Covolo Loredana, Capelli Michela, Ceretti Elisabetta, Feretti Donatella, Caimi Luigi, Gelatti Umberto
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, Brescia 25123, Italy.
BMC Public Health. 2013 Aug 26;13:777. doi: 10.1186/1471-2458-13-777.
Diabetes is one of the most widespread chronic disease. Although many medications are available for the treatment and prevention of diabetes, many people turn to nutritional supplements (NSs). In these years, the online sales have contributed to the growth of use of nutritional supplement. The aim of the research was to investigate the type of information provided by sales websites on NSs, and analyse the existence of scientific evidence about some of the most common ingredients found in available NSs for diabetes.
A web search was conducted in April 2012 to identify web sites selling NSs in the treatment of diabetes using Google, Yahoo and Bing! and the key word used was "diabetes nutritional supplements". Website content was evaluated for the quality of information available to consumers and for the presence of a complete list of ingredients in the first NS suggested by the site. Subsequently, in order to analyze the scientific evidence on the efficacy of these supplements a PubMed search was carried out on the ingredients that were shared in at least 3 nutritional supplements.
A total of 10 websites selling NSs were selected. Only half of the websites had a Food and Drug Administration disclaimer and 40% declared clearly that the NS offered was not a substitute for proper medication. A total of 10 NS ingredients were searched for on PubMed. Systematic reviews, meta-analyses or randomized control trials were present for all the ingredients except one. Most of the studies, however, were of poor quality and/or the results were conflicting.
Easy internet access to NSs lacking in adequate medical information and strong scientific evidence is a matter of public health concern, mainly considering that a misleading information could lead to an improper prevention both in healthy people and people suffering from diabetes. There is a clear need for more trials to assess the efficacy and safety of these NSs, better quality control of websites, more informed physicians and greater public awareness of these widely used products.
糖尿病是最普遍的慢性病之一。尽管有许多药物可用于治疗和预防糖尿病，但许多人还是选择营养补充剂。近年来，在线销售推动了营养补充剂使用的增长。本研究的目的是调查销售网站提供的有关营养补充剂的信息类型，并分析现有糖尿病营养补充剂中一些最常见成分的科学证据。
2012年4月进行了网络搜索，使用谷歌、雅虎和必应！来识别销售用于治疗糖尿病的营养补充剂的网站，使用的关键词是“糖尿病营养补充剂”。评估网站内容，看其向消费者提供的信息质量以及网站推荐的第一种营养补充剂中是否有完整的成分列表。随后，为了分析这些补充剂功效的科学证据，对至少在3种营养补充剂中都含有的成分在PubMed上进行了搜索。
共选择了10个销售营养补充剂的网站。只有一半的网站有食品药品监督管理局的免责声明，40%的网站明确声明所提供的营养补充剂不能替代正规药物。在PubMed上共搜索了10种营养补充剂成分。除一种成分外，所有成分都有系统评价、荟萃分析或随机对照试验。然而，大多数研究质量较差和/或结果相互矛盾。
容易通过互联网获取缺乏足够医学信息和有力科学证据的营养补充剂是一个公共卫生问题，主要是因为误导性信息可能导致健康人和糖尿病患者预防不当。显然需要更多试验来评估这些营养补充剂的功效和安全性，对网站进行更好的质量控制，让医生更了解情况，并提高公众对这些广泛使用产品的认识。
