Phytomedicine Plus (Nov 2023)
Effect of Coccinia grandis (Linn.) Voigt extract on glucose metabolism markers in a prediabetic population: A double-blind randomised clinical trial
Abstract
Background: There is increasing interest in the use of herbal medicines to prevent and manage the symptoms of type 2 diabetes mellitus (T2DM). Coccinia grandis has been traditionally used for blood glucose regulation and has shown promise in clinical trials for T2DM although it has not yet been assessed as an anti-glycaemic agent in a prediabetic population. Objective: This study aimed to assess the safety as well as the efficacy of a C. grandis extract in reducing blood glucose levels in a non-medicated prediabetic cohort over 12 weeks. Methods: The study was a single-site, double-blind, placebo-controlled randomised clinical trial conducted in 48 medically diagnosed prediabetic adults aged 27 to 73 years. Participants received either 1000 mg of a dried C. grandis hydroalcoholic extract per day (equivalent to 15 g/day of dried herb) or placebo (control) for 12 weeks. The primary outcome measure was group change scores in fasting blood glucose (FBG) levels measured at baseline, week 6 and week 12. Secondary outcome measures were 2 h post-prandial blood glucose (PPBG), fasting and 2 h post-prandial insulin (FI and PPI), glycated haemoglobin (HbA1c), c-peptide, full blood count (FBC), lipids (triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), emotional states of depression, anxiety and stress (DASS-21), adverse reactions and tolerability. Results: At 12 weeks there was a significant difference between the C. grandis and control groups in the change between their pre and post treatment measurements of FBG (p = 0.019, CI -1.272 to -0.105), 2 h PPBG (p = 0.039, CI 0.212 to 1.392) and TG (p= 0.046). Additionally, although non-significant, the difference between the change in PPI levels (p = 0.061) is worthy of further exploration to provide an understanding of the mechanisms of action of C. grandis extract in managing glucose dysregulation. There were no changes in HbA1c, lipids or biochemical markers in either group after treatment. The C. grandis extract was well tolerated and no adverse events were reported over the 12 weeks. Conclusion: C. grandis may be a suitable candidate for managing blood glucose dysregulation in those with prediabetes and further studies are warranted.
