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Effectiveness and safety of selenium supplementation for type 2 diabetes mellitus in adults: a systematic review of randomised controlled trials
Author(s) -
Stróżyk A.,
Osica Z.,
Przybylak J. D.,
Kołodziej M.,
Zalewski B. M.,
MrozikiewiczRakowska B.,
Szajewska H.
Publication year - 2019
Publication title -
journal of human nutrition and dietetics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.951
H-Index - 70
eISSN - 1365-277X
pISSN - 0952-3871
DOI - 10.1111/jhn.12670
Subject(s) - medicine , randomized controlled trial , diabetes mellitus , cochrane library , confidence interval , insulin resistance , type 2 diabetes , adverse effect , meta analysis , nausea , insulin , endocrinology
Background The role of selenium (Se) in the management of type 2 diabetes mellitus (T2 DM ) remains unclear. We systematically assessed the effectiveness and safety of Se supplementation in adults with T2 DM . Methods MEDLINE , EMBASE and the Cochrane Library were searched up to April 2018 for randomised controlled trials ( RCT s) evaluating the effectiveness of Se against a comparator on DM ‐related outcomes. Results Four RCT s (241 participants) were included. In individual RCT s, Se supplementation significantly reduced fasting insulin levels [mean difference ( MD ) = −3.6 μIU mL −1 ; 95% confidence interval ( CI ) = −6.36 to −0.84; MD = −5.8 μIU mL −1 ; 95% CI = −9.23 to −2.37], homeostasis model of assessment‐estimated insulin resistance (HOMA‐IR) ( MD = −1; 95% CI = −1.79 to −0.21; MD = −1.6; 95% CI , −2.58 to −0.62) and homeostasis model of assessment‐estimated B cell function (HOMA‐B) ( MD = −13.6; 95% CI = −23.4 to −3.8; MD = −22.6; 95% CI = −36.39 to −8.81). No effects of Se were noted on most of the other outcomes of interest. None of the RCT s assessed the mortality, diabetes‐related complications, non‐high‐density lipoprotein (non‐ HDL) , blood pressure and health‐related quality of life. The impact on HDL and fasting plasma glucose ( FPG ) was ambiguous. Only one adverse event (nausea) was reported as a reason for discontinuing the intervention; however, among the studies, the reporting was not accurate. Furthermore, only one RCT reported increase in FPG level in the Se group ( MD = 36.38 mg dL −1 ; 95% CI = 15.39–57.37). Conclusions Currently, there is no evidence to support the effectiveness of Se supplementation in the T2DM population.