Effectiveness and Safety of DLBS3233 in Newly Diagnosed Type 2 Diabetes Mellitus: A 12-week Clinical Trial

Heri Nugroho, Nurmilawati Nurmilawati, Diana Novitasari, Lidia Rombeallo, Rambu Farah Effendi, Reski Reski, Intan Surayya, Nugroho Agung Daryanto, Solomon Putera, Raymond Rubianto Tjandrawinata

Abstract


Background: DLBS3233, recognized as an agent enhancing insulin sensitivity, has exhibited promise as a therapeutic option for addressing type 2 diabetes mellitus (T2DM). This study aimed to evaluate the effectiveness and safety of DLBS3233, a natural compound, in individuals newly diagnosed with T2DM. Methods: A 12-week double-blind, randomized, placebo-controlled clinical trial was conducted with 104 eligible participants. They were assigned to receive DLBS3233 or a placebo along with lifestyle modifications. Various metabolic parameters, including fasting and post-meal plasma glucose levels at two hours, fasting insulin level, HOMA-IR, adiponectin level, lipid profile, superoxide dismutase (SOD) activity, GLUT-4 concentrations, and body weight measurements, were assessed at baseline, Week 6, and Week 12. Safety parameters assessment will include vital signs, liver function, renal function and adverse event. Results: Participants exhibited similar demographic characteristics in both groups. While no significant changes were noted in fasting plasma glucose and most other parameters, the DLBS3233 group significantly reduced 2-hour postprandial glucose at Week 12 (p = 0.026). There were no substantial differences in A1c levels, fasting insulin, insulin resistance, adiponectin levels, or lipid profiles between the two groups at any point in time. Safety parameters, including blood pressure, liver enzymes, heart rate, gamma GT, and serum creatinine, remained comparable between the groups. Conclusion: DLBS3233 showed potential for improving postprandial glucose control in newly diagnosed T2DM individuals. Although significant changes were limited, the study suggests that DLBS3233 could enhance glycemic regulation. The safety evaluation indicated no adverse effects on vital parameters. Further research with larger samples and more prolonged duration is warranted to comprehensively explore DLBS3233’s potential in T2DM management.


Keywords


Type 2 Diabetes Mellitus; DLBS3233; Insulin sensitivity; clinical trial

References


Galicia-Garcia U, Benito-Vicente A, Jebari S, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21(17):6275.

Zhang X, Jiang H, Ma X, Wu H. Increased serum level and impaired response to glucose fluctuation of asprosin is associated with type 2 diabetes mellitus. J Diabetes Investig. 2020;11(2):349–55.

Rahman MS, Hossain KS, Das S, et al. Role of insulin in health and disease: An update. Int J Mol Sci. 2021;22(12):6403.

Yaribeygi H, Sathyapalan T, Atkin SL, Sahebkar A. Molecular mechanisms linking oxidative stress and diabetes mellitus. Oxid Med Cell Longev. 2020;2020:e8609213.

Standards of Care in Diabetes.A bridged for primary care providers, clinical diabetes. American Diabetes Association. 2023 [Internet]. [cited 2023 Nov 23]. Available from: https://diabetesjournals.org/clinical/article/41/1/4/148029/Standards-of-Care-in-Diabetes-2023-Abridged-for

Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A Consensus Report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022;45(11):2753–86.

Permadi W, Hestiantoro A, Ritonga MA, et al. Administration of cinnamon and lagersroemia speciosa extract on lipid profile of polycystic ovarian syndrome women with high body mass index. J Hum Reprod Sci. 2021;14(1):16.

Manaf A, Tjandrawinata RR, Malinda D. Insulin sensitizer in prediabetes: a clinical study with DLBS3233, a combined bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa. Drug Des Devel Ther. 2016;10:1279–89.

Tjokroprawiro A, Murtiwi S, Tjandrawinata RR. DLBS3233, a combined bioactive fraction of Cinnamomum burmanii and Lagerstroemia speciosa, in type-2 diabetes mellitus patients inadequately controlled by metformin and other oral antidiabetic agents. J Complement Integr Med. 2016;13(4):413–20.

Hidayat ST, Mulyantoro I, Damas S, Tjandrawinata RR. The effect and safety assessment of metformin and DLBS3233 (A bioactive fraction of Lagerstroemia speciosa and Cinnamomum burmannii) on improving metabolic parameters in women with polycystic ovary syndrome. Int J Womens Health. 2023;15:971–85.

Waist circumference and waist-hip ratio: report of a WHO expert consultation [Internet]. [cited 2024 Jul 11]. Available from: https://www.who.int/publications/i/item/9789241501491

WHO Expert Consultation. Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies. Lancet Lond Engl. 2004;363(9403):157–63.

Alberti KGMM, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120(16):1640–5.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985;28(7):412–9.

Tandrasasmita OM, Wulan DD, Nailufar F, Sinambela J, Tjandrawinata RR. Glucose-lowering effect of DLBS3233 is mediated through phosphorylation of tyrosine and upregulation of PPARγ and GLUT4 expression. Int J Gen Med. 2011;4:345–57.

Nailufar F, Tandrasasmita OM, Tjandrawinata RR. DLBS3233 increases glucose uptake by mediating upregulation of PPARγ and PPARδ expression. Biomed Prev Nutr. 2011;1(2):71–8.

Kumawat M, Sharma TK, Singh I, et al. Antioxidant enzymes and lipid peroxidation in type 2 diabetes mellitus patients with and without nephropathy. North Am J Med Sci. 2013;5(3):213–9.

Bhatia S, Shukla R, Venkata Madhu S, Kaur Gambhir J, Madhava Prabhu K. Antioxidant status, lipid peroxidation and nitric oxide end products in patients of type 2 diabetes mellitus with nephropathy. Clin Biochem. 2003;36(7):557–62.

Leto D, Saltiel AR. Regulation of glucose transport by insulin: traffic control of GLUT4. Nat Rev Mol Cell Biol. 2012;13(6):383–96.

Achari AE, Jain SK. Adiponectin, a therapeutic target for obesity, diabetes, and endothelial dysfunction. Int J Mol Sci. 2017;18(6):1321.

Tjandrawinata RR, Suastika K, Nofiarny D. DLBS3233 extract, a novel insulin sensitizer with negligible risk of hypoglycemia: A phase-I study. Int J Diabetes Metab. 2019;20(1):13–12.


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