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Grading alternative treatments for diabetes The immense growth in alternative therapies has not bypassed diabetes treatment. Numerous products claiming to lower blood sugar levels or prevent and treat diabetes-related complications are advertised to consumers. And people with diabetes are 1.6 times more likely to use alternative therapies than people without diabetes. A 2008 article in The Journal of the American Dietetic Association reviewed eight dietary supplements commonly taken by people with diabetes. Natural Standard, an international research collaboration that compiles and synthesizes data on complementary and alternative therapies, ranked the scientific evidence supporting each product (see "Natural Standard grades," below). Of the three supplements that received a B rating and are reviewed here, two may cause a number of negative side effects (see "Bitter melon" and "Ginseng"). Five other products—aloe vera, chromium, cinnamon, fenugreek, and nopal (prickly pear)—were all ranked "C" and are not worth trying, as their potential benefits aren't proven.
Bitter melon Also known as bitter gourd, karela, or balsam pear, bitter melon is a relative of honeydew and cantaloupe melons. In one study, a pulpy extract of the fruit lowered glucose levels in people with diabetes; another study using an injectable preparation improved glucose levels in people with type 1 but not type 2 diabetes. Active ingredients include charantin, momordin, and insulin-like peptide (also known as plant insulin), which are thought to lower blood sugar. Evidence grade: B Dose: Varies; 50–100 milliliters of fresh juice, 3–15 grams of dry powder, or 100–200 mg encapsulated extract (but this latter form has not been tested and should be used with caution). Side effects and cautions: Gastrointestinal discomfort and hypoglycemic coma can occur, especially if bitter melon is taken with sulfonylureas. It may induce miscarriage, so women of childbearing age should avoid it, as should people of Mediterranean or Middle Eastern descent with known G6PDH deficiency, an inherited condition that can lead to severe forms of anemia. Ginseng The roots of this slow-growing plant have been used for centuries in Asian medicine. Both Asian ginseng (Panax ginseng) and American ginseng (Panax quinquefolius) appear to lower blood sugar in people with diabetes and lead to slight improvement in HbA1c values, possibly by lowering carbohydrate absorption in the liver and boosting insulin transport and uptake. Evidence grade: B Dose: Asian ginseng, 200 mg per day; American ginseng, 3 grams before a meal. Side effects and cautions: Insomnia is the most common side effect; others include anxiety, headache, or increased blood pressure. Because ginseng may decrease the effects of warfarin and diuretics, and may boost the effects of estrogens, certain painkillers, and antidepressants, people who take those medications should avoid this herb. Ginseng may also cause hypoglycemia if taken with sulfonylureas or glinides. Gymnema Gymnema leaves contain compounds thought to promote insulin's effect and stimulate and increase the number of beta cells. In addition, leaf extracts contain substances that interfere with taste buds, altering a person's ability to taste sweet and bitter, which may cause people to eat fewer sweet foods—another possible reason Gymnema may lower blood sugar. Evidence grade: B Dose: 400 mg per day of an extract standardized to contain 24% gymnemic acids. Side effects and cautions: Gymnema has no reported side effects, but may cause hypoglycemia if taken with sulfonylureas or glinides. The bottom line on diabetes supplements Some supplements pose potentially serious health risks, especially for people taking other prescription medicines, which is common among people with diabetes. What's more, dietary supplements are not regulated for quality or purity by the FDA, and some products may contain less or more of the active ingredient than their labels indicate. The National Center for Complementary and Alternative Medicine maintains that there isn't sufficient evidence to prove that supplements have substantial benefits for diabetes or its complications. The organization also stresses the importance of not using these alternative remedies to replace conventional medical therapy. If you do choose to supplement your diabetes treatment with an alternative therapy, consult your health care provider first. | |||||||||||||||||||||||||||||
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