TABLE 3.
Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach evidence certainty and summary of findings of the clinical important outcomes.
| Summary of findings: | ||||||
| Cinnamon compared to control for type 2 diabetes mellitus | ||||||
| Patient or population: Type 2 diabetes mellitus | ||||||
| Setting: | ||||||
| Intervention: Cinnamon | ||||||
| Comparison: Control |
| Outcomes | Anticipated absolute effects e (95% CI) | Relative effect (95% CI) | No. of participants (studies) | Certainty of the evidence (GRADE) | Comment | |
| Risk with control | Risk with Cinnamon | |||||
| Fasting plasma glucose follow-up: range 6 weeks to 16 weeks | - | SMD 0.54 SD lower (0.68 lower to 0.4 lower) | - | 968 (15 RCTs) | ⊕⊕○○ Low a , b | No explanation was provided |
| Body mass index follow-up: range 8 weeks to 12 weeks | - | MD 0.73 SD lower (0.94 lower to 0.51 lower) | - | 488 (7 RCTs) | ⊕⊕○○ Low c , d | No explanation was provided |
| Hemoglobin A1c follow-up: range 6 weeks to 16 weeks | - | SMD 0.63 SD lower (0.77 lower to 0.49 lower) | - | 1077 (16 RCTs) | ⊕⊕⊕○ Moderate a , b | No explanation was provided |
| Insulin follow-up: range 6 weeks to 12 weeks | - | SMD 0.66 SD lower (0.84 lower to 0.47 lower) | - | 595 (8 RCTs) | ⊕⊕○○ Low c , d | No explanation was provided |
| Homeostatic model assessment of insulin resistance follow-up: range 6 weeks to 12 weeks | - | SMD 0.8 SD lower (1.06 lower to 0.54 lower) | - | 363 (4 RCTs) | ⊕⊕○○ Low c , d | No explanation was provided |
| Triacylglycerol follow-up: range 6 weeks to 16 weeks | - | SMD 0.6 SD lower (0.76 lower to 0.44 lower) | - | 665 (11 RCTs) | ⊕⊕⊕○ Moderate a | No explanation was provided |
| Total cholesterol follow-up: range 6 weeks to 16 weeks | - | SMD 0.25 SD lower (0.42 lower to 0.07 lower) | - | 664 (11 RCTs) | ⊕⊕⊕○ Moderate a | No explanation was provided |
| Low-density lipoprotein cholesterol follow-up: range 6 weeks to 16 weeks | - | SMD 0.55 SD lower (0.72 lower to 0.39 lower) | - | 664 (11 RCTs) | ⊕⊕⊕○ Moderate a | No explanation was provided |
| High-density lipoprotein cholesterol follow-up: range 6 weeks to 16 weeks | - | SMD 0.57 SD higher (0.41 higher to 0.74 higher) | - | 664 (11 RCTs) | ⊕⊕⊕○ Moderate a | No explanation was provided |
CI: confidence interval; MD: mean difference; SMD: standardized mean difference. 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 the effect.
Differences in Vanschoonbeek et al. may be attributed to the inclusion of postmenopausal type 2 diabetes women; those of Akilen et al. and Zare et al. could be attributed to the fact that they studied only patients with poorly controlled type 2 diabetes.
Subjects of Vanschoonbeek et al. and Hasanzade et al.’s studies had time (6 weeks and 8 weeks) cinnamon dosage (1.5 g/d and 1 g/d) limitations.
There are obvious weaknesses in a few included studies.
The number of articles included is less than 10.
The risk in the intervention group (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).