A review of the mechanisms of action and clinical consequences of interactions between antidiabetic medications and botanicals

Diabetes is a complex condition with a variety of causes and patho-physiologies. The current single target approach has not provided ideal clinical outcomes for the treatment of the disease and its complications. Herbal medicine has been used for the management of various diseases such as diabetes over centuries. Many diabetic patients are known to use herbal medicines with antidiabetic properties in addition to their main stream treatments, which may present both a benefit as well as potential risk to effective management of their disease. In this review, we evaluate the clinical and experimental literature on herb–drug interactions in the treatment of diabetes. Pharmacokinetic and pharmaco-dynamic interactions between drugs and herbs are discussed, and some commonly used herbs, which can interact with antidiabetic drugs summarized. Herb–drug interactions can be a double-edgeds word presenting both risks (adverse drug events) and benefits (through enhancement). There is a general lack of data on herb–drug interactions. As such, more rigorous scientific research is urgently needed to guide clinical practice as well as to safeguard the wellbeing of diabetes patients.