The sweet pill?

At last count, there were 61 million diabetics in India. And, this number is likely to go up to 100 million in the coming years, if statistics by the International Diabetes Federation are to be believed. Spurred by the gravity of the situation, drug makers and researchers across the globe are working on new formulae to help control the disease. For instance, Germany's Boehringer Ingelheim has announced a new oral treatment, Jardiance, that will be available in India from November. At around the same time, a new herbal medicine will also hit the market to manage type II diabetes, mellitus.

Named BGR-34, the drug has been jointly developed by National Botanical Research Institute (NBRI) and Central Institute for Medicinal and Aromatic Plants (CIMAP). "A team of 10 scientists has been working on the project for more than two years. We chose to work on type two diabetes as majority of Indians are suffering from it," says C S Nautiyal, director, NBRI, who also had additional charge of CIMAP till last year.

The drug, which has now been patented, will be marketed across the country by Delhi-based Aimil Pharmaceuticals. "All the necessary permissions have been taken for making this drug commercially available," says AKS Rawat, senior principal scientist, NBRI, who worked on the project.

What makes this drug different from the various other herbal anti-diabetes concoctions available in the market is that it has been validated scientifically. "We have done all the safety checks. Scientific studies have found it safe and effective, with clinical trials showing more than 67 per cent success," says Rawat.

The team decided to base its formulation on ayurveda principles and chose plants listed under the ministry of Ayush. "The ones listed there are fit for human consumption. But we had to take care of purity and also ensure that none of these plants was endangered," explains Nautiyal.

Plants such as vijaysar and tinospora, which have been documented extensively in ancient ayurveda texts, have been used in the drug. "We chose those that have antioxidant properties, enhance immunity, help repair the pancreas and increase production of insulin within the body," says Rawat. "This drug has no side effects and can be used alongside modern medicine. Slowly you can reduce the dosage of allopathic drugs and depend on this to help manage type 2 diabetes."

Most ayurveda specialists working in this field have welcomed this development but are waiting to know more about the composition to gauge its possible effects. "I have not seen the ingredients yet to know if this will be useful or not. But yes, there are 20 to 30 herbs that can help manage diabetes in different ways," says Y K Saini, senior consultant (ayurveda medicine) at Delhi's BLK Super Specialty Hospital. A medical practitioner for the past 36 years, Saini has spent the past 12 years researching ways to manage diabetes. "There are herbs which are very useful if used in the right combination. Vijaysar and leaves of the madhunashini tree are some of these. The idea is to activate metabolism, activate the pancreas so that it generates insulin, sensitise the body to absorb insulin and enhance immunity," he says.

However, those who specialise in modern medicine are a little wary of herbal drugs. "We have done enough tests alongside companies that formulate such herbal remedies to know that these - if completely natural and quality controlled - can heal, but to a very small degree, say around 5 to 7 per cent. You will experience the same effects if you follow a good diet and opt for a lifestyle change," says Anoop Misra, chairman, Fortis CDOC Hospital for Diabetes and Allied Sciences. "These will not be beneficial for moderate or chronic diabetics." He feels that recent developments in modern medicine will be more effective for the latter. "For instance, a new compound was announced last year - the SGLT2 inhibitor - which works through a different pathway. While the earlier ones would act through the pancreas, this one acts through the kidney. It not only helps manage weight and blood pressure but also decreases the chance of death due to heart disease," says Misra.

Both Nautiyal and Saini agree that the BGR-34 might not be effective for those who are dependant on insulin injections. "It can't replace the injection for chronic patients," says Nautiyal, but feels that it will surely go a long way in helping pre-diabetics or those in the initial stages. "With the right kind of lifestyle modification and diet, it could help manage diabetes efficiently. Say, even if 30 to 50 per cent of your diabetes is cured and if sugar levels come down and remain down, isn't that a success?" asks Saini. While the debate rages on, BGR-34 is all set to make its debut in 15 days, with a box of 100 priced at Rs 500. Will it prove to be as effective as it claims to be - only time will tell.