A Comprehensive Review of Medicinal Plants with Antidiabetic Potential

Year 2025, Volume: 45 Issue: 1, 79 - 91, 01.03.2025

Ecenur Bayır , Gözde Elgin Cebe

https://doi.org/10.52794/hujpharm.1555432

Abstract

Diabetes is one of the most common chronic diseases and its incidence and prevalence have been increasing in recent years. Moreover, many comorbidities can be observed in addition to diabetes. For this reason, medicinal plants have been an important complementary treatment option for individuals with diabetes from past to present. However, as in every disease, the correct use of medicinal plants in diabetes is important. Failure to do so may worsen the course of the disease, cause side/adverse effects and lead to herb-drug interactions. This review aimed to identify antidiabetic medicinal plants comprehensively and to describe the most commonly used ones in detail. When the studies in the literature were evaluated, it was determined that many medicinal plants with antidiabetic effects have been used from past to present, but the potential mechanism of activity, positive/negative effects, dosages, and plant-drug interactions of many of them have not been fully revealed. Further research is needed, as the incorrect and unknowing use of these medicinal plants can worsen the course of the disease.

Keywords

Diabetes, Antidiabetics, Medicinal plants

References

• 1. Sapra A, Bhandari P. Diabetes. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2024.
• 2. Cefalu WT, Stephens JM, Ribnicky DM. Diabetes and herbal (botanical) medicine. In: Benzie IFF, Wachtel-Galor S, ‘editors’. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. Boca Raton (FL): CRC Press/Taylor & Francis, Chapter 19. 2011.
• 3. CDC. National diabetes statistics report, 2017. Estimates of diabetes and its burden in the United States.
• 4. Garza MC, Pérez-Calahorra S, Rodrigo-Carbó C, Sánchez- Calavera MA, Jarauta E, Mateo-Gallego R, Gracia-Rubio I, Lamiquiz-Moneo I. Effect of aromatic herbs and spices present in the mediterranean diet on the glycemic profile in type 2 diabetes subjects: a systematic review and meta-analysis. Nutrients. 2024;16:756. https://doi.org/10.3390/nu16060756.
• 5. Pearson-Stuttard J, Holloway S, Polya R, Sloan R, Zhang L, Gregg EW, Harrison K, Elvidge J, Jonsson P, Porter T. Variations in comorbidity burden in people with type 2 diabetes over disease duration: a population-based analysis of real world evidence. eClinicalMedicine. 2022;52: 101584. https://doi. org/10.1016/j.eclinm.2022.101584.
• 6. Redondo MJ, Hagopian WA, Oram R, Steck AK, Vehik K, Weedon M, Balasubramanyam A, Dabelea D. The clinical consequences of heterogeneity within and between different diabetes types. Diabetologia. 2020;63:2040–2048. https://doi. org/10.1007/s00125-020-05211-7.
• 7. Yedjou CG, Grigsby J, Mbemi A, Nelson D, Mildort B, Latinwo L, Tchounwou PB. The management of diabetes mellitus using medicinal plants and vitamins. Int. J. Mol. Sci. 2023;24(10):9085. https://doi.org/10.3390/ijms24109085.
• 8. Chang CLT, Lin Y, Bartolome AP, Chen YC, Chiu SC, Yang WC. Herbal therapies for type 2 diabetes mellitus: chemistry, biology, and potential application of selected plants and compounds. eCAM. 2013;378657:33. https://doi. org/10.1155/2013/378657.
• 9. Verma S, Gupta M, Popli H, Aggarwal G. Diabetes mellitus treatment using herbal drugs. International Journal of Phytomedicine. 2018;10(1):1-10. https://doi.org/10.5138/09750185.2181.
• 10. Xu YXZ, Xi S, Qian X. Evaluating traditional chinese medicine and herbal products for the treatment of gestational diabetes mellitus. J. Diabetes Res. 2019;2019: 9182595. https://doi. org/10.1155/2019/9182595.
• 11. Arista DM, Amelia R, Fitriani D, Khotimah H, Ratnaningrum SD, Irwanto Y, Nurseta T. Gestational diabetes mellitus: an overview and its potential treatment with herbs. GSCBPS. 2023;23(3):261–273. https://doi.org/10.30574/ gscbps.2023.23.3.0250.
• 12. Choudhury H, Pandey M, Hua CK, Mun CS, Jing JK, Kong L, Ern LY, Ashraf NA, Kit SW, Yee TS, Pichika MR, Gorain B, Kesherwani P. An update on natural compounds in the remedy of diabetes mellitus: a systematic review. eJTCM. 2018;8(3):361-376. https://doi.org/10.1016/j. jtcme.2017.08.012.
• 13. World Health Organization. World health Organization traditional medicine strategy 2014–2023. Geneva, Switzerland: WHO. 2013:1-78.
• 14. Roglic G. WHO Global report on diabetes: a summary. IJNCD. 2016;1:3.
• 15. da Rocha Fernandes J, Ogurtsova K, Linnenkamp U, Guariguata L, Seuring T, Zhang P, Cavan D, Makaroff LE. IDF Diabetes Atlas estimates of 2014 global health expenditures on diabetes. Diabetes. 2016;117:48-54.
• 16. Sharma N, Bora KS. Role of medicinal plants in the management of diabetes mellitus: a review. J. Pharm. Res. Int. 2021;33:2196–2207. https://doi.org/10.9734/jpri/2021/ v33i60B34864.
• 17. Jacob B, Narendhirakannan RT. Role of medicinal plants in the management of diabetes mellitus: a review. 3 Biotech. 2019;9:4. https://doi.org/10.1007/s13205-018-1528-0.
• 18. Tran N, Pham B, Le L. Bioactive compounds in anti-diabetic plants: from herbal medicine to modern drug discovery. Biology (Basel). 2020;9(9):252. https://doi.org/10.3390/biology9090252.
• 19. Karaman Ö, Elgin Cebe G. Diabetes and antidiabetic plants used in Turkey, J. Fac. Pharm. Ankara. 2016;40(3):47-61.
• 20. Ghorbani A. Best herbs for managing diabetes: a review of clinical studies. Braz. J. Pharm. Sci. 2013;48(3):413-422. https:// doi.org/10.1590/S1984-82502013000300003.
• 21. Modak M, Dixit P, Londhe J, Ghaskadbi S, Devasahayam TPA. Indian herbs and herbal drugs used for the treatment of diabetes. JCBN. 2007;40:163-173.
• 22. Willcox ML, Elugbaju C, Al-Anbaki M, Lown M, Graz B. Effectiveness of medicinal plants for glycaemic control in type 2 diabetes: an overview of meta-analyses of clinical trials. Front. pharmacol. 2021;12:777561. https://doi.org/10.3389/fphar.2021.777561.
• 23. Belmouhoub M, Tacherfiout M, Boukhalfa F, Khodja YK, Bachir-Bey M. Traditional medicinal plants used in the treatment of diabetes: ethnobotanical and ethnopharmacological studies and mechanisms of action. IJPBP. 2022;2(2):145-154.
• 24. Moradi B, Abbaszadeh S, Shahsavari S, Alizadeh M, Beyranvand F. The most useful medicinal herbs to treat diabetes. Biomed. Res. Ther. 2018;5(8):2538-2551. https://doi. org/10.15419/bmrat.v5i8.463.
• 25. Ahda M, Jaswir I, Khatib A, Ahmed QU, Mahfudh N, Ardini YD, Syed Mohamad SNA, Anwar M, Hernawan H, Miyashita K, Salamatullah AM. Phytochemical analysis, antioxidant, α-glucosidase inhibitory activity, and toxicity evaluation of Orthosiphon stamineus leaf extract. Sci. Rep. 2023;13:1. https://doi.org/10.1038/s41598-023-43251-2.
• 26. Bakhtiuary Z. Herbal medicines in diabetes. IJDO. 2011;3(2):88-95.
• 27. Hariyono H, Wibowo SA. The herbal supplements for diabetes mellitus type II. Sys Rev Pharm. 2022;13(9):600-605. https://doi.org/10.31858/0975-8453.13.9.600-605.
• 28. Wang Z, Wang J, Chan P. Treating type 2 diabetes mellitus with traditional chinese and indian medicinal herbs. eCAM. 2013;343594:17. https://doi.org/10.1155/2013/343594.
• 29. Patel P, Harde P, Pillai J, Darji N, Patel B. Antidiabetic herbal drugs a review. Pharmacophore. 2012;3 (1):18-29.
• 30. Food and Drug Administration. CPG sec 525.750 spices-definitions FDA. 2020.
• 31. Jiang Y, Yue R, Liu G, Liu J, Peng B, Yang M, Zhao L, Li Z. Garlic (Allium sativum L.) in diabetes and its complications: recent advances in mechanisms of action. Crit. Rev. Food Sci. Nutr. 2024;64(16):5290-5340. https://doi.org/10.1080/10408 398.2022.2153793.
• 32. Najafi N, Masoumi SJ. The Effect of Garlic (Allium sativum) supplementation in patients with type 2 diabetes mellitus: a systematic review. Int. J. Nutr. Sci. 2018;3(1):7-11.
• 33. Ojo OA, Adegboyega AE, Johnson GI, Umedum NL, Onuh K, Adeduro MN, Nwobodo VO, Elekan A, Alemika TE, Johnson TO. Deciphering the interactions of compounds from Allium sativum targeted towards identification of novel PTP 1B inhibitors in diabetes treatment: a computational approach. Inform. Med. Unlocked. 2021;26:100719. https://doi.org/10.1016/j.imu.2021.100719.
• 34. Susanti Y, Adriani M, Adi AC. Effect of single clove garlic extract (Allium sativum Linn) on blood sugar levels, malondialdehyde, insulin levels and insulin resistance (experiments in rats (rattus novergicus) induced by streptozotocin. SJIK. 2020;9(2):954–963. https://doi.org/10.30994/sjik.v9i2.411.
• 35. Kalhotra P, Chittepu VCSR, Osorio-Revilla G, Gallardo-Velazquez T. Phytochemicals in garlic extract inhibit therapeutic enzyme DPP-4 and induce skeletal muscle cell proliferation: a possible mechanism of action to benefit the treatment of diabetes mellitus. Biomolecules. 2020;10(2):305. https://doi.org/10.3390/biom10020305.
• 36. Sánchez M, González-Burgos E, Iglesias I, Gómez-Serranillos MP. Pharmacological update properties of Aloe vera and its major active constituents. Mol. 2020;25(6):1324. https://doi. org/10.3390/molecules25061324.
• 37. Choudhary M, Kochhar A, Sangha J. Hypoglycemic and hypolipidemic effect of Aloe vera L. in non-insulin dependent diabetics. J. Food Sci. Technol. 2014;51(1):90-6. https://doi. org/10.1002/ptr.5532.
• 38. Prakash D, Margaret J, Subramanian NS, Maheshbhai CM, Babubhai CK, Kiranbhai CS, Chaudhary SK, Popatbhai CU, Kumar Lodha HL. Effect of aloe vera juice on type 2 diabetes mellitus among Indian patients. Bioinformation. 2023;19(10):1015- 1019. https://doi.org/10.6026/973206300191015.
• 39. Budiastutik I, Subagio HW, Kartasurya MI, Widjanarko B, Kartini A, Suhartono S. The effect of Aloe vera on fasting blood glucose levels in pre-diabetes and type 2 diabetes mellitus: a systematic review and meta-analysis. J. Pharm. Pharmacogn. Res. 2022;10 (4):737-747. https://doi.org/10.56499/jppres22.1378_10.4.737.
• 40. Sharma MK, Chauhan J, Kumar M, Joshi CK, Sharma S, Lal C. Prospects of Aloe vera and its bioactive compounds in diabetes: critical review. J. Pure Appl. Microbiol. 2021;15(4):1781- 1797. https://doi.org/10.22207/JPAM.15.4.54.
• 41. Abo-Youssef AM, Messiha BAS. Beneficial effects of Aloe vera in treatment of diabetes: Comparative in vivo and in vitro studies. Bull. Fac. Pharm. Cairo Univ. 2013;51(1):7-11. https://doi.org/10.1016/j.bfopcu.2012.03.002.
• 42. Sharafati-Chaleshtori R, Nickdasti A, Mortezapour E, Pourhanifeh MH, Ghazanfari M, Movahedpour A, Khatami A, Ashrafizadeh M, Zarrabi A, Mahabady MK, Khani H, Mirzaei H. Artemisia species as a new candidate for diabetes therapy: a comprehensive review. Curr. Mol. Med. 2021;21(10):832-849. https://doi.org/10.2174/1566524020999210101234317.
• 43. Smoak P, Burke SJ, Martin TM, Batdorf HM, Floyd ZE, Collier JJ. Artemisia dracunculus L. ethanolic extract and an isolated component, DMC2, ameliorate inflammatory signaling in pancreatic β-cells via inhibition of p38 MAPK. Biomolecules. 2022;12(5):708. https://doi.org/10.3390/biom12050708.
• 44. Haghighian HK, Shiran M, Akha O, Ghafouri Z, Ghaedi E, Bayat S, Mazloomi MA, Houshmand G. Effects of tarragon powder on glucose metabolic changes, lipid profile and antioxidant enzyme levels in type 2 patients with diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Jundishapur J. Nat. Pharm. Prod. 2021;16(1):e102469. https:// doi.org/10.5812/jjnpp.102469.
• 45. Food and Drug Administration. CPG sec 525.750 spices-definitions FDA. 2020.
• 46. Mohsin SN, Saleem F, Humayun A, Tanweer A, Muddassir A. Prospective nutraceutical effects of cinnamon derivatives against ınsulin resistance in type ıı diabetes mellitus—evidence from the literature. Dose-Response. 2023;21(3):1-12. https:// doi.org/10.1177/15593258231200527.
• 47. Silva ML, Bernardo MA, Singh J, de Mesquita MF. Cinnamon as a complementary therapeutic approach for dysglycemia and dyslipidemia control in type 2 diabetes mellitus and its molecular mechanism of action: a review. Nutr. 2022;14(13):2773. https://doi.org/10.3390/nu14132773.
• 48. Mandal A, Sharma SK, Yadav SRM, Mirza AA, Thakur MS, Jachak S, Saini S, Roy P, Kant R, Patil M. (2023). Efficacy of young Cinnamomum zeylanicum Blume Bark on hyperglycemia and ptpase activity in type 2 diabetes. Cureus. 2023;15(2):e35023. https://doi.org/10.7759/cureus.35023.
• 49. Neto JCGL, Damasceno MMC, Ciol MA, de Freitas RWJF, de Araújo MFM, de Souza Teixeira CR, Carvalho GCN, de Siqueira Coelho Lisboa KW, de Souza DF, de Menezes Nogueira J, Marques RLL, Alencar AMPG. (2020). Analysis of the effectiveness of cinnamon (Cinnamomum verum) in the reduction of glycemic and lipidic levels of adults with type 2 diabetes: A study protocol. Medicine (Baltimore). 2020;99(1):e18553. https://doi.org/10.1097/MD.0000000000018553.
• 50. Laha S, Paul S. Gymnema sylvestre (gurmar): a potent herb with anti-diabetic and antioxidant potential. Phcog. J. 2019;11(2):201-206. https://doi.org/10.5530/pj.2019.11.33.
• 51. Muzaffar H, Qamar I, Bashir M, Jabeen F, Irfan S, Anwar H. Gymnema sylvestre supplementation restores normoglycemia, corrects dyslipidemia, and transcriptionally modulates pancreatic and hepatic gene expression in alloxan-induced hyperglycemic rats. Metabolites. 2023;13(4):516. https://doi. org/10.3390/metabo13040516.
• 52. Kashif M, Nasir A, Gulzaman Rafique MK, Abbas M, Rehman A, Riaz M, Rasool G, Mtewa AG. Unlocking the antidiabetic potential of Gymnema sylvestre, Trigonella foenumgraecum, and their combination thereof: an in-vivo evaluation. Food Sci. Nutr. 2023;11:7664–7672. https://doi.org/10.1002/ fsn3.3685.
• 53. Al-Mosawi A. The use of Gymnema sylvestre in the treatment of diabetes: The available evidence and expert opinion. Current Clinical Med. Edu. 2023;2(2):29-31.
• 54. Khan F, Sarker MMR, Ming LC, Mohamed IN, Zhao C, Sheikh BY, Tsong HF, Rashid MA. Comprehensive review on phytochemicals, pharmacological and clinical potentials of Gymnema sylvestre. Front. pharmacol. 2019;10:1223. https://doi.org/10.3389/fphar.2019.01223.
• 55. Liu Z, Gong J, Huang W, Lu F, Dong H. The effect of Momordica charantia in the treatment of diabetes mellitus: a review. eCAM. 2021;2021:3796265. https://doi.org/10.1155/2021/3796265.
• 56. Çiçek SS. Momordica charantia L.—diabetes-related bioactivities, quality control, and safetyconsiderations. Front. pharmacol. 2022;13:904643. https://doi.org/10.3389/ fphar.2022.904643.
• 57. Olawale F, Olofinsan K, Iwaloye O, Ologuntere TE. Phytochemicals from Nigerian medicinal plants modulate therapeutically- relevant diabetes targets: Insight from computational direction. ADTM. 2022;22:723–737. https://doi.org/10.1007/ s13596-021-00598-z.
• 58. Kim SK, Jung J, Jung JH, Yoon N, Kang SS, Roh GS, Hahm JR. Hypoglycemic efficacy and safety of Momordica charantia (bitter melon) in patients with type 2 diabetes mellitus. Complement Ther Med. 2020;52:102524. https://doi. org/10.1016/j.ctim.2020.102524.
• 59. Zhang X, Zhao Y, Song Y, Miao M. Effects of Momordica charantia L. supplementation on glycemic control and lipid profile in type 2 diabetes mellitus patients: a systematic review and meta-analysis of randomized controlled trials. Heliyon. 2024;10(2024):e31126. https://doi.org/10.1016/j.heliyon. 2024.e31126.
• 60. Vesa CM, Bungau SG, Tit DM, Purza AL, Bungau AF, Radu AF, Stociescu M. Exploring the ımpact of Momordica charantia on diabetes mellitus: from cell cultures to clinical Studies. Pharmacophore. 2024;15(2):32-42. https://doi.org/10.51847/ TiB6u3aEF5.
• 61. Peter EL, Kasali FM, Deyno S, Mtewa A, Nagendrappa PB, Tolo CU, Ogwang PE, Sesaazi D. Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: systematic review and meta-analysis. J. Ethnopharmacol. 2019;231:311-324. https://doi.org/10.1016/j.jep.2018.10.033.
• 62. Mariammal BGV, Devarajan DW, Jerrin R, Viswanathan S, Siddikuzzaman Gopal R. In vivo treatment efficacy of essential oil ısolated from seeds of Momordica charantia in streptozotocin- ınduced diabetes mellitus. Recent Pat Biotechnol. 2021;15(4):316-331. https://doi.org/10.2174/1872208315666 210910092105
• 63. Elekofehinti OO, Ariyo EO, Akinjiyan MO, Olayeriju OS, Lawal AO, Adanlawo IG, Teixeira Rocha JB. Potential use of bitter melon (Momordica charantia) derived compounds as antidiabetics: in silico and in vivo studies. Pathophysiol. 2018;25(4):327-333. https://doi.org/10.1016/j.pathophys. 2018.05.003
• 64. Hussain F, Hafeez J, Khalifa AS, Naeem M, Ali T, Eed EM. In vitro and in vivo study of inhibitory potentials of α-glucosidase and acetylcholinesterase and biochemical profiling of M. charantia in alloxan-induced diabetic rat models. Am. J. Transl. Res. 2022;14(6):3824-3839.
• 65. Xu B, Li Z, Zeng T, Zhan J, Wang S, Ho C-T, Li S. Bioactives of Momordica charantia as potential anti-diabetic/ hypoglycemic agents. Mol. 2022;27(7):2175. https://doi. org/10.3390/molecules27072175.
• 66. Habicht SD, Ludwig C, Yang R. Momordica charantia and type 2 diabetes: from in vitro to human studies. Curr. Diabetes Rev. 2014;10(1):48-60. https://doi.org/10.2174/15733998096 66131126152044
• 67. Haxhiraj M, White K, Terry C. The role of Fenugreek in the management of type 2 diabetes. nt. J. Mol. Sci. 2024;25(13):6987. https://doi.org/10.3390/ijms25136987.
• 68. Kim J, Noh W, Kim A, Choi Y, Kim YS. The effect of Fenugreek in type 2 diabetes and prediabetes: a systematic review and meta-analysis of randomized controlled trials. nt. J. Mol. Sci. 2023;24(18):13999. https://doi.org/10.3390/ijms241813999.
• 69. Shabil M, Bushi G, Bodige PK, Maradi PS, Patra BP, Padhi BK, Khubchandani J. Effect of Fenugreek on hyperglycemia: a systematic review and meta-analysis. Med. 2023;59(2):248. https://doi.org/10.3390/medicina59020248.
• 70. Geberemeskel GA, Debebe YG, Nguse NA. Antidiabetic effect of fenugreek seed powder solution (Trigonella foenum-graecum L.) on hyperlipidemia in diabetic patients, J. Diabetes Res. 2019;2019:8507453. https://doi.org/10.1155/2019/8507453.
• 71. Gaddam A, Galla C, Thummisetti S, Marikanty RK, Palanisamy UD, Rao PV. Role of fenugreek in the prevention of type 2 diabetes mellitus in prediabetes. J. Diabetes Metab. Disord. Control. 2015;14:74. https://doi.org/10.1186/s40200-015-0208-4.
• 72. Bayraktar DZ. The various therapeutic effects of ginger (Zingiber officinale Roscoe) on human health. Karya Journal of Health Science. 2021;2(2):55-60. https://doi.org/10.52831/kjhs.886448.
• 73. Akash MS, Rehman K, Tariq M, Chen S. Zingiber officinale and type 2 diabetes mellitus: evidence from experimental studies. Crit. Rev. Eukaryot Gene. Expr. 2015;25(2):91-112. https://doi.org/10.1615/critreveukaryotgeneexpr.2015013358.
• 74. Bakır B. The immunomodulatory effects of ginger (Zingiber officinale) extract on CD4 and CD8 expression in spleen of diabetic rats. Namik Kemal Med J. 2023;11(1):35-41. https:// doi.org/10.4274/nkmj.galenos.2023.25991.
• 75. Carvalho GCN, Lira-Neto JCG, Araújo MFM, Freitas RWJF, Zanetti ML, Damasceno MMC. Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial. Rev. Lat. Am. Enfermagem. 2020;28:e3369. https://doi.org/10.1590/1518-8345.3870.3369.
• 76. Zhu J, Chen H, Song Z, Wang X, Sun Z. Effects of ginger (Zingiber officinale Roscoe) on type 2 diabetes mellitus and components of the metabolic syndrome: a systematic review and meta-analysis of randomized controlled trials. eCAM. 2018;2018(1):5692962. https://doi.org/10.1155/2018/5692962.
• 77. Hajimoosayi F, Jahanian Sadatmahalleh S, Kazemnejad A, Pirjani R. Effect of ginger on the blood glucose level of women with gestational diabetes mellitus (GDM) with impaired glucose tolerance test (GTT): a randomized double-blind placebocontrolled trial. BMC Complement. Ther. Med. 2020;20:116. https://doi.org/10.1186/s12906-020-02908-5.