Diabetes,
often referred to by doctors as Diabetes Mellitus (DM) is one of the
metabolic diseases in which the person has high blood glucose (blood sugar).
The disease is as the result either because insulin production in the body is
inadequate, or because the body's cells do not respond properly to insulin, or
both. Patients with high blood sugar will typically experience frequent
urination, they will become increasingly thirsty and hungry. Diabetes is
classified into type 1 DM, type 2 DM and gestational Diabetes, which affects few
females during pregnancy. Type 1 is when the body does not
produce insulin, which constitutes approximately 10% of all diabetes cases
while type 2 is when the body does not produce enough insulin for proper
function. Type 2 constitutes approximately 90% of all cases of diabetes
worldwide. As of 2015, an estimated
415 million people were reported to be suffering from diabetes worldwide according
to the International Diabetes Federation, with type 2 approximating to the 90%
of the cases. This represents 8.3% of the adult population, with equal rates in
both women and men. In
Africa, more than 14 million cases are reported, accounting for about 4.3% of
average adults and responsible for more than 401, 276 deaths per year.
Unfortunately, Nigeria, the most populous country in the continent has the
highest burden of diabetes in Africa with more than 3.2 million diabetic
patients and the incidence of the disease is currently increasing at an
alarming rate.
Overweight and obese people have
a much higher risk of developing type 2 diabetes compared to those with a
healthy body weight. People with a lot of visceral fat, also known as central
obesity, fat belly or abdominal obesity, are especially at risk. Being
overweight/obese causes the body to release chemicals that can destabilize the
body's cardiovascular and metabolic systems. Being overweight, physically
inactive and eating the wrong foods may all contribute to the risk of
developing type 2 diabetes. Researchers from Imperial College London reported
in the journal Diabetologia that drinking of one bottle (non-diet) of
soft drink can raise the risk of developing type 2 diabetes by 22. The
scientists believe that the impact of sugary soft drinks on diabetes risk may
be a direct one, rather than simply an influence on body weight.
In Africa, Diabetes is a common disease among the
people above the age of 40 years, people have learnt to live with diabetes
through various controls and managements. People with type 1 diabetes need
to take insulin injections for the rest of their life while monitoring their
blood-glucose levels by carrying out regular blood tests and following a
special diet. However, the category of people suffering from type 1 are few
compared to the rest diabetic patients. People with early stage of type 2 diabetes
may be able to control it by losing weight through consistent physical
exercise, following a healthy diet, and monitoring their blood glucose levels.
However, type 2 diabetes is typically a progressive disease - it gradually gets
worse - and the patient will probably end up have to take insulin or any
appropriate medication after series of tests by medical experts. At present, the synthetic oral medications used
in the treatment of diabetes have characteristic profiles of serious side
effects to many patients. The side effects may include gastrointestinal
discomfort and nausea, liver and heart failures
as well as diarrhea. In addition to these side effects, the medications
may rather be costly and beyond the affordability of the majority of the
African populations. These limitations coupled with an exponential increase in
the prevalence of type 2 diabetes trigger researchers to scientifically
investigate a number of African plants as possible alternative therapies for
the treatment of type 2 diabetes. Unfortunately, basic research on type 2
diabetes is usually hard-to-execute in African countries because of some
procedural issues and lack of appropriate animal models.
A
Kano born, Nigerian citizen, Dr. Mohammed Auwal Ibrahim, took a challenge of
scientific development and validation of anti-diabetic plant-based remedies as
well as the identification of novel chemical leads (as anti-diabetics) from
African plants. The research work was successfully conducted at the School of Life Sciences, University of
KwaZulu-Natal (Westville Campus), Durban 4000, South Africa.
Interestingly, Dr. Ibrahim research
work was focused on the development of newer, more effective and less toxic
remedies against the type 2 diabetes. Several commonly found African plants
were used for the research that took some years to be accomplished. Among the
promising plants were Khaya senegalensis
(Madaci in Hausa) and Cassia singueana (Runhu in Hausa). He used a
number of molecular techniques involving in
vitro and in vivo models to demonstrate the potentials of some
African plants in the management of type 2 diabetes. Furthermore, other
molecular techniques were used to elucidate the mechanisms of actions of these
plants at molecular level. In addition, a number of analytical tools such as
nuclear magnetic resonance (NMR) was successfully used to identify (with
structural elucidation), for the first time, the pure bioactive anti-diabetic
compounds (components) from those plants. Subsequently, the potentials of these
compounds for the development of novel and possibly more effective
chemotherapeutic drugs against type 2 diabetes were demonstrated. The results have
shown that these plants have the potentials for future development and
commercialization as anti-diabetic herbal-based product that could benefit
African diabetics.
As commendable as Dr. Ibrahim's research work is,
it is not yet Uhuru; the development
of drugs for human consumption has to follow international standard
procedure. The first step of the procedure usually
involves the tedious process of identifying a single chemical entity (molecule)
from either a plant, microorganism or through synthetic chemistry that has the
potential to cure a particular disease. The second step is testing the molecule
in a preclinical trial and the last stage is undergoing clinical trials of the
molecule against the particular disease. According to medical specialists,
these tests are conducted by Panel of
experts within a minimum period of ten years and the molecules must passed
these testes successfully before they are approved as drugs. It is gratifying
to note that Dr. Ibrahim's work has successfully passed through the first step
that involves rigorous basic research to identify the single bioactive molecule
(from the selected plants) with potentials to cure type 2 diabetes. Overall, the
Nigerian Scientist identified four new molecules with these potentials. Hence,
those molecules have to pass through rounds of pre- and clinical trials before
they can eventually become drugs and be allowed to be used by the general
public. This may take next five years or more. One can understand why new drugs have to
undergo this rigorous and tedious process to safeguard human lives. However,
the time taken by the process is giving a sleepless night to some stakeholders;
how can this time be shorten while equally safeguarding the human lives? It is
due to this long period of time (10 - 15 years), the drug discovery process
takes, that recently Indians and Chinese (South Africa coming up also) came up
with the new concept of “reverse pharmacology”. A reverse pharmacology is a
situation in which, once a plant material is scientifically identified to cure a particular disease and it is safe
and once scientific investigations have confirmed the claim to be true. The available data will
simply be reviewed, packaged and then process for the herbal drugs commercialization
initiated. Within one to two years, the herbal products will be made available
to the consumers. This has resulted in the massive influx of Indians and
Chinese herbal-based remedies in to Nigeria with its attendant consequences on
our already shaken economy.
Interestingly however, even in this context, Dr. Ibrahim has also made
such studies and confirmed that three plant materials have the potentials to be
developed as anti-diabetic herbal remedies along this line. Hence, with Nigerian’s long history of
traditionally curing diseases with plants, the prospect of “reverse
pharmacology” approach to treating diabetes in Nigeria is a bright one. The
stakeholders should work in this direction for the benefits of Nigerians.
Fortunately,
Dr. M. A. Ibrahim came back to Nigeria and is currently lecturing at the
Department of Biochemistry, Ahmadu Bello University, Zaria. He is willing,
through his university to partner with the relevant government agencies and pharmaceutical
companies to initiate commercialization of scientifically validated
anti-diabetic herbal remedies for the benefit of Nigerians and citizens of
other African countries. The idea of "reverse pharmacology" should be
adopted by the Nigerian Society to meet the health challenges of the Diabetes
and perhaps other diseases. The ball is in the court of the Nigerian Authority
and the Nigerian medical experts.
Dr. Muhammad Auwal Ibrahim in his Lab.
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