Interaction between Anti Diabetic Drugs and Herbs: A Review

Diabetes is a long-term medical disorder characterized by elevated blood glucose levels due to inadequate insulin use. It is caused by a pathogenic process that results in insulin insufficiency due to the death of β-cells. Uneven insulin secretion and use contribute to diabetes mellitus. Pancreatic beta cell loss is a primary cause of diabetes mellitus, which is associated with both insulin insufficiency and insulin resistance. Herbal medicines have been used for treating illness since ancient times, with over 800 plants having potential anti-diabetic properties. These plants have numerous pharmacological and therapeutic applications, including lowering blood glucose levels and enhancing beta-cell function. It is a common trend in Asian countries specifically in India that herbal medicine/s along with allopathic medicine/s is used. Herbal drug interactions can occur when conventional medications and herbal remedies are used together, leading to elevated toxicity or pharmacological effects. Xenobiotic substrates can affect the biological activity of xenobiotic substrates and other compounds, leading to increased oral bioavailability and decreased clearance and excretion. Cytochrome induction, triggered by AhR and PXR receptors, can improve the activity of intestinal and hepatic enzymes, affecting oral bioavailability and plasma concentration. The therapeutic benefit of herbal drugs that induce cytochrome induction is reduced when taken concurrently, hence in the present review interactions (pharmacodynamic and pharmacokinetic) of 27 plants having anti-diabetic property with oral anti-diabetic agents have studied.