Scolaris Content Display Scolaris Content Display

Adapted PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) flow‐chart of study selection.
Figuras y tablas -
Figure 1

Adapted PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) flow‐chart of study selection.

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

Comparison 1 Momordica charantia capsules versus placebo, Outcome 1 Change in HbA1c.
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Analysis 1.1

Comparison 1 Momordica charantia capsules versus placebo, Outcome 1 Change in HbA1c.

Comparison 1 Momordica charantia capsules versus placebo, Outcome 2 Change in fasting blood glucose.
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Analysis 1.2

Comparison 1 Momordica charantia capsules versus placebo, Outcome 2 Change in fasting blood glucose.

Comparison 1 Momordica charantia capsules versus placebo, Outcome 3 Change in total cholesterol.
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Analysis 1.3

Comparison 1 Momordica charantia capsules versus placebo, Outcome 3 Change in total cholesterol.

Comparison 1 Momordica charantia capsules versus placebo, Outcome 4 Change in body mass index.
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Analysis 1.4

Comparison 1 Momordica charantia capsules versus placebo, Outcome 4 Change in body mass index.

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 1 Fasting blood glucose.
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Analysis 2.1

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 1 Fasting blood glucose.

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 2 Post‐prandial blood glucose.
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Analysis 2.2

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 2 Post‐prandial blood glucose.

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 3 Change in serum fructosamine.
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Analysis 2.3

Comparison 2 Momordica charantia (dried fruits) tablets versus placebo, Outcome 3 Change in serum fructosamine.

Comparison 3 Momordica charantia (dried fruits) capsules versus metformin, Outcome 1 Serum fructosamine.
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Analysis 3.1

Comparison 3 Momordica charantia (dried fruits) capsules versus metformin, Outcome 1 Serum fructosamine.

Summary of findings for the main comparison. Momordica charantia for type 2 diabetes mellitus

Momordica charantia for type 2 diabetes mellitus

Patient or population: Patients with type 2 diabetes mellitus
Settings: Out‐patients
Intervention: Momordica charantia
Comparison: Placebo, glibenclamide or metformin

Outcomes

Illustrative comparative risks* (95% CI)

Relative effect
(95% CI)

No of Participants
(studies)

Quality of the evidence
(GRADE)

Comments

Assumed risk

Corresponding risk

Control

Momordica charantia

Death from any cause

See comment

See comment

Not estimable

See comment

See comment

Not investigated

Morbidity

See comment

See comment

Not estimable

See comment

See comment

Not investigated

Adverse effects
(Follow‐up: 4 to 12 weeks)

Not estimable

Not estimable

Not estimable

479 (4)

⊕⊕⊝⊝
low1

3 out of 4 studies reported some adverse effects

Health‐related quality of life

See comment

See comment

Not estimable

See comment

See comment

Not investigated

Costs

See comment

See comment

Not estimable

See comment

See comment

Not investigated

Change in HbA1c from baseline to endpoint
(Follow‐up: 3 months)

0.2 (favouring placebo)

‐0.4 to 0.8

40 (1)

⊕⊝⊝⊝
very low2

*The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
CI: Confidence interval; RR: Risk ratio;

GRADE Working Group grades of evidence
High quality: Further research is very unlikely to change our confidence in the estimate of effect.
Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate.
Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate.
Very low quality: We are very uncertain about the estimate.

1 incomplete reporting of adverse effects in studies, short time periods

2 one study with low number of participants

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Summary of findings for the main comparison. Momordica charantia for type 2 diabetes mellitus
Table 1. Overview of study populations

Characteristic

Study ID

intervention & control

[n] screened

[n] randomised

[n] safety

[n] ITT

[n] finishing study

[%] of randomised participants
finishing study

Dans 2007 1

I: momordica charantia + oral hypoglycaemic agents
C: placebo + oral hypoglycaemic agents

I: 20

C: 20

T: 40

I: 20

C: 20

T: 40

I: 20

C: 20

T: 40

I: 19

C: 20

T: 39

I: 95

C: 100

T: 98

Fuangchan 2011 2

I1: momordica charantia 500 mg/day

I2: momordica charantia 1000 mg/day

I3: momordica charantia 2000 mg/day

C: metformin

I1: 33

I2: 32

I3: 31

C: 33

T: 129

I1: 33

I2: 32

I3: 31

C: 33

T: 129

I1: 33

I2: 32

I3: 31

C: 33

T: 129

I1: 31

I2: 30

I3: 29

C: 30

T: 120

I1: 94

I2: 94

I3: 94

C: 91

T: 93

John 2003 1

I: momordica charantia + oral hypoglycaemic agents
C: placebo + oral hypoglycaemic agents

I: 26

C: 24

T: 50

I: 26

C: 24

T: 50

I: 22

C: 19

T: 41

I: 85

C: 79

T: 82

Purificacion 2007 1

I: momordica charantia
C: glibenclamide

I: 128

C: 132

T: 260

I: 128

C: 132

T: 260

Total

all interventions

270

all controls

209

all interventions & controls

479

"‐" denotes not reported

1 no information how missing data were handled

2 last observation carried forward (LOCF) method was used for missing values

Abbreviations:

C: control; I: intervention; ITT: intention‐to‐treat; T: total

Figuras y tablas -
Table 1. Overview of study populations
Comparison 1. Momordica charantia capsules versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Change in HbA1c Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

2 Change in fasting blood glucose Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

3 Change in total cholesterol Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

4 Change in body mass index Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 1. Momordica charantia capsules versus placebo
Comparison 2. Momordica charantia (dried fruits) tablets versus placebo

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fasting blood glucose Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

2 Post‐prandial blood glucose Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

3 Change in serum fructosamine Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

Figuras y tablas -
Comparison 2. Momordica charantia (dried fruits) tablets versus placebo
Comparison 3. Momordica charantia (dried fruits) capsules versus metformin

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Serum fructosamine Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 momordica charantia 2000mg/day versus metformin

1

62

Mean Difference (IV, Random, 95% CI)

6.60 [‐9.64, 22.84]

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Comparison 3. Momordica charantia (dried fruits) capsules versus metformin