REVIEW Open Access

Ethnopharmacological review of medicinalplants used to manage diabetes inMoroccoElhassan Idm’hand*, Fouad Msanda and Khalil Cherifi

Abstract

Diabetes is a chronic metabolic disorder which affects millions of people every year. If diabetes is not controlled, itcan cause serious damage and a number of health complications. The aim of this paper was to review publishedethnobotanical and ethnopharmacological evidences of Moroccan plants with antidiabetic potentials. Publicationsdescribing the medicinal plants used for the treatment of diabetes in Morocco were searched from the databases,including Google Scholar, Elsevier, Medline, Web of Science, SCOPUS and Pubmed. Other literature source was alsoused including books and theses available in library. About 750 literature references were studied, and only 240research publications based on data from different Moroccan provinces published until June 2019 were included inthis review. In total, 255 plants species belonging to 70 families were reported. Compositae and Lamiaceae werementioned as the most represented families. The frequently used plant species in the dwellers of most regions ofMorocco are Trigonella foenum-graecum, Artemesia herba-alba, Nigella sativa, Olea europaea, Allium cepa and Marrubiumvulgare. This review provides useful information and current scientific knowledge on the medicinal plants used tomanage diabetes in Morocco. Medicinal plants reported should be submitted to chemical, pharmacological and clinicalstudies to identify pharmacologically active metabolites and to confirm their antidiabetic activity.

Keywords: Medicinal plants, Diabetes, Ethnobotany, Pharmacology, Toxicology, Morocco

IntroductionType 2 diabetes mellitus (T2DM), generally termed asdiabetes, is one of the major endocrine diseases whichaffects millions of people in the industrial and develop-ing countries [1, 2]. It is projected that the total numberof people with diabetes worldwide is expected to in-crease to 592 million by 2035 [3]. Diabetes is a metabolicdisease characterized by insufficient insulin secretion,impaired cellular action of the insulin or both [2, 4]. Thecharacteristic symptoms of diabetes are pruritus, poly-dipsia, weight loss, polyphagia, wasting, blurred vision,polyuria, tachycardia and hypotension [5, 6]. Dietary andlifestyle factors (Obesity, weight gain, physical inactivityand low fiber diet with a high glycemic index) play a

significant role in the development of diabetes [7]. Pro-longed uncontrolled hyperglycemic level causes an in-crease in oxidative stress activation of the polyolpathway, coronary artery disease, peripheral arterial dis-ease, stroke, diabetic nephropathy, neuropathy, periph-eral neuropathy, retinopathy, retinopathy leading tovision loss, chronic kidney disease, urinary problems,sexual dysfunction, and skin infections [3, 8, 9]. Thetreatment of diabetes mellitus is based on insulin, dietmodification and oral hypoglycemic agents. Herbalmedicine has developed as an alternative for the treat-ment of diabetes because oral hypoglycemic agents areexpensive and tagged with several side effects (nausea,skin reactions, liver disease, heart failure diarrhea, etc.)[10, 11]. In Morocco, there are numerous medicinalplants described for treatment of diabetes [2, 12–23].

© The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License,which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you giveappropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate ifchanges were made. The images or other third party material in this article are included in the article's Creative Commonslicence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commonslicence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtainpermission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

* Correspondence: idmhand-h@hotmail.comLaboratoire de Biotechnologies et Valorisation des Ressources Naturelles,Faculté des Sciences, B.P. 8106, Cité Dakhla, Agadir, Morocco

Idm’hand et al. Clinical Phytoscience (2020) 6:18 https://doi.org/10.1186/s40816-020-00166-z

The aim of this review article was to collect data for spe-cies wellknown for their antidiabetic effect in Morocco.

MethodThree researchers searched Google Scholar, Elsevier,Medline, Web of Science, SCOPUS and Pubmed biblio-graphic databases from January 2019 to July 2019 to ex-tract all data about the use of plants in folklore medicinefor treatment and management of diabetes in Moroccopublished in the period from January 1980 to June 2019,using English, French and Arabic keywords. The searchterms used were “Ethnobotanical survey”, “Moroccanmedicinal plants”, “anti-diabetic medicinal plants inMorocco”, “hypoglycemic plants in Morocco”, “diabetesin Morocco”. We reviewed the literature and collecteddata on the explored regions of Morocco (Beni Mellalregion, Rabat, Western Anti-Atlas, Izarene forest, Orien-tal Morocco, Northwestern Morocco, Sefrou region,Central Middle Atlas, Tizi n’ Test Region, Al Haouz-Rhamna, Tan-Tan, Meknes-Tafilalet and Fez–Boule-mane). About 750 literature references were studied, andonly 240 ethnobotanical articles and pharmacology pa-pers were included in this review. We did not includedarticles related to taxonomy, morphological characters,pharmacology, toxicity, ethnobotany, phytochemistry,clinical studies, cultivation, physiological, and anatomicalaspects of all the medicinal plants mentioned. We stud-ied in detail only the six plants most used for the treat-ment of diabetes in Morocco. We also excluded thearticles without accessible full text and duplicate articles.Plant taxonomy is confirmed through data available onsite (www.theplantlist.org).

ResultsEthnobotanical studiesA total of 255 plant species belonging to 70 familieswere reported as being used in the treatment and man-agement of diabetes in Morocco (Table 1). Among plantfamilies, Compositae had the highest number of speciesfollowed by Lamiaceae, Leguminosae, Apiaceae, Poaceaeand Brassicaceae. Compositae was the most frequentlycited plant family, which is consistent with the predom-inance of this plant family in the results of various stud-ies conducted in other countries [3, 27, 28]. Compositaehas been designated as the largest plant family of flower-ing plants worldwide, comprising 23,000 species and1535 genera, including many with considerable medi-cinal importance [29, 30]. The traditional medicinal ap-plications of several Compositae species have beenrecorded in the literature. Several bioactive compoundshave been evaluated for their biological activities [31]. Awide use of Compositae family plants in Morocco couldbe due to the large number of plant species belonging tothis family. Further, plants belonging to the Compositae

family contain a group of active phytochemical constitu-ents and some bitter-tasting secondary metabolites suchas sesquiterpene lactones [8, 30].Our evaluation of literature showed that indigenous

people used 19 plant parts (leaf, aerial part, fruit, leafystem, seed, root, bark, calyce, flower, stem, clove, gum,inflorescence, bark, pericarp, rhizome, stigma, tuber andyoung sprout) as herbal therapies for curing diabetes,but with, however, some preference for the leaves. Sev-eral procedures modes are used by the population tocreate medicinal formulations (decoction, cooked, infu-sion, powder, maceration, juice, raw and cataplasm).However, extractions by decoction, powder or infusionremain the most common processes. Most medicinalformulations were used internally via oral route. Thedose used varied considerably according to the patientsquestioned. The patients did not respect the precision ofdoses (some diabetics use specific doses, and others usenon-specific doses). Often, people use a mixture ofplants to treat diabetes. The duration of the use of plantswas badly defined ranging from a few days to severalyears. The majority of people with diabetes have re-course in medicinal plants to treat diabetes. The per-centage of use of phytotherapy varies between 51% and90%, depending on the regions. The use of herbal medi-cine among certain diabetics was done in combinationwith their conventional treatment. Women frequentlyused more medicinal plants than men. Diabetics havediscovered the disease by suggestive symptoms or by ascreening test.An ethnobotanical study was conducted out among

400 herbalists from the Beni Mellal region in order toidentify the medicinal plants used for the traditionaltreatment by the diabetic patients. The results identified45 species belonging to 25 botanical families. The mostused species are: Olea europaea, Salvia officinalis,Allium sativum and Trigonella foenum-graecum. Leavesand roots are the most used parts [24].To collect some information about antidiabetic plants

used in Rabat (capital city of Morocco), a survey wasundertaken from March 1st to April 30th 2018. The in-vestigations revealed 30 species of plants belonging to 18families. Lamiaceae and Leguminosae were the mostcommonly reported plant families. Interview resultsshowed that the most frequently used plants were Trigo-nella foenumgraecum, Salvia officinalis and Olea euro-paea [25].A survey was conducted by Barkaoui et al. [2], in Tiz-

nit (Western Anti-Atlas), in central Morocco. This studyshowed the importance of the use of medicinal plants bylocal population in the treatment of diabetes. Resultshave identified 48 medicinal plant species, belonging to25 families and 44 genera, used for treating diabetes inthe region. Plants growing in wild are most commonly

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 2 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Aizoaceae

Mesem

bryanthemum

theurkauffii

(Maire)Maire

Afzu

Leaf

andfru

itDecoctio

nandpo

wde

r1

[18]

Amaranthaceae

Anabasisaretioides

Moq

.&Coss.

exBu

nge

Chajra

mayeharrekha

rih/sellii

Aerialp

arts

Decoctio

n3

[17,18,21]

Amaranthaceae

Atriplexha

limus

L.Legtef

Leaf

Powde

r,de

coctionand

maceration

1[18]

Amaranthaceae

Dysph

ania

ambrosioides

(L.)

Mosyakin&Clemants

Mkhinza

Leaf

Infusion

9[12–14,16,18,19,22–24]

Amaranthaceae

Ham

madascoparia

(Pom

el)Iljin

Assay

Seed

Decoctio

n1

[2]

Amaranthaceae

Salso

latetragon

aDelile

Laarad

Leaf

andfru

itPo

wde

r1

[18]

Amaryllidaceae

Allium

ampeloprasum

L.Bo

rro

Bulb

Raw

2[18,25]

Amaryllidaceae

Allium

cepa

L.Basla

Bulb

Raw

andjuice

14[2,12–22,24,25]

Amaryllidaceae

Allium

sativum

L.Tiskert/Tou

ma

Bulb

Raw

9[12,13,17–19,21–24]

Anacardiaceae

Pistacia

atlanticaDesf.

Btem

/Igg/Drou

Fruit

Decoctio

n1

[2]

Anacardiaceae

Pistacia

lentiscus

L.Trou

/Tidekt

Leaf,g

umandecorce

Infusion

andde

coction

3[13,14,17]

Anacardiaceae

Searsia

albida

(Schou

sb.)Moffett

Zewaya/anaffis

Fruit

Raw

1[18]

Anacardiaceae

Searsia

tripartita(Ucria)Moffett

Jdari

Leaf

Powde

r1

[18]

Apiaceae

Ammivisn

aga(L.)Lam.

Bachnikha/Barghanisse

Inflorescen

ce(umbe

l)Decoctio

n11

[12–17,19–23]

Apiaceae

Ammodaucusleucotrichu

sCoss.

Kamou

nsoufi

Seed

Infusion

andde

coction

3[12,17,18]

Apiaceae

Apium

graveolens

L.Krafess

Seed

Infusion

1[12]

Apiaceae

Carum

carviL.

Lkarwya

Seed

Decoctio

n7

[2,17–21,24]

Apiaceae

Coriand

rum

sativum

LKo

sbor

Seed

Infusion

6[12,15–17,20,25]

Apiaceae

Cuminum

cyminum

L.Kamou

nSeed

Powde

r2

[17,18]

Apiaceae

Daucuscarota

L.Kh

izou

Root

Juiceandpu

ree

3[13,17,18]

Apiaceae

Eryngium

ilicifolium

Lam.

Tasnant/Iglifin

Stem

andleaf

Decoctio

nandpo

wde

r1

[2]

Apiaceae

Foeniculum

vulgareMill.

Nafaa

Seed

Decoctio

n9

[2,12,17–22,24]

Apiaceae

PastinacasativaL.

Leftlm

ahfour

Root

Raw

2[2,24]

Apiaceae

Petroselinum

crisp

m(M

ill.)Fuss

Maadn

ouss

Seed

Infusion

4[12,17,18,24]

Apiaceae

Pimpinella

anisu

mL.

Habbathlaw

aSeed

Decoctio

nandpo

wde

r7

[2,12,15,17,18,24,25]

Apiaceae

Ptycho

tisverticillataDub

yNou

nkha

Aerialp

arts

Infusion

2[13,23]

Apiaceae

Ridolfiasegetum

(L.)Moris

Tebch

Seed

Powde

r1

[17]

Apo

cynaceae

Apterantheseuropaea

(Guss.)

Murb.

Oukan

iddan

Stem

Decoctio

n,infusion

,andraw

1[2]

Apo

cynaceae

Calotropisprocera(Aito

n)Dryand.

Turja

Leaf

Powde

r1

[18]

Apo

cynaceae

Carallumaeuropaea

(Guss.)

N.E.Br.

Daghm

ous

Aerialp

arts

Maceration

3[12,17,26]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 3 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Apo

cynaceae

Nerium

oleand

erL.

Defla/Alili

Leaf

Fumigationandde

coction

13[2,12,14,15,17–24,26]

Apo

cynaceae

Periploca

laevigatasubsp.

angustifolia

(Labill.)Markgr.

Asllif

Fruit

Decoctio

n2

[2,26]

Arecaceae

Cham

aerops

humilisL.

Dum

/Tiguezden

/Ignadd

Root

Raw

andcooked

2[13,17]

Arecaceae

Hypha

enethebaica

(L.)Mart.

Dum

/karur

Fruit

Powde

r1

[18]

Arecaceae

Phoenixdactylifera

LTm

arFruit

Raw

andde

coction

5[12,17,18,20,23]

Aristolochiaceae

AristolochiabaeticaL.

Tisw

iknigrane/Berztem

Root

Powde

r1

[26]

Aristolochiaceae

Aristolochiafontan

esiiBo

iss.&Reut.

Berztem

Seed

Decoctio

n4

[15,17–19]

Asparagaceae

Agaveam

erican

aL.

Ssabra/Saybe

rLeaf

Decoctio

n1

[17]

Asparagaceae

AsparagusalbusL.

Sekkum

/Azzu

Youn

gsprouts

Raw

1[13]

Berberidaceae

Berberisvulgarissubsp.australis

(Boiss.)Heywoo

dArghis/Atizar

Leafystem

Decoctio

n1

[17]

Brassicaceae

Anastaticahierochu

nticaL.

ChajaratMaryem/lkem

cha

Stem

andleaf

Powde

r2

[13,18]

Brassicaceae

Brassicana

pusL.

Left

Rhizom

eJuice

1[18]

Brassicaceae

Brassicanigra(L.)K.Ko

chElkharde

lFlow

erPo

wde

randinfusion

1[17]

Brassicaceae

Brassicaoleracea

L.Krun

bmkawar/m

elfuf

Aerialp

artsandfru

itRaw

andmaceration

4[12,13,17,18]

Brassicaceae

Brassicarapa

L.Leftbe

ldi

Root

andleaf

Decoctio

n2

[13,17]

Brassicaceae

Diplotaxispitardiana

Maire

Kerkaz/Elharra

Flow

erPo

wde

r2

[17,18]

Brassicaceae

Erucavesicaria

(L.)Cav.

Ljerjir

Aerialp

arts

Juice

1[18]

Brassicaceae

Lepidium

sativum

L.Hab

errechad

Seed

Maceration,

decoction

andinfusion

7[12,17–19,21,24,25]

Brassicaceae

Nasturtium

officinaleR.Br.

Gernu

nes

Leafysteem

Maceration

1[18]

Brassicaceae

Ptilotrichu

mspinosum

(L.)Bo

iss.

Agu

erbaz

Stem

andleaf

Decoctio

n1

[13]

Brassicaceae

Raph

anus

sativus

L.Lfjel

Root

Raw

5[2,12,17,18,24]

Buxaceae

BuxusbalearicaLam.

Azazer/lb

akou

sLeaf

Decoctio

n2

[13,17]

Buxaceae

Buxussempervirens

L.Lbeks

Leaf

Decoctio

n1

[19]

Cactaceae

Opuntia

ficus

indica

(L.)Mill.

Lhnd

ia/Aknari

Stem

,roo

tandflower

Decoctio

n,juice

andpo

wde

r10

[2,12,13,15–18,20,22,24]

Capparaceae

Capparisdecidua(Forssk.)Edge

w.

Ignin

Fruit

Powde

r1

[18]

Capparaceae

CapparisspinosaL.

Kabar/Taylulut

Aerialp

arts,fruitandroot

Powde

r,de

coction

andinfusion

11[13,14,16–23,26]

Capparaceae

Maeruacrassifolia

Forssk.

Atil/Sed

ralkhadra

Leaf

Powde

randde

coction

1[18]

Caryoph

yllaceae

Herniaria

glabra

L.Hrasset

lehjer

Aerialp

arts

Decoctio

n1

[22]

Caryoph

yllaceae

Paronychia

argentea

Lam.

Tahido

urtn’im

ksaoum

Leafystem

Infusion

1[26]

Caryoph

yllaceae

Silene

vivian

iiSteud.

Gernlebzal

Steem

Raw

1[18]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 4 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Cistaceae

Cistus

albidusL.

Boutou

rLeaf

Decoctio

n1

[13]

Cistaceae

Cistus

creticus

L.Irg

elLeaf

Decoctio

nandpo

wde

r3

[2,17,26]

Cistaceae

Cistus

laurifoliusL.

Agu

llid

Seed

andflower

Powde

r2

[17,26]

Cistaceae

Cistus

salviifoliusL.

Irgel/Tirg

elt

Leaf

andseed

Decoctio

nandpo

wde

r2

[2,17]

Colchicaceae

Androcym

bium

gram

ineum

(Cav.)J.F.Macbr.

Temrate

legh

rab

Bulb

Infusion

1[17]

Com

positae

AchilleaodorataL.

Elqo

rte

Leaf

andflower

Infusion

1[17]

Com

positae

Anacycluspyrethrum

(L.)Lag.

Igun

tas/Tagun

decht

Root

Infusion

andpo

wde

r1

[13]

Com

positae

Antenn

aria

dioica

(L.)Gaertn.

Oud

enelfar

Leaf

Decoctio

n1

[17]

Com

positae

Anvilleagarciniisubsp.

radiata

(Coss.&Durieu)

And

erb.

Neg

dLeaf

Decoctio

nandpo

wde

r1

[18]

Com

positae

Artemisiaabrotanu

mL.

Chih

Aerialp

arts

Decoctio

n1

[17]

Com

positae

Artemisiaabsin

thium

L.Chiba

Aerialp

arts

Infusion

10[12,14,16,17,19–24]

Com

positae

ArtemisiaatlanticaCoss.&Durieu

Chihou

rika

Aerialp

arts

Infusion

1[17]

Com

positae

Artemisiaherba-alba

Asso

Izri/Chihdw

idi

Steam,leafandroot

Decoctio

nandinfusion

15[2,12,14–26]

Com

positae

ArtemisiamesatlanticaMaire

Chihalaallssat/Chihelkhrayssi

Aerialp

arts

Decoctio

n1

[17]

Com

positae

Artemisiareptan

sC.Sm.exLink

Chihiya

Leaf

Decoctio

n1

[18]

Com

positae

Centaureamaroccana

Bal

Bejjaae

nhal/Nog

guir

Flow

erInfusion

1[17]

Com

positae

Cham

aemelum

nobile(L.)All.

Babo

unj

Leaf

Decoctio

n2

[15,17]

Com

positae

Cichorium

intybusL.

Buaggad

Root

Infusion

1[18]

Com

positae

Cladan

thus

arabicus

(L.)Cass.

Taafs

Flow

erInfusion

1[17]

Com

positae

Cladan

thus

scariosus(Ball)

Obe

rpr.&Vo

gtArzgi/irzgi

Flow

erDecoctio

n1

[26]

Com

positae

Cyna

racardun

culusL.

Kharchou

fAerialp

arts

Decoctio

n7

[12,15,17–20,22]

Com

positae

Dittrichiaviscosa(L.)Greuter

Terehla/Bagram

anLeaf

Decoctio

n3

[13,17,26]

Com

positae

Echino

psspinosissimus

Turra

Taskra

Flow

erDecoctio

n3

[2,15,26]

Com

positae

Inulaconyza

(Griess.)DC.

Terreh

laRo

otDecoctio

n1

[17]

Com

positae

Inulahelenium

L.Terreh

ladamnatiya

Leaf

andflower

decoction

1[17]

Com

positae

LactucasativaL.

Khes

Leaf

Raw

4[12,17,21,22]

Com

positae

Laun

aeaarborescens(Batt.)

Murb.

Iferskel/M

oulbna

Stem

,leaf,root

andflower

Powde

r,de

coction

andinfusion

3[2,17,18]

Com

positae

Matricaria

cham

omillaL.

Mansania

Leaf

andflower

Decoctio

nandinfusion

3[14,17,24]

Com

positae

Pallenisspinosa(L.)Cass.

Nug

dAerialp

arts

decoction

1[17]

Com

positae

Scolym

ushispan

icus

L.Gurnina

/Taghd

iut

Stem

andleaf

Raw

andde

coction

3[13,17,26]

Com

positae

Scorzonera

undulata

Vahl

Tamtla

Flow

erRaw

1[2]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 5 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Com

positae

Sonchu

sarvensisL.

Kettan

elhe

nch

Leaf

Infusion

1[15]

Com

positae

Sonchu

stenerrimus

L.Tifaf

Leaf

Decoctio

n1

[18]

Com

positae

Tana

cetum

vulgareL

Lbalssam

Stem

Infusion

1[17]

Com

positae

Taraxacum

campylodesG.E.Haglund

Lhandb

aFlow

erandroot

Decoctio

n1

[17]

Com

positae

Warioniasaha

raeBenthe

mex

Benth.

&Coss.

Afssas

Leaf

Infusion

andpo

wde

r2

[2,18]

Cucurbitaceae

Citrulluscolocynthis(L.)Schrad.

Aferziz/lh

dej

Seed

andfru

itDecoctio

n,cataplasm

andpo

wde

r11

[2,12,13,17–19,21–23,25,26]

Cucurbitaceae

Cucumissativus

L.Lkhiar

Fruit

Raw

6[2,12,13,17,18,24]

Cucurbitaceae

Cucurbita

maximaDuche

sne

Garaa

lham

raLeaf

Decoctio

n1

[18]

Cucurbitaceae

Cucurbita

pepo

L.Takhsait/curjt

Fruit

Raw

andde

coction

5[13,14,17,18,24]

Cup

ressaceae

Juniperusph

oeniceaL.

Araar

finiqui

Leaf

andaerialp

arts

Powde

r,de

coctionand

maceration

4[13,17–19]

Cup

ressaceae

Juniperusthurifera

LTawayt

Leaf

Decoctio

n1

[13]

Cup

ressaceae

Tetraclinisarticulata(Vahl)Mast.

Araar

Leaf

andaerialp

arts

Infusion

andmaceration

9[12–15,17,21–24]

Cynom

oriaceae

Cyno

morium

coccinum

L.Tertut

Steem

Powde

r1

[18]

Cyperaceae

Bolboschoenu

smaritimus

(L.)Palla

Ssmar

Seed

Decoctio

n1

[17]

Cyperaceae

Cyperusrotund

usL.

Tara

Leaf

Powde

r1

[18]

Dracaen

aceae

Dracaenadracosubsp.ajgalBen

abid

&Cuzin

Ajgal

Stem

andleaf

Decoctio

n1

[2]

Ephe

draceae

EphedraalataDecne

.Chd

ida

Leafystem

Decoctio

nandpo

wde

r1

[18]

Ephe

draceae

Ephedraaltissim

aDesf.

Toug

elargan

Stem

,leafandwho

leplant

Decoctio

n2

[2,24]

Ephe

draceae

Ephedrafra

gilis

Desf.

Amater

Leafystem

Decoctio

n1

[26]

Ericaceae

Arbutusun

edoL.

Sasnu

Leaf

androot

Decoctio

n5

[13,14,22–24]

Euph

orbiaceae

Euph

orbiaofficinarum

subsp.

echinu

s(Hoo

k.f.&Coss.)

Vind

tTikiou

t/Daghm

ouss/zakou

mFruit,stem

andleaf

Maceraion

,decoctio

n,po

wde

randjuice

4[2,16–18]

Euph

orbiaceae

Euph

orbiaofficinarum

LTikiou

t/Daghm

ouss

Stem

andleaf

Powde

r1

[2]

Euph

orbiaceae

Euph

orbiaresin

ifera

O.Berg

Tikiwt

Leaf

Adrop

latexin

aglassof

water

4[13,19,24,26]

Euph

orbiaceae

Mercurialis

annu

aL.

Hurrig

aelmalssa

Leafystem

Infusion

,decoctio

nandjuice

2[17,18]

Euph

orbiaceae

Ricinu

scommun

isL.

Awriw

er/Lkharwaa

Seed

Poultice

1[18]

Fagaceae

Quercus

coccifera

L.Elqe

rmez

Leaf

Decoctio

n1

[17]

Gen

tianaceae

Centaurium

erythraeaRafn

Qussetelhayya/Ahchlaf

ntaw

rra

Flow

eringandaerialp

arts

Infusion

andde

coction

4[13,14,17,22]

Iridaceae

Crocus

sativus

L.Zaafranlhor

Stigma

Infusion

1[18]

Juglandaceae

Juglan

sregiaL.

Swak

/Gargaa

Leaf

andbark

Infusion

andde

coction

6[13,17,18,22,23,26]

Juncaceae

Juncus

maritimus

Lam.

Ssem

arFruitandstem

Decoctio

n2

[17,18]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 6 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Lamiaceae

Ajugaiva(L.)Schreb

.Timerna

nzen

khad/Chn

dkou

raStem

andleaf

Powde

randde

coction

12[2,12–15,17–19,22–24,26]

Lamiaceae

Ballota

hirsutaBenth

Merrouelhram

i/Merrou

Leafystem

Decoctio

n1

[17]

Lamiaceae

Clinopodium

alpinu

m(L.)Kuntze

Ziitra

Leaf

Decoctio

n2

[18,25]

Lamiaceae

Clinopodium

nepeta

subsp.

glan

dulosum

(Req

.)Govaerts

Manta

Aerialp

arts

Infusion

andde

coction

2[14,15]

Lamiaceae

Lavand

ulaan

gustifolia

Mill

Elkhzamazerqa/

ElkhzamaFassiya

Aerialp

artsandleafystem

Infusion

andde

coction

1[17]

Lamiaceae

Lavand

uladentataL.

Timzeria/Lakhzam

a/Jaada

Stem

andleaf

Decoctio

n,po

wde

r,infusion

andraw

6[2,14,17,21–23]

Lamiaceae

Lavand

ulamaroccana

Murb.

Igazioen

Stem

andleaf

Decoctio

n2

[2,26]

Lamiaceae

Lavand

ulamultifidaL

Khilt

lkhe

yl/Ko

hayla

Leaf

Decoctio

n1

[18]

Lamiaceae

Lavand

ulastoechas

L.Im

zeria/Tiken

kert/Lhalhal

Leaf

Decoctio

n5

[2,12,13,17,18]

Lamiaceae

Marrubium

vulgareL.

Mriw

t/Ifzi

Leaf

andaerialp

arts

Decoctio

nandinfusion

14[2,12–19,21–25]

Lamiaceae

Menthapulegium

L.Fliou

Leaf

andaerialp

arts

Decoctio

nandinfusion

8[2,13,15,17–19,21,23,25]

Lamiaceae

MenthaspicataL.

Nanaa/Liqam

aLeaf

andleafystem

Infusion

andde

coction

2[17,18]

Lamiaceae

Ocimum

basilicum

L.Lahb

aqStem

Infusion

2[13,17]

Lamiaceae

Origan

umcompactum

Benth.

Azukenn

i/Zaater/Zaatar

tadlaw

iStem

andleaf

Decoctio

nandinfusion

8[13–15,17,18,21–23]

Lamiaceae

Origan

umelon

gatum

(Bon

net)

Emb.

&Maire

Zaater

Leaf

Infusion

1[25]

Lamiaceae

Origan

ummajoran

aL.

Berded

ouch

Leaf

Powde

r1

[18]

Lamiaceae

Origan

umvulgareL

Zaatar

Leaf

Infusion

1[12]

Lamiaceae

Rosm

arinus

officinalisL.

Azir

Leaf

Powde

r,de

coction

andinfusion

11[2,13–15,17–19,21–23,25]

Lamiaceae

Salvia

officinalisL.

Salm

iaLeaf

Decoctio

nandinfusion

11[2,12,13,15–19,22–24,26]

Lamiaceae

Teucrium

polium

L.Tawerart/Flyoulbou

r/jaaidia

Leaf

Decoctio

nandpo

wde

r3

[2,19,26]

Lamiaceae

Thym

usbrousson

etiiBo

iss.

Zietra

Leaf

andstem

Infusion

andmaceration

1[25]

Lamiaceae

Thym

usalgeriensisBo

iss.&Reut.

Adu

chen

/Azukni/

Zaitra

Stem

andleaf

Decoctio

nandinfusion

1[13]

Lamiaceae

Thym

usmun

byan

usBo

iss.&Reut

Adu

chen

/Azukni/

Zaitra

Stem

andleaf

Decoctio

nandinfusion

1[13]

Lamiaceae

Thym

ussatureioides

Coss.

Asserkna/

Ziitra

Leaf

Infusion

,decoctio

n,po

wde

r,andmaceration

2[2,17]

Lamiaceae

Thym

usvulgarisL.

Adu

chen

/Azukni/

Zaitra

Leaf

Decoctio

nandinfusion

3[2,13,17]

Lamiaceae

Thym

uszygisL.

Adu

chen

/Azukni/

Zaitra

Stem

andleaf

Decoctio

nandinfusion

1[13]

Lauraceae

Cinn

amom

umcassia

(L.)J.P

resl

Qarfa

Bark

Decoctio

n5

[13,15,17,19,21]

Lauraceae

Cinn

amom

umverum

J.Presl

Dar

essini

Bark

Maceration

3[17,18,25]

Lauraceae

Laurus

nobilis

L.Ourak

sidn

amou

ssa/

Rand

Leaf

Infusion

andde

coction

2[12,17]

Lauraceae

Persea

american

aMill.

Lavoca

Seed

Powde

r4

[16,18,19,25]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 7 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Legu

minosae

Acacianilotica(L.)Delile

Amur/Sllaha

Fruit

Powde

r1

[18]

Legu

minosae

Acaciasenegal(L.)Willd.

Laalek

Gum

Powde

r1

[18]

Legu

minosae

Acaciatortilis(Forssk.)Hayne

Telh/Tadou

teRo

ot,fruitandleaf

Decoctio

nandpo

wde

r2

[17,18]

Legu

minosae

AnagyrisfoetidaL.

Fulg

nawa

Seed

Powde

r1

[18]

Legu

minosae

Arachishypogaea

L.Lgerta/Kaw

kaw

Seed

Powde

r1

[18]

Legu

minosae

Ceratoniasiliqua

L.Tikida/Lkharou

bLeaf

andseed

Decoctio

n,infusion

andpo

wde

r6

[2,12,17,18,24,25]

Legu

minosae

Cicerarietinum

L.Lhem

mes

Seed

Decoctio

nandpo

wde

r2

[18,24]

Legu

minosae

Faidherbia

albida

(Delile)A.Che

v.Cho

k/Talh/M

imou

zaRo

otDecoctio

n1

[17]

Legu

minosae

Glycine

max

(L.)Merr.

Soja

Seed

Macerationandraw

5[2,12,20,24,26]

Legu

minosae

Glycyrrhiza

glabra

LArk

souss

Bark

Infusion

1[25]

Legu

minosae

Lupinu

salbusL.

Tirm

s/Foul

gnaw

aSeed

Powde

r,Infusion

andde

coction

7[16–19,21,22,24]

Legu

minosae

Lupinu

san

gustifoliusL.

Ibaw

nde

kouk

Seed

Powde

randde

coction

3[2,17,26]

Legu

minosae

Lupinu

sluteus

L.Kikel/S

emqala

Seed

Decoctio

n1

[17]

Legu

minosae

MedicagosativaL.

Fassa

Aerialp

artsandseed

Infusion

,macerationandcooked

5[12,13,17,18,24]

Legu

minosae

Ono

nisna

trixL.

Hen

netreg

Leaf

Decoctio

n1

[18]

Legu

minosae

Ono

nistournefortiiCoss.

Afezdad

Leaf

Decoctio

n1

[18]

Legu

minosae

PhaseolusvulgarisL.

Lubya

Fruit

Decoctio

n,po

wde

randJuice

4[13,16–18]

Legu

minosae

Retamaraetam

(Forssk.)Web

bRtam

/Allug

Root

andleaf

Decoctio

n1

[17]

Legu

minosae

Retamaspha

erocarpa

(L.)Bo

iss.

Rtem

Root

Decoctio

n1

[20]

Legu

minosae

Trigon

ella

foenum

-graecum

L.Lhelba/Tifidas

Seed

Decoctio

n,infusion

,maceration

andpo

wde

r16

[2,12–26]

Legu

minosae

Viciafaba

L.Ful

Seed

Powde

r1

[18]

Legu

minosae

ViciasativaL.

Ayn

larnab

Seed

Powde

r1

[18]

Legu

minosae

Vign

aradiata(L.)R.Wilczek

Soja

Seed

Powde

r1

[18]

Legu

minosae

Vign

aun

guiculata(L.)Walp

Fulg

nawa

Seed

Decoctio

n1

[17]

Linaceae

Linu

musitatissim

umL.

Zariatelkattan

Seed

Decoctio

nandpo

wde

r7

[2,13,15,17,18,21,25]

Lythraceae

LawsoniainermisL.

Lhen

naLeaf

Decoctio

nandcataplasme

2[17,21]

Lythraceae

Punica

gran

atum

L.Rm

anPericarp

Decoctio

n,infusion

,and

powde

r8

[2,13,15,17–21]

Malvaceae

Abelmoschus

esculentus

(L.)Moe

nch

Lmloukhia

Fruit

Maceration

2[13,25]

Malvaceae

Hibiscus

sabdariffaL.

Karkadi/B

issam

Calyces

Infusion

3[17,18,26]

Molluginaceae

Corrigiola

litoralissubsp.teleph

iifolia

(Pou

rr.)Briq.

Sarghina

/Tawsarghine

Root

Powde

r2

[13,17]

Moraceae

FicuscaricaL.

Tazart/Lkarm

ous/Karm

a/chrih

a/Elbakur

Fruitandleaf

Decoctio

n8

[2,13,15,17,20,22–24]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 8 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Moraceae

Morus

alba

L.Tutlbari

Leaf

Infusion

3[13,17,19]

Musaceae

Musa×paradisia

caL.

Banan

Leaf

Decoctio

n1

[18]

Myristicaceae

Myristicafra

gran

sHou

tt.

Lgou

zaSeed

Powde

r1

[2]

Myrtaceae

Eucalyptus

camaldulensisDeh

nh.

Calitu

sLeaf

Decoctio

n1

[18]

Myrtaceae

Eucalyptus

globulus

Labill.

Calitu

sLeaf

andfru

itDecoctio

n8

[13–15,17,21–24]

Myrtaceae

Myrtuscommun

isL.

Rihane

Leaf

andfru

itDecoctio

nandinfusion

8[13,14,17,20–24]

Myrtaceae

Syzygium

arom

aticum

(L.)Merr.

&L.M.Perry

Kranfal

Fruitandclove

Infusion

,decoctio

n,po

wde

randmaceration

8[2,14,17–19,22,24,25]

Nitrariaceae

Peganu

mha

rmalaL.

Lharmel

Seed

Infusion

andpo

wde

r7

[13,15,17,20–23]

Oleaceae

Fraxinus

angustifolia

Vahl

Touzalt

Leaf

Infusion

2[13,23]

Oleaceae

Oleaeuropaea

L.Jbou

j/Azm

our/Zitoun

Leaf,fruitandflower

Decoctio

n,infusion

,maceration

andpo

wde

r15

[2,12,13,15–26]

Papaveraceae

Fumaria

officinalisL.

Hachichat

assebyane

Root

Decoctio

n1

[17]

Papaveraceae

Papaverrhoeas

L.Belaam

anSeed

Powde

r3

[2,24,26]

Pedaliaceae

Sesamum

indicum

L.Janjlan

Seed

Powde

r,Infusion

andde

coction

7[2,14,18,20–22,24]

Plantaginaceae

Globularia

alypum

L.Ayenlerneb

/Taselgha

Flow

er,leafandstem

Infusion

andde

coction

10[13,15–19,21–23,26]

Plantaginaceae

Globularia

repens

Lam.

Ain

lernab

Leaf

Decoctio

n1

[12]

Plum

baginaceae

Limon

ium

sinuatum

(L.)Mill.

Lgarsa

Leaf

Decoctio

n1

[18]

Poaceae

AvenasativaL.

Khortal

Seed

Powde

r,infusion

andde

coction

2[13,17]

Poaceae

AvenasterilisL.

Waskone

/Kh

ortal

Seed

Powde

r1

[26]

Poaceae

Castellia

tuberculosa(M

oris)Bo

rZw

anlm

karkeb

Seed

Decoctio

n1

[17]

Poaceae

Cyno

dondactylon

(L.)Pers.

Njem

Root

Decoctio

n1

[18]

Poaceae

Hordeum

vulgareL.

Chair/Zraa

Aerialp

artsandseed

Infusion

,pow

derandmaceration

3[2,17,18]

Poaceae

Lolium

perenn

eL.

Eziwane

Seed

Decoctio

n1

[26]

Poaceae

Panicum

miliaceum

L.Tafssout

Seed

Decoctio

n1

[17]

Poaceae

Panicum

turgidum

Forssk.

Umm

rekba

Stem

Decoctio

nandpo

wde

r1

[18]

Poaceae

Penn

isetum

glaucum

(L.)R.Br.

Illan

Seed

Infusion

andpo

wde

r3

[12,17,18]

Poaceae

Phalariscana

riensisL.

Zouan

Seed

andfru

itPo

wde

r,infusion

andde

coction

6[2,13,14,16,17,24]

Poaceae

Polypogonmon

speliensis(L.)Desf

Tugg

aFruit

Raw

1[18]

Poaceae

Sorghu

mbicolor(L.)Moe

nch

Bachna

Seed

Infusion

andde

coction

3[13,15,23]

Poaceae

Triticum

durum

Desf.

Zraa

Seed

Decoctio

n1

[17]

Poaceae

ZeamaysL.

Lahyat

Adra

Stigmas

Powde

r3

[14,24,26]

Polygo

naceae

Emex

spinosa(L.)Cam

pd.

Lhen

zab

Leaf

andbu

lbPo

wde

r1

[18]

Portulacaceae

Portulacaoleracea

L.Rejla

Aerialp

arts

Decoctio

n3

[12,17,26]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 9 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Ranu

nculaceae

Nigella

sativaL.

Habasoud

a/Sanou

jSeed

Infusion

,decoctio

nandpo

wde

r15

[2,13–26]

Rham

naceae

Ziziph

uslotus(L.)Lam.

Nbe

g/Azoug

gar/ssdra

Leaf,fruitandroot

Decoctio

nandpo

wde

r10

[2,15,17–20,22–24,26]

Rosaceae

Cydoniaoblong

aMill.

Sferjel

Fruit

Raw

1[20]

Rosaceae

Chaeno

meles

sinensis

(Dum

.Cou

rs.)

Koeh

neSferjel

Root

Decoctio

n2

[18,22]

Rosaceae

Eriobotrya

japonica

(Thu

nb.)Lind

l.Mzah

Leaf

Infusion

3[13,15,23]

Rosaceae

Fragaria

vescaL

Fraizbe

rri

Fruit

Raw

1[22]

Rosaceae

Malus

commun

is(L.)Po

ir.Etefah

Fruit

Juice

1[26]

Rosaceae

Prun

usarmeniaca

L.Luzelhar

Seed

Decoctio

n1

[17]

Rosaceae

Prun

usdulcis(M

ill.)D.A.W

ebb

Louz

imrzig/Louz

morr

Seed

andleaf

Raw

andde

coction

12[2,14,15,17,18,20–26]

Rosaceae

RubusvulgarisWeihe

&Nees

Laalig

Leaf

Powde

r1

[17]

Rubiaceae

Rubiatinctorum

L.Fowwa

Root

Powde

r1

[18]

Rutaceae

Citrus

medicaL

Lham

edbe

ldî

Fruit

Juiceandinfusion

1[17]

Rutaceae

Citrus

paradisiMacfad.

Pamblam

usFruit

Juice

1[17]

Rutaceae

Citrus

sinensis

(L.)Osbeck

Limun

Fruit

Raw

andjuice

2[12,18]

Rutaceae

Citrus

×aurantium

LLarenj/Zen

bue/trun

jLeaf,fruitandflower

Juice,infusion

andde

coction

7[14,16–21]

Rutaceae

Ruta

graveolens

L.Lfijel

Root

Decoctio

n2

[17,18]

Rutaceae

Ruta

mon

tana

(L.)L.

LFijel/Iwermi

Stem

andleaf

Decoctio

n,infusion

andpo

wde

r7

[13–15,17,19,20,23]

Salicaceae

Salix

alba

L.Saleflm

aLeaf

Decoctio

n1

[19]

Santalaceae

Viscum

album

LLenjbar

Seed

Infusion

1[15]

Sapo

taceae

Arganiaspinosa(L.)Skeels

Argan

Seed

Raw

andpo

wde

r8

[2,13,15–18,25,26]

Schisand

raceae

Illicium

verum

Hoo

k.f.

Badiana

Fruit

Decoctio

n1

[17]

Solanaceae

Capsicum

annu

umL.

FelfelH

ârr/soud

ania

Fruit

Raw

3[13,14,18]

Solanaceae

Daturastramon

ium

L.Sdag

jmel/M

etal

Seed

Decoctio

n1

[18]

Solanaceae

Lycopersicon

esculentum

Mill.

Maticha

Fruit

Raw

2[17,18]

Solanaceae

Nicotiana

tabacum

L.Nefha

Leaf

Decoctio

n1

[14]

Solanaceae

Solanu

mam

erican

umMill.

Ane

bdib

Leaf

Infusion

1[17]

Taxaceae

TaxusbaccataL.

Guelguem/Agu

elgu

imt

Root

Decoctio

n1

[17]

Theaceae

Camellia

sinensis

(L.)Ku

ntze

Attay

Leaf

Infusion

andde

coction

6[2,12,15,17,18,24]

Thym

elaeaceae

Thym

elaeahirsuta(L.)Endl.

Metnan

Leafystem

Powde

r2

[17,23]

Thym

elaeaceae

Thym

elaeatarton

raira

(L.)All.

Talazazt

Leaf

Decoctio

n1

[20]

Thym

elaeaceae

Thym

elaeavirgata(Desf.)Endl.

Metnan

Leafystem

Decoctio

n1

[17]

Urticaceae

Urticadioica

L.Taznagt/Tigzen

in/Lhriga

Stem

andleaf

Decoctio

nandinfusion

8[2,14,15,17,19,23,24,26]

Urticaceae

UrticapiluliferaL.

Hurrig

a/Tisrakmaz

Leaf

Decoctio

n2

[13,22]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 10 of 32

Table

1Plantsused

inthetreatm

entof

diabetes

inMorocco,citedin

ethn

obotanicalstud

ies(Con

tinued)

Family

Plantspecies

Vernacular

name

Partused

Prep

aration

Num

berof

citatio

nsReferences

Verben

aceae

Aloysia

citriodora

Palau

Alwiza

Leaf

Decoctio

nandinfusion

4[14–16,18]

Verben

aceae

VerbenaofficinalisL.

Alwiza

Leaf

Decoctio

n1

[25]

Vitaceae

Vitis

vinifera

L.Dalya/Zbib/Kerm

a/Adilite

Leaf

Decoctio

n3

[17,18,20]

Xantho

rrho

eaceae

Aloe

succotrinaLam.

Ssabra/Siber

Leaf

Powde

r5

[15,17,18,21,22]

Xantho

rrho

eaceae

Asph

odelus

microcarpus

Salzm.&

Viv.

Lberwag/blaluz/Tazia

Tube

rRaw

2[17,18]

Xantho

rrho

eaceae

Asph

odelus

tenu

ifoliusCav.

Lehyat

alaatrus/Tazya/Lbe

riwiga

Leaf

Decoctio

n1

[17]

Zing

iberaceae

Zing

iber

officinaleRo

scoe

Sekinjbir

Rhizom

eDecoctio

n,infusion

,pow

der

andmaceration

5[14,15,18,19,25]

Zygo

phyllaceae

Tetraena

gaetula(Emb.

&Maire)

Beier&Thulin

Aagaia

Leaf,roo

tandseed

Powde

r,Infusion

andde

coction

10[2,13,14,17–23]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 11 of 32

used for medicinal purposes in the study area (32 plantspecies). According to the authors, Allium sativum L.,Salvia officinalis L., Marrubium vulgare L. and Lavan-dula dentata L were the most frequently used plants totreat diabetes. Six plants were reported for the first timeas hypoglycemic plants: Dracaena draco subsp. ajgal,Euphorbia officinarum subsp. officinarum, Eryngium ili-cifolium Lam., Pastinaca sativa L., Scorzonera undulata,Ephedra altissima Desf.In Izarene forest (Northern Morocco), a survey was

undertaken in order to inventory the main medicinal plantsused in folk medicine to treat diabetes and arterial hyper-tension. The results obtained allowed an inventory of 40medicinal plant species used against diabetes. The mostcited plants for the treatment of diabetes were: Trigonellafoenum-graecum, Artemisia herba-alba, Ammi visnaga,Centaurium erythreae, Myrtus communis, Globulariaalypum, Nigella sativa, Tetraena gaetula, Olea europaea,Rosmarinus officinalis, Marrubium vulgare, Allium cepa,Ajuga iva, Salvia officinalis, Artemesia absinthium, Prunusdulcis, Capsicum annuum, Origanum compactum, Neriumoleander, and Urtica dioica [14].An ethnobotanical survey by Ziyyat et al. [23] in differ-

ent areas of Oriental Morocco reported that 34 plantspecies were used for the treatment of diabetes, of whichthe most used were Trigonella foenum-graecum, Globu-laria alypum, Artemisia herba-alba, Citrullus colocynthisand Tetraclinis articulata. Also a study was carried outin Oriental Morocco with 279 diabetic patients at theDepartment of Endocrinology and Metabolism of Mo-hammed VI Uneversity Hospitalin Oujda. The resultsshowed that the local population uses medicinal plantsfor the treatment of diabetes. Fifty plants are reported tobe used in the region for the treatment of diabetes. Thefive most common herbal medicines used were Salviaofficinalis, Trigonella foenum-graecum, Olea europaea,Artemisia herba-alba and Origanum vulgare [15].A study by Laadim et al. [12] in Sidi Slimane

(northwestern Morocco) reported that 59 plant specieswere cited by 700 diabetic patients for management of dia-betes. Five plants, Trigonella foenum-graecum, Oreganumvulgare, Salvia officinalis, Marrubium vulgare and Oleaeuropaea, were most used. The survey revealed that seedsand leaves are the part of the plant most often used inherbal preparations.In an ethnobotanical survey by Bousta et al. [16], 22

species of plants belonging to 19 families were reportedfor the treatment of diabetes in the Middle-Atlas regionof Morocco (Sefrou region). The most prominentplants reported were Olea europaea, Salvia officinalis,Trigonella foenum-graecum, Euphorbia officinarumsubsp. echinus, Globularia alypum, Coriandrum sati-vum. Respondents said that they inherited the know-ledge of their practices from their parents, traditional

healers, some books and nowadays from televisionprograms.Also in the Central Middle Atlas an ethnobotanical

study identified 76 medicinal plants, divided into 67genus and 40 families. Fourteen plants are reported forthe first time intraditional treatment of diabetes inMorocco. They are: Pistacia atlantica, Anacyclus pyreth-rum, Ptilotrichum spinosum, Cistus albidus, Juniperusthurifera, Thymus algeriensis, Thymus munbyanus, Thy-mus zygis, Abelmoschus esculentus, Fraxinus angustifolia,Sorghum bicolor and Eriobotrya japonica [13].To inventory the medicinal plants used in traditional

medicine to treat diabetes in the Tizi n’ Test Region(Taroudant Province), a survey was carried using semi-structured and structured questionnaires. Thirty-nineplant species belonging to 24 botanical families were re-corded for the treatment of diabetes. The most import-ant species were Artemisia herba-alba, Cistus creticus,Lavandula maroccana, Salvia officinalis and Olea euro-paea. Leaves were the parts predominantly used and de-coction was the most common method to prepare theformulations [26].Another ethnobotanical survey among the local popu-

lation in the region of Al Haouz-Rhamna (centralMorocco) reported that a total of 150 plant species be-longing to 54 families were used for the treatment ofdiabetes in the area. Among these species recorded 18are cited for the first time in the region as an antidia-betic plants namely: Chamaerops humilis, Cladanthusarabicus, Centaurea maroccana, Matricaria chamomilla,Tanacetum vulgare, Diplotaxis pitardiana, Berberis vul-garis subsp. australis, Corrigiola litoralis subsp. telephii-folia, Cistus laurifolius, Quercus coccifera, Ballotahirsuta, Buxus balearica, Lavandula stoechas, Ocimumbasilicum, Thymus satureioides, Ruta montana, Taxusbaccata and Thymelaea virgata [17].In the region of Tan-Tan (South of Morocco), a survey

reported that 129 medicinal species belonging to 53 fam-ilies were cited by 350 people for the treatment of diabeteswith the dominance of the most represented families inthe flora of Morocco. Some of the inventoried plant spe-cies are endemic to the Sahara such as Cynomorium cocci-neum, Atriplex halimus and Salsola tetragona, but othersare toxic including Aristolochia fontanesii, Euphorbia offi-cinarum and Nerium oleander [18].In the region of Meknes-Tafilalet (North-central

Morocco), an ethnobotanical study was undertaken inorder to inventory the main medicinal plants used infolk medicine to treat diabetes. In this region, the mostfrequently used plants include Allium cepa, Artemisiaherba-alba and Trigonella foenum graecum [19]. Also inthe North central region of Morocco (Fez–Boulemane),an ethnobotanical study reported that 90 medicinal spe-cies are used in the treatment of diabetes, hypertension

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 12 of 32

and renal diseases. Among these species, 9 plants aretoxic at high doses. For diabetes, 54 plants were cited, ofwhich the most cited were: Artemesia herba alba, Trigo-nella foenum-graecum and Tetraena gaetula [22].In the Errachidia province (South-eastern Morocco), a

survey was carried out to catalog the plants traditionallyused in the treatment of hypertension and diabetes mel-litus. The authors have inventoried 64 species belongingto 33 families, of which 45 plants were used in the treat-ment of diabetes. The most frequently cited plant spe-cies by the local population for management of diabetesare Ajuga iva, Allium cepa, Artemisia herba-alba,Carum carvi, Lepidium sativum, Nigella sativa, Oleaeuropaea, Peganum harmala, Phoenix dactylifera, Ros-marinus officinalis, and Tetraena gaetula [20]. Also insouth-eastern Morocco (Tafilalet region), an ethno-botanical study identified 92 medicinal plants used inthe treatment of diabetes mellitus, hypertension and car-diac diseases. The most frequently cited medicinal plantsused for their antidiabetic effects were Ammi visnaga,Artemesia herba-alba, Trigonella foeniculum-granum,Marrubium vulgare, Nigella sativa, Globularia alypum,Allium sativum, Olea europaea, Citrullus colocynthis,Aloe succotrina, Artemisia absinthium, Rosmarinus offi-cinalis, Thymus vulgaris, Eucalyptus globulus, Menthapulegium, Myrtus communis, Linum usitatissimum andCarum carvi [21].

Pharmacological and toxicological studiesAmong 255 plant species being used, 120 plants haveneither been explored experimentally for antidiabeticactivity. They are: Mesembryanthemum theurkauffii,Salsola tetragona, Searsia albida, Searsia tripartita,Eryngium ilicifolium, Pastinaca sativa, Ptychotis verticil-lata, Ridolfia segetum, Apteranthes europaea, Periplocalaevigata subsp. Angustifolia, Aristolochia fontanesii,Agave americana, Asparagus albus, Achillea odorata,Antennaria dioica, Anvillea garcinii subsp. radiata,Artemisia abrotanum, Artemisia atlantica, Artemisiamesatlantica, Artemisia reptans, Centaurea maroccana,Cladanthus arabicus, Cynara cardunculus, Dittrichiaviscosa, Echinops spinosissimus, Inula conyza, Inula hel-enium, Launaea arborescens, Pallenis spinosa, Scolymushispanicus, Scorzonera undulata, Sonchus arvensis,Sonchus tenerrimus, Tanacetum vulgare, Berberis vul-garis subsp. australis, Diplotaxis pitardiana, Eruca vesi-caria, Ptilotrichum spinosum, Buxus balearica, Maeruacrassifolia, Herniaria glabra, Silene vivianii, Cistus albi-dus, Cistus creticus, Cistus salviifolius, Androcymbiumgramineum, Juniperus thurifera, Tetraclinis articulata,Cynomorium coccineum, Bolboschoenus maritimus, Dra-caena draco subsp. ajgal, Ephedra alata, Ephedra altis-sima, Euphorbia officinarum subsp. echinus, Euphorbiaofficinarum subsp. officinarum, Hammada scoparia,

Euphorbia resinifera, Mercurialis annua, Anagyris foe-tida, Ceratonia siliqua, Cicer arietinum, Lupinus angu-stifolius, Lupinus luteus, Ononis natrix, Ononistournefortii, Retama sphaerocarpa, Vicia faba, Viciasativa, Quercus coccifera, Juncus maritimus, Ballota hir-suta, Clinopodium alpinum, Clinopodium nepeta subsp.glandulosum, Lavandula dentata, Lavandula maroc-cana, Lavandula multifida, Mentha pulegium, Menthaspicata, Origanum compactum, Origanum majorana,Origanum vulgare, Thymus algeriensis, Thymus munbya-nus, Thymus zygis, Corrigiola litoralis subsp. telephiifolia,Fumaria officinalis, Papaver rhoeas, Globularia repens,Limonium sinuatum, Avena sativa, Castellia tubercu-losa, Panicum miliaceum, Panicum turgidum, Polypogonmonspeliensis, Triticum durum, Emex spinosa, Fragariavesca, Rubus vulgaris, Rubia tinctorum, Salix alba, Illi-cium verum, Taxus baccata, Thymelaea tartonraira,Thymelaea virgata, Aloysia citriodora, Aloe succotrina,Asphodelus microcarpus, Mesembryanthemum theur-kauffii, Cladanthus scariosus, Paronychia argentea, Eph-edra fragilis, Glycyrrhiza glabra, Origanum elongatum,Thymus broussonetii, Avena sterilis, Lolium perenne,Malus communis, Verbena officinalis, Asphodelus tenui-folius and Tetraena gaetula. It is essential to study theeffects of unexplored plant species on diabetes in moredetail and to identify the active components and espe-cially to study the mechanisms of action of these plantextracts, in order to obtain further data on the pharma-cological effects of these plants.Despite the therapeutic effects of medicinal plants, exces-

sive consumption of some of the inventoried plants mightlead to harmful effects which are related to a variety ofcauses. To avoid danger to patients, prudent use as well assafety precautions is required, such as using lower doses.The main toxic plants are, Citrullus colocynthis [32], Da-tura stramonium [33], Euphorbia officinarum [34], Myris-tica fragrans [35], Artemisia herba alba [36], Peganumharmala [37], Ricinus communis [38], Tetraena gaetula[39], Nigella sativa [40] and Nerium oleander [32]. Despitetheir toxic properties, patients do not suffer any adverseconsequences. This indicates that the patients or the pro-vider of the plants are skilled in recognizing the potentialfor toxicity and taking the appropriate precautions.Of all medicinal plants reported in this study, 137

medicinal plants have been documented to demonstratea potent anti-diabetic effect in vitro or in vivo or in clin-ical studies. We present in Table 2 pharmacologicalstudies which have investigated directly or indirectlymedicinal plants used in Morocco to treat diabetes.Trigonella foenum-graecum, Artemesia herba-alba,Nigella sativa, Olea europaea, Allium cepa and Marru-bium vulgare were the most frequently used plants totreat diabetes based on number of citations. Theseplants are discussed in detail below.

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 13 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Amaranthaceae

Anabasis

aretioides

Moq

.&Coss.ex

Bung

e

Chajra

ma

yeharrekha

rih/sellii

Aqu

eous

extractof

aerialp

art

5mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

redu

ctionon

bloo

dglucoselevelsin

STZrats(p<

0.0001)

[41]

Amaranthaceae

Atriplexha

limus

L.Legtef

Aqu

eous

extractof

theleaves

200mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Aqu

eous

extractprod

uced

54%

(P<0.001)

decresein

fasting

bloo

dglucoselevelscomparedto

theinitialfastingbloo

dglucoselevelspriorto

thetreatm

ent

[42]

Amaranthaceae

Dysph

ania

ambrosioides

(L.)Mosyakin&

Clemants

Mkhinza

Crude

extractof

theleaves

100,200and

300mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Redu

ctionin

bloo

dglucosein

case

ofcrud

etreatm

entgrou

ps,

ascomparedwith

that

ofthecontrolg

roup

[43]

Amaryllidaceae

Allium

ampeloprasum

L.

Borro

Essentialo

ilsfro

mthegreenparts

150mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theessentialo

ilof

A.am

peloprasum

decreasedthebloo

dglucoselevelsignificantly

(P<0.05)at

thedo

seof

200mg/kg.

[44]

Amaryllidaceae

Allium

cepa

L.Basla

Aqu

eous

extractsof

thewho

leplant

200,250or

300mg/kg

BWAlloxan-

indu

ceddiabetic

rats

A.cepa

at200mg/kg

redu

cedfastingbloo

dglucoselevelsby

62.9%

(292.3±29.0to

108.2±4.6),at250mg/kg

itredu

ced

fastingbloo

dglucoselevelsby

69.7%

(296.3±37.8to

89.8±4.3)

whe

reas

at300mg/kg

itredu

ceditby

75.4%

(297.8±37.5to

73.4±3.0)

[45]

Amaryllidaceae

Allium

sativum

L.Tiskert

/Tou

ma

Aqu

eous

extractof

thebu

lbs

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Atweeks

2,5and7of

garlicextracttreatm

ent,theserum

glucoselevelsof

thegarlic-treateddiabeticratswereredu

ced

by29%,68%

and57%,respe

ctivelyin

comparison

tocontrold

ia-

betic

rats.

[46]

Anacardiaceae

Pistacia

atlanticaDesf.

Btem

/Igg/

Drou

N-hexaneextractof

theseed

s200mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theadministrationof

P.atlanticaextractsbo

dywt.tend

edto

bringthebloo

dglucosesign

ificantlytowardno

rmalvalues

from

thebe

ginn

ingof

theexpe

rimen

t

[47]

Anacardiaceae

Pistacia

lentiscus

L.Trou

/Tidekt

Crude

gum

100mg/kg

BWAlloxan-

indu

ceddiabetic

rats

After

6h,therewas

decreasedin

bloo

dglucose(280.8±9.0)

but

after24

hcrud

ePistacia

gum

show

edsign

ificant

decrease(195.2±20.4)as

comparedto

diabeticun

treatedrats

(352.4±23.6)

[48]

Apiaceae

Ammivisn

aga

(L.)Lam.

Bachnikha/

Barghanisse

Aqu

eous

extractof

fruits

20mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

decrease

ofbloo

dglucosein

norm

alrats6haftera

sing

leoraladministration(P<0.005)

and9days

afterrepe

ated

oraladministration(P<0.05).

[49]

Apiaceae

Ammodaucus

leucotrichu

sCoss.

Kamou

nsoufi

Aqu

eous

extractof

fruits

10mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

redu

ctionin

bloo

dglucoselevelsafterfour

(p<0.01)

and6h(p<0.001)

oftreatm

ent.Thiseffect

was

more

pron

ounced

than

gliben

clam

idewhich

caused

asign

ificant

decrease

inbloo

dglucoseat

thefourth

(p<0.05)andsixth(p<

0.01)ho

urafteroraladministration

[50]

Apiaceae

Apium

graveolens

L.Krafess

Hexane,chloroform

andmethano

lextractsof

stalkandleaves

100,200and

400mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Maxim

umpe

rcen

tage

ofbloo

dglucoseredu

ctionin

norm

oglycemicmiceat

8hwith

400mg/kg

dosesof

chloroform

extractwas

37%.H

owever,h

exaneextractandmethano

lextract

atthesamedo

sesprod

uceon

lyasm

alleffect

[51]

Apiaceae

Carum

carviL.

Lkarwya

Ethano

licextractof

theseed

s0.2,0.4and

0.6g/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificantlyde

creasedserum

glucoseandinsulin

indiabetic

ratsin

3and5hbu

tno

tin

healthyrats.

[52]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 14 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Apiaceae

Coriand

rum

sativum

LKo

sbor

Aqu

eous

extractof

fruits

250and500

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theaqueou

sextractof

fruits

decreasedthebloo

dglucoselevel

statisticallysign

ificant

whe

ncomparedwith

diabeticcontrol

[53]

Apiaceae

Cuminum

cyminum

L.Kamou

nEthano

licextractof

theseed

s250mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Aroun

d17.7%

and17.1%

declinein

bloo

dglucoselevelsat

0–300and0–1440

min,respe

ctively,on

streptozotocin-in

duced

diabeticrats

[54]

Apiaceae

Daucuscarota

L.Kh

izou

Alcoh

olicextractof

theseed

s100,200,300

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theadministrationof

D.carotaseed

sextract(300

mg/kg)for3

days

decreasedglucoseserum

level(p<0.05)

[55]

Apiaceae

Foeniculum

vulgareMill.

Nafaa

Essentialo

ilextractedfro

mthewho

leplant

30mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Inge

stionof

essentialo

ilcorrectedthehype

rglycemiafro

m(162.5±3.19

mg/dl)to

(81.97

±1.97

mg/dl)with

p<0.05

[56]

Apiaceae

Petroselinum

crisp

um(M

ill.)

Fuss

Maadn

ouss

Aqu

eous

extractof

theleaves

2g/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Diabe

ticratsshow

edagradualred

ucein

bloo

dglucoselevels

over

days

14—42.M

axim

umredu

ctionin

thebloo

dglucose

levelswas

observed

ontheday42,and

theredu

ctionwas

abou

t50%.

[10]

Apiaceae

Pimpinella

anisu

mL.

Habbat

hlaw

aDifferen

tfractions

ofmethano

licextract(hexane,be

nzen

e,ethyl

acetate,n-bu

tano

l,aqueou

s)

100,200,300,

400and

500μg

/ml

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Attheconcen

trationof

500μg

/ml,thesequ

ence

ofinhibitory

effectson

α-am

ylaseandα-

glucosidaseactivities

respectively

hadtheorde

ras

follows:Ethylacetate

(94%

and87%)>

hexane

(93%

and86%)>

benzen

e(91%

and85%)>

methano

l(84%

and

83%)>

aqueou

s(81%

and79%)>

n-bu

tano

l(75%

and77%).

[57]

Apo

cynaceae

Calotropis

procera(Aito

n)Dryand.

Turja

Chloroform

extractof

leaves

and

flowers

10,20and50

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theredu

ctionin

serum

glucoselevelswas

better

onthe21st

and27th

days

oftreatm

ent

[58]

Apo

cynaceae

Caralluma

europaea

(Guss.)

N.E.Br.

Daghm

ous

Methano

licextractof

theaerialp

arts

250,300mg/

kgBW

Alloxan-indu

ceddiabetes

inmice

Themethano

licextractexhibitedacontinuo

usmarked

redu

ctionof

bloo

dglucoselevels(P<0.001)

particularly6–8–10

haftertreatm

entin

diabeticmice

[59]

Apo

cynaceae

Nerium

oleand

erL.

Defla/Alili

Methano

licextractof

theleaves

50and200

mg/kg

BWAlloxan-indu

ceddiabetes

inmice

Glucose

levelw

aslowered

from

255.66

±1.52

mg/dl

onday0to

67.00±6.24

mg/dl

inday20,accou

ntingforasign

ificant

(p<

0.001)

73.79%

decrease

[60]

Arecaceae

Cham

aerops

humilisL.

Dum

/Tiguezden

/Ignadd

Aqu

eous

extractof

theleaves

10mg/kg

BWExpe

rimen

tally

indu

ced

obesity,h

yperglycem

iaandhype

rlide

mia(OHH)

inrats

Theplasmaglucoselevelsof

theOHHratsde

creased

sign

ificantlywith

daily

dosing

with

theplant-extract[from

base-

line12.04±0.94

mmol/L

to6.10

±0.27

mmol/L

(P<0.05)after

15days,and

to4.84

±0.22

mmol/L

(P<0.001)

after30

days]

[61]

Arecaceae

Hypha

ene

thebaica

(L.)

Mart.

Dum

/karur

Aqu

eous

suspen

sion

ofthepu

lp1g/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

redu

ctionon

bloo

dglucoselevelsin

STZrats(P<

0.05)

[62]

Arecaceae

Phoenix

dactylifera

L.Tm

arEthano

licextractof

theleaves

100,200and

400mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Asign

ificant

antid

iabe

ticeffect

at400mg/kg

was

observed

startin

gfro

mthe6thdayon

wards

(P<0.05),andfro

m10th

days

onwards

for200mg/kg

[63]

Brassicaceae

Anastatica

hierochu

nticaL.

Chajarat

Maryem/

lkem

cha

Water

extractof

theaerialp

arts

12.5mg/rat

Streptozotocin-in

duced

diabeticrats(STZ)

Theadministrationof

theplantextractindu

cedahypo

glycem

iceffect

inbo

thno

rmog

lycemicanddiabeticrats.Italso

caused

sign

ificant

improvem

entin

tissueinjury

indu

cedby

STZ

[64]

Brassicaceae

Brassicana

pus

L.Left

Hydro-alcoh

olicextract

16ml/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificantlyde

crease

ofbloo

dglucosecomparedto

diabetic

controlrats(P<0.05)

[65]

Brassicaceae

Brassicanigra

(L.)K.Ko

chElkharde

lChloroform,acetone

,ethanol

and

aqueou

sextractsof

theseed

s200mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thedm

inistrationof

aqueou

sextractdaily

once

for1mon

thbrou

ghtdo

wnfastingserum

glucoselevels

[66]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 15 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Brassicaceae

Brassica

oleracea

L.Krun

bmkawar/

melfuf

Differen

tfractions

(Petroleum

ethe

r,ethylacetate

andchloroform

)of

ethano

licextractof

theleaves

150mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificant

redu

ctionon

bloo

dglucoselevels(P<0.05)

[67]

Brassicaceae

Brassicarapa

L.Leftbe

ldi

Aqu

eous

extractof

theleaves

200and400

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Both

dosessign

ificantlyde

creased(p<0.001)

bloo

dglucose

levelsin

diabeticratsafter28

days

ofadministration

[68]

Brassicaceae

Lepidium

sativum

L.Hab

errechad

Seed

powde

r3g/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificant

decrease

(p≤0.05)in

fastingbloo

dglucoselevels

[69]

Brassicaceae

Nasturtium

officinaleR.Br.

Gernu

nes

Hydroalcoho

licextractof

theleaves

100and200

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Treatm

entof

diabeticratsfor4weeks

with

Nasturtium

officinale

extractsign

ificantlyde

creasedtheirserum

glucoselevels

[70]

Brassicaceae

Raph

anus

sativus

L.Lfjel

Root

juice

100,200,300,

and400mg/

kgBW

Streptozotocin-in

duced

diabeticrats(STZ)

Maxim

umredu

ctionof

15.9%

(p<0.001)

inbloo

dglucoselevel

at3hin

norm

alrats,w

hereas

theredu

ctionob

served

was

by23.8and28.3%

(p<0.001)

insub-

andmild-diabe

ticrats,

respectively

[71]

Buxaceae

Buxus

sempervirens

L.Lbeks

Aqu

eous

extractof

theleaves

5mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theaqueou

sextractredu

cedthebloo

dglucoseof

both

healthy

anddiabeticrats.Thisextractwas

also

ableto

improveoral

glucosetolerancein

diabeticratsanditam

elioratedhe

patic

histolog

y

[72]

Cactaceae

Opuntia

ficus

indica

(L.)Mill.

Lhnd

ia/

Aknari

Water

extractof

thewho

leplant

100mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificantlyde

crease

ofbloo

dglucosecomparedto

diabetic

controlrats(P<0.05)

[73]

Capparaceae

Capparis

decidua

(Forssk.)

Edge

w.

Ignin

Aqu

eous

andethano

licextractof

the

stem

250and500

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thefastingbloo

dglucoseleveld

ecreases

by58.5,83.6%

(aqu

eous

extract)and60.2,98.51

(ethanolicextract)after21st

dayin

diabeticratstreatedwith

adifferent

dosesof

250mgand

500mg/kg

BWrespectively

[74]

Capparaceae

Capparis

spinosaL.

Kabar

/Taylulut

Hydroalcoho

licextractof

theroot

0.2and0.4g/

kgBW

Streptozotocin-in

duced

diabeticrats(STZ)

Glucose

levelssign

ificantlyde

creasedaftertreatin

gwith

plant

extract(p=0.003)

[75]

Cistaceae

Cistus

laurifolius

L.Agu

llid

Aqu

eous

andethano

lextractsof

the

leaves

250and500

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thebloo

dglucoselevelsof

theSTZ-indu

ceddiabeticratswere

decreasedby

ethano

lextract

ascomparedto

controlg

roup

(16%

–34%

)

[76]

Com

positae

Anacyclus

pyrethrum

(L.)

Lag.

Igun

tas

/Tagun

decht

Aqu

eous

extractof

theroots

150and300

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thesign

ificant

redu

ction(p<0.01)of

bloo

dglucosewas

observed

at60

and120min

oftheexpe

rimen

t[77]

Com

positae

Artemisia

absin

thium

L.Chiba

Ethano

lextract

ofthewho

leplant

250,500and

1000

mg/kg

BW

Alloxan-

indu

ceddiabetic

rats

Atim

e-de

pend

entsign

ificant

hypo

glycem

icactivity

inmed

ium

dose

(500

mg/kg

BW,P

<0.01)andhigh

dose

(1000mg/kg

BW,

P<0.001),w

hich

was

clearly

afterday10

treatm

entpe

riod

[78]

Com

positae

Artemisia

herba-alba

Asso

Izri/Chih

dwidi

Aqu

eous

extractof

theaerialp

arts

0.39

g/kg

BWAlloxan-

indu

ceddiabetic

rats

Theadministrationof

Artemisiaherba-alba

indicatessign

ificant

(P<0.05)redu

ctionof

bloo

dglucoseconcen

trationandwas

foun

dto

beantid

iabe

tic

[79]

Com

positae

Cham

aemelum

nobile(L.)All.

Babo

unj

Aqu

eous

extractof

theaerialp

arts

20mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thebloo

dglucoselevelswerede

creasedfro

m6.1±0.06

mmol/l

to4.6±0.17

mmol/l(P<0.01)andfro

m21.1±1.31

mmol/lto

13.7±0.90

mmol/l(P<0.01)in

norm

alandSTZdiabeticrats,

respectively,after15

days

oftreatm

ent.

[80]

Com

positae

Cichorium

intybusL.

Buaggad

Ethano

licextractof

thewho

leplant

125mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thedaily

administrationfor14

days

todiabeticratsattenu

ated

serum

glucoseby

20%,trig

lycerid

esby

91%

andtotal

cholesterolb

y16%

[81]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 16 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Com

positae

Lactucasativa

L.Kh

esLactucaxanthin

isolated

from

Lactuca

sativa

6.854μg

α-Amylaseandα-

glucosidaseassays

using

streptozotocin

-indu

ced

diabeticratmod

els

Lactucaxanthin

sign

ificantlyinhibited(p<0.05)theactivity

ofα-

amylaseandα-glucosidase

[82]

Com

positae

Matricaria

cham

omillaL.

Mansania

Aqu

eous

extractof

theleaves

200mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theadministrationof

Matricariacham

omillaon

cedaily

for21

days

redu

cedtheelevated

Fasted

Bloo

dGlucose

by62.2%

(p<

0.001)

[83]

Com

positae

Taraxacum

campylodes

G.E.Haglund

Lhandb

aAqu

eous

extractandmethano

lextractof

roots,flowersandstem

s20,40,60,80

and100μg

/ml

α-glucosidaseandα-

amylaseen

zymeinhibit-

ingactivity

Thestem

show

edthehigh

estoverallinh

ibito

ryeffect

ofbo

th(alpha

amylase+alph

aglucosidase)

asan

averageof

abou

t87.2%

[84]

Com

positae

Warionia

saha

rae

Benthe

mex

Benth.&Coss.

Afssas

Aqu

eous

extractof

theaerialp

arts

5mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thebloo

dglucoselevelswerede

creasedin

norm

alandSTZ-

indu

ceddiabeticratsafter15

days

oftreatm

ent

[85]

Cucurbitaceae

Citrullus

colocynthis(L.)

Schrad.

Aferziz/lh

dej

Chloroform,ethanol

andaqueou

sextractsof

theroot

200mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Aqu

eous

extractshow

edsign

ificant

redu

ctionin

bloo

dsugar

level(58.70%

)whe

ncomparedwith

chloroform

(34.72%)and

ethano

lextracts(36.60%)(p<0.01)

[86]

Cucurbitaceae

Cucumissativus

L.Lkhiar

Ethano

lextract

ofthefru

it200and400

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thehype

rglycemiawas

sign

ificantly(P<0.05)lowered

bythe

administrationof

200mg/kg

and400mg/kg

body

weigh

tethano

lextract

[87]

Cucurbitaceae

Cucurbita

maxima

Duche

sne

Garaa

lham

raPetroleum

ethe

r,ethylacetate

and

alcoho

lextract

oftheseed

s200mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thebloo

dglucoseconcen

trationwas

sign

ificantly(P<0.05)

decreasedcomparedto

control

[88]

Cucurbitaceae

Cucurbita

pepo

L.Takhsait/

curjt

Fruitpo

wde

r2g/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificantlyde

crease

ofbloo

dglucosecomparedto

diabetic

controlrats(P<0.05)

[89]

Cup

ressaceae

Juniperus

phoeniceaL.

Araar

finiqui

Essentialo

il,he

xane

andmethano

lextractsof

theleaves

50,100

and

200μg

/mL

α-Amylaseinhibitio

nassay

TheIC50

values

ofessentialo

il,he

xane

andmethano

lextracts

againstα-am

ylasewere35.44,30.15and53.76μg

/mLrespect-

ively,andthoseagainstpancreaticlipasewere66.15,68.47and

60.22μg

/mLrespectively

[90]

Cyperaceae

Cyperus

rotund

usL.

Tara

Hydro-ethanolicextractof

thetube

rs200and500

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thishype

rglycemiawas

sign

ificantly(P<0.05)lowered

bythe

administrationof

Hydro-ethanolicextract

[91]

Ericaceae

Arbutusun

edo

L.Sasnu

Water

extractof

theroots

500mg/kg

BWOralg

lucose

tolerance

testin

rats(OGTT)

Thewater

extractprod

uced

ade

crease

ofglycem

iaat

1hand3

hafterglucoseloading(21.1%

,p<0.05

and14.1%,p

<0.05,

respectively)

[92]

Euph

orbiaceae

Ricinu

scommun

isL.

Awriw

er/

Lkharw

aaEthano

licextractof

theroot

125,250,500,

750,1000

and

2000

mg/kg

BW

Alloxan-

indu

ceddiabetic

rats

Five-hun

dred

milligram

perkilogram

body

weigh

tappe

ared

tobe

theeffectivedo

seas

itcaused

themaxim

umloweringof

the

fastingbloo

dglucose

[93]

Legu

minosae

Vign

aradiata

(L.)R.Wilczek

Soja

Raw,b

oiled,

andsprouted

mun

gbe

ans

Not

men

tione

dα-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

α-am

ylaseandα-glucosidaseinhibitory

activities

werehigh

er(p<0.05)in

sprouted

mun

gcomparedto

raw

mun

gandbo

iled

mun

g.

[94]

Legu

minosae

Vign

aun

guiculata(L.)

Walp

Fulg

nawa

Seed

oil

100and200

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificant

redu

ctionin

bloo

dglucoselevelw

asno

tedandat

thedo

seof

200mg/kg.b.wtserum

glucoselevelw

asfoun

dto

bevery

closeto

theno

n-diabeticcontrol

[95]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 17 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Gen

tianaceae

Centaurium

erythraeaRafn

Qusset

elhayya/

Ahchlaf

ntaw

rra

Aqu

eous

andbu

tano

licextractsof

theaerialp

arts

0,015ml/

100

gand0,66

ml

/100gBW

Oralg

lucose

tolerance

testoverload

“OGTT”

Theadministrationof

extractshasredu

cedsign

ificantlyglycem

iacomparedto

controlsat

t60,t90,t120

andt180

min

[96]

Iridaceae

Crocus

sativus

L.Zaafranlhor

Ethano

licExtractof

stigma

20,40and80

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thedo

seof

40mg/kg

was

foun

dto

bemoreeffectivedo

sein

intraperito

neallyrouteforde

creasing

bloo

dglucoselevel

[97]

Juglandaceae

Juglan

sregiaL.

Swak

/Gargaa

Alcoh

olicextractof

theleaves

200and400

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theextractredu

cedthehype

rglycemiasign

ificantlycompared

tocontrolg

roup

(P<0.05)

[98]

Lamiaceae

Ajugaiva(L.)

Schreb

.Timerna

nzen

khad/

Chn

dkou

ra

Lyop

hilised

aqueou

sextractof

the

who

leplant

10mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

redu

ctionin

bloo

dglucoselevelinno

rmalratsas

comparedto

theun

treatedgrou

psandto

thepre-treatm

ent

levels(0h)

(793.96mg/dl

at6hvs

100.73.34mg/dl

at0h,P<

0.01)

[99]

Lamiaceae

Lavand

ula

angustifolia

Mill

Elkhzama

zerqa/

Elkhzama

Fassiya

Methano

licextractof

thewho

leplant

12.5–400

μg/

ml

Inhibitory

effectson

both

horm

onesensitive

lipase

(HSL)andpancreatic

lipase(PL)

TheextractinhibitedHSL

activity

inado

sede

pend

entmanne

rwith

anIC50

of175.5μg

/ml.Likewise,itinhibitedthePL

activity

inado

sede

pend

entmanne

rwith

anIC50

of56.5μg

/ml

[100]

Lamiaceae

Lavand

ula

stoechas

L.Im

zeria/

Tikenkert/

Lhalhal

Essentialo

ilextractedfro

mtheaerial

parts

50mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Lavand

ulastoechas

essentialo

ilssign

ificantlyprotectedagainst

theincrease

ofbloo

dglucose

[101]

Lamiaceae

Marrubium

vulgareL.

Mriw

t/Ifzi

Methano

licextractof

theaerialp

arts

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

ahigh

lysign

ificant

redu

ctionin

theplasmaglucoselevel

startin

gat

the14th

dayof

treatm

ent,comparedto

before

treatm

ent(day

0)

[102]

Lamiaceae

Ocimum

basilicum

L.Lahb

aqAqu

eous

extractof

theleaves

20,18.2,16.3

and14.5mg/

ml

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Theaqueou

sextractshow

edstrong

a-glucosidaseanda-

amylaseinhibitin

gactivities

[103]

Lamiaceae

Rosm

arinus

officinalisL.

Azir

Ethano

licextractof

theleaves

50,100

and

200mg/kg

BWAlloxan-diabeticrabb

itsThehigh

estdo

se(200

mg/kg)sign

ificantlylowered

bloo

dglucoseleveland

increasedserum

insulin

concen

trationin

alloxan-diabeticrabb

its

[104]

Lamiaceae

Salvia

officinalis

L.Salm

iaEthano

licextractof

theleaves

0.1,0.2,and

0.4g/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theeffect

ofadministrationof

extractandgliben

clam

ide

tend

edto

bringserum

glucoseandinsulin

towards

norm

alvalues

[105]

Lamiaceae

Teucrium

polium

L.Tawerart/

Flyoulbou

r/jaaidia

Aqu

eous

decoctionof

theaerialp

arts

5ml(20%

w/v)

Streptozotocin-in

duced

diabeticrats(STZ)

sign

ificant

redu

ctions

inbloo

dglucoseconcen

tration4hafter

intraven

ousadministrationand24

hafterintraperito

neal

administration

[106]

Lamiaceae

Thym

ussatureioides

Coss.

Asserkna/

Ziitra

Aqu

eous

extractof

theaerialp

arts

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Adm

inistrationof

aqueou

sextractto

diabeticratsfor28

dredu

cedtheirfastingbloo

dglucoselevelssign

ificantly

comparedto

thediabeticcontrolrats

[107]

Lamiaceae

Thym

usvulgaris

L.Adu

chen

/Azukni/

Zaitra

Methano

l,ethano

land

aqueou

sextractof

thewho

leplant

2,4,8,10,

15μg

/ml

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Theresults

ofanti-diabeticactivity

prod

uced

byThym

usvulgaris

show

edthat

thevolatilecompo

unds

wereeffectiveto

α-glucosidaseandα-am

ylaseinhibitio

n.

[108]

Lauraceae

Cinn

amom

umcassia

(L.)

J.Presl

Qarfa

Aqu

eous

extractof

thebark

60mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Ahigh

lysign

ificant

(P<0.001)

decrease

inmeanfastingbloo

dglucoselevel,203.5±13.47on

10th

and191.5±12.72on

15th

dayas

comparedto

meanfastingbloo

dglucoselevel

[109]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 18 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Lauraceae

Cinn

amom

umverum

J.Presl

Dar

essini

Aqu

eous

extractof

thebark

200,400,600

and1200

mg/

kgBW

Alloxan-

indu

ceddiabetic

rats

After

30days,the

administrationof

diabeticratswith

thelowest

dose

(200

mg/kg

BW)of

extractswas

themostefficient

inaffectingsign

ificant

(P<0.05)redu

ctionin

thelevelsof

fasting

bloo

dglucose

[110]

Lauraceae

Laurus

nobilis

L.Ourak

sidn

amou

ssa/

Rand

Essentialo

ilandits

threemain

compo

nents

0.606to

1.300μl/m

Lα-glucosidaseinhibitio

nen

zyme

Essentialo

ilwas

foun

dto

inhibitα-glucosidaseover

90%.The

IC50-value

oftheoilw

asde

term

ined

tobe

1.748±0.021μL/m

L[111]

Lauraceae

Persea

american

aMill.

Lavoca

Aqu

eous

extractof

theseed

s20,30,40

g/l

Alloxan-

indu

ceddiabetic

rats

Theextractpo

ssessedasign

ificant

hypo

glycaemic(P<0.05)in

alloxan-indu

ceddiabeticrats,com

parableto

theeffect

gliben

clam

ide

[112]

Legu

minosae

Acacianilotica

(L.)Delile

Amur/Sllaha

Aqueousmethano

licextractof

pods

200,300and

400mg/kg

BWAlloxan-indu

ceddiabetic

rabb

itsAdo

seof

400mg/kg

BWmaxim

allyredu

cedthebloo

dglucose

levelsas

comparedto

thediabeticgrou

p(p<0.001).

[113]

Legu

minosae

Acaciasenegal

(L.)Willd.

Laalek

Ethylacetate

extractof

stem

bark

200and400

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Indiabeticrats,b

oththedo

ses(200

mg/kg

and400mg/kg)of

ethylacetate

extractwerefoun

dto

besign

ificantly(P<0.05)

activein

comparison

tocontrol

[114]

Legu

minosae

Acaciatortilis

(Forssk.)Hayne

Telh/

Tado

ute

Aqu

eous

extractof

theleaves

800mg/kg

BWDiagn

ostic

kits

Spectrop

hotometricallyin

rats

Theadministrationof

aqueou

sextractforsevenconsecutive

days

caused

sign

ificant

(P<0.05)de

crease

inbloo

dglucose

[115]

Legu

minosae

Arachis

hypogaea

L.Lgerta/

Kawkaw

Aqu

eous

extractof

theseed

s2ml

Alloxan-

indu

ceddiabetic

rats

Theextractcaused

asign

ificant

(P<0.05)de

crease

offasting

bloo

dglucoseof

both

norm

alandalloxan-indu

ceddiabeticrats

[116]

Legu

minosae

Faidherbia

albida

(Delile)

A.Che

v.

Cho

k/Talh/

Mim

ouza

Aqu

eous

extractof

stem

bark

125,250and

500mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thequ

eous

extractpo

ssessedanti-hype

rglycemiceffect

inal-

loxanindu

ceddiabeticrats

[117]

Legu

minosae

Glycine

max

(L.)

Merr.

Soja

Petroleum

ethe

r,alcoho

licand

aqueou

sextractof

seed

s100,200and

400mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Theantih

yperglycem

iceffect

ofaqueou

sextractshow

edon

set

atthe2n

dh;pe

akeffect

atthe4thhandtheantih

yperglycem

iceffect

was

sustaine

dtillthe

24th

h

[118]

Legu

minosae

Lupinu

salbusL.

Tirm

s/Foul

gnaw

aAqu

eous

extractof

seed

coat

18.4and36.8

mg/kg

BWGlucose

ResistantMice

Decreasein

bloo

dglucoseat

30min

relativeto

control,bu

tthis

differencewas

notsign

ificant

foreither

concen

tration

[119]

Legu

minosae

Medicago

sativaL.

Fassa

Aqu

eous

extractof

seed

s7mg/100g

BWAlloxan-

indu

ceddiabetic

rats

Theaqueou

sextracthashypo

glycem

iceffect

byincreasing

insulin

leveland

decreasing

insulin

resistance

[120]

Legu

minosae

Phaseolus

vulgarisL.

Lubya

Seed

s100,200and

300mg/kg

BWIndu

ctionof

hype

rglycemiain

ratsby

administrationof

glucose

Seed

sof

P.vulgarisat

ado

sage

of300g/kg

bwisshow

ing

maxim

albloo

dglucoseloweringeffect

indiabeticratsafter

third

hour

[121]

Legu

minosae

Retamaraetam

(Forssk.)Web

bRtam

/Allug

Methano

licextractof

thefru

its100,250and

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theextractsat

250or

500mg/kg

sign

ificantlylowered

bloo

dglucoselevelsat

the3rdand1stweekof

treatm

ent,respectively

[63]

Legu

minosae

Trigon

ella

foenum

-graecum

L.

Lhelba/

Tifid

asAlcoh

olicextractof

theseed

s1,2and4g

Alloxan-

indu

ceddiabetic

rats

Sign

ificant

redu

ctionon

bloo

dglucoselevelswas

seen

with

alcoho

licextract(74.33

±4.77

to60.56±1.9in

norm

alratsand

201.25

±7.69

to121.25

±6.25

indiabeticrats)(P<0.001)

[122]

Linaceae

Linu

musitatissim

umL.

Zariat

elkattan

Ethano

licextractof

theseed

s200and400

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Theextractsign

ificantlyredu

cedserum

glucoselevel.The

antih

yperglycaemiceffectsshow

edon

setat

4thh(P<0.001)

andpe

akeffect

at6thh(P<0.001)

[123]

Lythraceae

Lawsonia

inermisL.

Lhen

naEthano

licextractof

thewho

leplant

150,300and

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificantlyde

creasedlevelo

fbloo

dglucose.Theeffect

ofdo

seo500mg/kg

BWwas

foun

dto

bebe

tter

then

150and

300mg/kg

BW

[124]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 19 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Lythraceae

Punica

gran

atum

L.Rm

anEthano

licextractof

theleaves

500mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Sign

ificant

decrease

(P<0.01)in

bloo

dglucoselevelin

comparison

tocontrolg

roup

[125]

Malvaceae

Abelmoschus

esculentus

(L.)

Moe

nch

Lmloukhia

Peelandseed

powde

r100and200

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

(P<0.001)

redu

ctionin

bloo

dglucoseleveland

increase

inbo

dyweigh

tthan

diabeticcontrolrats

[126]

Malvaceae

Hibiscus

sabdariffaL.

Karkadi/

Bissam

Aqu

eous

extractsof

thecalyces

10–80μg

/mL

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Theextractscaused

inhibitio

nof

α-am

ylaseandα-glucosidase

activities

invitro

[127]

Moraceae

FicuscaricaL.

Tazart/

Lkarmou

s/Karm

a/chrih

a/Elbakur

Aqu

eous

extractof

theleaves

2.5g/100ml

Streptozotocin-in

duced

diabeticrats(STZ)

Theextractde

creased(p<0,025)

plasmaglucosein

diabetic

(27.9±4.5mmol/L

to19.6±9.9mmol/L)whileno

tin

norm

alrats

[128]

Moraceae

Morus

alba

L.Tutlbari

Alcoh

olextractof

theroot

bark

200,400and

600mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Asign

ificant

declinein

serum

glucoseleveltoavalueof

155

mg/dl,P

<0.05

ascomparedto

STZ-diabeticrats

[129]

Musaceae

Musa×

paradisia

caL.

Banan

Ethano

licextractsof

leaves,fruit

peels,stem

sandroots

100,250and

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Onlyleaves

andrip

efru

itpe

elsshow

edprom

isingantid

iabe

ticeffect

[130]

Myristicaceae

Myristica

fragran

sHou

tt.

Lgou

zaPetroleum

ethe

rextractof

theseed

s100and200

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Asign

ificant

decrease

inbloo

dglucoselevelfrom

56.5±3.19

(0h)

to49.75±2.05

mg%

(4h)

inno

rmog

lycaem

icrats

[131]

Myrtaceae

Eucalyptus

camaldulensis

Deh

nh.

Calitu

sEssentialo

ilextractedfro

mtheleaves

0.10

and0.25

ml

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Both

α-am

ylaseandα-glucosidasewereinhibitedby

ano

n-compe

titivemechanism

[132]

Myrtaceae

Eucalyptus

globulus

Labill.

Calitu

sAqu

eous

extractof

theleaves

150and300

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theaqueou

sextractexhibitedasign

ificant

anddo

se-dep

ende

nteffect

onthebloo

dglucoselevels(P<0.001).The

high

estdo

se(300

mg/kg)prod

uced

themostpron

ounced

loweringof

bloo

dglucoselevels

[133]

Myrtaceae

Myrtus

commun

isL.

Rihane

Hydroalcoho

lic,w

ater,and

ethano

lextractsof

theleaves

2andg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theethano

licextractof

leaves

(2g/kg)hadabe

tter

hypo

glycem

iceffect

indiabeticratscomparedwith

theaqueou

sextract(p<0.05)

[134]

Myrtaceae

Syzygium

arom

aticum

(L.)

Merr.&

L.M.Perry

Kranfal

Essentialo

ilextractedfro

mthebu

dsandseed

s1to

100μg

/mL

α-am

ylaseinhibitio

nen

zyme

Themaxim

umantid

iabe

ticactivity

forS.arom

aticum

essential

oilswas

notedat

thehigh

estdo

se(100

μg/m

L).

[135]

Nitrariaceae

Peganu

mha

rmalaL.

Lharmel

Ethano

licextractof

theseed

s150and250

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theoraladministrationof

ethano

licextractcauses

maxim

umfall

ofbloo

dglucoselevelto22.9%

(p<0.05)and29.4%

(p<0.01)

respectivelywith

thetw

odo

sesin

norm

aland30.3%

(p<0.01)

and48.4%

(p<0.001)

indiabeticrats

[11]

Oleaceae

Fraxinus

angustifolia

Vahl

Touzalt

Hydroalcoho

licextractsof

leaves

and

bark

25and50

mg/

kgBW

Streptozotocin-in

duced

diabeticrats(STZ)

Aconsiderablehypo

glycem

iceffect

was

noticed

2hafterthe

STZ-indu

ction,

with

ahigh

erefficiency(P<0.05)forleaf

extract

(68%

)as

comparedwith

bark

extract(57%

)

[136]

Oleaceae

Oleaeuropaea

L.Jbou

j/Azm

our/

Zitoun

Alcoh

olextractof

theleaves

0.1,0.25

and

0.5g/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theantid

iabe

ticeffect

oftheextractwas

moreeffectivethan

that

observed

with

gliben

clam

ide

[137]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 20 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Pedaliaceae

Sesamum

indicum

L.Janjlan

Ethano

licextractof

theseed

s500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Asign

ificant

decrease

intheelevated

bloo

dglucoseand

increase

inthelowered

insulin

andglycog

enlevels

[138]

Plantaginaceae

Globularia

alypum

L.Ayen

lerneb

/Taselgha

Aqu

eous

extractof

theleaves

100and20

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Inthediabeticrats,the

bloo

dglucoselevelswas

mostly

redu

ced,

dueto

repe

ated

oraltreatm

entof

G.alypum

leaves

(20

mg/kg

(P<0.001)

[139]

Poaceae

Cyno

don

dactylon

(L.)

Pers.

Njem

Aqu

eous

extractof

thewho

leplant

250,500and

1000

mg/kg

BW

Streptozotocin-in

duced

diabeticrats(STZ)

Thedo

seof

500mg/kg

was

iden

tifiedas

themosteffective

dose.Itlowersbloo

dglucoselevelaroun

d31%

after4hof

administrationin

norm

alrats

[140]

Poaceae

Hordeum

vulgareL.

Chair/Zraa

Hydroalcoho

licextractof

theseed

s0.1,0.25,0.5g/

kgBW

Streptozotocin-in

duced

diabeticrats(STZ)

Theextractat

dosesof

0.25

and0.5g/kg,w

ereon

lyeffectivein

detractin

gbloo

dglucoselevelsof

diabeticratsafter11

days

ofcontinueddaily

therapy

[141]

Poaceae

Penn

isetum

glaucum

(L.)

R.Br.

Illan

Hexane,ethylacetate,m

ethano

licand

aqueou

sextractsof

theseed

s250mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theaqueou

sextracthasshow

nmaxim

albloo

dglucose

loweringeffect

indiabeticrats

[142]

Poaceae

Phalaris

cana

riensisL.

Zouan

Encryptedpe

ptides

released

after

gastrointestinaldige

stionof

seed

proteins

0,200,400,

600,800,1000,

1200,and

1400

μg/m

L

Assay

forInhibitory

Activity

ofDipep

tidyl

PeptidaseIV

Thepe

ptides

show

ed43.5%

inhibitio

nof

dipe

ptidylpe

ptidaseIV

[143]

Poaceae

Sorghu

mbicolor(L.)

Moe

nch

Bachna

Driedextractof

thewho

leplant

0.4g/kg

BWHep

aticglucon

eoge

nesis

ofstreptozotocin-in

duced

diabeticrats

Thehypo

glycem

iceffect

ofextractwas

relatedto

hepatic

glucon

eoge

nesisbu

tno

ttheglucoseup

take

ofskeletalmuscle,

andtheeffect

was

similarto

that

ofanti-diabeticmed

ication

[144]

Poaceae

ZeamaysL.

Lahyat

Adra

Cornsilkaqueou

sextract

0.25–10.0mg/

mL0.25–8.0

mg/mL

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Invitroanalysisof

theextractshow

edthat

itexhibitedpo

tent

andmod

erateinhibitory

potentialagainstα-am

ylaseandα-

glucosidase,respectively.Theinhibitio

nwas

concen

tration-

depe

nden

twith

respectivehalf-maxim

alinhibitory

concen

tra-

tion(IC

50)values

of5.89

and0.93

mg/mL

[145]

Portulacaceae

Portulaca

oleracea

L.Rejla

Aqu

eous

extractof

thewho

leplant

200and400

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Thehypo

glycaemiceffect

ofextractbe

camesign

ificant

followingoraladministration1h,reache

dthepe

akat

1.5h(p<

0.01),andwas

stillsign

ificant

at4h

[6]

Ranu

nculaceae

Nigella

sativaL.

Habasoud

a/Sanou

jHydroalcholicextractof

theseed

s5,10,and

20mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

5mg/kg

BWisthemosteffectivedo

seforassessingtheanti-

hype

rglycemicpo

tentialo

fhydroalcho

licextractof

N.sativain

diabeticrats

[146]

Rham

naceae

Ziziph

uslotus

(L.)Lam.

Nbe

g/Azoug

gar/

ssdra

Aqu

eous

extractof

leaves

andfru

its250μL

150μL

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Z.lotusleaves

andfru

its,d

emon

stratedinhibitory

effectsagainst

α-am

ylase(IC

50:20.40–31.91

μg/m

L),and

α-glucosidase(IC

50:

8.66–27.95

μg/m

L)

[147]

Rosaceae

Cydonia

oblong

aMill.

Sferjel

Aqu

eous

extractof

thefru

its80,160,and

240mg/kg

Streptozotocin-in

duced

diabeticrats(STZ)

Theoraladministrationof

theextractpreven

teddiabetes-

indu

cedincrease

inserum

urea

andcreatin

inelevelsas

the

markersof

renald

ysfunctio

n

[148]

Rosaceae

Chaeno

meles

sinensis

(Dum

.Cou

rs.)

Koeh

ne

Sferjel

Ethylacetate

fractionfro

mthefru

its50

and100

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Theadministrationof

C.sin

ensis

fruits

extract(100

mg/kg

BW)

restored

thebloo

dglucoseto

almostno

rmallevel

[149]

Rosaceae

Eriobotrya

japonica

(Thu

nb.)Lind

l.

Mzah

Alcoh

olicextractof

theleaves

100,150and

200mg/kg

Alloxan-

indu

ceddiabetic

rats

Theextractexertedasig

nificant(P<0.05)h

ypog

lycaem

iceffectin

norm

alrabb

itswhich

was

however

short-lived.The

hypo

glycaemic

effectwas

notsig

nificant(P>0.1)inalloxan-treatedrabb

its

[150]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 21 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Rosaceae

Prun

usarmeniaca

L.Luzelhar

Thepo

maceandthede

toxified

kernelextract

4,6and8mg/

kg2,3and4

mg/kg

Alloxan-

indu

ceddiabetic

rats

Pomaceextractshow

edsign

ificant

(p≤0.05)antid

iabe

tic-activity

moreprom

inen

tthande

toxifiedkernelextractacutely,subchro-

nically

andon

long

er-terms

[151]

Rosaceae

Prun

usdulcis

(Mill.)D.A.

Web

b

Louz

imrzig/

Louz

morr

Ethano

lextract,ethylacetatefraction,

hexane

fraction,

chloroform

fraction,

n-bu

tano

lfraction,

water

fractionand

almon

doil

Not

men

tione

dProteintyrosine

phosph

atase-1B

(PTP1B)

inhibitio

n

Thealcoho

licextractshow

edstrong

anti-diabetic(PTP1B

inhib-

ition

)activity

with

anIC

500.46

μg/m

L[152]

Rutaceae

Citrus

medicaL

Lham

edbe

ldî

Petroleum

ethe

rextractof

the.Seed

s200and400

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

redu

ction(p<0.05)of

fastingbloo

dglucosein

dose

depe

nden

tmanne

rafter15

days

ofdrug

administration

[153]

Rutaceae

Citrus

paradisi

Macfad.

Pamblam

usPh

enolicextractfro

mgrapefruitpe

els

500mL

50mL

50mL

Interactionwith

α-am

ylase,α-glucosidase

andangioten

sin-I-

convertin

gen

zyme(ACE)

Theph

enolicextractsinhibitedα-am

ylase,α-glucosidaseand

ACEen

zymeactivities

[154]

Rutaceae

Citrus

sinensis

(L.)Osbeck

Peelethano

licextract

250and500

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Diabe

ticratstreatedwith

250and500mg/kg

ofextractshow

edasign

ificant

redu

ctionin

bloo

dglucoselevelsof

11and25%,

respectively

[155]

Rutaceae

Citrus

×aurantium

LLarenj/

Zenb

ue/

trun

j

Thealcoho

licextractof

fruitpe

el300and500

mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Onrepe

ated

administrationof

ethano

licextractfor21

days,a

sign

ificant

(P<0.001)

dose-dep

ende

ntde

crease

inbloo

dglu-

cose

ofthediabeticratswas

seen

ascomparedto

control

grou

p

[156]

Rutaceae

Ruta

graveolens

L.Lfijel

Water

extractof

thewho

leplant

125and50

mg/kg

BWNicotinam

ide-

streptozotocin-in

duced

(type2)

diabeticalbino

rats

Sign

ificant

amelioratio

nof

glucosetolerance

[157]

Rutaceae

Ruta

mon

tana

(L.)L.

LFijel

/Iwermi

Aqu

eous

extractof

theaerialp

arts

5mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Both

sing

leandrepe

ated

oraldo

sesprod

uced

sign

ificant

redu

ctions

inthebloo

dglucoselevelsin

norm

alandSTZ-

indu

cedrats

[158]

Santalaceae

Viscum

album

LLenjbar

Aqu

eous

extractof

theleaves

100and200

mg/kg

BWAlloxan-

indu

ceddiabetic

anim

als

Doses

of200mg/kg

and400mg/kg

BWprod

uced

sign

ificant

(p<0.05)loweringof

bloo

dsugarin

fasted

norm

alwhite

albino

ratsandalloxanizedrabb

itsrespectively

[159]

Sapo

taceae

Arganiaspinosa

(L.)Skeels

Argan

Aqu

eous

extractof

thefru

its10

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sing

leoraladministrationredu

cedbloo

dglucoselevels6hafter

administrationin

STZdiabeticrats.Furthermore,bloo

dglucose

levelswerede

creasedin

STZdiabeticratsafter7days

oftreatm

ent

[160]

Solanaceae

Capsicum

annu

umL.

FelfelH

ârr/

soud

ania

Water

extractof

nine

type

sof

pepp

er500mL

50mL

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Severalp

eppe

rextractshadhigh

a-glucosidaseinhibitory

activ-

ity.Selectextractssuch

asGreen

pepp

erandLong

hotpe

pper

hadless

orno

inhibitory

effect

onthea-am

ylaseactivity

[161]

Solanaceae

Datura

stramon

ium

L.Aqu

eous

extractof

theleaves

100–1000

μlα-am

ylaseinhibitio

nen

zyme

Theassaycarriedou

ton

alph

a-am

ylaseen

zymeshow

edthe

dose-dep

ende

ntincrease

ininhibitory

effect

with

IC50

730μg

[162]

Solanaceae

Lycopersicon

esculentum

Mill.Sdag

jmel/

Metal

Thesupe

rnatant(juicefraction)

0to

0.8mg/ml

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Strong

erinhibitio

nof

α-glucosidasethan

α-am

ylaseactivity

[163]

Solanaceae

Nicotiana

tabacum

L.Nefha

Acetone

,ethanol

andwater

extract

oftheleaves

250μL

α-am

ylaseandα-

glucosidaseinhibitio

nen

zyme

Theaqueou

sextractwas

mosteffectiveinhibitorof

α-am

ylase

(IC50

5.7mg/mL)

whileaceton

eextractexhibitedthebe

stin-

hibitory

potentialo

nα-glucosidase(IC

504.5mg/mL)

[164]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 22 of 32

Table

2In

vivo

andin

vitrostud

iesof

med

icinalplantsused

inthetreatm

entof

diabetes

inMorocco

(Con

tinued)

Family

Plantspecies

Vernacular

name

Plantextractsused

Dose(s)used

Mod

elsused

inthestud

yResults

References

Solanaceae

Solanu

mam

erican

umMill.

Ane

bdib

Aqu

eous

extractof

theleaves

200,400mg/

kgBW

Alloxan-

indu

ceddiabetic

rats

Sign

ificant

antih

yperglycem

icandhypo

lipidem

iceffectswhe

ncomparedto

diabeticcontrolrats(p<0.0001)

[165]

Theaceae

Camellia

sinensis

(L.)

Kuntze

Attay

Water

extract

2ml/1

00gBW

Streptozotocin-in

duced

diabeticrats(STZ)

Theinhibitory

effect

ofextracton

hype

rglycemiaindu

cedby

STZwas

statisticallysign

ificant

[166]

Thym

elaeaceae

Thym

elaea

hirsuta(L.)

Endl.

Metnan

Aqu

eous

extractof

theaerialp

arts

250mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

InSTZ-indu

ceddiabeticrats,singleoraladministrationof

T.hir-

suta

prod

uced

asign

ificant

decrease

ofbloo

dglucoselevels

[167]

Urticaceae

Urticadioica

L.Taznagt/

Tigzen

in/

Lhrig

a

Aqu

eous

extractof

theaerialp

arts

500mg/kg

BWAlloxan-

indu

ceddiabetic

rats

Theam

ount

ofglucoseabsorbed

inasegm

entjejunu

min

situ

was

8.05

±0.68

mgin

presen

ceof

nettleextractvs.11.11

±0.75

mgin

controlratsdu

ring2h(P<0.05)

[168]

Urticaceae

Urticapilulifera

L.Hurrig

a/

Tisrakmaz

Lectin

isolated

from

theseed

s100mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Sign

ificant

hypo

glycem

iceffect

was

foun

dat

thedo

seof

100

mg/kg

afteradministrationfor30

days

[169]

Vitaceae

Vitis

vinifera

L.Dalya/Zbib/

Kerm

a/Adilite

Ethano

licextractof

theleaves

250and500

mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Thedata

show

that

250mg/kg

oftheV.vinifera

extracthas

possessedremarkableeffect

onbloo

dglucoselevelaseq

ualas

referencedrug

.(11.8–26.0%

)

[170]

Zing

iberaceae

Zing

iber

officinale

Roscoe

Sekinjbir

Aqu

eous

extractof

theroot

500mg/kg

BWStreptozotocin-in

duced

diabeticrats(STZ)

Raw

ging

erwas

sign

ificantlyeffectivein

loweringserum

glucose,cholesteroland

triacylglycerollevelsin

theging

er-

treateddiabeticratscomparedwith

thecontrold

iabe

ticrats

[171]

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 23 of 32

Plants used most frequently for the treatment of diabetesin MoroccoTrigonella foenum-graecum L.Trigonella foenum-graecum L. (Fenugreek), is an annualplant, in the family Leguminosae, extensively cultivatedin many countries (Morocco, Egypt, China, India,Ethiopia,Turkey, Ukraine, Greece, etc.) [172]. Apart fromthe usage as an edible species and spice herb, fenugreekis known for its nutraceutical, medicinal, and pharmaceut-ical features. It has been reported that fenugreek is a valu-able medicinal plant with potential for curing abscesses,wounds, arthritis, bronchitis, digestive disorders, fever andsinusitis. It is cited as used in the treatment of diabetes byMoroccan ethnobotanical studies [2, 12–23]. Fenugreek isknown to have several pharmacological effects such as an-tidiabetic, lactation aid, antibacterial, gastric stimulant, foranorexia, galactogogue, hepatoprotective effect, antican-cer, anticarcinogenic, hypocholesterolemic, antioxidant,and immunological activities. Fenugreek is an excellentsource of neutral detergent fiber, proteins, vitamins as wellas chemical constituents [172–176].Hypoglycaemic activity of alcoholic extract of seeds of

Trigonella foenum-graecum was tested in both normaland alloxan-induced diabetic rats. Significant decrease inglycaemia was seen with alcoholic extract (74.33 ± 4.77to 60.56 ± 1.9 in normal rats and 201.25 ± 7.69 to121.25 ± 6.25 in diabetic rats) (P < 0.001) [122].Fenugreek water seed extract was found to increase

the body weight and decrease the fasting blood glucosein streptozocin-induced diabetic rats [177]. Similar re-sults were obtained in the study done by Abdelatif et al.[178] who found that there was a weight gain in fenu-greek treated rabbits as compared to the group that re-ceived only alloxan monohydrate. Plasma glucose levelwas reduced as compared to the alloxan monohydrateinduced diabetic rabbits.Administration of Trigonella foenum-graecum seeds

(2.5 and 5 g) for 4 weeks to sixty newly diagnosed diabeticpatients, improved blood glucose level in dose-dependent.The medium dose (5 g) of fenugreek seeds reduces signifi-cantly the glycemia (8.83 vs 6.45, p < 0.05) [179].An active compound (GII), isolated from water extract

of seeds of fenugreek orally administered to the subdia-betic and mild diabetic rabbits, was capable of reduceblood glucose in glucose tolerance test [180].

Artemisia herba-alba AssoArtemisia herba-alba Asso. (Compositae), known as thedesert wormwood (Shih in arabic), is a dwarf, semishrub,, strongly aromatic herb, growing widely in aridand semiarid areas of the Mediterranean basin and inWestern Asia spreading into middle east, north-westernHimalayas and India [181, 182]. This species is used me-dicinally to treat various diseases such as hypertension,

diarrhoea, diabetes, colds, muscle tensions, coughing, in-testinal distress and fever [183, 184]. It is cited as usedin the treatment of diabetes in Morocco [2, 12, 14–23].Numerous scientists have showed various biological

and pharmacological effects in Artemisia herba-alba es-sential oils, especially antibacterial, antispasmodic, anti-diabetic, antioxidant, leishmanicidal, and antifungal prop-erties [185–188]. In essential oils, monoterpenes were themajor components, essentially α- and β-thujones, cam-phor, 1,8-cineole and chrysanthenyl derivatives, but ses-quiterpenes also were found in some countries [189–192].Taştekin et al. [79] reported the hypoglycaemic effect

of aqueous extract of Artemisia herba-alba in alloxan-induced diabetic rats. Aqueous extract of the aerial partsat the dose of 0.39 g/kg BW (body weight) significantlyreduced (P < 0.05) blood glucose concentration. Itshypoglycaemic effect was comparable with that of insu-lin and repaglinide.In vitro screening of hypoglycemic activity of Arte-

misia herba-alba using α-amylase inhibition techniqueemphasized its activity in hypoglycemic remedy. The70% ethyl alcohol extract and mucilage of 70% ethyl al-cohol inhibited the activity of α-amylase by 11% and 2%respectively [193].A dose of 2 g/kg of hydro-alcoholic extracts of Arte-

misia herba-alba, orally administered daily for 18 weeks,to male mice fed high fat diet, significantly decreased theblood glucose level (143.8 ± 23.9 vs. 229.0 ± 20.8 mg/dl,p < 0.05), triglyceride (18.9 ± 11.1 vs. 62.8 ± 18.3 mg/dl,p < 0.05), total cholesterol (1.2 ± 0.1 vs. 1.8 ± 1.1 g/L, p <0.05) and serum insulin concentrations (1.7 ± 0.7 vs.3.3 ± 14.3 ng/ml, p < 0.05) [194].

Nigella sativa L.Nigella sativa L. (Family Ranunculaceae), commonlyknown as black seed or Kalonji seed, is widely grownmedicinal plant throughout the world. Seeds and theiroil have many food and medicinal uses [195, 196]. It hasreceived attention for its potential application in thetreatment and prevention of a number of diseases, suchas fever, asthma, diarrhoea, dyslipidaemia, common cold,headache, warts, stings of scorpions, bites of snake andrheumatic diseases [197–199]. Moreover, a variety ofsecondary metabolites has been identified in this species,such as fixed oil, protein, alkaloid, saponin, isochinolinealkaloids (nigellimin and nigellimin-N-oxide), pyrazol al-kaloids (nigellidin and nigellicin), thymoquinone, p-cymene, pinene, dithymoquinone, thymohydroquinone,carvacrol, carvone, limonene, 4-terpineol and citronellol[195, 196]. It has been reported to possess potent anti-inflammatory, anti-hyperlipidemic, anti-microbial, anti-cancer, anti-oxidant, anti-diabetic, anti-hypertensive, he-patoprotective, antiparasitic, analgesic, anti-nociceptive,anti-ulcer, anti-histaminic and wound healing activities

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 24 of 32

[196, 200]. Nigella sativa used in Morocco in the treat-ment of diabetes [2, 13–23].Alimohammadi et al. [146] reported the hypoglycaemic

effect of hydroalcholic extract of Nigella sativa seeds (5,10, and 20mg/kg BW) in streptozotocin-induced diabeticrats (STZ). Nigella sativa at 5mg/kg reduced blood glu-cose concentration level from (565.4 ± 30.9mg/dl) to(323.2 ± 32.2mg/dl), at 10mg/kg it reduced blood glucoseconcentration level from (565.4 ± 30.9mg/dl) to (513.2 ±42.7mg/dl), whereas at 20mg/kg it reduced it from(565.4 ± 30.9mg/dl) to (517.6 ± 27.3mg/dl).The antidiabetic activity of methanolic crude extract

and the commercial oil of Nigella sativa seeds in al-loxan- induced diabetic rats was examined by Houcheret al. [201]. Administration of the crude methanolic ex-tract at a dose of 810 mg/kg/day and the oil at a dose of2.5 ml/kg/day decreased significantly the blood glucose(decreases of 58.09 and 73.27% respectively) after 10 daysof treatment.Administration of the volatile oil extracted from Ni-

gella sativa seeds experimentally caused a significant de-crease in blood glucose level in alloxan-diabetic rabbits(2% and 21% decreases in the fasting glucose levels atthe 4 h and the 6 h time intervals, respectively) [202].

Olea europaea L.Olea europaea L. (Olive) belongs to the plant family Olea-ceae, is a small tree that produces the olive fruit, cultivatedin the coastal areas of the eastern Mediterranean basin,the contiguous coastal areas of southeastern Europe,northern Iran at the south end of the Caspian Sea, westernAsia, and northern Africa [203, 204]. Phytochemical inves-tigations on Olea europaea have revealed the presence ofvarious phytochemicals including phenolic compounds(oleuropein, hydroxytyrosol, verbascoside, apigenin-7-glucoside and luteolin-7-glucoside), flavonoids, secoiri-doids, triterpenes, biophenols, benzoic acid derivatives,xylitol, sterols, isochromans and sugars [204, 205]. Oleaeuropaea has a variety of medicinal properties and trad-itional uses. The plant has been used to treat diabetes,high blood pressure, cardiovascular diseases, influenza,chronic fatigue syndrome, to support time of recovery, im-mune system, stomach and intestinal diseases, commoncold, malaria, dengue, severe diarrhoea, respiratory andurinary tract infections, and as mouth cleanser [204, 206].Various biological activities of Olea europaea have beenextensively studied like antihypertensive, analgesic, anti-microbial, anticancer, antihyperglycemic, antidiabetic,anticonvulsant, antioxidant, anti-inflammatory, immuno-modulatory, antiviral, antinociceptive, and gastroprotec-tive activities [203, 204]. It is cited in the ethnobotanicalsurveys that the plant is used in the treatment of diabetesin Morocco [2, 12, 13, 15–23].

Eidi et al. [137] showed the antidiabetic effect of alco-hol extract of Olea europaea leaves in normal andstreptozotocin-induced diabetic rats. Rats were dividedinto nine groups, group1: normal control rats, groups 2,3, 4: normal ratstreated with Olea europaea, group 5:diabetic control rats, group 6, 7, 8: diabetic rats treatedwith Olea europaea, group 9: diabetic rats treated withglibenclamide. The administration of extract at a dose of0.1, 0.25 and 0.5 g/kg BW for 14 days significantly de-creased the blood glucose in diabetic rats (p < 0.05).Another study was conducted to check the antidiabetic

potential of oleanolic acid (an agonist for TGR5), iso-lated from Olea europeaea leaves in mice fed with a highfat diet. Oleanolic acid cause a decrease in blood glucoseconcentration and insulin levels and it enhances glucosetolerance [207].Several other studies demonstrated the antidiabetic ef-

fect of Olea europaea in streptozotocin diabetic rats[208–214], in alloxan diabetic rats [215–219], in alloxandiabetic rabbits [215], in human diabetic subjects [209]and in vitro α-amylase and α-glucosidase inhibitory ac-tivities [220, 221].

Allium cepa L.Allium cepa L., commonly known as onion, botanicallyclassified under the Amaryllidaceae family, is a biennialplant widely cultivated around the world. Onion is uti-lized as both vegetable and flavouring [222, 223].According to traditional medicine experts, Onion is one

of the oldest medicinal plants used to relieve several ail-ments including metabolic disease, wound healer, pneu-monia fighters, digestive problems, skin diseases andinsect bites, diabetes and asthma [224, 225]. Allium cepaused in Morocco in the treatment of diabetes [2, 12–22].There are many chemical constituents in Allium cepa,

including vitamins and minerals. Moreover, a variety of sec-ondary metabolites has been identified in this species, suchas phenolic compounds (particularly ferulic acid, gallic acid,protocatechuic acid, quercetin, and kaempferol), flavonoids(particularly quercetin aglycon, quercetin-3,4′-diglucoside,quercetin-4′-monoglucoside, quercetin-3-monoglucoside,quercetin 3-glycosides, delphinidin 3,5-diglycosides, quer-cetin 3,7,4′-triglucoside, quercetin 7,4′-diglucoside, quer-cetin 3,4′-diglucoside and isorhamnetin 3,4′-diglucoside),phytosterols and saponins [226–230].Recent studies have shown that this plant has differ-

ent biological properties, such as hypolipidemic, anti-hypertensive, antimicrobial, antioxidant, analgesic, anti-inflammatory, immunoprotective, and anti-diabetic effects[222, 224].The hypoglycemic effect of Allium cepa was confirmed

by aqueous extracts of the whole plant in alloxan (150mg/Kg BW) rat model of diabetes. Allium cepa at 200mg/kg reduced fasting blood glucose levels by 62.9%

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 25 of 32

(292.3 ± 29.0 to 108.2 ± 4.6), at 250 mg/kg it reducedfasting blood glucose levels by 69.7 (296.3 ± 37.8 to89.8 ± 4.3) whereas at 300 mg/kg it reduced it by 75.4%(297.8 ± 37.5 to 73.4 ± 3.0) [45].Another study showed the hypoglycemic effect of

onion juice on alloxan-induced diabetic rats. After 4week treatment of onion juice (1 ml/100 g body weight),significant anti-hyperglycaemic effect were observed intreated rats [231].The antidiabetic effect of 200 mg/kg body weight for

60 days of S-methyl cysteine sulfoxide (SMCS) isolatedfrom Allium cepa was studied and compared in alloxan-induced diabetic rats. Results suggested that the admin-istration of SMCS reduced blood glucose level [232].In another experiment conducted by El-Soud and Kha-

lil [233], they found that treatment with onion essentialoil caused a significant decrease in serum lipids, lipidperoxide formation, blood glucose and increase in seruminsulin in streptozotocin induced diabetic albino rats.

Marrubium vulgare L.Marrubium vulgare L. is a perennial herb of the Lamia-ceae family, popularly known as white horehound. Thisaromatic plant is native to the Mediterranean Sea regioncan be found in many temperate regions of Europe,North of Africa and Asia [234, 235]. It could be used tocure and treat several diseases, such as laryngitis, bron-chitis, skin abrasions, wounds, bronchial asthma, non-productive cough, hepatic affections and in phthisis[235, 236]. Marrubium vulgare is rich in phytochemicalslike amino acids, polysaccharides, tannins, phenols, fla-vonoids, alkaloids, steroids, lactones and, in particular,terpenes [237, 238]. The plant is reported to possesshypoglycemic, vasorelaxant, analgesic, antioxidant, anti-erdematogenic, anti-inflammatory, vasodilator and anti-hypertensive properties [236, 238]. Horehound used inMorocco in the treatment of diabetes [2, 12–19, 21–23].Elberry et al. [102] showed that methanolic extract of

the aerial parts of Marrubium vulgare can have benefi-cial effect in diabetes and its complication. They showedon a streptozotocin rat model the antidiabetic effect of adaily single oral dose of 500 mg/kg/day of Marrubiumvulgare for 28 days. The methanolic extract produced asignificant decrease in blood glucose starting on the sec-ond week and a significant increase in plasma insulinand tissue glycogen contents.The administration of an aqueous extract from aerial

parts infusion at dose 100, 200 and 300 mg/kg BW toalloxan-induced diabetic rats decreased significantly theblood glucose level in a dose dependent manner (a de-crease by 50% for the dose 100 mg/kg and more than60% for doses 200 and 300 mg/kg) [239].The antidiabetic activity of various ethanolic extracts

(root, leaf and stem) from Marrubium vulgare on

normoglycemic rats was examined by Vergara-Galiciaet al. [240].The intragastric administration of both ex-tracts (root and stem), at 100 mg/kg BW, significantlyreduced blood glucose level in healthy rat. Furthermore,the increase in plasma glucose level was significantlysuppressed by the ethanolic root extract after substrateoral administration.

ConclusionMany Moroccan medicinal plants are reported to haveblood sugar lowering properties that make them usefulfor the management of diabetes. We have reported 255medicinal plants species belonging to 70 families in thisstudy for the treatment of diabetes. Plants from theCompositae family were used most often in Morocco.The role of 135 Moroccan medicinal plants in the treat-ment of diabetes has been reviewed by several authors.However, 120 medicinal plants that are used for thetreatment of diabetes in Morocco have not yet beenstudied in great detail for their antidiabetic properties.Furthermore, there are very few scientific reports of toxi-cological properties of these plants which would guaran-tee the safety of patients. In general, the literature searchshowed that some users of medicinal plants have onlylittle information about toxic plants. In order to preventthe usage of toxic plants by the greater population, wehave reported the major plants that have side effects ac-cording to toxicological documentations. Despite thetherapeutic effects of medicinal plantsthey may have atoxicity risk which is related to a variety of causes in-cluding, contamination, misidentification, mistaken useof the wrong species, incorrect dosing and errors in use.Another problem, which may occur, is the possibility ofadverse interaction between conventional medicationand plant remedies. In conclusion, this review providesbaseline data for plant species that have the potential an-tidiabetic activity and their associated knowledge inMorocco. However, many of the plant species men-tioned require further pharmacological and clinical stud-ies in order to validate any effective plant remedies totreat diabetes.

AbbreviationsBW: Body weight; DM: Diabetes mellitus; SMCS: S-methyl cysteine sulfoxide;STZ: Streptozotocin-induced diabetic rats

AcknowledgementsNot applicable.

Authors’ contributionsEI Manuscript preparation. FM Manuscript review. KC Supervising the wholework. All authors read and approved the final manuscript.

FundingThere is no funding for review article.

Availability of data and materialsNot applicable.

Idm’hand et al. Clinical Phytoscience (2020) 6:18 Page 26 of 32

Ethics approval and consent to participateNot applicable.

Consent for publicationNot applicable.

Competing interestsThe authors declare that they have no competing interests.

Received: 26 October 2019 Accepted: 25 March 2020

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