Effectiveness and Safety of Ayurvedic Intervention as an adjuvant to the conventional therapy in Noninsulin Dependent Diabetes Mellitus (NIDDM): A Systematic Review with Meta-analysis of blinded Randomized Controlled Trials

Background Type 2 diabetes mellitus (T2DM), also known as Non-Insulin Dependent Diabetes Mellitus (NIDDM), accounts for the majority of global diabetes cases and remains a major cause of morbidity and mortality. Despite effective conventional therapies, glycemic control is frequently inadequate, often limited by side effects, high cost, and poor adherence. Ayurveda recommends different types of formulations for its management. This systematic review and meta-analysis evaluated the effectiveness and safety of Ayurvedic interventions administered as adjuvant to conventional therapy in T2DM. Method Following PRISMA guidelines, randomized blinded controlled trials were identified through PubMed, Cochrane Library, DOAJ, Google Scholar, and AYUSH Research Portal up to July 2025. Eligible trials compared Ayurvedic intervention along with conventional therapy vs conventional therapy alone. Primary outcomes were changes in fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c). Meta-analysis was performed on three sub-groups: single herb, polyherbal formulation and dietary supplement using RevMan 5.4. Risk of bias was assessed using Cochrane guidelines. Results Thirty-seven blinded RCTs involving 2296 participants were included. Ayurvedic adjuvant significantly reduced FPG (mean difference −9.79 mg/dL; 95% CI: −15.71 to −3.86; p=0.001) and HbA1c (mean difference −0.28%; 95% CI: −0.40 to −0.17; p<0.00001) compared with conventional therapy alone. Subgroup analysis showed dietary supplements, especially fenugreek-based formulations and Coccinia grandis (L.) Voigtextract, demonstrated the most consistent and reproducible benefits followed by polyherbal formulations, while single-herb interventions yielded mixed results. Adverse events were mostly mild gastrointestinal complaints, with no major safety concerns reported. Conclusion Ayurvedic intervention, when administered as adjuvant to conventional therapy, significantly improves plasma glucose (FPG) and glycated hemoglobin (HbA1c) with a favorable safety profile. Dietary supplements showed the most consistent and reproducible benefits. Larger multicenter RCTs with standardized formulations and longer follow-up are needed to confirm clinical utility and support integration of Ayurveda into evidence-based diabetes management.