The Potential of a Mixture of Aqueous Extracts of Salam Leaves (Syzygium polyanthum) and Sambiloto Leaves (Andrographis paniculata) as Adjuvant Therapy in the Management of Type 2 Diabetes Mellitus in Indonesia
DOI:
https://doi.org/10.53366/jimki.v11i3.772Keywords:
Andrographis paniculata, Antidiabetic, Syzygium Polyanthum, Type 2 Diabetes Mellitus [MeSH]Abstract
Background: Type 2 diabetes mellitus (T2DM) is a metabolic disorder that continues to increase in prevalence every year, especially in Indonesia. In molecular mechanisms, T2DM is closely related to oxidative stress and inflammation. This literature review is intended to further examine the potential of a mixture of aqueous extracts of S. polyanthum and A. paniculata leaves as an adjuvant therapy for T2DM in Indonesia.
Methods: Literature was searched using Google Scholar, Scopus, ResearchGate, and NCBI search sites. Inclusion and exclusion criteria were used to eliminate unrelated literature, resulting in 23 pieces of literature.
Discussion: Based on phytochemical screening, S. polyanthum leaves and A. paniculata leaves contain compounds with beneficial effects in modulating the metabolic profile of T2DM patients by reducing oxidative stress, inhibiting ?-glycosidase, increasing insulin levels, regenerating pancreatic ?-cells, increasing glycolytic enzyme activity, and reducing pro-inflammatory biomarker levels.
Conclusion: The mixture of aqueous extracts of S. polyanthum and A. paniculata leaves or combined with conventional drugs in the treatment of T2DM showed significant antidiabetic effects.
References
1.Khan MA, Hashim MJ, King JK, Govender RD, Mustafa H, Al Kaabi J. Epidemiology of type 2 diabetes – global burden of disease and forecasted trends. Journal of Epidemiology and Global Health. 2019;10(1):107. doi:10.2991/jegh.k.191028.001.
2.Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. International Journal of Molecular Sciences. 2020;21(17):6275. doi:10.3390/ijms21176275.
3.Toejing P, Khampithum N, Sirilun S, Chaiyasut C, Lailerd N. Influence of lactobacillus paracasei HII01 supplementation on glycemia and inflammatory biomarkers in type 2 diabetes: A randomized clinical trial. Foods. 2021;10(7):1455. doi:10.3390/foods10071455.
4.Khardori R, Nelson A, Gharaibeh S. Management of type 2 diabetes mellitus: A pathophysiologic approach. Clinical Focus Series: Diabetes Mellitus. 2018;37–37. doi:10.5005/jp/books/18021_5
5.Pang G-M, Li F-X, Yan Y, Zhang Y, Kong L-L, Zhu P, et al. Herbal medicine in the treatment of patients with type 2 diabetes mellitus. Chinese Medical Journal. 2019;132(1):78–85. doi:10.1097/cm9.0000000000000006
6.Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiological Reviews. 2018;98(4):2133–223. doi:10.1152/physrev.00063.2017
7.Zakaria NF, Hamid M, Khayat ME. Amino acid-induced impairment of insulin signaling and involvement of G-protein coupling receptor. Nutrients. 2021;13(7):2229. doi:10.3390/nu13072229
8.McKeegan K, Mason SA, Trewin AJ, Keske MA, Wadley GD, Della Gatta PA, et al. Reactive oxygen species in exercise and insulin resistance: Working towards personalized antioxidant treatment. Redox Biology. 2021;44:102005. doi:10.1016/j.redox.2021.102005
9.Hurrle S, Hsu WH. The etiology of oxidative stress in insulin resistance. Biomedical Journal. 2017;40(5):257–62. doi:10.1016/j.bj.2017.06.007
10.Ma J, Nakagawa Y, Kojima I, Shibata H. Prolonged insulin stimulation down-regulates glut4 through oxidative stress-mediated retromer inhibition by a protein kinase CK2-dependent mechanism in 3T3-L1 adipocytes. Journal of Biological Chemistry. 2014;289(1):133–42. doi:10.1074/jbc.m113.533240
11.Dr. dr. Soebagijo Adi Soelistijo, SpPD,K-EMD, FINASIM, FACP. Pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Perkumpulan Endrokinologi Indonesia (PERKENI); 2021.
12.Hussain A, Ali I, Khan AU, Khan TM. Glibenclamide-induced profound hypoglycaemic crisis: A case report. Therapeutic Advances in Endocrinology and Metabolism. 2016;7(2):84–7. doi:10.1177/2042018816632440
13.Hikmah N, Yuliet Y, Khaerati K. Pengaruh Pemberian Ekstrak Daun Salam (Syzygium polyanthum Wight.) Terhadap glibenklamid Dalam Menurunkan Kadar Glukosa Darah Mencit (mus musculus) Yang Diinduksi Aloksan. Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) (e-Journal). 2016;2(1):24–30. doi:10.22487/j24428744.2016.v2.i1.5300
14.Chandran R, Parimelazhagan T, George BP. Antihyperglycemic activity of the bark methanolic extract of syzygium mundagam in diabetic rats. Alexandria Journal of Medicine. 2017;53(4):317–24. doi:10.1016/j.ajme.2016.12.001
15.Chagas VT, França LM, Malik S, Paes AM. Syzygium cumini (L.) Skeels: A prominent source of bioactive molecules against cardiometabolic diseases. Frontiers in Pharmacology. 2015;6. doi:10.3389/fphar.2015.00259
16.Widyawati T, Yusoff N, Asmawi M, Ahmad M. Antihyperglycemic effect of methanol extract of Syzygium polyanthum (Wight.) leaf in streptozotocin-induced diabetic rats. Nutrients. 2015;7(9):7764–80. doi:10.3390/nu7095365
17.Widyawati T, Pase A, Daulay M, Sumantri IB. Syzygium polyanthum (Wight.) Walp ethanol extract decreased malondialdehyde level in type 2 diabetic patients. Pharmacognosy Journal. 2021;13(6s):1557–61. doi:10.5530/pj.2021.13.198
18.Jaiyesimi KF, Agunbiade OS, Ajiboye BO, Afolabi OB. Polyphenolic-rich extracts of andrographis paniculata mitigate hyperglycemia via attenuating ?-cell dysfunction, pro-inflammatory cytokines and oxidative stress in alloxan-induced diabetic wistar albino rat. Journal of Diabetes & Metabolic Disorders. 2020;19(2):1543–56. doi:10.1007/s40200-020-00690-2
19.Li Y, Yan H, Zhang Z, Zhang G, Sun Y, Yu P, et al. Andrographolide derivative al-1 improves insulin resistance through down-regulation of NF-?B Signalling pathway. British Journal of Pharmacology. 2015;172(12):3151–8. doi:10.1111/bph.13118
20.Akhtar M, Bin Mohd Sarib M, Ismail I, Abas F, Ismail A, Lajis N, et al. Anti-diabetic activity and metabolic changes induced by andrographis paniculata plant extract in obese diabetic rats. Molecules. 2016;21(8):1026. doi:10.3390/molecules21081026
21.Widharna R, Ferawati, Tamayanti W, Hendriati L, Hamid I, Widjajakusuma E. Antidiabetic effect of the aqueous extract mixture of andrographis paniculata and syzygium polyanthum leaf. European Journal of Medicinal Plants. 2015;6(2):82–91. doi:10.9734/ejmp/2015/15601
22.Widjajakusuma EC, Jonosewojo A, Hendriati L, Wijaya S, Ferawati, Surjadhana A, et al. Phytochemical screening and preliminary clinical trials of the aqueous extract mixture of andrographis paniculata (Burm. f.) wall. ex nees and syzygium polyanthum (Wight.) Walp leaves in metformin treated patients with type 2 diabetes. Phytomedicine. 2019;55:137–47. doi:10.1016/j.phymed.2018.07.002
23.Jutiviboonsuk A. The Role of Andrographis paniculata (Burm.f.) Wall. ex Nees in Drug Interactions. Siriraj Med J [Internet]. 2015 Aug. 31 [dikutip 19 Juli 2022];67(4). Available from: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/5523
2.Galicia-Garcia U, Benito-Vicente A, Jebari S, Larrea-Sebal A, Siddiqi H, Uribe KB, et al. Pathophysiology of type 2 diabetes mellitus. International Journal of Molecular Sciences. 2020;21(17):6275. doi:10.3390/ijms21176275.
3.Toejing P, Khampithum N, Sirilun S, Chaiyasut C, Lailerd N. Influence of lactobacillus paracasei HII01 supplementation on glycemia and inflammatory biomarkers in type 2 diabetes: A randomized clinical trial. Foods. 2021;10(7):1455. doi:10.3390/foods10071455.
4.Khardori R, Nelson A, Gharaibeh S. Management of type 2 diabetes mellitus: A pathophysiologic approach. Clinical Focus Series: Diabetes Mellitus. 2018;37–37. doi:10.5005/jp/books/18021_5
5.Pang G-M, Li F-X, Yan Y, Zhang Y, Kong L-L, Zhu P, et al. Herbal medicine in the treatment of patients with type 2 diabetes mellitus. Chinese Medical Journal. 2019;132(1):78–85. doi:10.1097/cm9.0000000000000006
6.Petersen MC, Shulman GI. Mechanisms of insulin action and insulin resistance. Physiological Reviews. 2018;98(4):2133–223. doi:10.1152/physrev.00063.2017
7.Zakaria NF, Hamid M, Khayat ME. Amino acid-induced impairment of insulin signaling and involvement of G-protein coupling receptor. Nutrients. 2021;13(7):2229. doi:10.3390/nu13072229
8.McKeegan K, Mason SA, Trewin AJ, Keske MA, Wadley GD, Della Gatta PA, et al. Reactive oxygen species in exercise and insulin resistance: Working towards personalized antioxidant treatment. Redox Biology. 2021;44:102005. doi:10.1016/j.redox.2021.102005
9.Hurrle S, Hsu WH. The etiology of oxidative stress in insulin resistance. Biomedical Journal. 2017;40(5):257–62. doi:10.1016/j.bj.2017.06.007
10.Ma J, Nakagawa Y, Kojima I, Shibata H. Prolonged insulin stimulation down-regulates glut4 through oxidative stress-mediated retromer inhibition by a protein kinase CK2-dependent mechanism in 3T3-L1 adipocytes. Journal of Biological Chemistry. 2014;289(1):133–42. doi:10.1074/jbc.m113.533240
11.Dr. dr. Soebagijo Adi Soelistijo, SpPD,K-EMD, FINASIM, FACP. Pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Perkumpulan Endrokinologi Indonesia (PERKENI); 2021.
12.Hussain A, Ali I, Khan AU, Khan TM. Glibenclamide-induced profound hypoglycaemic crisis: A case report. Therapeutic Advances in Endocrinology and Metabolism. 2016;7(2):84–7. doi:10.1177/2042018816632440
13.Hikmah N, Yuliet Y, Khaerati K. Pengaruh Pemberian Ekstrak Daun Salam (Syzygium polyanthum Wight.) Terhadap glibenklamid Dalam Menurunkan Kadar Glukosa Darah Mencit (mus musculus) Yang Diinduksi Aloksan. Jurnal Farmasi Galenika (Galenika Journal of Pharmacy) (e-Journal). 2016;2(1):24–30. doi:10.22487/j24428744.2016.v2.i1.5300
14.Chandran R, Parimelazhagan T, George BP. Antihyperglycemic activity of the bark methanolic extract of syzygium mundagam in diabetic rats. Alexandria Journal of Medicine. 2017;53(4):317–24. doi:10.1016/j.ajme.2016.12.001
15.Chagas VT, França LM, Malik S, Paes AM. Syzygium cumini (L.) Skeels: A prominent source of bioactive molecules against cardiometabolic diseases. Frontiers in Pharmacology. 2015;6. doi:10.3389/fphar.2015.00259
16.Widyawati T, Yusoff N, Asmawi M, Ahmad M. Antihyperglycemic effect of methanol extract of Syzygium polyanthum (Wight.) leaf in streptozotocin-induced diabetic rats. Nutrients. 2015;7(9):7764–80. doi:10.3390/nu7095365
17.Widyawati T, Pase A, Daulay M, Sumantri IB. Syzygium polyanthum (Wight.) Walp ethanol extract decreased malondialdehyde level in type 2 diabetic patients. Pharmacognosy Journal. 2021;13(6s):1557–61. doi:10.5530/pj.2021.13.198
18.Jaiyesimi KF, Agunbiade OS, Ajiboye BO, Afolabi OB. Polyphenolic-rich extracts of andrographis paniculata mitigate hyperglycemia via attenuating ?-cell dysfunction, pro-inflammatory cytokines and oxidative stress in alloxan-induced diabetic wistar albino rat. Journal of Diabetes & Metabolic Disorders. 2020;19(2):1543–56. doi:10.1007/s40200-020-00690-2
19.Li Y, Yan H, Zhang Z, Zhang G, Sun Y, Yu P, et al. Andrographolide derivative al-1 improves insulin resistance through down-regulation of NF-?B Signalling pathway. British Journal of Pharmacology. 2015;172(12):3151–8. doi:10.1111/bph.13118
20.Akhtar M, Bin Mohd Sarib M, Ismail I, Abas F, Ismail A, Lajis N, et al. Anti-diabetic activity and metabolic changes induced by andrographis paniculata plant extract in obese diabetic rats. Molecules. 2016;21(8):1026. doi:10.3390/molecules21081026
21.Widharna R, Ferawati, Tamayanti W, Hendriati L, Hamid I, Widjajakusuma E. Antidiabetic effect of the aqueous extract mixture of andrographis paniculata and syzygium polyanthum leaf. European Journal of Medicinal Plants. 2015;6(2):82–91. doi:10.9734/ejmp/2015/15601
22.Widjajakusuma EC, Jonosewojo A, Hendriati L, Wijaya S, Ferawati, Surjadhana A, et al. Phytochemical screening and preliminary clinical trials of the aqueous extract mixture of andrographis paniculata (Burm. f.) wall. ex nees and syzygium polyanthum (Wight.) Walp leaves in metformin treated patients with type 2 diabetes. Phytomedicine. 2019;55:137–47. doi:10.1016/j.phymed.2018.07.002
23.Jutiviboonsuk A. The Role of Andrographis paniculata (Burm.f.) Wall. ex Nees in Drug Interactions. Siriraj Med J [Internet]. 2015 Aug. 31 [dikutip 19 Juli 2022];67(4). Available from: https://he02.tci-thaijo.org/index.php/sirirajmedj/article/view/5523
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Copyright (c) 2025 Adinda Nezma Meidina, Nafilah Ramadhanti, Akbar Triandra, Yolanda Delia Putri, Rajwa Fairuz Putri Muftaridi
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The Potential of a Mixture of Aqueous Extracts of Salam Leaves (Syzygium polyanthum) and Sambiloto Leaves (Andrographis paniculata) as Adjuvant Therapy in the Management of Type 2 Diabetes Mellitus in Indonesia. (2025). JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia, 11(3), 1-10. https://doi.org/10.53366/jimki.v11i3.772