Traditional Chinese Medicine Compound Reduces Risk of Progression for Those With Prediabetes

Jinlinda granules, a traditional compound in Chinese medicine comprising 17 herbal ingredients, potentially reduced the risk of diabetes in individuals with impaired glucose tolerance (IGT) and multiple metabolic abnormalities, according to findings from a study published in JAMA Internal Medicine.¹

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IGT, also known as prediabetes, has been defined as 2-hour glucose levels of 140 to 199 mg per dL according to a 75-g oral glucose tolerance test. This range is above normal but below the level for diabetes, making IGT a significant risk factor. According to the authors of the current study, when IGT co-occurs with an additional diabetes risk factor, such as obesity, dyslipidemia, and hypertension, the risk of diabetes increases even more.^1,2

In China, Jinlinda is approved to treat type 2 diabetes, showing effects such as alleviating insulin resistance, lowering blood glucose level and glycated hemoglobin (HbA1C), and in some cases, reversing IGT. Investigators of the study aimed to determine whether Jinlida could reduce the diabetes risk for those with IGT and metabolic abnormalities by boosting insulin sensitivity.¹

The trial was a randomized, controlled, multicenter, double-blind study that included individuals based on diagnostic criteria in the Chinese Type 2 Diabetes Prevention and Treatment Guidelines (2017 edition). Investigators conducted the study from June 2019 to February 2023 at 35 centers in 21 cities in China. Individuals who were aged 18 to 70 years old, had abdominal obesity, and an IGT diagnosis were included. Individuals also had either hypertension, fasting triglyceride levels of 150.44 mg/dL or greater, or fasting high-density lipoprotein cholesterol levels of less than 40.15 mg/dL, according to the study authors.¹

All individuals received ongoing lifestyle interventions, including monthly sessions of at least 20 minutes of professional guidance and lifestyle intervention booklets containing information for adjusting daily habits, increasing physical activity, regulating intake of macronutrients and dietary fiber, and reducing sodium consumption. After a 1-month induction period, treatment was randomized to 9 grams of Jinlida 3 times per day or the placebo. Individuals did not use any other antidiabetic medications or health products, with oral or injectable.¹

Investigators evaluated for the development of diabetes (the primary end point), waist circumference, blood pressure, fasting, 2-hour postprandial plasma glucose levels, HbA1C, fasting insulin level, homeostatic model assessment for insulin resistance, total cholesterol, low-density lipoprotein cholesterol, high density lipoprotein cholesterol, triglyceride levels, ankle-brachial index, and carotid intima-media thickness (all secondary end points.¹

A total of 889 individuals were included in the study and received randomized treatment. The follow-up period lasted until February 2023, with a median duration of 2.20 years. There were 111 individuals who withdrew from the trial and 1 individual died, according to the study authors.¹

In the follow-up period, investigators found that 27.83% of individuals in the Jinlinda group developed diabetes compared with 42.66% in the placebo group. Furthermore, for individuals that completed the study, 39.18% achieved normal glucose tolerance compared with 25.64%, respectively.¹

As for secondary end points, the Jinlinda group showed greater reductions in waist circumference and body mass index compared with the placebo group. Blood glucose level and HbA1C improved more in the Jinlinda group, and there were beneficial effects on lipid profiles with Jinlinda. Total cholesterol levels were reduced by 12.4 and 5.9 mg/dL, respectively.¹

There were no significant differences in blood pressure between the 2 groups.¹ In the safety analysis, 94.81% in the Jinlinda group and 91.93% experienced adverse events, according to the study investigators.¹

References

1. Ji H, Zhao X, Chen X, et al. Jinlida for Diabetes Prevention in Impaired Glucose Tolerance and Multiple Metabolic Abnormalities: The FOCUS Randomized Clinical Trial. JAMA Intern Med. doi:10.1001/jamainternmed.2024.1190

2. Rao SS, Disraeli P, McGregor T. Impaired glucose tolerance and impaired fasting glucose. Am Fam Physician. 2004;69(8):1961-1968.