Effects of diacerein intake on cardiometabolic profiles in type 2 diabetics: A systematic review and meta-analysis of clinical trials

Background: A systematic review and meta-analysis of clinical trials were undertaken to evaluate the effect of diacerein intake on cardiometabolic profiles in patients with type 2 diabetes mellitus (T2DM). Methods: Electronic databases such as PubMed, EMBASE, Scopus, Web of Science, Google Scholar, and Cochrane Central Register of Controlled Trials were searched from inception to 31 July 2019. Sta-tistical heterogeneity was evaluated using Cochran’s Q test and I-square (I²) statistic. Data were pooled using random-effects models and weighted mean difference (WMD). Results: From 1,733 citations, seven clinical trials were eligible for inclusion and meta-analysis. A significant reduction in hemoglobin A1c (HbA1c) (WMD-0.73; 95%CI-1.25 to-0.21; P= 0.006; I²= 72.2%) and body mass index (BMI) (WMD-0.55; 95%CI-1.03 to-0.07; P= 0.026; I²= 9.5%) was iden-tified. However, no significant effect of diacerein intake was identified on fasting blood sugar (FBS) (WMD-9.00; 95%CI-22.57 to 4.57; P= 0.194; I²= 60.5%), homeostatic model assessment for insulin resistance (HOMA-IR) (WMD 0.39; 95%CI-0.95 to 1.73; P= 0.569; I²= 2.2%), body weight (WMD-0.54; 95%CI-1.10 to 0.02; P= 0.059), triglycerides (WMD-0.56; 95%CI-24.16 to 23.03; P= 0.963; I²= 0.0%), total-cholesterol (WMD-0.21; 95%CI-12.19 to 11.78; P= 0.973; I²= 0.0%), HDL-cholesterol (WMD-0.96; 95%CI-2.85 to 0.93; P= 0.321; I²= 0.0%), and LDL-cholesterol levels (WMD-0.09; 95%CI-8.43 to 8.25; P= 0.983; I²= 37.8%). Conclusion: Diacerein intake may reduce HbA1c and BMI; however, no evidence of the effect was observed for FBS, HOMA-IR, body weight, triglycerides, total cholesterol, HDL-cholesterol or LDL-cholesterol.