TABLE 4.

Diabetic active ingredients and mechanism of action of Chinese medicines.

Active ingredients	Chinese medicine	Action mechanism	Mechanism	Reference
Polysaccharides	Ginseng	Fasting blood glucose ↓, MDA ↓, insulin ↑, SOD activity ↑, liver glycogen content ↑	(1, 4)	[61]
		G6P activity ↓, hepatic glycogen synthase activity ↓, G6PD activity ↑, PFK activity ↑	(3)	[62]
	Lycii Fructus	HbA1c, GSP, insulin level, TC, TG, LDL‐C ↓; HDL‐C ↑; GLP‐1, PYY, GPR41, GPR43 expression ↑, GSK‐3β and PEPCK expression ↓, activation of InsR/PI3K/AKT signaling pathway	(2, 4)	[63]
	Vigna umbellata	Body weight ↓, fasting blood glucose ↓, TG↓, HDL‐C↑; Expression of INSR, IRS‐1, PI3K, AKT, and GLUT‐2 ↑ activates the PI3K/AKT signaling pathway	(2, 4)	[64]
	Astragali Radix	Body weight, fasting glucose, TC, TG, LDL‐C ↓, HDL‐C ↑, antioxidant enzyme activity ↑, MDA ↓	(2)	[35]
	Ophiopogonis Radix	Expression of PI3K, AKT, InsR, PPARγ ↑； expression of PTP‐1B at mRNA level and protein level ↓	(2, 3)	[65]
		Lowering blood sugar levels, increasing insulin levels, repairing islet destruction and damage to pancreatic beta cells	(1)	[66]
	Morus alba L.	Inhibited apoptosis, improved insulin secretion capacity of pancreatic β‐cells, and increased mRNA and protein expression of PDX‐1 and its downstream targets GLUT2 and GCK in pancreatic islet cells of diabetic rats.	(1, 3)	[67]
Saponins	Fructus Momordicae	FBG ↓, serum insulin ↑, mRNA levels of G6Pase and PEPCK ↑, fat oxidation‐related genes ↑, activation of AMPK signaling pathway	(2, 3)	[68]
	Ginseng	IRS‐1/PI3K/AKT insulin signaling pathway ↑, glucose uptake ↑; MAPK signaling pathway ↓, insulin resistance ↓	(2)	[69]
	Sanchi	Blood glucose and serum insulin levels ↓, mRNA expression of p‐PI3K, p‐AKT, IRS1 and GLUT4 ↑, IRS1‐PI3K‐AKT signaling pathway ↑	(1)	[70]
	Melandryum viscidulum	mRNA expression of Glut4, IRS‐1, Akt and PI3K ↑, mRNA expression of Moat1, Lipc, Lpcat4 and Smpd4 ↓, PI3K‐AKT signaling pathway ↑	(1)	[71]
	Corni Fructus	IL‐2, TNF‐α and CRP ↑, MDA ↓, SOD activity ↑, mRNA expression of p‐PI3K, p‐AKT, IRS1 and GLUT4 ↑, IRS1‐PI3K‐AKT signaling pathway ↑	(2, 4)	[72]
	Lily	Stimulation of glucose depletion in the liver with ↑ PPARγ expression induces GLUT4 translocation to the cell surface	(2)	[73]
Alkaloids	Morus alba L.	Activation of insulin receptor pathway and TGF‐β/Smads signaling pathway to improve insulin resistance and oxidative stress‐induced hyperglycemia	(2)	[74]
	Coptidis Rhizoma	GLP‐1 ↑; glucagonogen mRNA expression ↑	(2, 3)	[75]
	Tinosporae Radix	Blocking K‐ATP channels to stimulate insulin secretion	(1)	[76]
Flavonoids	Polygonati Odorati Rhizoma	Fasting blood glucose ↓, insulin ↑, α‐amylase activity ↓	(1, 3)	[77]
	India Madder Root	Scavenging of free radicals, SOD and catalase expression ↓, phosphorylation of IKK ↓	(4)	[78]
	Chinese Angelica	α‐amylase and ACAT activities ↓, TC and TG levels ↓	(3, 4)	[79]
	Liquorice root	FBG ↓, SOD ↑, MDA ↓	(4)	[80]
	Ginkgo biloba Linn	α‐amylase and α‐glucosidase activities↓	(3)	[81]
	Tangerine Peel	GK mRNA level ↑, PCK and G6P mRNA expression ↓, GLUT2 protein expression ↓, GLUT4 and PGC‐1 expression ↑	(3)	[82]
Terpenoids	Cyclocarya paliurus	Regulation of insulin resistance pathway, PI3K‐Akt signaling pathway, HIF‐1 signaling pathway, PPAR signaling pathway	(2, 4)	[83]
	Forsythiae Fructus	Scavenging free radicals, protecting and repairing pancreatic beta cells	(1)	[84]
	Polygoni Multiflori Radix	Improvement of insulin resistance, insulin sensitivity↑	(2)	[85]
	Dan‐Shen Root	α‐Glucosidase and α‐amylase activities↓	(3)	[86]
	Croton Tiglium	Glucose uptake ↑, alleviating insulin resistance	(2)	[87]
	Gynostemma pentaphyllum	2‐NBDG uptake ↑, GLUT4 translocation, AMPK and ACC signaling pathways ↑	(2, 3)	[88]

Note: ↑cytokine or pathway upregulation; ↓cytokine or pathway downregulation.