title: The effect of ginseng (the genus panax) on glycemic control: a systematic review and meta-analysis of randomized controlled clinical trials.
abstract: OBJECTIVE
  Despite the widespread use of ginseng in the management of diabetes, supporting evidence of its anti-hyperglycemic efficacy is limited, necessitating the need for evidence-based recommendations for the potential inclusion of ginseng in diabetes management.
  
  
  OBJECTIVE
  To elucidate the effect of ginseng on glycemic control in a systematic review and meta-analysis of randomized controlled trials in people with and without diabetes.
  
  
  METHODS
  MEDLINE, EMBASE, CINAHL and the Cochrane Library (through July 3, 2013).
  
  
  METHODS
  Randomized controlled trials ≥30 days assessing the glycemic effects of ginseng in people with and without diabetes.
  
  
  METHODS
  Relevant data were extracted by 2 independent reviewers. Discrepancies were resolved by consensus. The Heyland Methodological Quality Score and the Cochrane risk of bias tool were used to assess study quality and risk of bias respectively.
  
  
  RESULTS
  Sixteen trials were included, in which 16 fasting blood glucose (n = 770), 10 fasting plasma insulin (n = 349), 9 glycated hemoglobin (n = 264), and 7 homeostasis model assessment of insulin resistance (n = 305) comparisons were reported. Ginseng significantly reduced fasting blood glucose compared to control (MD =  -0.31 mmol/L [95% CI: -0.59 to -0.03], P = 0.03). Although there was no significant effect on fasting plasma insulin, glycated hemoglobin, or homeostasis model assessment of insulin resistance, a priori subgroup analyses did show significant reductions in glycated hemoglobin in parallel compared to crossover trials (MD = 0.22% [95%CI: 0.06 to 0.37], P = 0.01).
  
  
  CONCLUSIONS
  Most trials were of short duration (67% trials<12wks), and included participants with a relatively good glycemic control (median HbA1c non-diabetes = 5.4% [2 trials]; median HbA1c diabetes = 7.1% [7 trials]).
  
  
  CONCLUSIONS
  Ginseng modestly yet significantly improved fasting blood glucose in people with and without diabetes. In order to address the uncertainty in our effect estimates and provide better assessments of ginseng's anti-diabetic efficacy, larger and longer randomized controlled trials using standardized ginseng preparations are warranted.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01841229.
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Esra'
authors.initials: E
authors.lastname: Shishtar
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Departments of Pathology and Molecular Medicine, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: John L
authors.initials: JL
authors.lastname: Sievenpiper
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Djedovic
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Adrian I
authors.initials: AI
authors.lastname: Cozma
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Ha
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Viranda H
authors.initials: VH
authors.lastname: Jayalath
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: David J A
authors.initials: DJ
authors.lastname: Jenkins
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Sonia Blanco
authors.initials: SB
authors.lastname: Meija
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Clinical Epidemiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.
authors.forename: Russell J
authors.initials: RJ
authors.lastname: de Souza
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: Elena
authors.initials: E
authors.lastname: Jovanovski
authors.affiliation: Risk Factor Modification Centre, St. Michael's Hospital, Toronto, ON, Canada; Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Vuksan
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D003922:Diabetes Mellitus, Type 1 / Q000628:therapy; D003924:Diabetes Mellitus, Type 2 / Q000628:therapy; D005215:Fasting; D006442:Glycated Hemoglobin / Q000032:analysis; D029001:Herbal Medicine; D006706:Homeostasis; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008875:Middle Aged; D005894:Panax; D016032:Randomized Controlled Trials as Topic
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D007328:Insulin; C517652:hemoglobin A1c protein, human