By Nr Chinonso Cynthia Ukah. BNSc, RN, RM. Freelance Health Writer and DLHA Volunteer. Medically and editorially reviewed by the DLHA Team
Herbal treatment of diabetes in sub-Saharan Africa
Documented evidence shows that herbal medicines have the potential to cure diabetes. For instance, metformin, a widely used diabetic medication, was derived from the herb Galega officinalis.
Due to the rising cost of western medicines like insulin, there's a growing trend of about 4 billion people opting for herbal medicines in developing countries, including those in Africa, according to a 2022 WHO Report. [1] This is a probing issue that must be tackled with urgency.
The aim of this report is to look at the evidence in support or against the use of herbal remedies in treating diabetes in sub-Saharan Africa, so that you can make informed decisions about it.
Despite limited scientific backing, some African herbal medicines show potential in the treatment of diabetes. (See Table 1)
Bitter lemon (Momordica charantia known as Ejirin in the Nigerian Yoruba tribe) has been shown to demonstrate anti-diabetic properties. [2].
Garlic, commonly used by Guinea Africans, has shown ability to lower blood sugar levels according to a 2019 review. [2]
“Over half of South Africans reportedly use herbal medicines for diabetes” says a report from the South African Health Statistics. [3] Primarily bitter leaf, African potatoes, and Madagascar periwinkle are used.
This offers hope to diabetics in resource-poor African settings.
However, no two studies have conclusively established that herbal medicines cure diabetes with consistent data, partly due to varied preparation methods across Africa.
The claim that herbal medicines cure diabetes therefore, remains inconclusive.
Table 1: Showing 5 common herbal products used in the treatment of diabetes in Africa.
Click on image to enlarge.
According to data on diabetes treatment in Parirenyatwa Group of Hospitals Diabetic Clinic in Harare, Zimbabwe, nearly 1 million diabetics combine modern and herbal medicines, as less than half of them achieved good blood sugar control with modern medicine alone. [4]
An update on clinical observation carried out as far back as 2009 revealed that St. John's wort, a herbal medicine, increases the clearance of gliclazide which is an oral hypoglycemic drug. Similar cases have also been reported in Ethiopia. [5]
East Asian studies also reported that Ginkgo biloba extract increases hepatic clearance of insulin and oral hypoglycemic agents. [5]
Often, these combinations result in either an increased blood glucose level or severe hypoglycemia (decrease in blood glucose level), as the case may be.
Many traditionalists assume that herbs can safely complement prescribed diabetes medications. But they are unaware of serious health complications from herb-drug interactions.
Yes, risks are to be expected when herbal medicines and standard drugs are combined in the treatment of diabetes. The concern is that these risks are yet to be properly studied and therefore largely unknown.
How common is herbal medicine use for diabetes in Africa?
Over 4 billion diabetics in developing countries rely on herbal medicines.
Reports from South Africa show that 53% of diabetics use herbal medicines for treatment. [3]
Ezuruike and Prieto also found out that 50% of diabetic Nigerians combine herbal and modern medicine. Alarmingly, these patients are unaware of the specific herbal medicines they were using. [5]
In Egypt, diabetics turn to herbal medicines due to non-compliance with their modern antidiabetic medications and poor blood sugar control. [5] This trend exists in both rural and urban areas, with herbal remedies often used as first-line treatment or to complement insulin therapy.
Some patients conceal herbal drug use from their healthcare providers. This increases the risk of unidentified herb-drug interactions.
Are there side effects of herbal medicines for diabetes?
Herbal medicines can cause various unfavourable (adverse) reactions: These may include:
The purity of herbal mixtures is uncertain, with reports of contamination by heavy metals, pesticides, and conventional drugs identified from several studies. [6]
These issues pose additional risks to diabetic patients with already compromised organs.
With over 19 million adults in Africa living with diabetes (expected to more than double by 2045), the lack of scientific backing, potential drug interactions, and unpredictable side effects make herbal medicines a problematic alternative to conventional diabetes treatment. As African healthcare systems evolve, bridging the gap between traditional practices and modern medical standards is paramount for the safety and wellbeing of millions relying on these remedies.
1. World Health Organization Regional Office for Africa. African Traditional Medicine Day 2022 [Internet]. Brazzaville: WHO Regional Office for Africa; 2022 Aug 31 [cited 2024 Oct 19]. Available from here.
2. Oguntibeju OO. Hypoglycaemic and anti-diabetic activity of selected African medicinal plants. Int J Physiol Pathophysiol Pharmacol. 2019;11(6):224-237. Available from here.
3. Chetty L, Govender N, Reddy P. Traditional Medicine Use among Type 2 Diabetes Patients in KZN. Advances in Public Health. 2022;2022:7334080. doi:10.1155/2022/7334080. Available from here.
4. Usai R, Majoni S, Rwere F. Natural products for the treatment and management of diabetes mellitus in Zimbabwe-a review. Front Pharmacol. 2022;13:980819. doi:10.3389/fphar.2022.980819. Available from here.
5. Meshesha SG, Yeshak MY, Gebretekle GB, Tilahun Z, Fenta TG. Concomitant Use of Herbal and Conventional Medicines among Patients with Diabetes Mellitus in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study. Evid Based Complement Alternat Med. 2020;2020:4871459. doi: 10.1155/2020/4871459. Available from here.
6. Ekpor E, Osei E, Akyirem S. Prevalence and predictors of traditional medicine use among persons with diabetes in Africa: a systematic review. Int Health. 2024 May;16(3):252-260. doi: 10.1093/inthealth/ihad080. Available from here.
Related:
Type 1 Diabetes Mellitus: An Explainer for Africans
Type 2 Diabetes: What Africans Need to Know?
Published: October 20, 2024
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