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Background: Insulin secretory agents are commonly used to treat type 2 diabetes. However, traditional insulin secretory agents such as sulfonylureas and glinides have side effects of hypoglycemia. In recent years, researchers have discovered that berberine can inhibit the voltage-gated k+ channels of pancreatic ß cell membrane and promote insulin secretion without causing hypoglycemia, because the glucose-lowering effects of berberine are only under hyperglycemic conditions or in a high-glucose-dependent manner. In order to shed light on the glucose-lowing effects of berberine in type 2 diabetes with different baseline fasting plasma glucose (FPG) and glycosylated hemoglobin (HbA1c), we conducted a meta-analysis of randomized controlled trials. Methods: We searched eight databases, which included PubMed, EMBASE, Web of Science, the Cochrane Library, and the Chinese databases such as Sino-Med, China National Knowledge Infrastructure (CNKI), Wanfang Database, and VIP Database for Chinese Technical Periodicals, for randomized controlled trials, with berberine as the intervention and patients with type 2 diabetes mellitus as subjects, published up until November 2021. We analyzed the glucose-lowing effects of berberine, including its effects on FPG, HbA1c and 2-h plasma blood glucose (2hPBG), by calculating weighted mean differences (WMD) and 95% confidence interval (CI). To assess the safety of berberine, we analyzed the incidence of total adverse events and hypoglycemia by calculating relative risk (RR) and 95% CI. Results: Thirty-seven studies involving 3,048 patients were included in the meta-analysis. The results showed that berberine could reduce FPG (WMD = -0.82 mmol/L, 95% CI (-0.95, -0.70)), HbA1c (WMD = -0.63%, 95% CI (-0.72, -0.53)), and 2hPBG (WMD = -1.16 mmol/L, 95% CI (-1.36, -0.96)), with all results being statistically significant. Subgroup analyses revealed that the glucose-lowering effect of berberine was associated with baseline mean FPG and HbA1c in type 2 diabetes. In addition, berberine alone or in combination with oral hypoglycemic agents (OHAs) in the treatment of T2DM did not significantly increase the incidence of total adverse events (RR = 0.73, 95% CI (0.55, 0.97), p = 0.03) and the risk of hypoglycemia (RR = 0.48, 95% CI (0.21, 1.08), p = 0.08). Conclusion: Berberine has a glucose-lowering effect, which is related to the baseline FPG and HbA1c levels of patients. Treatment with berberine may be safe since it does not increase the incidence of total adverse events and the risk of hypoglycemia. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=292975, identifier CRD42021292975.
RESUMEN
OBJECTIVE: To study the Chinese medicine (CM) syndrome typing of hyperlipidemia inpatients, thus exploring the CM syndrome typing laws. METHODS: The clinical materials, including blood lipids, grading,complications, CM symptoms, and manifestations of tongue and pulse were recorded using self-formulated epidemiological questionnaire of CM syndrome in hyperlipidemia, and then these materials were statistically analyzed. RESULTS: Gan-qi stagnation syndrome (66.46%) was the most often seen syndrome in the 316 hyperlipidemia inpatients. Gan stagnation Pi-deficiency syndrome (35.44%), Gan-Shen yin deficiency syndrome (16.77%), Pi-Shen yang deficiency syndrome (13.61%), inner stagnation of phlegm and stasis syndrome (13.29%), hyperactivity of yang and hypoactivity of yin syndrome (9. 18%) were 5 common syndromes of hyperlipidemia. Gan stagnation Pi-deficiency syndrome occupied an important position among all types and at various levels. Results from the lipid classification of hyperlipidemia showed that mixed type with low HDL-C was the most often seen (108/316, 34.18%), followed by mixed hyperlipidemia (81/316, 25.63%). Totally the mixing type accounted for 59.81% (189/316), higher than hypertriglyceridemia (16.77%) and hypercholesterolemia (23.42%). CONCLUSIONS: Gan stagnation pi-deficiency syndrome might be the core syndrome affecting the lipid metabolism of hyperlipidemia. Mixed hyperlipidemia was the most often seen in clinics. Clinical medication should cover actions of decreasing TC and TG, and increasing HDL-C.
