The reason cited for his decision was the "recent evidence on the clinical efficacy of ampalaya against diabetes mellitus." The basis was the "clinical trials conducted by scientists at the University of the Philippines in Manila and Los Baños which have found that leaves of ampalaya growing in Mt. Makiling are comparable to synthetic drugs for diabetes….Other studies have established that ampalaya fruits and seeds have medicinal properties."

As we wrote in this column on September 15, 2003 (The Brewing Bitter Controversy), "….while ampalaya has the property to lower blood sugar, eating ampalaya or taking any of those ampalaya preparations (capsules, tea, etc) being marketed as herbal alternative "cure" for diabetes, alone and by themselves (in lieu of prescription medications for diabetes), is not effective enough to adequately and safely treat diabetes."

Announcing that ampalaya has been "scientifically validated herbal medicinal plants" is fine, but saying that the "ampalaya leaves are comparable to synthetic drugs for diabetes" is dangerously confusing to lay persons. That statement should be qualified for public safety.

"Ampalaya…is not intended to treat, prevent, mitigate, cure or diagnose (diabetes) disease," said Leticia B. Gutierrez, Director of the Philippine Bureau of Food and Drugs (BPAD) in her position paper released August 29, 2003. Then Health Secretary Manuel Dayrit on June 23 issued Circular 196-A series of 2003 where he "strongly advised all concerned to cease, desist and discontinue any endorsement ampalaya an alternative treatment for diabetes mellitus." I could not agree more with those two pronouncements.

While eating the sumptuous ampalaya vegetable and leaves can conceivably aid in the management of diabetes, using this alone or taking ampalaya preparations alone as an alternative method of treatment for diabetes, abandoning anti-diabetes medication prescribed by the physician, is most unsafe.

With the advent of these widely advertised ampalaya pills and drinks "for diabetes," there have been cases reported where diabetic patients unwittingly discontinued taking their prescription drugs and replaced them with ampalaya capsules, who went into coma, some of them dying. The ampalaya preparations were obviously not potent enough to control the diabetes.

Among those with pre-diabetes, people who are prone to develop the disease but who do not have the full-blown diabetes yet, physical exercises and dieting can significantly delay, and in some cases prevent, the onset of diabetes. It is conceivable that this pre-diabetic stage is where eating ampalaya regularly or using the ampalaya pills or tea as a part of the delaying regimen might be of real benefit in warding off the disease for as long as possible.

While it might be a bitter pill to swallow for some people, especially for the entrepreneurs marketing "food supplements," we have to face the fact that ampalaya derivatives (pills, tea, etc.) have not been fully proven to be totally effective, by themselves, as sole treatment for diabetes, to warrant abandonment of the physician-prescribed proprietary or generic drugs for diabetes. That is a fact the Department of Health and all health providers should accept. Furthermore, the DOH must explain and qualify its new circular as clearly as possible for public safety. Not to do so would be to trivialize and denigrate the sanctity of the healer’s precept of primum non nocere (first, do no harm) in treating living beings, the basic tenet of the Hippocratic Oath which all physicians took as they were sworn into the practice of medicine. Not doing so would also be a great disservice to the patients and a potential grave risk to people’s lives.

The January 29, 2008 circular of the Department of Health should be carefully understood with all its medical subtleties. The fact is, while ampalaya could be an aid in the treatment of diabetes, the ampalaya vegetable alone, and/or the ampalaya preparations being marketed as a treatment or "cure" for diabetes, alone and in themselves, are NOT effective enough to replace the anti-diabetic medications prescribed by the physician. Before using or shifting to this herbal alternative, patients should first discuss this thoroughly with their attending physician. To do otherwise would be foolhardy and dangerous.