Background
An epidemic of diabetes threatens the health of a large number of individuals in developed and developing countries alike [1]. Recent data from the USA indicate that the prevalence of prediabetes is 34.6 %, impaired fasting glucose (IFG) is 19.4 %, impaired glucose tolerance (IGT) is 5.4 % and that of IFG and IGT is 9.8 % in the adult population [2]. The epidemic of prediabetes is likely to compound the existing diabetes crisis as many individuals with IGT will develop type 2 diabetes mellitus (T2DM) in the future. It is estimated that approximately 316 million people worldwide are with IGT and this is predicted to rise to 471 million by 2035. According to the estimates of International Diabetes Federation (IDF) in 2013, India alone has 65.1 million people living with diabetes; this places India second to China [3]. Plants provide an excellent source of drugs and a large proportion of currently-available drugs have been either derived directly or indirectly from plant sources. Present literature suggests the existence of more than 800 plants that may possess hypoglycemic activity [4]. The use of medicinal plants in most developing countries, as a normative basis for the maintenance of good health, has been observed extensively. There is a growing global interest in herbal and other forms of traditional medicine [5].
An effective strategy to restrict global impacts of T2DM is by limiting the number of prediabetics [6]. It’s our focus to identify new effective therapeutic agents, with relatively low cost and low toxicity that can be used regularly to control a progression of T2DM in the prediabetic population. Thus, dietary supplements that can modulate glucose homeostasis and potentially improve lipid parameters would be desirable. Although numerous herbs are reported to possess antidiabetic activity, a significant amount of research and traditional usage suggests that Fenugreek seeds (Trigonella foenumgraecum) are among the best in terms of safety and efficacy [7]. Seeds of Fenugreek are a rich source of fiber and have multiple benefits in patients with diabetes [8]. Research in the past two decades has shown that Fenugreek seeds help to lower blood glucose in patients with diabetes. Its role as an antidiabetic, by reducing fasting blood glucose levels and improved glucose tolerance in human subjects was reported [9]. Fenugreek is currently available as a nutraceutical with claims to reduce hyperglycemia [10].
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Patients, who already manifest abnormalities of glucose handling, could benefit from a low-risk, inexpensive, food-based intervention aimed at normalizing their metabolic milieu. From the literature it is observed that Fenugreek is a dietary supplement that may hold promise in this regard. Though the hypoglycemic and hypolipidemic effects of Fenugreek were evaluated in animal and human models with T2DM [11], no study has been reported in prediabetics. The present study assesses the ability of Fenugreek to prevent T2DM in prediabetics having IGT/IFG. The objective of present study is to determine whether Fenugreek can prevent the outcome of T2DM in non diabetic people with prediabetes. If pharmacotherapy for prediabetes is initiated, it is important to realize that any therapy will require a long-term commitment by both subject and provider. In addition, it is important to review with the patient that there are limited data demonstrating the long-term health benefits of pharmacological intervention compared with lifestyle intervention [12]. Therefore the present Fenugreek interventional study was carried out for a period of 3 years.
