Supplementing antidiabetic drugs with micronutrients for glycemic control Original paper
This meta-analysis found that supplementing antidiabetic drugs with chromium, vitamin C, vitamin E, or coenzyme Q10 improved glycemic control in people with type 2 diabetes.
This Study Summary was published on May 3, 2022.
Background
Glycemic control is critical for preventing complications in people with type 2 diabetes (T2D).[1][2] Meta-analyses of randomized controlled trials suggest that supplementing with certain nutrients can improve some parameters of glycemic control in people with T2D.[3][4][5] However, the effect of add-on nutrient supplements (i.e., used alongside antidiabetic drugs) on glycemic control had yet to be investigated.
The study
This meta-analysis of 119 randomized controlled trials examined the effect of adding nutrient supplements to antidiabetic therapies (e.g., metformin, insulin) on glycemic control in people with T2D.
Nine nutrient supplements were analyzed:
- Vitamin D (29 studies; 400–6,000 IU/day)
- Omega-3 fatty acids (26 studies; 1–12 grams/day)
- Vitamin E (21 studies; 200–1,600 IU/day),
- Chromium (16 studies; 200–1,000 micrograms/day)
- Vitamin C (12 studies; 200–1,000 milligrams/day)
- Coenzyme Q10 (CoQ10; 11 studies; 150–200 milligrams/day)
- Zinc (5 studies; 30–240 milligrams/day)
- Alpha-lipoic acid (3 studies; 300–800 milligrams/day)
- Selenium (2 studies; 200 micrograms/day).
The outcomes assessed were HbA1c, fasting blood glucose, and HOMA-IR.
The results
Chromium improved HbA1c (−0.39%), fasting blood glucose (−16.30 mg/dL), and HOMA-IR (−2.48). The effect of chromium was greater in participants with an HbA1c ≥ 8%, and chromium picolinate was the most effective formulation.
Additionally, vitamin C improved HbA1c (−0.37%) and fasting blood glucose (−11.96 mg/dL); CoQ10 improved HbA1c (−0.23%) and fasting blood glucose (−8.84 mg/dL); vitamin E improved HbA1c (−0.23%) and HOMA-IR (−0.37); and omega-3 fatty acids improved HbA1c (−0.26%).
Note
There was moderate heterogeneity in the majority of the analyses, and the researchers were unable to identify the causes of heterogeneity in some of these, which reduces confidence in the findings.
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This Study Summary was published on May 3, 2022.
References
- ^I M Stratton, A I Adler, H A Neil, D R Matthews, S E Manley, C A Cull, D Hadden, R C Turner, R R HolmanAssociation of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational studyBMJ.(2000 Aug 12)
- ^Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group.Lancet.(1998-Sep-12)
- ^Fengyi Zhao, Da Pan, Niannian Wang, Hui Xia, Hong Zhang, Shaokang Wang, Guiju SunEffect of Chromium Supplementation on Blood Glucose and Lipid Levels in Patients with Type 2 Diabetes Mellitus: a Systematic Review and Meta-analysisBiol Trace Elem Res.(2022 Feb)
- ^Shi-Ying Zhang, Kai-Lin Yang, Liu-Ting Zeng, Xiao-He Wu, Hui-Yong HuangEffectiveness of Coenzyme Q10 Supplementation for Type 2 Diabetes Mellitus: A Systematic Review and Meta-AnalysisInt J Endocrinol.(2018 Sep 16)
- ^Ashor AW, Werner AD, Lara J, Willis ND, Mathers JC, Siervo MEffects of vitamin C supplementation on glycaemic control: a systematic review and meta-analysis of randomised controlled trialsEur J Clin Nutr.(2017 Dec)