Table 6. The summary of primary and secondary outcome findings and GRADE quality assessments for Comparison 5: comparing of LC plus chromium with the placebo.

Certainty assessment						Number of patients		Effect		Certainty
Total study	Risk of bias	Inconsistency	Indirectness	Imprecision	Other considerations	LC + Chromium	placebo	Relative (95% CI)	Absolute (95% CI)
Outcome: Serum FPG
1 RCT	not serious	not serious	not serious	seriousa	none	27	27	–	MD 3.4 lower (7.6 lower to 0.8 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum LDL
1 RCT	not serious	not serious	not serious	seriousa	none	27	27	–	MD 0.6 lower (19.95 lower to 18.75 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum Total cholesterol
1 RCT	not serious	not serious	not serious	seriousa	none	27	27	–	MD 9.7 lower (28.53 lower to 9.13 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum HDL
1 RCT	not serious	not serious	not serious	seriousa	none	27	27	–	MD 3.4 lower (8.2 lower to 1.4 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Serum Triglyceride
1 RCT	not serious	not serious	not serious	seriousa	none	27	27	–	MD 28.1 lower (47.25 lower to 8.95 lower)	$⨁⨁⨁○$ MODERATE
Outcome: Mental health status (using BDI)
1 RCT	not serious	not serious	not serious	seriousa	none	26	27	–	MD 1.5 lower (4.17 lower to 1.17 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Mental health status (using GHQ)
1 RCT	not serious	not serious	not serious	seriousa	none	26	27	–	MD 1.8 lower (7.1 lower to 3.5 higher)	$⨁⨁⨁○$ MODERATE
Outcome: Mental health status (using DASS)
1 RCT	not serious	not serious	not serious	seriousa	none	26	27	–	MD 3.5 lower (11.42 lower to 4.42 higher)	$⨁⨁⨁○$ MODERATE

Notes.

CI

Confidence interval

MD

Mean difference

RCT

Randomized controlled trial

BDI

Beck Depression Index

GHQ

General Health Questionnaire

DASS

Depression Anxiety Stress Score

GRADE

Working Group grades of evidence

High certainty: We are very confident that the true effect lies close to that of the estimate of the effect.

Moderate certainty: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.

Low certainty: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect.

Very low certainty: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect.

Explanations.

^anumber of participants <400.