Effect of Moringa oleifera Leaf Extract on Glycemic Parameters in Patients with Type 2 Diabetes Mellitus and Prediabetes: A Systematic Review and Meta-analysis
A B Kamrul-Hasan, Samir Kumar Talukder, Lakshmi Nagendra, Muhammad Shah Alam, Fatema Tuz Zahura Aalpona, Deep Dutta, Shahjada Selim
Abstract
Background: Moringa oleifera leaf (MOL) extract has been used traditionally for treating several diseases, including diabetes mellitus (DM). This study aimed to holistically analyze and summarize the efficacy and safety of MOL extract on glycemic parameters in patients with type 2 DM (T2DM) and prediabetes. Materials and Methods: Electronic databases were searched for randomized controlled trials (RCTs) and nonrandomized trials involving patients with T2DM or prediabetes receiving MOL extract in the intervention arm and placebo (or no MOL extract) in the control arm. The primary outcome was the changes in glycemic parameters, for example, hemoglobin A1c (HbA1c), fasting plasma glucose (FPG), and 2-h postprandial plasma glucose (2-h PPG), from the baseline at the end of the trial. Results: From 86 initially screened articles, data from 5 studies (3 RCTs and 2 nonrandomized trials) involving 260 subjects were analyzed. Subjects in the MOL extract group had similar reductions in HbA1c (mean difference [MD] −0.11%, 95% confidence interval [CI] [ −0.37, 0.14], P = 0.39, I 2 = 24% [not important heterogeneity], very low certainty of evidence) and FPG (MD −0.63 mmol/L, 95% CI [−1.89, 0.64], P = 0.33, I 2 = 94% [high heterogeneity], very low certainty of evidence) than the control group although reductions in 2-h PPG were greater in the MOL extract group (MD −3.46 mmol/L, 95% CI [−4.96, −2.16], P < 0.00001, I 2 = 0% [not important heterogeneity], very low certainty of evidence). Subjects in the MOL extract group achieved greater systolic and diastolic blood pressure reductions than the control group. No hypoglycemic events were reported in either group. Conclusion: Current preliminary data do not support MOL extract’s glucose-lowering efficacy in patients with T2DM and prediabetes.