NHP

Question 1

Bitter Melon

Answer 1

Contains Polypeptide-P, insulin like protein

Mechanism:
- Increase insulin production
- Preserve beta cell mass in pancreas
- Increases GLUT-4 receptors in muscle cells

AE:
- Gastrointestinal irritation
- Diarrhea
- Hypoglycemia

Question 2

Fenugreek

Answer 2

Cross sensitivity with nuts

Mechanism:
- Increase insulin secretion
- Reduces post prandial and fasting

AE:
- Antiplatelet effects, increases risk of bleeding and bruising

Question 3

Gymnema

Answer 3

Mechanism:
- Increases insulin secretion
- Regeneration of islet cells in pancreas

AE:
- Increases risk of hypoglycemia

Question 4

Berberine

Answer 4

Similar to metformin

Mechanism:
- Insulin sensitizing
- Increases glycolysis in liver

AE:
- GI side effects

Question 5

Panax Ginseng

Answer 5

Most potent ginseng

Mechanism
- Stimulates insulin secretion
- Blocks intestinal insulin absorption
- Enhances peripheral glucose uptake

AE:
- Insomnia, increased BP, increased bleeding time

Question 6

Cinnamon

Answer 6

Chinese Cinnamon

Mechanism:
- Reduce blood glucose in uncontrolled hyperglycemia
- Little effect in patients with controlled blood glucose (A1c < 7.0%)

AE:
- Contains cumarin, can cause hepatoxicity if consumed in high amounts or used with drugs with hepatoxicity risk

Question 7

White Mulberry

Answer 7

Reduces Carbohydrate Absorption
- Inhibits alpha-glucosidase enzyme
- Similar to carbose

Question 8

Fiber

Answer 8

Oats, Bran, Psyllium, Glucomannan

Slow gastric emptying and reduce cholesterol absorption