Cite this article as: Saravanan V. Sathasivampillai, Pholtan R.S. Rajamanoharan, Michael Munday and Michael Heinrich, Plants used to treat diabetes in Sri Lankan Siddha Medicine -an ethnopharmacological review of historical and modern sources, Journal of Ethnopharmacology, http://dx.doi.org/10. 1016/j.jep.2016.07.053 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract Introduction and background:In recent decades diabetes mellitus has become a considerable health problem in countries like Sri Lanka and results in an increasing economic burden hampering the social and economic development of these countries. About 60 to 70 % of the rural population in Sri Lanka rely on indigenous medicinal systems as their main source for primary health care. Siddha (Tamil) Medicine is one of the four Sri Lankan traditional medicinal systems and it is practised mostly in the eastern and northern provinces of Sri Lanka where the majority of Tamils reside. Aim:The foundation of this study is a documentation of plant species recorded in historical and modern Sri Lankan Siddha Medical documents used to treat diabetes. Based on the systematic documentation and analysis of Siddha concepts about diabetes and its signs and preparations used to treat diabetes in Sri Lankan Siddha Medicine, the plant species included in these preparations (excluding globally or very widely used, very well studied species) were evaluated in terms of the current stateof-the-art about these species' pharmacology and effectiveness in order to lay a foundation for their further development. Method:Historic and modern Sri Lankan university texts books in Tamil were used as sources for information on diabetes Siddha concepts and antidiabetic Sri Lankan Siddha Medicine preparations. Information on the known antidiabetic effects of extracts and compounds obtained from these species were used in order to assess the current state of the art of these species. Results and discussion: Information of ingredients, preparation methods, amount of ingredients used, and dosages of 60 antidiabetic Sri Lankan Siddha Medicine preparations were obtained. Animal parts including marine organisms, inorganic substances, and plants are the three types of ingredients used. Overall 171 plant species in 73 families were documented. Senna auriculata (L.) Roxb. (Fabaceae) was identified as the most frequently cited species. Globally distributed and very well studied plants were excluded in the pharmacological and clinical literature review which includes 123 plant species. The majority (48 %) of the plant species reviewed were studied up to in vivo level as...

Diabetes is affecting the social and economic developments in developing countries like Sri Lanka. Siddha Medicine (Tamil Medicine) is mostly practiced in the Eastern and Northern Provinces of Sri Lanka. Our recent review of Sri Lankan Siddha historical documents identified 171 plant species used to prepare anti-diabetic preparations. On the other hand, there is no study of plants currently used to treat diabetes in Sri Lankan Siddha Medicine. Hence, the aim of this study is to identify and document the plant species currently used in anti-diabetic preparations in Eastern Province, also enabling a comparative analysis with historical uses. Further, assessing the level of scientific evidence (in vitro, in vivo, and clinical studies) available for recorded species. A systematically prepared questionnaire was used to conduct an ethnobotanical survey with 27 Siddha healers residing in Eastern Province to identify the currently used anti-diabetic plants. Furthermore, Web of Science electronic database was used to assess the level of scientific evidence available excluding widespread and very well studied species. On average 325 diabetic patients were seen by 27 healers per week. Interestingly, inorganic substances, and animal parts used as ingredients in historical anti-diabetic preparations are currently not used in Eastern Province. A total of 88 plant species from 46 families were reported in this study. Syzygium cumini (L.) Skeels was the most frequently recorded species and the largest number of taxa are from Fabaceae. Remarkably, one third of reported species were not stated in Sri Lankan Siddha historical documents. The highest number of plant species (59%) have been studied up to an in vivo level followed by no scientific evidence for anti-diabetic activity found (27%), clinical evidence (10%), and in vitro (2%). This is the first ethnobotanical study of plants used to treat diabetes by Siddha healers in the Eastern Province in Sri Lanka. Moreover, awareness should be created to the diabetics about the side effects of herb-drug interactions and complications caused by taking both herbal preparations and biomedical drugs.

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Nymphaea pubescens Willd belongs to the Nymphaeaceae family. This plant species is used to treat various diseases including diabetes, diarrhea, dysentery, hemorrhages, and indigestion in traditional medicines around the world. Compounds like Arbutin, D-malic acid, Ergosterol, Fumaric acid, and Gluconic acid have been isolated from N. pubescens. As N. pubescens pharmacological activities are not systematically reviewed, this review is intended to analyze, recap, and document the reported bioactivities of N. pubescens. Appropriate published papers were obtained using the Web of Science, Scopus, PubMed, and ScienceDirect databases from 1900 to June 2021. Until now, anticancer, antidementia, antidiabetic, antihepatotoxic, antiinflammatory, antioxidant, and hypolipidemic activities have been reported for different parts of N. pubescens. Remarkably, hitherto, no pharmacological active compound has been isolated from N. pubescens. This review provides a foundation for future research on this plant species.

Myristica dactyloides Gaertn. is an endemic plant species to Sri Lanka and it belongs to Myristicaceae family. M. dactyloides is a medicinal plant that is used to treat various illnesses in traditional medicine in Sri Lanka. There is no review published for M. dactyloides. Thus, this works aims summarize and present a comprehensive review including the phytochemistry of this plant species. This work would provide a foundation for further studying the phytochemistry and pharmacological activities of M. dactyloides. Web of Science (an electronic database) was utilized to identify relevant published work. A sum of 21 compounds have been found in various parts of M. dactyloides belong to classes like arylalkanone and lignan. More compounds were identified from stem bark. Compounds including Malabaricone A have been identified in both seed and stem bark. On the other hand, this is no scientific evidence available for any pharmacological activity study for ethnomedical uses. This work provides a basis for further studying the phytochemistry and pharmacological activities of this plant.