Abstract
IntroductionPrevention of the rapid growth in incidence of type 2 diabetes (T2DM) is a big challenge for clinicians. In China, many trials have indicated that Tianqi capsule, which contains several Chinese herbal medicines as part of a large healing system called traditional Chinese medicine, could decrease the incidence of T2DM. The review assessed the effectiveness of Tianqi capsule in prevention of T2DM.MethodsSeven electronic databases were searched to identify eligible trials published from the inception of the databases up until May 1, 2017. Randomized controlled trials (RCTs) of Tianqi capsule for impaired glucose tolerance (IGT) were included. Data extraction and quality assessment were performed according to the Cochrane review standards. A random or a fixed effect model was used to analyze outcomes which were expressed as risk ratios (RRs) or mean differences (MD), and I 2 statistics were used to assess heterogeneity.ResultsSix trials were identified that included 1027 subjects. Meta-analysis showed that subjects who received Tianqi capsule plus lifestyle modification (LM) were less likely to progress to T2DM compared to controls (RR 0.55, 95% CI 0.44–0.68). Subjects who received Tianqi capsule plus LM were more likely to have glucose return to normal compared to controls (RR 0.69; 95% CI 0.62–0.78); and they had reduced fasting plasma glucose (FBG) (MD − 0.35; 95% CI − 0.55 to − 0.16) and 2-h plasma glucose (2 h PG) (MD − 1.04; 95% CI − 1.75 to − 0.32). There was no statistical difference between the two groups for IGT stabilized incidence (RR 0.89; 95% CI 0.71–1.12). No obvious adverse events occurred.ConclusionIn patients with IGT, Tianqi capsule reduced the risk of progression to T2DM and increased the possibility of regression toward normoglycemia. As a result of the limited number of RCTs and the methodological drawbacks of the included studies, the results should be interpreted with caution.
Highlights
Prevention of the rapid growth in incidence of type 2 diabetes (T2DM) is a big challenge for clinicians
Meta-analysis showed that subjects who received Tianqi capsule plus lifestyle modification (LM) were less likely to progress to T2DM compared to controls (RR 0.55, 95% confidence intervals (CIs) 0.44–0.68)
Subjects who received Tianqi capsule plus LM were more likely to have glucose return to normal compared to controls (RR 0.69; 95% CI 0.62–0.78); and they had reduced fasting plasma glucose (FBG) (MD - 0.35; 95% CI - 0.55 to - 0.16) and 2-h plasma glucose (2 h PG) (MD - 1.04; 95% CI - 1.75 to - 0.32)
Summary
Prevention of the rapid growth in incidence of type 2 diabetes (T2DM) is a big challenge for clinicians. In China, many trials have indicated that Tianqi capsule, which contains several Chinese herbal medicines as part of a large healing system called traditional Chinese medicine, could decrease the incidence of T2DM. Current guidelines recommend that IGT patients undergo lifestyle modifications, which have been shown to be effective for reducing the incidence of T2DM [6,7,8]. Metformin is commonly used to treat prediabetes and acarbose use is restricted to specific countries, but neither is formally approved for this indication, while other oral anti-diabetic drugs and anti-obesity drugs are not currently recommended for diabetes prevention, randomized controlled trials (RCTs) have shown effectiveness [9, 10]. Tianqi capsule is reported to decrease hemoglobin A1c and blood glucose [11,12,13,14]. We performed a systematic review and meta-analysis to assess the efficacy and safety of Tianqi capsule in preventing T2DM
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