Berberine 1g/day (500mg BID)
Umbrella meta-analysis: berberine significantly reduces fasting blood glucose, HbA1c, HOMA-IR, fasting insulin, IL-6, TNF-α, and CRP, with meaningful effect sizes across all markers. In a prediabetes-specific RCT, 12 weeks of berberine brought fasting plasma glucose from the pre-range back below threshold. Mechanism: AMPK activation and KCNH6 potassium channel modulation driving glucose-dependent insulin secretion.