Sweet potato for type 2 diabetes mellitus
ABSTRACT Sweet potato (Ipomoea batatas) is among the most nutritious subtropical and tropical vegetables. It is also used in traditional medicine practices for type 2 diabetes mellitus. Research in animal and human models suggests a possible role of sweet potato in glycaemic control.
To assess the effects of sweet potato for type 2 diabetes mellitus.
We searched several electronic databases, among these The Cochrane Library (issue 7, 2011), MEDLINE, EMBASE, CINAHL, SIGLE and LILACS (all up to July 2011), combined with handsearches. No language restriction was used.
We included randomised controlled trials that compared sweet potato with a placebo or a control intervention with or without pharmacological or non-pharmacological interventions.
Two authors independently selected the trials and extracted the data. We evaluated risk of bias using the items randomisation, allocation concealment, blinding, completeness of outcome data, selective reporting and other potential sources of bias.
Three randomised controlled trials (RCTs) met our inclusion criteria: these investigated a total of 140 participants and ranged from six weeks to five months duration. The studies were contributed by the same author. Overall, the risk of bias of these trials was unclear or high. All RCTs compared the effect of sweet potato preparations with placebo on the glycaemic control in type 2 diabetes mellitus. There was a statistically significant improvement in glycosylated haemoglobin A1c (HbA1c) at three to five months with 4 g/day sweet potato preparations compared to placebo (mean difference (MD) -0.3% (95% CI -0.6 to -0.04), P = 0.02; 122 participants, two trials). No serious adverse effects were reported. Diabetic complications and morbidity, death from any cause, health-related quality of life, well-being, functional outcomes and costs were not investigated.
There is insufficient evidence to recommend sweet potato for type 2 diabetes mellitus. Improvement in trial methodology as well as addressing the issues of standardization and the quality control of preparations of other varieties of sweet potato are required. For medical nutritional therapy, further observational trials and RCTs evaluating the effects of sweet potato are needed to guide any recommendations in clinical practice.
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ABSTRACT: Background: The aim of conventional medical therapy in diabetic foot infections is to control infection, thereby reducing amputation rates, infectious morbidity, and death. Any delay incurred during a trial of home remedies could allow an infection to progress unchecked, increasing the risk of these adverse outcomes. This study sought to determine the effects of delayed operative interventions and amputations in these patients. Methods: A questionnaire study targeting all consecutive patients admitted with diabetic foot infection was carried out over 1 year. Two groups were defined, ie, a medical therapy group comprising patients who sought medical attention after detecting their infection and a home remedy group comprising those who voluntarily chose to delay medical therapy in favor of home remedies. The patients were followed throughout their hospital admissions. We recorded the duration of hospitalization and number of operative debridements and amputations performed. Results: There were 695 patients with diabetic foot infections, comprising 382 in the medical therapy group and 313 in the home remedy group. Many were previously hospitalized for foot infections in the medical therapy (78%) and home remedy (74.8%) groups. The trial of home remedies lasted for a mean duration of 8.9 days. The home remedy group had a longer duration of hospitalization (16.3 versus 8.5 days; P<0.001), more operative debridements (99.7% versus 94.5%; P<0.001), and more debridements per patient (2.85 versus 2.45; P<0.001). Additionally, in the home remedy group, there was an estimated increase in expenditure of US $10,821.72 US per patient and a trend toward more major amputations (9.3% versus 5.2%; P=0.073). Conclusion: There are negative outcomes when patients delay conventional medical therapy in favour of home remedies to treat diabetic foot infections. These treatments need not be mutually exclusive. We encourage persons with diabetes who wish to try home remedies to seek medical advice in addition as a part of holistic care.Risk Management and Healthcare Policy 11/2014; 7(1):239-243. DOI:10.2147/RMHP.S72236