Journal of Ethnopharmacology 102 (2005) 202–207 Psyllium decreased serum glucose and glycosylated hemoglobin significantly in diabetic outpatients Seyed Ali Ziai a,∗ , Bagher Larijani b , Shahin Akhoondzadeh a , Hossein Fakhrzadeh b , Arezoo Dastpak a , Fatemeh Bandarian b , Afsaneh Rezai a , Hassanali Naghdi Badi c , Tara Emami d a Department of Pharmacology, Institute of Medicinal Plants, ACECR, No. 97 Bozorgmehr Street, Qods Street, Enghelab Avenue, P.O. Box 13145-1446, Tehran, Iran b Endocrinology & Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran c Department of Cultivation & Development, Institute of Medicinal Plants, ACECR, and Tarbiat Modarres University, Tehran, Iran d Department of Biotechnology, Razi Institute, Karaj, Iran Received 8 October 2004; received in revised form 12 May 2005; accepted 7 June 2005 Available online 8 September 2005 Abstract Psyllium is a bulk-forming laxative and is high in both fiber and mucilage. The beneficial effect of dietary fiber in the management of type II diabetes, has not been totally demonstrated. The purpose of this study was to determine the plasma-lowering effects of 5.1 g b.i.d. of psyllium husk fiber, as an adjunct to dietary and drug therapy on lipid and glucose levels, in patients with type II diabetes. Patients were randomly selected from an outpatient clinic of primary care to participate in a double-blind placebo-controlled study in which Plantago ovata Forsk., or placebo was given in combination with their anti-diabetic drugs. Forty-nine subjects were included in the study that were given diet counseling before the study and then followed for 8 weeks in the treatment period. Fasting plasma glucose (FBS) was measured every 2 weeks, and total plasma cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglyceride (TG), and insulin levels were measured every 4 weeks. Glycosylated hemoglobin (HbA1c) was also measured at the beginning and ending of the study. The test products (psyllium or placebo) were supplied to subjects in identically labeled foil packets containing a 5.1 g dose of product, to consume two doses per day, half an hour before breakfast and dinner. Both products were well tolerated, with no serious adverse events related to treatment was reported in either. Better gastric tolerance to metformin was recorded in the psyllium group. FBS, and HbA1c, showed a significant reduction (p < 0.05), whereas HDL-C increased significantly (p < 0.05) following psyllium treatment. LDL/HDL ratio was significantly decreased (p < 0.05). Our results show that 5.1 g b.i.d. of psyllium for persons with type II diabetes is safe, well tolerated, and improves glycemic control. © 2005 Elsevier Ireland Ltd. All rights reserved. Keywords: Blood glucose; Cholesterol; Clinical trial; Diabetes mellitus; HbA1c; Plantago ovata Forsk; Triglycerides 1. Introduction Psyllium seeds from the Plantago ovata Forsk., belong to the plantaginaceae family, contain 10–30% mucilage. Psyllium is a common ingredient in over-the-counter bulk laxative products (Leung and Foster, 1996). Numerous double-blind trials have found that supplementation with ∗ Corresponding author. Fax: +98 21 6465554. E-mail address: saziai@gmail.com (S.A. Ziai). Plantago psyllium can lower total cholesterol (TC), and LDL-C (Anderson et al., 2000). Levels of HDL-C were shown to increase by psyllium supplementation (Oson et al., 1997). The cholesterol-lowering effect of psyllium has been reported in children (Davidson et al., 1996), as well as in adults (Florholmen et al., 1982). Psyllium supplementation has also improved blood sugar levels in some people with diabetes (Florholmen et al., 1982; Rodriguez-Moran et al., 1998; Anderson et al., 1999). The soluble fiber component of psyllium is believed to account for this effect. The 0378-8741/$ – see front matter © 2005 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.jep.2005.06.042