Antidiabetic Activity of Combination of Binahong (Anredera cordifolia Ten. Steenis), Cherry (Muntingia calabura L.) and Brotowali (Tinospora crispa L.) Extracts

BACKGROUND: Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. Diabetes mellitus is a silent killer because sufferers are often not aware of it when it is realized, complications have occurred. Treatment for this disease must be done for life to control blood sugar in the body; however, oral antidiabetic drugs often produce unwanted side effects such as bloating, diarrhea, and stomach cramps. One of the treatments for diabetes is to find sources of treatment using natural ingredients that are relatively safe, including using plants as medicines. Based on several studies, Binahong leaves (Anredera cordifolia Ten. Steenis), brotowali (Tinospora crispa L.), and cherry (Muntingia calabura L.) are medicinal plants that can be used to reduce blood sugar levels. This study aims to test the antidiabetic activity using in vivo and in vitro testing methods of extracts of binahong leaves, cherry leaves, brotowali stems and their combinations. METHODS: In vivo method uses animal modeling of insulin deficiency, whereas in vitro method with alpha glycosidase inhibition activity assay. The administration of extracts was repeated every day for 14 days and blood glucose levels were measured on the 0, 7(th), and 14(th) days. Then surgery was performed on the pancreas and calculated the area of the islets of Langerhans, and the number of alpha and beta cells in the pancreas. The inhibitory activity of the alpha-glucosidase enzyme with the IC(50) value of each extract and its combination was determined, with acarbose used as a standard. RESULT: The combination of binahong leaves (Anredera cordifolia Ten.Steenis) and cherry leaves (Muntingia calabura L.) and the combination of brotowali stems (Tinospora crispa (L.) and binahong leaves showed in vivo antidiabetic activity with insulin deficiency method. The combination of these extracts was able to reduce blood sugar levels until the observation on day 14. In in vitro testing by inhibiting alpha-glucosidase enzymes, binahong leaves extract, brotowali stems, and cherry leaves were able to inhibit alpha-glucosidase enzymes at IC(50) of 35.07 ± 2.35; 29.42 ± 1.40; and 26.63 ± 1.15, respectively. CONCLUSION: The best combination of extracts by in vitro and in vivo methods was shown in the combination of binahong leaf and brotowal stem extract binahong leaves, brotowali stems (2:1).