Harnessing Herbal Power: A Systematic Review of Phytopharmaceuticals in Type 2 Diabetes Management

The Type 2 diabetes mellitus (T2DM) is one of the key health crises facing the world, with the prevalence expected to surpass 783 million adults by the year 2045. It causes premature disability, death and enormous social and economic costs. It is believed that the number of diabetes mellitus (DM) may increase to 592 million in 2035. Although there are conventional therapies, they are very expensive and limited. Despite the fact drugs that are produced synthetically are effective in controlling the disease, there are some side effects that are related with their long-term use. Consequently, the role of the traditional medicine such as plant extracts and pharmacological compounds derived out of plants is becoming very popular. The purpose of this review is to bring together the existing research on the effectiveness of herbal medicine in treating T2DM and especially phytochemicals based on in vitro, in vivo and clinical studies.

This review is the first to put a list of mechanisms into seven functional domains (1): insulin secretion and 2 -cell protection (2), insulin signaling facilitation (PI3K/Akt, AMPK, GLUT4) (3), carbohydrate digestion inhibition (alpha -amylase, 3 -glucosidase) (4), lipid metabolism control (5), carbohydrate oxidative stress (6), 3 -cell inflammation, and (7) gut microbiota control. It addresses also a wide range of herbal extracts and commercial products in order to estimate their capacity in the symptoms and complications of T2DM alleviation.

Some of the plant-derived metabolites, including antidiabetic properties expressed in their antioxidant, alkaloids and polysaccharides, are discussed. Growing evidence shows that phytochemicals control the secretion and activity of glucagon-like peptide-1 (GLP-1) receptor and is another natural way of using incretin-based therapy.

The results of the researches suggest that plant-based compounds are effective in the management of T2DM due to different biochemical processes such as restoration of the pancreatic β-cells functions, insulin sensitization, the stimulation of insulin secretion, the inhibition of hepatic gluconeogenesis, enhancement of glucose absorption, and the suppression of G-6-phosphatase, α-amylase, and α-glucosidase activity.