Ginkgo biloba L. as a Potential Alternative Therapy to Improve the Management of Diabetes: An Overview on Phytochemical Insights, Mechanisms, and Therapeutic Applications.

Abstract

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia and associated with severe complications, including cardiovascular diseases, neuropathy, nephropathy, and retinopathy. Although synthetic antidiabetic drugs are available, the side effects and limited long-term effectiveness of these medications highlight the urgent need for safer, more potent alternative therapies. Ginkgo biloba L., a traditional medicinal plant rich in flavonoids, terpenoids, and bilobalide, has attracted attention for its potential role in diabetes management. This review critically evaluates the antidiabetic potential of G. biloba by analyzing evidence from in vitro, in vivo, and clinical studies. Moreover, this review highlights the pharmacological actions of G. biloba and its key bioactive compounds, focusing on their mechanisms of action, including the activation of adenosine monophosphate-activated protein kinase (AMPK), the translocation of glucose transporter type 4 (GLUT4), and the inhibition of protein tyrosine phosphatases. The review also discusses the therapeutic implications of G. biloba supplementation and identifies gaps in clinical validation, optimal dosing, and safety profiling. Preclinical studies have demonstrated that G. biloba improves glycemic control by enhancing glucose uptake, regulating insulin secretion, inhibiting α-glucosidase activity, and exerting antioxidant and anti-inflammatory effects. Additionally, clinical trials suggest that supplementation with G. biloba can reduce oxidative stress, improve lipid profiles, and mitigate diabetes-related complications. However, despite these promising outcomes, inconsistencies remain in present study designs, dosages, and patient populations, which question the validity of results. Furthermore, studies related to the antidiabetic effect and underlying mechanisms of G. biloba, such as modulation of AMPK pathways and GLUT4 expression, also remain inadequate and warrant further systematic investigation. G. biloba may still be considered a complementary treatment approach in managing diabetes due to its broad pharmacological activities and favorable safety profile. However, well-designed, large-scale clinical trials are crucial for establishing standardized dosing regimens, confirming long-term safety, and fully elucidating the mechanisms of action. Integrating G. biloba into therapeutic strategies could offer a natural, and effective adjunct for enhancing glycemic control and reducing diabetes-related complications.