Herbal Medicine as an Alternative Medicine for Treating Diabetes: The Global Burden

Diabetes mellitus (DM) affects 150 million people worldwide including 50 million in India. The incidence rate of the disease is expected to double by 2025. Diabetes emerges due to several factors such as inhibition of glucose absorption, increase in glucose uptake and upregulation of glucose transporters, activation of the nuclear receptor PPARí µí»¾, increase in adiponectin release, glycogen metabolism, absent or decreased insulin production and/or impaired function, insulin mimetic and insulinotropic effect, elevation of D-Chloroinositol, incretin mimetics and incretin enhancers, and the role of endogenous opioids on glucose homeostasis and antioxidants. Based on the pancreatic effect, DM is classified as type 1 (insulin dependent diabetes mellitus (IDDM)) and type 2 (nonin-sulin dependent diabetes mellitus (NIDDM)). DM induced hyperglycemia leads to many clinical complications either at the macrovascular level causing coronary artery and cerebrovascular diseases or at the microvascular level causing renal failure, blindness, limb amputation, neurological complications , and premature death [1, 2]. The symptoms of DM include severe hypoglycemia, lactic acidosis, idiosyncratic liver cell injury, permanent neurological deficit, digestive discomfort, headache, and dizziness. Existing therapeutics against DM mainly include synthetic hypoglycemic drugs and insulin. These anti-DM drugs usually target a single metabolic pathway to regulate hyper-glycemia and are laced with numerous side effects and their efficacies are questionable. Therefore, it is imperative to develop new therapeutic paradigms that can act on more than one key metabolic pathway concerning carbohydrate, fat, or protein metabolism. Herbal preparations from over 200 traditional plants and their bioactive constituents are known to possess antidiabetic property as demonstrated by various screening methods. The extracts or constituents of some plants may act at different levels such as inhibiting glucose absorption from intestines, increasing insulin secretion from the pancreas, enhancing glucose uptake by adipose and muscle tissues, or inhibiting glucose production from hepatocytes [2]. Accordingly, there are ample possibilities to exploit phytochemicals as effective alternative medicines with limited or no side effects. Given that limited information is available regarding the evidence-based therapeutic usage of many antidiabetic plants, this special issue was proposed. It attracted many submissions; following a peer review, only seven submissions were recommended for publication. These articles include review articles and technical papers that provide comprehensive reports on antidiabetic plants and the mode of action of their active ingredients. The review article " Botanical, pharmacological, phyto-chemical, and toxicological aspects of the antidiabetic plant Bidens pilosa L. " written by W.-C. Yang provides up-to-date information on …