Antidiabetic Property: (Azadirachta indica, Trigonella foenum graceum, Phyllantus emblica, Syzygium cumini, Rotula aquatica, Curcuma longa, Terminalia chebula).
The risk of complications in patients with type 2 diabetes is strongly associated with hyperglycemia. Any reduction in HbA1c is likely to reduce the risk of complications. Patients with HbA1c values in the normal range have the lowest risk.
A dramatic decrease in the risk of complications for each 1% reduction in mean HbA1c is as follows: 21% reduction in any end-point related to diabetes, 21% in deaths related to diabetes, 21% in all cause mortality, 37% in microvascular complications, 43% in amputations and death from peripheral vascular disease, 14% in MI, 12% in stroke and 16% in heart failure.
The 7 herbs possess hypoglcemic and antihyperglycemic activity. They produce hyperglycemia by targeting the gut, liver and the pancreas. The modes of action of Cogent db+ are as follows: Controls blood glucose levels by increasing glycolysis and decreasing gluconeogenesis with a lower demand of pancreatic insulin and this is achieved by regulating the activity of hepatic glucose metabolic enzymes.
Causes hypoglycemia by stimulating insulin release or synthesis from the pancreatic β-cells (insulin secretagogues).
Increasing sensitivity of tissues to available insulin.
Decreases insulin resistance.
Inhibits glucose transport-blood modulating effect due mainly to delayed gastric emptying with direct interference with intestinal glucose absorption.
The soluble dietary fiber decreases absorption of glucose by slowing transit time in the gut (reduces blood glucose, HbA1c and glycosylated hemoglobin).
Acts by improving the ability of the body's tissue to absorb glucose thus enhancing the effectiveness of insulin.
Normalizes the glycated hemoglobin and HbA1c within a 3-month period thereby reducing the risk associated with hyperglycemia, cardiovascular complications, kidney failure, blindness and amputation.
Anti-inflammatory Effect: (Azadirachta indica, Trigonella foenum graceum, Terminalia chebula, Curcuma longa, Tribulus terrestris).
Inflammation plays a pivotal role in the development of type 2 diabetes. The other factor is the immune system. Investigators have concluded in recent years that heart disease and type 2 diabetes may be linked to inflammation. Inflammation in blood vessels might slow the passage of insulin to the liver, muscles and other tissues. It could also interfere with insulin's effectiveness in lowering blood glucose levels. Increased inflammation associated with endothelial and platelet activation in patients with type 2 diabetes may play a role in vascular dysfunction.
The 5 herbs in Cogent db+, while restoring normoglycemia, ensure the control of diabetic symptoms and reduction of microangiopathic complications. There are other complications associated with Diabetes that trigger inflammatory responses.
Exerts its anti-inflammatory activity by inhibition of a number of different molecules that play a role in inflammation -leukotrienes, phospholipase, thromboxane, prostaglandins, nitric oxide, collagenase, elastase, hyaluronidase, monocytes chemoattractant protein-1 (MCR-1), interferon inducible protein, tumor necrosis factor and interleukin 12 (IL-12).
Contains anti-inflammatory ingredients which are potent inhibitors of cyclooxygenase (COX-2) and lipoxygenase. Limits the activity of 2 enzymes that are involved in promoting and maintaining inflammation.
The oxidation of low-density lipoproteins (LDL) plays an important role in the development of atherosclerosis. Inhibition of plasma and LDL-lipid, plasma tocopherol, plasma retinol LDL, TBARS, LDL lipid peroxidases.
Stabilizes the serum levels of liver enzymes eg, aspartate transaminase, alanine transaminase, alkaline phosphatase, acid phosphatase, glutamate oxaloacetate transaminase, glutamate pyruvate transaminase, serum aspartate aminotransferase (AST), alanine aminotransferase ALT, etc.
Inhibits or lowers platelet aggregation.
Decreases total serum cholesterol and triglycerides and increases HDL cholesterol.
Recruitment of leukocytes by endothelial cells and their subsequent migration from the vasculature into the tissues play a major role in inflammation. NF-kappa B- plays a role in the suppression of expression of adhesion molecules in endothelial cells. Leukocytes recruitment is inhibited.
Inhibits angiogenesis by preventing proliferation and migration of endothelial cells.
Inhibits inducible nitric oxide synthesis by decreasing iNOS proteins and iNOS mRNA level. The inhibition of inducible nitric oxide synthesis might contribute to anti-inflammatory activities.
Decreases the effect of inflammatory cytokine release.
Antioxidant Activity: (Phyllanthus emblica, Trigonella foenum graceum, Terminalia chebula, Curcuma longa, Terminalia bellerica).
Free radicals, also known as reactive oxygen species, play a role in the etiology of several major diseases including atherosclerosis and diabetes. There is increased oxidative stress in combination with reduced antioxidant status; this results in greater vulnerability to the damaging effects of free radicals. Oxygen free radical activity can initiate peroxidation of lipids, which in turn stimulates glycation of protein, inactivation of enzymes and alterations in the structure and function of collagel and basement and other membranes. These processes appear to promote the long-term complications of diabetes eg, atherosclerosis and neuropathy.
The 5 herbs in Cogent db+ possess potential antioxidant activity.
Increase the number and activity of free-radical-destroying enzymes, like superoxide dismutase, catalase and glutathione peroxidase; prevent and remove oxidized cholesterol thereby preventing heart attacks.
Prevent and inhibit lipid peroxidation and antioxidant status and scavenge hydroxyl and super-oxide radicals. Lipid peroxidation is increased in diabetic state-preventing oxidation stress in heart and erythrocytes.
Potent antioxidant, potent agent for scavenging nitric oxide and regulation of pathological conditions caused by excessive generation of nitric oxide and its oxidation product peroxynitrite.
Prevent or decrease oxidative stress/suppress Reactive Oxygen Species (ROS).
Rejuvenation Property of Destroyed Tissues and Cells: (Phyllanthus emblica, Tribulus terrestris, Terminalia chebula, Azadirachta indica, Terminalia bellerica).
Rejuvenation, in Ayurveda, is termed Rasayana. Rasayana herbs have a toning and rejuvenating effect on the digestive system, nervous system and various internal organs like the adrenals and pancreas. The Rasayana herb helps to nourish blood, lymph, muscles, adipose tissue and semen; prevent degenerative changes; and improve metabolic processes. They also invigorate the body in general by sustaining the required balance between anabolism and catabolism. The rejuvenative herbs aim at keeping the enzymes in the tissue cells in their normal functioning conditions. These cells are revitalized and their composition is changed.
The 5 herbs in Cogent db+ act by regenerating the pancreatic islet cells both quantitatively and qualitatively- stimulating the production of insulin - thereby restoring the normal blood glucose levels.
Blood Purificatory Activity: (Azadirachta indica, Curcuma longa, Terminalia chebula, Rotula aquatica).
The major irritants in diabetic individuals are the accumulation of toxins and metabolic by-products which are responsible for the many side effects and serious pathological changes seen in various organs. The cholesterol, triglyceride levels in the blood and serum levels in the liver are elevated and destabilized. Blood is thickened and affects the blood pressure. Cells and tissues in various parts of the body become devoid of energy.
The 4 herbs in Cogent db+ contain very powerful blood purifiers and detoxifiers. They clear the toxins involved in most of the inflammatory processes. These herbs contain alkaloids, which are liver-protective and regenerative. They help to eliminate the accumulated toxins. They alter the existing nutritive and excretory processes, gradually restoring the normal body functions.
Boosting the Immune System Activity: (Phyllanthus emblica, Terminalia chebula, Terminalia bellerica)- Triphala.
The immune system is responsible for protecting the body against bacteria, viruses and other organisms. It creates antibodies which react to specific foreign agents. Scientists believe that the fundamental cause of type 2 diabetes is related to the immune system. The mechanism of the immune system is its ability to eliminate pathogen before they cause disease. In diabetes mellitus, the immune system becomes depressed and this leads to vulnerability to most pathogenic organisms.
The herbs in Cogent db+ help to fight infection by strengthening the immune system.
Enhance natural killer cell activity and antibody-dependent cytotoxicity.
Cytoprotective and immunomodulatory properties.
Promote health, immunity and longevity; strengthen all the tissues of the body and prevent disease.
Decrease phagocytosis and γ-interferon (γ-IFN) production.
Inhibition of Aldose Reductase: (Phyllanthus emblica, Terminalia chebula, Syzygium cumini, Curcuma longa, Trigonella foenum graceum, Tribulus terrestris, Azadirachta indica).
Considerable evidence suggests that products of aldose reductase, the 1st enzyme of the polyol pathway, may represent a biochemical link between hyperglycemia and diabetic complication in the eye and other major organ systems. Inhibition of aldose reductase provides a therapeutically rational means to delay the onset of progression of diabetic complication.
The 7 herbs inhibit the Aldose reductase enzyme and prevent the formation of cataract, a late complication of diabetic retinopathy and also peripheral neuropathy.
Sexual Dysfunction (A neglected complication): (Tribulus terrestris, Phyllanthus emblica).
Erectile dysfunction (ED) is common in men with diabetes. Diabetic men are 3 times as likely to develop ED as non-diabetic men. The cause is multi-factorial but most commonly reflects endothelial dysfunction and autonomic neuropathy. Female sexual dysfunction (FSD) is more difficult to define and a specific study in diabetics is limited. Problems of arousal, lubrication and orgasmic dysfunction occur.
Erectile dysfunction and low sexual interest attributed to diabetes can arise due to lowered testosterone production. Research has shown that Tribulus terrestris contains 3 groups of active phytochemicals eg, dioscin, protodioscin and diosgenin. These substances have an effect on sexual performance and may treat various sexual disorders.
They regulate sexual energy level and strength by increasing the percentage of free testosterone level for men, and they also affect pregnenolone, progesterone and estrogen.
The hormone-balancing effects of Tribulus terrestris make this herb suitable for premenstrual and menopausal syndrome in women. Tribulus terrestris increased the concentration of hormones, including estradiol, with testosterone being very slightly influenced, thereby improving reproduction function, libido and ovulation.
Phyllanthus emblica increases blood flow to the genitals to improve sexual function and the power of an erection.
Clinical Studies: See table.
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