title: Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis.
abstract: OBJECTIVE
  Diabetes mellitus is a global epidemic and one of the leading causes of morbidity and mortality. Additional medications that are novel, affordable, and efficacious are needed to treat this rampant disease. This meta-analysis was performed to ascertain the effectiveness of oral aloe vera consumption on the reduction of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c).
  
  
  METHODS
  PubMed, CINAHL, Natural Medicines Comprehensive Database, and Natural Standard databases were searched. Studies of aloe vera's effect on FBG, HbA1c, homeostasis model assessment-estimated insulin resistance (HOMA-IR), fasting serum insulin, fructosamine, and oral glucose tolerance test (OGTT) in prediabetic and diabetic populations were examined. After data extraction, the parameters of FBG and HbA1c had appropriate data for meta-analyses. Extracted data were verified and then analyzed by StatsDirect Statistical Software. Reductions of FBG and HbA1c were reported as the weighted mean differences from baseline, calculated by a random-effects model with 95% confidence intervals. Subgroup analyses to determine clinical and statistical heterogeneity were also performed. Publication bias was assessed by using the Egger bias statistic.
  
  
  RESULTS
  Nine studies were included in the FBG parameter (n = 283); 5 of these studies included HbA1c data (n = 89). Aloe vera decreased FBG by 46.6 mg/dL (p < 0.0001) and HbA1c by 1.05% (p = 0.004). Significant reductions of both endpoints were maintained in all subgroup analyses. Additionally, the data suggest that patients with an FBG ≥200 mg/dL may see a greater benefit. A mean FBG reduction of 109.9 mg/dL was observed in this population (p ≤ 0.0001). The Egger statistic showed publication bias with FBG but not with HbA1c (p = 0.010 and p = 0.602, respectively).
  
  
  CONCLUSIONS
  These results support the use of oral aloe vera for significantly reducing FBG (46.6 mg/dL) and HbA1c (1.05%). Further clinical studies that are more robust and better controlled are warranted to further explore these findings.
authors.affiliation: 1 Department of Pharmacy, David Grant Medical Center , Travis Air Force Base, Fairfield, CA.
authors.forename: William R
authors.initials: WR
authors.lastname: Dick
authors.affiliation: 1 Department of Pharmacy, David Grant Medical Center , Travis Air Force Base, Fairfield, CA.
authors.forename: Emily A
authors.initials: EA
authors.lastname: Fletcher
authors.affiliation: 1 Department of Pharmacy, David Grant Medical Center , Travis Air Force Base, Fairfield, CA.|2 Department of Pharmacy Practice, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific , Stockton, CA.
authors.forename: Sachin A
authors.initials: SA
authors.lastname: Shah
mesh_terms: D000504:Aloe / Q000737:chemistry*; D001786:Blood Glucose / Q000187:drug effects*; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008517:Phytotherapy; D010936:Plant Extracts / Q000494:pharmacology* / Q000627:therapeutic use*
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; D010936:Plant Extracts