Individualized homeopathic medicines in preventing the progression from pre-diabetes to diabetes: A double-blind, randomized, placebo-controlled, parallel-arm trial

CONTEXT

Pre-diabetes is a significant public health problem worldwide. India has a very high rate of progression from pre-diabetes to diabetes, 75-78 per thousand persons per year.

OBJECTIVE

To study the efficacy of individualized homeopathic medicinal products (HMPs) against placebos in preventing the progression from pre-diabetes to diabetes.

DESIGN

Six-month, double-blind, randomized (1:1), two parallel arms, placebo-controlled trial.

SETTING

Outpatient departments of D. N. De Homoeopathic Medical College and Hospital, Kolkata, West Bengal, India.

PATIENTS

Sixty participants with pre-diabetes.

INTERVENTIONS

Verum: HMPs plus yoga therapy (YT; n = 30); control: identical-looking placebos plus YT (n = 30).

MAIN OUTCOME MEASURES

The primary efficacy endpoint was the proportion of participants progressing from pre-diabetes to diabetes, measured after three and six months. Secondary outcomes comprised of fasting blood glucose (FBS), oral glucose tolerance test (OGTT), glycated hemoglobin percentage (HbA1c%), lipid profile, liver enzymes (alanine transaminase, aspartate transaminase), urea and creatinine, and Measure Yourself Medical Outcome Profile version 2 (MYMOP-2); all measured after 3 and 6 months.

RESULTS

The proportion of participants converted from pre-diabetics to diabetics (n/N; n = diabetics, N = prediabetics) was significantly less in the verum group than control: HbA1C% (month 3: verum - 2/30 versus control - 11/30, p = 0.003; month 6: 3/30 vs. 2/30, p = 0.008), OGTT (month 3: 0/30 vs. 8/30, p = 0.015; month 6: 0/30 vs. 1/30, p = 0.008), but not according to FBS (month 3: 1/30 vs. 1/30, p = 0.779; month 6: 1/30 vs. 3/30, p = 0.469). Several secondary outcomes also revealed significant improvements in the verum group than in placebo: HbA1C% (p < 0.001), OGTT (p = 0.001), serum ALT (p = 0.031), creatinine (p = 0.012), and MYMOP-2 profile scores (p < 0.001). Sulphur, Bryonia alba, and Thuja occidentalis were the most frequently indicated medicines. Thus, HMPs outperformed placebos by successfully preventing the progression of pre-diabetes to diabetes.

TRIAL REGISTRATION

Clinical Trials Registry - India CTRI/2022/04/042,026; UTN: U1111-1277-0021.

Histopathological study of solitary nodules of thyroid

OBJECTIVE

To determine the incidence of various thyroid disorders manifesting as Solitary Thyroid Nodule and also to evaluate the histomorphology of the lesions.

MATERIALS AND METHODS

Hundred specimens of Solitary Thyroid Nodules were studied for gross characteristics, microscopic features, age and sex incidence.

RESULTS

Of the 100 cases of Solitary Thyroid Nodules, 66% were non neoplastic and 34% were neoplastic. Among the neoplasms, 21% were malignant and 13% were benign. The age incidence ranged from 20-50 years for non neoplastic lesions and 20-40 years for neoplasms. A female preponderance was seen for both non neoplastic and neoplastic conditions. The solitary nodules involved the right side of the thyroid more commonly than the left. Involutional colloid nodule was the predominant type of solitary nodule (52%). Among the malignant neoplasms, papillary carcinoma was the commonest solitary nodule (13%). One case each of hyalinising trabecular adenoma, columnar cell variant of papillary carcinoma and medullary carcinoma unusually presenting as solitary nodules were encountered in the present study.

CONCLUSION

Histomorphologic evaluation of Solitary Thyroid Nodules presenting without a background setting of multinodular goiter is challenging and mandatory as the diagnoses ranges from the common non neoplastic lesions like involuting nodules to the rare neoplastic conditions like medullary carcinoma.