Postprandial glucose-lowering effects of fermented red ginseng in subjects with impaired fasting glucose or type 2 diabetes: a randomized, double-blind, placebo-controlled clinical trial

Mi-Ra Oh, Soo-Hyun Park, Sun-Young Kim, Hyang-Im Back, Min-Gul Kim, Ji-Young Jeon, Ki-Chan Ha, Won-Taek Na, Youn-Soo Cha, Byung-Hyun Park, Tae-sun Park, Soo-Wan Chae, Mi-Ra Oh, Soo-Hyun Park, Sun-Young Kim, Hyang-Im Back, Min-Gul Kim, Ji-Young Jeon, Ki-Chan Ha, Won-Taek Na, Youn-Soo Cha, Byung-Hyun Park, Tae-sun Park, Soo-Wan Chae

Abstract

Background: Red ginseng is prepared by steaming raw ginseng, a process believed to increase the pharmacological efficacy. Further bioconversion of red ginseng through fermentation is known to increase its intestinal absorption and bioactivity, and bioconversion diminishes the toxicity of red ginseng's metabolite. This study was conducted to investigate the effects of daily supplementation with fermented red ginseng (FRG) on glycemic status in subjects with impaired fasting glucose or type 2 diabetes.

Methods: This study was a four-week long, randomized, double-blind, placebo-controlled trial. Forty-two subjects with impaired fasting glucose or type 2 diabetes were randomly allocated to two groups assigned to consume either the placebo or fermented red ginseng (FRG) three times per day for four weeks. Fasting and postprandial glucose profiles during meal tolerance tests were assessed before and after the intervention.

Results: FRG supplementation led to a significant reduction in postprandial glucose levels and led to an increase in postprandial insulin levels compared to the placebo group. There was a consistently significant improvement in the glucose area under the curve (AUC) in the FRG group. However, fasting glucose, insulin, and lipid profiles were not different from the placebo group.

Conclusion: Daily supplementation with FRG lowered postprandial glucose levels in subjects with impaired fasting glucose or type 2 diabetes.

Trial registration: ClinicalTrials.gov: NCT01826409.

Figures

Figure 1
Figure 1
Disposition of participants in the clinical trial of FRG versus placebo. Number of study participants enrolled, allocated, followed, and analyzed, shown using the CONSORT 2010 Flow Diagram.
Figure 2
Figure 2
The effect of FRG supplementation on glucose levels during meal tolerance tests. Data are shown as mean ± SEM for 21 subjects. **p < 0.01 vs. placebo at four weeks.

References

    1. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047–1053.
    1. The DECODE study group. Glucose tolerance and mortality: comparison of WHO and American Diabetes Association diagnostic criteria. The DECODE study group. European Diabetes Epidemiology Group. Diabetes Epidemiology: Collaborative analysis Of Diagnostic criteria in Europe. Lancet. 1999;354(9179):617–621.
    1. Meigs JB, Nathan DM, D’Agostino RB Sr, Wilson PW. Fasting and postchallenge glycemia and cardiovascular disease risk: the Framingham Offspring Study. Diabetes Care. 2002;25(10):1845–1850.
    1. Hong CE, Lyu SY. Anti-inflammatory and anti-oxidative effects of Korean red ginseng extract in human keratinocytes. Immune Netw. 2011;11(1):42–49.
    1. Jung JW, Kang HR, Ji GE, Park MS, Song WJ, Kim MH, Kwon JW, Kim TW, Park HW, Cho SH, Min KU. Therapeutic effects of fermented red ginseng in allergic rhinitis: a randomized, double-blind, placebo-controlled study. Allergy Asthma Immunol Res. 2011;3(2):103–110.
    1. Lee JS, Choi HS, Kang SW, Chung JH, Park HK, Ban JY, Kwon OY, Hong HP, Ko YG. Therapeutic effect of Korean red ginseng on inflammatory cytokines in rats with focal cerebral ischemia/reperfusion injury. Am J Chin Med. 2011;39(1):83–94.
    1. Wee JJ, Park KM, Chung AS. In: Herbal Medicine: Biomolecular and Clinical Aspects. 2. Benzie IFF, Wachtel-Galor S, editor. Boca Raton (FL); 2011. Biological Activities Of Ginseng And Its Application To Human Health.
    1. Sun S, Qi LW, Du GJ, Mehendale SR, Wang CZ, Yuan CS. Red notoginseng: higher ginsenoside content and stronger anticancer potential than Asian and American ginseng. Food Chem. 2011;125(4):1299–1305.
    1. Taira S, Ikeda R, Yokota N, Osaka I, Sakamoto M, Kato M, Sahashi Y. Mass spectrometric imaging of ginsenosides localization in Panax ginseng root. Am J Chin Med. 2010;38(3):485–493.
    1. Wang CZ, Ni M, Sun S, Li XL, He H, Mehendale SR, Yuan CS. Detection of adulteration of notoginseng root extract with other panax species by quantitative HPLC coupled with PCA. J Agri Food Chem. 2009;57(6):2363–2367.
    1. Li H, Zhou M, Zhao A, Jia W. Traditional Chinese medicine: balancing the gut ecosystem. Phytother Res. 2009;23(9):1332–1335.
    1. Wang HY, Qi LW, Wang CZ, Li P. Bioactivity enhancement of herbal supplements by intestinal microbiota focusing on ginsenosides. Am J Chin Med. 2011;39(6):1103–1115.
    1. Bae EA, Park SY, Kim DH. Constitutive beta-glucosidases hydrolyzing ginsenoside Rb1 and Rb2 from human intestinal bacteria. Biol Pharm Bull. 2000;23(12):1481–1485.
    1. Bae EA, Han MJ, Choo MK, Park SY, Kim DH. Metabolism of 20(S)- and 20(R)-ginsenoside Rg3 by human intestinal bacteria and its relation to in vitro biological activities. Biol Pharm Bull. 2002;25(1):58–63.
    1. Bae EA, Han MJ, Kim EJ, Kim DH. Transformation of ginseng saponins to ginsenoside Rh2 by acids and human intestinal bacteria and biological activities of their transformants. Arch Pharm Res. 2004;27(1):61–67.
    1. Mochizuki M, Yoo YC, Matsuzawa K, Sato K, Saiki I, Tono-oka S, Samukawa K, Azuma I. Inhibitory effect of tumor metastasis in mice by saponins, ginsenoside-Rb2, 20(R)- and 20(S)-ginsenoside-Rg3, of red ginseng. Biol Pharm Bull. 1995;18(9):1197–1202.
    1. Park EK, Choo MK, Kim EJ, Han MJ, Kim DH. Antiallergic activity of ginsenoside Rh2. Biol Pharm Bull. 2003;26(11):1581–1584.
    1. Trinh HT, Han SJ, Kim SW, Lee YC, Kim DH. Bifidus fermentation increases hypolipidemic and hypoglycemic effects of red ginseng. J Microbiol Biotechnol. 2007;17(7):1127–1133.
    1. Yuan HD, Chung SH. Protective effects of fermented ginseng on streptozotocin-induced pancreatic beta-cell damage through inhibition of NF-kappaB. Int J Mol Med. 2010;25(1):53–58.
    1. Chakraborty H, Gu H. A mixed model approach for intent-to-treat analysis in longitudinal clinical trials with missing values. [ ]
    1. Kim HY, Kim K. Regulation of signaling molecules associated with insulin action, insulin secretion and pancreatic beta-cell mass in the hypoglycemic effects of Korean red ginseng in Goto-Kakizaki rats. J Ethnopharmacol. 2012;142(1):53–58.
    1. Ha KS, Jo SH, Kang BH, Apostolidis E, Lee MS, Jang HD, Kwon YI. In vitro and in vivo antihyperglycemic effect of 2 amadori rearrangement compounds, arginyl-fructose and arginyl-fructosyl-glucose. J Food Sci. 2011;76(8):H188–193.
    1. Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di Buono M, Lee KS, Leiter LA, Nam KY, Arnason JT, Choi M, Naeem A. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis. 2008;18(1):46–56.
    1. Liang ZQ, Srinivasan S, Kim YJ, Kim HB, Wang HT, Yang DC. Lactobacillus kimchicus sp. nov., a beta-glucosidase-producing bacterium isolated from kimchi. Int J Syst Evol Microbiol. 2011;61(Pt 4):894–897.
    1. Kim B-G, Choi S-Y, Kim M-R, Suhd HJ, Park HJ. Changes of ginsenosides in Korean red ginseng (Panax ginseng) fermented by Lactobacillus plantarum M1. Process Biochem. 2010;45:1319–1324.
    1. Kim BG, Shin KS, Yoon TJ, Yu KW, Ra KS, Kim JM, Kim SY, Suh HJ. Fermentation of Korean red ginseng by Lactobacillus plantarum M-2 and its immunological activities. Appl Biochem Biotechnol. 2011;165(5–6):1107–1119.
    1. Luo JZ, Luo L. Ginseng on hyperglycemia: effects and mechanisms. Evid Based Complement Alternat Med : eCAM. 2009;6(4):423–427.
    1. Sievenpiper JL, Arnason JT, Leiter LA, Vuksan V. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr. 2004;23(3):248–258.
    1. Sievenpiper JL, Sung MK, Di Buono M, Seung-Lee K, Nam KY, Arnason JT, Leiter LA, Vuksan V. Korean red ginseng rootlets decrease acute postprandial glycemia: results from sequential preparation- and dose-finding studies. J Am Coll Nutr. 2006;25(2):100–107.
    1. Jin H, Seo JH, Uhm YK, Jung CY, Lee SK, Yim SV. Pharmacokinetic comparison of ginsenoside metabolite IH-901 from fermented and non-fermented ginseng in healthy Korean volunteers. J Ethnopharmacol. 2012;139(2):664–667.
    1. Kim ST, Kim HB, Lee KH, Choi YR, Kim HJ, Shin IS, Gyoung YS, Joo SS. Steam-dried ginseng berry fermented with Lactobacillus plantarum controls the increase of blood glucose and body weight in type 2 obese diabetic db/db mice. J Agrci Food Chem. 2012;60(21):5438–5445.
    1. Onomura M, Tsukada H, Fukuda K, Hosokawa M, Nakamura H, Kodama M, Ohya M, Seino Y. Effects of ginseng radix on sugar absorption in the small intestine. Am J Chin Med. 1999;27(3–4):347–354.
    1. Suzuki Y, Ito Y, Konno C, Furuya T. Effects of tissue cultured ginseng on gastric secretion and pepsin activity. Yakugaku zasshi. 1991;111(12):770–774.
    1. Waki I, Kyo H, Yasuda M, Kimura M. Effects of a hypoglycemic component of ginseng radix on insulin biosynthesis in normal and diabetic animals. J Pharmacobiodyn. 1982;5(8):547–554.
    1. Reeds DN, Patterson BW, Okunade A, Holloszy JO, Polonsky KS, Klein S. Ginseng and ginsenoside Re do not improve beta-cell function or insulin sensitivity in overweight and obese subjects with impaired glucose tolerance or diabetes. Diabetes Care. 2011;34(5):1071–1076.
    1. Defronzo RA. Lilly Lecture 1987: The triumvirate: β-cell, muscle, liver: a collusion Responsible for NIDDM. Diabetes Care. 1988;37(6):667–687.

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