to reduce depression, anxiety and is widely popular
as an aphrodisiac, owing to its effect on sexual enhancement (Bella & Shamloul, 2014). The
answer also accurately mentions about conduction of HbA1c tests to determine average blood
sugar levels and is correct in correlating cognitive dysfunction with diabetes. Furthermore, the
mention of moderate exercise to improve diabetes and cognitive impairment has been proved by
various studies (Feil, Zhu & Sultzer, 2012).
Response 2
The second response accurately identifies presence of the organic chemical compound
coumarin in cassia cinnamon has been found to cause toxicity to the liver and high prevalence of
reduced renal function (Borges Bubols et al., 2013). Furthermore, effect of ginseng on bleeding
can be attributed to the fact that ginseng contains phytocoumarins that interact with antiplatelet
drugs, thereby inhibiting platelet aggregation and associated fibrinolysis (Jovanovski et al.,
2014). It also correctly mentions that an HbA1c range between 5.7-6.4% indicates higher
likelihood of a person of getting diabetes. However, the normal creatinine levels for a male are
0.6-1.2 mg/dL, unlike the range mentioned in the answer (Udy et al., 2014). However, recording

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INR levels beyond 4.5 would increase higher risk of bleeding and hemorrhage (van Ryn, Baruch
& Clemens, 2012). Moreover, the answer is also correct in discussing about using another
cinnamon extract that does not contain coumarin, to avoid further health complications.
Response 3
Although there are evidences that illustrate the effectiveness of cinnamon in lowering
blood sugar levels, it will not be used as the primary herbal remedy due to the fact that the
American Diabetes Association (ADA) has not recommended it due to inadequate standardized
formulations (Rafehi, Ververis & Karagiannis, 2012). Thus, the treatment will focus on use of
fenugreek. According to these studies, the seeds of the aromatic plant Trigonella foenum
graecum L. are found to have high soluble fiber content that lowers blood glucose levels by
reducing absorption and digestion of carbohydrate rich meals (Neelakantan et al., 2014).
Furthermore, administration of these seeds has demonstrated promising effects on management
of anti-hyperglycemic effects on animal models (Kamble et al., 2013). Dietary supplementation
of fenugreek is also associated with reduced insulin resistance (Gaddam et al., 2015). Thus,
fenugreek seeds will be used as the primary herbal therapy.
In addition to the aforementioned therapy, suggested medication for lowering blood
glucose levels will include administration of metformin. It contains metformin hydrochloride as
the active ingredient and helps in treating diabetes by reducing the amount of sugar that is
produced by the liver (Diabetes Prevention Program Research Group, 2012). Furthermore, it also
decreases the amount of sugar absorbed by intestinal cells, thereby lowering blood glucose levels
(Diabetes Prevention Program Research Group, 2015). Thus, use of metformin in combination

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with the herbal remedy of fenugreek seeds will control high blood sugar and reduce risks of
associated nerve problems, blindness and renal damage.
References
Allen, R. W., Schwartzman, E., Baker, W. L., Coleman, C. I., & Phung, O. J. (2013). Cinnamon
use in type 2 diabetes: an updated systematic review and meta-analysis. The Annals of
Family Medicine, 11(5), 452-459.
Bella, A. J., & Shamloul, R. (2014). Traditional plant aphrodisiacs and male sexual
dysfunction. Phytotherapy research, 28(6), 831-835.
Borges Bubols, G., da Rocha Vianna, D., Medina-Remon, A., von Poser, G., Maria Lamuela-
Raventos, R., Lucia Eifler-Lima, V., & Cristina Garcia, S. (2013). The antioxidant
activity of coumarins and flavonoids. Mini reviews in medicinal chemistry, 13(3), 318-
334.
Diabetes Prevention Program Research Group. (2012). The 10-year cost-effectiveness of lifestyle
intervention or metformin for diabetes prevention: an intent-to-treat analysis of the
DPP/DPPOS. Diabetes care, 35(4), 723-730.
Diabetes Prevention Program Research Group. (2015). Long-term effects of lifestyle intervention
or metformin on diabetes development and microvascular complications over 15-year
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endocrinology, 3(11), 866-875.

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Feil, D. G., Zhu, C. W., & Sultzer, D. L. (2012). The relationship between cognitive impairment
and diabetes self-management in a population-based community sample of older adults
with Type 2 diabetes. Journal of behavioral medicine, 35(2), 190-199.
Gaddam, A., Galla, C., Thummisetti, S., Marikanty, R. K., Palanisamy, U. D., & Rao, P. V.
(2015). Role of Fenugreek in the prevention of type 2 diabetes mellitus in
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Jovanovski, E., Bateman, E. A., Bhardwaj, J., Fairgrieve, C., Mucalo, I., Jenkins, A. L., &
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Kamble, H., Kandhare, A. D., Bodhankar, S., Mohan, V., & Thakurdesai, P. (2013). Effect of
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Lee, K. J., & Ji, G. E. (2014). The effect of fermented red ginseng on depression is mediated by
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Neelakantan, N., Narayanan, M., de Souza, R. J., & van Dam, R. M. (2014). Effect of fenugreek
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trials. Nutrition journal, 13(1), 7.
Rafehi, H., Ververis, K., & Karagiannis, T. C. (2012). Controversies surrounding the clinical
potential of cinnamon for the management of diabetes. Diabetes, Obesity and
Metabolism, 14(6), 493-499.

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Ranasinghe, P., Jayawardana, R., Galappaththy, P., Constantine, G. R., de Vas Gunawardana, N.,
& Katulanda, P. (2012). Efficacy and safety of ‘true’cinnamon (Cinnamomum
zeylanicum) as a pharmaceutical agent in diabetes: a systematic review and meta‐
analysis. Diabetic medicine, 29(12), 1480-1492.
Udy, A. A., Baptista, J. P., Lim, N. L., Joynt, G. M., Jarrett, P., Wockner, L., ... & Lipman, J.
(2014). Augmented renal clearance in the ICU: results of a multicenter observational
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concentrations. Critical care medicine, 42(3), 520-527.
van Ryn, J., Baruch, L., & Clemens, A. (2012). Interpretation of point-of-care INR results in
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