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Efficacy and Safety of Nutrient Supplements for Glycemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis
Fong, C.; Alesi, S.; Mousa, A.; Moran, L.J.; Deed, G.; Grant, S.; Tapia, K.; Ee, C. Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients2022, 14, 2295.
Fong, C.; Alesi, S.; Mousa, A.; Moran, L.J.; Deed, G.; Grant, S.; Tapia, K.; Ee, C. Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients 2022, 14, 2295.
Fong, C.; Alesi, S.; Mousa, A.; Moran, L.J.; Deed, G.; Grant, S.; Tapia, K.; Ee, C. Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients2022, 14, 2295.
Fong, C.; Alesi, S.; Mousa, A.; Moran, L.J.; Deed, G.; Grant, S.; Tapia, K.; Ee, C. Efficacy and Safety of Nutrient Supplements for Glycaemic Control and Insulin Resistance in Type 2 Diabetes: An Umbrella Review and Hierarchical Evidence Synthesis. Nutrients 2022, 14, 2295.
Abstract
Background: Nutrient supplements are widely used for type 2 diabetes (T2D) yet evidence-based guidance for clinicians is lacking. Methods: We searched the four electronic databases from November 2015–December 2021. The most recent, most comprehensive, high-ranked systematic reviews, meta-analyses and/or umbrella reviews of randomised controlled trials in adults with T2D were included. Data were extracted on study characteristics, aggregate outcome measures per group (glycemic control, measures of insulin sensitivity and secretion), adverse events, and GRADE assessments. Quality was assessed using AMSTAR-2. Results: Twelve meta-analyses and one umbrella review were included. There was very low certainty evidence that chromium, Vitamin C and omega-3 polyunsaturated fatty acids (-3 PUFAs) were superior to placebo for the primary outcome of HbA1c (MD -0.54%, -0.54% and ES -0.27 respectively). Probiotics were superior to placebo for HbA1c (WMD -0.43%). There was very low certainty evidence that Vitamin D was superior to placebo for lowering HbA1c in trials of <6 months (MD -0.17%). Magnesium, zinc, Vitamin C, probiotics and polyphenols were superior to placebo for FBG. Vitamin D was superior to placebo for insulin resistance. Data on safety was limited. Conclusions: Future research should identify who may benefit from nutrient supplementation, safety, and optimal regimens and formulations.
Keywords
type 2 diabetes; glycemic control; insulin resistance; nutrients; umbrella review
Subject
MEDICINE & PHARMACOLOGY, Nutrition
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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