Diabetes mellitus (DM) is the name of a group of metabolic diseases that result from a disorder in the secretion, function, or both of insulin [1]. The type 2 diabetes mellitus (T2DM) epidemic, which is associated with an increasing burden of obesity, is projected to affect over 600 million people worldwide over the next two decades [2]. In 2017, the International Diabetes Federation estimated that 425 million people worldwide had DM, and the number is expected to rise to 629 million in 2045 [3]. Recent studies indicate that the prevalence of T2DM in Iran has increased substantially over the years, with current estimates ranging from 10.8 % to 14.2 % among adults, depending on the region and demographic factors [4].

Dietary interventions can help diabetic patients to improve blood glucose control, reduce the risk of complications, and improve overall health outcomes [5]. There is increasing interest in using herbal medicines as adjunctive therapy to treat T2DM [6]. Phytotherapy, the use of medicinal plants for treating diseases, has gained significant importance in modern medicine. It offers a viable alternative to conventional treatments, particularly in addressing the global health care challenges [7]. Herbal medicines have potential in treating DM, including improvements in blood glucose control, insulin sensitivity and secretion, reduction in diabetes-related complications, and fewer side effects compared to conventional pharmacological therapies [8]. Okra (Abelmoschus esculentus), a vegetable commonly consumed in many parts of the world. Okra has traditionally been used for medicinal purposes and recent studies suggest it may have potential antidiabetic and antihyperlipidemic effects [9]. This tropical and subtropical plant is found in the Middle East and Iran. The green peel of okra is used as a vegetable in traditional Asian medicine, with its healing properties attributed to the polysaccharides in its pods [10]. Okra is rich in bioactive compounds in its fruit, seeds, and leaves. The fruit has carotenoids, phenolic compounds, and flavonoids, which contribute to its antioxidant, anti-inflammatory, antidiabetic, and neuroprotective properties, which make it an effective means of treating various diseases [11]. Okra polysaccharides can enhance insulin secretion by restoring β-cell function in the pancreas. This is achieved through the upregulation of glucose transporter-4 (GLUT-4) and peroxisome proliferator-activated receptor-γ (PPAR-γ) expression, which improves glucose uptake in cells [12]. Some studies have confirmed the effect of okra on lowering blood sugar in diabetic mice. While these findings are promising, researchers emphasize the need for further studies, particularly in human subjects, to confirm okra's efficacy in managing T2DM [13], [14]. Some medicinal plants like Okra exhibit hypoglycemic effects, potentially interacting with diabetes treatments. Caution is advised, as individual responses vary, and unmonitored use may lead to unsafe blood sugar levels and complications [8]. The lack of standardization in dosage and preparation methods across studies makes it challenging to draw definitive conclusions. While animal studies show promising results, more clinical trials are needed to establish okra's efficacy in humans [15]. Therefore, it is important to investigate the impact of herbal medicines on glycemic control in diabetic patients [16].

Therefore, the present study is conducted with the aim of investigating the effect of okra fruit on glycemic control in patients with T2DM.