Efficacy and safety of

Purpose: The objective of this study was to assess the safety and efficacy of Patients and methods: A randomized, double-blind, placebo-controlled trial was conducted at Walailak University Hospital, Thailand. Participants were assigned 1:1 to receive Results: Seventy participants completed the trial (CA n = 34; placebo n = 36). Median age was 57 vs. 60 years, with women comprising 55.9% vs. 41.7% (CA vs. placebo). At 6 months, an unadjusted between-group difference in HbA1c was observed (p = 0.006); however, in the prespecified adjusted analysis (ANCOVA controlling for baseline HbA1c, diabetes duration, and sulfonylurea use) there were no between-group differences in HbA1c, fasting plasma glucose, or LDL-C. Although small within-group reductions in LDL-C were noted, the adjusted between-group comparison was not significant (p = 0.536), so lipid findings are exploratory. CA was well tolerated; mild, transient gastrointestinal symptoms were most common (5/34, 14.7%). Conclusion: CA supplementation was safe but did not produce a significant change in glycemic or lipid outcomes compared to placebo. Further studies with larger sample sizes, longer durations, and higher doses are warranted to verify potential metabolic effects. Clinical Trial Registration: This trial was registered with the Thai Clinical Trials Registry (TCTR20221219003); https://www.thaiclinicaltrials.org/show/TCTR20221219003.