Astragalus Membranaceus for Type 2 Diabetes Mellitus and Its Complications: From Molecular Mechanisms to Therapeutic Potential

Jiayu Zhang; Wenbo Gao; Shaohua Hu; Ying Liu

doi:10.71204/83zf0y22

Authors

Jiayu Zhang Beijing University of Chinese Medicine Author
Wenbo Gao Beijing University of Chinese Medicine Author
Shaohua Hu Beijing University of Chinese Medicine Author
Ying Liu Beijing University of Chinese Medicine Author

DOI:

https://doi.org/10.71204/83zf0y22

Keywords:

Astragalus Membranaceus, Astragalus Polysaccharides, Astragaloside Ⅳ, Flavonoids, Type 2 diabetes mellitus, Diabetic Complications

Abstract

Astragalus membranaceus is a traditional Chinese medicine widely used in the management of diabetes mellitus. Its major bioactive constituents—astragalus polysaccharides (APS), astragaloside IV (AS-IV), and flavonoids—demonstrate significant anti-diabetic properties. This review summarizes current evidence on the therapeutic potential and molecular mechanisms of A. membranaceus and its major components in treating T2DM and its complications. Literature was retrieved from six databases: PubMed, Science Direct, Academic Journals, Web of Science, Research Gate, and Google Scholar. Search terms included “type 2 diabetes mellitus”, “Astragalus membranaceus”, “polysaccharides”, “saponins”, “flavonoids”, and their combinations. Bioactive compounds from A. membranaceus modulate glucose metabolism and ameliorate insulin resistance (IR). APS restores glucose homeostasis via the PI3K/Akt and AMPK pathways, alleviates endoplasmic reticulum (ER) stress, and regulates gut microbiota. It also confers protection against diabetic cardiomyopathy, nephropathy, cognitive dysfunction, bladder dysfunction, and ulcers through anti-inflammatory, antioxidative, and pro-autophagic activities. AS-IV improves dysregulated glucolipid metabolism by modulating the AMPK/mTOR, ERK1/2, and NF-κB pathways. Flavonoids exert renoprotective effects by mitigating mitochondrial dysfunction and inflammation. A. membranaceus and its bioactive constituents provide a multitargeted strategy to alleviate T2DM and its complications by regulating metabolic, inflammatory, and oxidative stress pathways. However, poor oral bioavailability remains a major limitation for clinical translation. Recent advances in structural modifications and novel delivery systems offer promising avenues to overcome this challenge. As an alternative or adjunctive therapy, A. membranaceus holds considerable potential in diabetes management.

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