Effect of Puguntano Extract (Curanga Fel-Terrae Merr.) on hs-CRP Level in Newly Diagnosed Type 2 Diabetes Mellitus Patient

Hartono Apriliasta Purba, Santi Syafril, Dharma Lindarto


BACKGROUND: Inflammation is one of the factors that associated with insulin resistance which causes type 2 diabetes mellitus (T2DM). Inflammation can be measured by using high sensitivity C-reactive protein (hs-CRP), a quantitative measurement of CRP concentration. Puguntano is a plant that traditionally used for antidiabetic treatment found in North Sumatera. The objective of this study is to know the effect of Puguntano extract on hs-CRP level in newly diagnosed T2DM patient.

METHODS: The study was a randomized controlled clinical trial on 24 newly diagnosed T2DM patients. Subjects were divided into 2 groups. The first group was given Puguntano extract with starting doses at 100 mg daily, then the dose was increased in titration up to a maximum dose of 2x100 mg daily depending on blood sugar level monitoring. Meanwhile, the other group (which serves as a control group) was given metformin with starting doses at 500 mg daily, then the dose was increased in titration up to a maximum dose of 3x500 mg per day depending on blood sugar level monitoring. The hs-CRP and HbA1c are assessed at the baseline and after 12 weeks of treatment.

RESULTS: The hs-CRP level was decreased in Puguntano group by 1.41 (-7.54-0.52) (p=0.06) and decrease by 0.58 (-7.86-33.41) (p=0.695) in metformin group. There was no difference in hs-CRP level between the two groups (p=0.630).

CONCLUSION: Puguntano extract showed the effect of lowering HbA1C and hs-CRP level in T2DM patients, although it was not statistically significant.

KEYWORDS: type 2 diabetes mellitus, hs-CRP, puguntano

Full Text:



Donath MY, Schumann DM, Faulenbach M, Ellingsgaard H, Perren A, Ehses JA. Islet inflammation in type 2 diabetes: from metabolic stress to therapy. Diabetes Care. 2008; 31(Suppl 2): S161-4, CrossRef.

Hotamisligil GS, Erbay E. Nutrient sensing and inflammation in metabolic diseases. Nat Rev Immunol. 2008; 8: 923-34, CrossRef.

Ehses JA, Ellingsgaard H, Böni-Schnetzler M, Donath MY. Pancreatic islet inflammation in type 2 diabetes: From α and β cell compensation to dysfunction. Arch Physiol Biochem. 2009; 115: 240-7, CrossRef.

Handojo I. Imunoasai Terapan pada Beberapa Penyakit Infeksi. Surabaya: Airlangga University Press; 2004.

Pickup JC. Inflammation and activated innate immunity in the pathogenesis of type 2 diabetes. Diabetes Care. 2004; 27: 813-23, CrossRef.

Laaksonen DE, Niskanen L, Myyssonen K, Punnonen K, Tuomainen TP, Valkonen VP,et al. C-reactive protein and the development of the metabolic syndrome and diabetes in middle-aged men. Diabetologia. 2004; 47: 1403-10, CrossRef.

Juwita NA. Karakterisasi Simplisia dan Uji Efek Antiinflamasi Ekstrak Etanol Daun Puguntanoh (Curanga fel-terrae Merr.) terhadap Mencit Jantan. Medan: Fakultas Farmasi Universitas Sumatera Utara; 2009.

Harfina F, Bahri S, Saragih A. Pengaruh Serbuk Daun Puguntano (Curanga fel terrae Merr.) Pada Pasien Diabetes Melitus. J Pharm Pharmacol. 2012; 1: 112-8, article.

Depkes RI. Inventaris Tanaman Obat Indonesia (I). Cetakan Pertama. Jakarta: Departemen Kesehatan RI 2000.

Sitorus P, Harahap U, Pandapotan M, Barus T. Isolation of β-sitosterol from n-hexane extract of Picria fel-terrae Lour. Leave and study of its antidiabetic effect in alloxan induced diabetic Mice. Int J PharmTech Res. 2014; 6: 137-41, article.

Akash MS, Rehman K, Chen S. Role of inflammatory mechanisms in pathogenesis of type 2 diabetes mellitus. J Cell Biochem. 2013; 114: 525-31, CrossRef.

Abdulkadir AAA, Thanoon IAJ. Comparative effects of glibenclamide and metformin on C-reactive protein and oxidant -antioxidant status in patients with type II diabetes Mellitus. Sultan Qaboos Univ Med J. 2012; 12: 55-61, CrossRef.

De Jager J, Kooy A, Lehert P, Bets D, Wulffelé MG, Teerlink T, et al. Effects of short-term treatment with metformin on markers of endothelial function and inflammatory activity in type 2 diabetes mellitus: a randomized, placebo-controlled trial. J Intern Med. 2005; 257: 100-9, CrossRef.

Harahap U, Patilaya P, Mariane, Yuliasmi S, Husori Di, Prasetyo BE, et al. Profil fitokimia ekstrak etanol daun puguntano [curanga fel-terrae (merr.) lour.] yang berpotensi sebagai antiasma. Seminar Nasional Sains & Teknologi V Lembaga Penelitian Universitas Lampung. 2013; (n.v): 422-6, article.

American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2015; 38 (Suppl 1): S1-93, CrossRef.

Perkeni (The Indonesian Society of Endocrinology). Konsensus Diagnosis Dan Penatalaksanaan Diabetes Mellitus. Jakarta: Balai Penerbit; 2015.

Chakraborty A, Chowdhury S, Bhattacharyya M. Effect of metformin on oxidative stress, nitrosative stress and inflammatory biomarkers in type 2 diabetes patients. Diabetes Res Clin Pract. 2011; 93: 56-62, CrossRef.

Pradhan AD, Everett BM, Cook NR, Rifai N, Ridker PM. Effects of initiating insulin and metformin on glycemic control and inflammatory biomarkers among patients with type 2 diabetes: The LANCET randomized trial. JAMA. 2009; 302: 1186-94, CrossRef.

DOI: https://doi.org/10.18585/inabj.v10i1.362

Indexed by:






The Prodia Education and Research Institute