Boscisucrophage: A Natural <scp>SGLT1</scp> /2 Inhibitor From <i>Boscia senegalensis</i> for Managing Type 2 Diabetes

<i>Boscia senegalensis</i> (Pers.) Lam. Ex Poir. (Capparaceae) is an important local famine food plant in Africa and is widely exploited by healers in the Sahelian region for its seeds, which are used to reduce hyperglycemia. We studied the efficacy of the commercial dosage form of <i>Boscia senegalensis</i>, namely Boscisucrophage (BSP), in type 2 diabetes (T2DM) patients with resistance to oral antihyperglycemic drugs. The clinical benefits of BSP were in a prospective, single-center, open-label, single-arm interventional study involving 43 naïve patients and 289 diabetic patients resistant to oral antidiabetic drugs. All patients received capsules containing a fixed dose of 350 mg of BSP, taken three times daily for 12 weeks. Outcomes were monitored through venous blood glucose levels, glycosylated hemoglobin (HbA1c), urine glucose excretion (UGE), aspartate aminotransferase, alanine aminotransferase, creatinine levels, and clinical examination of functional symptoms. In the clinical study, BSP significantly reduced glycemia and HbA1c levels, increased urine glucose excretion (UGE), and alleviated the side effects and functional symptoms of T2DM. Our clinical findings provide preliminary evidence supporting the potential use of BSP to reduce glycemia and HbA1c in T2DM patients resistant to oral antihyperglycemic drugs, with no significant adverse effects observed in this study. These results highlight BSP's potential as a dual SGLT1/SGLT2 inhibitor, suggesting a novel mechanism of action. However, further validation through randomized controlled trials is necessary to confirm these findings. <b>Trial Registration:</b> National Ethics Committee (N°679/PR/PM/MSP/SE/SG/DHATC/SGH/SRH/13).