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From environmentally friendly hybrid cars and heating with solar power to organic or natural foods, our culture is increasingly embracing green strategies. "Using natural dietary supplements to support healthy blood sugar levels and minimize the impact of glycation is a rational continuation of this green philosophy," says Steven Joyal, MD, vice president of Scientific Affairs and Medical Development for the Life Extension Foundation in Ft. Lauderdale, Florida (www.lef.org). He is also author of the book What Your Doctor May Not Tell You About Diabetes.
"Optimal diabetes management is a partnership between patient and physician," Dr. Joyal notes. "Proactive, involved patients do best with diabetes management. Patients interested in natural diabetes solutions should read and digest as much objective information as possible on available natural options for diabetes. Further, partnership with a physician knowledgeable in natural diabetes treatment options is important."
"Some are interested in treating themselves naturally. However, the majority use prescribed medication along with supplements," adds diabetes educator Marci Sloane, MS, RD, LD/N, CDE, of American Diabetes Wholesale (www.americandiabeteswholesale.com) in Pompano Beach, Florida. If you want to start taking natural supplements or nutraceuticals to help treat your diabetes, you might start by going to the health food store and talking with the salesperson. "Some people do searches online, not always from reputable sources," Sloane says, "and some buy books, not always from reputable sources." She recommends that people speak with a nutritionist and a pharmacist to learn about possible interactions with their current medication.
If you are willing to treat your diabetes with more natural alternatives, perhaps you will eat more balanced meals, exercise, and reduce stress, all of which help to sensitize your body to insulin. "If people want to try drinking cinnamon tea and test their blood sugar to see if it is helping to lower their glucose levels, that is safe. However, to take high doses of anything can be dangerous, and research needs to go into this prior to use," Sloane says.
Of course, each individual is different, but you can achieve improvements in blood sugar control with a comprehensive program that includes diet, exercise, and nutritional supplementation. In the vast majority of cases, you can expect to significantly reduce the amount of medication used to control blood sugar levels. "Nutritional supplements are not drugs," Dr. Joyal says. "Drugs tend to have powerful effects, including side effects. Nutritional supplements tend to act more gently and are best utilized to support healthy physiological function in the body."
Thirty-eight-year-old Ken Savage was diagnosed with diabetes about nine years ago. After being told to exercise and eat right, he was given glypizide and metformin. Byetta came later, when those medications gave him lots of gas and cramping. Byetta injections helped his blood sugar to drop a little, and he was prescribed a multi-vitamin and vitamin D as well. He's is also on fish oil and Caltrate®, along with St. John's Wort and cinnamon. The Massachusetts resident says that he didn't really notice much change when he used the supplements. "The meds I was on made me either very low or just maintained a higher blood sugar level," he explains. "It wasn't until I took exercise and [watched] what I was eating where I saw the real changes. The supplements are a good idea if you're deficient, but I controlled things more with diet and exercise than with the meds," Savage says. See his website (www.battlediabetes.com) for his take on a number of diabetes-related issues and research he has done on his own.
Coffee Berry and Beta Cell Function
Beta cell function and insulin sensitivity are two key components of metabolic health. Type 2 diabetics have reduced beta cell function and impaired insulin sensitivity. Beta cells reside in the pancreas and their primary function is to secrete insulin in response to glucose levels in the bloodstream. Coffee Berry is one natural ingredient that offers beta cell support. "Your morning cup of coffee started out as a bright red fruit (berry)," Dr. Joyal explains. "The coffee berry is rich in antioxidants and other phytonutrients known as polyphenols." These polyphenols (or phenolic acids) have been shown to be helpful in supporting optimal blood glucose levels, as well as in fighting damaging free radicals and protecting cardiovascular health. "But before you plug in your twelve-cup coffee maker and get out your 20-ounce coffee mug," Dr. Joyal advises, "we need to look at the best way for you to get the benefits from coffee berries." Greater power appears to be in the whole berry fruit, not just in the coffee seed, or bean, which is what remains after the outer layers of the berries are separated out and the beans are roasted, according to Dr. Joyal. Coffee berries contain polyphenols that have been shown to support healthy blood glucose levels, cholesterol and triglyceride levels and reduce free radical damage, among other benefits that are especially important for people with insulin resistance and/or diabetes. "Much of these benefits are significantly reduced once the berries are harvested, processed and roasted to make the cup of coffee you enjoy," Dr. Joyal says. "To reap the optimal positive impact of the entire coffee berry, it's an intelligent strategy to take a supplement that contains all the polyphenols found in the fruit without all the caffeine or advanced glycation end products (AGEs) from dry roasting the coffee beans at high temperatures," he says.
Coffee berry contains some well-studied phytochemicals such as chlorogenic acid and caffeic acid. Since glucose generation from glycogen stored in the liver is often overactive in people with high blood sugar, reducing the gene expression of key enzymes involved with this action can lead to reduced blood sugar levels.
Chlorogenic and Caffeic Acid
Dr. Joyal explains that chlorogenic acid has been shown to inhibit the gene expression of an important enzyme involved in glucose generation from glycogen in a dose-dependent manner, resulting in reduced glucose production. Scientific studies have also demonstrated that chlorogenic acid has an antagonistic effect on glucose transport, decreasing the intestinal absorption rate of glucose.
It has also been found that caffeic acid increases glucose uptake into cells, helping remove it from the bloodstream. When caffeic acid is injected into diabetic animals, a dose-dependent reduction in plasma glucose is observed. Caffeic acid can reduce elevated plasma glucose in the insulin-resistant patient who receives a glucose challenge test.
This spice has interesting benefits for supporting insulin sensitivity. Cinnamon contains certain water-soluble compounds, known collectively as polyphenols, that can increase glucose metabolism, which helps lower blood levels and fight free radical damage. "Cinnamon can also help reduce lipid levels while improving glucose metabolism, which is an ideal combination in fighting metabolic problems and cardiovascular disease," says Dr. Joyal. The number of studies of the effectiveness of cinnamon in diabetes continues to grow. "The water-soluble polyphenol polymers in cinnamon were recently found to increase insulin-dependent glucose metabolism by roughly 20-fold," Dr. Joyal says. "The water-soluble cinnamon polyphenols displayed significant antioxidant activity. Moreover, these polyphenol polymers are able to upregulate the expression of genes involved in activating the cell membrane's insulin receptors, thus increasing glucose uptake and lowering blood glucose levels." Dr. Joyal says that the water-soluble cinnamon extract is preferable to ground cinnamon due to concerns over chronic ingestion of volatile compounds such as aldehydes, alcohols, and esters found in whole cinnamon and the potential for chromosome damage with these substances.
Michael Triggs was diagnosed with diabetes 10 years ago. The 42-year-old had developed a skin abscess that needed immediate attention. While he was at the emergency room, his blood sugar was checked and found to be over 400. "They started me on insulin shots while I was in the hospital," he explains. Following surgery for the abscess, he was put on metformin (glucophage). For the last 10 months, he has been taking two supplements from Life Extension®. One is called Enhanced Cinsulin® with Glucose Management Proprietary Blend. It combines concentrated amounts of bioactive compounds in one formula: Cinsulin®, a standardized type-A polymer water extract (bark) of Cinnamomum cassia; chromium; quercetin, a vegetable-derived bioflavonoid; CoffeeBerry® Forte extract, which contains chlorogenic acid; green tea extract; and GlucoHelpTM, a patented banaba extract standardized for corosolic acid. Triggs has read Dr. Joyal's book and says he learned a lot from it. "Had I known a few things, I could have started making some changes earlier in my life [in terms of] pre-diabetes and metabolic syndrome," he adds.
Triggs, who lives in Las Vegas, also uses a weight loss product from the same company called Optimized Irvingia with Phase 3TM Calorie Control Complex, a compound containing a natural substance found in plants called L-arbinose that helps reduce the number of absorbed calories from sugar. It also consists of a green tea phytosome cellular energy enhancer; alpha-amylase enzyme (natural bean extract, Phaseolus vulgaris; alpha-glucosidase enzyme (patented seaweed extract/InSea2 TM; an extract from a West African food named Irvingia gabonensis to help support leptin sensitivity; Glycerol-3-phosphate dehydrogenase; and adiponectin (hormone). "I have lost some weight and have had a much easier time managing my blood sugar level," Triggs says. He also takes Omega-3 fish oil and CoQ10, but not specifically for diabetes. He plans to continue the supplements and hopes to eventually get off the metformin. Visit the Life Extension® web site listed above for more in-depth product information.
A Brief List of Supplements, to Research Further
Yellow in color and an ingredient in the spice tumeric, curcumin is a potent anti-inflammatory that may reduce disease states (many diseases start with inflammation), according to Sloane. Omega 3 fatty acids - the DHA and EPA in fish oil - can lower triglycerides in high doses of 3,000 to 4,000 mg a day. "The ALA source of omega 3s (flaxseed, pumpkin seed, hemp, and walnuts) are not well absorbed by the body. They must be converted into DHA and EPA to be absorbed," she states. "Since the diet consists of so many omega 6s, the competition is too great and the absorption from ALA is about 10 to 15%."
Benfotiamine is B1. It may help with nerve endings. "CoQ10 doesn't seem to have side effects. It's a blood thinner, though," Sloane says. "It may help with the heart, a major diabetes complication. CoQ10 is made by the body and decreases as we age, but when we take statins (cholesterol-lowering drugs) and replace the CoQ10, it is more heart protective along with the statin."
Whey protein isolate is the higher quality form - better than whey protein concentrate and found in protein drinks. "It may assist with weight loss (drinks that are fewer calories and filling) and lower blood sugar, depending on what the person typically eats," Sloane says. A 10-pound weight loss may reduce blood sugar levels significantly.
Pomegranate is an antioxidant that keeps the body strong and is good for any disease state. Alpha-lipoic acid (300 to 600 mg) may reduce neuropathy symptoms and may also lower blood glucose levels somewhat.
Bitter melon may activate an enzyme that is responsible for regulating metabolism and transporting glucose from the blood into the cells.
Gogi berries may lower the oxidative stress that the eye undergoes as a result of type 2 diabetes. It is an antioxidant with high levels of zeaxanthin, lutein, polysaccharides, and polyphenolics, which have shown to improve vision. Researchers are studying the effects of gogi berries on oxidative stress, one of the factors that occurs in diabetic retinopathy.
Chromium GTF (glucose transport factor) may help balance levels with 600 to 1,000 mcg daily.
Magnesium may be depleted in diabetes and heart disease patients. Supplement with 400 mg, or have levels tested first.
Salacia Oblonga is known as Saptrangi and Ponkoranti (Indian ayrvedic herb). It may control the rise in blood sugar that follows a meal. This is the beverage made from the herb. Studies found a similar reduction in blood levels of insulin.
Gymnema Sylvestre is an Indian herb that may help support healthy blood sugar levels and glucose metabolism by mediation of insulin release and activity and augmentation of healthy pancreatic function. Data also suggests that beta cells may be regenerated/repaired in type 2 diabetic patients.
Prickly pear (Nopal Cactus) cactus is a herbal hypoglycemic that can be used in combination with ginseng, cinnamon, and Gymnema Sylvestre.
Fenugreek: 4-hydroxyisoleucine (an amino acid derived from fenugreek) may help stimulate the secretion of insulin, reduce insulin resistance, and decrease blood sugar levels.
Vanadium may improve sensitivity to insulin in both type 1 and type 2 diabetes. Warning: Vanadyl compounds similar to those found in health food stores have been found to kill beta cells. However, the research was done with animals, and it is not known what the danger is to humans. Food sources, including pepper, dill, radishes, eggs, vegetable oils, buckwheat, and oats, might be a better option.
Barley: Whole grains and cereal-fiber containing products may reduce the risk of developing type 2 diabetes. These foods have shown to have favorable effects on intermediate markers for diabetes, particularly on blood glucose and insulin levels in non-diabetics and diabetics.
L-Carnitine supplements in a calorie-restricted diet may improve insulin resistance in patients with impaired fasting glucose and may result in significant plasma insulin changes.
DHEA-PC may slow progression of type 2 diabetes and delay onset of hyperglycemia and hypertriglyceridemia.
L-Carsonine may have an anti-glycation effect and protect against the formation of abnormal proteins when sugar aldehydes react with proteins.
Green Tea may improve glucose tolerance and insulin sensitivity by lowering fasting blood levels of glucose, insulin, triglycerides, and free fatty acids. It may also improve the ability of these fat cells to respond to insulin, along with the ability to absorb blood sugar, which may be greatly increased.
"Physicians must be aware of what the patient is taking, i.e., all prescribed medications and supplements," Sloane emphasizes.
Risks and Conclusions
Supplements may have medicinal properties, however, so they may enhance the actions of the medications taken. "There are many blood thinners on the market that people are unaware of. For example, gingko biloba, CoQ10, fish oil, aspirin, Coumadin and vitamin E," Sloane says. "Using an abundance of blood thinners may possibly lead to hemorrhagic stroke if taken with a prescribed blood thinner like Coumadin." You need to be careful and check with your prescribing physician and pharmacist.
Some multi-vitamins contain vitamin K, so people taking Coumadin should take a multi-vitamin without vitamin K. Those taking niacin to raise HDL cholesterol may raise blood sugar slightly. Individuals trying Gymnema Sylvestre and taking glyburide or glipizide might have a dramatic lowering effect. "This is why it is critical not to self-medicate with supplements without speaking with a pharmacist," Sloane notes.
Supplements can also interfere with the absorption of another supplement. There are some that are shown to not have side effects, and particular doses are recommended as being safe by reputable sources such as the NIH or ADA, for example. The benefits of treating more naturally might be fewer side effects and a more diluted form of the "medicine."
Some of you may be able to discontinue your prescribed medication and rely solely on supplements if you are committed to following a complete program consisting of balancing your meals as suggested by diabetes educators, exercising, stress reduction, and appropriate times of blood sugar monitoring. "Others will not have controlled blood sugar levels with supplements only. Be careful, check your blood sugar more frequently, be prepared with low blood sugar treatments, and communicate with your physician and pharmacist and diabetes educator," Sloane concludes.
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