Benefits of herbal products in management of type 2 diabetes

This post explores a recent study on the benefits of herbal products in management of type 2 diabetes (from Medscape Apple Cider Vinegar, Fenugreek Best Herbal Remedies for T2D – Medscape – August 25, 2023.)

In a recent systematic review, Apple cider vinegar and fenugreek seeds are the most effective at reducing fasting blood glucose and A1c levels compared with four other popular herbal remedies for type 2 diabetes.

The review included 44 randomized clinical trials with more than 3000 participants using six herbal remedies: apple cider vinegar, cinnamon, curcumin, fenugreek seeds, ginger, and saffron.

Apple cider vinegar, fenugreek seeds, curcumin (turmeric), and cinnamon resulted in statistically significant reductions in fasting blood glucose compared with the control groups in the clinical trials. Out of all the remedies, the authors found apple cider vinegar to be the most effective for lowering fasting blood glucose levels.

The review also found that apple cider vinegar and fenugreek seeds had a statistically significant effect on reducing A1c compared with the control groups. The authors found the herbal remedies made no difference to insulin level or homeostatic model assessment for insulin resistance (HOMA-IR).

The results are published online in Diabetes & Metabolic Syndrome: Clinical Research & Reviews. The authors said they hoped the review would help medical professionals and people with type 2 diabetes understand the effectiveness of different herbal remedies and consider incorporating these remedies into standard care.

The authors wanted to understand how the herbal remedies worked by including insulin level and HOMA-IR as measurable outcomes but found nothing conclusive. Instead, they speculated that the effect of apple cider vinegar and fenugreek seeds on blood glucose and A1c could be related to delayed gastric emptying, among other mechanisms.

Apple cider vinegar had three clinical trials to back the finding, and fenugreek seeds had four studies supporting the results — fewer than the other included remedies. The authors also identified risks of bias from the randomization process and the allocation concealment process in several of the included trials.

Most of the studies included only short follow-up periods, meaning that the long-term effects of using these herbal remedies to help manage type 2 diabetes remain unclear.

The six herbal remedies included in the study were chosen out of dozens of popular complementary medicines for the strength and number of clinical trials backing their use.

A recent review of herbal remedies for glycemic control in type 2 diabetes, said he was surprised that apple cider vinegar came out on top in this analysis.

This review by Merlin Wilcox et al. concluded that aloe vera leaf gel, psyllium fiber, and fenugreek seeds appeared to be the most effective at reducing A1c compared with the control groups of the included trials, out of 18 plant-based remedies.