Berberine is a natural plant alkaloid found, among others, in the plant families Annonaceae, Menispermaceae, Berberidaceae, Papaveraceae, Rutaceae, and Ranunculaceae. Its primary source, however, is barberry (Berberis). This compound exhibits broad-spectrum biological activity, primarily affecting metabolic processes. Preclinical and clinical studies have shown that berberine may regulate glucose and lipid levels, as well as insulin sensitivity. For this reason, in recent years it has become the subject of numerous scientific studies, particularly in the context of metabolic disorders such as type 2 diabetes and metabolic syndrome.
Experimental and clinical studies describe its specific metabolic effects. Among others, reductions in triglyceride levels and LDL cholesterol fractions have been demonstrated, accompanied by a simultaneous increase in HDL cholesterol. A decrease in fasting glucose levels and an improvement in insulin sensitivity have also been observed. Additionally, its effects on inflammatory processes, gut microbiota composition, and body weight regulation are being analyzed, indicating its multi-level metabolic action.
In 2022, a meta-analysis evaluated the effects of berberine on carbohydrate metabolism in patients with type 2 diabetes. The authors analyzed randomized clinical trials published up to November 2021 by searching eight scientific databases, including PubMed, EMBASE, Web of Science, and several Chinese databases. Only studies of patients with type 2 diabetes receiving berberine as the main intervention were included. In total, 37 randomized trials with 3,048 patients were analyzed. Most studies were conducted in China, with one from Iran. The results of this meta-analysis help synthesize the evidence on berberine’s role in the management of carbohydrate metabolism in individuals with type 2 diabetes, providing clinicians and researchers with a comprehensive assessment of current research. Key findings showed that berberine treatment was associated with significant improvements in carbohydrate metabolism in patients with type 2 diabetes.
The analyzed studies primarily assessed fasting plasma glucose (FPG), 2-hour postprandial blood glucose (2hPBG), glycated hemoglobin (HbA1c), and berberine safety. The meta-analysis showed that berberine significantly improved carbohydrate metabolism: fasting glucose was 0.82 mmol/L lower than in controls, postprandial glycemia decreased by 1.16 mmol/L, and HbA1c was reduced by 0.63%. All results were statistically significant.
Furthermore, the authors conducted subgroup analyses, which showed that berberine’s effectiveness was partly dependent on baseline glucose and HbA1c levels. The greatest benefits were observed in individuals with higher glycemic values before starting therapy. An important part of the study was also the safety analysis of supplementation. In nine studies assessing the risk of hypoglycemia, no significant differences were found between the berberine and control groups. The authors also emphasized that the total number of adverse events was lower in the berberine-supplemented groups.
Based on the analysis, the authors concluded that berberine has a significant glucose-lowering effect in patients with type 2 diabetes and may serve as a valuable support to standard therapy for carbohydrate metabolism disorders. At the same time, they highlighted the need for further high-quality studies to better determine its long-term efficacy and safety.
Based on: Xie W, Su F, Wang G, Peng Z, Xu Y, Zhang Y, Xu N, Hou K, Hu Z, Chen Y and Chen R (2022) Glucose-lowering effect of berberine on type 2 diabetes: A systematic review and meta-analysis. Front. Pharmacol. 13:1015045. doi: 10.3389/fphar.2022.1015045
