The systemic review evaluated the results from different clinical trials to determine the effects of ginseng supplementation on specific cardiovascular biomarkers and is unique in its exclusive focus on individuals with dysglycemia.
Noteworthy findings indicate that treatment with ginseng (2g/day) significantly reduced levels of low-density lipoprotein (‘bad’) cholesterol (LDL-C), as well as serum levels of triglycerides (TG) in individuals with prediabetes and T2DM.
Ginseng treatment also decreased patient blood pressure (BP) by activating endothelial nitric oxide synthase and the release of nitric oxide, however some subjects experienced increased heart rate (HR).
Herbal demand growing
T2DM is the fastest-growing metabolic disorder on a global scale and cardiovascular disease (CVD) is a major comorbidity associated with the disease, affecting 32.2% of individuals with diabetes.
Many herbal medications are effective at controlling the symptoms of diabetes and ginseng is the most popular among patients seeking a holistic approach to treatment, due to its proven health benefits: as an anti-diabetic, anti-hyperlipidaemic, anti-inflammatory, and hepatoprotective.
The trend for complementary and alternative medicine (CAM) in general is growing and, as a consequence, there is increasing emphasis on pre-emptive therapeutic treatment and new therapies. However, managing the disease remains a challenge, the study authors say.
The current evaluation sought to elucidate inconsistencies in existing clinical research on ginseng and its impact on dysglycemia. Researchers evaluated a range of cardiovascular biomarkers, including anthropometric indices, glycaemic and lipid profiles, blood pressure (BP), inflammatory biomarkers, adipocytokines, and liver function.
The assessment of human trials and in vitro and in vivo studies suggest that ginseng modulates insulin secretion, glucose uptake, and glucose metabolism through inhibition of β-cell apoptosis and by raising the production of glucagon-like peptide-1 (GLP-1) to exert anti-diabetic effects.
Researchers discovered that ginseng decreased fasting plasma glucose (FPG) levels and improved insulin resistance (IR) in T2DM.
Supplementation significantly improved FPG when the consumption lasted for eight weeks or more and significantly reduced homeostatic model assessment of insulin resistance (HOMA-IR) values regardless of the length of follow-up.
The authors say the effect of ginseng intake on FPG appears to be dependent on baseline levels of FPG, dose, and duration of intervention.
Ginseng consumption significantly accelerated the heart rate (HR) and elevated levels of tumour necrosis factor-α (TNF-α), however it did not affect measures of hepatic function in patients.
“Some evidence has suggested that ginseng has favourable impacts on hepatocellular function through its anti-inflammatory, anti-oxidative, and anti-apoptotic properties”, the authors comment.
Data was derived from electronic databases (PubMed/MEDLINE, Scopus, Web of Science, and Cochrane library) up until 10 April 2022.
Parallel and crossover randomised trials were included in the review, and researchers conducted dose-response and meta-regression analyses.
The probability of bias in the included RCTs was explored through the Cochrane Risk of Bias Tool for clinical trials. Two independent authors assessed each publication’s quality.
Quality of evidence for each result was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Two independent reviewers (S.S. and K.N.) graded each outcome based on the risk of bias, inconsistency (heterogeneity), indirectness, and imprecision, as specified in the GRADE guideline.
There are limitations in the research, such as small sample sizes with only one including more than 100 participants; there was minimal diversity as around half of the trials were conducted in Asia, and certain confounders, such as smoking and duration of diabetes, were not included due to poor reporting.
Despite these limitations and advisory requirements for large-scale trials to verify findings, the authors assert that results may assist health agencies in formulating future guidelines for the use of ginseng in managing diabetes and the associated risk factors and preventing the progression of prediabetes.
Published online: https://doi.org/10.3390/nu14122401
‘The Efficacy of Ginseng (Panax) on Human Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis’
Kaveh Naseri et al.