Abstract
Type 2 diabetes mellitus is a chronic hyperglycemic condition due to progressively impaired glucose regulation. Momordica charantia L. could potentially improve hyperglycemia because its fruit extracts can alleviate insulin resistance, beta-cell dysfunction, and increase serum insulin level. We evaluated the effect of M. charantia L. in comparison with a vehicle on glycemic control in animal models of type 2 diabetes mellitus. MEDLINE, Web of Science, Scopus, and CINAHL databases were searched without language restriction through April 2019. About 66 studies involving 1861 animals that examined the effect of M. charantia L. on type 2 diabetes mellitus were included. Fruits and seed extracts reduced fasting plasma glucose (FPG) and glycosylated hemoglobin A1c in comparison to vehicle control: (42 studies, 815 animals; SMD, -6.86 [95% CI; -7.95, -5.77], 3 studies, 59 animals; SMD; -7.76 [95% CI; -12.50, -3.01]) respectively. Also, the extracts have hepato-renal protective effects at varying doses and duration of administration. Despite the observed significant glycemic control effect, poor methodological quality calls for future researches to focus on standardizing extract based on chemical markers and adopt measures to improve the quality of preclinical studies such as sample size calculation, randomization, and blinding.
Highlights
Type 2 diabetes mellitus (T2DM) is a chronic hyperglycemic condition in response to progressively impaired glucose regulation due to insulin resistance and beta-cell dysfunction [1,2]
101 People with T2DM use oral hypoglycemic agents (OHAs) for glycemic control and ameliorating diabetes complications, but the OHAs have in recent years been linked to intolerable side effects and increasing failure rate [8], leaving the majority of people with T2DM using medicinal plants as alternative therapy [9,10]
We described the impact of study design methodological features and publication bias on the efficacy of M. charantia L. and suggested areas of focus for future animal research which may reliably predict clinical efficacy
Summary
Type 2 diabetes mellitus (T2DM) is a chronic hyperglycemic condition in response to progressively impaired glucose regulation due to insulin resistance and beta-cell dysfunction [1,2]. The antidiabetic activity of M. charantia L. has been investigated in several animal models of type 2 diabetes mellitus [13,14] Majority of these studies used chemically induced T2DM in various animal species and assessed improvement of features of T2DM such as hyperglycemia, insulin resistance, beta-cell dysfunction, serum insulin level, beta- cell mass, dyslipidemia [15–18]. These features are crucial in the clinical evaluation of the efficacy of antidiabetic activity of herbal products as reported in previous systematic reviews and meta-analysis based on randomized clinical trials [19,20]. To potentially increase the certainty of evidence, we evaluated the effect of M. charantia L. in comparison with vehicle on glycemic control in animal models of type 2 diabetes mellitus
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