Interactions between Herbal Medicines and Oral Antidiabetic Drugs in Patients with DiabetesMellitus: A Review of Mechanisms of Action / Interaksi antara Herbal dan Antidiabetik Oral pada Penderita Diabetes Melitus: Tinjauan Mekanisme Aksi

The increasing use of herbal products among patients with diabetes mellitus highlights the need for a clear understanding of their potential interactions with oral antidiabetic drugs (OADs). Such interactions may be synergistic or may pose risks, particularly hypoglycemia. To identify the mechanisms underlying interactions between herbal products and OADs and to assess their relevance in the management of type 2 diabetes mellitus. A literature search was conducted through Google Scholar, PubMed, and ScienceDirect using keywords related to herbal products, oral antidiabetic drugs, and drug interactions. Articles were selected based on inclusion criteria (2015–2025, original research, human subjects with type 2 diabetes mellitus or animal models, English or Indonesian language, and involving OADs) and relevant exclusion criteria. The most frequently reported interactions were pharmacodynamic, particularly the combination of Cinnamomum verum, Curcuma longa, and Momordica charantia with metformin or sulfonylureas, which enhanced insulin sensitivity, activated AMPK, or stimulated insulin secretion, potentially increasing the risk of hypoglycemia. Pharmacokinetic interactions were also identified, such as ginseng-induced modulation of the OCT1 transporter, which may influence metformin accumulation. Several other herbal products, including Aloe vera, demonstrated glucose-lowering activity; however, evidence of direct interactions with OADs remains limited, suggesting a primarily supportive role. Interactions between herbal products and oral antidiabetic drugs have important clinical implications, as they may alter both therapeutic efficacy and safety. Close monitoring and patient education are essential, alongside further research to clarify interactions that remain insufficiently documented.

Peningkatan penggunaan herbal pada penderita diabetes melitus memerlukan pemahaman yang jelas mengenai potensi interaksi dengan antidiabetik oral (OAD). Interaksi tersebut dapat bersifat sinergis maupun menimbulkan risiko, terutama hipoglikemia. Mengidentifikasi mekanisme interaksi antara herbal dan OAD serta menilai relevansinya dalam terapi diabetes melitus tipe 2. Penelusuran literatur dilakukan melalui Google Scholar, PubMed, dan ScienceDirect menggunakan kata kunci terkait herbal, antidiabetik oral, dan interaksi obat. Artikel diseleksi berdasarkan kriteria inklusi (2015–2025, original research, subjek diabetes melitus tipe 2 atau model hewan, bahasa Inggris/Indonesia, serta penggunaan OAD) dan eksklusi yang relevan. Interaksi yang paling sering dilaporkan bersifat farmakodinamik, terutama kombinasi Cinnamomum verum, Curcuma longa, dan Momordica charantia dengan metformin atau sulfonilurea yang meningkatkan sensitivitas insulin, mengaktivasi AMPK, atau menstimulasi sekresi insulin sehingga berpotensi menimbulkan hipoglikemia. Interaksi farmakokinetik juga ditemukan, misalnya modulasi transporter OCT1 oleh ginseng yang dapat memengaruhi akumulasi metformin. Beberapa herbal lain, termasuk Aloe vera, menunjukkan aktivitas penurun glukosa darah, namun bukti interaksi langsung dengan OAD masih terbatas sehingga perannya cenderung bersifat pendukung. Interaksi antara herbal dan antidiabetik oral memiliki implikasi klinis yang penting karena berpotensi mengubah efektivitas maupun keamanan terapi. Pemantauan ketat dan edukasi pasien diperlukan, disertai penelitian lebih lanjut untuk memperjelas interaksi yang belum terdokumentasi secara memadai.