Having determined her haemoglobin, I did a test to determine her glucose handling capability through glycated haemoglobin or HbA1c. Sure enough the level was at the limit of 6.5%, indicating that she is experiencing an impaired glucose tolerance state. Having explained to her about the condition she is now facing, she has asked that she be put on a diet to control her sugar intake. After two months the fasting sugar level had slightly decreased. She was encouraged.
On the fourth month, the sugar level seemed to have stabilised but still at the impaired tolerance level but I noticed her pulse rate had gone down to 54 beats per minute. She also admitted of being increasingly tired and listless. Her blood pressure was, however, normal.
From my experience with patients when there is a decrease in pulse rate to this level what we term as bradycardia (Pulse rate lower than 60 beats per minute ), the patient must have taken something which is cardioactive (affecting the heart) like some drug or foods containing such agents.
The lady denied taking anything besides the medication for her hypertension. I was not satisfied and kept gently asking her to think of what she had been taking the last month or so which was not in her normal diet. After some cajoling and patience on my part, she revealed that she has been taking an ulam ("salad" in English) twice a day in increasing amount to reduce her sugar level in the body!
I immediately knew what it was and mentioned it to her, yes, it was the same herb/fruit called "jering" in Malay or its botanical name Archidendron Jiringa It has a bitter taste and the local people believe it reduces the sugar level and cure diabetes!
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| "Buah Jering" tree |
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| "Buah Jering" Pod |
I told her to stop taking the fruit/herb as somehow it has an effect on the heart. She stopped it and after about two months her heart rate had returned to normal but her sugar level had again increased and I decided to put her on an anti-diabetic medication as unsupervised diet control and use of herbs could be detrimental to her.
It is sad that people are taking herbs which they think are not chemically active and end up having adverse effects on their organs such as the heart and liver.
The problem is these so called herbs are not properly researched and no one knows about what dosages people need to take to have desirable effects and control of side-effects. A lot of experiences are anecdotal in nature and no one could say for sure that their disease status became better following all these herbs ingestion. I have seen more negative effects on the users of these herbs. But then of course these are clinic patients, that kind of statistics are not valid.
A concerned doctor has cautioned over the use of this fruit here
The doctor's letter was in response to an article on buah jering's purported medicinal properties in the same news portal this link The lack of information on the use of this herb/legume could cause undesirable medical conditions in some patients who are out to prove that they can do away with western medications.
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