The rising occurrence of diabetes mellitus is attributed to many factors. Despite the effectiveness of the latest therapeutic agents, long-term use has been affected by their side effects, expense, incompleteness and patient non-compliance. Herbal and plant-derived therapies, which were previously used traditionally, have gained much more interest as complementary or alternative approaches to diabetes mellitus treatment. Herbal medicine represents a complex mixture of numerous phytochemicals; the action of each phytochemical is associated with its potential to produce an antidiabetic effect through multiple methods. These methods include stimulating insulin release, increasing insulin sensitivity, inhibiting carbohydrate digestion, modifying glucose transporters, and decreasing oxidative stress. The purpose of this review is to comprehensively evaluate the use of herbal medicines in controlling diabetes, while also integrating both mechanistic and clinical studies. The pathophysiology of diabetes with the corresponding herbal treatment will also be reviewed, in order to provide an in-depth assessment of the methods of action of herbal medications. Additionally, we consider clinical significance of therapeutic uses for medicinal plants using both evidence-based and clinical data. This helps us to evaluate limitations and inherent problems, such as their inability to produce consistent results and variation in plant composition. We also assess regulatory limitations and restrictions that affect clinical applications and guide future implementation strategies for diabetes mellitus treatment.
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