Evaluating the role of bromelain in diabetes management: a systematic review of research evidence and mechanisms of action

Abstract Background The use of complementary and alternative medicine is becoming increasingly important in the prevention and management of complications related to diabetes. Methods A comprehensive literature search was conducted across major databases (EMBASE, Scopus, PubMed, Google Scholar, Web of Science, Cochrane Library) up to December 2024. The search focused on studies examining the effect of bromelain on glycemic control, lipid profiles, and related mediators in diabetes. Key findings Bromelain supplementation demonstrated positive effects on key metabolic markers. Bromelain may stimulate AMPK in muscle cells, enhancing glucose uptake and utilization, potentially lowering blood glucose levels, and benefiting individuals with diabetes. Although direct evidence of bromelain’s impact on incretin levels is limited, its ability to modulate gastrointestinal function and improve nutrient absorption could indirectly influence incretin secretion. Moreover, Peptides or smaller amino acids resulting from bromelain’s proteolytic activity enter the bloodstream and potentially enhance nutrient absorption, which plays an important role in evaluating the therapeutic potential of bromelain in diabetes management. Conclusion Bromelain supplementation is effective in improving glycemic and lipid indices in diabetes. However, further research is needed to clarify the underlying mechanisms, including bromelain’s potential interaction with the incretin system and its role in modulating insulin resistance through various pathways.