PRELIMINARY

Diabetes mellitus (DM) is a group of metabolic diseases that occur due to abnormalities in insulin secretion,

insulin action or both. Chronic hyperglycemia in diabetes associated with long-term damage, dysfunction or

failure of multiple organs, especially the eyes, kidneys, nerves, heart, and blood vessels. 1 WHO defines diabetes

based on laboratory examination with a glucose concentration of more than 7.8 mmol / l (126 mg / dl) after fasting

or more than 11.1 mmol / l (200 mg / dl) two hours after carbohydrate diet or two hours after diet equivalent to 75

g glucose. 2

World Heatlh Organization (WHO) reported that there were 347 million people worldwide are diagnosed with

diabetes. The prevalence of diabetes in the world is estimated at about 6.4% in 2010 and is predicted to rise to

7.7% in 2030. Most of the increase in prevalence in developing countries. 3

DM causes disturbances in the metabolism of carbohydrates, proteins, and fats caused by insufficiency

atauresistensi secretion of insulin, and / or keduanya.Hal this be the reason why oral medication and injections in

recent decades has not behasil troubleshooting DM. Various drugs only react to some parts of the pathogenic

process. For example, a sulfonylurea antidiabetic drugs to stimulate insulin secretion from pancreatic cells or by

reducing hepatic clearance of the hormone can not be the only drug for the treatment of type 2 diabetes mellitus

who are not only related etiology cell function pancreas. 3

Treatment with insulin injections and oral medications for men gobati DM is not only expensive, but long-

term use can lead to various complications. Several species of wild plants has demonstrated its effectiveness,

non-toxic, and has substances that can treat diabetes. In Africa, some plants have been studied as Anacadium

occidental, Congronema latifolium, Vernonia amygdalina, and others shown to lower blood glucose levels in

diabetes. This is because the effectiveness, side effects are minimal, and relatively inexpensive. 4

African tea leaf (Vernonia amigdalina) has a height of about 2-5m. The plant is cultivated in Nigeria as a

vegetable. This plant is very useful for etnoterapi diabetes, asthma, skistostomiasis, malaria, diarrhea,

tuberculosis, abdominal pain, fever, and cough. 5 The plant is not so popular in Indonesia. Most people know the

efficacy of this leaf eat them with boiled and engulfed as vegetables. 6 Vernonia amygdalina have

antihiperglikemia effect, antihiperlipidemia, and protection of the kidney in mice diabetes because it can increase

insulin secretion from the cell pankrea s and carbohydrate transfer mechanism in the network. Phytochemical

substances contained in extracts of Vernonia amygdalina are flavonoids, saponins, polyphenols

and tannins. 3 flavonoids and polyphenols known as a good antioxidant. Vitamin A, C, and vitamin E is most found

in the extract act as protective cells and tissues in the degenerative process of diabetes mellitus. Saponins,

sterols, glycosida, tannins and flavonoids Sintes is potentially induces an increase in insulin. 8

METHOD

This type of research that will be done is research using randomized designs Pre and Post Test Control

Group Design to find a picture of blood glucose levels in mice induced DM alloxan. Maintenance, alloxan injection
performed in the laboratory of Pharmacy STIKES Minang. Extracting leaves of Vernonia amygdalina done in the

laboratory Kopertis integrated, Padang in January 2016. The study population was white

mice (Mus musculus) male. Samples were as many as 15 mice were divided into 3 groups: negative control

group (K1), a group of mice induced alloxan (K2), and a group of mice induced by alloxan and extracts

of Vernonia amygdalina l. The sampling was based on inclusion and exclusion criteria.The inclusion criteria of

this study are male mice of 6-7 weeks old and weighing 20-30 grams and no anatomic defects or illness, while an

exclusion criterion in this study were dead or diseased mice.

The data obtained are grouped into a frequency distribution tables and table relationships

between groups of mice K1, K2, and P. Data were analyzed using T test and One Way Anova Test with a degree

of confidence 9 5%. Hypothesis was accepted if p <0.05.

RESULTS

Information: K1 = Control mice

K2 = Mice induced alloxan
P = Mice diikduksi alloxan + extract VA

Figure 1. Graph of blood sugar levels

The mean fasting blood glucose levels of three groups of mice at the end of the acclimatization worth

normal, whereas after five days there is an increasing alloxan induced exceeds the value noemal (> 126mg / dl)

in the group K2 and P. At the end of the experiment a significant increase in the K2 group, while the group P

decreased mean fasting blood glucose levels after 10 days treated with extract of Vernonia amygdalina.

Table 1. The results of the comparability test analysis Effect of treatment at the end of acclimation
K1 (mg / K2 (mg / P (mg /

dl) dl) Mean dl) Mean

Mean SD SD significance
 SD

80.40 63.4 84.20

Average 15 323 18.370 24.682 0.382

Test one final GDP wayanova acclimatization. Test post-hoc LSD: K1 K2 vs. p = 0, 0.182; K1 vs P p = 0, 649; K2 vs. P p =
0, 360

Comparability test aimed to compare the mean glucose levels between groups of mice. The results of

the analysis of significance using One Way Anova at the end of acclimation mice gained significant difference (p>

0.05), namely with significant value of 0, 382.

Table 2. Table 2 Results of the analysis of the comparability test Influence Treatment After Induction

K1 (mg K2 (mg P (mg /

/ dl) / dl) dl)

Mean Mean Mean

SD SD SD significance

80.60 152.20 175.00

Average 23.384 15.304 44.435 0,001

Test one wayanova GDP after alloxan induction. Test post-hoc LSD: K1 K2 vs. p = 0.003; K1 vs P p = 0, 000; K2 vs. P p = 0,

198

Analysis of treatment effect was tested by the mean blood glucose levels between groups after alloxan

induced.The results of the analysis of significance using One Way ANOVA showed that p = 0.00 1. This means

that the averageblood glucose levels in all three groups after treatment given significantly different (p <0.05). The

results of post-hoct LSDtest showed a significant difference (P <0.05) in the negative control group (K1) with

control positive (K2) and a negative control (K1) with treatment (P). This is because the increase in blood glucose

levels were significant in the positive control group (K2) and treatment (P) after induction of alloxan 150mg / kg.

Table 3. The results of test analysis comparability Influence

Treatment At the end of the experiment

K1

(mg / K2 (mg / P (mg /

dl) dl) dl)

Mean Mean Mean

SD SD SD significance

Average 76.60

435.80 100.80

8.295 139.820 5.975 0,000

Test one wayanova GDP at the end of the study. Test post-hoc LSD: K1 K2 vs. p = 0.000; K1 vs P p = 0.648; K2 vs. P p = 0,
000
 Analysis of treatment effect was tested by the mean blood glucose levels between the groups after

being given treatment. The results of the analysis of significance using One Way ANOVA showed that p =

0.000. The results of post-hoct LSD test showed a significant difference (P <0.05) in the negative control group

(K1) with the positive control (K2). It is because the increase in blood glucose levels in the positive control group

(K2) again experienced an increase in blood glucose levels at the end of the experiment. However, a significant

difference (P> 0.05) are in the negative control group (K1) to the treatment group (P) due to blood glucose

treatment groups (P) returned to normal after being fed extracts of Vernonia amygdalina 200mg / kg 2 times a

day ,

DISCUSSION

Gluoksa levels of fasting blood at the end of the acclimatization valuable group of mice a normal

(<126mg / dl). These results are consistent with research from the American Diabetes Association in 2011 that

normal blood glucose levels, ie <126mg / dl for fasting glucose and <200mg / dl for random blood glucose levels.

Insulin acts as a hormone effective to store glucose in cells in normal people. Additionally receptors

such as GLUT 1, GLUT 2, GLUT 3, and GLUT 4 was also instrumental in the process of storage of glucose in

cells that are not downloading imbulkan conditions of hyperglycemia. 9

Fasting blood glucose levels in the positive control group (K2) and treatment (P) 5 days after induction

of alloxan 150mg / kg single doses increased> 126mg / dl.

Alloxan has been used as a substance that can cause the condition of diabetes in experimental

animals. Alloksan can be given intravenously, intraperitoneal, and intramuscular. The usual dose is used for

inducing in intr aperitoneal is 150mg / kg dose. Alloksan cause pancreatic cell damage through the activation

reaction of reactive oxygen species (ROS), Fenton reaction, and the reaction of insulin and related K + ATPase. 10

Alloxan reacts by damaging substance esensia l in the beta cells of the pancreas that causes a carrier

granules of insulin is reduced. Alloxan increase the release of insulin from the pancreatic beta cells but had no

effect on the secretion glukogon. This effect is specific to pancreatic beta cells so that alloxan with high

concentrations has no effect on other networks. Alloxan diabetogenic effect by urging kerusaakn beta cell

membrane by increasing permeabititas. 11

However, a different result was found by some researchers that tid ak all experimental animals have

elevated levels of blood glucose. A decrease in blood glucose levels in animals induced alloxan can occur due to

pancreatic cells have the ability to regenerate. Age and animal immunity and alloxan dose also affects the

pancreatic cell damage.Alloxan can also damage the kidneys resulting in failure of the filtration tubules of

glucose so that the glucose out memalui urine and blood glucose levels to be down. 12

Blood glucose levels at the end of perc obaan shows the results of a negative control (K1) is worth the

normal, positive control increased blood glucose levels significantly, while the treatment group (P) which has

been given extracts of Vernonia amygdalina 200mg / kg 2 times a day had decreased glucose levels blood.
 Vernonia amygdalina contains many minerals such as phosphorus, calcium, potassium,

magnesium, zinc, iron, and vitamins (A, C, and E). Phytochemical the greatest role as antihipergikemi is

flavonoids, polyphenols, farmer n, alkaloids, glycosides, isoflavones, cholinergic acid, and safonin. Chronic

exposure of cells against oxidative substances (ROS) of alloxan resulted in pancreatic cell destruction and

inhibits regeneration of pancreatic cells resulting in elevated blood sugar levels. Flavonoids serves to inhibit the

activity or improved its mendeaktivasi ROS and regeneration of pancreatic cells. These substances not only

play a role in pancreatic cells but also on the network associated with diabetes complications. polyphenols

inhibit the function mekanise glucose uptake in the intestine and peripheral jarigan that activate the enzyme

alpha-glucosidase, G6Pase inhibit liverenzymes, increased expression of GLUT 4, and modulate the expression

of GLUT 2 in pancreatic cells. These substances can also inhibit alpha-amylase, sucrase, which is working on

a sodium glucose transporter (GLUT-1-S) in the brush border of intestinal cells. Isoflavones, tannins, acids

cholinergic, alkaloids, glycosides, and safonin also found by researchers in the role of the enzyme inhibitors on S-

GLUT-1. 2

Based on histopathological picture, the pancreatic beta cells in mice induced alloxan alone and mice

induced by alloxan and extracts of Vernonia amygdalina showed that pancreatic beta cells of mice induced by

alloxan just undergone degeneration. There are areas of necrotic cells undergo sclerosis on. In the

histopathology of pancreatic beta cells in mice diindukis alloxan and given extracts of Vernonia amygdalina there

are many areas of cell proliferation, meaning the pancreatic beta cells to regenerate. 7

The results differ by Akinola, et al in 2009 said that the Vernonia extract amygdalina not have anti-

hyperglycemic effect on the first 3 weeks of the experiment. After 3 weeks, fasting blood glucose levels in mice

decreased until reaching normal. The study was conducted for 7 weeks at a dose of 400mg bw / d. This happens

because of the effects of streptozocin y ang cause necrosis strong effect on pancreatic cells and thus require a

longer treatment time. This study also used the normal mice were given extracts of Vernonia amygdalina 400mg

bw / d and found that the extract can lower blood glucose kada r in normal mice since the beginning of the

study. This is because bioaviabilitas Vernonia amygdalina against pancreatic normal mice better than DM mice. 13

Research by Ekam, et al in 2013 doing research with Vernonia amygdalina dose of 100mg / kg and

200mg / kg body weight of the mice for 14 days with a variety of different types of solvents. The results showed

that both doses with alcohol solvent capable of lowering blood glucose levels mainly dose of 200mg / kg, but

each dose was not able to lower blood glucose levels to normal. However, better results contained in the extract

obtained by solvent benzene and blood glucose levels were normal at the end of the study. 14

Research by Happy, et al in 2014 doing research with extracts of Vernonia amygdalina dose of 100 mg /

kg per day for 14 days. The results showed that there is no decline in blood glucose levels were significantly (P>

0.05) on the first day until the seventh day of the study. The eighth day until the end of the study there is a
decrease in blood glucose levels were significantly (P <0.05) in mice DM. This is because the dose of 100mg / kg

body weight per day is not enough to lower blood glucose levels more quickly 7. 15

CONCLUSION

P emberian extract Vernonia amygdalina could lower content glucose blood fasting in significant on mice DM.