# Single-ingredient garlic tablets 900 mg/day; powder, processing, and active-constituent specifications unverified × Reduction of HbA1c in adults with type 2 diabetes Verdict 3062 · Evidence Check Stored-material review date: 2026-10-06 Original evidence cut-off: 2026-09-08 Review-criteria version: 1.0 Public page/material preparation date: 2026-10-26 Clinical papers were not read directly; existing review summaries were checked. No new clinical-literature search was performed. Unverified does not mean that research is absent or that there is no effect. ## Assessment scope - Population: Adults with established type 2 diabetes. Diagnosis, age, baseline HbA1c, inclusion/exclusion and balance between arms remain unverified. - Ingredient, formulation and route: Oral single-ingredient garlic tablets derived from Allium sativum L. cloves. Powder, extraction methods, manufacturing/batch and alliin/allicin specifications remain unverified. - Dose: Nominal 900 mg/day. Per-dose amount, divided frequency, actual intake, adherence and active-constituent amounts remain unverified. - Comparator: Placebo tablets. Metformin is a separate active arm, and common stable glucose-lowering medication is unverified. Placebo composition/appearance and actual arm schedules also remain unverified. - Measured outcome: Absolute between-group HbA1c change at 24 weeks. P<.005 was reported for each garlic arm versus placebo, but the selected absolute %p, 95%CI, completed/ITT denominators and prespecified single rank 1 primary hierarchy remain unverified. - Duration: 24-week treatment and measurements at 12 and 24 weeks. Actual schedules, completion and persistence after stopping remain unverified. - Questions outside this scope: Do not fill missing absolute effects/CIs for the selected 900 mg tablet using P values or meta-analysis means mixing other formulations.; The primary trial’s 7 arms, description of 210 participants and 30 per arm do not establish actual completed/ITT or selected-comparison analysis denominators.; The first meta-analysis’s HbA1c 3 trials/7 effects differ from the second’s 27 RCTs/1,619 participants across all endpoints. Included-trial/participant overlap and independent replication of the selected formulation remain unverified.; Keep fasting glucose, HOMA-IR and lipids separate from HbA1c. Do not extend results to replacing diabetes medication, preventing complications or identical effects from all garlic foods.; Raw garlic, powder, oil, aged garlic extract, black garlic, fermented garlic and isolated SAC do not share the same tablet specifications. Optimal dose, maintenance after stopping, subgroups and long-term/rare-event/vulnerable-group safety are separate questions.; Do not turn original caution wording into actual harm incidence, causal risks, safety certification or individual intake instructions. ## Checklist items ### N01 · Is the selected 900 mg tablet, 24-week HbA1c comparison with placebo distinguished from other garlic claims? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The comparison concerns oral single-ingredient garlic tablets 900 mg/day for 24 weeks versus placebo for HbA1c in adults with established type 2 diabetes. Other glycemic/lipid outcomes and complications are separate. - Why unverified: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established. - Reason for missing information: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established. - Required materials and conditions: Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing - Materials to obtain first: Original locations for the current claim, formulation/route, selected dose, population, endpoint, comparator and timing - Further research: Review separate boundaries only when adding a new question. A new clinical trial is not required to identify this question. - Conditions for verification: Link the current article’s selected 900 mg/day, 24-week HbA1c and placebo question to excluded endpoints. - Why this condition is needed: The specific HbA1c question with evidence gaps must first be fixed. - Application exceptions: Verifying the question’s identity does not verify the absolute effect or formulation specifications. - Remaining uncertainty: Verification is limited to the identity of the original claim and its inclusion/exclusion boundaries; efficacy is not established. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N02 · Have the 7-arm primary trial and two meta-analyses been kept from being double-counted as independent trials? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The 3 retained reports comprise a 7-arm primary trial and 2 meta-analyses. The 7 arms, 7 HbA1c effects and 27 RCTs are not added together to create a new independent-trial count. - Why unverified: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified. - Reason for missing information: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified. - Required materials and conditions: Links among primary reports, reviews, included-trial tables, registrations and report families - Materials to obtain first: Links among primary reports, reviews, included-trial tables, registrations and report families - Further research: First construct a study-level results table by comparing included-trial tables with registration numbers, authors and recruitment periods. - Conditions for verification: Separate the roles of 1 primary-trial report and 2 meta-analysis reports, the same 7 arms, and unresolved included-trial overlap. - Why this condition is needed: Counting multiple arms and reviews as additional independent replications inflates the evidence. - Application exceptions: Retain null values and unverified states when original family tables and unique-participant relationships are unavailable. - Remaining uncertainty: This verifies report distinctions and the prohibition on double-counting. The reviews’ included trials and overlap with the primary trial/participants remain unverified. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N03 · Are the summaries actually read in this conversion distinguished from reading external papers, supplements and registrations? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The entire current 3062 retained summary was read, including Korean/English content, 3 evidence entries, 3 citations and 1 correction. Original papers, meta-analysis full texts/supplements and registrations were not accessed, acquired or read in this conversion. - Why unverified: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content. - Reason for missing information: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content. - Required materials and conditions: Material identity, public/access status, acquisition, actual reading level, date, original location and identity - Materials to obtain first: Material identity, public/access status, acquisition, actual reading level, date, original location and identity - Further research: For lawfully acquired material, record the sections/tables read and file identity in a separate event. - Conditions for verification: Show actual reading of the local retained summary separately from external material unread in this conversion, and link summaries to their exact original locations. - Why this condition is needed: External links and retained summaries must not be represented as reading a paper’s full text. - Application exceptions: Access not attempted differs from inaccessible, failed access and 0 results. - Remaining uncertainty: This distinguishes actual reading in this conversion from historical statements; it does not verify full-text content. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N04 · Are adults with type 2 diabetes and the actual selection/baseline status in the selected primary trial verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The population is recorded as adults with established type 2 diabetes. Detailed diagnostic criteria, age distribution, baseline HbA1c, inclusion/exclusion and balance between arms are not verified in the retained summary. - Why unverified: Only the population label is verified; detailed selection and baseline tables remain unverified. - Reason for missing information: Only the population label is verified; detailed selection and baseline tables remain unverified. - Required materials and conditions: Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms - Materials to obtain first: Diagnosis, age, baseline HbA1c, inclusion/exclusion, baseline medication/disease and balance between arms - Further research: Retrieve the primary trial’s Methods and baseline table to review population matching, separating direct population-specific studies when needed. - Conditions for verification: Explain the match between the primary trial’s actual population and the selected question, and unverified baseline/selection details. - Why this condition is needed: Sharing the label diabetes does not make a meta-analysis’s mixed populations applicable to this population. - Application exceptions: Do not transfer figures from other populations or formulations to the selected arms. - Remaining uncertainty: Only the population label is verified; detailed selection and baseline tables remain unverified. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N05 · Are the source, specifications and active constituents of the selected single-ingredient garlic tablet verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The single-ingredient garlic tablet derives from Allium sativum L. cloves. Powder, extraction method and alliin/allicin specifications remain unverified; other garlic products are not substituted. - Why unverified: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified. - Reason for missing information: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified. - Required materials and conditions: Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition - Materials to obtain first: Exact product name, manufacturing/processing, powder/extraction method, batch, alliin/allicin assays and single-ingredient composition - Further research: First check the primary trial’s product documents and constituent assays; design formulation-specific effect studies as separate comparisons. - Conditions for verification: Distinguish the verified scope of an oral single-ingredient tablet from unverified specifications, and exclude other garlic formulations. - Why this condition is needed: Food, oil, AGE and black garlic must not be mixed with the tablet’s actual exposure. - Application exceptions: The source Allium sativum cloves alone does not establish processing or active-constituent specifications. - Remaining uncertainty: Tablet/source labels exist, but actual manufacturing/batch and constituent-specification matching remain unverified. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N06 · Are the per-dose amount, divided schedule and actual intake of 900 mg/day verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The selected 900 mg/day is recorded, but per-dose amount, divided frequency, actual intake/adherence and active-constituent amount remain unverified. - Why unverified: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established. - Reason for missing information: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established. - Required materials and conditions: Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content - Materials to obtain first: Dosing table for the 900 mg arm, per-dose amount/frequency, actual intake, adherence and product content - Further research: Retrieve the primary trial’s dosing table and adherence data. Review direct dose comparisons separately for an optimal-dose claim. - Conditions for verification: Preserve the original 900 mg/day and record unverified divided dosing, intake and active-constituent amounts. - Why this condition is needed: Nominal daily dose must be distinguished from actual administered exposure to attribute the selected dose accurately. - Application exceptions: Do not import other dose arms or meta-analysis dose-response results as the selected 900 mg schedule. - Remaining uncertainty: The daily-dose label is verified, but the actual schedule and administered exposure cannot be established. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N07 · Are common glucose-lowering medication, changes and adherence in the placebo and 900 mg arms verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Whether stable glucose-lowering medication was maintained in common is unverified. Metformin is a separate active arm, so neither garlic nor placebo arms are described as both receiving metformin. - Why unverified: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable. - Reason for missing information: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable. - Required materials and conditions: Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling - Materials to obtain first: Common glucose-lowering drugs by arm, stable-treatment period, changes/rescue treatment, adherence and analytical handling - Further research: First check the primary trial’s Methods, concomitant-medication table, treatment changes and SAP to clarify the effect of interest. - Conditions for verification: Distinguish common treatment in both arms from a separate active arm, recording the impact of unverified concomitant treatment/changes. - Why this condition is needed: Contributions from other glucose-lowering treatment must not be attributed to the selected garlic effect. - Application exceptions: Metformin is a separate active arm and is not assumed to be common maintenance medication. - Remaining uncertainty: Actual data on common concomitant medication, changes by arm, rescue treatment and adherence are unavailable. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N08 · Are the actual roles of placebo tablets and the separate metformin active arm verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The selected comparator is placebo tablets, while metformin is a separate active arm. Details of placebo composition, matching appearance and the active-arm schedule remain unverified. - Why unverified: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved. - Reason for missing information: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved. - Required materials and conditions: Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast - Materials to obtain first: Allocation table for the 7 arms, placebo composition/appearance, active-arm dose, common treatment and selected contrast - Further research: Retrieve arm-composition/allocation tables and define a separate question before adding an active-drug comparison. - Conditions for verification: Fix the selected contrast as 900 mg versus placebo, explaining unverified placebo details and actual active-arm composition. - Why this condition is needed: Garlic versus placebo and garlic versus an active drug are different questions. - Application exceptions: Do not substitute the separate active drug for placebo or common background treatment in both arms. - Remaining uncertainty: Placebo/active-arm roles are distinguished, but actual arm composition and placebo matching details remain unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N09 · Are the actual schedules of 24-week treatment and measurements at 12 and 24 weeks verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The record describes 24-week treatment and measurements at 12 and 24 weeks. The selected endpoint is 24-week HbA1c; detailed schedules, actual completion and follow-up after stopping remain unverified. - Why unverified: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified. - Reason for missing information: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified. - Required materials and conditions: Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration - Materials to obtain first: Treatment/testing schedules by arm, baseline/12-week/24-week measurements, completion/stopping and follow-up duration - Further research: Retrieve original schedules and time-specific measurement/completion data; effects after stopping require separate follow-up. - Conditions for verification: Preserve the selected 24-week endpoint and 12-week interim measurement, leaving actual schedules/losses by arm unverified. - Why this condition is needed: A 12-week interim value must not become the selected 24-week effect or a sustained effect after treatment stops. - Application exceptions: Distinguish measurement times from actual completed follow-up and long-term maintenance duration. - Remaining uncertainty: Nominal treatment/measurement times are available, but actual follow-up schedules and completion are unverified. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N10 · Are the definition and units of absolute between-group HbA1c change verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The selected question concerns absolute between-group HbA1c change at 24 weeks. Only significance is retained for the primary trial, so the exact measure and computational contrast for the selected absolute effect remain unverified. - Why unverified: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result. - Reason for missing information: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result. - Required materials and conditions: Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c - Materials to obtain first: Units, baseline/final values/change, contrast of interest, direction and analytical definition for 24-week HbA1c - Further research: Retrieve baseline/final/change values and contrast definitions from the original results table to link them to the selected effect. - Conditions for verification: Distinguish the question of absolute between-group HbA1c change at 24 weeks from the level of actually reported results and unverified information. - Why this condition is needed: Significance, glucose values and pooled means must not be mixed with the selected absolute HbA1c effect. - Application exceptions: Do not interchange % and %p, within-group before/after and between-group comparisons, or final values and changes. - Remaining uncertainty: No table is available to compare the question’s endpoint/measure with the primary trial’s quantitative result. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N11 · Are HbA1c assay methods, collection times and assessment procedures verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: HbA1c measurement and the 24-week endpoint are recorded, but assay methods, standardization, assessor/laboratory blinding and procedures by arm are not verified in the retained summary. - Why unverified: The single-blind label alone does not identify who was blinded for which measurement. - Reason for missing information: The single-blind label alone does not identify who was blinded for which measurement. - Required materials and conditions: Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling - Materials to obtain first: Laboratory method/standardization, blood-collection timing, identical procedures by arm, assessor blinding and error handling - Further research: Acquire the original Methods, laboratory procedures and measurement-quality data. - Conditions for verification: Explain the actual scope and unverified aspects of testing, collection, standardization and blinding. - Why this condition is needed: Actual procedures are needed to examine whether differences in measurement conditions could explain result differences. - Application exceptions: The objective-marker name HbA1c alone does not establish absence of measurement bias. - Remaining uncertainty: The single-blind label alone does not identify who was blinded for which measurement. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N12 · Can the described 210 participants and 30 per arm be distinguished from actual 900 mg/placebo analysis denominators at 24 weeks? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The record describes 210 participants and 30 per arm; completion and ITT remain unverified. The 210 are not used as the actual analysis n for the selected 900 mg versus placebo comparison. - Why unverified: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved. - Reason for missing information: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved. - Required materials and conditions: Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram - Materials to obtain first: Recruitment/allocation, completion by arm, 24-week measurements, ITT/PP analysis n and participant flow diagram - Further research: Retrieve original flow diagrams and arm-by-time/analysis tables to link the actual denominators for the selected contrast. - Conditions for verification: Preserve the original description of 210 participants and 30 per arm, distinguishing recruitment/allocation/completion/analysis roles and unverified information. - Why this condition is needed: A described sample size must not be established as a completed/analysis denominator. - Application exceptions: Do not substitute 30 in each of 7 arms for an analysis of 210 in the 900 mg/placebo contrast. - Remaining uncertainty: Original sample-size wording exists, but completed/analysis denominators by stage, arm and time are unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N13 · Are missingness, dropout, exclusions and analytical handling in the selected two arms verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Completion and ITT are recorded as unverified; counts of missingness, dropout and exclusions by arm and their handling are not verified. - Why unverified: Analysis losses, reasons and handling cannot be read from the currently retained material. - Reason for missing information: Analysis losses, reasons and handling cannot be read from the currently retained material. - Required materials and conditions: Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses - Materials to obtain first: Missingness/dropout by arm, exclusion reasons, imputed values, ITT/PP and sensitivity analyses - Further research: Acquire participant flow diagrams, analysis plans and sensitivity-analysis material. - Conditions for verification: Verify actual losses/handling for the selected 900 mg/placebo arms or explain that they remain unverified within the current material. - Why this condition is needed: Original sample size alone cannot establish that no analysis losses occurred. - Application exceptions: Do not fill losses absent from the current summary with 0 or 100% completion. - Remaining uncertainty: Analysis losses, reasons and handling cannot be read from the currently retained material. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N14 · Are randomization methods, concealment and baseline balance in the 7-arm controlled trial verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The primary study is a 7-arm single-blind controlled trial with an unverified randomization method. A meta-analysis’s RCT title is not transferred as verification of the primary trial’s allocation procedures. - Why unverified: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved. - Reason for missing information: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved. - Required materials and conditions: Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process - Materials to obtain first: Original random sequence, allocation concealment, arm composition, baseline tables and recruitment process - Further research: Retrieve original Methods, allocation and baseline data to examine design limitations for the selected contrast. - Conditions for verification: Distinguish the 7-arm single-blind controlled-trial wording from unverified allocation/concealment/balance. - Why this condition is needed: Controlled-trial/review-RCT labels must not be inherited as adequate allocation in the primary trial. - Application exceptions: An unverified randomization method does not establish that the trial was nonrandomized. - Remaining uncertainty: Arm composition and controlled/blinding labels exist, but actual allocation, concealment and balance remain unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02 ### N15 · Are the people blinded, placebo appearance and assessment blinding verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Only the single-blind label is retained; whether participants, clinicians or testers were blinded, placebo matching and unblinding remain unverified. - Why unverified: Material is unavailable to establish actual implementation beyond the blinding label. - Reason for missing information: Material is unavailable to establish actual implementation beyond the blinding label. - Required materials and conditions: Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures - Materials to obtain first: Who was blinded, placebo appearance, blinding assessment/unblinding and tester procedures - Further research: Acquire the primary trial’s blinding Methods and placebo/measurement procedures. - Conditions for verification: Distinguish original blinding wording from unverified people and actual procedures for each outcome. - Why this condition is needed: The single-blind label must not be read as resolving all performance/measurement bias. - Application exceptions: An objective endpoint does not erase unverified performance/concomitant-treatment differences or measurement procedures. - Remaining uncertainty: Material is unavailable to establish actual implementation beyond the blinding label. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N16 · Are ITT/PP, adjustment, between-group contrasts and analytical models for the selected result verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Only P<.005 for garlic arms including 900 mg versus placebo, with completion and ITT unverified, is retained. Exact analysis populations, adjustment, models and the selected contrast definition remain unverified. - Why unverified: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes. - Reason for missing information: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes. - Required materials and conditions: Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions - Materials to obtain first: Original SAP, ITT/PP analysis populations, baseline adjustment, between-/within-group comparisons and multi-arm contrast definitions - Further research: Retrieve the selected results table and analysis plan/model to link contrasts, denominators and adjustment. - Conditions for verification: Compare the absolute between-group effect of interest at 24 weeks with actual analytical definitions and unverified aspects. - Why this condition is needed: Without knowing which effect is estimated, the P value cannot be read as the selected absolute between-group effect. - Application exceptions: Do not arbitrarily fill the analysis as ITT or turn within-group improvement into an additional effect. - Remaining uncertainty: Significance wording alone cannot determine allocation effects, adherence effects or adjusted between-group changes. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N17 · Are the attribution of P<.005 for each garlic arm versus placebo and the selected effect’s limitations distinguished? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: P<.005 for each garlic arm versus placebo, including 900 mg/day, is recorded. The selected absolute between-group difference and 95%CI remain unverified. - Why unverified: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established. - Reason for missing information: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established. - Required materials and conditions: Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition - Materials to obtain first: Original 24-week results table, contrasts by arm, tests, multiple comparisons and effect definition - Further research: Acquire the original results table and handling of multiple arms in testing, linking only the selected contrast separately. - Conditions for verification: Attribute P<.005 to the original statement and show alongside it that the 900 mg absolute effect and CI remain unverified. - Why this condition is needed: P values and effect size/precision provide different information. - Application exceptions: Do not convert each dose arm’s P value into the selected absolute %p or CI, or pool them as identical effects. - Remaining uncertainty: Significance wording is retained, but test/contrast, effect-size and multiple-comparison details cannot be established. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N18 · Are the absolute 24-week HbA1c effect and 95%CI for the selected 900 mg tablet verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The selected 900 mg absolute between-group %p, 95%CI and completed denominator remain unverified. Meta-analysis estimates of −0.50%p/−0.53%p are not established effects of the selected tablet. - Why unverified: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established. - Reason for missing information: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established. - Required materials and conditions: Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference - Materials to obtain first: Baseline/final/change HbA1c in the selected/placebo arms, absolute between-group %p, variance, 95%CI and evidence for an important difference - Further research: Retrieve the primary trial’s selected results table, variance and denominators. If unavailable, quantitative replication research needs prespecified outcome reporting. - Conditions for verification: Link the selected 900 mg absolute effect, interval and evidence for importance, or leave them precisely unverified. - Why this condition is needed: Primary-trial counts, significance and pooled means cannot determine the selected effect’s size or adequacy. - Application exceptions: Do not calculate and fill missing effects or CIs from P values or meta-analysis WMDs for other formulations. - Remaining uncertainty: The selected absolute effect, CI and analytical definitions are missing, so effect size, precision and importance cannot be established. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N19 · Can the primary trial’s prespecified 24-week HbA1c rank 1 outcome hierarchy and analysis plan be compared with actual reporting? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: A prespecified single rank 1 primary 24-week HbA1c endpoint in the primary trial is unverified, and the registration check is recorded as unable to verify. CRD42024628780 is a meta-analysis registration label. - Why unverified: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available. - Reason for missing information: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available. - Required materials and conditions: Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history - Materials to obtain first: Contemporaneous primary-trial registration versions, protocol, SAP, endpoints/times and multi-arm change history - Further research: Retrieve contemporaneous registration, protocol and SAP to compare the prespecified hierarchy for 24-week HbA1c and the selected 900 mg contrast. - Conditions for verification: Explicitly state that a prespecified single rank 1 primary endpoint is unverified and registration/SAP were not compared, separating review registration. - Why this condition is needed: Comparing prespecified plans with reports is needed to examine favorable selection of endpoints, times or arms. - Application exceptions: Unable to verify registration does not establish nonregistration; do not use review PROSPERO as a primary-trial NCT. - Remaining uncertainty: No direct comparison of the primary trial’s prespecified hierarchy, analysis plan or changes is available. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02 ### N20 · Is material available to distinguish the pooled HbA1c value from 3 trials and 7 effects from the selected tablet’s effect? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: HbA1c in the first meta-analysis involves 3 trials and 7 effects, with WMD −0.50%p (95%CI −0.66~−0.33). Mixed formulations and background treatments mean this is not an established effect of the selected tablet. - Why unverified: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved. - Reason for missing information: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved. - Required materials and conditions: HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis - Materials to obtain first: HbA1c included trials, formulations/doses, populations, background treatments, times and effect/shared-control tables in the first meta-analysis - Further research: Retrieve included-trial tables and original results to link exposure, timing and shared controls for each HbA1c effect. - Conditions for verification: Explain the reported WMD/CI, roles of 3 trials and 7 effects, mixed formulations/background treatments and indirectness for the selected effect. - Why this condition is needed: Multi-arm effects from the same trial and varied formulations/concomitant treatments must not be pooled as the selected 900 mg effect. - Application exceptions: Do not substitute 7 independent trials for 3 trials and 7 effects. - Remaining uncertainty: Pooled reported values/scale exist, but product, population, background-treatment and shared-control matching by effect remain unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02 ### N21 · Is the overall scale of 27 RCTs and 1,619 participants across all endpoints distinguished from the HbA1c analysis scale? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The second meta-analysis records 27 RCTs and 1,619 participants across all endpoints, with HbA1c WMD −0.53%p (95%CI −0.86~−0.20). Replication counts for the selected formulation and HbA1c analysis n remain unverified. - Why unverified: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved. - Reason for missing information: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved. - Required materials and conditions: Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis - Materials to obtain first: Endpoint-specific trials/participants, products, populations, times, background treatments and HbA1c analysis tables in the second meta-analysis - Further research: Retrieve endpoint-specific included-trial/effect tables, products and durations to separate the relevant HbA1c analysis. - Conditions for verification: Preserve overall scale and HbA1c WMD/CI separately, marking endpoint-specific denominators and directness unverified. - Why this condition is needed: Reading all-endpoint scale as the sample size for HbA1c or the selected 900 mg comparison overstates precision. - Application exceptions: The 27 RCTs and 1,619 participants describe all endpoints; do not transfer them as unique HbA1c analysis n. - Remaining uncertainty: Overall scale and a reported HbA1c mean exist, but endpoint-/formulation-specific denominators and matching for the selected question remain unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S03 ### N22 · Are included-trial and unique-participant overlaps between the primary trial and the two reviews verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The original retained summary has no trial-family or included-trial/participant overlap table. Overlap between the primary trial and both reviews, and independent replications of the selected 900 mg, are unresolved. - Why unverified: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships. - Reason for missing information: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships. - Required materials and conditions: Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links - Materials to obtain first: Included-trial tables for both reviews, primary/multi-arm reports, registration numbers, recruitment sites/periods and unique-participant links - Further research: First construct a report-family table, comparing recruitment periods, sites and registrations to verify overlap. - Conditions for verification: Explain the verified scope of primary-trial inclusion, overlap between reviews and unique-study/participant counts. - Why this condition is needed: Different reviews citing the same primary trial do not add independent replication evidence. - Application exceptions: Different bibliographic DOIs for reviews alone do not establish independent included trials/participants. - Remaining uncertainty: The existence of same/different reports is known, but material is unavailable to establish included-trial and unique-participant relationships. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N23 · Are the scope and causes of I²96.4% and a positive publication-bias test in the first meta-analysis verified? Verification status: Partly verified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The first meta-analysis records I²=96.4% and a positive publication-bias test. Test methods, effect distributions, missing results and causes remain unverified in the retained summary. - Why unverified: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared. - Reason for missing information: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared. - Required materials and conditions: HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results - Materials to obtain first: HbA1c effect distributions, I²/variance, heterogeneity/bias-test methods, prespecified hypotheses and missing results - Further research: Retrieve original forest plots, tests and formulation/background-treatment/time-specific results to review explanations for heterogeneity. - Conditions for verification: Link reported heterogeneity, the positive test and unverified methods/causes to limitations in applying results to the selected formulation. - Why this condition is needed: The positive pooled mean and extreme heterogeneity must both be retained. - Application exceptions: A positive test alone must not generate a missing-trial count or corrected effect, or invalidate all trials. - Remaining uncertainty: Heterogeneity and test labels exist, but causes, test scope and missing results were not directly compared. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S02 ### N24 · Have −0.50%p and −0.53%p been kept from being forced into the same analysis or an actual conflict? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Retain the first meta-analysis’s −0.50%p/CI−0.66~−0.33 and the second’s −0.53%p/CI−0.86~−0.20 separately. Retain the second’s conclusion that additional high-quality RCTs are needed. - Why unverified: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews. - Reason for missing information: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews. - Required materials and conditions: Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews - Materials to obtain first: Results/CIs, analysis scope, products/background treatments and endpoint-specific inclusion differences between the two reviews - Further research: Compare analytical scopes/included trials before separately reviewing whether an actual conflict concerns the same question. - Conditions for verification: Attribute both original reported values/CIs, heterogeneity and the need for additional high-quality RCTs to their respective sources without combining them. - Why this condition is needed: Differences between means with different analytical scopes must neither be ignored nor declared conflicts about the same question. - Application exceptions: Differences between review estimates alone do not establish conflicting data, equivalence or an effect of 0. - Remaining uncertainty: Verification is limited to separately retaining each reported value and limitation; it does not establish homogeneity, independence or efficacy of the reviews. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S02, S03 ### N25 · Are an optimal 900 mg dose, persistence after stopping and effects in specific subgroups verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: A 7-arm primary trial and a dose-response meta-analysis title exist, but direct results for optimality of 900 mg, maintenance after stopping and prespecified subgroup interactions remain unverified. - Why unverified: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified. - Reason for missing information: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified. - Required materials and conditions: Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates - Materials to obtain first: Direct dose contrasts, cessation/long-term follow-up, prespecified subgroups, interactions and separate estimates - Further research: Claims of an optimal dose, maintenance or subgroups require product-fixed direct contrasts and prespecified subgroup/follow-up studies. - Conditions for verification: Distinguish the 7-arm/review dose-response labels from unverified direct extension results for 900 mg. - Why this condition is needed: The selected 24-week result must not be extended to an optimal dose, long-term maintenance or effects in special populations. - Application exceptions: Do not require all extension research as mandatory for the current narrow 24-week HbA1c question. - Remaining uncertainty: Direct results supporting extensions beyond the current selected 24-week HbA1c scope were not verified. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S03 ### N26 · Has an HbA1c difference been kept from being extended to replacing diabetes medication or preventing complications? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Fasting glucose, HOMA-IR and lipids are kept separate from the selected HbA1c endpoint; results cannot be extended to replacing diabetes medication, preventing complications or identical effects from all garlic foods. - Why unverified: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment. - Reason for missing information: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment. - Required materials and conditions: Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events - Materials to obtain first: Original boundaries between the HbA1c surrogate and questions about medication replacement, complications and events - Further research: Separate claims of replacement treatment or complication prevention require direct comparisons/event data for those clinical questions. - Conditions for verification: Explicitly prohibit extensions to medication replacement, complications and effects from all garlic foods. - Why this condition is needed: A surrogate-marker change does not automatically answer questions about other treatments or clinical events. - Application exceptions: Do not require event trials as mandatory to verify the numerical HbA1c question. - Remaining uncertainty: Verification concerns explicit interpretive boundaries; it does not judge an absence of clinical-event effects or safety of replacement treatment. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N27 · Are funding, product provision and conflicts of interest for the primary trial and both reviews actually verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Primary-trial funding/product provision are unverified; the two meta-analyses are recorded as academic research with mixed original-trial funding. Original I1 is historical and is not new independence certification. - Why unverified: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved. - Reason for missing information: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved. - Required materials and conditions: Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report - Materials to obtain first: Funding, product provision, author employment/patents, declared COI and institutional/independent-family relationships by report - Further research: Retrieve funding, provision, COI, author and institutional information separately for primary papers/reviews, recording the actual scope. - Conditions for verification: Separate unverified primary-trial funding/product provision from the reviews’ wording of academic research and mixed primary-trial funding. - Why this condition is needed: Unverified funding must not be credited as independent funding or absence of conflicts. - Application exceptions: Do not inherit an academic-research label or original I1 as independent funding or replication certification. - Remaining uncertainty: Specific funding, provision, author employment/patents, declared COI and independent-institution relationships are unresolved. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N28 · Are hypoglycemic, gastrointestinal and bleeding events and collection methods for the selected formulation verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The original caution concerns monitoring hypoglycemia with glucose-lowering medication, gastrointestinal discomfort, bleeding risk and content variation. Actual primary-trial event definitions/collection, occurrence by arm, severity and stopping remain unverified. - Why unverified: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted. - Reason for missing information: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted. - Required materials and conditions: Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout - Materials to obtain first: Event definitions, active/spontaneous collection, severity, events/stopping by arm and missingness/dropout - Further research: Acquire primary-trial AE, stopping and collection tables; review safety questions separately with suitable harm designs. - Conditions for verification: Separate caution wording from actual events/collection and the boundaries between not reported and not read. - Why this condition is needed: General caution wording must not become actual primary-trial adverse-event counts or absence of harm. - Application exceptions: Unverified harm data do not delete HbA1c reports; record separate states. - Remaining uncertainty: Cautions are retained, but actual collection/counting is unverified, so no events or safety cannot be asserted. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N29 · Are harm timing, denominators, follow-up and comparative risks in the selected two arms verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Nominal 24 weeks, a description of 210 participants and 30 per arm exist, but harm occurrence/recovery, stopping/re-exposure, event denominators by arm, actual follow-up and comparative risks remain unverified. - Why unverified: Efficacy scale/duration cannot establish harm frequency or comparative risk. - Reason for missing information: Efficacy scale/duration cannot establish harm frequency or comparative risk. - Required materials and conditions: Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates - Materials to obtain first: Exposure/events, stopping/recovery times, exposed people/people with events/event counts by arm, follow-up time and comparative estimates - Further research: Retrieve original arm-specific AE/stopping/exposure-time tables; long-term and rare harms need suitable follow-up data. - Conditions for verification: Link reporting of actual harm timing, controls, denominators/duration to currently unverified information. - Why this condition is needed: The scale of 210 participants/30 per arm and the 24-week schedule must not automatically become harm incidence or causal denominators. - Application exceptions: Do not calculate harm risk from efficacy times/sample sizes or extrapolate background rates. - Remaining uncertainty: Efficacy scale/duration cannot establish harm frequency or comparative risk. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N30 · Are glucose-lowering medication, baseline disease, other exposures and alternative explanations for harms reviewed? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: A caution to monitor hypoglycemia with glucose-lowering medication exists, but actual common medication is unverified, and baseline risks/other exposures and alternative event explanations by arm are unavailable. - Why unverified: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate. - Reason for missing information: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate. - Required materials and conditions: Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment - Materials to obtain first: Concomitant medication by arm, baseline hypoglycemia/bleeding/disease, other exposures, changes and alternatives/adjustment - Further research: Link original concomitant-medication, baseline and event records to review alternative explanations for harm and temporal relationships. - Conditions for verification: Distinguish the warning context from the verified scope of actual co-exposure, underlying disease and alternatives. - Why this condition is needed: A concomitant-use caution alone must not attribute actual events solely to garlic. - Application exceptions: Missing alternative-explanation information does not establish that no other causes existed. - Remaining uncertainty: Without actual event/co-exposure data, caution wording cannot be extended to a causal-risk estimate. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01 ### N31 · Is the scope of other independent harm records, long-term/rare risks and vulnerable groups verified? Verification status: Unverified Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Harm-family tables, repeated events and direct long-term/rare-event/vulnerable-group data are not verified in the current 3 reports. The original caution does not certify overall safety. - Why unverified: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety. - Reason for missing information: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety. - Required materials and conditions: Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions - Materials to obtain first: Unique harm families, regulatory reports versus recitations, long-term/rare events, special-population exposure and interactions - Further research: Review separate harm questions through unique-event links and suitable long-term follow-up/registration data. - Conditions for verification: Separate direct harm replications and unverified long-term/vulnerable-group information from original efficacy material. - Why this condition is needed: Short-term efficacy trials/reviews must not be promoted to independent harm replications or overall safety. - Application exceptions: Do not require every rare-harm study for the current HbA1c question or add together repeated citations of the same event. - Remaining uncertainty: Efficacy reports and pooled means alone cannot verify independent harm replications or long-term/vulnerable-group safety. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N32 · Are positive signals, the unverified selected effect and cautions explained at distinct levels? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Positive P values/heterogeneous meta-analysis directions exist, but the selected 900 mg absolute effect, denominator and prespecified hierarchy remain unverified; safety retains the original Caution. Do not extend this to medication replacement or individual intake instructions. - Why unverified: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety. - Reason for missing information: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety. - Required materials and conditions: Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing - Materials to obtain first: Boundaries between P/pooled direction, selected quantitative gaps, original cautions and incidence/causality/individual prescribing - Further research: Revisit each question/row if actual quantitative or harm data are added; retain original boundaries until then. - Conditions for verification: Retain positive statements alongside unverified selected effects/harms, explicitly explaining limits on causal/incidence extensions. - Why this condition is needed: Positive efficacy signals must not become safety, medication replacement or an established selected quantitative effect. - Application exceptions: Do not revise uncertainty and caution into a new safety grade or individual intake instructions. - Remaining uncertainty: Verification concerns currently supportable wording and limits on extension; it is not new certification of efficacy, causality or safety. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N33 · Are the original 2026-09-08 reference date, 09-14 correction history, generic English wording and current scope distinguished? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: The original verdict-review date is 2026-09-08, with a 09-14 history of correcting 3 English-placeholder fields. Current generic-principle wording in English evidence/citations remains exactly as recorded; this conversion is not specific numerical verification, a new search or a correction. - Why unverified: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried. - Reason for missing information: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried. - Required materials and conditions: Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope - Materials to obtain first: Original verdict-review date, corrections, original Korean/English/evidence/citation fields and current reading/search/publication-status scope - Further research: If original-data correction/evidence updating is separately requested, preserve the whole original and handle original locations/version changes as an event. - Conditions for verification: Link original dates, corrections/English wording and actual reading of the retained summary to the absence of searching/external reading; do not label no response as 0 studies. - Why this condition is needed: Historical access/correction labels must not be backdated into full-text reading, a current search or specific English verification in this conversion. - Application exceptions: Preserve original generic English principles; no translation correction or historical reconstruction is performed in this conversion. - Remaining uncertainty: Verification concerns preservation of original dates, history, current values and work scope. Specific replacements in the English correction history were neither reconstructed nor certified; current publication/retraction status was not queried. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ### N34 · Have original C46, Caution, all axes and empty subclaims been kept from being inherited as new condition states/grades? Verification status: Met Reading scope: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. - Current findings: Original C46, Caution, B/S/R1/I1/EX/B1/CX, booleans/empty strings, subclaims=[] and bilingual synthesis/corrections are preserved unchanged. Row states are not new efficacy grades or recalculations of the original score. - Why unverified: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion. - Reason for missing information: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion. - Required materials and conditions: Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims - Materials to obtain first: Original typed grade/score/safety, bilingual synthesis/grade decisions, axes, corrections and empty subclaims - Further research: Correcting the original verdict requires a separate request and version/change event. It is not rescoring in this sheet conversion. - Conditions for verification: Link original values/types unchanged, explaining that no new score/grade or subclaim index is generated. - Why this condition is needed: Conversion-table states preserve information by condition and must not automatically recalculate the original efficacy verdict. - Application exceptions: Do not display original verification labels or C46 as independent clinical certification, a new efficacy score or a condition-fulfillment rate. - Remaining uncertainty: Verification concerns preservation of original verdict history, types and boundaries; existing verification labels are not inherited as independent clinical certification in this conversion. - Referenced methods: Existing method principles distinguish population, formulation, dose, timing, endpoint, comparison, denominators, overlap, funding and harms in the retained reports. Detailed conditions are Chamgap’s own application. - Related sources: S01, S02, S03 ## Evidence and sources ### S01 Ashraf R et al. J Med Plants Res. 2011;5:2922-2928. DOI: 10.5897/JMPR.9000523. [Official source](https://academicjournals.org/journal/JMPR/article-abstract/C214F3118656) Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. Findings recorded in the summary: P<.005 for each garlic arm versus placebo, including 900 mg/day. The selected absolute difference and CI remain unverified. Record level: The prespecified single rank 1 primary status, absolute %p and 95%CI for 24-week HbA1c remain unverified. A description of 210 participants and 30 per arm does not establish completed/ITT denominators. Independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Retained verdict summary | Retained verdict summary read | Retained copy acquired; summary read | Stored existing review summary read | Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | External bibliographic/abstract gateway | Bibliographic link retained; external material unread | External access not attempted; not acquired | Not read | This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | Original full-text/supplement gateway | DOI gateway retained; full text/supplements unread | External access not attempted; not acquired | Not read | This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | Primary-trial registration; location unverified | Registration location/version unverified; unread | External access not attempted; not acquired | Not read | Primary-trial registration is retained as unable to verify. The exact location/version is unverified; nonregistration is not established. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | ### S02 Ebrahimzadeh A et al. Nutr Metab Insights. 2026. PMID: 41695233. DOI: 10.1177/11786388251413660. PROSPERO CRD42024628780. [PubMed](https://pubmed.ncbi.nlm.nih.gov/41695233/) Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. Findings recorded in the summary: WMD −0.50%p, 95%CI −0.66~−0.33; I²=96.4%; positive publication-bias test. Record level: This pooled value mixes formulations/background treatments and is not an established effect of the selected 900 mg tablet. Matching by effect, bias-test methods/causes and missing results remain unverified. Independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Retained verdict summary | Retained verdict summary read | Retained copy acquired; summary read | Stored existing review summary read | Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | External bibliographic/abstract gateway | Bibliographic link retained; external material unread | External access not attempted; not acquired | Not read | This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | Original full-text/supplement gateway | DOI gateway retained; full text/supplements unread | External access not attempted; not acquired | Not read | This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | Meta-analysis registration; PROSPERO CRD42024628780 | Registration location/version unverified; unread | External access not attempted; not acquired | Not read | This is the review-registration ID in the retained citation. Its exact URL/version is unverified in this conversion, and it is not a primary-trial NCT. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | ### S03 Alsanie SA et al. Diabetes Res Clin Pract. 2026;239:113407. PMID: 42398591. DOI: 10.1016/j.diabres.2026.113407. [PubMed](https://pubmed.ncbi.nlm.nih.gov/42398591/) Materials actually read: The retained Korean/English summaries and case-specific condition/application records were read. External abstracts, full texts, registration, protocols and analysis plans remain unread, with access not attempted. Findings recorded in the summary: HbA1c WMD −0.53%p, 95%CI −0.86~−0.20. Record level: Retain the original conclusion that additional high-quality RCTs are needed. All-endpoint scale is not transferred to HbA1c or selected-tablet analysis denominators. Independent replication: Distinguish reports from the 7-arm primary trial and two meta-analyses. HbA1c 3 trials/7 effects are not counted as 7 independent trials; 27 RCTs/1,619 participants describe all endpoints. Primary-trial inclusion, overlap between reviews, unique-trial/participant totals and independent replication of the selected formulation remain unverified. | Material | Public availability | Access status | Actually read | Notes | |---|---|---|---|---| | Retained verdict summary | Retained verdict summary read | Retained copy acquired; summary read | Stored existing review summary read | Relevant content in the retained Korean/English summary, evidence and citation was read. This does not establish acquisition or reading of the original clinical paper. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | External bibliographic/abstract gateway | Bibliographic link retained; external material unread | External access not attempted; not acquired | Not read | This is an external link from the retained citation. The current response, bibliographic identity, abstract content and public access were not checked. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | | Original full-text/supplement gateway | DOI gateway retained; full text/supplements unread | External access not attempted; not acquired | Not read | This is a full-text/supplement gateway linked by the DOI in the retained citation. Provision, access, acquisition and reading remain unverified; access was not attempted in this conversion. This citation is linked in the retained summary. External abstracts, full texts, registration, protocols and analysis plans were not read in this conversion, and independent clinical validation was not performed. The material check date is the original date retained in the summary and condition records. The original verdict-review date does not establish a search cut-off or historical access dates for individual materials; external access was not attempted in this conversion. | ## Review criteria and methods These are Chamgap's own application conditions, informed by the relevant sections of official methodological guidance. They do not constitute official assessment-tool certification or a new efficacy score. - M03 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-03) · §3.1, §3.2.1–3.2.3, MECIR C5/C7/C13 · Clearly record the question, eligibility conditions and reasons for changes, and distinguish variations in interventions. · Retained method-application records were reused. External originals were not reread and method content was not reassessed. - M04 [Cochrane Handbook 6.5.1 (2025), chapter updated 2025-03](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-04) · §4.5, §4.6.1–4.6.3, MECIR C42 · Distinguish studies from reports and link them; do not omit a study solely because results are unreported. · Retained method-application records were reused. External originals were not reread and method content was not reassessed. - M08 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-08) · §8.1–8.2.3, Table 8.2.a · Define the outcome and effect of interest, then examine randomization, deviations, missing data, measurement and selective reporting. · Retained method-application records were reused. External originals were not reread and method content was not reassessed. - M15 [Cochrane Handbook 6.5 (2024), chapter updated 2023-08](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-15) · §15.2.4, §15.3.1–15.3.3 · Distinguish effect estimates, intervals, importance and applicability. Sample size alone does not determine precision. · Retained method-application records were reused. External originals were not reread and method content was not reassessed. - M19 [Cochrane Handbook 6.5 (2024), chapter updated 2019-10](https://www.cochrane.org/authors/handbooks-and-manuals/handbook/current/chapter-19) · §19.1.2, §19.2.1–19.2.4 · Harm questions may require different designs, populations and follow-up from efficacy questions. Case reports do not establish incidence rates. · Retained method-application records were reused. External originals were not reread and method content was not reassessed. ## What the statuses mean - Partly verified: Some required facts are known, but the stated conditions involving analyses, populations, formulation or denominators remain unverified. - Unverified: Direct information is unverified in the retained record. This does not establish an effect of 0, no studies or absence of harm. - Review incomplete: Reading of the material or review of a condition is incomplete. This does not establish absence of studies or efficacy. - Not reported: The needed information was not found in material actually read. This is distinguished from unread material. - Inaccessible: Access was actually attempted but the material was not acquired. This is distinguished from access not attempted. - Insufficient evidence matching the conditions: Evidence directly matching the defined question and conditions is insufficient. This does not establish absence of all research. - Not applicable: A specific condition does not apply to the question. This does not substitute for unread or unverified material. - Conflicting data: This covers discrepancies in material about the same question, denominator and timing. Differences between separate questions are not automatically treated as conflicts. - Met: The retained identity, observation or scope required by this item was checked within stated limits. This does not establish efficacy or full-text certification. ## Change history 2026-10-26 · Public page/materials 1.0. The public view and materials were prepared from the existing 34 items. No new clinical search, verification-state change or scoring was performed.