Table 3.
Diet and alternative medicine
| Product | Diabetes type (patients, n) | Study design | Potential mechanisms | Key findings | Reference |
|---|---|---|---|---|---|
| Silymarin (milk thistle, silybum) | Type 2 (60) | RCT | Antioxidant, anti-inflammatory Antiapoptotic |
Silymarin (140 mg three times daily) for 3 months reduced albuminuria, urine TNF-α, urine, and serum malondialdehyde (oxidative stress marker) compared to baseline. | Fallahzadeh et al218 |
| Zinc | Type 2 (54) | Non-RCT | Antioxidant, improved glycemic control | Zinc supplement (50 mg elemental zinc) for 12 weeks improved glycemic control, lipids, and albuminuria compared to baseline. Effects on albuminuria were not shown to be independent of other metabolic effects. | Khan et al219 |
| Type 2 (50) | RCT crossover | Zinc supplement (30 mg elemental zinc) for 12 weeks reduced HbA1c and albuminuria compared to baseline. A 4-week washout was carried out before crossover. | Parham et al220 | ||
| Curcumin (turmeric) | Type 2 (40) | RCT | Antioxidant | Turmeric capsules 500 mg three times daily for 2 months reduced albuminuria, TGF-β, and IL-18 levels compared to baseline. | Khajehdehi et al221 |
| Green tea | Recruiting | RCT | Antioxidant | This trial is currently recruiting: Clinical Trials NCT01923597. Diabetic patients randomized to green tea extract, epigallocatechin, or placebo for 3 months. The primary outcome is a change in albuminuria. | None |
| Fish oil | Type 1 (36) | RCT | Anti-inflammatory Immunomodulatory |
1-year fish oil supplementation 4.6 g/day did not affect albuminuria or kidney function. | Rossing et al222 |
Abbreviation: HbA1c, hemoglobin A1c; RCT, randomized controlled trial.