According to the World Health Organization (WHO) the number of deaths owing to diabetes would double between 2005 and 2030. People in low and middle-income countries are vulnerable to diabetes related complications and deaths. Almost halve of all diabetes patients die of heart diseases and strokes. The sluggish blood flow and reduction in sensitivity in the feet, lead to foot ulcers. The difficult to treat foot ulcers and the slow wound healing process in diabetics might eventually lead to limb amputation.

Excess glucose in the blood damages the eyes. Diabetic retinopathy is a common cause of retinal damage in diabetics that can eventually cause blindness. Around 2 percent people who have suffered from diabetes for over 15 years become blind and approximately one in every ten diabetics suffer from severe vision problems.

Untreated diabetes lead to kidney malfunctioning. Kidney failure is linked to the death of 10 to 20 percent diabetics worldwide. Long-term accumulation of sugar in the blood damages the nerves in about one in every two people with diabetes. Diabetic neuropathy cause tingling, pain, weakness and loss of sensation in the hands and feet.

Bitter melon grows in the tropical and subtropical regions of Asia, Africa and the Caribbean. In India, it is known as Karela. The plant is a vine with tendrils that can grow up to a height of 5m. Flowers usually appear on the plant during the summer and monsoon. Fruiting usually occurs in September and November.

Despite its bitter taste, the fruit of the bitter melon plant is part of the cuisine in the South Asian countries. The fruit is eaten when it is unripe. The ripe fruit is more bitter and distasteful. In Ayurveda, bitter melon is revered for its anti-diabetic properties. The main phychemicals associated with the hypoglycemic effect of bitter melon include alkaloids and peptides known as charantins that mimic insulin.

Even frying does not destroy the hypoglycemic property of bitter melon fruit. Laboratory studies indicate that daily intake of fried bitter melon fruits produces small but significant improvement in glucose tolerance. (Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH. “Improvement in glucose tolerance due to Momordica charantia (karela). Br Medical J (Clin Res Ed). 1981 Jun 6;282(6279):1823-4).

The hypoglycemic effect of the bitter vegetable has been confirmed in a large number of in vitro, in vivo and clinical trials. Clinical trials have highlighted the efficacy of insulin-like compounds in bitter melon in lowering the blood glucose level in diabetics. Purified protein extract of bitter melon, extracted from the fruit and the tissue cultures of the bitter melon plant exhibits properties similar to insulin obtained from animal pancreas. The blood sugar lowering effect of the vegetable is noticeable within 30 to 60 minutes after taking the bitter gourd extract. (Baldwa VS, bhandari CM, Pangaria A, Goyal RK. “Clinical trial in patients with diabetes mellitus of an insulin-like compound obtained from plant source.” Ups J Med Sci. 1977;82(1):39-41). The level of hyperglycemia or high blood sugar could decline by 50 percent within five hours after taking the Momordica charantia extract. Researchers speculate that an extrapancreatic effect of the vegetable might improve glucose metabolism. (Bailey CJ, Day C, Turner SL, Leatherdale BA. “Cerasee, a traditional treatment for diabetes. Studies in normal and streptozoticon diabetic mice.” Diabetes Res. 1985 Mar;2(2):81-4). The blood sugar lowered with the help of bitter melon might remain at the low level for several days even after discontinuing the herbal treatment. (Singh N, Tyagi SD, Agarwal SC. “Effects of long term feeding of acetone extract of Momordica charantia (whole fruit powder) on alloxan diabetic albino rat.” Indian J Physiol Pharmacol. 1989 Apr-Jun;33(2):97-100).

Bitter melon owes its hypoglycemic property to a peptide known as polypeptide-p. Experimental studies have shown that subcutaneous administration of polypeptide-p to diabetics could reduce the blood sugar level. (Khanna P, Jain SC, Panagariya A, Dixit VP. “Hypoglycemic activity of polypeptide-p from a plant source.” J Nat Prod. 1981 Nov-Dec;44(6):648-55)

Bitter melon significantly improves glucose tolerance in diabetics. In a clinical trial researchers found that daily intake of Momordica charantia fruit juice improves glucose tolerance in 73 percent diabetics with maturity onset diabetes. (Wlihinda J, Karunanayake EH, Sheriff MH, Jayasinghe KS. “Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes.” J Ethnopharmacol. 1986 Sep;17(3):277-82).

Prolonged intake of Momordica charantia could reduce the serum cholesterol level in diabetics. Excess cholesterol build-up might reduce sensitivity to insulin. (Singh N, Tyagi SD, Agarwal SC. “Effects of long term feeding of acetone extract of Momordica charantia (whole fruit powder) on alloxan diabetic albino rat.” Indian J Physiol Pharmacol. 1989 Apr-Jun;33(2):97-100). The phytocompounds in Momordica charantia helps to improve insulin sensitivity by inhibiting activities of proteins and enzymes that obstruct the proper functioning of the insulin signaling pathway. (Klomann SD, Mueller AS, Pallauf J, Krawinkel MB. “Antidiabetic effects of bitter gourd extracts in insulin-resistant db/db mice.” Br J Nutr. 2010 Dec;104(11):1613-20).

Experimental studies have shown that bitter melon fruit pulp almost doubled the number of beta cells, total beta cells area and the islet size in the pancreas of diabetics. Momordica charantia treated diabetics tend to have more insulin granules. The fasting blood sugar level would plummet significantly by consuming bitter melon daily. (Hafizur RM, Kabir N, Chishti S. “Modulation of pancreatic beta-cells in neonatally streptozotocin-induced type 2 diabetic rats by the ethanolic extract of Momordica charantia fruit pulp.” Nat Prod Res. 2011 Feb;25(4):353-67).

Excess sugar in the blood tends to accelerate cataract formation. Bitter melon might delay onset of cataract in diabetics. (Srivastava Y, Venkatakrishna-Bhatt H, Verma Y. “Effect of Momordica charantia Linn, pomous aqueous extract on cataractgenesis in murrin alloxan diabetes.” Pharmacol Res Commun. 1988 Mar;20(3):201-9).

Disorder in glucose metabolism alters the normal antioxidant enzymes level. Diabetes complications are triggered by oxidative stress. Untreated diabetes is linked to oxidative damage to the heart, kidneys, liver and other organs. Bitter melon fruit pulp and seeds helps to improve the antioxidant activities in the body. By boosting the antioxidant activities, Momordica charantia could protect the vital organs from diabetes-induced oxidative stress. (Tripathi UN, Chanda D. “Anti-hyperglycemic and anti-oxidative effect of aqueous extract of Momordica charantia pulp and Trigonella foenum graecum seed in alloxan-induced diabetic rats.” Indian J Biochem Biophys. 2010 Aug;47(4):227-33).

Momordica charantia could help to prevent neurological deficits in diabetics. It attenuates cerebral damage and oxidative stress in diabetics. (Malik ZA, Singh M, Sharma PL. “Neuroprotective effect of Momordica charantia in global cerebral ischemia and reperfusion induced neuronal damage in diabetic mice.” J Ethnopharmacol. 2011 Jan 27;133(2):729-34).

To keep your blood glucose level under control, along with the antidiabetic drugs and Karela supplement, you should adopt a healthy lifestyle. Regular exercises and a balanced diet could reduce your glycemic load. A healthy body weight could prevent complications of diabetes. At least 30 minutes of moderate physical activity for at least five days a week is beneficial for people with diabetes. In a study in Japan, researchers have observed that the blood glucose levels of diabetic animals that combine bitter gourd intake with physical activities is lower than the blood glucose levels of subjects who either exercise or consume bitter gourd extract. (Miura T, Itoh Y, Iwamoto N, Kato M, Ishida T. “Suppressive activity of the fruit of Momordica charantia with exercise on blood glucose in type 2 diabetic mice.” Biol Pharm Bull. 2004 Feb;27(2):248-50).

A healthy diet comprising of three to five servings of fruits and vegetables and limiting sugar and saturated fat intake might prevent abnormal increase in the blood sugar level. To prevent abnormal fluctuations in the blood sugar level, diabetics should not stay on empty stomach for a long time. You should take your meals according to schedule. Skipping meals increase the risk of hypoglycemia in diabetics on antidiabetic medications. Diabetics should frequently monitor their blood sugar level.

Blood pressure control, blood lipid control, regular foot care, screening for early signs of retinopathy and kidney diseases might reduce the risk of developing diabetes related complications.

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