Abstract
Objective: This study aims to explore the adjuvant effect of multi-strain probiotics with either saffron, cardamom, ginger, or cinnamon herbs to achieve synergistic management for controlling type 2 diabetes (T2D).
 Methods: Eighty-eight adult male, Wistar rats were used. Eight rats were kept as healthy control. Eighty rats were used to induce type 2 diabetic rats (T2DR) and were randomly assigned to ten groups. One group was an offer to 0.2 ml multi-strain probiotics orally. The rest of T2DR were gavage with 100 mg/kg aqueous extract of saffron, cardamom, ginger, or cinnamon without or with 0.2 ml multi-strain probiotics orally. Bodyweight gain (BWG), and feed efficiency ratio (FER) were recorded. Determination of oral glucose tolerance test (OGTT), serum insulin, C-peptide, HDL, LDL, HDL/total cholesterol ratio were performed. Serum antioxidant activity, Th1and Th2 cytokines and histopathology of the pancreas were done.
 Results: Comparable with T2DR, solely multi-strain probiotics or with herbs caused a significant reduction in BWG (P<0.05). Groups fed saffron, cardamom, and ginger and enriched with multi-strain probiotic showed significant improvement in OGTT, serum insulin, C-peptide and lipid abnormalities (P<0.05) compared to T2DR. Besides, they had antioxidant and anti-inflammatory effects. The group received ginger alone exerted anti-hyperglycemia and anti-inflammatory effects. However, cinnamon had a moderate anti-diabetic effect and solely probiotics did not show a significant benefit for all parameters except BWG.
 Conclusion: Cardamom, saffron, and ginger enriched with multi-strain probiotics achieve a synergistic relationship for managing T2D. This finding exhibits a possible new hypothesis to manage diabetes that needs further study.
Highlights
Obesity and diabetes mellitus (DM) are the most common metabolic disorders lead to morbidity and mortality
The differences in the bodyweight of rats treated with saffron, cardamom, and cinnamon aqueous extracts were not significant comparable to type 2 diabetic rats (T2DR); it was significant in group fed ginger
Depending upon the overall results obtained in the current work, one can notice that herbs are not enough to control complications associated with type 2 diabetes
Summary
Obesity and diabetes mellitus (DM) are the most common metabolic disorders lead to morbidity and mortality. It becomes rapidly increased in Eastern societies as in the Kingdom of Saudi Arabia (KSA), due to the modern diet lifestyle [1]. KSA among the top ten countries worldwide with a high prevalence of diabetes [2, 3]. Medical drug remains a controversial issue [7, 8]. These have taken challenged to use alternative therapy for DM based on nutraceuticals and functional foods [9]
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