Type 2 diabetes mellitus (DM) is a heterogeneous metabolic disorder characterized by chronic hyperglycemia and glucose intolerance. The search for safer and more effective antihyperglycemic drugs of plant origin is a priority due to the limited number of drugs available to treat metabolic syndrome. This review aims to compile various classes of plant-derived diterpenes and elucidate the mechanisms underlying their potential roles in key pathways involved in regulating diabetes and metabolic disorders. It also provides a critical evaluation of their preclinical efficacy, bioavailability, and translational potential. Studies show that diterpenes have a prominent effect on various biochemical pathways that help maintain glucose homeostasis by either interfering with insulin secretion and signaling pathways or modulating carbohydrate metabolism. Notable diterpenes include labdanes like andrographolide (targeting insulin signaling, inflammation, and gluconeogenesis), pimarane and abietane types (inhibiting α-glucosidase and protein tyrosine phosphatase 1B), and kauranes (enhancing insulin secretion and sensitivity). The SwissTargetPrediction software was utilized to predict the targets of major diterpenes from each class, suggesting that these compounds interact with a broad spectrum of protein classes (e.g., kinases, nuclear receptors, proteases), thereby reflecting multitarget pharmacological profiles. A few members of this group, such as stevioside and rebaudioside A, have progressed to clinical trials, demonstrating safety and modest reductions in postprandial glucose levels. Although other diterpenes have shown promise in preclinical models of diabetes and metabolic disorders, robust clinical data on their efficacy and safety are still lacking. These findings highlight the therapeutic potential of plant-derived diterpenes, but further research is needed to overcome limitations related to bioavailability, mechanistic clarity, and translational validation, thereby advancing them toward clinical application.
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