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World J Diabetes. Jun 15, 2026; 17(6): 118936
Published online Jun 15, 2026. doi: 10.4239/wjd.118936
Published online Jun 15, 2026. doi: 10.4239/wjd.118936
Gut microbiota: Unseen conductor of polyherbal efficacy in diabetic neuropathy
Si Chen, Yu-Xiang Liu, Zhi-Bo Zhao, Jun-Hu Li, Xiao-Shuang Zhou, Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People’s Hospital, Taiyuan 030012, Shanxi Province, China
Shu-Qin Tang, Department of Nephrology, Dazhou Central Hospital, Dadukou 635000, Sichuan Province, China
Xiao-Shuang Zhou, Medicinal Basic Research Innovation Center of Chronic Kidney Disease, Ministry of Education, Shanxi Medical University, Taiyuan 030012, Shanxi Province, China
Xiao-Shuang Zhou, College III of Clinical Medicine, Shanxi University of Traditional Chinese Medicine, Taiyuan 030024, Shanxi Province, China
Co-corresponding authors: Jun-Hu Li and Xiao-Shuang Zhou.
Author contributions: Zhou XS and Li JH designed the overall framework of the review, and they are co-corresponding authors; Chen S wrote the initial draft of the manuscript; Tang SQ and Li JH were responsible for literature research and data collation; Liu YX and Zhao ZB participated in the revision and polishing of the manuscript; all authors have read and approved the final manuscript.
AI contribution statement: We only used ChatGPT 4.0 to assist with English language polishing, grammar correction, and sentence optimization to improve academic expression and readability. All core scientific content, logic, and viewpoints were fully completed by the authors. We confirm that no AI tools such as ChatGPT, Grammarly, DeepL, or any other similar software were used in the preparation of the response to reviewers or the revision of the manuscript.
Supported by the National Natural Science Foundation of China, No. 82300846; and the Project of the Central Government Guiding Local Technological Development, No. YDZJSX2025B007.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Xiao-Shuang Zhou, MD, Doctor, Department of Nephrology, The Fifth Clinical Medical College of Shanxi Medical University, Shanxi Provincial People’s Hospital, No. 29 Shuangta Temple Street, Yingze District, Taiyuan 030012, Shanxi Province, China.
Received: January 15, 2026
Revised: March 17, 2026
Accepted: May 11, 2026
Published online: June 15, 2026
Processing time: 148 Days and 5.4 Hours
Revised: March 17, 2026
Accepted: May 11, 2026
Published online: June 15, 2026
Processing time: 148 Days and 5.4 Hours
Core Tip
Core Tip: This review proposes a gut-centric theoretical model to explain the broad therapeutic effects of a polyherbal extract (PHE) against diabetic neuropathy. We hypothesize that the PHE acts primarily by remodeling the gut microbiota. This single action restoring a healthy gut ecosystem can mechanistically account for the observed systemic reductions in inflammation, oxidative stress, and metabolic dysfunction. This perspective reframes traditional herbal medicine as a form of ecological intervention, highlighting the gut microbiome as a pivotal and unifying target for treating complex, multi-system diseases.