Evidence Landscape of Shilajatu (Asphaltum punjabinum) in the Management of Diabetes Mellitus: A Scoping Review

Shilajatu (Asphaltum punjabinum), a herbo-mineral exudate described in Ayurveda as a Rasayana, has been traditionally indicated in Prameha (diabetes mellitus). Its chemical matrix, enriched with fulvic acids, dibenzo-α-pyrones, and trace elements, is proposed to influence insulin signalling, mitochondrial function, oxidative balance, and lipid homeostasis. To systematically map and synthesize the available preclinical and clinical evidence regarding the antidiabetic efficacy of Shilajatu, a scoping review was conducted in accordance with PRISMA-ScR guidelines. Electronic databases (PubMed, Scopus, Web of Science, Google Scholar, and AYUSH Research Portal) were searched from 1980 to December 2025. Eligible studies included in vivo experimental models and clinical investigations evaluating glycaemic and diabetes-related outcomes following oral administration of Shilajatu. Data were charted using standardized extraction templates and synthesized descriptively. Out of 152 identified records, seven studies fulfilled eligibility criteria, comprising four in vivo studies, two clinical trials, and one case report. Preclinical findings demonstrated significant attenuation of hyperglycaemia, improved insulin sensitivity (including reductions in HOMA-IR), restoration of antioxidant enzyme activity (Superoxide dismutase, Catalase, Glutathione peroxidase), suppression of inflammatory mediators, and protection against diabetes-associated organ damage. Clinical studies reported reductions in fasting blood glucose (18.04-26.03%) and postprandial glucose (19.29-27.75%) over 8-12 weeks, with parallel improvement in classical diabetic symptoms and lipid parameters. A case report documented a reduction in HbA1c from 12.8% to 7.3% over 90 days. Available evidence indicates that Shilajatu exerts multimodal antidiabetic effects through coordinated metabolic, oxidative, and inflammatory pathway modulation. However, larger randomized controlled trials with standardized preparations and validated biomarkers are required to establish definitive clinical efficacy and translational relevance.