Bromocriptine in type 2 diabetes: a promising alternative, a systematic review and meta-analysis

Type 2 diabetes mellitus is a chronic condition driven by insulin resistance and impaired beta-cell function. As beta cells gradually lose function, blood glucose levels rise, leading to clinical diabetes. This condition also elevates the risk of cardiovascular complications. Treatment typically requires multiple medications with different mechanisms of action. Recent developments include bromocriptine, a dopamine agonist approved by the Food and Drug Administration (FDA) for type 2 diabetes, which has been shown to reduce plasma glucose, triglycerides, and free fatty acid levels. To deepen our understanding of type 2 diabetes and refine treatment approaches, a comprehensive analysis of clinical studies and related data is essential.

This systematic review and meta-analysis investigated the efficacy of bromocriptine in diabetes outcomes by analyzing randomized clinical trials (RCTs) in English up to November 25, 2024. The comprehensive search spanned Scopus, PubMed, and Web of Science, with additional studies identified through supplementary web searches and reference list checks. Inclusion criteria required clinical trials with clear methodologies and defined drug dosages. Data extraction gathered information on study design, outcomes, and intervention specifics, with quality assessment using the JADAD scoring system. Statistical analysis focused on standard mean difference (SMD), while the I² statistic measured study heterogeneity. A funnel plot analysis was employed to identify publication bias, with all analyses conducted using Comprehensive Meta-Analysis and Stata software.

Eighteen RCTs were conducted, revealing that dopamine D2 agonists have a relatively strong impact on reducing Hemoglobin A1C (HbA1c) and fasting blood sugar (FBS). However, with I² values of 96% for HbA1c and 99% for FBS, the results show high heterogeneity among the studies.

Bromocriptine presents a promising alternative for individuals with diabetes who cannot tolerate conventional medications. Its unique mechanism of action might offer relief to those who suffer from side effects associated with standard treatments, providing a novel way to manage blood sugar levels.