Attenuation of Fasting and Postprandial Glucose Exposure by Standardized Salacia reticulata Extract in Adults with Prediabetes: A Randomized, Double-Blind, Placebo-Controlled Trial.

Clinical evidence for Salacia reticulata extract (SR) in prediabetes remains limited, particularly with respect to its effects on comprehensive glucose exposure across multiple oral glucose tolerance test (OGTT)-derived intervals. This randomized, double-blind, placebo-controlled trial evaluated the effects of a standardized SR administered for 12 weeks on fasting and postprandial glucose exposure in adults with prediabetes. One hundred participants meeting prediabetes criteria (fasting plasma glucose [FPG] 100-139 mg/dL and postprandial plasma glucose [PPG] 140-199 mg/dL) were selected. Participants with dual fasting and postprandial glycemic impairments were randomly assigned to receive SR (500 mg/day, n = 50) or placebo (n = 50). Efficacy and safety outcomes were assessed at baseline and after the intervention. Compared with placebo, SR significantly reduced FPG and PPG to 90 and 120 min after supplementation (all P < .05). Glucose areas under the curve at 0-30, 0-60, 0-90, and 0-120 min were significantly lower in the SR group compared with placebo, with significant percent reductions in postprandial glucose spikes from baseline to week 12 (all P < .05). Additionally, HbA1c and triglycerides were significantly reduced, while 1,5-anhydroglucitol was significantly increased compared with placebo. Total glucagon-like peptide-1 (GLP-1) levels showed a significant between-group difference. No clinically meaningful safety concerns were observed. Twelve weeks of supplementation with standardized SR attenuated fasting and postprandial glucose concentrations, including significant reductions in OGTT-derived glucose spikes. These findings extend clinical evidence of S. reticulata to early-stage dysglycemia and support its potential role in glycemic stabilization in prediabetes.