Diabetes mellitus in ECOWAS: an overview of the safety and efficacy of medicinal plants used in traditional medicine practices

BACKGROUND: The rich biodiversity of West Africa supports a vast repository of medicinal plants, with traditional medicine playing a central role in managing diseases such as diabetes. Despite their widespread use, the safety and efficacy of these herbal treatments have not been scientifically explored. This study aims to analyze the traditional uses of antidiabetic plants in Economic Community of West African States countries in relation to the available scientific evidence. METHODS: A three-step approach was used. Firstly, ethnopharmacological studies on diabetes management in West Africa were identified. Secondly, the twelve most cited plants were selected on the basis of their frequency of citation of traditional antidiabetic uses, and their citation in at least five of the countries considered. Thirdly, scientific databases were searched for available in vitro, in vivo, and clinical studies examining the antidiabetic effects, antioxidant properties, and potential toxicity of the twelve plants selected. RESULTS: This study identified 638 medicinal plants from 32 ethnopharmacological studies conducted in eight West African countries. The twelve most cited plants were Mangifera indica, Rauvolfia vomitoria, Azadirachta indica, Morinda lucida, Launea taraxacifolia, Momordica charantia, Phyllanthus amarus, Vernonia amygdalina, Carica papaya, Annona senegalensis, Allium sativum and Ocimum gratissimum. Most remedies were prepared from leaves, roots, and bark, commonly as decoctions or macerations, and demonstrated notable hypoglycemic activity. However, the mechanism of action behind the antidiabetic activity of these plants has rarely been addressed, and few of these plants have undergone clinical trials and in-depth toxicological evaluations. CONCLUSION: This review highlights a significant gap between traditional knowledge and scientific assessment. Although these traditional medicinal plants show promise for diabetes management, further scientific validation is needed to ensure their safe and effective use in modern healthcare systems.