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• Indonesia has rich biodiversity and ethnic groups applying for traditional medicine as antidiabetic. • Numerous ethnopharmacological surveys were conducted on medicinal plants in Indonesia. • Ethnopharmacological studies of antidiabetic plants have prospects for further development. 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 essential field 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 vitro and in 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 vitro and in 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. [ABSTRACT FROM AUTHOR]

Purpose: Exploration of plant combinations could be an alternative approach for diabetes treatment. The aim of this study is to evaluate the hypoglycemic effect of combination of A. indica and G. procumbens ethanolic extracts in alloxan-induced diabetic rats. Methods: Powder of A. indica and G. procumbens leaves were macerated with ethanol 70%. Determination of rutin in A. indica and quercetin in G. procumbens were performed by TLCdensitometry. Hyperglycemia in rats was induced by an intraperitoneal injection of alloxan monohydrate at a single dose of 150 mg/kgBW. The rats were treated with 3 dosage variation of combinations for 15 days. Hypoglycemic effect was evaluated by estimating the blood glucose levels and the rats pancreas histological study. Results: A. indica contained 2.90±0.15% of rutin and G. procumbens contained 18.86±0.86% of quercetin. Combination at the ratio of 50mg/kgBW A. indica:112.5mg/kgBW G. procumbens showed the highest hypoglycemic effect: 68.74±4.83% (preprandial) and 73.91±3.18% (postprandial). Histological studies indicated that this combination improved the morphology of the islets of Langerhans and β cells. It also increased insulin expression and decreased the elevated-glucose concentrations. Conclusion: This study showed that combination of both extracts has better hypoglycemic effect than the single treatment of A. indica or G. procumbens. Combination of both extracts was potential to develop as a blood glucose-lowering agent for diabetic patients. [ABSTRACT FROM AUTHOR]