Antidiabetic effect of combined extract of Coccinia grandis and Blumea balsamifera on streptozotocin-nicotinamide induced diabetic rats

Background: Coccinia grandis and Blumea balsamifera are two medicinal plants that have been known to have good antidiabetic properties. Combining these two plant extracts may generate a greater effect that can increase efficacy and decrease the dose. Objective: This research investigated the antidiabetic activity of the combination of C. grandis and B. balsamifera leaves extracts on experimental diabetic rats. Materials and methods: The dried leaves of C. grandis and B. balsamifera were powdered and macerated with ethanol 70% (v/v). A diabetic condition in male Wistar albino rats was generated by intraperitoneal injection of a single dose of streptozotocin (65 mg/kg) followed by nicotinamide (110 mg/kg). Diabetes-confirmed rats were then given glibenclamide (4.5 mg/kg), C. grandis extract (300 mg/kg), B. balsamifera extract (150 mg/kg), and the combined extracts with a dose ratio of 1:1, 1:3, and 3:1. The treatment was performed for 28 days and fasting blood glucose was tested once a week. The pancreas and liver organs were taken on day 29 for antioxidant, histological, and immunohistochemical assessment. Results: Among all the extracts, the combined extract with a ratio of 1:3 showed the greatest glucose lowering effect. This combination also lowered malondialdehyde levels while increasing superoxide dismutase and catalase levels in the pancreas and liver organs. Histological examination showed this combination regenerated the islet of Langerhans. It also increased pancreatic insulin expression in immunohistochemical evaluation. Conclusion: This study revealed that the combined extracts of C. grandis and B. balsamifera exhibited enhanced antidiabetic activity via ameliorating oxidative stress, regenerating beta-cells, and increasing insulin expression.