Department of Pharmacology, All India Institute of Medical Sciences, Deoghar, Jharkhand, India.
College of Nursing, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
Diabetes Metab Syndr. 2023 Aug;17(8):102826. doi: 10.1016/j.dsx.2023.102826. Epub 2023 Jul 7.
There are several herbal formulations for type 2 diabetes (T2D), but many of them have never been directly compared to establish the most effective methods. Therefore, the present systematic review and network meta-analysis aimed to compare and rank the effects of herbal formulations by combining direct and indirect evidence on the management of type 2 diabetes.
From five electronic databases, relevant studies on the effectiveness of herbal formulations for glycemic status for people with type 2 diabetes were retrieved. Only randomized controlled trials that were published in English and looked at how herbal formulations affected adults' (>18-year-old) glycemic levels were included. A systematic review and network meta-analysis design with the random-effects model was used.
A total of 44 trials included 3130 participants on six herbs were included in the final analysis. Apple cider vinegar (ACV) (standardized mean difference (SMD) = -28.99), cinnamon (-9.73), curcumin (-13.15), and fenugreek (-19.64) significantly reduced fasting blood glucose (FBG) compared with placebo (all p < 0.05). Notably, only ACV (SMD = -2.10) and fenugreek seeds (0.84) were found significantly effective in reducing HbA1C. ACV was most effective herb to reduce FBG comparison with other herbs.
Several herbs could be considered as a valuable adjuvant therapy regarding glycemic control of type 2 diabetes patients. Health professionals should be encouraged to incorporate these herbs for the management of type 2 diabetes as part of their standard care.
有几种用于 2 型糖尿病（T2D）的草药配方，但其中许多从未被直接比较过，以确定最有效的方法。因此，本系统评价和网络荟萃分析旨在结合直接和间接证据，比较和排列草药配方在管理 2 型糖尿病方面的效果。
从五个电子数据库中检索了关于草药配方对 2 型糖尿病患者血糖状况有效性的相关研究。仅纳入了以英语发表的、观察草药配方对成年人（>18 岁）血糖水平影响的随机对照试验。采用随机效应模型的系统评价和网络荟萃分析设计。
共有 44 项试验，涉及 6 种草药，共纳入 3130 名参与者，最终纳入了分析。与安慰剂相比，苹果醋（ACV）（标准化均数差（SMD）=-28.99）、肉桂（-9.73）、姜黄素（-13.15）和葫芦巴（-19.64）均显著降低空腹血糖（FBG）（均 P<0.05）。值得注意的是，只有 ACV（SMD=-2.10）和葫芦巴种子（0.84）在降低 HbA1C 方面被发现具有显著效果。与其他草药相比，ACV 是降低 FBG 最有效的草药。
几种草药可被视为 2 型糖尿病患者血糖控制的有价值的辅助治疗方法。应鼓励卫生专业人员将这些草药纳入 2 型糖尿病的管理中，作为其标准护理的一部分。
