Diabetes mellitus (DM) is a chronic metabolic condition that affected more than 537 million adults across the globe in 2021, and this figure is projected to climb to approximately 783 million by 2045. The disorder is fundamentally characterised by sustained elevation of blood glucose arising from impaired insulin secretion, diminished insulin effectiveness, or a combination of both. Over time, uncontrolled hyperglycaemia damages the retinal vessels, glomeruli, peripheral nerves, and major arteries, giving rise to the array of micro- and macrovascular complications that dominate DM-related morbidity. Although the pharmacological toolkit available to clinicians has grown considerably—spanning biguanides, sulphonylureas, DPP-4 inhibitors, SGLT-2 inhibitors, and GLP-1 receptor agonists—each drug class carries its own profile of adverse effects, variable patient tolerability, and cost barriers that are particularly pronounced in low-resource settings where the burden of DM is rising most sharply. For thousands of years, plant-based remedies have served as the primary antidiabetic treatment across virtually every major civilisation. Species such as Momordica charantia, Gymnema sylvestre, Trigonella foenum-graecum, Berberis aristata, and Curcuma longa harbour pharmacologically active phytochemicals —alkaloids, flavonoids, terpenoids, and polyphenols—that simultaneously act on multiple pathways involved in diabetic pathophysiology. Despite well-documented efficacy in laboratory models and a growing body of clinical evidence, these plant-derived compounds face persistent biopharmaceutical obstacles including poor water solubility, extensive first-pass metabolism, limited oral bioavailability, and chemical instability.
Dhand et al. (Wed,) studied this question.