Type 2 Diabetes

Shujie Wang et al. (2022) · Gut microbes

This randomized trial with 365 adults who had newly diagnosed type 2 diabetes explored whether combining berberine, a plant compound extracted from the Chinese herb Coptis chinensis (Huanglian), with a probiotic mix lowers postprandial lipidemia, the rise in blood fats and cholesterol after a meal. The authors note that cholesterol measured after eating is also an important heart-disease risk marker, that after-meal blood fats are common in diabetes, and that very few treatments target them. Berberine was already known to lower fasting cholesterol, but whether it helps after meals was unknown. Probiotics are live bacteria, and the nine-strain mix here included Bifidobacterium breve. This analysis came from a 12-week, double-blind, placebo-controlled trial at 20 centers in China, with 365 participants split into four groups: placebo (91), probiotics alone (92), berberine alone (84), and both (98). Participants were drug-naive adults aged 20 to 70, averaging about 52. They took berberine pills twice daily before meals, and probiotic powder once daily at bedtime. After a standard 100 g carbohydrate meal, blood drawn 120 minutes later measured cholesterol and triglycerides, and stool samples tracked gut bacteria. Only the combination significantly cut after-meal total cholesterol (24.29 mg/dL drop versus 8.66 with placebo, adjusted P = .001, a gap that chance is very unlikely to explain) and after-meal LDL cholesterol (16.54 versus 7.35 mg/dL, P = .043). Berberine alone and probiotics alone did not differ significantly from placebo for these two measures. After-meal triglycerides fell with berberine alone (P = .037) and the combination (P = .035) equally, so probiotics added nothing there, and HDL (good) cholesterol did not differ between groups. Thirty-one blood lipid molecules changed only with the combination, versus eight with berberine and two with probiotics. In stool, B. breve rose with the combination, and higher levels went with lower after-meal cholesterol. In lab dishes, berberine slowed B. breve growth but switched on its fatty-acid-uptake genes (called fadD). Adverse events were not reported in this paper. The authors conclude that berberine plus probiotics acts synergistically on after-meal blood fats, with the probiotic replacing Bifidobacteria that berberine suppresses and berberine activating the bacteria's fat-handling genes. They state the limits plainly: only 13 weeks and no heart-attack or stroke outcomes, testing only after a carbohydrate meal, and unknown applicability to people already on statins. The authors propose that probiotics containing Bifidobacterium may be needed when berberine is used as a lipid-lowering agent. They suggest studying fatty meals and other gut-related pathways in future work.

Fernanda A Espinoza-Hernández et al. (2022) · Evidence-based complementary and alternative medicine : eCAM

This 42-day study in laboratory rats tested three plants long used in Mexican traditional medicine for diabetes: Ageratina petiolaris, Calea urticifolia, and Eryngium cymosum. Type 2 diabetes (a condition where the body cannot properly regulate blood sugar) causes 90-95% of diabetes cases and is a leading cause of death in Mexico, where many people, especially in rural communities with limited access to health services, drink these plants as traditional teas alongside or instead of prescribed medication. The researchers wanted to know whether the plants' previously documented short-term blood-sugar-lowering effects would hold up over six weeks of continuous use. Six groups of six rats each were given hyperglycemia (high blood sugar) through a standard chemical induction method, then treated once daily for 42 days with one of: a placebo, a combination of two standard diabetes drugs (metformin and glibenclamide) as a positive comparison, or the traditional-strength tea extract of one of the three plants. A separate untreated, non-hyperglycemic group served as a healthy baseline. Researchers tracked blood glucose weekly, a longer-term blood sugar marker called HbA1c three times over the study, and blood fat (triglyceride) levels every two weeks. Rats given no treatment for their high blood sugar got steadily worse across the study. Ageratina petiolaris lowered blood glucose by 33% from its own starting point (a statistically meaningful reduction, p=0.0281), kept the HbA1c rise to just 2.63 percentage points versus roughly 10 points in the untreated group (p=0.0303), and was the only plant extract to also significantly reduce blood triglycerides (p=0.0031). Calea urticifolia and Eryngium cymosum did not significantly lower overall blood glucose compared to the untreated group, but they did significantly limit the HbA1c rise to about 2.4-3.0 percentage points each (both p=0.0156) - meaning that even without a clear glucose-lowering signal, both plants measurably slowed the longer-term worsening of blood sugar control. Neither of these two plants meaningfully affected triglycerides. The study's authors suggest chlorogenic acid, found in all three plants, may explain their shared blood-sugar effects, while a different compound unique to Ageratina petiolaris may explain its additional benefit for triglycerides. This is animal, not human, research, and the study did not examine pancreatic tissue, insulin levels, or the specific fat particles that matter most for heart-disease risk. The findings support these plants as promising candidates for further development but do not establish that the same doses would work the same way in people.

Galib Ruknuddin et al. (2026) · JMIR research protocols

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.

Yan-Kun Chen et al. (2023) · Frontiers in endocrinology

This literature review asks two connected questions: what actually drives obesity and type 2 diabetes at a biological level, and whether Traditional Chinese Medicine has anything to offer in managing them. The two conditions are closely linked — the review notes that type 2 diabetes accounts for roughly 90% of all diabetes cases and is strongly tied to excess weight. There is a practical bind behind the question, too: several standard diabetes drugs, including insulin and sulfonylureas, make weight loss harder rather than easier. The authors searched PubMed, Scopus and Web of Science for work published between 2019 and 2023, covering molecular, cellular and clinical studies of how obesity, diabetes and TCM interact. It is important to be clear about what kind of review this is: a narrative overview rather than a systematic one. There is no count of included trials, no pooled statistics and no formal assessment of study quality, so it maps a field rather than measuring an effect. On mechanism, the review draws a useful distinction between visceral fat — stored around the liver, pancreas and kidneys, hormonally active, and the type that drives insulin resistance — and subcutaneous fat sitting under the skin. This is why apple-shaped fat distribution carries more metabolic risk than pear-shaped. The scale of the problem is stark: the World Health Organization counted 1.9 billion overweight adults in 2016, 650 million of them with obesity, and 38.2 million children under five overweight or obese in 2019. The TCM proposal is that acupuncture, herbal remedies and dietary therapy act on inflammation, oxidative stress, insulin resistance and the balance of gut bacteria. What this review does not provide is evidence of how well any of that works. No effect sizes, no confidence intervals, no trial results for any specific TCM intervention appear. The authors themselves conclude only that TCM may be promising and that well-designed studies are still needed to confirm both efficacy and safety. Read it as a map of plausible mechanisms and an argument for research, not as grounds for choosing a treatment.

Metha Yaikwawong et al. (2024) · Nutrition journal

This 12-month randomized, double-blind, placebo-controlled trial with 272 adults with type 2 diabetes (T2DM) and obesity explored whether curcumin, the active compound in turmeric (Curcuma longa), could protect the pancreatic beta cells that produce insulin. In T2DM, obesity drives insulin resistance (cells responding poorly to insulin), which forces beta cells to work harder until their function starts to decline. Researchers tracked beta-cell function using HOMA-beta, an index calculated from fasting insulin and glucose, alongside HOMA-IR (a related index for insulin resistance) and two hormones made by fat tissue: adiponectin, which improves insulin sensitivity, and leptin, which signals fullness but runs high with excess body fat. Participants, all 35 or older and already taking metformin, were randomly assigned to six capsules a day (1,500 mg total) of standardized curcumin extract or an identical-looking placebo for 12 months, with 115 people in the placebo group and 114 in the curcumin group at randomization. Neither participants nor staff knew who received which capsule. Blood was drawn at baseline and every three months to measure fasting glucose, HbA1c (average blood sugar over about three months), body weight, BMI, insulin, HOMA-beta, HOMA-IR, adiponectin, and leptin. By 12 months, curcumin-treated participants had notably better beta-cell function than the placebo group (HOMA-beta 136.2 vs. 105.2; P<0.01, meaning their beta cells were working more efficiently), a difference that only became significant at 9 and 12 months, suggesting the benefit builds gradually rather than appearing right away. Insulin resistance dropped further with curcumin (HOMA-IR 4.86 vs. 6.04; P<0.001, lower is better), and blood sugar control improved (fasting glucose 115 vs. 131 mg/dL, P<0.05; HbA1c 6.12% vs. 6.47%, P<0.05). The curcumin group also lost more weight (66.1 vs. 69.3 kg, P<0.001) and lowered BMI (25.98 vs. 27.34, P<0.001), while adiponectin rose (14.5 vs. 10.4 ug/mL, P<0.001, more of the "good" fat hormone) and leptin fell (9.4 vs. 20.7 ug/mL, P<0.001, less of the fullness hormone that runs high in obesity). The authors connect these changes to curcumin's anti-inflammatory activity, since inflammation is a known driver of beta-cell decline. Mild side effects, abdominal pain, diarrhea, and headache, occurred in both groups with no one dropping out because of them, and liver and kidney markers stayed normal, suggesting curcumin extract is reasonably safe as a year-long add-on for people already managing T2DM with metformin. Because the trial tested only one dose at a single Thai hospital, it cannot show whether a different dose would work better or whether these results generalize elsewhere. Larger, multi-center trials testing a range of doses would help confirm curcumin's place alongside standard diabetes care.