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6,45,68,92,106,107 The peripheral and central GLP-1 receptor activation that is presented below has so far been proven with animal evidence only (Figure 7)

Nemati M, Nemati S, Taheri AM, Heidari B

Clinical Recommendations If you have diabetes and are considering berberine: Never start berberine without discussing it with your GP or diabetes specialist nurse Increase blood glucose monitoring frequency if berberine is commenced Be vigilant for hypoglycaemia symptoms: sweating, tremor, hunger, confusion, or palpitations Your diabetes medication doses may require adjustment under clinical supervision Keep fast-acting glucose (e.g., glucose tablets, sugary drink) readily available and follow your local hypoglycaemia management plan NICE guidelines (NG28) for type 2 diabetes management do not include berberine as a recommended treatment option

P., & Kushnir, V