Traditional East African medicinal plants as modulators of gut microbiota in obesity-associated diabetes: A short communication

The prevalence of obesity and type 2 diabetes mellitus (T2DM) is rapidly growing in East Africa as a result of urbanisation, changing diets, and sedentary lifestyles. According to the International Diabetes Federation (IDF), 4.2 per cent of the adult population in sub-Saharan Africa (24 million people) has diabetes, which is expected to be more than 55 million by 2045, with East Africa making its fair share of the burden. Gut microbiota dysbiosis, which is observed as the loss of short-chain fatty acid (SCFA)-producing bacteria and a rise in the pro-inflammatory taxa, is a key mechanistic connection between obesity and T2DM. The traditional medications, including metformin, sulfonylureas, insulin, and the new anti-obesity medications, are all clinically effective, but they are expensive, less available, and have low tolerance in the East African population. Conversely, native medicinal plants Moringa oleifera, Warburgia ugandensis, Aloe secundiflora, and Azadirachta indica are clinically accessible, acceptable and have antimicrobial, prebiotic, and anti-inflammatory phytochemicals that can potentially alter the composition and activity of gut microbiota. This short communication narratively reviewed recent discoveries in the fields of ethnopharmacology, phytochemistry, and microbiome science in PubMed, Scopus, Web of Science, and Google Scholar from 2015 to 2025. The discussion focuses on the translational pathways between phytochemical-microbiota interactions and metabolic health outcomes, as well as the existing gaps in the evidence base and the need for systematic methodologies and clinical validation in East African settings. We suggest interdisciplinary trials that include phytochemical standardisation or microbiome sequencing and culturally appropriate community-based approaches.