Biogetica Brings To You Hyponidd Tablets, Effective In Postponing Need For Insulin Therapy.

Nov. 23, 2009 - PRLog -- Biogetica offers treatments for Diabetes that includes Hyponidd (containing Gymnema Sylvestre and Pterocarpus marsupium) tablets. They have been used as effectively as metformin for lowering insulin resistance and hyperandrogenemia in anovulatory women with PCOS without any side effects of metformin.

Their comparative clinical study is as given below:

Efficacy of herbal formulation (HYPONIDD) in the management of anovulatory PCOS women: A comparison with metformin
Herbal formulation (Hyponidd) as insulin sensitizing drug.

Authors:
Dr. Mrs. Meena Chimote M.D.; DNB.
Dr. Nirmalendu Nath PhD.
Dr.Natachandra Manohar Chimote PhD

Polycystic ovarian syndrome (PCOS) is a heterogeneous disorder characterized by menstrual irregularities, clinical and / or biochemical hyperandrogenism and hyperinsulinemia secondary to reduced insulin sensitivity and is the most common endocrinopathy in women, affecting 5–10% of the population. In recent years it has been widely recognized that most women with PCOS have some degree of insulin resistance. Therefore, abnormality of insulin secretion and action has been implicated in the pathophysiology of PCOS.

Metformin is the most thoroughly investigated drug studied to reverse the hyperinsulinaemia of PCOS and its clinical and metabolic expressions. Ayurvedic medicines such as Gymnema sylvestere (Gudmar: a source of acarbose) and Pterocarpus marsupium (a source of D- chiro inositol) are known to have antidiabetic activity. Therefore we carried out a comparative study of efficacy of Indian herbal drug- Hyponidd@ (marketed by Charak Pharmaceuticals (I) Pvt. Ltd. India) prepared from extracts of plants and metformin in anovulatory PCOS women.

Material and Methods

Patient selection
172 PCOS patients participated in this study. All women were in good health and none had taken any medication known to affect carbohydrate metabolism or gonadal function for at least 6 months before the study. Inclusion criteria were established for PCOS patients as per Rotterdam revised consensus on diagnosis criteria 25 for PCOS.

The Ethical Committee of our Reproductive Endocrine department approved the study and written informed consent was obtained from each PCOS woman. For each woman, the body mass index (BMI) was and Waist: Hip ratio was calculated. In all patients, basal fasting serum concentrations of LH, FSH, estradiol, testosterone, PRL, insulin, fasting blood sugar and SHBG were determined on day 2 or day 3 of the follicular phase of a spontaneous or progestin-induced cycle. Ultrasound ovarian volume was calculated during the follicular phase.

Final 160 PCOS women were randomly divided into two equal groups i.e. Hyponidd group (n = 80) and Metformin group (n = 80). Each woman was instructed to take the drug half an hour before food intake. At the end of the treatment, each patient underwent the same clinical, endocrine evaluations as prior to the treatment.

Results

Anthropometric parameters
Each group was evaluated for the changes in the weight, BMI, WHR and hormone parameters after the treatment. Intercomparison between Hyponidd and metformin groups after treatment showed that Hyponidd treatment was more effective in reducing waist girth, WHR and BMI than metformin. However, reduction in clinical hyperandrogenism was quite evident and similar in both the groups.


Metabolic parameters
Most importantly, hyperinsulinemia, fasting glucose: fasting insulin ratio (FG: FI) and indicators of insulin resistance such as homeostasis model assessment of insulin resistance and β cell function index in Hyponidd group showed very significant and parallel improvement like metformin group.

Hormone parameters
A decline in LH: FSH ratio was significant in both the groups after treatment.
Interestingly reduction in baseline post-treatment estradiol level in Hyponidd group was significant as compared to metformin group. Comparative results established that Hyponidd treatment was not only as effective as metformin in reducing insulin resistance and improving ovulation rate but also helped in reducing obesity, LH: FSH ratio and hyperandrogenemia significantly as compared to metformin.

Side effects
8 subjects in metformin group on account of gastrointestinal disturbances such as nausea, vomiting, abdominal pain and diarrhea gave up treatment in between whereas; Hyponidd group completed the treatment without any such complaint.
This finding has truly established a better tolerance with Hyponidd as compared to metformin.

Conclusion: Herbal medicine Hyponidd is as effective as metformin in reducing insulin resistance, hyperandrogenemia and in increasing ovulation rate in anovulatory PCOS women with added advantage of almost no side effect of gastric disorders as found in metformin. However, the reduction in BMI and waist girth as well as decrease in the incidence of LH: FSH ratio with Hyponidd treatment was more perceptible as compared to metformin. To explain these results, particularly effect of reduced centroid obesity in the form of reduced WHR and BMI; further studies are warranted to support the efficacy of this herbal medicine.

References
1. Dunaif A, Segal KR, Futterweit W and Dobrjansky A. Profound peripheral insulin
resistance, independent of obesity, in polycystic ovary syndrome. Diabetes. 1989,
2. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and
implications for pathogenesis. Endocr Rev.1997
3. Ibanez L, Vallus C, Ferrer A, Marcos MV, Rodriguez-Hierro, de Zegher F Sensitization of insulin induces ovulation in nonadolescents with anovulatory hyperandrogenism. J Clin Endocrinol Metab. 2001
4. Shanmugasundaram ER, Rajeshwari G, Baskaran K, Rajeshkumar BR, Radha
Shanmugasundaram K and Kizar Ahmath B. Use of Gymnema sylvestre leaf extract in
the control of blood glucose in insulin-dependent diabetes mellitus. J. Ethanopharmacol.1990
5. Manickam M, Ramanathan M, Jahromi M, Jahromi MA, Chaurasia JP and Ray AB.
Antihyperglycemic activity of phenolics from Pterocarpus marsupium. J Nat Prod. 1997

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