This article followed all ethical standards for research without direct contact with human or animal subjects.

Diabetes management includes a variety of treatment approaches, ranging from modern methods involving medication and lifestyle changes to complementary therapies such as herbal medicine and acupuncture.

Contemporary diabetes treatments primarily include pharmacological interventions, lifestyle changes, and the use of glucose-monitoring technology. These methods are evidence-based and widely used in conventional medicine (Lee et al. 2019).

Insulin, metformin, and sulfonylureas are common medications prescribed to diabetic patients to control blood glucose levels. Insulin therapy is especially important for people with T1D and T2D who do not get enough control from oral medications alone. Commonly used diabetes drugs include: insulin, biguanides, sulfonylureas, meglitinides, thiazolidinediones (TZDs), Alpha-Glucosidase Inhibitors, Dipeptidyl Peptidase-4 (DPP-4) Inhibitors, Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors, and Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists. Other treatments include gene therapy and dual agonists (Lee et al. 2019).

Dietary changes, regular physical activity, and weight management are all important aspects of diabetes management. These interventions help to control blood glucose levels while also lowering the risk of complications such as cardiovascular disease and neuropathy (Barnard, Hernandez & Jenkins 2015).

The introduction of continuous glucose monitors (CGMs) and insulin pumps has transformed diabetes care. These technologies provide real-time glucose readings and automated insulin delivery, which improves glycaemic control and reduces patients’ disease management burden (Ahmadi, De Backer & Dovc 2020).

Contemporary treatments have significantly improved the quality of life for diabetics. Improved glucose control lowers the risk of complications, resulting in fewer hospitalisations and a longer, healthier life (Nascimento et al. 2025). Access to advanced technologies such as CGMs and insulin pumps enables more precise management, allowing patients to live more active and fulfilling lives.

While modern diabetes medications have transformed the management of diabetes, they are not without drawbacks. Issues such as variable efficacy, side effects, high costs, limited access, and patient adherence challenges highlight the importance of continuous innovation and improvement in diabetes treatment. Some of the challenges experienced by patients include and are not limited to the following (Deressa et al. 2024; Nascimento et al. 2025):

The high cost of current diabetes treatments can be a barrier to access, especially in low- and middle-income countries (WHO 2020). The need for regular medication, glucose monitoring supplies, and advanced technologies can result in significant healthcare costs, affecting the affordability and availability of care.

Healthcare professionals and society generally accept and support contemporary treatments; however, there may still be a stigma attached to the visible aspects of diabetes management, such as insulin injections and glucose monitoring. Education and awareness campaigns are critical for reducing stigma and increasing acceptance.

Herbal medicine, acupuncture, and dietary supplements are examples of complementary diabetes treatments. These methods are frequently combined with conventional treatments to improve overall health and well-being. For centuries, herbal remedies such as bitter melon, fenugreek, and berberine have been used to treat diabetes symptoms. These natural treatments are believed to have hypoglycaemic properties and are widely used in many cultures around the world (Holistic Diabetes Care 2022).

With the prevalence and rapid increase of diabetes in Africa, many people rely on traditional medicine to manage their condition (Eddouks 2012; Tsabang et al. 2016). African traditional medicine has a long history that predates written records and has been passed down through oral traditions (Tsabang et al. 2016). Traditional healers, also known as herbalists, diviners, or spiritual healers, play an important role in African communities, providing treatments for a variety of health issues using natural remedies derived from plants, animals, and minerals (Eddouks 2012; Tsabang et al. 2016). Ailments such as diabetes are often well treated by traditional remedies.

Traditional medicine in Africa is inextricably linked with cultural beliefs and practices (Sagbo & Hussein 2022; Tsabang et al. 2016). It is based on a holistic approach to health that considers an individual’s physical, spiritual, and social needs. This holistic approach is especially important in the management of chronic conditions such as diabetes, which necessitates comprehensive care that addresses not only physical symptoms but also emotional and lifestyle factors associated with the disease.

African traditional medicine provides a wide range of diabetes treatments, many of which are derived from local flora and fauna (Eddouks 2012). The following are some of the most widely used traditional diabetes treatments in Africa.

In India, where diabetes prevalence has reached alarming levels, traditional medicine systems such as Ayurveda, Siddha, and Unani provide novel approaches to managing the disease (IDF 2019; Sadiku et al. 2019). Indian traditional medicine includes a wide range of herbal remedies, dietary practices, and holistic treatments that have been used for centuries to promote health and treat a variety of ailments, including diabetes (Sadiku et al. 2019; Sen & Chakraborty 2017).

In China, where the prevalence of diabetes has risen sharply in recent years, Traditional Chinese Medicine (TCM) offers a unique and time-honoured approach to managing the disease. Traditional Chinese Medicine, with its holistic perspective and emphasis on natural remedies, has been used for centuries to treat various ailments, including diabetes (Luo, Fabre & Rodwin 2019). Traditional Chinese Medicine is a comprehensive medical system that has been used for more than 2000 years (Luo et al. 2019). It is founded on the concepts of balance and harmony within and between the body and nature. Traditional Chinese Medicine encompasses a diverse set of practices, including herbal medicine, acupuncture, dietary therapy, and Qi Gong, all of which aim to restore and maintain health by balancing the body’s vital energy, or Qi (Holmes & Linong 2014).

While modern medicine offers effective treatments, many cultures around the world continue to use traditional and folkloric practices to manage diabetes (Gucciardi et al. 2019; IDF 2021). These practices, which are frequently rooted in centuries-old traditions and passed down through generations, provide unique perspectives and solutions for managing blood sugar levels and improving overall health.

Folklore medicine, also known as folk or traditional medicine, refers to a diverse set of healing practices and beliefs that are unique to different cultures (Gucciardi et al. 2019; Sharma 2015). These practices frequently use natural resources such as herbs, foods, and minerals. The environment, cultural beliefs, and availability of natural resources have all had an impact on folklore practices for diabetes management in various regions (Reid et al. 2018).

Apart from herbal remedies previously discussed, in folklore medicine, diet plays an important role in diabetes management (Gucciardi et al. 2019; Sharma 2015). These practices frequently involve eating specific foods that are thought to have a positive impact on blood sugar levels and overall health. These include:

In many cultures, spiritual and ritual practices are an important part of folklore medicine for diabetes management. These practices frequently include the use of prayer, meditation, and rituals to promote healing and harmony as outlined below (Al Fariqi 2023; Reid et al. 2018; Sharma 2015):

Folklore medicine takes a holistic approach to health that includes the body, mind, and spirit. This approach can lead to a more complete understanding of health and disease, promoting overall well-being and balance. Many folklore practices rely on readily available and inexpensive natural resources, making them accessible to a wide range of people (Reid et al. 2018). This can be especially useful in low-income or rural areas where access to modern healthcare is limited.

While many folklore practices show promise for diabetes management, more research is needed to validate their efficacy and ensure their safety when combined with modern medical treatments. Healthcare providers can better support patients on their diabetes management journey and promote overall health and well-being if they respect and understand the cultural significance of these practices.

Contemporary treatments for diabetes are primarily focused on controlling blood glucose levels, preventing complications, and improving quality of life. These treatments include medications, lifestyle modifications, and medical monitoring, whereas complementary treatments for diabetes involve a wide range of practices that are used alongside or in place of conventional treatments, including herbal medicines, acupuncture, dietary supplements, and mind-body therapies (Kavitha, Ramesh & Johnson 2020).

Contemporary diabetes treatments are widely accepted and trusted in many societies, particularly in industrialised countries where scientific research and technological advancements play an important role in healthcare (Kavitha et al. 2020). The use of evidence-based practices builds trust and credibility among patients and healthcare providers, resulting in widespread acceptance and use of contemporary treatments. In diverse societies, contemporary treatments are frequently modified to accommodate cultural beliefs and practices, thereby increasing their acceptability and effectiveness across populations (Singh, Thomas & Kumar 2019). However, in some communities, there may be a gap between modern medical practices and traditional beliefs, affecting treatment adherence and patient outcomes.

Complementary diabetes treatments are deeply rooted in cultural traditions and frequently align with patients’ personal beliefs and values (Kavitha et al. 2020; Singh et al. 2019). Complementary and Alternative Medicine (CAM) practices provide patients with a sense of continuity with ancestral traditions while also aligning with holistic health approaches, providing comfort and familiarity. While complementary treatments are widely used in many cultures, they may be viewed sceptically in societies that value scientific evidence and conventional medicine. Patients who use CAM may face social pressure to conform to current medical practices, which can influence their willingness to pursue alternative therapies (Rahman, Hosseinzadeh & Hasnain 2021).

Patients who choose contemporary treatments frequently do so because they believe in scientific evidence and the recommendations of healthcare professionals (Rahman et al. 2021). Patients are more likely to follow treatments that are supported by clinical evidence and recommended by their doctors, resulting in improved health outcomes and adherence to prescribed therapies (Hsu et al. 2023). The possibility of side effects and complications from current treatments can influence patient decisions, leading some to seek alternative therapies or combine conventional and complementary approaches (Gupta, Das & Sengupta 2019).

Furthermore, these patients frequently value a holistic approach to health and seek therapies that are consistent with their personal beliefs and preferences (Rahman et al. 2021; Singh et al. 2019). Complementary and Alternative Medicine practices encourage patients to actively participate in their health and well-being, instilling a sense of control and self-care. This empowerment can result in higher patient satisfaction and engagement in their treatment plans. Many patients prefer to combine complementary treatments with conventional care, seeking a balanced approach that benefits both medical systems (Perez, Gutierrez & Lopez 2018; Zhang, Chen & Liu 2018), which ultimately improves patient outcomes and overall quality of life.

Diabetes treatments today frequently include advanced technologies, medications, and specialised medical services, all of which can be expensive (Hsu et al. 2023; Rahman et al. 2021). The cost of modern medical care can contribute to rising healthcare costs and economic disparities because not all patients can afford expensive therapies or have access to comprehensive health insurance (Gupta et al. 2019). Contemporary treatments are typically covered by health insurance plans, reducing the financial burden on patients (O’Brien, Bock & Sargut 2020). However, disparities in insurance coverage can result in unequal care and health outcomes.

Complementary diabetes treatments are generally more affordable and accessible, especially in low-income and rural communities where conventional medical services are limited (Rahman et al. 2021; Singh et al. 2019). Complementary and Alternative Medicine practices frequently involve lower costs for treatment and maintenance of health, making them an appealing option for people looking for affordable healthcare solutions (Gupta et al. 2019; Singh et al. 2019). Despite their cost-effectiveness, complementary treatments may be excluded from health insurance plans, limiting their availability and integration into mainstream healthcare systems. This lack of coverage can create barriers for patients who want to try CAM therapies.

Modern treatments can have significant social and psychological consequences for patients and their families (Chukwuma 2018). Patients undergoing contemporary treatments frequently benefit from strong social support networks, which include family, friends, and healthcare providers (Chukwuma 2018; Fagninou et al. 2019). This support can improve emotional well-being and health outcomes. The use of modern treatments may be associated with social stigma, especially for chronic conditions such as diabetes that necessitate ongoing medical care. Patients may feel vulnerable and out of control over their health (Fagninou et al. 2019).

Complementary treatments can provide social and psychological benefits by instilling a sense of community and cultural identity. Complementary and Alternative Medicine practices frequently include community-based activities and group support, which improve social connections and foster a sense of belonging (Perez et al. 2018). This community involvement can boost mental health and overall well-being. Many complementary treatments include spiritual and mind-body practices, giving patients a greater sense of fulfilment and purpose (Cooper et al. 2021). This comprehensive approach can reduce stress, improve coping mechanisms, and improve overall well-being.

Sustainable drug discovery for diabetes necessitates a multifaceted approach that incorporates cutting-edge technologies, encourages collaboration, and prioritises environmental and patient-centric practices. The pharmaceutical industry can create innovative and effective diabetes treatments by combining multi-omics technologies, artificial intelligence (AI) and machine learning (ML), green chemistry, and public–private partnerships (Franco et al. 2020). Enhancing patient involvement and promoting open science will ensure that these treatments meet the needs of diabetics while also contributing to a more sustainable and equitable healthcare system (Furman & Muller 2020). As the prevalence of diabetes rises, these recommendations will be critical to advancing drug discovery and improving the lives of millions of people worldwide.

The traditional process of drug discovery is lengthy, costly, and often fraught with high failure rates. For diabetes, the challenges include (Khan & Pillay 2020): (1) Diabetes pathophysiology is complex, with genetic, environmental, and lifestyle factors all playing a role, making it difficult to effectively target a single pathway; (2) Existing animal models and in vitro systems may not accurately simulate human diabetes, resulting in disparities in drug efficacy and safety; (3) A large number of potential drugs fail in clinical trials because of insufficient efficacy or safety concerns, resulting in significant financial losses. Despite these obstacles, there have been significant advances in diabetes treatment, including (Halban et al. 2021):

Integrating multi-omics approaches, such as genomics, proteomics, metabolomics, and transcriptomics, can provide a thorough understanding of the molecular mechanisms underlying diabetes (Halban et al. 2021; Kahn, Cooper & Del Prato 2021). This comprehensive approach can help to identify new biomarkers and therapeutic targets, accelerating drug discovery.

The adoption of AI and ML can revolutionise drug discovery by making it easier to analyse large datasets, predict drug interactions, and identify potential drug candidates (Rosen & Spiegelman 2019). Furthermore, AI and ML can significantly reduce the time and cost of drug discovery, improve drug candidate selection accuracy, and predict clinical trial outcomes (Dankwa-Mullan et al. 2019).

Green chemistry is concerned with developing chemical processes that have a low environmental impact, generate less waste, and improve the sustainability of drug production (Halban et al. 2021). This approach is critical for developing environmentally friendly diabetes medicines, as it promotes the use of renewable resources, reduces reliance on toxic reagents, lowers energy consumption, and encourages regulatory bodies to incentivize pharmaceutical companies to adopt green chemistry practices. (Halban et al. 2021; Rosen & Spiegelman 2019). Green chemistry has the potential to lead to the development of environmentally sustainable drugs, lower pharmaceutical manufacturing’s carbon footprint, and promote responsible natural resource use.

Collaboration between public research institutions and private industry can maximise resources, expertise, and funding, accelerating the discovery and development of new diabetes treatments (Thompson, Kessler & Williams 2017). This can be accomplished by forming public–private research consortia focused on diabetes drug discovery, as well as developing funding mechanisms that encourage collaborative research and incentivise innovation (Franco et al. 2020). Public–private partnerships can help to share knowledge and technology, improve drug discovery efficiency, and get new treatments to market faster.

The promotion of Open Science and Data Sharing fosters transparency, collaboration, and innovation, allowing researchers to build on each other’s work and accelerate the discovery of new diabetes treatments (Furman & Muller 2020). Open access repositories for sharing research data, protocols, and findings on diabetes drug discovery should be created and maintained (Perez et al. 2018). Furthermore, creating online platforms allows researchers around the world to collaborate and exchange knowledge (Perez et al. 2018). Open science can reduce duplication of effort, improve research reproducibility, and promote a more collaborative and efficient drug discovery process (Kahn et al. 2021).

Incorporating patients’ perspectives into drug development can increase the relevance and acceptability of new treatments, ensuring that they meet the needs and preferences of diabetics (Perez et al. 2018). Involving patients in the design and execution of clinical trials helps to gain insight into their experiences and preferences. Use patient-reported outcomes to evaluate how new treatments affect quality of life and daily functioning. Patient-centred approaches can help to develop more effective and acceptable treatments, increase patient adherence, and improve overall health outcomes (Cooper et al. 2021).

The rising prevalence of diabetes necessitates innovative and long-term drug discovery approaches to develop effective therapies that address the disease’s underlying mechanisms.