Herb-Drug Interaction of Traditional Indian Herbs Used for Treatment of Diabetes Mellitus: An Evidence-Based Review.

The growing trend of nutraceuticals in diabetes management makes it imperative to document traditional knowledge of medicines under a single heading to help researchers formulate new functional foods. According to the World Health Organization, about 90% of the population in developing countries use plant products in primary health care either alone or in conjunction with western medicine. About 800 plants worldwide have been reported to possess powerful antidiabetic potential by enhancing insulin secretion, improving insulin resistance, α-glucosidase enzyme inhibitory activity, anti-inflammatory effects, regenerating pancreatic β-cells and mitigating diabetesassociated oxidative stress. Most natural remedies mediate enhancement of glucose uptake and suppression of hepatic glucose output by stimulating glycolysis, glucose oxidation and glycogenesis, along with reducing glycogen degradation and gluconeogenesis. Herbal treatment for managing diabetic symptomatologies has been a part of the Indian traditional system of medicine. This review evaluates the efficacy and safety of commonly used ethnomedicinal plants in India by providing an insight into the molecular and cellular mechanisms of action of key bioactives. As herbal remedies are complex mixtures of various bioactive entities, there is high probability of interaction with prescription drugs via pharmacokinetic or pharmacodynamic mechanisms. In addition, diabetic patients present different comorbidities and hence may be treated with multiple medications, increasing the chances of herb-drug interaction. [ABSTRACT FROM AUTHOR]