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Introduction: Diabetes mellitus is a chronic metabolic disorder characterized by impaired glucose homeostasis and long-term vascular complications. Ayurveda describes Madhumeha as a condition analogous to diabetes, and Dravyaguna Shastra provides a rich repository of herbs with anti-diabetic potential. Herbs such as Gymnema sylvestre (Gudmar), Momordica charantia (Karavellaka), Pterocarpus marsupium (Vijayasar), Syzygium cumini (Jambu), and Trigonella foenum-graecum (Methi) are classically documented for reducing excessive Meda and Mootra, correlating with glycemic regulation. Methods: Literature was reviewed using PubMed, Scopus, Web of Science, Embase, and Google Scholar, along with classical Ayurvedic texts (Charaka Samhita, Sushruta Samhita, Bhavaprakasha). Keywords included “Ayurveda and diabetes,” “Madhumeha Dravyaguna,” and specific herb names. Inclusion criteria: in vitro, in vivo, and clinical studies published between 1950–2025. Exclusion criteria: non-English reports without translation, anecdotal accounts, and poorly described studies. Results: Ayurveda describes Tikta (bitter), Kashaya (astringent), and Katu (pungent) rasa herbs with Kapha-Meda hara and Pramehaghna properties. Modern pharmacology validates multiple mechanisms: stimulation of insulin secretion (e.g., Gymnema), regeneration of pancreatic β-cells (Pterocarpus), enhanced peripheral glucose uptake (Trigonella), inhibition of intestinal glucose absorption (Momordica), and α-glucosidase inhibition (Syzygium). Clinical studies demonstrate reduced fasting blood glucose, improved HbA1c, and lipid-lowering effects. Discussion: Ayurvedic anti-diabetic herbs largely align with modern mechanisms—antioxidant, insulinogenic, hypolipidemic, and enzyme-inhibitory effects. However, most clinical trials are small-scale and heterogeneous. Standardization of phytoconstituents, dose optimization, and long-term safety trials remain gaps. Conclusion: Integration of Dravyaguna wisdom with pharmacological validation highlights the potential of Ayurvedic herbs as complementary therapies for diabetes. With rigorous research, standardized formulations could offer evidence-based options to improve glycemic control and prevent complications.

KEYWORDS: Ayurveda, Diabetes mellitus, Dravyaguna, Herbal medicine, Madhumeha