Meta-analysis of Aloe vera on blood glucose

J. Pharm. Pharmacogn. Res., vol. 10, no. 4, pp. 737-747, July-August 2022.

Review

The effect of Aloe vera on fasting blood glucose levels in pre-diabetes and type 2 diabetes mellitus: A systematic review and meta-analysis

[Efecto del Aloe vera sobre los niveles de glucosa en sangre en ayunas en prediabetes y diabetes mellitus tipo 2: Una revisión sistemática y meta-análisis]

Indah Budiastutik1, Hertanto Wahyu Subagio2*, Martha Irene Kartasurya3, Bagoes Widjanarko1, Apoina Kartini3, Soegiyanto4, Suhartono Suhartono5

1Doctoral Program of Public Health, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.

2Faculty of Medicine, Diponegoro University, Semarang, Indonesia.

3Public Health Nutrition Department, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.

4Doctoral Program of Sport Education, Postgraduate, Universitas Negeri Semarang, Indonesia.

5Department of Environmental Health, Faculty of Public Health, Diponegoro University, Semarang, Indonesia.

*E-mail: hertantows@lecturer.undip.ac.id

Abstract

Context: Aloe vera is a traditional medicinal plant that shows a wide range of biological activities. Previous studies demonstrated the antihyperglycemic effect of Aloe vera but with inconsistent results.

Aims: To quantitatively summarize the effect of Aloe vera on fasting blood glucose in pre-diabetes and type 2 diabetes mellitus by a meta-analysis.

Methods: PubMed, Scopus, Springer Link, Science Direct, Proquest, and Google Scholar were used to identify clinical trials evaluating the effect of Aloe vera on fasting blood glucose published between 2011 and 2021. The inclusion criteria were: (1) original research with a clinical trial design evaluating the effect of Aloe vera on fasting blood glucose in pre-diabetes and/or type 2 diabetes mellitus; (2) providing the data of the mean fasting blood glucose and standard deviation in both control and intervention group, and; (3) Aloe vera was used as the only intervention. The pooled effect of Aloe vera on fasting blood glucose was evaluated using the random effect model, and publication bias was assessed by Funnel plots and Fail Safe-N.

Results: A total of 25 trials were included from 13 publications involving 642 patients. The results showed that Aloe vera significantly reduced fasting blood glucose (-0.35 [95% CI, -1454, -0.616] mg/dL; p<0.001) compared to control. Aloe vera might have a more remarkable effect in males, BMI not more than 30 mg/kg2, type 2 diabetes mellitus, administered for ≥ 8 weeks, dose at 200 mg, and capsule administration. However, a high heterogeneity across the studies was found.

Conclusions: Aloe vera may reduce fasting blood glucose in pre-diabetes and type 2 diabetes mellitus. However, further study with a well-design and standardized preparation is needed to emphasize the effect of Aloe vera on blood glucose control.

Keywords: Aloe vera; hyperglycemia; meta-analysis; systematic reviews.

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Resumen

Contexto: El Aloe vera es una planta medicinal tradicional que presenta una amplia gama de actividades biológicas. Estudios previos demostraron el efecto antihiperglucémico del Aloe vera pero con resultados inconsistentes.

Objetivos: Resumir cuantitativamente el efecto del Aloe vera sobre la glucemia en ayunas en prediabetes y diabetes mellitus tipo 2 mediante un meta-análisis.

Métodos: Se utilizaron PubMed, Scopus, Springer Link, Science Direct Proquest, y Google Scholar para identificar los ensayos clínicos que evaluaron el efecto del Aloe vera sobre la glucemia en ayunas publicados entre 2011 y 2021. Los criterios de inclusión fueron: (1) investigación original con un diseño de ensayo que evalúa el efecto del Aloe vera sobre la glucosa en sangre en ayunas en prediabetes y/o diabetes mellitus tipo 2; (2) proporcionar los datos de la media de glucosa en sangre en ayunas y la desviación estándar tanto en el grupo de control como en el de intervención, y; (3) Se utilizó Aloe vera como única intervención. El efecto combinado del Aloe vera sobre la glucosa en sangre en ayunas se evaluó mediante el modelo de efectos aleatorios, y el sesgo de publicación se evaluó mediante gráficos en embudo y Fail Safe-N.

Resultados: Se incluyeron un total de 25 ensayos de 13 publicaciones con 642 pacientes. Los resultados mostraron que el Aloe vera redujo significativamente la glucosa en sangre en ayunas (-0,35 [IC del 95 %, -1454, -0,616] mg/dL; p<0,001) en comparación con el control. El Aloe vera podría tener un efecto más notable en varones, IMC no superior a 30 mg/kg2, diabetes mellitus tipo 2, administrado durante ≥ 8 semanas, dosis de 200 mg y administración en cápsula. Además, se encontró una alta heterogeneidad entre los estudios.

Conclusiones: El Aloe vera puede reducir la glucemia en ayunas en prediabetes y diabetes mellitus tipo 2. Sin embargo, se necesitan más estudios con una preparación bien diseñada y estandarizada para enfatizar el efecto del Aloe vera en el control de la glucosa en sangre.

Palabras Clave: Aloe vera; hiperglucemia; meta-análisis; revisiones sistemáticas.

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Citation Format: Budiastutik I, Subagio HM, Kartasurya MI, Widjanarko B, Soegiyanto, Kartini A, Suhartono S (2022) The effect of Aloe vera on fasting blood glucose levels in pre-diabetes and type 2 diabetes mellitus: A systematic review and meta-analysis. J Pharm Pharmacogn Res 10(4): 737–747.
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