This chapter mainly focuses the current guidelines in management of hyperglycemia from ethnopharmacy perspective. The existence of type-2 diabetes is increasing in epidemic proportions in low- to middle-income countries. United Kingdom Prospective Diabetes Study (UKPDS) proved that strict glycemic control reduces both microvascular and macrovascular complications. DiabCare Asia study has carried out to find the mean HbA1c among 12 different Asian countries. The use of basal insulin/insulin analogs as the start-up insulin is recommended by the ADA/EASD consensus statement. Insulin resistance, dietary pattern, glucose metabolism and genetic variation depends on the racial and ethnicity. Hence ethnopharmacy perspective based guidelines should be used for the proper evaluation. Characteristics of type-2 diabetes vary from Asian populations to European populations. The higher insulin responses, increased insulin resistance and insulin sensitivity are some of the pathophysiology of diabetes which varies according to the ethnicity. Diabetes therapies also differ based on ethnic variations.