Chromium‐Containing Traditional Chinese Medicine, Tianmai Xiaoke Tablet, for Newly Diagnosed Type 2 Diabetes Mellitus: A Meta‐Analysis and Systematic Review of Randomized Clinical Trials

Abstract

Objective Chromium-containing traditional Chinese medicine Tianmai Xiaoke tablet (TMXKT) is approved for treating newly diagnosed type 2 diabetes mellitus (T2DM) in China. This review aimed to compile the evidence from randomized clinical trials (RCTs) and quantify the effects of TMXKT on newly diagnosed T2DM. MethodsSeven online databases were investigated up to March 20, 2017. The meta-analysis included RCTs investigating the treatment of newly diagnosed T2DM, in which TMXKT combined with conventional therapy was compared with placebo or conventional therapy. The risk of bias was evaluated using the Cochrane Collaboration tool. The estimated mean difference (MD) and the standardized mean difference were within 95% confidence intervals (CI) with respect to the interstudy heterogeneity. The outcomes were measured using fasting blood glucose (FBG), 2-h postprandial blood glucose (2hPG), glycosylated hemoglobin A1c (HbA1c), and body mass index (BMI) levels. ResultsTMXKT combined with conventional therapy lowered FBG level (MD = −0.68, 95% CI −0.90 to −0.45, P < 0.00001), 2hPG (MD = −1.33, 95% CI −1.86 to −0.79, P < 0.00001), HbA1c (MD = −0.46, 95% CI −0.57 to −0.36, P < 0.00001), and BMI (MD = −0.77, 95% CI −1.12 to −0.41, P < 0.00001). ConclusionsTMXKT combined with conventional therapy is beneficial for patients with newly diagnosed T2DM. However, the effectiveness and safety of TMXKT are uncertain because of the limited number of trials and low methodological quality. Therefore, practitioners should be cautious when applying TMXKT in daily practice. Also, well-designed clinical trials are needed in the future.

Comparative efficacy and safety of traditional Chinese patent medicine for the treatment of type 2 diabetes mellitus

“…Pharmacological investigations indicated that TCPMs present beneficial effects on reducing body weight, enhancing insulin sensitivity, protecting β-cells, improving insulin secretion, correcting glucose and lipid metabolism disorders, and improving the microcirculation and the immune system. [ 5 6 7 8 9 10 11 12 13 ] For example, the Tianmai Xiaoke tablet which contains of Schisandra Chinensis, Ophiopogon Japonicus, Trichosanthis Radix and Chromium Picolinate is approved by the State Food and Drug Administration of China (state medical license number Z20049007) can decrease FBG and HbA1c levels in T2DM patients. [26] In addition, some studies demonstrated that Tianmai Xiaoke tablets could down-regulate PTP1B and PCK2 by activating the insulin signaling pathway, thereby reducing the HbA1c level in diabetic rats.…”

“…[ 5 6 7 8 9 10 11 12 13 ] For example, the Tianmai Xiaoke tablet which contains of Schisandra Chinensis, Ophiopogon Japonicus, Trichosanthis Radix and Chromium Picolinate is approved by the State Food and Drug Administration of China (state medical license number Z20049007) can decrease FBG and HbA1c levels in T2DM patients. [26] In addition, some studies demonstrated that Tianmai Xiaoke tablets could down-regulate PTP1B and PCK2 by activating the insulin signaling pathway, thereby reducing the HbA1c level in diabetic rats. [27] Moreover, the Jinlida granule was verified that it could significantly improve glycemic control, alleviate insulin resistance, and promote insulin secretion, with greater improvements in patients with a long disease course.…”

“…Many traditional Chinese patent medicine (TCPMs) are used as adjuvant drugs combined with conventional Western medicine therapy in the treatment of T2DM, including Jinlida granule, Xiaoke pill, Shenqi Jiangtang granule, Jinqi Jiangtang Tablet, Tianmai Xiaoke tablet, etc. [ 5 6 7 8 9 10 11 12 13 14 ] Besides, relevant treatment guidelines also highlight the important role of TCPMs (e.g., Jinlida granule) against this disease. [15] However, a direct comparison of the efficacy and safety of different TCPMs for the treatment of T2DM is lacked, which affects the optimal choice of the clinical treatment plan.…”

Gestasyonel Diyabetik ve Nondiyabetik Gebelerin Glukoz, Lipid, Krom Seviyelerinin Sağlıklı Gruplara Göre Değişimlerinin İncelenmesi

“…DM'nin en sık görülen türü olan Tip 2 DM'li hastalarla yapılan birçok çalışmada; diyabetli hastaların krom düzeylerinin, sağlıklı bireylere göre düşük olduğu sonucuna ulaşılmıştır [23,24]. Bu çalışmaların ışığında, Tip 2 DM'li hastalara tedavi amacıyla krom takviyesi verilmesi ile ilgili birçok çalışma yapılmıştır [25,26]. Tip 2 DM ve krom arasında ki ilişkiye yönelik yapılan bu çalışmalarda; krom düzeylerinin, Tip 2 DM'li hastalarda düşük olduğu ve krom takviyesinin de sınırlı bir etki ortaya koyduğu sonucuna ulaşılmıştır.…”

Combination of amylopectin and chromium form improves energy storage and reduces muscle fatigue in rats during exhaustive exercise

“…Cr not only acts as an antioxidant (23), but also involves the metabolism of carbohydrate, fat, and protein (24,25) and enables the activation of insulin and reduces fat deposits in the body (26). Cr is commonly used in the management of glucose and insulin metabolism by diabetic patients (27)(28)(29) and for muscle fatigue (30). Moreover, recent studies reported that Cr elevates insulin-stimulated glucose uptake in adipocytes (31) and cultured muscle cells (32).…”