Abstract
(Poly)phenols have been reported to confer protective effects against type 2 diabetes but the precise association remains elusive. This meta-analysis aimed to assess the effects of (poly)phenol intake on well-established biomarkers in people with type 2 diabetes or at risk of developing diabetes. A systematic search was conducted using the following selection criteria: (1) human randomized controlled trials involving individuals with prediabetes and type 2 diabetes; (2) one or more of the following biomarkers: glucose, glycated haemoglobin (HbA1c), insulin, pro-insulin, homeostatic model assessment of insulin resistance (HOMA-IR), islet amyloid polypeptide (IAPP)/amylin, pro-IAPP/pro-amylin, glucagon, C-peptide; (3) chronic intervention with pure or enriched mixtures of (poly)phenols. From 488 references, 88 were assessed for eligibility; data were extracted from 27 studies and 20 were used for meta-analysis. The groups included in the meta-analysis were: (poly)phenol mixtures, isoflavones, flavanols, anthocyanins and resveratrol. Estimated intervention/control mean differences evidenced that, overall, the consumption of (poly)phenols contributed to reduced fasting glucose levels (-3.32mg/dL; 95% CI -5.86, -0.77; P = 0.011). Hb1Ac was only slightly reduced (-0.24%; 95% CI -0.43, -0.044; P = 0.016) whereas the levels of insulin and HOMA-IR were not altered. Subgroup comparative analyses indicated a stronger effect on blood glucose in individuals with diabetes (-5.86mg/dL, 95% CI -11.34, -0.39; P = 0.036) and this effect was even stronger in individuals taking anti-diabetic medication (-10.17mg/dL, 95% CI -16.59, -3.75; P = 0.002). Our results support that the consumption of (poly)phenols may contribute to lower glucose levels in individuals with type 2 diabetes or at risk of diabetes and that these compounds may also act in combination with anti-diabetic drugs.
Highlights
IntroductionType 2 diabetes mellitus (hereafter referred as diabetes) affects hundreds of millions of people worldwide, being projected that by 2040 the number of individuals with diabetes will reach 642 million [1]
Type 2 diabetes mellitus affects hundreds of millions of people worldwide, being projected that by 2040 the number of individuals with diabetes will reach 642 million [1]
All RCTs with duration between 4 weeks and 1 year were included for the meta-analysis of glucose (20 RCTs), insulin (16 RCTs) and homeostatic model assessment of insulin resistance (HOMA-IR) (12 RCTs)
Summary
Type 2 diabetes mellitus (hereafter referred as diabetes) affects hundreds of millions of people worldwide, being projected that by 2040 the number of individuals with diabetes will reach 642 million [1]. It is generally considered that diabetes results from the combination of genetic and environmental factors. Different loci have been put forward as risk factors for diabetes [2], lifestyle factors such as obesity, lack of physical exercise, calorie-rich diets, and smoking have been considered the greatest players in the disease [3]. These are potentially modifiable factors which can delay the disease onset and progression.
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