Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis

Peter, Emanuel L.; Kasali, Félicien Mushagalusa; Deyno, Serawit; Mtewa, Andrew G.; Nagendrappa, Prakash B.; Tolo, Casim Umba; Ogwang, Patrick Engeu; Sesaazi, Duncan C.

doi:10.1016/j.jep.2018.10.033

Cited by 74 publications

(65 citation statements)

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“…The biases due to small studies effect, methodological flaws, use of inappropriate animal models of the human condition, use of unstandardized intervention, inappropriate use of statistics, and poor or selective reporting need immediate attention. Together, this systematic review and meta-analysis suggests that previous clinical trials of M. charantia L. could have been conducted based on inadequate evidence of efficacy from preclinical studies, and partly this could explains conflicting clinical trial results observed in the meta-analysis [20,120,121].…”

Section: Discussionmentioning

confidence: 99%

“…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 also 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].…”

Section: Introductionmentioning

confidence: 99%

“…The proposed mechanisms include; improved histological architecture of the islets of Langerhans and beta-cell regeneration [16,21,22], insulin secretagogue [23, 24], enhance peripheral glucose utilization, inhibit glucose-6-phosphatase and fructose biphosphatase glucogenic enzymes [25], increases peroxisome proliferator-activated receptor gamma (PPAR-γ) activity and decreases protein Kinase C (PKC-β) activity in kidneys [26]. Despite the number of preclinical studies performed each year continuing to increase, and our understanding of M. charantia L. mode of action is improving, a recent meta-analysis of five randomized clinical trials confirmed its glucose lowering ability with only very low certainty of evidence [19]. There is also a lack of consensus on the proposed mode of action due to contradictory findings of existing preclinical studies.…”

Section: Introductionmentioning

confidence: 99%

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The efficacy and safety ofMomordica charantiaL. in animal models of type 2 diabetes mellitus; A systematic review and meta-analysis

Peter

Nagendrappa

Kaligirwa

et al. 2019

Preprint

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49Background 50 Momordica charantia L. (Cucurbitaceae) has been used to control hyperglycemia in people with 51 type 2 diabetes mellitus in Asia, South America, and Africa for decades. However, a meta-analysis 52 of clinical trials confirmed very low-quality evidence of its efficacy. To potentially increase the 53 certainty of evidence, we evaluated the effect of M. charantia L. in comparison with vehicle on 54 glycemic control in animal models of type 2 diabetes mellitus. 55 Methods 56Review authors searched in MEDLINE, Web of Science, Scopus, and CINAHL databases without 57 language restriction through April 2019. Two authors independently evaluated full texts, assessed 58 the risk of bias, and extracted data. We analyzed the influence of study design and evidence of 59 publication bias. 60 Results 61The review included 66 studies involving 1861 animals. They had a follow up between 7 and 90 62 days. Majority 29 (43.9%) used Wistar albino rats, and 37 (56.1%) used male animals. Thirty-two 63 (48%) used an aqueous extract of fresh fruits. M. charantia L. reduced fasting plasma glucose 64 (FPG) and glycosylated hemoglobin A1c in comparison to vehicle control (42 studies, 815 65 animals; SMD, -6.86 [95% CI; -7.95, -5.77], 3 studies, 59 animals; SMD; -7.76 [95%CI; -12.50, -66 3.01]) respectively. Magnitude of FPG was large in Wistar albino rat subgroup; SMD; -10.29, 67 [95%CI; -12.55, -8.03]. Publication bias changed FPG to non-significant -2.46 SMD, [95%CI; -68 5.10, 0.17]. We downgraded the evidence to moderate quality due to poor methodological quality, 69 high risk of bias, unexplained heterogeneity, suspected publication bias, and lack of standardized 70 dose. 4 71 Conclusion 72 M. charantia L. lowers elevated plasma glucose level in type 2 diabetes mellitus animal models. 73 Publication bias and poor methodological quality call for future researches to focus on 74 standardizing dose with chemical markers and provide measures to improve preclinical type 2 75 diabetes mellitus studies. 76 Systematic review registration CRD42019119181 77 Keywords 78 Bitter gourd; type 2 diabetes mellitus; efficacy; safety; meta-analysis; preclinical. 79 80 81 82 83 84 85 86 87 88 89 90 91 92 5 93 94 Introduction 95 Type 2 diabetes mellitus (T2DM) is a chronic hyperglycemic condition in response to 96 progressively impaired glucose regulation due to insulin resistance and beta-cell dysfunction [1,2]. 97 The chronicity of hyperglycemia causes microvascular complications in the retina, renal 98 glomerulus and peripheral nerves [3]; and increases the risk of accelerated atherosclerosis and 99 premature death [4]. Other complications include dementia, sexual dysfunction, depression and 100 lower-limb amputations [5-7]. 101 People with T2DM use oral hypoglycemic agents (OHAs) for glycemic control and ameliorating 102 diabetes complications, but the OHAs have in recent years been linked to intolerable side effects 103 and increasing failure rate [8], leaving the majority of people with T2DM using medicinal plants 104 as alternative the...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The efficacy and safety ofMomordica charantiaL. in animal models of type 2 diabetes mellitus; A systematic review and meta-analysis

Peter

Nagendrappa

Kaligirwa

et al. 2019

Preprint

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“…5 M. Charantia is a plant belonging to the Cucurbitaceae family and is widely distributed in tropical and subtropical areas around the world. [5][6][7] Studies have determined that this plant contains a great diversity of primary and secondary metabolites 8,9 with therapeutic potential as antiulcer properties 6,10 , antioxidant [11][12][13][14] , antimicrobial 6,8,12,[15][16][17] , anthelmintic 18,19 , antidiabetic 6,11,20,21 , antiinflammatory 21,22 , antihyperglycemic 6,21,23 and anticancer 4,19,21,24 , and nutritional as antilipolytic. 11,25 Bacterial resistance is one of the main problems around the world, it is thought that by 2050 bacterial resistance will be one of the leading causes of death in the world.…”

Section: Introductionmentioning

confidence: 99%

Antimicrobial Activity and Chemical Composition of Momordica Charantia: A Review

Torre¹,

Sagástegui-Guarniz²,

Silva-Correa³

et al. 2020

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Bitter melon, bitter cucumber or bitter gourd are some of the names given to M. charantia. It belongs to the Cucurbitaceae family. 44 M. charantia is a vegetable with many culinary uses, especially in Asia and Africa, and is commonly cultivated in Africa, India, Malaysia, China and South America. 44,45 M.ABSTRACT Momordica charantia L. (bitter melon) is a plant belonging to the Cucurbitaceae family and is widely distributed in tropical and subtropical areas around the world, mainly in Asia, India, China and Brazil, where it is traditionally used as a medicinal plant, and the fruits of some varieties of M. charantia are consumed as food. Studies have determined that this plant contains a great diversity of bioactive compounds with therapeutic potential like charantin, α-momorcharin and MAP30, and highlighting its properties as antidiabetic, antiulcer, antioxidant, antimicrobial, anthelmintic, antihyperglycemic and anticancer. Review shows the complete botanical description of the plant (fruits, leaves, stem, etc.), the bioactive chemical compounds reported in the plant species, the antimicrobial activity of the extracts or fractions of M. charantia, emphasizing the antibacterial and antifungal activities, with respective values of MIC (Minimum Inhibitory Concentration) reported according to the methodology used in each study. The review seeks to update the phytochemical and pharmacological knowledge of M. charantia, which would be useful for researchers in their search for new chemical compounds of the plant, studies of its safety and efficacy, as well as the evaluation of its possible synergistic action in combination with other antimicrobials, in order to find new therapeutic alternatives against bacterial resistance.

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“…Momordica charantia L. (Family; Cucurbitaceae) has increasingly become alternative therapy for type 2 diabetes mellitus [10]. The plant is distributed widely throughout tropical and subtropical regions and considered native to the African and Australian continents [11].…”

Section: Introductionmentioning

confidence: 99%

Systematic review and meta-analysis protocol for efficacy and safety of Momordica charantia L. on animal models of type 2 diabetes mellitus

et al. 2020

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Background: Studies on several preclinical models of type 2 diabetes mellitus have been conducted to establish the hypoglycemic activity of Momordica charantia L. Concerned with appropriateness of these models, we designed a systematic review to establish the efficacy and safety of M. charantia L. in preclinical models of type 2 diabetes mellitus. Methods: Review authors will search without language restriction in MEDLINE/PubMed, Web of Science, Embase, Scopus, and CINAHL databases through April 2019. Search filters will be applied to enhance search efficiency. The authors will search for gray literature in Google and Google Scholar, OpenGrey, and ProQuest Dissertations & Theses. Two authors will evaluate full texts, extract data, and asses risk of bias independently. The review will include randomized or non-randomized studies that assessed the efficacy or safety of M. charantia L. with vehicle control group. The primary endpoint will be fasting blood glucose level. We will use Egger's test to assess publication biases. Chi-square test and I 2 will be used to assess heterogeneity in effect size of the primary outcome. Using RevMan software version 5.3, the authors will perform a meta-analysis of quantitative data. Discussion: The strength of evidence will be rated as high, moderate, low, or very low using GRADE framework for animal studies. This systematic review will potentially improve research practice by identifying risks of bias and design features that compromise translatability and contribute to evidence-based clinical trial design.

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Momordica charantia L. lowers elevated glycaemia in type 2 diabetes mellitus patients: Systematic review and meta-analysis

Cited by 74 publications

References 43 publications

The efficacy and safety ofMomordica charantiaL. in animal models of type 2 diabetes mellitus; A systematic review and meta-analysis

The efficacy and safety ofMomordica charantiaL. in animal models of type 2 diabetes mellitus; A systematic review and meta-analysis

Antimicrobial Activity and Chemical Composition of Momordica Charantia: A Review

Systematic review and meta-analysis protocol for efficacy and safety of Momordica charantia L. on animal models of type 2 diabetes mellitus

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