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.
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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
30
Gymnema Sylvestre, 300mg capsules 2 times daily with the first bite of breakfast and dinner
Placebo, 300mg capsules 2 times daily with the first bite of breakfast and dinner
Institute of Experimental and Clinical Therapeutics (INTEC), CUCS, University of Guadalajara
Guadalajara, Jalisco, Mexico
Fasting Plasma Glucose
After intervention by spectrophotometry
Time frame: 90 days
2-hour Post Load Plasma Glucose (2-h PG)
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.
Time frame: 90 days
Glycated Hemoglobin A1c (A1C)
After intervention by high-performance liquid chromatography
Time frame: 90 days
Total Insulin Secretion (Insulinogenic Index)
Total insulin secretion was calculated with the insulinogenic index (ΔABC insulin / ΔABC glucose) after intervention.
Time frame: 90 days
First Phase of Insulin Secretion
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.
Time frame: 90 days
Insulin Sensitivity (Matsuda Index)
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.
Time frame: 90 days
Area Under the Curve of Glucose
Area under the curve of glucose was obtained using the trapezoidal integration.
Time frame: 90 days
Area Under the Curve of Insulin
After intervention area under the curve of insulin
Time frame: 90 days
Body Weight (BW)
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
Time frame: 12 weeks
Body Mass Index (BMI)
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
Time frame: 12 weeks
Waist Circumference (WC)
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
Time frame: 12 weeks
Systolic Blood Pressure (SBP)
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
Time frame: 12 weeks
Diastolic Blood Pressure (DBP)
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
Time frame: 12 weeks
Total Cholesterol
After intervention by spectrophotometry
Time frame: 90 days
Triglycerides
After intervention by spectrophotometry
Time frame: 90 days
High Density Lipoprotein Cholesterol
After intervention by spectrophotometry
Time frame: 90 days
Low Density Lipoprotein
After intervention by spectrophotometry
Time frame: 90 days
Very Low Density Lipoprotein
After intervention by spectrophotometry
Time frame: 90 days
Creatinine
After intervention by spectrophotometry
Time frame: 90 days
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