Alternative and Complementary Therapies Used in the Diabetes Management

Type 2 diabetes mellitus (T2D) is a complex metabolic disorder driven by hyperglycaemia, insulin resistance, inflammation, and cardiometabolic dysfunction, necessitating multi targeted and integrative management strategies. This review synthesizes evidence up to 2025 on Ayurvedic polyherbal formulations, individual botanicals, yoga and meditation, and major dietary patterns as adjuncts to standard diabetes care. Recent clinical data indicate a cautiously positive but incremental role for well standardized Ayurvedic formulations. Randomized and real-world studies of polyherbals (e.g., combinations containing Gymnema sylvestre, Syzygium cumini, Trigonella foenum-graecum, Emblica officinalis, Tinospora cordifolia, Berberis aristata, and cinnamon) demonstrate modest but clinically meaningful reductions in fasting glucose and HbA₁c (0.3–0.8%) over 8–24 weeks when used alongside conventional therapy, with generally good short-term tolerability. Mechanistic and network-pharmacology studies explain these effects through poly-target actions on insulin signaling (IRS–PI3K–Akt), AMPK activation, incretin modulation, hepatic gluconeogenesis, oxidative stress, adipose inflammation, and gut-level carbohydrate handling. Focused sections detail fenugreek, jamun, and gurmar, highlighting their bioactive constituents, mechanistic plausibility, formulation advances, dosing considerations, and safety caveats. Meta-analyses and recent randomized trials show that yoga and mindfulness-based interventions yield small-to-moderate improvements in glycaemic indices, stress, and quality of life, mediated by autonomic rebalance, reduced HPA-axis activation, improved muscle glucose uptake, and better self-care behaviors. Dietary pattern evidence from 2025 confirms that Mediterranean, plant-based, DASH/DRRD, and low-carbohydrate or ketogenic diets can improve glycaemic control, weight, and cardiometabolic risk, with differences in sustainability and patient suitability. Overall, the integrated evidence supports a personalized, adjunctive approach: combining evidence-guided Ayurvedic nutraceuticals, structured mind–body practices, and sustainable dietary patterns with standard pharmacotherapy. Future priorities include longer, double-blind trials with standardized products, mechanistic human studies, and pragmatic implementation research to clarify long-term efficacy, safety, and generalizability.