Efficacy and mechanisms of Gynostemma pentaphyllum as a medicine food homology herb in glycemic control: a meta-analysis with review

Introduction: (Thunb.) Makino is a traditional "medicine food homology" plant widely consumed in Asia to promote health. Its safety profile makes it a promising diabetes candidate. This study systematically evaluates its efficacy in glycemic control and elucidates its mechanisms of action. Methods: We conducted a meta-analysis of clinical studies from PubMed, CNKI, and Embase. Random-effects models calculated pooled mean differences (MD) for fasting plasma glucose (FPG), 2-h postprandial glucose (2hPG), and glycated hemoglobin (HbA1c). A systematic review also summarized its antidiabetic mechanisms. Results: significantly reduced FPG (MD = -0.79 mmol/L, 95% CI = -1.08 to -0.51), HbA1c (MD = -1.01%, 95% CI = -1.41 to -0.61), and 2hPG (MD = -0.90 mmol/L, 95% CI = -1.95 to -0.15). Long-term and monotherapy treatments showed superior efficacy. The mechanistic review revealed hypoglycemic effects via multiple pathways, including enhanced glucose uptake, reduced glucose production, increased insulin secretion, and improved insulin resistance. Discussion: provides effective glycemic control through multi-target pharmacological mechanisms, solidifying its potential as a comprehensive therapeutic approach for diabetes management.