Last updated July 12, 2026
Key finding
Both SZ-A and canagliflozin significantly reduced HbA1c.
This study compared the efficacy and safety of mulberry twig alkaloids (SZ-A) to canagliflozin in individuals with poorly controlled type 2 diabetes, finding both treatments effective in reducing key glucose metrics.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
This study compared the efficacy and safety of mulberry twig alkaloids (SZ-A) to canagliflozin in individuals with poorly controlled type 2 diabetes, finding both treatments effective in reducing key glucose metrics.
The findings are clinically significant as they suggest that mulberry twig alkaloids could serve as an alternative treatment for patients with poorly controlled type 2 diabetes, alongside existing medications like canagliflozin. This could provide more options for patients who may not respond well to traditional treatments, potentially improving overall diabetes management.
The study's population may not be representative of all diabetes patients. Limited long-term safety data on mulberry twig alkaloids. Effectiveness comparisons were not fully established.
Published in
Publication details and source links for this paper.
Huiqin L, ShanShan T, Xiao Z, et al. Efficacy and safety of mulberry twig alkaloids versus canagliflozin in poorly controlled type 2 diabetes. Scientific Reports. 2026;16:18502. doi:10.1038/s41598-026-48843-2
Both SZ-A and canagliflozin significantly reduced HbA1c by -1.62% (p=0.001).
Both SZ-A and canagliflozin significantly reduced fasting plasma glucose by -2.64 mmol/L (p=0.001).
Both SZ-A and canagliflozin significantly reduced body weight.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Mulberry twig alkaloids (SZ-A) and Blood glucose, Body weight, Fasting Plasma Glucose (FPG), and 9 more.
This study contributes evidence to
Primary intervention
Mulberry twig alkaloids (SZ-A)
Primary outcomes
Evidence topics
Primary intervention
Primary outcomes
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
3
Related topics
12
Evidence pairs
483
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Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
Evidence topic
Contributes evidence
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Primary evidence
Evidence relationship
Related evidence
Evidence relationship
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Evidence relationship
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Core evidence
The primary outcomes reported in this study.
Mulberry twig alkaloids (SZ-A) → Blood glucose
Mulberry twig alkaloids (SZ-A) → Blood glucose
Mulberry twig alkaloids (SZ-A) → Fasting Plasma Glucose (FPG)
Mulberry twig alkaloids (SZ-A) → Fasting Plasma Glucose (FPG)
Mulberry twig alkaloids (SZ-A) → Glucose iAUC (OGTT)
Mulberry twig alkaloids (SZ-A) → Glucose iAUC (OGTT)
Mulberry twig alkaloids (SZ-A) → Insulin resistance
Mulberry twig alkaloids (SZ-A) → Insulin resistance
Mulberry twig alkaloids (SZ-A) → Insulin sensitivity
Mulberry twig alkaloids (SZ-A) → Insulin sensitivity
Mulberry twig alkaloids (SZ-A) → Postprandial blood glucose
Mulberry twig alkaloids (SZ-A) → Postprandial blood glucose
Mulberry twig alkaloids (SZ-A) → Time above range
Mulberry twig alkaloids (SZ-A) → Time above range
Mulberry twig alkaloids (SZ-A) → Time in range
Mulberry twig alkaloids (SZ-A) → Time in range
Mulberry twig alkaloids (SZ-A) → Triglycerides
Mulberry twig alkaloids (SZ-A) → Triglycerides
Mulberry twig alkaloids (SZ-A) → Waist circumference
Mulberry twig alkaloids (SZ-A) → Waist circumference
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Mulberry Therapies and Fasting Glucose, Mulberry Therapies and Body Weight.
This study contributes to the evidence on the following intervention-outcome relationships.
Medications
Medications
Curated evidence collections and hubs this study is part of.
All studies measuring Body Weight
Measures Body Weight as a key outcome.
All studies measuring Fasting Glucose
Measures Fasting Glucose as a key outcome.
All studies on Mulberry Therapies
Contributes to Mulberry Therapies evidence base.
Latest published studies
Published within the last 2 years.
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1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Mulberry Therapies appears to improve Fasting Glucose.
ConsistencyScore™: Results are consistent across studies.
Ranked evidence signals
Blood glucose
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Fasting Plasma Glucose (FPG)
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a small number of supporting studies and should be interpreted cautiously.
Limitations
Mulberry Therapies appears to improve CGM Time in Range.
ConsistencyScore™: Results are mixed and should be interpreted cautiously.
Ranked evidence signals
Time above range
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Time in range
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is cautious because the available studies report mixed findings.
Limitations
Mulberry Therapies appears to improve Body Weight.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Body weight
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Current evidence does not show a clear benefit of Mulberry Therapies for Insulin Resistance.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Insulin resistance
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Insulin sensitivity
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | neutral | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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