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Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials

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Abstract

Propose

This study aims to systematically review the randomized controlled trials that address the effectiveness and safety of herbal medicine in patients with type 1 diabetes.

Methods

The Cochrane Library (latest issue); MEDLINE (until recent); EMBASE (until recent); AMED (Allied and Complementary Medicine Database) (until recent); and CINHAL (until recent) were searched electronically for the identification of trials until October 2019. Articles were initially screened based on title and abstract and then by full text by two independent authors. References of retrieved studies were hand-searched for further studies. Risk of bias was assessed according to the Cochrane handbook of systematic reviews of interventions. The results were summarized into GRADE (grading of recommendations, assessment, development and evaluation) tables. No meta-analysis was applicable as only one study was found for each intervention.

Results

Four RCTs were finally included in the systematic review with an overall moderate quality of conduct and low quality of reporting. The sample sizes were very small. The results of these RCTs show that cinnamon pills and Berberine/Silymarine compound capsules may decrease blood glucose indices from baseline, while fenugreek seeds and fig leaf decoction do not show any statistically significant effect.

Conclusions

The evidence is scarce and no recommendations can be made based on current evidence. Further trials with more rigorous methodology and stronger quality of reporting are needed to make conclusions.

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Data availability

All data generated or analyzed during this study are included in this published article.

Abbreviations

MEDLINE:

Medical Literature Analysis and Retrieval System Online,

AMED:

Allied and Complementary Medicine Database,

Embase:

Excerpta Medica Database,

CONSORT:

Consolidated Standards of Reporting Trials,

CINAHL:

Cumulative Index of Nursing and Allied Health Literature,

BMI:

Body Mass Index,

DM:

Diabetes Mellitus.

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Acknowledgements

Authors would like to thank clinical librarians to retrieve information from literature.

Funding

This work was supported by the Iran University of Medical Sciences (IUMS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Author information

Authors and Affiliations

  1. Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran, Iran

    Farzaneh Barzkar, Hamid Reza Baradaran & Mohammad Ebrahim Khamseh

  2. School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Roya Vesal Azad

  3. Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran

    Jalil Koohpayehzadeh

  4. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    Yousef Moradi

Authors
  1. Farzaneh Barzkar
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  2. Hamid Reza Baradaran
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  4. Roya Vesal Azad
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Contributions

HRB, MEK and JK Conceived and designed this study. FB, YM and RVA searched and retrieved all information. FB, YM and HRB conducted the risk of bias assessment and evaluation of study results. All authors contributed to writing the manuscript. All the authors read and approved the final manuscript.

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Correspondence to Hamid Reza Baradaran.

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Barzkar, F., Baradaran, H.R., Khamseh, M.E. et al. Medicinal plants in the adjunctive treatment of patients with type-1 diabetes: a systematic review of randomized clinical trials. J Diabetes Metab Disord 19, 1917–1929 (2020). https://doi.org/10.1007/s40200-020-00633-x

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