Diabetes is one of the most common endocrine disorders that increases the economic burden on the public health system. In this regard, understanding the effect of available herbs on diabetes can be useful. This systematic review was performed to determine the effect of Salvia officinalis on blood glycemic indexes and blood lipid profile (primary outcomes) and 2 h postprandial blood glucose (2HPPG), alanine transaminase (ALT) (U/L) and aspartate transaminase (AST) (U/L) and its side effects (secondary outcomes) in diabetic patients. A systematic search was conducted in the English (Cochrane Library, Medline (PubMed), Scopus, CINAHL, ProQuest and Persian databases since inception to March 2021, without publication time restriction. Two authors separately evaluated the quality of the articles using Cochrane Collaboration’s tool for assessing the risk of bias in randomized trials and extracted the data. Heterogeneity of data was evaluated by squared I (I2). Three studies included in the review and all of them included in meta-analysis. The results of meta-analysis showed that S. officinalis reduced fasting blood sugar (FBS) (mg/dL) (MD: −31.15; 95% CI: −37.56 to −24.73; p<0.00001). It also reduced HbA1c (%) (MD: −0.94; 95% CI: −1.25 to −0.63; p<0.00001) and total cholesterol (mg/dL) (MD: −43.64; 95% CI: −83.26 to −4.02; p=0.03) and reduction of low-density protein (LDL) (mg/dL) (MD: −19.23; 95% CI: −35.81 to −2.65; p=0.02) but it did not have a significant effect on triglyceride (mg/dL) (p=0.09), and high-density lipoprotein (HDL) (mg/dL) (p=0.18). Regarding the secondary outcomes, S. officinalis also had significant effect on 2HPPG, but it did not have a significant effect on ALT (U/L) and AST (U/L). No specific side effects for this plant were reported in these three studies. The results showed that S. officinalis has a positive effect on blood glycemic status and blood lipid profile in diabetes except for triglyceride and HDL. However, due to the small number of included articles, it is recommended that stronger clinical trials be conducted in this field.
Funding source: Tabriz University of Medical Sciences
Award Identifier / Grant number: 65126
Hereby, we thank all of the authors and researchers of the surveys that are used in this article and we would like to thank Student Research Committee, Tabriz University of Medical Sciences for their support.
Research funding: This research was funded by Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran (Grant No. 65126).
Author contribution: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Authors state no conflict of interest.
Informed consent: Not applicable.
Ethical approval: Not applicable.
1. Whiting, DR, Guariguata, L, Weil, C, Shaw, J. IDF Diabetes Atlas: global estimates of the prevalence of diabetes for 2011 and 2030. Diabetes Res Clin Pract 2011;94:311–21, https://doi.org/10.1016/j.diabres.2011.10.029.Search in Google Scholar PubMed
2. Azimi-Nezhad, M, Ghayour-Mobarhan, M, Parizadeh, MR, Safarian, M, Esmaeili, H, Parizadeh, SMJ, et al.. Prevalence of type 2 diabetes mellitus in Iran and its relationship with gender, urbanisation, education, marital status and occupation. Singap Med J 2008;49:571–6.Search in Google Scholar
3. Noshad, S, Afarideh, M, Heidari, B, Mechanick, JI, Esteghamati, A. Diabetes care in Iran: where we stand and where we are headed. Ann Glob Health 2015;81:839–50, https://doi.org/10.1016/j.aogh.2015.10.003.Search in Google Scholar PubMed
6. Behradmanesh, S, Derees, F, Rafieian-Kopaei, M. Effect of Salvia officinalis on diabetic patients. J Ren Inj Prev 2013;2:51–4, https://doi.org/10.12861/jrip.2013.18.Search in Google Scholar PubMed PubMed Central
7. Esmaeilizadeh, M, Ghorbani, A. Pharmacological properties of Salvia officinalis and its components. J Tradit Complementary Med 2017;7:433–40, https://doi.org/10.1016/j.jtcme.2016.12.014.Search in Google Scholar PubMed PubMed Central
8. Alizadeh, A, Shaabani, M. Essential oil composition, phenolic content, antioxidant and antimicrobial activity in Salvia officinalis L. cultivated in Iran. Adv Environ Biol 2012;6:221–6.Search in Google Scholar
9. Lima, CF, Azevedo, MF, Araujo, R, Fernandes-Ferreira, M, Pereira-Wilson, C. Metformin-like effect of Salvia officinalis (common sage): is it useful in diabetes prevention? Br J Nutr 2006;96:326–33, https://doi.org/10.1079/bjn20061832.Search in Google Scholar PubMed
10. Alarcon-Aguilar, FJ, Roman-Ramos, R, Flores-Saenz, JL, Aguirre-Garcia, F. Investigation on the hypoglycaemic effects of extracts of four Mexican medicinal plants in normal and alloxan-diabetic mice. Phytother Res 2002;16:383–6, https://doi.org/10.1002/ptr.914.Search in Google Scholar PubMed
11. Eidi, M, Eidi, A, Zamanizadeh, H. Effect of Salvia officinalis L. leaves on serum glucose and insulin in healthy and streptozotocin-induced diabetic rats. J Ethnopharmacol 2005;100:310–3, https://doi.org/10.1016/j.jep.2005.03.008.Search in Google Scholar PubMed
12. Kianbakht, S, Dabaghian, FH. Improved glycemic control and lipid profile in hyperlipidemic type 2 diabetic patients consuming Salvia officinalis L. leaf extract: a randomized placebo. Controlled clinical trial. Compl Ther Med 2013;21:441–6, https://doi.org/10.1016/j.ctim.2013.07.004.Search in Google Scholar PubMed
13. Kianbakht, S, Nabati, F, Abasi, B. Salvia officinalis (Sage) leaf extract as add-on to statin therapy in hypercholesterolemic type 2 diabetic patients: a randomized clinical trial. Int J Mol Cell Med 2016;5:141–8.Search in Google Scholar
14. World Health Organization. WHO Global Report on Traditional and Complementary Medicine 2019 [Internet]. Geneva: World Health Organization; 2019:1–228 pp. Available from: https://apps.who.int/iris/bitstream/handle/10665/312342/9789241515436-eng.pdf?ua=1.Search in Google Scholar
15. Gopalakrishnan, S, Ganeshkumar, P. Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare. J Fam Med Prim Care 2013;2:9–14, https://doi.org/10.4103/2249-4863.109934.Search in Google Scholar PubMed PubMed Central
16. Higgins, JPT, Altman, DG, Gøtzsche, PC, Jüni, P, Moher, D, Oxman, AD, et al.. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials. Br Med J 2011;343:d5928. https://doi.org/10.1136/bmj.d5928.Search in Google Scholar PubMed PubMed Central
17. Higgins, JPT, Thomas, J, Chandler, J, Cumpston, M, Li, T, Page, MJ, et al.. Cochrane handbook for systematic reviews of interventions. In: Cochrane handbook for systematic reviews of interventions. Chichester, UK: John Wiley & Sons; 2019:1–694 pp.10.1002/9781119536604Search in Google Scholar
18. Moghaddam, G, Roghani, M. Effect of Salvia officinalis L. on serum level of glucose, lipid profiles and tissue level of Malondialdehyde in diabetic rats. J Gorgan Univ Med Sci 2015;17:38–44.Search in Google Scholar
19. Higgins, JPT, Li, T, Deeks, JJ. Choosing effect measures and computing estimates of effect. In: Cochrane handbook for systematic reviews of interventions. Chichester, UK: John Wiley & Sons; 2019:143–76 pp. Available from: https://training.cochrane.org/handbook/current/chapter-06#section-6-5-2.10.1002/9781119536604.ch6Search in Google Scholar
20. Junhai, L, Xuemei, D, Xiulin, S. Effect of Milkvetch root and Red Sage root injections in treating patients with early diabetic nephropathy. J Jilin Med College 2007;28:75–7.Search in Google Scholar
21. Ramezani, M, Taghian, F. The effect of 8 weeks aerobic training and glycogon consumption on serum apelin and insulin resistance in women with type 2 diabetes. Iran J Diabetes Obes 2019;11:164–72. https://doi.org/10.18502/ijdo.v11i3.2605.Search in Google Scholar
22. Belhadj, S, Hentati, O, Hammami, M, Ben Hadj, A, Boudawara, T, Dammak, M, et al.. Metabolic impairments and tissue disorders in alloxan-induced diabetic rats are alleviated by Salvia officinalis L. essential oil. Biomed Pharmacother 2018;108:985–95, https://doi.org/10.1016/j.biopha.2018.09.108.Search in Google Scholar PubMed
23. Khedher, MRB, Hammami, M, Arch, JRS, Hislop, DC, Eze, D, Wargent, ET, et al.. Preventive effects of Salvia officinalis leaf extract on insulin resistance and inflammation in a model of high fat dietinduced obesity in mice that responds to rosiglitazone. Peer J 2018;6.p. e4166, https://doi.org/10.7717/peerj.4166.Search in Google Scholar PubMed PubMed Central
24. Aly, NH. Therapeutic effects of some promising anti-diabetic plants on diabetic rats. African J Biol 2010;6:159–67.Search in Google Scholar
The online version of this article offers supplementary material (https://doi.org/10.1515/jcim-2021-0425).
© 2022 Walter de Gruyter GmbH, Berlin/Boston