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Effect of Gymnema Sylvestre on Patients With Impaired Glucose Tolerance.

Phase 2
Completed
Conditions
Impaired Glucose Tolerance
Interventions
Drug: Gymnema Sylvestre
Drug: Placebo
Registration Number
NCT02708966
Lead Sponsor
University of Guadalajara
Brief Summary

Prediabetes (PD) was defined as an state in which glucose levels are above normal but not enough to meet criteria for the diagnosis of type 2 diabetes (T2D). PD can be presented as impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and glycated hemoglobin A1c (A1C) altered. The International Diabetes Federation (IDF) reported that in 2013 the prevalence of IGT was 6.9% which is equivalent to approximately 316 million individuals with IGT, it is expected that by 2035 this number will increase to 417 million people affected. Many hypoglycemic effects attributed to Gymnema sylvestre have been reported, including: increase of insulin secretion, regeneration of pancreatic islet cells, increased glucose utilization in various ways and inhibition of glucose uptake in the intestine.

Detailed Description

The target is to evaluate the effect of the administration of Gymnema Sylvestre on glycemic control, insulin secretion and insulin sensibility on patients with IGT. The investigators will conduct a double-blind trial, randomized, placebo control group, each group 12 female and male patients, between 30 and 59 years old with IGT (2-h values in the oral glucose tolerance test, OGTT) from 140 mg / dL to 199 mg / dL), Body Mass Index (BMI) from 25 to 34.9 kg / m2. Randomization will determine who will receive the intervention during the 9-week trial (Gymnema Sylvestre capsules, 300 mg 2 times daily with the first bite of breakfast and dinner or homologated placebo capsules). The clinical findings and laboratory tests include a metabolic profile and biosafety, which will be made at baseline and at week 9. Body weight, body fat, BMI and blood pressure will be determined during the initial and final visit. Adverse events and adherence to treatment will be documented. Statistical analysis: Mann-Whitney U test, Wilcoxon and Fisher exact test. It is considered with significance at p \<0.05.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria
  • BMI: 25.0-34.99 kg / m2.
  • Diagnosis of IGT (2h-OGTT Values between 140mg / dl and 199mg / dl.)
  • Written informed consent.
  • body weight stable over the last 3 months.
  • Women in follicular phase of the menstrual cycle (days 3 to 8 of the cycle) at the time of laboratory tests.
  • Women who are not contemplated get pregnant within the next 6 months.
Exclusion Criteria
  • Women pregnant or breastfeeding.
  • Physical or mental disability that makes it impossible to perform the intervention.
  • Diagnosis of hypertension or heart failure.
  • Smokers.
  • Untreated thyroid disease.
  • Consumption of oral agents or other medications or supplements with proven properties that modify the behavior of glucose and lipids (oral hypoglycemic agents, insulin, lipid-lowering).
  • Diagnosis of liver disease or elevation twice of the upper normal value of liver enzymes.
  • Diagnosis of renal disease or creatinine > 1.5 mg / dl.
  • Diagnosis of Type 2 Diabetes Mellitus (T2DM) Fasting glucose ≥ 126 mg / dL and/or 2h-OGTT ≥ 200 mg / dL and/or A1C ≥ 6.5%.
  • Total Cholesterol ≥ 280 mg/dL.
  • Triglycerides ≥ 300 mg/dL.
  • Known allergy to calcined magnesia or Gymnema sylvestre.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Gymnema SylvestreGymnema SylvestrePatients with IGT
PlaceboPlaceboPatients with IGT
Primary Outcome Measures
NameTimeMethod
Fasting Plasma Glucose90 days

After intervention by spectrophotometry

2-hour Post Load Plasma Glucose (2-h PG)90 days

The blood sample for determining of 2-h PG, was taken two hours after the ingestion of the drink with 75 g dextrose and was evaluated by spectrophotometry method. The value was expressed on mmol/L.

Glycated Hemoglobin A1c (A1C)90 days

After intervention by high-performance liquid chromatography

Insulin Sensitivity (Matsuda Index)90 days

Insulin sensitivity was calculated with Matsuda index \[10,000 / √glucose 0' x insulin 0') (mean glucose oral glucose tolerance test (OGTT) x mean insulin OGTT)\] after intervention.

Total Insulin Secretion (Insulinogenic Index)90 days

Total insulin secretion was calculated with the insulinogenic index (ΔABC insulin / ΔABC glucose) after intervention.

First Phase of Insulin Secretion90 days

First phase of insulin secretion was estimated using the Stumvoll index (1283+ 1.829 x insulin 30' - 138.7 x glucose 30' + 3.772 x insulin 0') after intervention.

Secondary Outcome Measures
NameTimeMethod
Body Weight (BW)12 weeks

The weight was measured at baseline, week 4, week 8 and week 12 with a bioimpedance balance and the entered values reflect the weight at week 12

High Density Lipoprotein Cholesterol90 days

After intervention by spectrophotometry

Low Density Lipoprotein90 days

After intervention by spectrophotometry

Area Under the Curve of Glucose90 days

Area under the curve of glucose was obtained using the trapezoidal integration.

Area Under the Curve of Insulin90 days

After intervention area under the curve of insulin

Body Mass Index (BMI)12 weeks

The Body Mass index was calculated at baseline and at week 12 with the Quetelet index and the entered values reflect the body mass index at week 12

Total Cholesterol90 days

After intervention by spectrophotometry

Triglycerides90 days

After intervention by spectrophotometry

Waist Circumference (WC)12 weeks

Waist circumference was evaluated at baseline and at week 12 with a flexible tape and the entered values reflects the waist circumference measure at week 12

Systolic Blood Pressure (SBP)12 weeks

The Systolic Blood Pressure was evaluated at baseline and week 12 with a digital sphygmomanometer and the entered values reflect the blood pressure at week 12

Diastolic Blood Pressure (DBP)12 weeks

The Diastolic blood pressure was evaluated at baseline and week 12 with a digital sphygmomanometer and the entered values reflect the blood pressure at week 12

Very Low Density Lipoprotein90 days

After intervention by spectrophotometry

Creatinine90 days

After intervention by spectrophotometry

Trial Locations

Locations (1)

Institute of Experimental and Clinical Therapeutics (INTEC), CUCS, University of Guadalajara

🇲🇽

Guadalajara, Jalisco, Mexico

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