Clinical use of ginseng in treatment of diabetes

Ginseng has been used for centuries in traditional Chinese medicine to treat a wide variety of diseases. In this section we will discuss the evidence for use of ginseng in the treatment of diabetes.

Background

There are different species of ginseng, of which Panax quinquefolius (American ginseng) and Panax ginseng (Chinese ginseng) are the main species. The ginseng species belong to the genus Panax of the ivy family (Araliaceae). Panax ginseng can be classified according to how it is processed: fresh ginseng (less than 4 years old), white ginseng (4-6 years old and dried after peeling), and red ginseng (harvested at 6 years old and dried after peeling) [1] [2].

Evidence clinical use

An electronic search on Medline using PubMed (12 May 2013) identified 89 publications [a]; 6 publications were randomised studies amongst patients with diabetes or impaired glucose tolerance that compared ginseng to placebo [3] [4] [5] [6] [7] [8]. Three studies reported beneficial effects on the fasting blood glucose [3] [5] [7]. Data on HbA1c were only measured or reported in three studies, but no beneficial effects were observed [3] [6] [8].

The search strategy also revealed a systematic review that had searched for studies investigating the effects of red ginseng. It was concluded that the evidence for the effectiveness of red ginseng in controlling glucose in type 2 diabetes mellitus is not convincing [3]. Korean, Japanese and Chinese databases had also been searched by the authors. Only 4 randomised controlled trials (RCTs) were identified, of which only one trial [9] was considered to have a low risk of bias, according to the Cochrane criteria. Red ginseng was compared to placebo in this trial and after 12 weeks of treatment no beneficial effects on the primary outcome, HbA1c, were observed [6].

A recently published systematic review, that aimed to summarise RCTs assessing the efficacy and safety of ginseng in the Korean literature [2], found 2 additional RCTs comparing the effects of red ginseng with no treatment or placebo [10] [11]. Both studies did not show any beneficial effects on fasting blood glucose [2]. HbA1c was measured in one study, but no effects were seen [2].

Conclusion

There is no evidence supporting the use of ginseng for diabetes mellitus. A few studies have showed beneficial effects of ginseng on fasting plasma glucose, but none of the studies have reported superior effects on HbA1c.

References

  1. ^ Jang DJ, Lee MS, Shin BC, Lee YC, Ernst E (2008) Red ginseng for treating erectile dysfunction: a systematic review. Br J Clin Pharmacol 66: 444–450.

  2. ^ Choi J, Kim T-H, Choi T-Y, Lee MS (2013) Ginseng for Health Care: A Systematic Review of Randomized Controlled Trials in Korean Literature. PLoS ONE 8(4): e59978. doi:10.1371/journal.pone.0059978

  3. ^ Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care. 1995 Oct;18(10):1373-5.

  4. ^ Vuksan V, Sievenpiper JL, Koo VY, Francis T, Beljan-Zdravkovic U, Xu Z, Vidgen E. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med. 2000 Apr 10;160(7):1009-13.

  5. ^ Ma SW, Benzie IF, Chu TT, Fok BS, Tomlinson B, Critchley LA. Effect of Panax ginseng supplementation on biomarkers of glucose tolerance, antioxidant status and oxidative stress in type 2 diabetic subjects: results of a placebo-controlled human intervention trial. Diabetes Obes Metab. 2008 Nov;10(11):1125-7.

  6. ^ Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di Buono M, et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis 2008;18:46-56.

  7. ^ Shin SK, Kwon JH, Jeong YJ, Jeon SM, Choi JY, Choi MS. Supplementation of cheonggukjang and red ginseng cheonggukjang can improve plasma lipid profile and fasting blood glucose concentration in subjects with impaired fasting glucose. J Med Food. 2011 Jan-Feb;14(1-2):108-13.

  8. ^ Reeds DN, Patterson BW, Okunade A, Holloszy JO, Polonsky KS, Klein S. Ginseng and ginsenoside Re do not improve β-cell function or insulin sensitivity in overweight and obese subjects with impaired glucose tolerance or diabetes. Diabetes Care. 2011 May;34(5):1071-6.

  9. ^ Kim S, Shin BC, Lee MS, Lee H, Ernst E. Red ginseng for type 2 diabetes mellitus: a systematic review of randomized controlled trials. Chin J Integr Med. 2011 Dec;17(12):937-44.

  10. ^ Choi KM, Lee EJ (1997) Effects of red ginseng on the lipid peroxidation of erythrocyte and antioxidant superoxide dismutase (SOD) activity In NIDDM Patients. J Ginseng Res 21: 153–159.

  11. ^ Kim HO (2011) Effects of fermented red ginseng on blood glucose and insulin resistance in patients with type 2 diabetes mellitus. Busan: Department of Food Science and Nutrition, Pusan National University. Doctoral dissertation.

Footnotes

  1. ^ Search strategy: ("Panax"[Mesh] OR "ginseng pentadecapeptide, Panax ginseng"[Supplementary Concept] OR ("panax"[MeSH Terms] OR "panax"[All Fields] OR "ginseng"[All Fields]) AND "Diabetes Mellitus"[Mesh]) AND (((clinical[Title/Abstract] AND trial[Title/Abstract]) OR clinical trials[MeSH Terms] OR clinical trial[Publication Type] OR random*[Title/Abstract] OR random allocation[MeSH Terms] OR therapeutic use[MeSH Subheading]) OR systematic[sb])

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