Withania somnifera (Indian ginseng) in diabetes mellitus: A systematic review and meta‐analysis of scientific evidence from experimental research to clinical application

Abstract

Withania somnifera Dunal, also known as Indian ginseng, has been in use since ancient times in the management of diabetes mellitus (DM). This systematic review and meta-analysis evaluated the efficacy/effectiveness, safety and tolerability of W. somnifera in managing DM. Literature search (published/unpublished) was performed from inception to April 2019 in guidelines recommended databases. A total of 6 in-vitro, 13 pre-clinical and 5 clinical studies were included for systematic evaluation. W. somnifera treatment in DM significantly restored the altered levels of blood glucose (experimental data; mean difference, −196.27; 95% confidence interval [−220.96, −171.58]; p < .00001) glycosylated haemoglobin (HbA1c), insulin, lipid profile, serum and oxidative stress markers with no safety concerns. The results suggest the potential role of W. somnifera in managing DM. However, the available clinical data are not considerably enough to provide novel and sufficiently robust evidence for the use of W. somnifera in managing DM. To further strength the antidiabetic profile of W. somnifera, well-designed randomized-controlled trial(s) with alarger sample size and longer duration is warranted with evaluation of its effect primarily on blood glucose, HbA1c and insulin. Future research also needs to elucidate the molecular mechanism(s) of W. somnifera including its active principles in DM. K E Y W O R D Sdiabetes mellitus, Indian ginseng, meta-analysis, oxidative stress, systematic review

Evolution of the adaptogenic concept from traditional use to medical systems: Pharmacology of stress‐ and aging‐related diseases

“…Several systematic reviews and assessment reports have been conducted on the clinical efficacy and safety of ginseng, 2,372–374 Eleutherococcus , 375 Rhodiola , 376–382 Withania , 383–388 and other adaptogens on several indications such as cognitive function, 33,72 cardiovascular diseases, 389 chronic pulmonary disease, 390 prevention of common cold, 391 and erectile dysfunction 392 . The clinical evidence of the benefits of W. somnifera in male infertility is also promising but very limited to provide sufficiently robust evidence because of the small number of eligible studies and available data 393 .…”

“…The results suggest the potential role of W. somnifera in managing diabetes mellitus, but evidence is not robust because of insufficient available clinical data. Furthermore, well‐designed randomized controlled trials (RCTs) with a larger sample size and longer duration are warranted to evaluate its effect primarily on blood glucose, HbA1c, and insulin 386 . In five studies conducted in patients with anxiety and stress, significant (in most cases) improvements were observed with Withania intervention as compared with placebo, but cases of potential bias were identified 383 .…”

Withania somnifera (L.) Dunal: Opportunity for Clinical Repurposing in COVID-19 Management

“…WS, being a Rasayana botanical, shows immune homeostasis through cytokine modulation (Rasool and Varalakshmi, 2006), anti-inflammatory (Ritchie and Singanayagam, 2020), and organprotective effects. There is well-explored scientific evidence of clinical benefits of WS in diabetes (Durg et al, 2020), hypertension (Shalini Kushwaha et al, 2012c, and cancer (Biswal et al, 2013). Therefore, the Rasayana effect of WS may be beneficial in the multifactorial pathophysiology of COVID-19.…”

Sarcopenia: Etiology, Nutritional Approaches, and miRNAs

“…Withania somnifera (Ashawagandha), also called "Indian ginseng", is an herb highly valued and used for centuries by Ayurvedic medicine, mainly for its adaptogenic and antistress activity, which is considered a proven Rasavātam [119] Due to its safety and effectiveness in improving quality of life and physical performance while decreasing fatigability [120], Ashwagandha is one of the most studied herbal products with potential antimicrobial, anti-inflammatory, antitumor, antistress, neuroprotective, cardioprotective, antioxidant, and antidiabetic properties [121][122][123].…”

Effects of Ashwagandha (Withania somnifera) on Physical Performance: Systematic Review and Bayesian Meta-Analysis

“…Although it has been used therapeutically for a number of reasons, Ashwagandha supplementation lacks sufficient information to be considered effective for all proposed conditions [ 4 ]. However, several recent systematic reviews and meta-analyses have shown its potential and safety for controlling anxiety [ 12 ], fighting male infertility [ 13 ], improving the function of the reproductive system [ 14 ], serving as an adjuvant to the treatment of diabetes [ 15 ] and avoiding the deterioration of cognitive function [ 16 ]. However, it seems that some of the secondary metabolites of Ashwagandha could have some potential at the level of physical performance improvement, being responsible for various effects at the metabolic and physiological level through the regulation of certain anti-inflammatory and anti-oxidative pathways [ 4 , 17 ].…”