The main action of P. kurroa in treating hyperglycemia is attributed to the bitter principles, kutkin contained in the roots. These bitter principles are known to stimulate secretion of gastrin, secretin & chotecystokinin pancreozymin which then stimulate the secretion 19 of insulin by B-cells of pancreas .

The secondary influence of P. kurroa in correcting diabetes is by its action as an immunomodulator by the iridoid glycoside fraction 20,21 which increases the body’s lowered immunity.

Liver plays a key role in a number of bodily functions. One of the more important roles of liver is maintaining a normal blood glucose concentration by controlling glycogenesis & glycogenolysis. Normal functioning of the liver is therefore extremely essential in maintaining glucose homeostasis in the body. Dysfunctioning of liver may lead to greatly altered carbohydrate & hence glucose metabolism. In such circumstances, a hepatoprotective & corrective agent is also required to restore normalcy of liver function especially if the patient is diabetic. P. kurroa exerts its hepatoprotective & corrective actions due to its glycosides, 22,23 picrosides l & ll . These glycosides have been proved to be useful in regulating liver functions & thus, could be beneficial indirectly in controlling diabetes. It is noted that reduction of liver glycogen is the prominent feature of hepatotoxicity. The disappearance of glycogen from the liver is either due to increased glycogenolysis or due to interference in glycogenesis.

Whatever may be the mechanism of glycogen disappearing from the liver, the result obtained clearly indicates that treatment with P. 24 kurroa results in accumulation of glycogen in the liver .

Sulfonyl urea such as glibenclamide are known to precipitate 25 cholestasis during diabetes therapy . It may be followed by 26 jaundice . Adjuvant therapy with KARNIM provides protection & prevents such toxic influence of allopathic anti-diabetics. P. kurroa, a component of KARNIM is known to induce bile secretion”& thus prevents cholestasis.

Picroside I H H Glu-(6′-Cinnamoyl)
Picroside II Vanilloyl Glucose H
Picroside III H Glu-(6′-Feruloyl) H
Kutkoside H Glucose Vanilloyl