Table 2.

List of drugs used in T2DM

S. no	Plant/drug	Extract/compound	Mechanism of action	Organ function	Findings	Recommended/not recommended	Reference
1	Moringa oleifera	Moringa seeds	Lessening the expression of iNOS, IL-1β, NO, TNF-α	Liver	↓plasma glucose levels, HbA1c	Recommended	[113]
2	Garcinia macrophylla	5,7,4′,5″,7″,3‴,4‴-heptahydroxyflavanone [3–6″] flavones	Antibacterial, antioxidant, and anti-T2DM	-	↓ glucose level	Recommended	[114]
3	Albendazole lansoprazole	-	Activation of AMPK and PPAR pathways and incretin-like effect	-	↑ glucose, HbA1c, triglyceride, LDL, leptin ↓insulin and HOMA-β	Recommended	[115]
4	Remogliflozin etabonate (100 mg and 250 mg)	-	SGLT2 inhibition improves urinary glucose excretion thereby decreases blood glucose levels		↓ glucose levels	Recommended	[116]
5	Metformin hydrochloride	-	Lessens intestinal glucose absorption, declines hepatic glucose production, increases insulin sensitivity	Liver	↓HbA1c levels, FBG, and weight loss	Recommended	[117]
6	Remogliflozin metformin teneligliptin	-	-	-	↓glucose levels, weight	Recommended	[118]
7	Rhizoma coptidis	Berberine and polyphenols	Improves β cell dysfunction	Liver adipose tissues	↓IL-6, TNFα ↑islet cell viability	Recommended	[119]
8		Alkaline and flavone category compounds	MAPK1, STAT3, INSR, and 38 signalling pathways	-	Insulin resistance	Recommended	[120]
9	Morus alba	Chlorogenic acid, isoquercitrin, and quercitrin	-	-	Glucose absorption, insulin secretion, antioxidant, anti-inflammatory, antihyperglycemic, and antihyperlipidemic activities, declined obesity	Recommended	[121]
10	Zingiber officinale	-	-	Heart	↑diastole function and blood pressure ↓ HbA1c, triglycerides	Recommended	[122]
11	Glargine/lixisenatide	-	GLP-1 RA, control postprandial glucose improved β-cell function	-	↓ HbA1c, weight gain ↓ glucose levels	Recommended	[123]
12	Gegen Qinlian decoction berberine	-	Proinflammatory cytokines Nfkb1, Stat1, and Ifnrg1	Pancreas	Enriched gut microflora ↓ glucose levels	-	[124]
13	Gegen Qinlian decoction (meta-analysis study)	-	-	Pancreas	↓ glucose levels ↑islet function ↓insulin resistance and sensitivity indexes	A need for clinical prognosis and islet function	[125]
14	Huanglian Jiedu decoction	Decoction has Huanglian, Huangqin, Huangbo, and Zhizi mixture	Targets AKT1, IL-6, FOS, VEGFA, CASP3	Pancreas	↓ glucose levels, HbA1c	Recommended	[126]
15		-	Enhance GLUT4, INSR, MAPK1	-	Improve in fasting glucose level, lipid level, insulin sensitivity index	Recommended	[127]
16	Nigella sativa (meta-analysis study)	Thymol, thymohydroquinone, dithymoquinone, nigellone, alpha-hederin, flavonoids, and fatty acids	Antidiabetic, antioxidant, anticancer, hypolipidemic, and anti-inflammatory properties	-	↓ HbA1c, glucose level, insulin resistance	Recommended	[128]
17	Metformin with Chinese traditional medicine	-	-	-	Lessened the hyperglycemia, altered gut microflora, improved insulin resistance	Recommended	[129]
18	GLP-1RAs and oral anti-diabetic drugs (meta-analysis)	-	-	Heart	Improvement in left ventricular diastolic function	Recommended	[130]
19	GLP-1 RA and SGLT-2i (meta-analysis)	-	-	Pancreas	5 studies—GLP-1 RA showed decreasing effect in cardiovascular complications, glucose reduction	Recommended	[131]
20	Metformin and DDP-4 inhibitors	-	AMPK pathway activation, NFK-β, and mTOR suppression	-	Adverse outcome from COVID-19	Not recommended	[132]
21	Statin, fibrates, and its combination	-	-	-	↓lipid levels	Recommended	[133]
22	Incretin, DDP-4 inhibitors, and GLP-1 RA	-	-	-	↓ HbA1c	Recommended	[134]
23	Anti-hyperglycaemic therapies (GLP-1 RA and SGLT2i)	-	-	-	No change in HbA1c levels	Recommended	[135]
24	Metformin (meta-analysis)	-	-	-	↓ HbA1c ↓ glucose levels	Recommended	[136]
25	Aspirin and statin	-	-	Heart	↓cardiovascular complications in T2DM	Recommended	[133]
26	Tofogliflozin with DDP-4 inhibitors	-	-	Pancreas	↓postprandial glucose	Recommended	[137]
27	Momordica charantia	-	-	Pancreas	↑insulin secretion ↓glucose uptake	Recommended	[138, 139]
28	Metformin	-	-	Pancreas	↑epigenetic markers	Recommended for diagnosis	[140]
29	Chenpi	5-OH PMFs	Antidigestive and anti-inflammatory AMPK activation		↓hepatic steatosis ↓glucose levels	Recommended	[141]
30	Aloe vera	-	-	-	↓glucose levels	Recommended	[142]
31	Berberine	-	-	Pancreas	↓ HbA1c levels ↓ cholesterol and triglyceride ↑insulin secretion	Recommended	[143]
32	Pueraria lobata (meta-analysis)	-	-	Pancreas	Anti-diabetic activity	Recommended	[144]
33	SGLT-2i and GLP-1 RA	-	-	Heart	↓cardiorenal problems, stroke	Recommended	[145]
34		-	-	Heart kidney	↓renal risk No significance in cardio condition	Recommended	[146, 147]
35	Sulfonylureas, DPP-4 inhibitors, meglitinides	-	-	Heart	↑myocardium infection	Recommended	[148]
36	Acupuncture with Chinese herbal medicine (meta-analysis)	-			↓glucose levels ↑ insulin sensitivity and resistance	Recommended	[149]
37	Ipragliflozin (meta-analysis)	-	-	-	↑ genital infection No significance in glucose level	Not recommended	[150]
38	Ginseng supplementation	-	-	-	↑fasting glucose, postprandial insulin, and HOMA-IR Lipid levels were altered	Recommended	[151]
39	Shenqi Jiangtang Granules Baihu Jia Renshen Decoction Tianqi Jiangtang Capsule (meta-analysis)	-	-	Pancreas	↓hypoglycemia levels	Recommended	[152–154]
40	Chinese tradition medicine vs. Western medicine (meta-analysis)	-	-	Pancreas	Traditional medicine showed enhanced insulin sensitivity, decreasing body weight, protects from β cells	Recommended	[155]
41	Cotadutide (meta-analysis)	-	-	Pancreas	↓glucose levels, HbA1c and body weight	Recommended	[156]
42	SGD	-	Influences PI3K-Akt, AMPK, and PPAR	Pancreas	↓ glucose levels and lipid levels ↓	Recommended	[157]
43	Sancai powder	-	-	Pancreas	↓glucose levels, HbA1c, lipid levels	Recommended	[117]
44	Zhimu-Huangbai herb pair	-	-	Pancreas	↓glucose levels	Recommended	[158]
45	Naoxintong capsule	-	Arachidonic acid metabolism, fatty acid β-oxidation, and glycerophospholipid metabolism	Pancreas	↓hyperlipidemia, hyperglycemia, myocardial infarction, insulin resistance	Recommended	[159, p. 20]
46	Pioglitazone and canagliflozin	-	-	-	↓ glucose levels, lipid levels, HbA1c	Recommended	[160]
47	Canagliflozin	-	-	Kidney	↑ renal oxygen in T2DM	Recommended	[161]
48	Pine bark extract	-	-	Pancreas	↓ HbA1c, VCAM-1, cholesterol levels, UACR	Recommended	[162]
49	Jinlida granules	-	-	Pancreas	↓ HbA1c and glucose levels	Recommended	[163]

iNOS, inducible nitric oxide synthase; IL-1β, interleukin-1 beta; NO, nitric oxide; TNF-α, tumour necrosis factor alpha; HbA1c, glycated haemoglobin; T2DM, type 2 diabetes mellitus; LDL, low density cholesterol; HOMA-β, homeostasis model assessment of β-cell function; AMPK, adenosine 5′ -monophosphate activated protein kinase; PPAR, peroxisome proliferator-activated receptor; SGLT-2, sodium glucose co-transporter-2; SGLT-2i, sodium-glucose cotransporter-2 inhibitors; FBG, fasting blood glucose; GLP-1 RA, glucagon-like peptide 1 receptor agonists; DDP-4, dipeptidyl peptidase-4 inhibitors; NFK-β, nuclear factor kappa B; mTOR, mammalian target of rapamycin; COVID-19, coronavirus disease-19; 5-OH PMFs, 5-demethylated poly methoxy flavones; HOMA-IR, homeostatic model assessment of insulin resistance; SGD, Shengmai-Yin and Ganmai dazao decoction; VCAM-1, vascular cell adhesion molecule 1; UACR, urinary albumin-to-creatinine ratio; PPAR, peroxisome proliferator-activated receptors; P13K-Akt, phosphatidylinositol 3-kinase-protein kinase B; GLUT4, glucose transporter type 4; INSR, insulin receptor; MAPK1, mitogen-activated protein kinase 1; IL-6, interleukin-6; FOS, Fos proto-oncogene; AP-1, transcription factor subunit; VEGFA, vascular endothelial growth factor A; CASP3, caspase 3; Stat1, signal transducer and activator of transcription 1; Ifngr1, interferon gamma receptor 1; STAT3, signal transducer and activator of transcription 3