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Treatment of diabetes mellitus with Traditional Chinese Medicine has a long history. The aim of this study is to establish the safety and efficacy of traditional Chinese medicine combined with glibenclamide to treat type 2 diabetes mellitus. In a controlled, double blind, multicentre non-inferiority trial, 800 patients with unsatisfactory glycemic control (fasting glucose 7-13 mmol/L and HbA1c 7-11%) were randomly assigned to receive Xiaoke Pill, a compound of Chinese herbs combined with glibenclamide, or Glibenclamide in two study groups - drug naive group, and patients previously treated with metformin monotherapy (metformin group). Outcome measures at 48 weeks were the incidence and rate of hypoglycemia, mean difference in HbA1c, and proportion of patients with HbA1c<6.5%. In drug naïve group, the total hypoglycemia rate and the mild hypoglycemic episode in the Xiaoke Pill arm were 38% (p = 0.024) and 41% (p = 0.002) less compared to Glibenclamide arm; in Metformin group, the average annual rate of hypoglycemia was 62% lower in Xiaoke Pill arm (p = 0.003). Respective mean changes in HbA1c from baseline were -0.70% and -0.66% for Xiaoke Pill and Glibenclamide, with a between-group difference (95% CI) of -0.04% (-0.20, 0.12) in the drug naïve group, and those in metformin group were -0.45% and -0.59%, 0.14% (-0.12, 0.39) respectively. The respective proportions of patients with a HbA1c level <6.5% were 26.6% and 23.4% in the drug naïve group and 20.1% and 18.9% in the metformin group. In patients with type 2 diabetes and inadequate glycaemic control, treatment with Xiaoke Pill led to significant reduction in risk of hypoglycemia and similar improvements in glycemic control after 48 weeks compared to Glibenclamide. Chinese Clinical Trial Register number, ChiCTR-TRC-08000074.

Citation

Linong Ji, Xiaolin Tong, Hongyuan Wang, Haoming Tian, Huimin Zhou, Lili Zhang, Qifu Li, Yizhong Wang, Hongmei Li, Min Liu, Hongjie Yang, Yanbin Gao, Yan Li, Quanmin Li, Xiaohui Guo, Gangyi Yang, Zhongai Zhang, Zhiguang Zhou, Guang Ning, Yingli Chen, Sanjoy Paul, Evidence-Based Medical Research of Xiaoke Pill Study Group. Efficacy and safety of traditional chinese medicine for diabetes: a double-blind, randomised, controlled trial. PloS one. 2013;8(2):e56703

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PMID: 23460810

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