Fenugreek for T2DM: Systematic Review

Background

The NHS spends over £8 billion per year on medicine to treat diabetes. However, less than half of people take their medicines as prescribed. There are over 431,000 people of South Asian descent with type 2 diabetes in the UK. They have higher blood sugar levels, and more health problems from diabetes than the White population. In India, 67% of patients with type 2 diabetes use natural remedies, which are also popular in Asian communities in the UK (1). Immigrants bring their traditions with them, so for example in an interview study of members of the Pakistani community in Bradford (UK), many preferred using herbal medicine compared to conventional medicine (2). Fenugreek seed powder (Trigonella foenum-graecum) is one of the most popular, potentially safe and effective “natural remedies” for self-management of diabetes used by communities in China and the Indian subcontinent. However, there is no clear guidance for patients on which preparations, doses or length of treatment are the most effective (3).

Aims

To evaluate whether Fenugreek preparations reduce blood sugar levels in patients with type 2 diabetes, and if so, by how much

To estimate the proportion of patients who experience side effects from Fenugreek

To determine the best preparation(s), dose(s) and length of treatment for Fenugreek

Approach

We will conduct a high-quality, up-to-date systematic review of existing clinical trials on the effectiveness, safety and adverse effects of Fenugreek preparations for type 2 diabetes. Although two reviews have been published, they are both over 5 years old, one reports data incorrectly, and there are now at least 7 additional trials with a total of 928 participants which could be included in an updated review.

As several trials have been published in Chinese, we will work with the Centre for Evidence-Based Chinese Medicine (Beijing University of Chinese medicine). We will include studies in all languages and will search both English and Chinese databases. We will compare results from different preparations of fenugreek and different length of treatment, if data allows.

Involving the public

Two members of the public will advise on the review, including its design and dissemination of results.

Sharing Findings

We will publish in a scientific journal, on publicly accessible websites and produce public engagement materials.

Impact

Our findings will enable patients to make better evidence-informed choices about self-management of type 2 diabetes using Fenugreek. This will inform whether a further clinical trial is needed, and will also support an application to the NIHR “Programme Grants for Applied Research”, for developing an intervention to improve self-management of diabetes through providing evidence-based information and advice on natural remedies to patients from ethnic minority communities in the UK.

Amount awarded: £43,084