PMID- 36638933 OWN - NLM STAT- MEDLINE DCOM- 20230214 LR - 20230227 IS - 1096-1186 (Electronic) IS - 1043-6618 (Linking) VI - 188 DP - 2023 Feb TI - Comparative effects of vitamin and mineral supplements in the management of type 2 diabetes in primary care: A systematic review and network meta-analysis of randomized controlled trials. PG - 106647 LID - S1043-6618(23)00003-8 [pii] LID - 10.1016/j.phrs.2023.106647 [doi] AB - Medical nutrition treatment can manage diabetes and slow or prevent its complications. The comparative effects of micronutrient supplements, however, have not yet been well established. We aimed at evaluating the comparative effects of vitamin and mineral supplements on managing glycemic control and lipid metabolism for type 2 diabetes mellitus (T2DM) to inform clinical practice. Electronic and hand searches for randomized controlled trials (RCTs) were performed until June 1, 2022. We selected RCTs enrolling patients with T2DM who were treated with vitamin supplements, mineral supplements, or placebo/no treatment. Data were pooled via frequentist random-effects network meta-analyses. A total of 170 eligible trials and 14223 participants were included. Low to very low certainty evidence established chromium supplements as the most effective in reducing fasting blood glucose levels and homeostasis model assessment of insulin resistance (SUCRAs: 90.4% and 78.3%, respectively). Vitamin K supplements ranked best in reducing glycated hemoglobin A1c and fasting insulin levels (SUCRAs: 97.0% and 82.3%, respectively), with moderate to very low certainty evidence. Vanadium supplements ranked best in lowering total cholesterol levels with very low evidence certainty (SUCRAs:100%). Niacin supplements ranked best in triglyceride reductions and increasing high-density lipoprotein cholesterol levels with low to very low evidence certainty (SUCRAs:93.7% and 94.6%, respectively). Vitamin E supplements ranked best in reducing low-density lipoprotein cholesterol levels with very low evidence certainty (SUCRAs:80.0%). Our analyses indicated that micronutrient supplements, especially chromium, vitamin E, vitamin K, vanadium, and niacin supplements, may be more efficacious in managing T2DM than other micronutrients. Considering the clinical importance of these findings, new research is needed to get better insight into this issue. CI - Copyright (c) 2023 The Authors. Published by Elsevier Ltd.. All rights reserved. FAU - Xia, Jiayue AU - Xia J AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Yu, Junhui AU - Yu J AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Xu, Hai AU - Xu H AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Zhou, Yuhao AU - Zhou Y AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Li, Hui AU - Li H AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Yin, Shiyu AU - Yin S AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Xu, Dengfeng AU - Xu D AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Wang, Yuanyuan AU - Wang Y AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Xia, Hui AU - Xia H AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Liao, Wang AU - Liao W AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China; China-DRIs Expert Committee on Macronutrients, P.R. China. FAU - Wang, Shaokang AU - Wang S AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China. FAU - Sun, Guiju AU - Sun G AD - Key Laboratory of Environmental Medicine and Engineering of Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, P.R. China; Department of Nutrition and Food Hygiene, School of Public Health, Southeast University, Nanjing 210009, P.R. China; China-DRIs Expert Committee on Macronutrients, P.R. China. Electronic address: gjsun@seu.edu.cn. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Review PT - Systematic Review DEP - 20230110 PL - Netherlands TA - Pharmacol Res JT - Pharmacological research JID - 8907422 RN - 0 (Vitamins) RN - 00J9J9XKDE (Vanadium) RN - 2679MF687A (Niacin) RN - 0 (Minerals) RN - 1406-18-4 (Vitamin E) RN - 0 (Micronutrients) RN - 12001-79-5 (Vitamin K) RN - 0R0008Q3JB (Chromium) RN - 97C5T2UQ7J (Cholesterol) SB - IM MH - Humans MH - Vitamins/therapeutic use MH - Network Meta-Analysis MH - Vanadium MH - *Niacin MH - Randomized Controlled Trials as Topic MH - Dietary Supplements MH - Minerals/therapeutic use MH - Vitamin E MH - Micronutrients MH - *Diabetes Mellitus, Type 2/drug therapy MH - Vitamin K MH - Chromium MH - Primary Health Care MH - Cholesterol OTO - NOTNLM OT - Cholecalciferol (PubChem CID: 5280795) OT - Chromium (PubChem CID: 23976) OT - Folic Acid (PubChem CID: 135398658) OT - Glucose control OT - Lipid metabolism OT - Mineral OT - Network meta-analysis OT - Nicotinic acid (PubChem CID: 938) OT - Type 2 diabetes mellitus OT - Vanadium (PubChem CID: 23990) OT - Vitamin OT - Vitamin E (PubChem CID: 14985) OT - Vitamin K (PubChem CID: 5280483) OT - Zinc (PubChem CID: 23994) COIS- Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. EDAT- 2023/01/14 06:00 MHDA- 2023/02/15 06:00 CRDT- 2023/01/13 19:25 PHST- 2022/11/21 00:00 [received] PHST- 2023/01/08 00:00 [revised] PHST- 2023/01/08 00:00 [accepted] PHST- 2023/01/14 06:00 [pubmed] PHST- 2023/02/15 06:00 [medline] PHST- 2023/01/13 19:25 [entrez] AID - S1043-6618(23)00003-8 [pii] AID - 10.1016/j.phrs.2023.106647 [doi] PST - ppublish SO - Pharmacol Res. 2023 Feb;188:106647. doi: 10.1016/j.phrs.2023.106647. Epub 2023 Jan 10.