The Effect of Berberis (Vulgaris and Integerrima) on Cardiovascular Risk Factors in Patients With Type 2 Diabetes Mellitus: A Systematic Review, Meta-Analysis, and GRADE Assessment

INTRODUCTION AND AIM: Type 2 diabetes mellitus (T2DM) raises cardiovascular disease risk, but evidence on Berberis's impact is limited and inconsistent. This systematic review and meta-analysis aimed to assess effect of Berberis supplement on cardiovascular risk factors in patients with T2DM. MATERIALS AND METHODS: We extensively searched Embase, Web of Science, Scopus, PubMed, and the Cochrane Library for randomized controlled trials (RCTs) up to October 25, 2024. This study primarily assesses Berberis's impact on improving glycemic indices, with secondary measures including obesity, blood pressure and lipid profile parameters. FINDINGS: After reviewing 784 articles, we included data from eight RCTs involving 451 participants with T2DM. The results of meta-analysis indicated that Berberis administration significantly reduced weight (WMD: -2.25; 95% CI: -3.11 to -1.39), body mass index (BMI, WMD: -0.57; 95% CI: -0.98 to -0.17), TG (WMD: -19.32; 95% CI: -30.95 to -1.69), TC (WMD: -28.57; 95% CI: -30.22 to -21.51), LDL-C (WMD: -17.47; 95% CI: -24.18 to -10.75), FBS (WMD: -14.54; 95% CI: -23.83, -5.25), HbA1c (WMD: -0.65; 95% CI: -1.30, -0.00), HOMA-IR (WMD: -1.82; 95% CI: -3.60, -0.05), and insulin (WMD: -4.40; 95% CI: -7.15, -1.65). However, no statistically significant effect on blood pressure and HDL-C level was observed with Berberis intervention. CONCLUSION: This meta-analysis hints at Berberis's potential benefits for T2DM. However, more extensive trials are needed to confirm its advantages definitively.