Type 2 diabetes: Apple cider vinegar most effective for reducing blood sugar of all herbal remedies

The review, published in Diabetes & Metabolic Syndrome: Clinical Research & Reviews, included 44 RCTs (randomized clinical trials) comprising more than 3000 participants using six herbal remedies: saffron, ginger, fenugreek seeds, curcumin, cinnamon, and apple cider vinegar.

The authors found apple cider vinegar to be the most effective for reducing fasting blood glucose levels.

Fenugreek seeds, ACV, curcumin (turmeric), and cinnamon resulted in statistically significant reductions in fasting blood glucose compared with the control groups in the clinical trials.

The authors found the herbal remedies made no difference to insulin level or HOMA-IR (homeostatic model assessment for insulin resistance).

Several herbal remedies used by patients with type 2 diabetes (T2D) have considerably increased insulin sensitivity. Such remedies help maintain a healthy glycemic status with no side effects. Clinical trial data and computerized methods indicate herbal medications to be one of the best remedies for type 2 diabetes.

Many herbal remedies have never been directly compared to establish the most effective methods. Therefore, Subodh Kumar, All India Institute of Medical Sciences (AIIMS), Deoghar, Jharkhand, India, and colleagues aimed to compare and rank the effects of herbal formulation by combining direct and indirect evidence on T2D management.

For this purpose, they retrieved relevant studies on the effectiveness of herbal formulations for glycemic status for patients with type 2 diabetes, from five electronic databases. The review included only randomized controlled trials that were published in English and looked at the effect of herbal formulations on the glycemic levels of adults (> 18 years). A systematic review and network meta-analysis design with the random-effects model was used.

The authors reported the following findings:

• The final analysis included a total of 44 trials including 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.
• Only ACV (SMD = −2.10) and fenugreek seeds (0.84) were significantly effective in reducing HbA1C.
• ACV was the most effective herb to reduce FBG compared with other herbs.

"Several herbs could be considered as a valuable adjuvant therapy regarding glycemic control of type 2 diabetes patients," the researchers wrote. "Health professionals should be encouraged to incorporate these herbs for diabetes management as part of their standard care."

Reference:

Kumar, S., Sharma, S. K., Mudgal, S. K., Gaur, R., Agarwal, R., Singh, H., & Kalra, S. (2023). Comparative effectiveness of six herbs in the management of glycemic status of type 2 diabetes mellitus patients: A systematic review and network meta-analysis of randomized controlled trials. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 17(8), 102826. https://doi.org/10.1016/j.dsx.2023.102826