REVIEW Anti-Diabetic Potential of Panax Notoginseng Saponins (PNS): A Review Rosette Uzayisenga, 1,2 Peter Amwoga Ayeka 1,3 and Yi Wang 1 * 1 Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 88 Yuquan Road, Tianjin 300193, PR China 2 District Pharmacy, Ministry of Health, P.O. Box 84, Kigali, Rwanda 3 Department of Biological sciences, Egerton University, P.O. Box 536, Egerton, Kenya Herbal medicines have traditionally played a major role in the management of diabetes in Asian countries for centuries. Panax notoginseng (Burk) F. H. Chen (Araliaceae) known as Tiánqī or san qi is a well-known medicinal herb in Asia for its long history of use in Chinese medicine. Qualified as ‘the miracle root for the preservation of life’, it has been used in China for 600 years, for treatment of various diseases. Panax notoginseng saponins (PNS) are the key active components. PNS have been widely used in China for treatment of cardiovascular diseases. However, scientific studies have shown a wide range of other pharmacological applications including anti-cancer, neuroprotective and anti-inflammatory agents, immunologic adjuvant and prevention of diabetes complications. Recently, hypoglycemic and anti-obesity properties of PNS have also been demonstrated. The present review highlights the effects of PNS on glucose production and absorption, and on inflammatory processes that seem to play an important role in the development of diabetes. Copyright © 2013 John Wiley & Sons, Ltd. Keywords: diabetes mellitus; Panax notoginseng; Panax notoginseng saponins. INTRODUCTION Herbs have been very useful from time immemorial for the treatment of chronic physiological disorders, diabetes included (Chaturvedi, 2012). Herbal therapy for the management of diabetes and its complications has been practiced all over the World successfully (Jarald et al., 2008). Herbal medicines have traditionally played a major role in the management of diabetes in Asian countries (Wang et al., 2004). With the distinctive traditional medical opinions and natural medicines mainly originated in herbs, the traditional Chinese medicine performed a good clinical practice and is showing a bright future in the therapy of diabetes mellitus (DM) and its complications (Li et al., 2004). DM referred to as hyperglycemia that results from defects in insulin secretion, decrease in insulin sensitiv- ity or both (Kohei, 2010; Wold et al., 2005) is a major health problem predisposing to markedly increased complications (Perera and Li, 2011) and the world’s fastest growing disease (Australia, 2007) rated as the third ‘killer’ of mankind along with cancer, cardiovascu- lar and cerebrovascular diseases because of its high prevalence, morbidity and mortality (Li et al., 2004). It has become the most common metabolic disease world- wide due to the severe long-term health complications associated with it (Coman et al., 2012). In the past two decades, decreased physical activity, increasing obesity, stress and changes in food consumption have been implicated in this increasing prevalence (Edwin et al., 2006). The cause of diabetes is a mystery, although both genetic and environmental factors such as obesity and lack of exercise appear to play a role (Li et al., 2004). Hyperglycemia is one of the main pathophysiological features of diabetes. Long-term hyperglycemia will result in various microvascular and macrovasular complications such as hyperlipidemia, atherosclerosis, diabetic nephropathy; renal failure; retinopathy and blindness (Waugh et al., 2007). DM is classified into two major categories: type 1 DM (T1DM) and type 2 DM (T2DM) (Skyler, 2004). T1DM also called insulin-dependent DM (IDDM) or juvenile onset DM, occurs as a result of deficiency of insulin due to destructive lesions of pancreatic b-cells and usually progresses to the stage of absolute insulin deficiency (Kuzuya et al., 2002; Li et al., 2004). T2DM referred to as non-insulin-dependent DM or adult onset DM, in which the body does not produce enough or properly use insulin, is characterized mainly by insulin resistance and pancreatic ß-cell dysfunction. It is the most common form of diabetes, accounting for 90–95% of diabetes (Li et al., 2004; Salas-Salvado et al., 2011). T2DM is a complex disease caused by a combination of genetic factors related to impaired insulin secretion, insulin resistance and environmental factors such as obesity, overeating, lack of exercise and stress, as well as aging. (Kohei, 2010; Salas-Salvado et al., 2011). Impaired postprandial insulin secretion due to the functional defects and the loss of surviving pancreatic ß-cells leads to hyperglycemia and a subsequent decline in insulin sensitivity (Aziz and Wheatcroft, 2011; Saini, 2010). Insulin and leptin resistance, both common metabolic abnormalities often associated with obesity, hypertension, * Correspondence to: Yi Wang, Tianjin State Key Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, 88 Yuquan Road, Tianjin 300193, PR China. E-mail: vip_wangyi@126.com PHYTOTHERAPY RESEARCH Phytother. Res. (2013) Published online in Wiley Online Library (wileyonlinelibrary.com) DOI: 10.1002/ptr.5026 Copyright © 2013 John Wiley & Sons, Ltd. Received 07 February 2013 Revised 18 March 2013 Accepted 21 May 2013