The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.

<h4>Importance</h4>Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management.<h4>Obj...

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Main Authors: Esra' Shishtar, John L Sievenpiper, Vladimir Djedovic, Adrian I Cozma, Vanessa Ha, Viranda H Jayalath, David J A Jenkins, Sonia Blanco Meija, Russell J de Souza, Elena Jovanovski, Vladimir Vuksan
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2014-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0107391
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author Esra' Shishtar
John L Sievenpiper
Vladimir Djedovic
Adrian I Cozma
Vanessa Ha
Viranda H Jayalath
David J A Jenkins
Sonia Blanco Meija
Russell J de Souza
Elena Jovanovski
Vladimir Vuksan
author_facet Esra' Shishtar
John L Sievenpiper
Vladimir Djedovic
Adrian I Cozma
Vanessa Ha
Viranda H Jayalath
David J A Jenkins
Sonia Blanco Meija
Russell J de Souza
Elena Jovanovski
Vladimir Vuksan
author_sort Esra' Shishtar
collection DOAJ
description <h4>Importance</h4>Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management.<h4>Objective</h4>To elucidate the effect of ginseng on glycemic control in a systematic review and meta-analysis of randomized controlled trials in people with and without diabetes.<h4>Data sources</h4>MEDLINE, EMBASE, CINAHL and the Cochrane Library (through July 3, 2013).<h4>Study selection</h4>Randomized controlled trials ≥30 days assessing the glycemic effects of ginseng in people with and without diabetes.<h4>Data extraction</h4>Relevant data were extracted by 2 independent reviewers. Discrepancies were resolved by consensus. The Heyland Methodological Quality Score and the Cochrane risk of bias tool were used to assess study quality and risk of bias respectively.<h4>Data synthesis</h4>Sixteen trials were included, in which 16 fasting blood glucose (n = 770), 10 fasting plasma insulin (n = 349), 9 glycated hemoglobin (n = 264), and 7 homeostasis model assessment of insulin resistance (n = 305) comparisons were reported. Ginseng significantly reduced fasting blood glucose compared to control (MD =  -0.31 mmol/L [95% CI: -0.59 to -0.03], P = 0.03). Although there was no significant effect on fasting plasma insulin, glycated hemoglobin, or homeostasis model assessment of insulin resistance, a priori subgroup analyses did show significant reductions in glycated hemoglobin in parallel compared to crossover trials (MD = 0.22% [95%CI: 0.06 to 0.37], P = 0.01).<h4>Limitations</h4>Most trials were of short duration (67% trials<12wks), and included participants with a relatively good glycemic control (median HbA1c non-diabetes = 5.4% [2 trials]; median HbA1c diabetes = 7.1% [7 trials]).<h4>Conclusions</h4>Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. In order to address the uncertainty in our effect estimates and provide better assessments of ginseng's anti-diabetic efficacy, larger and longer randomized controlled trials using standardized ginseng preparations are warranted.<h4>Trial registration</h4>ClinicalTrials.gov NCT01841229.
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spelling doaj-art-ff8b19f9a1f840f3935fe0bd9d69da482025-08-20T03:56:08ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0199e10739110.1371/journal.pone.0107391The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.Esra' ShishtarJohn L SievenpiperVladimir DjedovicAdrian I CozmaVanessa HaViranda H JayalathDavid J A JenkinsSonia Blanco MeijaRussell J de SouzaElena JovanovskiVladimir Vuksan<h4>Importance</h4>Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management.<h4>Objective</h4>To elucidate the effect of ginseng on glycemic control in a systematic review and meta-analysis of randomized controlled trials in people with and without diabetes.<h4>Data sources</h4>MEDLINE, EMBASE, CINAHL and the Cochrane Library (through July 3, 2013).<h4>Study selection</h4>Randomized controlled trials ≥30 days assessing the glycemic effects of ginseng in people with and without diabetes.<h4>Data extraction</h4>Relevant data were extracted by 2 independent reviewers. Discrepancies were resolved by consensus. The Heyland Methodological Quality Score and the Cochrane risk of bias tool were used to assess study quality and risk of bias respectively.<h4>Data synthesis</h4>Sixteen trials were included, in which 16 fasting blood glucose (n = 770), 10 fasting plasma insulin (n = 349), 9 glycated hemoglobin (n = 264), and 7 homeostasis model assessment of insulin resistance (n = 305) comparisons were reported. Ginseng significantly reduced fasting blood glucose compared to control (MD =  -0.31 mmol/L [95% CI: -0.59 to -0.03], P = 0.03). Although there was no significant effect on fasting plasma insulin, glycated hemoglobin, or homeostasis model assessment of insulin resistance, a priori subgroup analyses did show significant reductions in glycated hemoglobin in parallel compared to crossover trials (MD = 0.22% [95%CI: 0.06 to 0.37], P = 0.01).<h4>Limitations</h4>Most trials were of short duration (67% trials<12wks), and included participants with a relatively good glycemic control (median HbA1c non-diabetes = 5.4% [2 trials]; median HbA1c diabetes = 7.1% [7 trials]).<h4>Conclusions</h4>Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. In order to address the uncertainty in our effect estimates and provide better assessments of ginseng's anti-diabetic efficacy, larger and longer randomized controlled trials using standardized ginseng preparations are warranted.<h4>Trial registration</h4>ClinicalTrials.gov NCT01841229.https://doi.org/10.1371/journal.pone.0107391
spellingShingle Esra' Shishtar
John L Sievenpiper
Vladimir Djedovic
Adrian I Cozma
Vanessa Ha
Viranda H Jayalath
David J A Jenkins
Sonia Blanco Meija
Russell J de Souza
Elena Jovanovski
Vladimir Vuksan
The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
PLoS ONE
title The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
title_full The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
title_fullStr The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
title_full_unstemmed The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
title_short The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
title_sort effect of ginseng the genus panax on glycemic control a systematic review and meta analysis of randomized controlled clinical trials
url https://doi.org/10.1371/journal.pone.0107391
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