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J Ethnopharmacol. 2017 Jun 9;205:116-122. doi: 10.1016/j.jep.2017.05.003. Epub 2017 May 3.

"DAK", a traditional decoction in Palau, as adjuvant for patients with insufficient control of diabetes mellitus type II.

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Pacific Academic Institute for Research, 822 Ernguul Rd., Koror, Palau.
Foundation Antenna Technologies, Avenue de la Grenade 24, 1207 Geneva, Switzerland.
ENSAT-National Institute of Agronomy and Environment of Toulouse, Avenue de l'Agrobiopole, BP 32607 Auzeville-Tolosane, France.
School of Pharmaceutical Sciences, University of Geneva, University of Lausanne, CMU, Rue Michel Servet 1, 1211 Geneva, Switzerland.
Institute of Food, Nutrition and Health, ETH Zurich, Schorenstrasse 16, 8603 Schwerzenbach, Switzerland.
Pacific Academic Institute for Research, 822 Ernguul Rd., Koror, Palau; Foundation Antenna Technologies, Avenue de la Grenade 24, 1207 Geneva, Switzerland. Electronic address:



Can a medicinal plant be useful when standard modern treatment is insufficient? After a population survey in the Republic of Palau (retrospective treatment-outcome study, following the reverse pharmacology approach) on local treatments and associated outcomes for diabetes, a traditional drink made with Phaleria nisidai Kaneh and several other plants called "Delal A Kar", (meaning "mother of medicine") appeared as a promising therapy. This is the first clinical study on a standardized version of "Delal A Kar" called DAK.


This is a study of the effect of DAK as adjuvant therapy when diabetes control is insufficient.


In this randomized, double blind, crossover study conducted in Koror, Palau, DAK or placebo was assigned to 68 patients with type II diabetes treated with oral hypoglycemic agents and with insufficient glycaemic control. All patients received instructions on how to improve their diet and a home glucometer for blood glucose follow-up.


Fifty-five patients completed the study and significant improvements were observed in both groups over the 12 weeks follow-up period: weight decreased an average of 2 to -4.5 pounds (p<0,001) and HbA1C also decreased from 9.7% to 7.8% (p<0,001), with a consistent trend toward better outcomes after DAK, as compared to placebo. The average effect of Ongael was 0.5% (SD 2.5) decrease of HbA1C. Furthermore, seventy-five percent (41/55) of the patients reduced their HbA1C by at least 0.7% at 12 weeks.


The observed trends in this trial suggest that poorly controlled diabetic patients improved their control of diabetes within 12 weeks when drinking DAK for at least 6 weeks. The drink DAK, in addition to the usual prevention activities of special diet and physical exercise, was followed by improvement of diabetes control (HbA1C) and decrease of blood pressure and weight.


The study protocol was approved by the Institutional Ethical Committee and registered by international Australia and New Zealand trial registry (Request Number: 369395) FUNDING: Pacific Academic Institute for Research office fund, Belau Medical Clinic, The Environment, Inc, Antenna Foundation, Grandjean and Michèle Berset funds and the Weil Foundation.


Diabetes mellitus type II; Mangiferin; Palau; Phaleria nisidai

[Indexed for MEDLINE]

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