It is progressively obvious that not only is a cure for the current worldwide diabetes epidemic required but also for its major complications, affecting both small and large blood vessels. These complications occur in the majority of individuals with both Type-1 and Type-2 diabetes. Incidence and pervasiveness of diabetes mellitus are rapid becoming high in middle- and low-income countries where about 80% of people living in those countries depend on traditional medicines. Innumerable and diverse reports abound in the literature on studies conducted to investigate the ameliorative effects of medicinal plants on various pathophysiological complications of diabetes mellitus. Traditional medicines derived from medicinal plants are used by about 60% of the world’s population. Although there are various perspectives to reduce the ill effects of diabetes and its secondary complications, herbal formulations are preferred due to lesser side effects and low cost. The present review emphasizes on medicinal plants that could be beneficial for the treatment of diabetes-induced macrovascular and microvascular complications.

Keywords: Diabetic Complications, Diabetes, Type-1 diabetes, Type-2 diabetes, macrovascular complication, microvascular complication

Author Biography

REKHA BISHT, Department of Pharmacology, Indore Institute of Pharmacy, Indore, Madhya Pradesh, India.

Indore Institute of Pharmacy, Indore (M.P.)

Assistant Professor


1. Deshpande AD, Harris-Hayes M, Schootman M. Epidemiology of diabetes and diabetes-related complications. Phys Ther 2008;88:1254 64.
2. Jose D, Aleykutty NA, Jyoti H. Effect of combination of two plant extracts on diabetes mellitus. Int J Pharm Pharm Sci 2018;10:49-52.
3. Forbes JM, Cooper ME. Mechanisms of diabetic complications. Physiol Rev 2013;93:137-88.
4. Subramania K, Pathakb S, Hosseinkhani H. Recent trends in diabetes treatment using nanotechnology. Dig J Nanomater Biostruct 2012;7:85 95.
5. Naslafkih A, Sestier F. Diabetes mellitus related morbidity, risk of hospitalization and disability. J Insur Med 2003;35:102-13.
6. Nguyen DV, Shaw LC, Grant MB. Inflammation in the pathogenesis of microvascular complications in diabetes. Front Endocrinol (Lausanne) 2012;3:170.
7. Henry WL Jr. The complications of diabetes mellitus. J Natl Med Assoc 1987;79:677-80.
8. Gogoi N, Bhuyan B. In vivo anti-diabetic activity evaluation of the bark of Cascabela thevetia L. In streptozotocin induced diabetic rats. Int J Pharm Pharm Sci 2017;9:48-53.
9. Modak M, Dixit P, Londhe J, Ghaskadbi S, Devasagayam TP. Indian herbs and herbal drugs used for the treatment of diabetes. J Clin Biochem Nutr 2007;40:163-73.
10. Namazi N, Alizadeh M, Mirtaheri E, Farajnia S. The effect of dried Glycyrrhiza glabra L. extract on obesity management with regard to PPAR-?2 (Pro12Ala) gene polymorphism in obese subjects following an energy restricted diet. Adv Pharm Bull 2017;7:221-8.
11. Raveendra KR, Jayachandra, Srinivasa V, Sushma KR, Allan JJ, Goudar KS, et al. An extract of Glycyrrhiza glabra (GutGard) alleviates symptoms of functional dyspepsia: A randomized, double-blind, placebo-controlled study. Evid Based Complement Alternat Med 2012;2012:216970.
12. Kataya HH, Hamza AA, Ramadan GA, Khasawneh MA. Effect of licorice extract on the complications of diabetes nephropathy in rats. Drug Chem Toxicol 2011;34:101-8.
13. Fasola TR, Ukwenya B, Oyagbemi AA, Omobowale TO, Ajibade TO. Antidiabetic and antioxidant effects of Croton lobatus L. In alloxan-induced diabetic rats. J Intercult Ethnopharmacol 2016;5:364-71.
14. Chacko SM, Thambi PT, Kuttan R, Nishigaki I. Beneficial effects of green tea: A literature review. Chin Med 2010;5:13.
15. Ramadan G, El-Beih NM, Abd El-Ghffar EA. Modulatory effects of black v. Green tea aqueous extract on hyperglycaemia, hyperlipidaemia and liver dysfunction in diabetic and obese rat models. Br J Nutr 2009;102:1611-9.
16. Goyal S, Gupta N, Chatterjee S. Investigating therapeutic potential of Trigonella foenum-graecum L. As our defense mechanism against several human diseases. J Toxicol 2016;2016:1250387.
17. Xue W, Lei J, Li X, Zhang R. Trigonella foenum-graecum seed extract protects kidney function and morphology in diabetic rats via its antioxidant activity. Nutr Res 2011;31:555-62.
18. Sayed AA, Khalifa M, Abd el-Latif FF. Fenugreek attenuation of diabetic nephropathy in alloxan-diabetic rats: Attenuation of diabetic nephropathy in rats. J Physiol Biochem 2012;68:263-9.
19. Sini S, Malathy NS. Phytochemical characteristics of Ichnocarpus frutescens. (L) R.Br. Anc Sci Life 2006;25:71-5.
20. Kumarappan CT, Mandal SC. Polyphenolic extract of Ichnocarpus frutescens attenuates diabetic complications in streptozotocin-treated diabetic rats. Ren Fail 2008;30:307-22.
21. Ramkumar KM, Ponmanickam P, Velayuthaprabhu S, Archunan G, Rajaguru P. Protective effect of Gymnema montanum against renal damage in experimental diabetic rats. Food Chem Toxicol 2009;47:2516 21.
22. Ananthan R, Latha M, Ramkumar KM, Pari L, Baskar C, Bai VN, et al. Effect of Gymnema montanum leaves on serum and tissue lipids in alloxan diabetic rats. Exp Diabesity Res 2003;4:183-9.
23. Palani S, Raja S, Rajalingam D, Kumar RP, Kumar BS. Therapeutic Efficacy of Pimpinella tirupatiensis (Apiaceae) on acetaminophen induced hepatotoxicity and oxidative stress in male albino rats. Pharmacologyonline 2009;2:708-19.
24. Saddala RR, Thopireddy L, Ganapathi N, Kesireddy SR. Regulation of cardiac oxidative stress and lipid peroxidation in streptozotocin-induced diabetic rats treated with aqueous extract of Pimpinella tirupatiensis tuberous root. Exp Toxicol Pathol 2013;65:15-9.
25. Yang Y, Lewis MM, Bello AM, Wasilewski E, Clarke HA, Kotra LP, et al. Cannabis sativa (Hemp) seeds, ?9-tetrahydrocannabinol, and potential overdose. Cannabis Cannabinoid Res 2017;2:274-81.
26. Comelli F, Bettoni I, Colleoni M, Giagnoni G, Costa B. Beneficial effects of a Cannabis sativa extract treatment on diabetes-induced neuropathy and oxidative stress. Phytother Res 2009;23:1678-84.
27. Lim DW, Kim JG, Kim YT. Analgesic effect of Indian gooseberry (Emblica officinalis fruit) extracts on postoperative and neuropathic pain in rats. Nutrients 2016;8:760.
28. Tiwari V, Kuhad A, Chopra K. Emblica officinalis corrects functional, biochemical and molecular deficits in experimental diabetic neuropathy by targeting the oxido-nitrosative stress mediated inflammatory cascade. Phytother Res 2011;25:1527-36.
29. Ashwell M. Stevia, nature’s zero-calorie sustainable sweetener: A new player in the fight against obesity. Nutr Today 2015;50:129-34.
30. Marcinek K, Krejpcio Z. Stevia rebaudiana Bertoni: Health promoting properties and therapeutic applications. J Verbr Lebensm 2015;11:3-8.
31. Shivanna N, Naika M, Khanum F, Kaul VK. Antioxidant, anti-diabetic and renal protective properties of Stevia rebaudiana. J Diabetes Complications 2013;27:103-13.
32. Raghu R, Lu KH, Sheen LY. Recent research progress on garlic as a potential anticarcinogenic agent against major digestive cancers. J Tradit Complement Med 2012;2:192-201.
33. Mariee AD, Abd-Allah GM, El-Yamany MF. Renal oxidative stress and nitric oxide production in streptozotocin-induced diabetic nephropathy in rats: The possible modulatory effects of garlic (Allium sativum L.). Biotechnol Appl Biochem 2009;52:227-32.
34. Salahuddin A, Katary M. Effects of grape seed proanthocyanidin extract in attenuating diabetic complications in streptozotocin-induced diabetic rats. J Appl Pharm 2017;9:1-6.
35. Cui XP, Li BY, Gao HQ, Wei N, Wang WL, Lu M, et al. Effects of grape seed proanthocyanidin extracts on peripheral nerves in streptozocin-induced diabetic rats. J Nutr Sci Vitaminol (Tokyo) 2008;54:321-8.
36. Rao BS, Reddy KE, Parveen K, Narendra BL, Shekhar SC, Mangala L, et al. Effects of Cleome viscosa on hyperalgesia, oxidative stress and lipid profile in STZ induced diabetic neuropathy in Wistar rats. Pak J Pharm Sci 2014;27:1137-45.
37. Cortés-Rojas DF, de Souza CR, Oliveira WP. Clove (Syzygium aromaticum): A precious spice. Asian Pac J Trop Biomed 2014;4:90-6.
38. Nangle MR, Gibson TM, Cotter MA, Cameron NE. Effects of eugenol on nerve and vascular dysfunction in streptozotocin-diabetic rats. Planta Med 2006;72:494-500.
39. Mahboubi M. Caraway as important medicinal plants in management of diseases. Nat Prod Bioprospect 2019;9:1-11.
40. Sadiq S, Nagi AH, Shahzad M, Zia A. The reno-protective effect of aqueous extract of Carum carvi (black zeera) seeds in streptozotocin induced diabetic nephropathy in rodents. Saudi J Kidney Dis Transpl 2010;21:1058-65.
41. Gilani AH, Shaheen F, Zaman M, Janbaz KH, Shah BH, Akhtar MS, et al. Studies on antihypertensive and antispasmodic activities of methanol extract of Acacia nilotica pods. Phytother Res 1999;13:665-9.
42. Omara EA, Nada SA, Farrag AR, Sharaf WM, El-Toumy SA. Therapeutic effect of acacia nilotica pods extract on streptozotocin induced diabetic nephropathy in rat. Phytomedicine 2012;19:1059-67.
43. Ahmad A, Husain A, Mujeeb M, Khan SA, Najmi AK, Siddique NA, et al. A review on therapeutic potential of Nigella sativa: A miracle herb. Asian Pac J Trop Biomed 2013;3:337-52.
44. Meral I, Yener Z, Kahraman T, Mert N. Effect of Nigella sativa on glucose concentration, lipid peroxidation, anti-oxidant defence system and liver damage in experimentally-induced diabetic rabbits. J Vet Med A Physiol Pathol Clin Med 2001;48:593-9.
45. Alzohairy MA. Therapeutics role of Azadirachta indica (Neem) and their active constituents in diseases prevention and treatment. Evid Based Complement Alternat Med 2016;2016:11.
46. Hussain HE. Reversal of diabetic retinopathy in streptozotocin induced diabetic rats using traditional Indian anti-diabetic plant, Azadirachta indica (L.). Indian J Clin Biochem 2002;17:115-23.
47. Hashmi MA, Khan A, Hanif M, Farooq U, Perveen S. Traditional uses, phytochemistry, and pharmacology of Olea europaea (Olive). Evid Based Complement Alternat Med 2015;2015:541591.
48. Kaeidi A, Esmaeili-Mahani S, Sheibani V, Abbasnejad M, Rasoulian B, Hajializadeh Z, et al. Olive (Olea europaea L.) leaf extract attenuates early diabetic neuropathic pain through prevention of high glucose-induced apoptosis: In vitro and in vivo studies. J Ethnopharmacol 2011;136:188-96.
49. Ahmed F, Urooj A. Pharmacognostical studies on Ficus racemosa stem bark. Pharmacogn J 2011;3:19-24.
50. Solanki ND, Bhavsar SK. An evaluation of the protective role of Ficus racemosa Linn. In streptozotocin-induced diabetic neuropathy with neurodegeneration. Indian J Pharmacol 2015;47:610-5.
51. Sharma SB, Tanwar RS, Rini AC, Singh UR, Gupta S, Shukla SK, et al. Protective effect of Morus rubra L. Leaf extract on diet-induced atherosclerosis in diabetic rats. Indian J Biochem Biophys 2010;47:26 31.
52. Rajendran V, Krishnegowda A, Nachiappan V. Antihyperlipidemic activity of Cassia auriculata flower extract in oleic acid induced hyperlipidemia in Saccharomyces cerevisiae. J Food Sci Technol 2017;54:2965-72.
53. Gupta S, Sharma SB, Singh UR, Bansal SK. Salutary effect of Cassia auriculata L. Leaves on hyperglycemia-induced atherosclerotic environment in streptozotocin rats. Cardiovasc Toxicol 2011;11:308 15.
54. Niratkers CR, Preeti, Malti. Antimicrobial activity of leaf extract of Morus indica (Mulberry) from Chhattisgarh. Asian J Plant Sci Res 2015;5:28-31.
55. Andallu B, Varadacharyulu NCh. Control of hyperglycemia and retardation of cataract by mulberry (Morus indica L.) leaves in streptozotocin diabetic rats. Indian J Exp Biol 2002;40:791-5.
56. Donepudi AC, Aleksunes LM, Driscoll MV, Seeram NP, Slitt AL. The traditional ayurvedic medicine, Eugenia jambolana (Jamun fruit), decreases liver inflammation, injury and fibrosis during cholestasis. Liver Int 2012;32:560-73.
57. Tanwar RS, Sharma SB, Singh UR, Prabhu KM. Antiatherosclerotic potential of active principle isolated from Eugenia jambolana in streptozotocin-induced diabetic rats. Evid Based Complement Alternat Med 2011;2011:127641.
58. Moghadamtousi SZ, Fadaeinasab M, Nikzad S, Mohan G, Ali HM, Kadir HA, et al. Annona muricata (Annonaceae): A review of its traditional uses, isolated acetogenins and biological activities. Int J Mol Sci 2015;16:15625-58.
59. Agbai EO, Njoku CJ, Nwanegwo CO, Nwafor A. Effect of aqueous extract of Annona muricata seed on atherogenicity in streptozotocin-induced diabetic rats. Afr J Pharm Pharmacol 2015;9:745-55.
60. Surjushe A, Vasani R, Saple DG. Aloe vera: A short review. Indian J Dermatol 2008;53:163-6.
61. Saberi M, Gholami S. An investigation on the effects of the Aloe vera extract on the thickness of the retina in male diabetic rats. Iran J Vet Res 2012;13:296-302.
62. Kim YS, Lee YM, Kim JH, Kim JS. Polygonum cuspidatum inhibits pancreatic lipase activity and adipogenesis via attenuation of lipid accumulation. BMC Complement Altern Med 2013;13:282.
63. Sohn E, Kim J, Kim CS, Lee YM, Kim JS. Extract of Polygonum cuspidatum attenuates diabetic retinopathy by inhibiting the high-mobility group box-1 (HMGB1) signaling pathway in streptozotocin-induced diabetic rats. Nutrients 2016;8:140.
64. Bisht R, Bhattacharaya S. Some medicinal plants of Uttarakhand (India) with antimicrobial activity: A review. Pharmacologyonline 2011;2:428 439.
65. Rahman S, Parvin R. Therapeutic potential of Aegle marmelos (L.) an overview. Asian Pac J Trop Dis 2014;4:71-7.
66. Bhatti R, Sharma R, Singh J, Singh A, Ishar MP. Effect of Aegle marmelos (L.) Correa on alloxan induced early stage diabetic nephropathy in rats. Indian J Exp Biol 2013;51:464-9.
67. Yadav AV, Kawale LA, Nade VS. Effect of Morus alba L. (mulberry) leaves on anxiety in mice. Indian J Pharmacol 2008;40:32-6.
68. El-Sayyed H, Badawy G, Elnabi SH, Elaimy I, Al Shehari E. Ameliorative effect of Morus alba leaves extract against developmental retinopathy in pups of diabetic and aluminum intoxicated pregnant albino rats. Asian Pac J Trop Biomed 2015;5:300-9.
69. Goncalves E, Herrera I, Duarte M, Bustamante RO, Lampo M, Velásquez G, et al. Global invasion of Lantana camara: Has the climatic niche been conserved across continents? PLoS One 2014;9:e111468.
70. Mekala S, Kumar NM, Das L, Shetty N, Amuthan A, Vulli V, et al. Evaluation of wound healing activity of ethanolic extract of Lantana camara in streptozotocin induced diabetic rats. Int J Pharm Pharm Sci 2014;6:631-3.
71. Pattanayak P, Behera P, Das D, Panda SK. Ocimum sanctum Linn. A reservoir plant for therapeutic applications: An overview. Pharmacogn Rev 2010;4:95-105.
72. Gautam MK, Goel RK. Wound healing effect of Ocimum sanctum leaves extract in diabetic rats. Int J Pharmacol Pharm Sci 2013;7:538 42.
249 Views | 101 Downloads
How to Cite
REKHA BISHT. “PHYTOCHEMICAL MANAGEMENT OF DIABETIC COMPLICATIONS, EXPERIMENTAL EVIDENCES”. Asian Journal of Pharmaceutical and Clinical Research, Vol. 12, no. 9, July 2019, pp. 46-50, doi:10.22159/ajpcr.2019.v12i9.34442.
Review Article(s)