Status of Evidence on the Efficacy and Safety of Indian Traditional Medicine for Prediabetes and Type 2 Diabetes Mellitus: Protocol for a Systematic Review and Evidence Map Synthesis.

The short version

This paper is not a study of a treatment — it is a detailed, PROSPERO-registered plan (protocol) for a future systematic review that will evaluate India's AYUSH traditional medicine systems (Ayurveda, yoga and naturopathy, Unani, Siddha, Sowa Rigpa/Tibetan medicine, and homeopathy — governing prevention and personalized care) for managing prediabetes and type 2 diabetes. Diabetes affects roughly 537 million people worldwide, a number expected to more than double by 2050, and India alone had over 74 million cases in 2021 — with about half going undiagnosed — making a clear-eyed evidence review of its traditional treatment options a genuine public-health priority. Once underway, two independent researchers will search major databases (PubMed, Scopus, Web of Science, Embase) plus AYUSH-specific sources, screening for studies conducted in India that test any of these six systems — whether used alone or alongside standard diabetes care — measuring outcomes like blood sugar levels (fasting and after meals), long-term blood sugar control (HbA1c), and insulin resistance, alongside safety data. As of this publication, there are no results to report (the review had not yet started; database searching was planned for September 2025). What the protocol does establish is exactly how quality will be judged: each study will be scored with standard tools (from the NIH, and the Cochrane risk-of-bias tool for randomized trials) and then sorted into a visual "evidence map" — graded green, yellow, or red by the World Health Organization's A/B/C evidence-quality scale — showing at a glance where each traditional system has strong support and where the gaps are. The completed review and its findings are expected around December 2026, with publication in early 2027. For now, the practical takeaway is that this protocol tells us what will be studied and how carefully, not what was found. Until the finished evidence map is published, none of the six systems named here has established evidence for diabetes management; the protocol itself states upfront limitations even for the eventual review: English-language sources only, India-based studies only, and no pooled statistical meta-analysis planned.

Key findings

• This publication is a PROTOCOL — a detailed plan for a future systematic review — not the review itself, so it contains no findings yet about whether any AYUSH (Ayurveda, yoga, naturopathy, Unani, Siddha, Sowa Rigpa, homeopathy) treatment actually helps diabetes or prediabetes.
• The planned review will only include studies conducted in India or involving Indian populations, so its eventual conclusions may not generalize to how these traditions are practiced or studied elsewhere.
• Researchers plan to grade each study's quality (using NIH tools and, for randomized trials, the Cochrane risk-of-bias tool) and sort the evidence into a visual "evidence map" by traditional-medicine system and by grade (WHO grades A, B, or C), making it easy to see where evidence is strong versus where more research is needed.
• The review is a systematic map, not a meta-analysis — it will not pool studies' statistics into one combined number, because the studies use very different designs and outcome measures.
• The completed review and its results are expected in early 2027; until then, this protocol tells us what will be studied and how, not what was found.

Common questions