The advantages and disadvantages of a 'herbal' medicine in a patient with diabetes mellitus: a case report.
BACKGROUND
Patient-initiated alternative treatments in the management of chronic conditions are common and increasing in the United Kingdom. To date, there have been no reports of herbal medicine use alone in the management of diabetes mellitus. We report here the case of a man who attained excellent glycaemic control using a 'herbal' medicine and reveal how important it was to identify the products of active constituents.


METHODS
A 48-year-old man attending our clinic in Tooting, South London with known Type 2 diabetes, with evidence of both micro- and macro-vascular diabetes-related complications, was poorly controlled despite a drug regimen consisting of oral metformin and twice daily insulin. He went to India for at least 1 year and on returning to the clinic had excellent glycaemic control off all diabetic medication. While away he had started himself on a regimen of three different 'herbal' balls. Samples of blood were found to contain chlorpropamide in a therapeutic concentration; chlorpropamide was also found in one of the balls. He has been counselled on the potential risks associated with chlorpropamide and his treatment reverted to a more conventional treatment regimen.


CONCLUSIONS
General practitioners and hospital physicians should be alert to those patients returning from abroad on effective 'herbal' medications that these may in fact contain an active ingredient.
Wood
D M
DM
Pharmacology and Clinical Pharmacology, Department of Basic Medical Sciences, St George's Hospital Medical School, London, UK.
Athwal
S
S
Panahloo
A
A
D002747:Chlorpropamide / Q000009:adverse effects / Q000627:therapeutic use*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy*; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D008517:Phytotherapy / Q000379:methods; D028321:Plant Preparations / Q000627:therapeutic use*; D016896:Treatment Outcome
D007004:Hypoglycemic Agents; D028321:Plant Preparations; D002747:Chlorpropamide