Traditionally used for gastrointestinal symptoms, berberine has emerged as a potent cardiometabolic aid with diverse benefits and mechanisms of action. It has hypoglycemic effects, via both an inhibition of alpha-glucosidase activity and an upregulation of insulin receptors in peripheral tissues, thereby improving insulin sensitivity.Furthermore, it activates Nrf2, a key regulator of cellular antioxidant defense, and attenuates glucose induced neurotoxicity, suggesting a therapeutic potential for diabetic neuropathy.