Korean Red Ginseng as adjunctive therapy improves postprandial insulin sensitivity and lipid profiles in T2DM

Despite advancements in pharmacotherapy, managing type 2 diabetes mellitus (T2DM) often requires adjunctive strategies to address multifaceted metabolic dysregulation beyond glycemic control. Current oral antidiabetic therapies may not fully optimize insulin sensitivity, lipid profiles, or mitigate oxidative stress, leaving gaps in comprehensive patient care. Korean Red Ginseng (KRG), a traditional herbal medicine, has shown promise in preclinical studies for its potential antidiabetic effects, but robust randomized controlled trial (RCT) evidence evaluating its metabolic efficacy and short-term safety as an add-on therapy in patients already on stable oral antidiabetic medications has been limited.

This 12-week randomized, double-blind, placebo-controlled trial enrolled 70 adults with well-controlled T2DM who were already receiving stable oral antidiabetic medications. Participants were randomly assigned to receive either Korean Red Ginseng 2 g/day or a placebo. Primary outcomes included oral glucose tolerance test (OGTT)-derived insulin, C-peptide, and glucagon responses, along with various insulin sensitivity indices. Secondary endpoints assessed fasting plasma glucose (FPG), HbA1c, oxidative stress markers (oxidized low-density lipoprotein, malondialdehyde), antioxidant capacity, lipid profiles, and renal and hepatic safety parameters. Efficacy analyses included 65 participants with post-baseline data, using baseline-adjusted ANCOVA with Benjamini-Hochberg false discovery rate correction for between-group comparisons.

Compared to placebo, Korean Red Ginseng significantly lowered 120-min OGTT insulin (adjusted mean difference -6.992, 95% CI -14.205 to -0.222; p=0.047) and increased ISI(0-120), an insulin sensitivity index (5.400, 0.972 to 9.829; p=0.018). These findings suggest an improvement in postprandial insulin dynamics. Furthermore, KRG was associated with favorable changes in lipid and oxidative stress markers: > KRG significantly reduced oxidized low-density lipoprotein by -5.645 (95% CI -10.054 to -1.238; p=0.013) and malondialdehyde by -0.571 (95% CI -1.090 to -0.053; p=0.031) compared to placebo. Total cholesterol also decreased by -12.633 (-24.752 to -0.515; p=0.041), and low-density lipoprotein cholesterol by -10.171 (-18.130 to -2.211; p=0.013). Notably, FPG, 2-h glucose, and HbA1c did not show significant differences between groups. The study reported no hypoglycemic events, and renal and hepatic safety markers remained stable, indicating good tolerability.