Citrullus colocynthis and Its Potential Role Against Diabetes and Its Complications

Abstract Citrullus colocynthis was reported in multiple ethnopharmacologic studies from different part of the world as a traditional remedy for a variety of diseases including gastrointestinal, musculoskeletal, neurological, cardiovascular, and respiratory disorders also, diabetes mellitus is known as the most popular traditional indication of C. colocynthis . In all, 46 studies on animal model of diabetes have investigated antidiabetic effects of C. colocynthis . Regardless of the dose and the part of the plant which was used, in all studies C. colocynthis showed blood glucose lowering effect. The efficacy and safety of C. colocynthis in patients with diabetes mellitus type II is evaluated in six clinical studies. These studies have used different doses of C. colocynthis from 125 to 1000 mg daily dose (mostly 300 mg/day divided in three doses) for 1–3 months. The result of these studies showed improvement in glycemic indexes (fasting blood glucose level and HbA1c), and lipids [total cholesterol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglyceride] of patients with diabetes receiving C. colocynthis supplementation compared to placebo. Decrease in neuropathic pain severity and improvement in nerve function is also reported by topical use of C. colocynthis oil in patients with painful diabetic polyneuropathy. Beta-pyrazol-1-yl-alanine and saponin fractions are the main insulinotropic active ingredients of C. colocynthis . Its inhibitory effect on glucose absorption, gluconeogensis, and glycogenolysis pathways is supported by multiple studies.