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

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

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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.

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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.

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Comparison 1 Effects of Ayurvedic treatments on HbA1c, Outcome 1 Proprietary herbal mixtures ‐ HbA1c at end of study.
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Analysis 1.1

Comparison 1 Effects of Ayurvedic treatments on HbA1c, Outcome 1 Proprietary herbal mixtures ‐ HbA1c at end of study.

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Comparison 1 Effects of Ayurvedic treatments on HbA1c, Outcome 2 Proprietary herbal mixtures ‐ HbA1c change.
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Analysis 1.2

Comparison 1 Effects of Ayurvedic treatments on HbA1c, Outcome 2 Proprietary herbal mixtures ‐ HbA1c change.

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Comparison 2 Effects of Ayurvedic treatments on fasting blood sugar, Outcome 1 Fasting blood sugar at end of study.
Figuras y tablas -
Analysis 2.1

Comparison 2 Effects of Ayurvedic treatments on fasting blood sugar, Outcome 1 Fasting blood sugar at end of study.

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Comparison 2 Effects of Ayurvedic treatments on fasting blood sugar, Outcome 2 Change in fasting blood sugar at end of study.
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Analysis 2.2

Comparison 2 Effects of Ayurvedic treatments on fasting blood sugar, Outcome 2 Change in fasting blood sugar at end of study.

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Comparison 3 Effects of Ayurvedic treatments on post prandial blood sugar, Outcome 1 Post prandial blood sugar at end of study.
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Analysis 3.1

Comparison 3 Effects of Ayurvedic treatments on post prandial blood sugar, Outcome 1 Post prandial blood sugar at end of study.

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Comparison 4 Effects of Ayurvedic treatments on insulin levels at end of study, Outcome 1 Fasting insulin levels at end of study.
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Analysis 4.1

Comparison 4 Effects of Ayurvedic treatments on insulin levels at end of study, Outcome 1 Fasting insulin levels at end of study.

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Comparison 4 Effects of Ayurvedic treatments on insulin levels at end of study, Outcome 2 Stimulated insulin levels at end of study.
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Analysis 4.2

Comparison 4 Effects of Ayurvedic treatments on insulin levels at end of study, Outcome 2 Stimulated insulin levels at end of study.

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Comparison 5 Effects of Ayurvedic treatments on C‐peptide levels at end of study, Outcome 1 Fasting C‐peptide at end of study.
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Analysis 5.1

Comparison 5 Effects of Ayurvedic treatments on C‐peptide levels at end of study, Outcome 1 Fasting C‐peptide at end of study.

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Comparison 5 Effects of Ayurvedic treatments on C‐peptide levels at end of study, Outcome 2 Stimulated C‐peptide at end of study.
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Analysis 5.2

Comparison 5 Effects of Ayurvedic treatments on C‐peptide levels at end of study, Outcome 2 Stimulated C‐peptide at end of study.

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Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 1 Total cholesterol.
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Analysis 6.1

Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 1 Total cholesterol.

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Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 2 HDL‐cholesterol.
Figuras y tablas -
Analysis 6.2

Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 2 HDL‐cholesterol.

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Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 3 LDL‐cholesterol.
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Analysis 6.3

Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 3 LDL‐cholesterol.

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Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 4 Triglycerides.
Figuras y tablas -
Analysis 6.4

Comparison 6 Effects of Ayurvedic treatments on lipid profile (end of study), Outcome 4 Triglycerides.

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Table 1. Overview of study populations

Characteristic

Study ID

Intervention(s) & control(s)

[n] screened

[n] randomized

[n] safety

[n] ITT

[n] finishing study

[%] of randomized participants
finishing study

Comments

Agrawal 2002

I: Inolter®

C: Placebo

I: ‐

C: ‐

T: 90

I: 30

C: 30

T: 60

I: 30

C: 30

T: 60

I: 30

C: 30

T: 60

I: 30

C: 30

T: 60

100%

Dubey 1993

I: Diabecon® (D‐400)

C: Placebo

I: 14

C: 14

T: 28

I: 14

C: 14

T: 28

I: 14

C: 14

T: 28

I: 14

C: 14

T: 28

I: 14

C: 14

T: 28

100%

no withdrawals reported

Elder 2006

I: MA471 (mixture of herbs) + meditation, diet, exercise

C: Usual care + diabetes education

I: ‐

C: ‐

T: 89

I: 30

C: 30

T: 60

I: 27

C: 28

T: 55

I: 26

C: 28

T: 54

I: 26

C: 28

T: 54

90%

3 participants in Vedic and 2 in control groups withdrew due to time constraints, 1 in Vedic group did not complete 6 month follow‐up

Hsia 2004

I: Pancreas tonic (herbal mixture)

C: Placebo

I: ‐

C: ‐

T: 63

I: 31

C: 16

T: 47

‐

I: 23

C: 13

T: 36

I: 23

C: 13

T: 36

76.6%

1 in placebo and 4 in treatment group withdrawn due to non‐compliance, others withdrew mainly due to inconvenience

Mohan 1998

I: Diabecon® (D‐400)

C: Placebo

I: 20

C: 20

T: 40

I: 20

C: 20

T: 40

I: 19

C: 18

T: 37

‐

I: 17

C: 15

T: 32

80%

8 withdrew ‐ 2 in placebo and 1 in treatment group due to non‐compliance, 2 in treatment group due to gastritis and skin rashes, 3 in placebo group due to uncontrolled diabetes

Poongothai 2002

I: Hyponidd®

C: Placebo

I: 20

C: 20

T: 40

I: 20

C: 20

T: 40

I: ‐

C: ‐

T: 35

I: 16

C:16

T: 32

I: 16

C: 16

T: 32

80%

8 withdrawals ‐ 5 due to non‐compliance, 2 had
severe hyperglycaemia and 1 due to elevated liver enzymes

Shekhar 2002

I: Cogent db®

C: Usual care (antidiabetic drugs)

I: 39

C: 40

T: 79

I: 39

C: 40

T: 79

I: 30

C: 30

T: 60

I: 30

C:30

T: 60

I: 30

C: 30

T: 60

75.9%

19 withdrawals ‐ 4 due to non‐compliance with
medication, 15 due to withdrawn consent

Total

I: 184

C: 170

T: 354

I: 156

C: 146

T: 302

"‐" denotes not reported

C: control; I: intervention; ITT: intention‐to‐treat; T: Total
Figuras y tablas -
Table 1. Overview of study populations
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Comparison 1. Effects of Ayurvedic treatments on HbA1c

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Proprietary herbal mixtures ‐ HbA1c at end of study Show forest plot

6

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Diabecon

1

32

Mean Difference (IV, Random, 95% CI)

‐1.0 [‐1.87, ‐0.13]

1.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

‐0.5 [‐1.54, 0.54]

1.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐2.10 [‐3.25, ‐0.95]

1.4 Pancreas Tonic

2

36

Mean Difference (IV, Random, 95% CI)

‐0.45 [‐4.17, 3.28]

1.5 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

‐0.80 [‐0.93, ‐0.67]

2 Proprietary herbal mixtures ‐ HbA1c change Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

‐0.91 [‐1.43, ‐0.39]
Figuras y tablas -
Comparison 1. Effects of Ayurvedic treatments on HbA1c
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Comparison 2. Effects of Ayurvedic treatments on fasting blood sugar

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fasting blood sugar at end of study Show forest plot

4

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Diabecon

2

60

Mean Difference (IV, Random, 95% CI)

‐17.84 [‐27.70, ‐7.98]

1.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

‐12.0 [‐52.89, 28.89]

1.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐63.0 [‐97.01, ‐28.99]

2 Change in fasting blood sugar at end of study Show forest plot

1

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

‐38.95 [‐65.56, ‐12.34]
Figuras y tablas -
Comparison 2. Effects of Ayurvedic treatments on fasting blood sugar
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Comparison 3. Effects of Ayurvedic treatments on post prandial blood sugar

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Post prandial blood sugar at end of study Show forest plot

4

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Diabecon

2

60

Mean Difference (IV, Random, 95% CI)

‐66.13 [‐114.21, ‐18.05]

1.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

‐8.0 [‐62.96, 46.96]

1.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

59.40 [7.21, 111.59]
Figuras y tablas -
Comparison 3. Effects of Ayurvedic treatments on post prandial blood sugar
Ir a la tabla de la revisión
Comparison 4. Effects of Ayurvedic treatments on insulin levels at end of study

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fasting insulin levels at end of study Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Diabecon

1

32

Mean Difference (IV, Random, 95% CI)

3.90 [0.39, 7.41]

1.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

1.10 [‐3.29, 5.49]

1.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐2.90 [‐7.56, 1.76]

2 Stimulated insulin levels at end of study Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Diabecon

1

32

Mean Difference (IV, Random, 95% CI)

15.5 [7.92, 23.08]

2.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

3.30 [‐8.39, 14.99]

2.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐16.9 [‐44.92, 11.12]
Figuras y tablas -
Comparison 4. Effects of Ayurvedic treatments on insulin levels at end of study
Ir a la tabla de la revisión
Comparison 5. Effects of Ayurvedic treatments on C‐peptide levels at end of study

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Fasting C‐peptide at end of study Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Diabecon‐ Proprietary Drug

1

32

Mean Difference (IV, Random, 95% CI)

0.38 [0.24, 0.52]

1.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

0.10 [‐0.04, 0.24]

1.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐0.20 [‐1.28, 0.88]

2 Stimulated C‐peptide at end of study Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Diabecon

1

32

Mean Difference (IV, Random, 95% CI)

0.40 [‐0.09, 0.89]

2.2 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

0.10 [‐0.37, 0.57]

2.3 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

0.80 [‐1.50, 3.10]
Figuras y tablas -
Comparison 5. Effects of Ayurvedic treatments on C‐peptide levels at end of study
Ir a la tabla de la revisión
Comparison 6. Effects of Ayurvedic treatments on lipid profile (end of study)

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Total cholesterol Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

1.1 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

‐1.0 [‐30.64, 28.64]

1.2 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐27.05 [‐48.71, ‐5.39]

1.3 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

2.10 [‐8.96, 13.16]

2 HDL‐cholesterol Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

2.1 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

2.0 [‐3.27, 7.27]

2.2 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

0.0 [‐5.87, 5.87]

2.3 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

3.90 [2.09, 5.71]

3 LDL‐cholesterol Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

3.1 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

6.00 [‐18.20, 30.20]

3.2 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐11.60 [‐36.35, 13.15]

3.3 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

‐8.40 [‐10.82, ‐5.98]

4 Triglycerides Show forest plot

3

Mean Difference (IV, Random, 95% CI)

Subtotals only

4.1 Hyponidd

1

32

Mean Difference (IV, Random, 95% CI)

‐32.0 [‐149.32, 85.32]

4.2 Cogent DB

1

60

Mean Difference (IV, Random, 95% CI)

‐44.21 [‐89.21, 0.79]

4.3 Inolter

1

60

Mean Difference (IV, Random, 95% CI)

‐16.80 [‐22.63, ‐10.97]
Figuras y tablas -
Comparison 6. Effects of Ayurvedic treatments on lipid profile (end of study)
Ir a la tabla de la revisión