Abstract
BACKGROUND: Phytotherapeutic agents, including Momordica charantia, have been proposed as complementary strategies to enhance metabolic control in type 2 diabetes mellitus patients on oral antidiabetic drugs. METHODS: This was a real-world, longitudinal, comparative cohort study with treatment escalation, conducted in patients with type 2 diabetes mellitus receiving metformin therapy. All patients were initially prescribed add-on dapagliflozin at 10 mg/day and re-evaluated after 6 months. Based on glycemic response at 6 months, patients were stratified into two groups: 70 patients with persistent inadequate glycemic control received adjunctive supplementation with a standardized Momordica charantia extract for 3 months (intervention group), while 85 patients who achieved glycemic targets continued dual antidiabetic therapy alone (control group). Anthropometric, hemodynamic, and metabolic parameters were assessed at baseline, 6 months, and 9 months from baseline. RESULTS: Between-group analyses revealed divergent glycemic trajectories during the 6-9 month interval. In the intervention group, HbA1c decreased from 7.82 ± 0.58% at baseline to 6.93 ± 0.30% at 6 months and to 6.34 ± 0.42% at 9 months, while in the control group, glycemic parameters showed only modest additional changes after 6 months. The reduction in HbA1c and fasting plasma glucose between 6 and 9 months was significantly greater in patients receiving Momordica charantia compared with controls (p < 0.001). Fasting plasma glucose declined from 138.4 ± 17.5 mg/dL at baseline to 122.3 ± 13.1 mg/dL at 6 months and to 113.3 ± 12.2 mg/dL at 9 months in the intervention group. Dapagliflozin therapy was associated with significant improvements in body weight, BMI, and blood pressure at 6 months in both groups, whereas adjunctive Momordica charantia supplementation did not produce significant additional effects on anthropometric or hemodynamic parameters. CONCLUSIONS: Adjunctive Momordica charantia supplementation was associated with additional improvements in glycemic control compared with continuation of dual antidiabetic therapy alone, with the most pronounced effects observed for HbA1c and fasting plasma glucose. These findings support a potential adjunctive role for phytotherapeutic supplementation in patients with suboptimal glycemic control receiving contemporary standard therapy.