Interaksi antara Herbal dan Antidiabetik Oral pada Penderita Diabetes Melitus: Tinjauan Mekanisme Aksi
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Peningkatan penggunaan herbal pada penderita diabetes melitus memerlukan pemahaman yang jelas mengenai potensi interaksi dengan antidiabetik oral (OAD). Interaksi tersebut dapat bersifat sinergis maupun menimbulkan risiko, terutama hipoglikemia. Mengidentifikasi mekanisme interaksi antara herbal dan OAD serta menilai relevansinya dalam terapi diabetes melitus tipe 2. Penelusuran literatur dilakukan melalui Google Scholar, PubMed, dan ScienceDirect menggunakan kata kunci terkait herbal, antidiabetik oral, dan interaksi obat. Artikel diseleksi berdasarkan kriteria inklusi (2015–2025, original research, subjek diabetes melitus tipe 2 atau model hewan, bahasa Inggris/Indonesia, serta penggunaan OAD) dan eksklusi yang relevan. Interaksi yang paling sering dilaporkan bersifat farmakodinamik, terutama kombinasi Cinnamomum verum, Curcuma longa, dan Momordica charantia dengan metformin atau sulfonilurea yang meningkatkan sensitivitas insulin, mengaktivasi AMPK, atau menstimulasi sekresi insulin sehingga berpotensi menimbulkan hipoglikemia. Interaksi farmakokinetik juga ditemukan, misalnya modulasi transporter OCT1 oleh ginseng yang dapat memengaruhi akumulasi metformin. Beberapa herbal lain, termasuk Aloe vera, menunjukkan aktivitas penurun glukosa darah, namun bukti interaksi langsung dengan OAD masih terbatas sehingga perannya cenderung bersifat pendukung. Interaksi antara herbal dan antidiabetik oral memiliki implikasi klinis yang penting karena berpotensi mengubah efektivitas maupun keamanan terapi. Pemantauan ketat dan edukasi pasien diperlukan, disertai penelitian lebih lanjut untuk memperjelas interaksi yang belum terdokumentasi secara memadai.
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Referensi
] World Health Organization. Diabetes. Retrieved from https://www.who.int/health-topics/diabetes (2020).
] International Diabetes Federation. Diabetes complications. In IDF Diabetes Atlas. 10th ed. (2023).
] Badan Kebijakan Pembangunan Kesehatan. Survei Kesehatan Indonesia (SKI) dalam Angka (2023).
] Sitanggang PG, Kalsum U, Wisudariani E. Faktor Risiko Kejadian Diabetes Melitus Tipe 2 pada Pegawai Pemerintah di Indonesia. Jurnal Ilmiah Kedokteran dan Kesehatan. 2025;4(3):291–305.
] Marathe PH, Gao HX, Close KL. American Diabetes Association Standards of Medical Care in Diabetes 2017. Journal of diabetes. NLM (Medline). 2017;320–324.
] Malihah D, et al. Pola pengobatan antidiabetes terhadap pasien diabetes melitus tipe ii rawat jalan di rsau dr. M. Salamun. 2022.
] Dewi RS, et al. Persepsi Masyarakat Mengenai Obat Tradisional Di Kelurahan Simpang Baru Kecamatan Tampan Kota Pekanbaru. Jurnal Penelitian Farmasi Indonesia. 2019;8(2).
] Maideen NMP, Balasubramaniam R. Pharmacologically relevant drug interactions of sulfonylurea antidiabetics with common herbs. Journal of HerbMed Pharmacology. 2018;7(3):200–210.
] Astuti Y, Riani N, Elviana N. Edukasi Pengenalan Obat Herbal Untuk Penyakit Diabetes Mellitus Di Wilayah Kelurahan Pondok Ranggon. Jurnal Medika Hutama. 2022;03.
] Mierza V, et al. Potential Study of Indonesian Herbal Plants as Antidiabetics in Type 2 Diabetic Patients. Journal of Pharmaceutical and Sciences. 2023;6:529–540.
] Rohmah A, et al. Sistematic literatur review : Interaksi Obat Glibenklamid dengan Herbal pada Diabetes Melitus. Jurnal Ilmiah Pharmacy. 2024;11(2).
] Baxter K, Stockley IH. Stockley’s drug interactions : a source book of interactions, their mechanisms, clinical importance and management. Pharmaceutical Press (2010).
] Rombolà L, et al. Pharmacokinetic interactions between herbal medicines and drugs: Their mechanisms and clinical relevance. Life. MDPI AG. 2020;1–30.
] Reddy KY. Pharmacognosy And Plant Metabolites (2020).
] Amalia RD, Aditama L, Rahem A. Pengetahuan, Sikap Dan Praktik Penggunaan Obat Antidiabetes Secara Konvensional Dan Komplementer Pada Pasien Diabetes Di Rumah Sakit X Kota Malang. Jurnal Insan Farmasi Indonesia. 2025;8(1):35–45.
] Pramesthi ADED, Ardana M, Indriyanti N. Drug-Herb Interaction between Metformin and Momordica charantia in Diabetic Mice. Molecular and Cellular Biomedical Sciences. 2019;3(2):81.
] Islam M, et al. Momordica charantia (Bitter melon) in Combination with Metformin Potentiates Hypoglycemic and Hypolipidemic Effects in Alloxan-induced Diabetic Rats. Bangladesh Pharmaceutical Journal. 2018;21(2):109–117.
] Lee CW, et al. Change of metformin concentrations in the liver as a pharmacological target site of metformin after long-term combined treatment with ginseng berry extract. Frontiers in Pharmacology. 2023;14.
] Nam SJ, et al. Effect of red ginseng extract on the pharmacokinetics and efficacy of metformin in streptozotocin-induced diabetic rats. Pharmaceutics. 2018;10(3).
] Carella AM. Hypoglycemia by Ginseng in type 2 Diabetic Patient: Case Report. New Insights in Obesity: Genetics and Beyond. 2017;1(1):001–006.
] Bocha Y, et al. The Conjoint effects of Cinnamon and Metformin on Anthropometric and Glycemic indices in Drug Naïve type II Diabetic patients, Med. Forum (2022).
] Mondal P, et al. Herb-drug interaction study between Aloe vera and glimepiride in normal and diabetic rats. Egyptian Pharmaceutical Journal. 2020;19(2):124–135.
] Desai S, Thakkar V, Gandhi T. The combined effect of medicinal plant extract and sulfonylurea agent: a preliminary study to evaluate anti-diabetic potential in experimental animals. Journal of Medical Pharmaceutical and Allied Sciences. 2024;13(6):6847–6854.
] Birje SS, Mehrotra NA, Birje S. Study Of In-Vitro Α-Glucosidase Inhibitory Activity Of Syzygium Aromaticum And Its Herb Drug Interaction With Acarbose And Metformin. International Journal of Life Sciences and Review 114 IJLSR. 2018;4(8):144–122.
] Haque MA, et al. Abelmoschus esculentus (L.) Moench Pod Extract Revealed Antagonistic Effect against the Synergistic Antidiabetic Activity of Metformin and Acarbose upon Concomitant Administration in Glucose-Induced Hyperglycemic Mice. Biologics. 2022;2(2):128–138.
] Li Z, et al. Pharmacodynamic Interactions between Puerarin and Metformin in Type-2 Diabetic Rats. Molecules. 2022;27(21).
] Shiming Z, et al. Swietenine potentiates the antihyperglycemic and antioxidant activity of Metformin in Streptozotocin induced diabetic rats. Biomedicine and Pharmacotherapy. 2021;139.
] Tan SP, et al. Bitter melon (Momordica charantia L.) bioactive composition and health benefits: A review. Food Reviews International. 2016;32(2):181–202.
] Lo HY, et al. Identification of the bioactive and consensus peptide motif from Momordica charantia insulin receptor-binding protein. Food Chemistry. 2016;204:298–305.
] Silva ML, et al. Cinnamon as a Complementary Therapeutic Approach for Dysglycemia and Dyslipidemia Control in Type 2 Diabetes Mellitus and Its Molecular Mechanism of Action: A Review. Nutrients. MDPI. 2022.
] L. Gonçalves L, et al. Assessment of Human Health Risk of Toxic Elements Due to Cinnamon Ingestion in the Diet. Biological Trace Element Research. 2019;189(2):313–324.
] Koepsell H. Update on drug-drug interaction at organic cation transporters: mechanisms, clinical impact, and proposal for advanced in vitro testing. Expert Opinion on Drug Metabolism and Toxicology. Taylor and Francis Ltd. 2021;635–653.
] Samodelov SL, et al. Organic cation transporters in human physiology, pharmacology, and toxicology. International Journal of Molecular Sciences. MDPI AG. 2020;1–21.
] Kawoosa F, et al. Role of human organic cation transporter-1 (OCT-1/SLC22A1) in modulating the response to metformin in patients with type 2 diabetes. BMC Endocrine Disorders. 2022;22(1).
] Thomas I, Gregg B. Metformin; a review of its history and future: from lilac to longevity. Pediatric Diabetes. Blackwell Publishing Ltd. 2017;10–16.
] Liu Y, et al. Puerarin suppresses the hepatic gluconeogenesis via activation of PI3K/Akt signaling pathway in diabetic rats and HepG2 cells. Biomedicine and Pharmacotherapy. 2021;137.
] Sufiyan Siddiqui BS. Hypoglycemic and Hepatoprotective Effects of Processed Aloe vera Gel in a Mice Model of Alloxan Induced Diabetes Mellitus. Journal of Diabetes & Metabolism. 2013;04(09).
] Elaibi HK, Mutlag FF. A comprehensive review of Aloe vera: Multifaceted health benefits and anti-diabetic properties, Article in Journal of Research in Chemistry (2023).
] Campbell JE, Newgard CB. Mechanisms controlling pancreatic islet cell function in insulin secretion. Nature Reviews Molecular Cell Biology. Nature Research. 2021;142–158.
] Samarh SN, Khalaf NA, Hajhamad MM. Evidence based medical use of aloe vera extracts, short review of literature. International Journal of Research in Medical Sciences. 2017;5(10):4198.
] Huang CN, et al. Active subfractions of Abelmoschus esculentus substantially prevent free fatty acid-induced ß cell apoptosis via inhibiting dipeptidyl peptidase-4. PLoS ONE. 2017;12(7).
] Liao Z, et al. Polysaccharide from Okra (Abelmoschus esculentus (L.) Moench) Improves Antioxidant Capacity via PI3K/AKT Pathways and Nrf2 Translocation in a Type 2 Diabetes Model. Molecules. 2019;24(10).
] Wang C, et al. Puerarin ameliorates hyperglycemia in HFD diabetic mice by promoting β-cell neogenesis via GLP-1R signaling activation. Phytomedicine. 2020;70.
] Chen X, et al. Synergistic hypoglycemic effects of pumpkin polysaccharides and puerarin on type II diabetes mellitus mice. Molecules. 2019;24(5).
] Foretz M, et al. Understanding the glucoregulatory mechanisms of metformin in type 2 diabetes mellitus Understanding the glucoregulatory mechanisms of met-formin in type 2 diabetes mellitus. Nature Reviews Endocrinology. 2019;10.
] Mak KK, et al. Swietenine Alleviates Nonalcoholic Fatty Liver Disease in Diabetic Mice via Lipogenesis Inhibition and Antioxidant Mechanisms. Antioxidants. 2023;12(3).