Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial

Carvalho, Gerdane Celene Nunes; Lira-Neto, José Claudio Garcia; Araújo, Márcio Flávio Moura de; Freitas, Roberto Wagner Júnior Freire de; Zanetti, Maria Lúcia; Damasceno, Marta Maria Coelho

doi:10.1590/1518-8345.3870.3369

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Revista Latino-Americana de Enfermagem

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Original Article • Rev. Latino-Am. Enfermagem 28 • 2020 • https://doi.org/10.1590/1518-8345.3870.3369 copy

Effectiveness of ginger in reducing metabolic levels in people with diabetes: a randomized clinical trial^* * Paper extracted from doctoral dissertation “Efeito do gengibre (zingiber officinale) no controle glicêmico e lipêmico de pessoas com diabetes tipo 2: ensaio clínico randomizado duplo cego controlado por placebo”, presented to Universidade Federal do Ceará, Departamento de Enfermagem, Fortaleza, CE, Brazil. Supported by Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Grant # 310496/2017-9, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

to evaluate the effectiveness of ginge (Zingiber officinale) in reducing blood sugar and lipid levels in people with type 2 diabetes.

Method:

a randomized and double-blind clinical trial conducted with people with type 2 diabetes in primary care facilities. The study included individuals aged between 20 and 80 years old, using oral antidiabetic drugs and with HbA1c levels between 6.0% and 10%. The participants were paired 1:1, allocated in two distinct groups, and randomized in blocks, based on their HbA1c levels. In the experimental group, the participants used 1.2g of ginger and, in the control group, 1.2g of placebo, daily for 90 days. The primary outcome was a reduction in fasting blood sugar and HbA1c, and the secondary outcome was a reduction in lipids and HOMA-IR. 103 individuals completed the study, 47 in the experimental group and 56 in the control group.

Results:

the participants in the experimental group showed a greater reduction in the blood glucose and total cholesterol values compared to the control group.

Conclusion:

the use of ginger can help in the treatment of people with diabetes, and data support the inclusion of this herbal drug in the clinical practice of nurses. RBR-2rt2wy

Descriptors:
Ginger; Type 2 Diabetes Mellitus, Type 2; Blood Glucose; Lipids; Clinical Trial; Placebo

Variables	Total (n=103)	Control Group (n=56)	Experimental Group (n=47)	p
Time with diabetes				0.670^* * Chi-square test;
2-5 years	42 (40.8%)	22 (39.3%)	20 (42.6%)
5-10 years	33 (32.0%)	20 (35.7%)	13 (27.7%)
> 10 years	28 (27.2%)	14 (25.0%)	14 (29.8%)
Hypertension				0.274^* * Chi-square test;
Yes	62 (60.2%)	31 (55.4%)	31 (66%)
No	41 (39.8%)	25 (44.6%)	16 (34%)
Follow-up in the PHCU				0.558^* * Chi-square test;
Monthly	18 (17.5%)	09 (16.1%)	09 (19.1%)
Quarterly	45 (43.7%)	28 (50.0%)	17 (36.2%)
Semiannual	26 (25.2%)	12 (21.4%)	14 (29.8%)
Others	14 (13.6%)	07 (12.5%)	07 (14.9%)
Physical Activity
Before the Intervention	38 (35.9%)	21 (37.5%)	17 (36.2%)	0.889^* * Chi-square test;
After the Intervention	35 (34.0%)	19 (33.9%)	16 (34.0%)	0.990^* * Chi-square test;
Hypoglycemia in the last 30 days				0.623^* * Chi-square test;
Yes	04 (3.9%)	03 (5.4%)	01 (2.1%)
No	99 (96.1%)	53 (94.6%)	46 (97.9%)
Hyperglycemia in the last 30 days				0.081^† † Fisher's exact test;
Yes	13 (12.6%)	04 (7.1%)	09 (19.1%)
No	90 (87.4%)	52 (92.9%)	38 (80.9%)
Systolic blood pressure		0.527^‡ ‡ Wilcoxon's test;	0.870^‡ ‡ Wilcoxon's test;
Before the Intervention	128.27±17.96	125.02±15.93	131.53±19.99	0.146^§ § Mann-Whitney's test. 95% confidence interval
After the Intervention	128.04±16.52	125.32±14.36	130.77±18.69	0.147^§ § Mann-Whitney's test. 95% confidence interval
Diastolic blood pressure		0.955^‡ ‡ Wilcoxon's test;	0.066^‡ ‡ Wilcoxon's test;
Before the Intervention	78.78±9.18	77.09±8.90	80.47±9.47	0.039^§ § Mann-Whitney's test. 95% confidence interval
After the Intervention	76.59±12.10	76.34±9.44	76.85±14.77	0.937^§ § Mann-Whitney's test. 95% confidence interval

Variables	Total (n=103)	Control Group (n=56)	Experimental Group (n=47)	p
Morisky and Green Expanded
High adherence	92 (89.3%)	48 (85.7%)	44 (93.6%)	0.196^* * Fisher's exact test;
Medium adherence	11 (10.7%)	08 (14.3%)	03 (06.4%)
Batalla-Martinez
Adherent	55 (53.4%)	27 (48.2%)	28 (59.6%)	0.171^† † Pearson's chi-square test; 95% confidence interval
Non-adherent	48 (45.6%)	29 (51.8%)	19 (40.4%)

Variables	Before	After	Difference	p
Fasting blood sugar
Control Group	185.23 ± 74.16	175.98 ± 72.57	-9.25 ± 48.44	0.041^† † Wilcoxon's test;
Experimental Group	203.60 ± 88.24	174.05 ± 64.10	-29.55 ± 53.76	0.001^† † Wilcoxon's test;
p-value	0.297^* * Mann-Whitney's test;	0.931^* * Mann-Whitney's test;	0.130^* * Mann-Whitney's test;
HbA1c
Control Group	8.36 ± 1.89	8.29 ± 1.86	-0.06 ± 1.05	0.361^† † Wilcoxon's test;
Experimental Group	8.40 ± 1.96	8.14 ± 1.81	-0.26 ± 1.05	0.144^† † Wilcoxon's test;
p-value	0.853^* * Mann-Whitney's test;	0.721^* * Mann-Whitney's test;	0.765^* * Mann-Whitney's test;
Total cholesterol
Control Group	210.16 ± 57.53	202.07 ± 63.58	-8.09 ± 75.32	0.040^† † Wilcoxon's test;
Experimental Group	195.36 ± 46.59	183.74 ± 43.4	-11.62 ± 30.55	0.010^† † Wilcoxon's test;
p-value	0.160^† † Wilcoxon's test;	0.073^* * Mann-Whitney's test;	0.884^* * Mann-Whitney's test;
HDL^‡ ‡ HDL = HDL cholesterol;
Control Group	50.00 ± 11.01	48.88 ± 10.1	-1.13 ± 11.87	0.516^† † Wilcoxon's test;
Experimental Group	48.04 ± 11.03	50.30 ± 10.9	2.26 ± 9.03	0.098^† † Wilcoxon's test;
p-value	0.372^† † Wilcoxon's test;	0.112^* * Mann-Whitney's test;	0.684^* * Mann-Whitney's test;
LDL^§ § LDL = LDL cholesterol; 95% confidence interval
Control Group	126.79 ± 42.81	114.81 ± 57.06	-11.97 ± 66.15	0.001^† † Wilcoxon's test;
Experimental Group	114.21 ± 32.08	106.76 ± 28.43	-7.45 ± 23.12	0.018^† † Wilcoxon's test;
p-value	0.100^† † Wilcoxon's test;	0.716^* * Mann-Whitney's test;	0.120^* * Mann-Whitney's test;
Triglycerides
Control Group	222.41 ± 130.95	217.71 ± 133.18	-4.70 ± 92.67	0.712^† † Wilcoxon's test;
Experimental Group	178.83 ± 94.96	174.19 ± 94.44	-4.64 ± 62.16	0.958^† † Wilcoxon's test;
p-value	0.072^* * Mann-Whitney's test;	0.131^* * Mann-Whitney's test;	0.776^* * Mann-Whitney's test;
HOMA-IR
Control Group	3.01 ± 1.91	3.20 ± 2.10	0.19 ± 1.75	0.563^† † Wilcoxon's test;
Experimental Group	2.99 ± 2.10	3.21 ± 1.90	0.27 ± 2.27	0.251^† † Wilcoxon's test;
p-value	0.770^* * Mann-Whitney's test;	0.830^* * Mann-Whitney's test;	0.586^* * Mann-Whitney's test;

Control Group	FBS	CT	HDL	LDL	Experimental Group	FBS	CT	HDL	LDL
Constant	0.276	0.022	0.005	0.115	Constant	0.972	0.005	0.049	0.002
Age^* * Simple lineal regression;	0.617	0.135	0.052	0.315	Age	0.190	0.413	0.711	0.283
Gender^† † Multinomial regression;	0.578	0.294	0.530	0.342	Gender	0.380	0.110	0.653	0.036^‡ ‡ p < 0.05
Skin color^† † Multinomial regression;	0.136	0.022^‡ ‡ p < 0.05	0.015^‡ ‡ p < 0.05	0.036	Skin color	0.351	0.760	0.727	0.858
Years of study^* * Simple lineal regression;	0.392	0.777	0.979	0.961	Years of study	0.298	0.796	0.274	0.515
Schooling^† † Multinomial regression;	0.467	0.669	0.598	0.777	Schooling	0.357	0.900	0.604	0.304
Employed^† † Multinomial regression;	0.216	0.503	0.402	0.336	Employed	0.836	0.605	0.628	0.831
Monthly Income^* * Simple lineal regression;	0.104	0.627	0.605	0.399	Monthly Income	0.453	0.308	0.202	0.140
Economic Class^† † Multinomial regression;	0.240	0.213	0.037^‡ ‡ p < 0.05	0.311	Economic Class	0.115	0.928	0.599	0.600
Marital status	0.999	0.322	0.048^‡ ‡ p < 0.05	0.402	Marital status	0.231	0.902	0.581	0.459
Who they live with^† † Multinomial regression;	0.594	0.691	0.408	0.915	Who they live with	0.213	0.219	0.466	0.089
Time with DM2^* * Simple lineal regression;	0.096	0.502	0.662	0.499	Time with DM2	0.009^‡ ‡ p < 0.05	0.970	0.954	0.584
Arterial Hypertension	0.398	0.013^‡ ‡ p < 0.05	0.040^‡ ‡ p < 0.05	0.038	Arterial Hypertension	0.066	0.176	0.630	0.191
Monitored in the PHCU^† † Multinomial regression;	0.211	0.045^‡ ‡ p < 0.05	0.115	0.151	Follow-up in the PHCU	0.025^‡ ‡ p < 0.05	0.500	0.509	0.475

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[1] Corresponding author: José Claudio Garcia Lira Neto E-mail: jclira@live.com