Andreea Zurbau1,2,3, Lea Smircic Duvnjak4,5, Sasa Magas4, Elena Jovanovski1,2, Jelena Miocic4, Alexandra L Jenkins2, David J A Jenkins1,2,6,7,8, Robert G Josse1,2,6,7,8, Lawrence A Leiter1,2,6,7,8, John L Sievenpiper1,2,3,6,7,8, Vladimir Vuksan9,10,11,12,13. 1. Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 2. Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada. 3. Toronto 3D Knowledge Synthesis and Clinical Trials Unit, Toronto, ON, Canada. 4. Vuk Vrhovac Clinic for Diabetes, Endocrinology and Metabolic Diseases, University Hospital Merkur, Zagreb, Croatia. 5. School of Medicine, University of Zagreb, Zagreb, Croatia. 6. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. 7. Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada. 8. Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. 9. Department of Nutritional Sciences, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. v.vuksan@utoronto.ca. 10. Clinical Nutrition and Risk Factor Modification Center, St. Michael's Hospital, Toronto, ON, Canada. v.vuksan@utoronto.ca. 11. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. v.vuksan@utoronto.ca. 12. Division of Endocrinology and Metabolism, St. Michael's Hospital, Toronto, ON, Canada. v.vuksan@utoronto.ca. 13. Departments of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada. v.vuksan@utoronto.ca.
Abstract
PURPOSE:Viscous dietary fiber, functional seeds and ginseng roots have individually been proposed for the management of diabetes. We explored whether their co-administration would improve glycemic control in type 2 diabetes beyond conventional therapy. METHODS: In a randomized, double-blind, controlled trial conducted at two academic centers (Toronto, Canada and Zagreb, Croatia), individuals with type 2 diabetes were assigned to either an active intervention (10 g viscous fiber, 60 g white chia seeds, 1.5 g American and 0.75 g Korean red ginseng extracts), or energy and fiber-matched control (53 g oat bran, 25 g inulin, 25 g maltodextrose and 2.25 g wheat bran) intervention for 24 weeks, while on conventional standard of care. The prespecified primary endpoint was end difference at week 24 in HbA1c, following an intent-to-treat analysis adjusted for center and baseline. RESULTS:Between January 2016 and April 2018, 104 participants (60M:44F; mean ±SEM age 59 ± 0.8 years; BMI 29.0 ± 0.4 kg/m2; HbA1c 7.0 ± 0.6%) managed with antihyperglycemic agent(s) (n = 98) or lifestyle (n = 6), were randomized (n = 52 test; n = 52 control). At week 24, HbA1c levels were 0.27 ± 0.1% lower on test compared to control (p = 0.03). There was a tendency towards an interaction by baseline HbA1c (p = 0.07), in which a greater reduction was seen in participants with baseline HbA1c > 7% vs ≤ 7% (- 0.56 ± 0.2% vs 0.03 ± 0.2%). Diet and body weight remained unchanged. The interventions were well tolerated with no related adverse events and with high retention rate of 84%. CONCLUSIONS:Co-administration of selected dietary and herbal therapies was well-tolerated and may provide greater glycemic control as add-on therapy in type 2 diabetes. Registration: Clinicaltrials.gov NCT02553382 (registered on September 17, 2015).
RCT Entities:
PURPOSE: Viscous dietary fiber, functional seeds and ginseng roots have individually been proposed for the management of diabetes. We explored whether their co-administration would improve glycemic control in type 2 diabetes beyond conventional therapy. METHODS: In a randomized, double-blind, controlled trial conducted at two academic centers (Toronto, Canada and Zagreb, Croatia), individuals with type 2 diabetes were assigned to either an active intervention (10 g viscous fiber, 60 g white chia seeds, 1.5 g American and 0.75 g Korean red ginseng extracts), or energy and fiber-matched control (53 g oat bran, 25 g inulin, 25 g maltodextrose and 2.25 g wheat bran) intervention for 24 weeks, while on conventional standard of care. The prespecified primary endpoint was end difference at week 24 in HbA1c, following an intent-to-treat analysis adjusted for center and baseline. RESULTS: Between January 2016 and April 2018, 104 participants (60M:44F; mean ± SEM age 59 ± 0.8 years; BMI 29.0 ± 0.4 kg/m2; HbA1c 7.0 ± 0.6%) managed with antihyperglycemic agent(s) (n = 98) or lifestyle (n = 6), were randomized (n = 52 test; n = 52 control). At week 24, HbA1c levels were 0.27 ± 0.1% lower on test compared to control (p = 0.03). There was a tendency towards an interaction by baseline HbA1c (p = 0.07), in which a greater reduction was seen in participants with baseline HbA1c > 7% vs ≤ 7% (- 0.56 ± 0.2% vs 0.03 ± 0.2%). Diet and body weight remained unchanged. The interventions were well tolerated with no related adverse events and with high retention rate of 84%. CONCLUSIONS: Co-administration of selected dietary and herbal therapies was well-tolerated and may provide greater glycemic control as add-on therapy in type 2 diabetes. Registration: Clinicaltrials.gov NCT02553382 (registered on September 17, 2015).
Authors: V Vuksan; A L Jenkins; C Brissette; L Choleva; E Jovanovski; A L Gibbs; R P Bazinet; F Au-Yeung; A Zurbau; H V T Ho; L Duvnjak; J L Sievenpiper; R G Josse; A Hanna Journal: Nutr Metab Cardiovasc Dis Date: 2016-12-09 Impact factor: 4.222
Authors: V Vuksan; L Choleva; E Jovanovski; A L Jenkins; F Au-Yeung; A G Dias; H V T Ho; A Zurbau; L Duvnjak Journal: Eur J Clin Nutr Date: 2016-12-21 Impact factor: 4.016
Authors: Lawrence A Leiter; Lori Berard; C Keith Bowering; Alice Y Cheng; Keith G Dawson; Jean-Marie Ekoé; Carl Fournier; Lianne Goldin; Stewart B Harris; Peter Lin; Thomas Ransom; Mary Tan; Hwee Teoh; Ross T Tsuyuki; Dana Whitham; Vincent Woo; Jean-François Yale; Anatoly Langer Journal: Can J Diabetes Date: 2013-04-23 Impact factor: 4.190
Authors: Leanne R De Souza; Alexandra L Jenkins; Elena Jovanovski; Dario Rahelić; Vladimir Vuksan Journal: J Ethnopharmacol Date: 2014-11-04 Impact factor: 4.360
Authors: Alexandra L Jenkins; Linda M Morgan; Jacqueline Bishop; Elena Jovanovski; David J A Jenkins; Vladimir Vuksan Journal: Eur J Nutr Date: 2017-07-07 Impact factor: 5.614
Authors: Vladimir Vuksan; Mi-Kyung Sung; John L Sievenpiper; P Mark Stavro; Alexandra L Jenkins; Marco Di Buono; Kwang-Seung Lee; Lawrence A Leiter; Ki Yeul Nam; John T Arnason; Melody Choi; Asima Naeem Journal: Nutr Metab Cardiovasc Dis Date: 2006-07-24 Impact factor: 4.222
Authors: Vladimir Vuksan; Dana Whitham; John L Sievenpiper; Alexandra L Jenkins; Alexander L Rogovik; Richard P Bazinet; Edward Vidgen; Amir Hanna Journal: Diabetes Care Date: 2007-08-08 Impact factor: 19.112