Overall and Sex-Specific Effect of Berberine on Glycemic and Insulin-Related Traits: a Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials
PubMed 37598753 · doi:10.1016/j.tjnut.2023.08.016
What was done
Authors conducted a systematic review and meta-analysis (PROSPERO CRD42022345172) of randomized placebo-controlled trials of berberine identified through Medline, Embase, CNKI, registries, and prior reviews. Random-effects inverse-variance weighting was used to calculate mean differences for glycemic and insulin traits. Subgroup analyses were conducted across sex, diabetes status, trial duration, berberine dosage, and ethnicity across 20 included trials (n = 1,761).
What was found
Berberine significantly reduced: - Fasting glucose: -0.52 mmol/L (95% CI: -0.72 to -0.33; 18 studies, n = 1,522) - HbA1c: -4.48 mmol/mol (95% CI: -6.53 to -2.44; 7 studies, n = 756) - Fasting insulin: -2.36 mU/L (95% CI: -3.64 to -1.08; 11 studies, n = 966) - HOMA-IR: -0.85 (95% CI: -1.16 to -0.53; 12 studies, n = 1,065) - 2-hour postprandial glucose: -1.81 mmol/L (95% CI: -2.37 to -1.24; 4 studies, n = 501) Comparing 4 trials conducted exclusively in women to 1 trial in men, women showed greater reductions in fasting glucose (mean difference -0.21 mmol/L, 95% CI -0.41 to -0.00) and HOMA-IR (mean difference -0.97, 95% CI -1.84 to -0.10). Greater fasting glucose reductions were also reported for individuals with diabetes and Asian populations.
Why it matters
This review quantifies the modest glycemic and insulin-sensitizing benefits of berberine supplementation and highlights potential heterogeneity in response across biological sex, baseline metabolic status, and ethnicity.
Limits
The sex-disaggregated analysis is severely constrained by data availability, relying on only 4 female-only trials and a single male-only trial. The abstract reports no safety or adverse-event outcomes, average study sample sizes were modest (under 100 participants per trial on average), and long-term durability of effect beyond standard trial durations was not characterized.
Cited by
- supports Berberine drops blood sugar and HbA1c in human randomized controlled trials and is similar in function to metformin.