Author(s): Anna Müller and Lukas Schneider

Abstract:

Background: Type 2 diabetes mellitus and hypertension are highly prevalent, frequently coexisting chronic conditions that impose a growing global burden, especially in low- and middle-income countries. Many patients use herbal medicines alongside conventional therapies, yet the clinical value and safety of such practices remain incompletely defined.

Objective: This narrative review aimed to synthesise evidence on the epidemiology of herbal medicine use among people with diabetes and hypertension, evaluate the efficacy and safety of herbal interventions targeting glycaemic and blood-pressure control, and appraise their potential role as adjuncts in chronic disease management.

Methods: A structured search of major biomedical databases identified epidemiological reports, clinical trials, systematic reviews and surveys addressing herbal medicine use in adults with diabetes and/or hypertension. Eligible studies reported on prevalence and patterns of use, clinical outcomes related to glycaemic and blood-pressure control, or safety and herb-drug interactions. Data were extracted on study characteristics, interventions, outcomes and adverse events, and summarised descriptively.

Results: Sixteen key sources met the inclusion criteria. Surveys from diverse regions reported that approximately one-third to nearly nine-tenths of patients with diabetes used herbal medicines, often without disclosing this to healthcare providers. Clinical evidence indicated that several standardised herbal preparations and polyherbal formulations produced modest improvements in fasting plasma glucose, HbA1c and, in some studies, blood-pressure parameters when used as adjuncts to conventional therapy. Most interventions were well tolerated in the short term, but heterogeneity in products and designs, small sample sizes, short follow-up and limited systematic safety assessment restricted firm conclusions.

Conclusion: Herbal medicines are widely used by patients with diabetes and hypertension and may offer modest adjunctive benefits for cardiometabolic control. However, current evidence is insufficient to support their use as replacements for guideline-directed pharmacotherapy. Improved clinical communication, stronger regulatory oversight and rigorous, well-designed trials are required to define which herbal interventions can be safely and effectively integrated into chronic disease management.

DOI: 10.22271/flora.2025.v13.i6a.1047