The efficacy and safety of <em>Ginkgo biloba</em> extract as an adjuvant in type 2 diabetes mellitus patients ineffectively managed with metformin: a double-blind, randomized, placebo-controlled trial

Abstract

Background and aimType 2 diabetes mellitus (T2DM) is one of the major diseases confronting the health care systems. In diabetes mellitus (DM), combined use of oral hypoglycemic medications has been shown to be more effective than metformin (Met) alone in glycemic control. This study determined the effects of Ginkgo biloba (GKB) extract as an adjuvant to Met in patients with uncontrolled T2DM.Subjects and methodsSixty T2DM patients were recruited in a randomized, placebo-controlled, double-blinded, and multicenter trial. The patients, currently using Met, were randomly grouped into those treated with either GKB extract (120 mg/day) or placebo (starch, 120 mg/day) for 90 days. Blood glycated hemoglobin (HbA1c), fasting serum glucose, serum insulin, body mass index (BMI), waist circumference (WC), insulin resistance, and visceral adiposity index (VAI) were determined before (baseline) and after 90 days of GKB extract treatment.ResultsGKB extract significantly decreased blood HbA1c (7.7%±1.2% vs baseline 8.6%±1.6%, P<0.001), fasting serum glucose (154.7±36.1 mg/dL vs baseline 194.4±66.1 mg/dL, P<0.001) and insulin (13.4±7.8 μU/mL vs baseline 18.5±8.9 μU/mL, P=0.006) levels, BMI (31.6±5.1 kg/m2 vs baseline 34.0±6.0 kg/m2, P<0.001), waist WC (102.6±10.5 cm vs baseline 106.0±10.9 cm, P<0.001), and VAI (158.9±67.2 vs baseline 192.0±86.2, P=0.007). GKB extract did not negatively impact the liver, kidney, or hematopoietic functions.ConclusionGKB extract as an adjuvant was effective in improving Met treatment outcomes in T2DM patients. Thus, it is suggested that GKB extract is an effective dietary supplement for the control of DM in humans.

Herbal Medicine for Cardiovascular Diseases: Efficacy, Mechanisms, and Safety

“…Combination of EGb 761 also had increased therapeutic effect in patients with uncontrolled diabetes. Indeed, a randomized controlled trial showed that the combination of EGb 761 with metformin is more effective than metformin alone in improving the outcomes of patients with uncontrolled T2DM (Aziz et al, 2018).…”

Effect of Ginkgo biloba on lipid profile in hypertensive patients on Valsartan monotherapy

“…19 Ginkgo biloba extract (GBE) is widely used as a dietary supplement for the treatment of cardiovascular disorders particularly ischemic cardiac syndrome 20 . The mixture of biologically active ingredients present in GBE has a number of physiological effects, including antioxidant 21 , vasodilation 22 and inhibition of platelet aggregation 23 . In addition to these actions, GBE reduces the formation and size of atherosclerotic plaques in high-risk cardiovascular patients, minimizes lipid peroxidation, and decreases the level of lipoprotein (a) 24 .…”

Effects of Ginkgo biloba intake on cardiometabolic parameters in patients with type 2 diabetes mellitus: A systematic review and meta‐analysis of clinical trials

“…At the next step, 27 full-text articles assessed for eligibility and 7 of them were finally included in the present meta-analysis. Four of them were conducted in China (Jie & Hai, 2005;Li et al, 2009;Shi et al, 2019;Zhao et al, 2016), one in the United States (Kudolo, 2001), one in Iraq (Aziz et al, 2018) and one other in Lithuania (Lasaite et al, 2014). All of the papers were parallel design and total of them performed on T2DM subjects.…”

“…In addition to it is efficacy in the prevention of cardiovascular complications of diabetes by reducing platelet hyperactivity in patients with T2DM (Kudolo, Delaney, & Blodgett, 2005;Kudolo, Dorsey, & Blodgett, 2002;Lim et al, 2011), these findings trigger the investigations of GKB supplementation for T2DM patients (Aziz et al, 2018;Jie & Hai, 2005;Kudolo, 2001;Lasaite, Spadiene, Savickiene, Skesters, & Silova, 2014;Li, Zheng, Lou, Lu, & Ye, 2009;Shi et al, 2019;Zhao, Yu, Liu, & An, 2016). In a trial conducted on diabetic patients with uncontrolled glycemic status, GKB intake at a dosage of 120 mg/day for 3 months significantly reduced fasting blood sugar (FBS) and HbA1c levels (Aziz et al, 2018), and in another trial a significant decrease in total cholesterol, triglycerides, LDL-cholesterol levels was achieved after 1 month supplementation with 20 mg/day GKB in T2DM patients (Jie & Hai, 2005). However, in another study taking 72 mg/day GKB for 36 months did not affect lipidemic and glycemic parameters in diabetic patients (Zhao et al, 2016).…”