As the world's third-largest island, Borneo is recognized as a biodiversity hotspot due to its abundant and varied plant and animal life. Sarawak, a Malaysian state located in the northwestern region of Borneo, stands out for both its ecological richness and cultural diversity. Spanning around 124,450 square kilometers, Sarawak hosts numerous indigenous groups, each possessing distinct cultural traditions, languages, and systems of traditional knowledge (Rajoo et al., 2022).

The tropical rainforests of Sarawak have been the primary source of sustenance, medicine, and cultural identity for its indigenous peoples for millennia. These forests, among the oldest in the world, harbor an estimated 15,000 species of flowering plants, 3,000 species of trees, 1,000 species of orchids, and 2,000 species of ferns (Sarawak Forest Department, 2020). This botanical wealth has given rise to a rich tradition of ethnomedicinal practices among the various indigenous communities of Sarawak.

The state is home to over 30 distinct ethnic groups, including the Iban, Bidayuh, Orang Ulu (encompassing smaller groups such as the Kayan, Kenyah, and Penan), Melanau, and others. Each of these communities has developed its own unique relationship with the surrounding forest ecosystem, resulting in a diverse array of traditional medicinal practices and ethnobotanical knowledge (Ting et al., 2016). These traditional healing systems have been passed down through generations, evolving and adapting to changing environmental and social conditions.

However, rapid modernization, deforestation, and urbanization in recent decades have posed significant challenges to the preservation of this traditional knowledge. The migration of younger generations to urban centers, coupled with the increasing availability of modern healthcare, has led to a gradual erosion of traditional medicinal practices in many communities (Foo et al., 2016). Paradoxically, this loss of traditional knowledge is occurring at a time when the global scientific community is increasingly recognizing the potential of ethnobotanical research in drug discovery and the management of chronic diseases.

Diabetes mellitus remains a pressing public health challenge in Malaysia (Institute for Public Health, 2020), including Sarawak. As of 2021, Malaysia ranked among the top five countries for the number of adults (20–79 years) with diabetes, with cases rising from 2 million in 2011 to 4.4 million in 2021 (IDF, 2021). This prevalence significantly surpasses the global average of 10.5% reported by the International Diabetes Federation 2021 (International Diabetes Federation IDF 2021), reflecting an urgent need for targeted interventions and prevention strategies.

The rising incidence of diabetes in Malaysia, including Sarawak, is attributed to various factors such as rapid urbanization, sedentary lifestyles, and dietary changes. However, the management and treatment of diabetes in these communities are complicated by several prevalent misconceptions. These include beliefs that diabetes is not a serious condition, that it only affects the elderly or the overweight, and that it can be cured rather than managed (Minhat & Hamedon, 2014). Such misconceptions can lead to delayed diagnosis, poor adherence to treatment regimens, and a reluctance to adopt lifestyle modifications necessary for effective diabetes management.

Furthermore, there is a significant gap in the literature regarding the use of traditional herbal medicines for diabetes management among Sarawak's indigenous communities. While several studies have documented the use of herbal remedies for various ailments in these communities (Ripen and Noweg, 2017, Kassim et al., 2016, Patrick et al., 2023, Mukti, 2024, Rajoo et al., 2022, Rajoo et al., 2024), comprehensive research on diabetes-specific traditional treatments is lacking. This gap is particularly noteworthy given the increasing global interest in ethnopharmacological approaches to diabetes management (Patel et al., 2012).

The intersection of rising diabetes prevalence, eroding traditional knowledge, and the potential of ethnobotanical research presents a unique opportunity for investigation. By documenting and analyzing the traditional herbal medicines used for diabetes management among Sarawak's indigenous communities, we can not only preserve valuable cultural knowledge but also potentially uncover novel therapeutic agents for diabetes treatment.

This study aims to bridge this knowledge gap by focusing on six indigenous communities in Sarawak: the Kenyah, Melanau, Kayan, Iban, Punan, and Baketan. Each of these communities has a distinct cultural background and traditional medicinal system, providing a diverse and rich source of ethnobotanical knowledge. By examining their traditional approaches to diabetes management, we can gain insights into potentially effective herbal treatments and contribute to the broader field of ethnopharmacology.

To document the traditional herbal medicines used for diabetes management among the Kenyah, Melanau, Kayan, Iban, Punan, and Baketan communities of Sarawak.

To identify the most commonly used plant species for diabetes treatment across these communities.

To compare the traditional diabetes management practices among these communities and identify how their cultural beliefs and practices shaped their respective ethnomedicinal systems.

By achieving these objectives, this study aims to ensure the protection of indigenous herbal medicinal knowledge, enhance our understanding of ethnobotanical approaches to diabetes management, and potentially inform future drug discovery efforts. Moreover, it seeks to provide valuable insights that could help in developing culturally appropriate diabetes education and management programs for indigenous communities in Sarawak and beyond.