Safety and efficacy of Momordica charantia Linnaeus in pre-diabetes and type 2 diabetes mellitus patients: a systematic review and meta-analysis protocol

Abstract

BackgroundMomordica charantia Linnaeus (Cucurbitaceae) has been used traditionally as a nutritious food and as a herbal medicine for type 2 diabetes mellitus. However, human studies that investigated its glycemic control have generated inconsistent findings. Therefore, this systematic review and meta-analysis is aimed at evaluating the safety and efficacy of M. charantia L. preparations in human studies that have investigated its role in glycemic control.MethodsThis protocol has been prepared according to Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P). The review will include randomized clinical trials and non-randomized clinical trials. The included studies will have assessed glycemic control of M. charantia preparations with placebo or standard oral anti-hyperglycemic agents in adult pre-diabetes and/or type 2 diabetes mellitus patients and have at least 4 weeks of follow-up. The primary outcomes of review are fasting blood glucose levels, glycosylated hemoglobin A1c, and post-prandial blood glucose level. Electronic database search for published literatures will be conducted without language restriction in EMBASE, MEDLINE/PubMed, the Cochrane Library, SCOPUS, Web of Sciences, and CINAHL databases. Search for gray literatures and references of the retrieved full-text articles will be conducted in Google, Google Scholar, OpenGrey, ProQuest dissertations & Theses, British Library EThos, and university digital library systems. Two independent reviewers will later evaluate full texts, extract data, and assess risk of bias of eligible articles. Publication biases will be assessed by testing asymmetry of funnel plot using Egger’s or Begg’s tests while heterogeneity will be assessed using Cochran Q test, P value, and I2. Revman software version 5.3 will be used for meta-analysis including subgroup and sensitivity analysis.DiscussionThis systematic review and meta-analysis will investigate both safety and efficacy of M. charantia preparations in type 2 diabetes mellitus. The review results will be published in a peer-reviewed journal. The results will bring better understanding of clinical outcomes in treatment of type 2 diabetes mellitus patients and highlight gaps for future research.Systematic review registrationPROSPERO CRD42018083653.Electronic supplementary materialThe online version of this article (10.1186/s13643-018-0847-x) contains supplementary material, which is available to authorized users.

Understanding the Combined Effects of High Glucose Induced Hyper-Osmotic Stress and Oxygen Tension in the Progression of Tumourigenesis: From Mechanism to Anti-Cancer Therapeutics

“…Momordin Ic and Gallic Acid are already independently tested in animal models of tumours for safety and efficacy [ 37 , 38 ]. Therefore, plant extracts enriched in Momordin Ic and Gallic Acid, such as Momordica charantia , will be tested in further studies [ 72 , 73 , 74 ]. Momordica charantia is in Phase II clinical trials in modern medical practice ( , accessed on 21 February 2023); , accessed on 21 February 2023).…”

¿Es útil la Momordica charantia (melón amargo) para el tratamiento de la Diabetes Mellitus tipo 2?

“…La búsqueda de literatura se realizó en las bases de datos EMBASE, MEDLINE/PubMed, la Biblioteca Cochrane, SCOPUS, Web of Science, y CINAHL sin restricción de idioma, mientras que la literatura gris y las referencias de los artículos de texto completo recuperados se realizaron en Google, Google Scholar, OpenGrey, disertaciones y tesis de ProQuest, British Library Ethos y sistemas de bibliotecas digitales universitarias. 8,9 Peter et al (2018) reportaron que solo se incluyeron tres estudios, los cuales no contenían información cuantitativa para su meta-análisis por lo que concluye que no hay evidencias que sustenten su uso en el tratamiento de la DMT2. Mientras que Peter et al (2019), identificaron 130 artículos relacionados con el tema de los cuales solo diez cumplieron con los criterios de inclusión para su meta-análisis, con un riesgo de sesgo de alto a moderado, encontrando que, en comparación con el placebo, la formulación monoherbal de M. charantia reduce significativamente la glucosa en ayunas, glucosa posprandial y hemoglobina glicosilada, pero presenta baja calidad porque el estudio tenía un riesgo de sesgo incierto e inadecuado tamaño de la muestra y no se informaron efectos adversos graves.…”

“…Mientras que Peter et al (2019), identificaron 130 artículos relacionados con el tema de los cuales solo diez cumplieron con los criterios de inclusión para su meta-análisis, con un riesgo de sesgo de alto a moderado, encontrando que, en comparación con el placebo, la formulación monoherbal de M. charantia reduce significativamente la glucosa en ayunas, glucosa posprandial y hemoglobina glicosilada, pero presenta baja calidad porque el estudio tenía un riesgo de sesgo incierto e inadecuado tamaño de la muestra y no se informaron efectos adversos graves. 8,9 En virtud de la necesidad de aumentar estudios de medicina basada en la evidencia siguiendo protocolos de búsqueda y análisis estandarizados que garanticen tomar decisiones en nuevos tratamientos o investigaciones en la práctica médica, en la FES Zaragoza, UNAM, se creó la Red Académica Asesora de Revisiones Sistemáticas (R.A.A.R.S), apoyada por el Proyecto PAPIME PE203421. Donde se permitió mostrar que M. charantia con dosis de 2000-3000 mg/día de pulpa de fruto durante 12 semanas muestra una disminución en la concentración sanguínea de glucosa de -26.48 mg/dL [IC95% -39.28, -13.69, p<0.0001] (Figura 2).…”

Pancreatic safety of DPP-4 inhibitors in type 2 diabetes millitus

“…The I 2 statistic will quantify the global heterogeneity, and the Cochran Q test and its P value will also be used to evaluate the heterogeneity. [14] The predictive interval graph and confidence interval will be plotted to present the influence of heterogeneity on each pairwise comparison. Furthermore, the similarity will be evaluated by comparing the critical clinical and methodological characteristics that can influence the effects of studies between 2 sets.…”