Effect of coadministration of enriched Korean Red Ginseng ( Panax ginseng) and American ginseng ( Panax quinquefolius L) on cardiometabolic outcomes in type-2 diabetes: A randomized controlled trial

Abstract

Background: Diabetes mellitus and hypertension often occur together, amplifying cardiovascular disease (CVD) risk and emphasizing the need for a multitargeted treatment approach. American ginseng (AG) and Korean Red Ginseng (KRG) species could improve glycemic control via complementary mechanisms. Additionally, a KRG-inherent component, ginsenoside Rg3, may moderate blood pressure (BP). Our objective was to investigate the therapeutic potential of coadministration of Rg3-enriched Korean Red Ginseng (Rg3-KRG) and AG, added to standard of care therapy, in the management of hypertension and cardiometabolic risk factors in type-2 diabetes.

Methods: Within a randomized controlled, parallel design of 80 participants with type-2 diabetes (HbA1c: 6.5-8%) and hypertension (systolic BP: 140-160 mmHg or treated), supplementation with either 2.25 g/day of combined Rg3-KRG + AG or wheat-bran control was assessed over a 12-wk intervention period. The primary endpoint was ambulatory 24-h systolic BP. Additional endpoints included further hemodynamic assessment, glycemic control, plasma lipids and safety monitoring.

Results: Combined ginseng intervention generated a mean ± SE decrease in primary endpoint of 24-h systolic BP (-3.98 ± 2.0 mmHg, p = 0.04). Additionally, there was a greater reduction in HbA1c (-0.35 ± 0.1% [-3.8 ± 1.1 mmol/mol], p = 0.02), and change in blood lipids: total cholesterol (-0.50 ± 0.2 mmol/l, p = 0.01), non-HDL-C (-0.54 ± 0.2 mmol/l, p = 0.01), triglycerides (-0.40 ± 0.2 mmol/l, p = 0.02) and LDL-C (-0.35 ± 0.2 mmol/l, p = 0.06) at 12 wks, relative to control. No adverse safety outcomes were observed.

Conclusion: Coadministration of Rg3-KRG + AG is an effective addon for improving BP along with attaining favorable cardiometabolic outcomes in individuals with type 2 diabetes. Ginseng derivatives may offer clinical utility when included in the polypharmacy and lifestyle treatment of diabetes.

Clinical trial registration: Clinicaltrials.gov identifier, NCT01578837.

Keywords: Ginseng; Hypertension; Randomized controlled trial; Type-2 diabetes.

Conflict of interest statement

V Vuksan holds an American (No. 7,326,404 B2) and Canadian (No. 2,410,556) patent for use of viscous fiber blend in diabetes, metabolic syndrome and cholesterol lowering. VV was partial owner of Glycemic Index Laboratories, Inc. (Toronto, ON, Canada) during 2004–2015. JL Sievenpiper has received research support from the 10.13039/501100000024Canadian Institutes of health Research (CIHR), 10.13039/100013528Diabetes Canada, PSI Foundation, 10.13039/501100000064Banting and Best Diabetes Centre (BBDC), Canadian Nutrition Society (CNS), American Society for Nutrition (ASN), Calorie Control Council, INC International Nut and Dried Fruit Council Foundation, National Dried Fruit Trade Association, The Tate and Lyle Nutritional Research Fund at the 10.13039/501100000181University of Toronto, and The Glycemic Control and Cardiovascular Disease in Type 2 Diabetes Fund at the 10.13039/501100000181University of Toronto (a fund established by the Alberta Pulse Growers). He has received speaker fees and/or honoraria from 10.13039/100013528Diabetes Canada, Canadian Nutrition Society (CNS), Dr. Pepper Snapple Group, 10.13039/100010710Dairy Farmers of Canada, Nutrition Foundation of Italy (NFI), C3 Collaborating for Health, Sprim Brasil, WhiteWave Foods, Rippe Lifestyle, mdBriefcase, Alberta Milk, FoodMinds LLC, Memac Ogilvy & Mather LLC, 10.13039/100004396PepsiCo, The Ginger Network LLC, International Sweeteners Association, Pulse Canada, and GI Foundation. He has ad hoc consulting arrangements with Winston & Strawn LLP, Perkins Coie LLP, and Tate & Lyle. He is a member of the European Fruit Juice Association Scientific Expert Panel. He is on the Clinical Practice Guidelines Expert Committees of Diabetes Canada, European Association for the study of Diabetes (EASD), and Canadian Cardiovascular Society (CCS), as well as an expert writing panel of the American Society for Nutrition (ASN). He serves as an unpaid scientific advisor for the Food, Nutrition, and Safety Program (FNSP) and the Technical Committee on Carbohydrates of the International Life Science Institute (ILSI), North America. He is a member of the International Carbohydrate Quality Consortium (ICQC), Executive Board Member of the Diabetes and Nutrition Study Group (DNSG) of the EASD and Director of the Toronto 3D Knowledge Synthesis and Clinical Trials foundation. His wife is an employee of Unilever Canada. AL Jenkins is vice president and partial owner of Glycemic Index Laboratories, Inc. (Toronto, ON, Canada) a clinical research organization. No other authors declared conflict of interest.

© 2020 The Korean Society of Ginseng, Published by Elsevier Korea LLC.

Figures

Fig. 1

Study flowchart.

Fig. 2

Mean absolute 24-h systolic blood pressure profile at week-12 in participants with type-2 diabetes following either a control or combined ginseng (Rg3-KRG + AG) intervention. Abbreviations: BP-Blood Pressure; Error bars indicate SE; Grey diamond – Control; Black triangle– Combined ginseng.