The effect of boiled cosmos caudatus leaves on blood sugar levels in elderly patients with diabetes mellitus 10.55131/jphd/2026/240109

Main Article Content

Ellen Pesak
Jon Welliam Tangka
Semuel Tambuwun
Maykel Alfian Kiling
Jane Annita Kolompoy
Esther Novilian Tamunu
Rommy David Watuseke
Syamsu Alam
Bongakaraeng Bongakaraeng
Fitrilia Betahai

Abstract

In Indonesia, diabetes mellitus is one of the ten most common diseases among the elderly, with North Sulawesi Province having the highest prevalence. Cosmos caudatus leaves contain bioactive components, such as flavonoids and phenolic compounds, which have been shown to be effective in increasing insulin resistance and sensitivity in patients with DM. This study aimed to evaluate the effect of boiled Cosmos caudatus leaves on blood sugar levels in elderly patients with diabetes mellitus at the Bahu Health Center in Manado City. This study used a quantitative approach with a quasi-experiment, one-group pre-test post-test design. Ninety elderly respondents with diabetes mellitus at the Bahu Health Center in Manado City were included in this study. Blood sugar levels were measured before and after the intervention with boiled C. caudatus leaves. The intervention involved administering boiled water prepared from seven Cosmos caudatus leaves twice daily, in the morning and evening, at a dose of 250 ml each time. The findings showed that Cosmos caudatus exhibits a range of nutritional and phytochemical properties that support its use as a functional food. Its composition provides benefits for digestive health, energy provision, and antioxidant protection. There was a significant difference in the blood sugar levels of the respondents before and after the intervention. Statistical analysis showed a p-value of < 0.001. Therefore, it can be concluded that this intervention was significant. Boiled leaves of Cosmos caudatushave been proven to be effective in lowering blood sugar levels in elderly patients with diabetes mellitus.

Article Details

How to Cite
1.
Pesak E, Jon Welliam Tangka, Semuel Tambuwun, Maykel Alfian Kiling, Jane Annita Kolompoy, Esther Novilian Tamunu, Rommy David Watuseke, Syamsu Alam, Bongakaraeng Bongakaraeng, Fitrilia Betahai. The effect of boiled cosmos caudatus leaves on blood sugar levels in elderly patients with diabetes mellitus: 10.55131/jphd/2026/240109. J Public Hlth Dev [internet]. 2026 Jan. 29 [cited 2026 Feb. 2];24(1):119-31. available from: https://he01.tci-thaijo.org/index.php/AIHD-MU/article/view/275801
Section
Original Articles
Author Biographies

Ellen Pesak, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Jon Welliam Tangka, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Semuel Tambuwun, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Maykel Alfian Kiling, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Jane Annita Kolompoy, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Esther Novilian Tamunu, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Rommy David Watuseke, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Syamsu Alam, Department of Environmental Health, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Environmental Health, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Bongakaraeng Bongakaraeng, Department of Environmental Health, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Environmental Health, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Fitrilia Betahai, Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

Department of Nursing, Politeknik Kesehatan, Kementrian Kesehatan Manado, Manado, North Sulawesi, Indonesia

References

Dilworth L, Facey A, Omoruyi F. Diabetes Mellitus And Its Metabolic Complications: The Role Of Adipose Tissues. Int J Mol Sci. 2021;22(14):1–18.

Mohaghegh P, Rafiei F, Sadeghi Sedeh B, Ansari M. Factors Affecting Blood Sugar Levels In Type 2 Diabetic Patients Referred To Imam Reza Clinic Of Arak, Iran. J Of Shahrekord Univ Of Medic Sci. 2022;24(3):122–6.

Edussuriya Asj, Subhashini Sys, Amarasinghe Kds, Kumari Gsd, Perera Kmon, Munidasa Kgpk. Experiences Of Patients On Natural Herbal Treatments For Diabetes Mellitus At The Diabetes Clinic In Base Hospital - Matara, Sri Lanka. J Patient Exp. 2021;8(1):1–5.

Saeedi P, Petersohn I, Salpea P, Malanda B, Karuranga S, Unwin N, Et Al. Global And Regional Diabetes Prevalence Estimates For 2019 And Projections For 2030 And 2045: Results From The International Diabetes Federation Diabetes Atlas, 9th Edition. Diab Res Clin Pract. 2019;157(11):1–10.

Nasihah M. The Potential Of Ngokilo Leaves Extract (Stachytarpheta Mutabilis. Vahl) As A Lowering Of Blood Glucose Levels Of White Mice (Rattus Norvegicus). Biolink. 2021; 7(2):204–14.

Cai Xt, Zhu Q, Liu Ss, Wang Mr, Wu T, Hong J, Et Al. Associations Between The Metabolic Score For Insulin Resistance Index And The Risk Of Type 2 Diabetes Mellitus Among Non-Obese Adults: Insights From A Population-Based Cohort Study. Int J Gen Med. 2021;14(11):7729–40.

Anjastya Ha, Yuniartika W. Spiritual Spiritual Therapy (Dhikr) Can Decrease Blood Sugar Levels In Diabetes Mellitus Patients In The Intensive Care Unit (Icu): A Study Literature. Klasics. 2022;2(01):16–26.

Dea Firdaus M, Artanti N, Hanafi M, Rosmalena R. Phytochemical Constituents And In Vitro Antidiabetic And Antioxidant Properties Of Various Extracts Of Kenikir (Cosmos Caudatus) Leaves. Pharmacognosy J. 2021;13(4):890–5.

R.A. Tanzila, Ni Made Elva Mayasari, Dita Azzahra Maso. The Effect Of Medium Intensity Physical Activity On Blood Glucose Levels In Diabetes Mellitus. Inter J Of Islamic And Comple Medic. 2020;1(1):37–40.

Nelyanti Da, Ta’adi T, Anwar Mc. The Effectiveness Of Acupressure And Smart Gymnastic On Fasting Blood Sugar Levels Among Patients With Type II Diabetes Mellitus. Inter J Of Nurs And Health Serv. 2020;3(6):687–94.

Mu’minah N, Suherman Ws, Krismantoro T, Nasution Sf. The Influence Of Tai Chi Gymnastics And Diabetic Gymnastics On Decreasing Blood Sugar Levels In The Elderly Type 2 Diabetes Mellitus. Inter J Of Phys Educ, Sports And Health. 2024;11(1):25–8.

Bakara Dm, Kurniyati. Self-Management Education To Control Blood Sugar Levels And Hba1c Value For Type 2 Diabetes Patients. Malaysian J Of Nurs. 2022;14(01):84–9.

Mohamed A, Staite E, Ismail K, Winkley K. A Systematic Review Of Diabetes Self‐Management Education Interventions For People With Type 2 Diabetes Mellitus In The Asian Western Pacific (Awp) Region. Nurs Open. 2019;6(4):1424–37.

Hidayah K, Suwondo A, Kusmiyati Y. The Effectiveness Of Kenikir Extract (Cosmos Caudatus) To Increase The Hormone Prolactin In Puerperal Mothers. Eduvest - J Of Univ Stud. 2023;3(10):1865–70.

Barzkar F, Baradaran Hr, Khamseh Me, Vesal Azad R, Koohpayehzadeh J, Moradi Y. Medicinal Plants In The Adjunctive Treatment Of Patients With Type-1 Diabetes: A Systematic Review Of Randomized Clinical Trials. J Diabetes Metab Disord. 2020;19(2):1917–29.

Batubara K, Sinaga E, Sianturi Mibr, Siregar Hk. The Effect Of Manggist Skin Juice On The Stability Of Blood Sugar Levels In Diabetes Mellitus (Dm) Patients. Malahayati Nurs J. 2023;5(11):3848–55.

Tao F, Wang P, Dai Z, Zhang C, Li D, Fan H, Et Al. Neohesperidin Dihydrochalcone Improves Hyperglycemia And Insulin Resistance In Diabetic Zebrafish. Acs Food Scie & Tech. 2023;3(9):1548–58.

Naz A, Khan M, Kibria S. Unlocking The Insightful Antidiabetic Effects Of Lemongrass (Cymbopogon Citratus): A Comprehensive Review. Phytonutrients. 2024;3(8):90–104.

Babu Pva, Liu D, Gilbert Er. Recent Advances In Understanding The Anti-Diabetic Actions Of Dietary Flavonoids. J Nutr Biochem. 2013; 24(11):1777–89.

Al-Ishaq Rk, Abotaleb M, Kubatka P, Kajo K, Büsselberg D. Flavonoids And Their Anti-Diabetic Effects: Cellular Mechanisms And Effects To Improve Blood Sugar Levels. Biomolecules. 2019;9(9):430–9.

Tan Y, Tam Cc, Rolston M, Alves P, Chen L, Meng S, Et Al. Quercetin Ameliorates Insulin Resistance And Restores Gut Microbiome In Mice On High-Fat Diets. Antioxidants. 2021; 10(8):1–17.

Zhang R, Qiu X, He C, Deng R, Huo C, Fang B. From Life’s Essential 8 To Metabolic Syndrome: Insights From Nhanes Database And Network Pharmacology Analysis Of Quercetin. Front Nutr. 2024;11(10):1–16.

Cui Z, Zhao X, Amevor Fk, Du X, Wang Y, Li D, Et Al. Therapeutic Application Of Quercetin In Aging-Related Diseases: Sirt1 As A Potential Mechanism. Front Immunol. 2022; 13(7):1–26.

Sun J, Pan Y, Li X, Wang L, Liu M, Tu P, Et Al. Quercetin Attenuates Osteoporosis In Orchiectomy Mice By Regulating Glucose And Lipid Metabolism Via The Gprc6a/Ampk/ Mtor Signaling Pathway. Front Endocrinol (Lausanne). 2022;13(4):1–13.

Tura A, Herfs V, Maaßen T, Zuo H, Vardanyan S, Prasuhn M, Et Al. Quercetin Impairs The Growth Of Uveal Melanoma Cells By Interfering With Glucose Uptake And Metabolism. Int J Mol Sci. 2024; 25(8):1–19.

Menati L, Meisami A, Zarebavani M. The Potential Effects Of Dietary Flavones On Diabetic Nephropathy; A Review Of Mechanisms. J Renal Inj Prev. 2020;9(2):E09–E09.

Zhou M, Konigsberg Wh, Hao C, Pan Y, Sun J, Wang X. Bioactivity And Mechanisms Of Flavonoids In Decreasing Insulin Resistance. J Enzyme Inhib Med Chem. 2023; 38(1):1–11.

Sari Yo, Permatasari D, Mariza W, Fitria N, Lailiani R. Application Of Home Medication Review (Hmr) On Patient Adherence In Type 2 Diabetes Mellitus (T2dm) Blood Sugar Management. J Sains Farm & Klinis. 2023;9(Sup):160–7.

Alqathama A, Alluhiabi G, Baghdadi H, Aljahani L, Khan O, Jabal S, Et Al. Herbal Medicine From The Perspective Of Type Ii Diabetic Patients And Physicians: What Is The Relationship? Bmc Complement Med Ther. 2020;20(1):1–9.

Zeinabeh Mz, Atefeh A, Masumeh Ghp, Tania D, Mojgan S, Katayoun A. The Effect Of Mindfulness-Based Stress Reduction Counseling On Blood Glucose And Perceived Stress In Women With Gestational Diabetes. Rev Brasileira De Ginec E Obste / Rbgo Gynec And Obst. 2023;45(09): 517–23.

Vivó-Barrachina L, Rojas-Chacón Mj, Navarro-Salazar R, Belda-Sanchis V, Pérez-Murillo J, Peiró-Puig A, Et Al. The Role Of Natural Products On Diabetes Mellitus Treatment: A Systematic Review Of Randomized Controlled Trials. Pharmaceutics. 2022;14(1):1–12.

Chen Cc, Chen Cl, Ko Y. The Misconceptions And Determinants Of Diabetes Knowledge In Patients With Diabetes In Taiwan. J Diabetes Res. 2020;2020(6):1–5.

Desi, Kalesaran Afc, Kaunang Wpj. Knowledge, Physical Activity, And Control Of Type 2 Diabetes Mellitus At Lansot Primary Health Center Tomohon, Indonesia. Int J Community Med Public Health. 2023;10(11): 4075–81.

Purković M, Vukašinović D, Radak U. The Importance Of Physical Activity In Diabetes. Biomedicinska Istraživanja. 2021;12(2):125–38.

Çinar D, Yava A, Olgun N, Koyuncu A, Eti Aslan F. Use Of Herbal Products And Food Supplements Of Type 2 Diabetes Patients. Health & Res J. 2022;8(3):202–13.

El Bayoumy I. Herbal Use And Perceptions Among Patients With Type 2 Diabetes Mellitus In Kuwait. Clin Res Notes. 2022;3(1):01–7.

Saleh I, Aziz Sa, Melati M, Andarwulan N. Morpho-Physiology And Metabolite Content Of Cosmos Caudatus Kunth. And Yellow And Orange Cosmos Sulphureus Cav. Biodiversitas. 2023;24(10):5739–46.

Sudrajat A, Romadhona M, Manurung S, Suratun S, Yardes N, Lusiani D, Et Al. Relationship Between Family History, Diet And Sedentary Behavior With The Incidence Of Diabetes Mellitus. Asian J Of Dental And Health Sci. 2023;3(2):26–31.

Ra Js. Sex Differences In Factors Associated With Prediabetes In Korean Adults. Osong Public Health Res Perspect. 2022;13(2):142–52.

Koyama T, Kuriyama N, Ozaki E, Tomida S, Uehara R, Nishida Y, Et Al. Sedentary Time Is Associated With Cardiometabolic Diseases In A Large Japanese Population: A Cross-Sectional Study. J Atheroscler Thromb. 2020;27(10):1097–107.