Diabetes is one of the most significant global health challenges today, with the prevalence of type 2 diabetes mellitus (T2DM) rising rapidly due to factors such as dietary changes, physical inactivity, and the impact of modern lifestyles (Sami et al., 2017). A recent report from the Indian Council of Medical Research-India Diabetes (ICMR-INDIAB, 2023) study estimated that India alone has over 101 million individuals living with diabetes in 2023, a number projected to surpass 134 million by 2045 (Anjana et al., 2023; Pradeepa and Mohan, 2021). These alarming trends underscore the urgent need for innovative strategies to curb the diabetes epidemic and its associated health burdens.

Despite the development of numerous oral antidiabetic drugs (OADs) in modern medicine, their long-term efficacy is often limited by adverse side effects, leaving the search for a more comprehensive and effective treatment (Kaur et al., 2019). In cases where OADs fail, insulin therapy becomes necessary, though it carries its own challenges, such as an increased risk of hypoglycaemia and weight gain, thereby further compounding the economic burden of diabetes management (Kashi et al., 2013).

The integration of indigenous and western medicine presents a promising approach to tackling the increasing burden of diabetes. By combining the strengths of both systems, healthcare can become more holistic, accessible, and effective.

The Ayurvedic medical system, with its roots in India for thousands of years, offers valuable strategies for managing and preventing diabetes, especially considering the limitations posed by modern antidiabetic therapies. In Ayurvedic literature, diabetes is classified as Madhumeha, a subtype of Prameha, with symptoms that closely resemble those of type 2 diabetes mellitus (Manyam, 2004). Treatments often emphasize a variety of herbal and herbo-mineral formulations designed to balance bodily functions and address underlying causes (Shastri and Samhita, 1994). Given the complex and multifactorial nature of diabetes, which involves insulin resistance, pancreatic dysfunction, and inflammation, a multifaceted treatment approach is essential. Polyherbal formulations provide a unique advantage by working synergistically to target multiple pathways, thereby offering a more comprehensive therapeutic effect (Karole et al., 2019).

Glucomap (MA-471) is a polyherbal Ayurvedic formulation derived from classical Ayurvedic texts, composed of eight key medicinal plants such as Syzygium cumini (Jamun), Momordica charantia (Bitter gourd), Aegle marmelos (Bael), etc. (Table 1) all of which have demonstrated antidiabetic potential in clinical studies (Sidana et al., 2017; Kumari et al., 2018; Sharma et al., 2016). The antidiabetic effect of Jamun is mainly attributed to its active compound jamboline, which inhibits the enzymatic conversion of starch into sugar (Rizvi et al., 2022). M. charantia exerts its effects through multiple molecular pathways, enhancing glucose metabolism and insulin sensitivity (Keller et al., 2011). The synergistic action of these herbs likely contributes to the overall antidiabetic efficacy of Glucomap. Additionally, these herbs are generally associated with no side effects, making them a safer and cost-effective option that complements modern medicine. This growing interest in integrating Ayurvedic solutions with contemporary treatment highlights the need for rigorous clinical research to validate and optimize these traditional therapies for diabetes management.

Glucomap has shown promising efficacy in clinical trials for managing type 2 diabetes mellitus (T2DM). Preliminary studies have reported beneficial outcomes when used alone as well as in combination with oral antidiabetic drugs (OADs), in both newly diagnosed and long-standing cases. Notably, Sircar et al. (1996) and Dixit et al. (2004) observed significant reductions in glycosylated haemoglobin (HbA1c), fasting blood glucose (FBG), and improvements in hyperlipidaemia with adjunctive Glucomap therapy.

The present study was undertaken to reassess the efficacy and safety of Glucomap in light of recent advancements in diabetes management and limitations of earlier research. The initial study by Sircar et al. (1996), though encouraging, lacked statistical power due to a small sample size and did not follow a standardized intervention protocol. Furthermore, the introduction of newer oral hypoglycemic agents and changing patient characteristics—including increasing obesity, reduced physical activity, earlier onset of type 2 diabetes, and changes in diagnostic criteria over the years—highlighted the need to re-evaluate Glucomap’s therapeutic role in the context of current clinical practice. Therefore, the objective of the present study was to evaluate the addition of Glucomap to standard treatment for improving blood glucose control and to explore its potential mechanisms of action, particularly its effects on insulin resistance and insulin secretion—both central to the pathophysiology of type 2 diabetes. The study also assessed the impact of Glucomap on serum C-reactive protein (CRP), an inflammatory marker associated with metabolic syndrome, elevated triglycerides, and increased cardiovascular risk in individuals with type 2 diabetes (Jeong et al., 2019). In addition, the study examined its role in reducing the required dosage of oral hypoglycemic agents (OHAs). The outcomes of this study may help establish Glucomap as a complementary therapy in the management of diabetes within current clinical practice.