A 12-week, open-label, randomized, controlled trial investigating effect of mulberry leaves plus lifestyle intervention on glycemic control compare with lifestyle intervention alone in patients with obesity and patients with type 2 diabetes (T2DM)
Diabetes remains a common leading cause of morbidity and mortality among population worldwide over decades. Obesity, a crucial risk factors for developing T2DM, commonly exists with insulin resistance and impaired beta-cell function. Early management in individuals at high risk of T2DM should be therefore considered for preventing or delaying the progression of diabetes and diabetic complications. Since 1-deoxynojirimycin (DNJ), the major antihyperglycemic compound of mulberry leaves, inhibits alpha-glucosidase activities, ingestion of mulberry leaves results in the suppression of postprandial hyperglycemia. Long-term effects of mulberry leaves on glycemic profiles have been demonstrated in numerous clinical studies; however, the results were controversial. In addition, no study was conducted in patients with obesity. As a result, this open-label, randomized controlled study aims to investigate efficacy and safety of mulberry leaves in combination with lifestyle intervention (diet control) on glycemic control in non-diabetic patients with obesity and patients with early-stage T2DM. Efficacy of the interventions will be assessed based on the changes in glycemic indexes, expression of proteins related to insulin resistance and T2DM, and lipid profiles. Meanwhile, safety will be measured by the changes in renal and hepatic enzymes and patient-self reports. The outcomes will be monitored at 4-week interval throughout 12 weeks of the study period.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Dried powder of mulberry leaves crude extract containing 12 mg of DNJ will be packed in a sealed packet with light and moisture protection. Participants will be instructed to mix 1 packet of the powder with a half glass (approximately 120 mL) of plain water and ingest thrice daily before meals. Additionally, they will be informed to rinse the glass with more water and drink to ensure that all of the powder will be taken.
Participants will be requested for diet control. They will be asked for attending the diet control program, maintaining diet pattern throughout the study period, and recording a 3-day food record. Individual counseling and assessment of compliance will be performed by licensed dietitians every 4 weeks. Diet control is principally based on carbohydrate counting.
Pornanong Aramwit
Bangkok, Thailand
Effect on 2-hour postprandial glucose (PPG) during 75-g oral glucose tolerance test (OGTT) (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of the 2-hour PPG (in mg/dL) during 75-g OGTT at week 12
Time frame: 12 weeks
Effect on fasting plasma glucose (FPG) (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of FPG (in mg/dL) at week 4, 8, and 12
Time frame: 12 weeks
Effect on glycated hemoglobin (A1C) (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of A1C (in %) at week 12
Time frame: 12 weeks
Effect on total cholesterol (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of total cholesterol (in mg/dL) at week 12
Time frame: 12 weeks
Effect on high-density lipoprotein cholesterol (HDL-C) (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of HDL-C (in mg/dL) at week 12
Time frame: 12 weeks
Effect on triglycerides (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of triglycerides (in mg/dL) at week 12
Time frame: 12 weeks
Effect on low-density lipoprotein cholesterol (LDL-C) (efficacy)
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To evaluate difference between the treatment group and the control group, and change from baseline of LDL-C (in mg/dL) at week 12
Time frame: 12 weeks
Effect on insulin resistance index (efficacy)
To evaluate difference between the treatment group and the control group, and change from baseline of Homeostasis model assessment indexes of insulin resistance (HOMA-IR) at week 12
Time frame: 12 weeks
Adverse effects on renal function (safety)
To evaluate difference between the treatment group and the control group, and change from baseline of serum creatinine (in mg/dL) at week 12
Time frame: 12 weeks
Adverse effects on hepatic function 1 (safety)
To evaluate difference between the treatment group and the control group, and change from baseline of aspartate aminotransferase (AST) (in units/L) at week 12
Time frame: 12 weeks
Adverse effects on hepatic function 2 (safety)
To evaluate difference between the treatment group and the control group, and change from baseline of alanine aminotransferase (ALT) (in units/L) at week 12
Time frame: 12 weeks
Self-reported adverse events (safety)
Participants in the treatment group (those who were assigned to administer mulberry leaves) were asked to report adverse events caused by mulberry leaves administration (i.e. constipation, diarrhea, abdominal cramp, bloating, and hypoglycemia) to the researchers.
Time frame: 12 weeks