A Review of the Interactive Effects of Exercise and Medicinal Plants on Glycemic Indices and Lipid Profile in Diabetes Mellitus

Background: Diabetes is a common and non-communicable disease that is on the rise around the world due to the lifestyle and eating habits of people. Long-term complications of diabetes include retinopathy, neuropathy, nephropathy, cardiac symptoms, genitourinary symptoms, sexual symptoms, and cerebrovascular events. Based on the numerous studies to reduce the complications of diabetes, exercise and medicinal plants (due to not having the side effects of synthetic drugs) are the most important strategies to control blood glucose and hyperlipidemia; however, the simultaneous impact of these two interventions has recently been considered by researchers. Therefore, it seems necessary to review these studies in the field of sports nutrition and use these two interventions at the same time. Objective:This study aimed to review the effects of consuming 10 medicinal plants simultaneously with exercise. Methods We searched all databases, especially Web of Science, PubMed, SID, Magiran, with relevant keywords, such as "medicinal plant", "anti-diabetic component", "exercise", "training", "glycemic index", and "lipid profile", without time limit. The articles were then categorized based on exercise and herbs on carbohydrates and lipids metabolism. Results: According to the studies conducted in the databases, 564 articles related to exercise and medicinal plants were observed. However, according to the inclusion criteria (dealing with physical activity, medicinal plants, and also diabetes), 34 articles related to the effects of exercises and medicinal plants in diabetes status were selected. Among the obtained studies, 10 medicinal plants, most of which were studied simultaneously with exercises, were examined. The results showed that medicinal plants, with their antioxidant activity and mechanisms related to stimulating insulin secretion, control hyperlipidemia. They act along with exercise activities depending on the type, intensity, and duration and increase the body's antioxidant activity and glucose consumption in muscle via non-insulin-dependent pathways in diabetic conditions. Conclusion: It seems that due to the challenging nature of the exercise intervention, using plant antioxidants along with physical activity will lead to improved metabolic parameters in diabetic patients. However, to confirm the safety of consumption, besides examining the therapeutic effects of plants and their active compounds, their toxicity should also be investigated. Also, the small number of samples, failure to follow the long-term effects of simultaneous use of medical plants and exercise, and lack of precise diet control in human samples are limitations of this study. So conducting human studies in this area with caution and deleting the overcoming limitations is necessary for future research.