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Natural Strategies for Diabetes-Part I Outline of Natural Approaches to Diabetes Control David J. DeRose, MD, MPH Prepared for the Three Angels Broadcasting Network’s Health for a Lifetime Taped December 2005
Key Natural Strategies for Type 2 Diabetes l Weight reduction l Exercise l Dietary Changes • Replace saturated fats and trans fatty acids with monounsaturated fats • Emphasize high fiber choices • Consider a wholly plant-based diet l Talk with your doctor about simplifying drug regimens
l Supplements worthy of consideration: • Guar • Garlic • Bitter Melon • Ginseng • Chromium • Alpha lipoic acid • Vanadium • GLA • Bilberry • Gymnema sylvestre • Fenugreek
Insights on selected supplements
I. Garlic l So long as someone is not on a drug with a critical therapeutic window; there is evidence that garlic may have salutary effects with limited side effects. l Typical dosage: 4 grams of fresh garlic or equivalent preparations (9.6 mg allicin-releasing potential in one recent study showed beneficial lipid effects). l However, some research suggests many garlic pills release only small amounts of their active ingredients. l Garlic References: Kannar D, et al. J Am Coll Nutr 2001 Jun;20(3):225-31; Lawson LD, Wang ZJ. J Agric Food Chem 2001 May;49(5):2592-9
II. Ginseng l 200 mg of Asian Ginseng (Panax ginseng) per day for eight weeks improved mood, physical activity and lowered fasting blood glucose, hemoglobin A1c levels and body weight. l Criticism of the study is that weight reduction by itself will result in blood sugar improvements. l Note that Siberian Ginseng (Eleutherococcus senticosus) does not contain the ginsenosides that are among the active blood sugar-lowering components. l More rigorous studies of American Ginseng (Panax quinquefolius) demonstrated that 3000 mg of powdered root taken with a standardized “meal” could blunt the post meal blood sugar rise in individuals with type 2 diabetes. l The same group found that doses beyond 3000 mg gave no additional blood sugar effect. l This raises the question that the threshold for blood sugar lowering may be considerably lower than 3000 mg
Ginseng concerns l Allergies, asthma in susceptible individuals l Ginseng can lower blood concentrations of warfarin l May induce mania if used concomitantly with the antidepressant phenelzine. l May have steroid-like effects including both estrogenic and corticosteroid effects l Has been associated also with hypertension, insomnia, nervousness and headache
Ginseng Conclusions l High dose American ginseng has documented effectiveness in type 2 diabetes: 3000 mg with or up to 2 hours before a meal l Not recommended for people taking medications with a critical therapeutic window such as warfarin l Relatively contraindicated in hypertension as well as conditions where estrogenic or corticosteroid effects could be detrimental l Probably not a good choice in individuals with history of need for psychiatric medications
Ginseng References: u Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 1995 Oct;18(10):1373-5. u Vuksan V, et al. Diabetes Care 2000 Sep;23(9):1221-6 u Vuksan V, et al. Arch Intern Med 2000 Apr 10;160(7):1009-13
III. Gymnema sylvestre l Active constituents § Gymnemosides § Gymnemic acids
l Possible mechanisms (how it seems to work) § Well established role in decreasing sweet-perceptions, may help with “sweet tooth”/sugar cravings § Demonstrated to decrease caloric intake § May decrease intestinal fat and glucose absorption § Beta-cell stimulant and “tonic”? § Insulinomimetic (acts like insulin) § May also have lipid lowering effects
l Side Effects § Hypoglycemia § Animal models suggest that it may raise blood pressure § Recognize that the literature is very sparse on human studies of G. sylvestre
l Recommendations § 400 mg/d of GS4, a G. sylvestre extract may aid in diabetic control, with few side effects or contraindications noted § If G. syvestre is used careful monitoring for side-effects is recommended
IV. Momordica (bitter melon, karela) l Active ingredients § Momordin/ charantin (hypoglycemic) § Momordicine alkaloid § Polypeptide P
l Possible mechanisms (how it seems to work) § Increases glucose uptake § Increases glycogen synthesis § Insulinomimetic
l Side Effects § Diarrhea/ abdominal distress § Abortifacient (may cause abortions) § Hypoglycemia § Favism (a severe reaction that can also occur with fava beans)
l Drug Interactions § Chlorpropamide
l Uses u Blood sugar lowering u Animal models suggest that this plant may also lower insulin resistance. u A water-soluble extract of the fruits significantly reduced blood glucose concentrations during a 50 g oral glucose tolerance test in the diabetics and after force-feeding in the rats. u Fried karela (momordica) fruits consumed as a daily dietary supplement produced small but significant improvements in glucose tolerance. u Improvement in glucose tolerance was not associated with an increase in insulin production. u Selected reference: Leatherdale BA, Panesar RK, Singh G, Atkins TW, Bailey CJ, Bignell AH. Improvement in glucose tolerance due to Momordica charantia (karela). Br Med J (Clin Res Ed) 1981 Jun 6;282(6279):1823-4
V. Soluble Fiber-Rich Plant Products l Examples: guar gum, psyllium, beta-glucan rich barley l Lipid lowering effects in addition to blood sugar lowering effects l Favorable effect on prolonging blood levels of CCK (cholecystokinin) which has been shown to reduce food intake in animals and humans l References: § Am. J. Physiol. 274 (Gastrointest. Liver Physiol. 37): G607–G613, 1998 § Am J Clin Nutr 1999;69:55–63.
See Part II for information on fenugreek, alpha lipoic acid, vanadium, chromium, and niacinamide (nicotinamide) Home | Presentations | About Us | Videos | Books | Health Info | Links | CHIP | Mail In Order Form | 3ABN Features | Contact Us |
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