Endocrine Abstracts

Introduction: Moringa oleifera (MO) (also known as ‘drumstick’) is a tree belonging to the family Moringaceae, genus Moringa, originally native from the Himalayans but currently cultivated in many tropical and subtropical regions around the world. It has been used as a food source and for traditional medicine purposes due to possible antihyperglycemic, antioxidant, anti-inflammatory, and lipid regulating properties, and have been reported earlier by different scientific groups using animal models.

Case Report: 44 year old patient, chronic haemoldialysis since 2017 for nephropathy of undetermined aetiology. Has been reporting hypoglycemia at 0.4 g/l for 3 months, with no disturbance of consciousness. His history includes regular intake of moringa leaves, coinciding with the onset of hypoglycemia. The Hypoglycemia assessment was negative, and the abdomino-pelvic CT scan did not reveal a pancreatic mass. The evolution was marked by the disappearance of hypoglycemia after moringa was stopped.

Discussion and Conclusion: The tree Moringa oleifera (MO) MO has been used in traditional medicine for the treatment of various conditions and, more recently, has been proposed to be of benefit in numerous diseases including cardiovascular, diabetes, cancer, neurological, gastroenterological, and inflammatory. MO aqueous leaf extract has been shown to inhibit the activity of α-glucosidase, pancreatic α-amylase, and intestinal sucrose, contributing to antihyperglycemic properties. These inhibitory effects are possible thanks to phenols, flavonoids, and tannins present in MO. A delay in carbohydrate digestion, caused by the inhibition of these enzymes, leads to a reduction in post-prandial hyperglycemia and hemoglobin A1C (HbA1C). These inhibitory effects of flavonoids, including quercetin and kaempferol, have been biochemically explained due to an increase in the number of hydroxyl groups on the B ring, and to the presence of a 2,3-double bond. In addition, these compounds have been studied regarding protective and regenerative properties on pancreatic beta-cells, augmenting insulin production and release. However, the hypoglycemic effects of MO on humans are not as clear given the scarce number of human studies, together with a diverse range of methodologies and MO doses. Therefore, more structured studies are needed to clarify if MO has an effect on insulin levels or activity.