Interlinking diabetes and Alzheimer's disease: A pathway through medicinal plant-based treatments.

ETHNOPHARMACOLOGICAL RELEVANCE: Indian traditional medicine has long utilized medicinal plants for the management of chronic diseases such as Diabetes mellitus (DM) and related neurological complications, Alzheimer's disease (AD). The growing global burden of DM and its associated complications continues to rise; hence, it seems essential to explore effective, targeted therapies to mitigate their progression. Plant-based therapeutics have garnered significant attention for their safety, efficacy and ability to modulate multiple biological pathways. Indigenous medicinal plants, such as Sesbania grandiflora (L.) Poir., Moringa oleifera Lam., Centella asiatica (L.) Urb., Psidium guajava (L.), Aegle marmelos (L.) Corrêa, and Catharanthus roseus (L.) G. Don has been historically employed in ethnomedicine such as classical Ayurvedic texts, scientific literature and has a comprehensive and synergistic approach to address symptoms associated with DM and cognitive decline. AIM OF THE STUDY: This review explores the interwined pathophysiological pathways between DM and AD, highlighting the potential of medicinal plants through (pre-clinical and clinical evidence), bridging the therapeutic gap. Additionally, we also discussed the currently used conventional antidiabetic drug that has been employed for managing AD. RESULTS: In this study, six ayurvedic plants with dual activity against DM and AD are thoroughly reviewed with historical context, preclinical and clinical context. The plant's secondary metabolites have demonstrated significant antidiabetic and neuroprotective activities by regulating glucose metabolism, reducing oxidative stress, preventing amyloid-beta accumulation, etc. CONCLUSION: DM and AD share pathophysiology and multifaceted causes, requiring multi-targeted herbal remedies. The selected six Ayurveda medicinal plants showcase the dual benefits for both diseases. The obstacles, such as stability, pharmacokinetics, and safety, remain substantial barriers; addressing these challenges could constrain the clinical translation. This review demands further research to address the challenges to facilitate the effective integration of traditional medicinal knowledge with contemporary practice.