Herbal Remedies for Diabetes: Insights from Indian Medicinal Plants

Introduction
Diabetes mellitus (DM), commonly referred to as diabetes, originates from the Greek word diabino, meaning “to pass through,” referring to the excessive excretion of glucose in urine. It is a chronic metabolic and, in some cases, autoimmune disorder characterized by persistently elevated blood glucose levels due to either insufficient insulin secretion, impaired insulin action, or both [1]. When blood sugar levels rise abnormally, glucose may also appear in urine, a condition historically associated with the naming of the disease. Diabetes is strongly linked to alterations in lifestyle, dietary habits, and delayed diagnosis, which contribute significantly to its progression and complications. Globally, diabetes is considered one of the most serious health challenges of the 21st century. It is currently ranked among the leading causes of mortality and disability, with projections suggesting a continuous rise in prevalence, particularly in developing and urbanizing nations. The disease not only imposes a heavy physical burden on individuals but also leads to substantial social and economic losses, straining healthcare systems and affecting overall productivity [9]. In fact, diabetes is now recognized as the fifth leading cause of death worldwide, highlighting the urgency of effective prevention and management strategies. Modern medicine provides several treatment options, including insulin therapy and a variety of oral hypoglycemic drugs. However, these interventions are often associated with limitations such as side effects, high costs, and lack of availability in resource-constrained settings. As a result, there has been an increased global interest in complementary and alternative approaches, particularly herbal medicine [2-5].

Herbal remedies have been utilized for centuries as part of traditional healing systems, and their popularity has expanded in recent decades due to their accessibility, affordability, and relatively lower risk of adverse effects. The World Health Organization (WHO) estimates that approximately 21,000 plant species worldwide are used for medicinal purposes, with many showing potential for the treatment and management of diabetes. These plants are rich in bioactive compounds, including alkaloids, flavonoids, tannins, terpenoids, and phenolic compounds, which are believed to exert antidiabetic effects through diverse mechanisms, such as enhancing insulin secretion, improving glucose uptake, and protecting pancreatic β-cells from damage.

Given the rapid growth of interest in herbal medicine and the alarming increase in diabetes prevalence, it becomes crucial to explore, document, and validate medicinal plants traditionally employed for diabetes management. Such knowledge not only helps in developing safer and cost-effective therapies but also contributes to global efforts in integrating traditional wisdom with modern biomedical research.

Among these 2500 species are in India, out of which 150 species are used commercially on a fairly large scale [19]. India is the largest producer of medicinal herbs and is called as botanical garden of the world [101]. The current review focuses on diabetes and plants used in diabetes. Sulfonylurea and meglitinide drugs stimulate insulin secretion, which causes an increase in peripheral glucose absorption by biguanides and thiazolidinediones [39]. There is currently no permanent cure for diabetes, and while several therapeutic approaches are available, most treatments are associated with notable limitations. Long-term use of antidiabetic drugs can lead to reduced efficacy, drug resistance, toxicity, and undesirable side effects. For instance, sulfonylureas—commonly prescribed oral hypoglycemic agents—lose their effectiveness in nearly 44% of patients after six years of continuous treatment [25]. Such challenges highlight the urgent need for safer and more sustainable management strategies.

According to global health estimates, the burden of diabetes continues to rise at an alarming pace. In 2014, approximately 8.5% of adults aged 18 years and above were living with diabetes. By 2019, the disease was directly responsible for 1.5 million deaths, with nearly 48% of these occurring before the age of 70. Furthermore, hyperglycemia contributes significantly to complications: about 20% of cardiovascular-related deaths are attributed to elevated blood glucose levels, and diabetes is a leading cause of renal failure, accounting for an estimated 460,000 new cases of kidney disease annually [71].

Between 2000 and 2019, the global age-standardized mortality rate due to diabetes increased by 3%, with a disproportionate impact observed in low- and middle-income countries. In lower-middle-income regions, deaths associated with diabetes rose by nearly 13% during the same period [38]. These figures underscore the escalating global health challenge posed by diabetes and the pressing need for innovative therapeutic strategies, particularly those that are accessible, cost-effective, and associated with fewer long-term complications.

According to centers for Disease Control and prevention CDC there are two types of diabetes. Type 1 and type 2, but gestational diabetes is also quite common. All these types cause hyperglycemia because off facing problems related to with insulin hormone. Diabetes has various ranges of other about 2% of people have these [38]. In type 1 disease is insulin insufficiency related to a lack of functional beta cells. Here insulin is used exogenously [62]. T1DM influences 5 to 10% of individuals and is generally predominant in youngsters, in this manner otherwise called “adolescent diabetes” or “insulin-subordinate diabetes” [22, 62].  Type 2 is an insulin-independent type.  Type II diabetes is the more common form of diabetes constituting 90% of the diabetic population. It occurs due to receptor insusceptibility. Medication, exercise, and dietary changes were used as treatment for type 2 diabetes [9]. Gestational diabetes occurs in pregnancy. It is caused due to insulin-blocking hormones that inhibit the insulin hormone from the beta cell [16]. The following are the symptoms of diabetes [6,70]: high blood sugar levels, excessive thirst, frequent urination, extreme hunger, weight loss, blurred vision, irritability, mood changes, weakness, tiredness, vomiting, and nausea.

Diabetes is a chronic metabolic disorder characterized by elevated fasting and postprandial blood glucose levels. Global projections indicate a sharp rise in prevalence, with the number of people affected expected to increase from 4% in 1995 to 5.4% by 2025 [66]. According to WHO estimates, developing nations will bear the greatest share of this burden. Evidence from India over the past decade highlights not only a high prevalence of diabetes but also its rapid increase, particularly among urban populations [91]. It is estimated that the number of adults with diabetes in India, currently around 33 million, will rise to 57.2 million by 2025 [75]. Although the exact pathophysiology of diabetes remains unclear, experimental findings suggest that free radicals play a critical role in both the onset of the disease [69] and the progression of its complications [80, 13, 60]. Free radicals disrupt biological functions, while antioxidants capable of neutralizing them have been shown in numerous studies to reduce the severity of diabetes-related complications and even prevent experimentally induced diabetes in animal models [72, 76].

One of the major challenges in incorporating herbal medicine into modern therapeutic practices is the lack of sufficient scientific and clinical validation regarding its safety and efficacy. Furthermore, identifying and standardizing the active phytochemical components of herbal extracts is essential. Rigorous pharmacological, toxicological, and bioassay-based studies, along with the use of appropriate animal models, are required to establish reliability and ensure safety in clinical applications. At present, various treatment options such as insulin therapy, oral hypoglycemic agents, and dietary interventions are available to manage diabetes. Glucose-lowering drugs exert their effects through different mechanisms; however, the disease continues to affect multiple organ systems including nerves, blood vessels, eyes, kidneys, and the heart, making long-term management a global health priority.

Materials and Methods

The purpose of this review was to thoroughly analyze and compile published research on diabetes from 1988 to 2025, 37 years. A comprehensive literature search was conducted using electronic databases such as PubMed, Science Direct, Scopus, Google Scholar, Web of Science, and Academic journals.

Results and Discussion

There are many antidiabetic plants used in the treatment of diabetes. Here are 130 species that belongs to different families are given below. The plant species and their mode of use are given in Table 1. Plants are an excellent natural remedy for diabetes. The following leaf components are utilized to extract antidiabetic compounds: pulp, pulp and wood, fruit, flower, root, seed, plant extract, aerial portion, and latex (Fig.1).

Conclusion

This review highlights the shortcomings in published research on the use of medicinal herbs as an intervention for diabetes in humans. Research on the plants used for diabetes showed promising results in the treatment of diabetes-related conditions like hyperglycemia. It includes that leaves are widely used for diabetes treatment.  It’s also important to note that different extraction techniques and procedures are applied to various medicinal plants in different parts (Table 1).

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