Articles

Natural Alternatives for Type 2 Diabetes

By Vicki L. Wade, PharmD, RPh.

Diabetes Mellitus is a chronic condition in which the body does not produce or properly utilize insulin. Insulin, a hormone produced by the pancreas, is required to convert sugar, starches, and other foods into energy needed for daily life. In the United States, approximately 18.2 million people (6.3% of the population) have diabetes. There are four types of diabetes (Type 1, Type 2, Pre-diabetes, and Gestational diabetes).

Type 2 diabetes, which is also known as adult-onset diabetes or non-insulin dependent diabetes, is the most common form of diabetes. In Type 2 diabetes, the body does not produce enough insulin or the cells do not respond to the insulin that the body makes. Type 2 diabetes can be effectively managed with a healthy diet, exercise, controlling weight gain, and by regularly testing the blood glucose level. Some individuals are required to take daily oral medications or insulin injections to control their blood sugars. Patients with Type 2 diabetes have an increased risk of developing heart disease or having a stroke, diabetic nephropathy (kidney disease), neuropathy (nerve ending damage), or retinopathy (eye disease).

A recent report published by the National Center for Complementary and Alternative Medicine recently detailed studies on six different dietary supplements that may offer benefits on managing blood glucose levels or the disease complications in patients with diabetes.

Alpha-Lipoic Acid, also known as ALA, lipoic acid or thioctic acid, is an antioxidant, which is similar to a vitamin. An antioxidant is a substance that prevents cell damage by free radials during periods of oxidative stress. A high level of blood glucose, which is common in patients with diabetes, is one cause of oxidative stress. ALA can be found in dietary supplements and in foods such as liver, spinach, broccoli, and potatoes. A small number of research studies in animals and in people have shown ALA to be beneficial for glucose uptake in muscle, sensitivity of body to insulin, diabetic neuropathy, and/or weight loss. One general precaution with taking ALA is that your blood glucose may be lowered too much, thus making it vitally important to monitor blood glucose levels daily.

Chromium, also known as chromium picolinate, chromium chloride, chromium nicotinate) is a trace mineral that helps insulin facilitate the uptake of glucose into cells so that it can be "burned" for energy. Chromium can be found in whole grains, meats, animal fats, fish, brown sugar, coffee, tea and some spices. Chromium is a controversial supplement in which some studies show beneficial effects on diabetes and others don’t. One known beneficial effect of chromium is that it can add to insulin in its effects on blood glucose, thus causing a lowering effect. There is also literature to suggest that chromium is beneficial to lower total cholesterol and triglycerides. Some human studies have shown that chromium can help people lose weight and increase lean muscle mass.

Coenzyme Q10, also referred to as CoQ10, vitamin Q10, ubiquinone, and ubiquinol, helps cells make energy and also acts as an antioxidant. CoQ10 can be found in meats and seafood in small amounts. Evidence shows that CoQ10 has little or no effect on blood glucose control, but it does help fight against heart disease in people with diabetes. CoQ10 appears to promote relaxation in both the arteries and veins, therefore helping to reduce angina and blood pressure. CoQ10 is generally considered a safe supplement to take. However, there is data to show that it may interact with the action of warfarin, high blood pressure medications, and some chemotherapy medications.

Garlic, also known as allium sativum, is commonly used as a food seasoning. Garlic does not directly affect diabetes, but it is another supplement that has been proven effective in treating heart disease. Garlic’s main medicinal uses include cardiovascular protection, as it improves cholesterol levels, lowers blood pressure, inhibits blood clots, and improves circulation. Alliin, allicin, dially disulfide, and other metabolites are responsible for garlic’s strong smell and taste as well as many of the medicinal benefits. It is believed that cooking may destroy these key ingredients. Therefore, it is believed that raw garlic offers the most medicinal benefits. Garlic may be responsible for cholesterol reductions in the 6% to 12% range. While garlic also appears to have a small effect on lowering blood pressure (about 5-7%) but the overall results from small studies are not conclusive. It is believed that garlic may relax blood vessels, causing them to widen and allowing blood to flow more easily. In addition, the thickness of the blood may be reduced by taking garlic, which may block the body's production of thromboxane, a chemical involved in blood clotting and blood vessel tightening. Garlic is considered a fairly safe supplement to take. The most common side effect of taking garlic is its unfortunate odor.

Magnesium is one of the most abundant minerals in the human body. Magnesium can be found in green leafy vegetables, nuts, seeds, and some whole grains. It is important for several bodily functions-such as energy production, lipid and protein synthesis, nerve impulses, muscle relaxation and contraction and bone formation. Magnesium does not directly affect blood glucose control, but literature suggests that low magnesium levels may make glucose control worse and can contribute to diabetes complications. Literature suggests that magnesium, along with Vitamin B6, is important for the proper functioning of insulin so that glucose can get into the cells properly. Magnesium is considered to be a safe supplement to take for most adults at low doses, however, high doses can cause diarrhea, nausea, loss of appetite, muscle weakness, difficulty breathing, extremely low blood pressure, irregular heart rate, and confusion. It is also important to know that certain drugs such as antibiotics, drugs that prevent osteoporosis, high blood pressure medications, muscle relaxants, and diuretics can interact with magensium.

Omega-3 fatty acids are a group of fatty polyunsaturated fatty acids that come from food sources, such as fish (especially salmon, mackerel, herring, and sardines), fish oil, and some vegetable oils. Omega-3 fatty acids are important for heart function. Heart function is important in diabetic patients since diabetes increases a person’s risk for heart disease and stroke. Research has shown that omega-3 fatty acids are effective in reducing the risk of cardiovascular disease. Omega-3 fatty acids have been proven to decrease the risk of arrhythmias, decrease triglyceride levels, decrease the rate of hardening of blood vessels, and to slightly lower blood pressure. Increasing omega-3 fatty acid intake is recommended preferably through foods. Omega-3 fatty acids are on the list of food substances "generally recognized as safe" by the U.S. Food and Drug Administration Potential side effects of omega-3 fatty acids include a fishy aftertaste, belching, stomach disturbances, and nausea.

The National Center for Complementary and Alternative Medicine has several ongoing studies to determine the effects of substances on diabetes. These research projects are studying the effects of:

- Chromium on high blood glucose levels,
- Yoga on glucose control in people at risk for diabetes,
- Ginkgo biloba extract on diabetes medications.

It is important to note that none of the supplements mentioned in this article have been proven as a replacement for prescription medications used to treat diabetes or any of the disease complications. Some conditions or medications may prohibit a patient from using certain supplements, so talk to a physician or pharmacist prior to initiating any dietary supplements. Some of the supplements mentioned in this article may have an effect on a patient’s blood glucose level, so it is especially important that patients continue to monitor their blood glucose levels daily.

References:

1. American Diabetes Association. Standards of Medical Care for Patients with Diabetes Mellitus. Diabetes Care 2005; 28:S4-36.
2. American Diabetes Association. All About Diabetes. Available at: http://www.diabetes.org/about-diabetes.jsp. Accessed: July 25, 2005.
3. American Heart Association. Fish and Omega-3 Fatty Acids: AHA Recommendation. Available at: http://www.americanheart.org/presenter/jhtml?identifier=4632. Accessed: July 25, 2005.
4. Drug Digest. Coenzyme Q10. Available at: http://www.drugdigest.org/DD/DVH/HerbsWho/0,3923,4021|Coenzyme%2BQ%252D10,00.html. Accessed: July 25, 2005.
5. Drug Digest. Garlic. Available at: http://www.drugdigest.org/DD/DVH/HerbsWho/0,3923,4041|Garlic,00.html. Accessed: July 25, 2005.
6. LaValle JB, Krinsky DL, Hawkins EB, et al. Natural Therapeutics Pocket Guide. Lexi-Comp. 2000.
7. National Cancer Institute&National Center for Complementary and Alternative Medicine. Coenzyme Q10: Questions and Answers. Available at: http://cis.nci.nih.gov/fact/9_16.htm. Accessed: July 25, 2005.
8. Stengler M and Balch JF. The Natural Physicians Healing Therapies. Prentice Hall: New Jersey. 1991.