---
title: Systematic Review and Meta-Analysis Investigates Tocotrienol Supplementation and Blood Sugar Balance
description: Tocotrienols, a form of vitamin E, may help lower HbA1c in type 2 diabetes, a meta-analysis of ten randomized controlled trials found.
image: https://www.casi.org/hubfs/casi/featured/9-29-blood-sugar-tocotrienols.jpeg
---

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Science Update

# Systematic Review and Meta-Analysis Investigates Tocotrienol Supplementation and Blood Sugar Balance

CA Cory Ambrose, ND, MAT Sep 29, 2023

![Systematic Review and Meta-Analysis Investigates Tocotrienol Supplementation and Blood Sugar Balance](https://www.casi.org/hs-fs/hubfs/casi/featured/9-29-blood-sugar-tocotrienols.jpeg?width=960)

Abnormalities in blood sugar regulation have been linked to changes in [antioxidative status](https://pubmed.ncbi.nlm.nih.gov/37321474/) and the inflammatory response. Vitamin E is a powerful antioxidant that helps support cellular function and normal inflammation. It has several forms that have different actions within the body. On a molecular level, the structural differences between tocopherols and tocotrienols may contribute to their different actions. For instance, the bond types and composition of tocotrienol side chains help support a more even [distribution and fluidity](https://pubmed.ncbi.nlm.nih.gov/37321474/) with the cell’s phospholipid bilayer.

While tocopherols are perhaps the best-known form of vitamin E, research indicates that tocotrienols have a relatively high bioavailability and may possess additional qualities in support of [cellular health, cardiovascular function, and lipid metabolism](https://pubmed.ncbi.nlm.nih.gov/1433170/). Emerging evidence also suggests that [tocotrienols](https://pubmed.ncbi.nlm.nih.gov/37321474/) may help maintain healthy blood sugar homeostasis. 

A recently published systematic review and meta-analysis by [Phang and colleagues](https://pubmed.ncbi.nlm.nih.gov/37321474/) explored the potential connection between tocotrienol supplementation and glucose metabolism in individuals with type 2 diabetes mellitus (T2DM). The study included data from 10 randomized controlled trials that administered tocotrienol-rich fraction as the primary intervention. A tocotrienol-rich fraction consists of a 70% mixture of tocotrienol isomers. Sample sizes ranged from 43 to 300 participants and study durations were between 8 weeks and 18 months. Administered amounts ranged from 200 to 420 total tocotrienols. Parameters related to blood pressure, inflammation (high-sensitivity C-reactive protein, or hs-CRP), and blood sugar homeostasis (hemoglobin A1c, or HbA1c) were included in the meta-analysis. 

Overall conclusions of the meta-analysis included [significant decreases](https://pubmed.ncbi.nlm.nih.gov/37321474/) in HbA1c. Upon subgroup analysis, significant reductions in HbA1c were indicated when the duration of T2DM was less than 10 years, when the intervention lasted less than 6 months, and with a baseline HbA1c lower than 8.0%. In individuals with an HbA1c baseline higher than 8.0%, greater reductions in HbA1c were observed when compared with those with a lower than 8.0% baseline upon tocotrienol supplementation. While only non-significant decreases in systolic blood pressure and hs-CRP were reported, these results indicate that future clinical studies assessing tocotrienols’ effect on these parameters are warranted. Drawbacks to this study include relatively small sample sizes, lack of uniformity in biometric parameters, and varying study durations. 

While more research is needed, tocotrienols may help support blood glucose metabolism and cardiovascular health, in addition to their supportive role for antioxidative stress and the inflammatory response. [Tocotrienols](https://pubmed.ncbi.nlm.nih.gov/37321474/) can be found in rice bran oil, annatto, and certain grains including oats, barley, and rye.

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CA

### Cory Ambrose, ND, MAT

Clinical Application

## Clinical Considerations in Practice

 In clinical practice, practitioners considering the topics discussed above may also weigh nutrient form, delivery and formulation, alongside individual patient variability.

### Practitioner Formulation Example

![Annatto-E® 300](https://cdn.sanity.io/images/lemtscrs/production-www/845bd9496594847df921cab3a43d8881dbc81e0d-2000x2000.png?w=128&h=128&fit=max&auto=format)

Annatto-E® 300

300 mg delta- and gamma-tocotrienols · Softgels

[Explore Formulations →](https://www.designsforhealth.com/products/annatto-e-300mg)

## Continue your research

#### [Science Update A Case Series on an Allulose-Containing Gummy in Healthy Adults Monitored by Continuous Glucose Monitoring Sep 09, 2026](https://www.casi.org/articles/a-case-series-on-an-allulose-containing-gummy-in-healthy-adults-monitored-by-continuous-glucose-monitoring)

#### [Research & Education PCOS Is Now PMOS: Understanding the New Terminology and Its Metabolic Implications Jun 11, 2026](https://www.casi.org/articles/pcos-is-now-pmos-understanding-the-new-terminology-and-its-metabolic-implications)

#### [Research & Education How Akkermansia Supports GLP-1 Production and Metabolic Function May 27, 2026](https://www.casi.org/articles/akkermansia-supports-glp-1-production-metabolic-function)

#### [Science Update Bifidobacterium Postbiotic Promotes Healthy Body Composition and Akkermansia Genus: A Randomized Controlled Trial Apr 14, 2026](https://www.casi.org/articles/bifidobacterium-postbiotic-promotes-healthy-body-composition-and-akkermansia-genus-a-randomized-controlled-trial)

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