Ginseng, one of the oldest traditional Chinese medicinal herbs, has been used widely in China and Asia for thousands of years.
Ginsenosides extracted from ginseng, which is derived from the roots and rhizomes of Panax ginseng C. A. Meyer, have been used in China as an adjuvant in the treatment of
diabetes mellitus. Owing to the technical complexity of
ginsenoside production, the total
ginsenosides are generally extracted. Accumulating evidence has shown that
ginsenosides exert
antidiabetic effects. In vivo and in vitro tests revealed the potential of
ginsenoside Rg1, Rg3, Rg5, Rb1, Rb2, Rb3,
compound K, Rk1, Re, ginseng total
saponins, malonyl
ginsenosides, Rd, Rh2, F2,
protopanaxadiol (
PPD) and
protopanaxatriol (PPT)-type
saponins to treat diabetes and its complications, including
type 1 diabetes mellitus,
type 2 diabetes mellitus,
diabetic nephropathy, diabetic
cognitive dysfunction,
type 2 diabetes mellitus with
fatty liver disease, diabetic
cerebral infarction,
diabetic cardiomyopathy, and diabetic
erectile dysfunction. Many effects are attributed to
ginsenosides, including gluconeogenesis reduction, improvement of
insulin resistance,
glucose transport, insulinotropic action, islet cell protection, hepatoprotective activity, anti-inflammatory effect, myocardial protection,
lipid regulation, improvement of
glucose tolerance, antioxidation, improvement of
erectile dysfunction, regulation of gut flora metabolism, neuroprotection, anti-angiopathy, anti-neurotoxic effects, immunosuppression, and renoprotection effect. The molecular targets of these effects mainly contains GLUTs, SGLT1,
GLP-1, FoxO1, TNF-α,
IL-6,
caspase-3, bcl-2, MDA, SOD, STAT5-PPAR gamma pathway, PI3K/Akt pathway, AMPK-JNK pathway, NF-κB pathway, and endoplasmic reticulum stress. Rg1, Rg3, Rb1, and
compound K demonstrated the most promising therapeutic prospects as potential adjuvant medicines for the treatment of diabetes. This paper highlights the underlying pharmacological mechanisms of the anti-diabetic effects of
ginsenosides.