Therapeutic potential of okra (Abelmoschus esculentus) in dysglycaemia and metabolic dysfunction: A systematic review and meta-analysis across the diabetes spectrum.

The aim of this systematic review and meta-analysis was to evaluate comprehensively the therapeutic potential of Abelmoschus esculentus (okra) supplementation across the diabetes spectrum of key metabolic risk factors. A search was conducted in PubMed, Scopus, Web of Science, EMBASE and the Cochrane Library, up to 23 July 2025, to identify randomized controlled trials evaluating the effects of okra supplementation on metabolic risk factors in diabetes. Fourteen randomized controlled trials published between 2020 and 2025, including a total of 836 participants, were analysed. Okra supplementation led to significant reductions in 2 h postprandial glucose [weighted mean difference (WMD) = -22.39 mg/dL, 95% confidence interval (CI): -41.39 to -3.38; P = 0.021], fasting blood sugar (WMD = -23.66 mg/dL, 95% CI: -34.20 to -13.12; P < 0.001), glycosylated haemoglobin (WMD = -0.30%, 95% CI: -0.59 to -0.02; P = 0.034), homeostatic model assessment for insulin resistance (WMD = -0.59 units, 95% CI: -1.01 to -0.18; P = 0.005), low-density lipoprotein cholesterol (WMD = -8.55 mg/dL, 95% CI: -14.42 to -2.68; P = 0.004) and total cholesterol (WMD = -12.58 mg/dL, 95% CI: -22.78 to -2.37; P = 0.016) levels. The certainty of evidence was very low for most outcomes, except for diastolic blood pressure and glycosylated haemoglobin, which were rated as low. Regarding methodological quality, six trials were rated as good, two as fair and six as poor. Okra supplementation might improve glycaemic control and lipid profiles, indicating its potential as a complementary approach in diabetes management. Despite limitations from small and heterogeneous trials, these findings support future research on optimal dosing, safety and personalized applications in metabolic disease management.