Effects of dietary supplementation in treatment and control of progression and complications of insulin-dependent diabetes mellitus: a systematic review with meta-analyses of randomized clinical trials.

IF 1.9 4区 医学 Q2 BIOLOGY
L C Ferraz, M D R Barros, K M M Almeida, M B G Silva, N B Bueno
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引用次数: 0

Abstract

There is no safe and effective prevention for insulin-dependent diabetes (IDDM) mellitus, which makes it highly dependent on its treatment. This systematic review with meta-analyses of randomized clinical trials investigated the overall effects of dietary supplements of vitamins, minerals, trace elements, and non-essential compounds with antioxidant properties, fatty acids, and amino acids in IDDM. Searches of MEDLINE, Embase, CENTRAL, LILACS, The Grey Literature Report, and ClinicaTrials.gov, and citations from previous reviews were used to identify reports published through July 2023. The Risk of Bias 2 (RoB2) tool was used to analyze the risk of bias and GRADE was used to assess the quality of the results. Fifty-eight studies (n=3,044) were included in qualitative analyses and seventeen (n=723) in meta-analyses. Qualitative analyses showed few positive effects on some metabolic function markers, such as endothelial and renal function and lipid profile. Meta-analyses showed a positive effect of omega-3 on glycated hemoglobin (HbA1c) (RMD=-0.33; 95%CI: -0.53, -0.12, P=0.002; I2=0%; GRADE: low quality; 4 studies) and of vitamin D on fasting C-peptide (FCP) (RMD=0.05; 95%CI: 0.01, 0.9, P=0.023; I2=0%; GRADE: very low quality; 4 studies). Most studies showed bias concern or high risk of bias. A recommendation for dietary supplementation in IDDM cannot be made because of the few positive results within different interventions and markers, the serious risk of bias in the included studies, and the low quality of evidence from meta-analyses. The positive result of vitamin D on FCP is preliminary, requiring further investigation.

膳食补充剂对治疗和控制胰岛素依赖型糖尿病病情发展和并发症的影响:随机临床试验的系统综述和荟萃分析。
胰岛素依赖型糖尿病(IDM)没有安全有效的预防措施,因此高度依赖治疗。本系统综述对随机临床试验进行了荟萃分析,研究了膳食补充剂中维生素、矿物质、微量元素、具有抗氧化特性的非必需化合物、脂肪酸和氨基酸对 IDDM 的总体影响。通过检索 MEDLINE、Embase、CENTRAL、LILACS、The Grey Literature Report 和 ClinicaTrials.gov,以及以往综述的引文,确定了 2023 年 7 月之前发表的报告。偏倚风险2(RoB2)工具用于分析偏倚风险,GRADE用于评估结果的质量。定性分析纳入了 58 项研究(n=3,044),荟萃分析纳入了 17 项研究(n=723)。定性分析显示,对一些代谢功能指标(如内皮和肾功能以及血脂状况)几乎没有积极影响。元分析显示,欧米伽-3对糖化血红蛋白(HbA1c)有积极影响(RMD=-0.33;95%CI:-0.53,-0.12,P=0.002;I2=0%;GRADE:低质量;4项研究),维生素D对空腹C肽(FCP)有积极影响(RMD=0.05;95%CI:0.01,0.9,P=0.023;I2=0%;GRADE:极低质量;4项研究)。大多数研究存在偏倚问题或偏倚风险较高。由于不同干预措施和指标的阳性结果较少,纳入的研究存在严重的偏倚风险,以及荟萃分析的证据质量较低,因此无法就 IDDM 的膳食补充提出建议。维生素 D 对 FCP 的阳性结果是初步的,需要进一步研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.00
自引率
0.00%
发文量
129
审稿时长
2 months
期刊介绍: The Brazilian Journal of Medical and Biological Research, founded by Michel Jamra, is edited and published monthly by the Associação Brasileira de Divulgação Científica (ABDC), a federation of Brazilian scientific societies: - Sociedade Brasileira de Biofísica (SBBf) - Sociedade Brasileira de Farmacologia e Terapêutica Experimental (SBFTE) - Sociedade Brasileira de Fisiologia (SBFis) - Sociedade Brasileira de Imunologia (SBI) - Sociedade Brasileira de Investigação Clínica (SBIC) - Sociedade Brasileira de Neurociências e Comportamento (SBNeC).
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