Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials

Abstract

Propose This study aims to systematically review the randomized controlled trials that address the effectiveness and safety of herbal medicine in patients with type 1 diabetes. Methods The Cochrane Library (latest issue); MEDLINE (until recent); EMBASE (until recent); AMED (Allied and Complementary Medicine Database) (until recent); and CINHAL (until recent) were searched electronically for the identification of trials until October 2019. Articles were initially screened based on title and abstract and then by full text by two independent authors. References of retrieved studies were hand-searched for further studies. Risk of bias was assessed according to the Cochrane handbook of systematic reviews of interventions. The results were summarized into GRADE (grading of recommendations, assessment, development and evaluation) tables. No meta-analysis was applicable as only one study was found for each intervention. Results Four RCTs were finally included in the systematic review with an overall moderate quality of conduct and low quality of reporting. The sample sizes were very small. The results of these RCTs show that cinnamon pills and Berberine/Silymarine compound capsules may decrease blood glucose indices from baseline, while fenugreek seeds and fig leaf decoction do not show any statistically significant effect. Conclusions The evidence is scarce and no recommendations can be made based on current evidence. Further trials with more rigorous methodology and stronger quality of reporting are needed to make conclusions.

Momordica balsamina: phytochemistry and pharmacological potential of a gifted species

“…Despite that, there is an ongoing effort to find out more effective and affordable antidiabetic drugs, with less side effects (American Diabetes Association 2020 ; Knura et al 2021 ). Taking advantage of the ethnopharmacological uses, plants have been selected for bioassay-guided isolation and identification of new lead antidiabetic compounds (Barzkar et al 2020 ; Gaonkar and Hullatti 2020 ; Fu et al 2021 ; Wasana et al 2021 ; Lee et al 2021 ; Ignat et al 2021 ; Abu-Odeh and Talib 2021 ). Thus, metformin, the drug mostly prescribed on the treatment of type-2 diabetes, is a synthetic derivative of galegine, isolated from Galega officinalis L. (Fabaceae) (Cragg and Newman 2013 ; Bailey 2017 ).…”

Comprehensive Approach to Medical Nutrition Therapy in Patients with Type 2 Diabetes Mellitus: From Diet to Bioactive Compounds

“…Berberine, an alkaloid component obtained from roots and rhizomes, has a variety of therapeutic applications for inflammation, infections, and diabetes [ 216 , 217 ]. Regarding the latter, it has been demonstrated that berberine increases insulin sensitivity and insulin expression, decreases blood insulin levels, stimulates beta cell regeneration, has antioxidant enzyme activity, and reduces lipid peroxidation [ 216 , 217 , 218 ]. A recent systematic review (18 RCTs) evidenced that berberine decreased HOMA-IR and fasting plasma glucose, and improved lipid profile [ 217 ].…”