Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis

Purpose.There are controversial data regarding the beneficial effects of ascorbic acid (AA) supplementation in type 2 diabetes mellitus (T2DM). In this systematic review, we aimed to criticize the current relevant data from both observational and randomized controlled trials (RCTs). Methods. All obs...

Full description

Bibliographic Details
Main Authors: Ozra Tabatabaei-Malazy, Shekoufeh Nikfar, Bagher Larijani, Mohammad Abdollahi
Format: Article
Language:English
Published: Frontiers Media S.A. 2015-01-01
Series:Journal of Pharmacy & Pharmaceutical Sciences
Online Access:https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/23408
_version_ 1797722772934230016
author Ozra Tabatabaei-Malazy
Shekoufeh Nikfar
Bagher Larijani
Mohammad Abdollahi
author_facet Ozra Tabatabaei-Malazy
Shekoufeh Nikfar
Bagher Larijani
Mohammad Abdollahi
author_sort Ozra Tabatabaei-Malazy
collection DOAJ
description Purpose.There are controversial data regarding the beneficial effects of ascorbic acid (AA) supplementation in type 2 diabetes mellitus (T2DM). In this systematic review, we aimed to criticize the current relevant data from both observational and randomized controlled trials (RCTs). Methods. All observational and RCTs conducted to assess anti-hyperglycemic effects of AA in diabetics, published before January 2013, were included. To obtain all related studies Google Scholar, PubMed, Scopus, IranMedex, and Magiran web databases were searched. Exclusion criteria were animal studies, and studies conducted in Type 1 DM, children or pregnant women. Main outcome measures were fasting blood sugar (FBS), and glycated hemoglobin (HbA1c). According to degree of heterogeneity, fixed or random effect models were employed. Meta-analyses were done using Stats Direct software, version 3.0.97. The quality of included articles and publication bias were also assessed. Results. We selected 38 articles; 26 observational studies and 12 RCTs. Due to severe methodological heterogeneity in all observational studies and some of RCTs, we could pool data from only 5 RCTs in a meta-analysis. Single intake of AA versus placebo showed a significant effect on FBS; with the standardized mean difference (SMD): -20.59, 95% confidence intervals (95% CI): -40.77 to -0.4 (p= 0.04), but non-significant effect on HbA1c; SMD: -0.46, 95% CI: -1.75 to 0.84 (p= 0.4). Effect of other antioxidants with/without AA supplementation on FBSwere nonsignificant; SMD: -4.26 (p= 0.8), and SMD: -12.04 (p= 0.3), respectively. Also, their effect on HbA1c was non-significant; SMD: 0.53 (p= 0.11), and SMD: 0.28 (p= 0.34), respectively. Conclusions. Our study supports the positive effect of AA in reduction of FBS in diabetics, however, due to insufficient evidence ragarding long term safety of AA supplementation and limited number of  RCTs, the long term use of this vitamin for its anti-diabetic properties cannot be strongly recommended.   This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.
first_indexed 2024-03-12T09:53:25Z
format Article
id doaj.art-75f165e4945f42ba9e765f802a8c03c4
institution Directory Open Access Journal
issn 1482-1826
language English
last_indexed 2024-03-12T09:53:25Z
publishDate 2015-01-01
publisher Frontiers Media S.A.
record_format Article
series Journal of Pharmacy & Pharmaceutical Sciences
spelling doaj.art-75f165e4945f42ba9e765f802a8c03c42023-09-02T12:23:43ZengFrontiers Media S.A.Journal of Pharmacy & Pharmaceutical Sciences1482-18262015-01-0117410.18433/J3ZG6RInfluence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-AnalysisOzra Tabatabaei-Malazy0Shekoufeh Nikfar1Bagher Larijani2Mohammad Abdollahi3Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.Department of Pharmacoeconomics and Pharmaceutical Administration, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran.Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.Faculty of Pharmacy, and Pharmaceutical Sciences Research Center, Tehran University of Medical SciencesPurpose.There are controversial data regarding the beneficial effects of ascorbic acid (AA) supplementation in type 2 diabetes mellitus (T2DM). In this systematic review, we aimed to criticize the current relevant data from both observational and randomized controlled trials (RCTs). Methods. All observational and RCTs conducted to assess anti-hyperglycemic effects of AA in diabetics, published before January 2013, were included. To obtain all related studies Google Scholar, PubMed, Scopus, IranMedex, and Magiran web databases were searched. Exclusion criteria were animal studies, and studies conducted in Type 1 DM, children or pregnant women. Main outcome measures were fasting blood sugar (FBS), and glycated hemoglobin (HbA1c). According to degree of heterogeneity, fixed or random effect models were employed. Meta-analyses were done using Stats Direct software, version 3.0.97. The quality of included articles and publication bias were also assessed. Results. We selected 38 articles; 26 observational studies and 12 RCTs. Due to severe methodological heterogeneity in all observational studies and some of RCTs, we could pool data from only 5 RCTs in a meta-analysis. Single intake of AA versus placebo showed a significant effect on FBS; with the standardized mean difference (SMD): -20.59, 95% confidence intervals (95% CI): -40.77 to -0.4 (p= 0.04), but non-significant effect on HbA1c; SMD: -0.46, 95% CI: -1.75 to 0.84 (p= 0.4). Effect of other antioxidants with/without AA supplementation on FBSwere nonsignificant; SMD: -4.26 (p= 0.8), and SMD: -12.04 (p= 0.3), respectively. Also, their effect on HbA1c was non-significant; SMD: 0.53 (p= 0.11), and SMD: 0.28 (p= 0.34), respectively. Conclusions. Our study supports the positive effect of AA in reduction of FBS in diabetics, however, due to insufficient evidence ragarding long term safety of AA supplementation and limited number of  RCTs, the long term use of this vitamin for its anti-diabetic properties cannot be strongly recommended.   This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/23408
spellingShingle Ozra Tabatabaei-Malazy
Shekoufeh Nikfar
Bagher Larijani
Mohammad Abdollahi
Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
Journal of Pharmacy & Pharmaceutical Sciences
title Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
title_full Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
title_fullStr Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
title_full_unstemmed Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
title_short Influence of Ascorbic Acid Supplementation on Type 2 Diabetes Mellitus in Observational and Randomized Controlled Trials; A Systematic Review with Meta-Analysis
title_sort influence of ascorbic acid supplementation on type 2 diabetes mellitus in observational and randomized controlled trials a systematic review with meta analysis
url https://journals.library.ualberta.ca/jpps/index.php/JPPS/article/view/23408
work_keys_str_mv AT ozratabatabaeimalazy influenceofascorbicacidsupplementationontype2diabetesmellitusinobservationalandrandomizedcontrolledtrialsasystematicreviewwithmetaanalysis
AT shekoufehnikfar influenceofascorbicacidsupplementationontype2diabetesmellitusinobservationalandrandomizedcontrolledtrialsasystematicreviewwithmetaanalysis
AT bagherlarijani influenceofascorbicacidsupplementationontype2diabetesmellitusinobservationalandrandomizedcontrolledtrialsasystematicreviewwithmetaanalysis
AT mohammadabdollahi influenceofascorbicacidsupplementationontype2diabetesmellitusinobservationalandrandomizedcontrolledtrialsasystematicreviewwithmetaanalysis