A review of medicinal plants for the treatment of Diabetes mellitus: The case of Indonesia

Indonesia is rich in biodiversity and ethnic groups, including those that use traditional medicine to treat diabetes mellitus (DM). Ethnopharmacological of antidiabetic medicinal plants is still an essentialfield of study to organize preclinical and clinical trials. This study presents a review of the ethnopharmacology of antidiabetic plants and their scientific information, focusing on highlighting gaps and direction for further studies. Data were obtained from online and offline sources to identify Indonesian medicinal plants used to lower blood glucose. Ethnopharmacological literature was searched from Google Scholar with keywords: ethnobotany AND medicinal plant AND diabetes AND Indonesia; an ancient book (Cabe Puyang Warisan Nenek Moyang), government reports on ethnopharmacological surveys, and BSc/MSc/PhD theses indexed and not indexed internationally. Subsequently, other sections regarding preclinical trials (in vitroandin vivo), phytochemical issues, clinical trials, and toxicological assessments were searched from Scopus with the relevant keywords. A total of 229 medicinal plant species belonging to 70 families and are used to treat DM were listed in this study. Among these plants, Asteraceae and Orthosiphon aristatus(Blume) Miq. were the most dominant plant family and species, respectively. Most of the herbal recipes were from North Sumatera (102 recipes). Leaf and boiling were the most applied plant part and mode of preparation, respectively. Furthermore, the top 10 highly cited antidiabetic medicinal plants from ethnopharmacological data were assessed in the preclinical (in vitroandin vivo), phytochemical issues, clinical trials, and toxicological tests. Pharmacological, phytochemical, clinical, and toxicological studies have been reported; meanwhile, many research opportunities can be explored, especially plants lacking scientific evidence. This study’s application is expected to accelerate the drug discovery and development from natural resources to treat DM. Moreover, hopefully, medicinal plants can be one of the solutions to treat DM that is effective, safe, and sustainable.