Antidiabetic, Antioxidant, and Metabolic Effects of Aloe Vera in Diabetic Rodent Models: A Systematic Review and Meta-Analysis

Background Information: Diabetes mellitus represents a global health challenge, prompting investigation into plant-derived therapies including Aloe vera (AV). Despite extensive preclinical research, the therapeutic efficacy of AV in diabetic rodent models remains heterogeneously reported. Purpose: To systematically evaluate and quantify the effects of Aloe vera administration on glycaemic control, oxidative stress, lipid metabolism, and organ protection in rodent models of diabetes mellitus. Methods: Following PRISMA guidelines, we conducted a comprehensive search of multiple databases for controlled studies investigating AV effects in diabetic rodent models. Primary outcomes included fasting blood glucose (FBG) and glycated haemoglobin (HbA1c), while secondary outcomes encompassed insulin levels, oxidative stress markers (SOD, CAT, GSH, MDA), lipid profile parameters, and histopathological changes. Results: Random-effects meta-analysis was performed using standardized mean differences (SMD) with 95% confidence intervals. Forty-eight studies met the inclusion criteria, encompassing variations in animal models, diabetes induction methods, AV preparations, dosing regimens, and treatment durations. AV administration significantly reduced fasting blood glucose (SMD = -7.893; 95% CI: -9.257 to -6.529) and glycated haemoglobin (HbA1c; (SMD = -5.229; 95% CI: -7.687 to -2.772), while increasing insulin levels (SMD = 4.418; 95% CI: 2.856 to 5.981) across diabetic rodent models. Antioxidant defence was enhanced through increased SOD, catalase, and glutathione levels, alongside reduced lipid peroxidation. AV also improved lipid profiles and demonstrated pancreatic, hepatic, and renal protective effects. Despite substantial heterogeneity, sensitivity analyses confirmed the robustness of the primary findings. Histopathological findings further demonstrated preservation of pancreatic β-cell architecture, restoration of hepatic and renal tissue integrity, and broader organ-protective effects in AV-treated diabetic rodents. Conclusion: This meta-analysis provides robust evidence for AV's therapeutic potential in diabetic rodent models, demonstrating significant improvements in glycemic control, antioxidant status, and lipid metabolism. High heterogeneity suggests the need for standardized protocols in future research. These findings support the translational potential of AV for diabetes management, warranting well-designed clinical trials.