Type 2 diabetes mellitus (T2DM) represents a chronic metabolic disorder characterized by disrupted carbohydrate and lipid balance, resulting in hyperglycemia. This study evaluated the impact of polysaccharides derived from Cynanchum auriculatum Royle ex Wight (CRP) on mitigating hyperglycemia and modulating intestinal microbiota in T2DM mice. Findings indicated that CRP is mainly linked by →6)α-D-Glcp-(1→ and CRP-H demonstrated greater efficacy than CRP-L in regulating hypoglycemic-related indicators such as serum high-density lipoprotein cholesterol (HDL-c) level. Additionally, CRP at varying doses enhanced the mRNA expression of insulin receptor substrate 1 (IRS-1), phosphatidylinositol 3-kinase (PI3K), protein kinase B (AKT-1), and glucose transporter 2 (GLUT-2). Following a 4-week CRP-H treatment, a significant reduction in the Firmicutes/Bacteroidetes ratio at the phylum level was observed, alongside a marked increase in the relative abundance of beneficial genera such as Limosillactobacillus and Prevotella. Overall, CRP-H displayed enhanced hypoglycemic properties by activating the IRS-1/PI3K/AKT-1/GLUT-2 pathway and enriching beneficial gut bacteria, including Prevotella and Limosillactobacillus. This study establishes a foundational framework for further development and application of Cynanchum auriculatum Royle ex Wight resources, emphasizing the hypoglycemic potential of CRP.
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