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Combined effect of interventions with pure or enriched mixtures of (poly)phenols and anti-diabetic medication in type 2 diabetes management: a meta-analysis of randomized controlled human trials

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Abstract

Purpose

(Poly)phenols have been reported to confer protective effects against type 2 diabetes but the precise association remains elusive. This meta-analysis aimed to assess the effects of (poly)phenol intake on well-established biomarkers in people with type 2 diabetes or at risk of developing diabetes.

Methods

A systematic search was conducted using the following selection criteria: (1) human randomized controlled trials involving individuals with prediabetes and type 2 diabetes; (2) one or more of the following biomarkers: glucose, glycated haemoglobin (HbA1c), insulin, pro-insulin, homeostatic model assessment of insulin resistance (HOMA-IR), islet amyloid polypeptide (IAPP)/amylin, pro-IAPP/pro-amylin, glucagon, C-peptide; (3) chronic intervention with pure or enriched mixtures of (poly)phenols. From 488 references, 88 were assessed for eligibility; data were extracted from 27 studies and 20 were used for meta-analysis. The groups included in the meta-analysis were: (poly)phenol mixtures, isoflavones, flavanols, anthocyanins and resveratrol.

Results

Estimated intervention/control mean differences evidenced that, overall, the consumption of (poly)phenols contributed to reduced fasting glucose levels (− 3.32 mg/dL; 95% CI − 5.86, − 0.77; P = 0.011). Hb1Ac was only slightly reduced (− 0.24%; 95% CI − 0.43, − 0.044; P = 0.016) whereas the levels of insulin and HOMA-IR were not altered. Subgroup comparative analyses indicated a stronger effect on blood glucose in individuals with diabetes (− 5.86 mg/dL, 95% CI − 11.34, − 0.39; P = 0.036) and this effect was even stronger in individuals taking anti-diabetic medication (− 10.17 mg/dL, 95% CI − 16.59, − 3.75; P = 0.002).

Conclusions

Our results support that the consumption of (poly)phenols may contribute to lower glucose levels in individuals with type 2 diabetes or at risk of diabetes and that these compounds may also act in combination with anti-diabetic drugs.

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Notes

  1. The total number of studies is equal to 21 because one of the studies depicts results from 2 interventions (a (poly)phenol mixture and resveratrol).

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Acknowledgements

The present study was conducted within COST Action FA1403—POSITIVe. iNOVA4Health—UID/Multi/04462/2019, a program financially supported by Fundação para a Ciência e Tecnologia (FCT)/Ministério da Educação e Ciência, through national funds and co-funded by FEDER under the PT2020 Partnership Agreement is acknowledged. Funding from INTERFACE Programme, through the Innovation, Technology and Circular Economy Fund (FITEC), is gratefully acknowledged. UIDP/04748/2020, a program financially supported by FCT is also acknowledged. This study was also supported by FCT via PTDC/BIA-MOL31104/2017 and UID/Multi/04462/2019-SubProj iNOVA4Health 44 to RM, SFRH/PD/BD/135504/2018 to AFR, SFRH/BPD/110426/2015 to RR. Sociedade Portuguesa de Diabetologia for the Nuno Castelo-Branco Prize—2016 attributed to RM and RR is also acknowledged.

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Authors and Affiliations

  1. iBET, Instituto de Biologia Experimental e Tecnológica, Apartado 12, 2781-901, Oeiras, Portugal

    Ana F. Raimundo, Filipa Félix, Cláudia N. Santos & Regina Menezes

  2. CEDOC, Chronic Diseases Research Centre, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo dos Mártires da Pátria, 130, 1169-056, Lisbon, Portugal

    Ana F. Raimundo, João Gilsa-Lopes, Rogério Ribeiro, Cláudia N. Santos & Regina Menezes

  3. Instituto de Tecnologia Química e Biológica António Xavier, Universidade Nova de Lisboa, Av. da República, 2780-157, Oeiras, Portugal

    Ana F. Raimundo, Filipa Félix, Cláudia N. Santos, Paula Pinto & Regina Menezes

  4. APDP, Associação Protectora Dos Diabéticos de Portugal, Lisbon, Portugal

    Rita Andrade, Dulce do Ó, Ana Raimundo & Rogério Ribeiro

  5. Research Group On Quality, Safety and Bioactivity of Plant Foods, Department of Food Science and Technology, CEBAS-CSIC, Murcia, Spain

    María-Teresa García-Conesa & Antonio González-Sarrías

  6. iBiMed-UA, Aveiro, Portugal

    Rogério Ribeiro

  7. Department of Nutritional Sciences, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, UK

    Ana Rodriguez-Mateos & Brian Wang

  8. Department of Food and Nutritional Sciences, School of Chemistry, Food and Pharmacy, University of Reading, Reading, UK

    Manuel Schär

  9. Instituto Politécnico de Santarém, Escola Superior Agrária, S. Pedro, 2001-904, Santarém, Portugal

    Ana Silva, Inês Cruz & Paula Pinto

  10. Life Quality Research Centre, Avenida Dr. Mário Soares N.º 110, 2040-413, Rio Maior, Portugal

    Paula Pinto

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Raimundo, A.F., Félix, F., Andrade, R. et al. Combined effect of interventions with pure or enriched mixtures of (poly)phenols and anti-diabetic medication in type 2 diabetes management: a meta-analysis of randomized controlled human trials. Eur J Nutr 59, 1329–1343 (2020). https://doi.org/10.1007/s00394-020-02189-1

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