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Natural Strategies for Diabetes-Part II Outline of Natural Approaches to Diabetes Control-Part II David J. DeRose, MD, MPH Prepared for the Three Angels Broadcasting Network’s Health for a Lifetime Taped December 2005
continued from Part I VI. Fenugreek l Appears to help lower blood sugar by multiple mechanisms § Delays glucose absorption § Prolongs gastric transit § Fiber effects § Note: also appears to have lipid lowering properties
VII. Alpha lipoic acid l Demonstrated benefits in both type 1 and type 2 diabetes l May help prevent diabetes pathologies including: § macular degeneration § cataracts § neuropathy l Demonstrated to help treat peripheral and autonomic diabetic neuropathy. § Dosages of 600 - 800 mg/d often used § Older studies show neuropathy benefits with as little as 50 mg twice daily l Appears to have beneficial effects in improving insulin sensitivity and treating and/or preventing diabetic complications l Regimens in the range of 600 -1800 mg/day have often been used § the absence of a dose response effect in some studies raises the question as to whether lower doses may be efficacious § It may be reasonable to start at dosages as low as 50 mg twice daily while assessing clinically l Appears to have few side effects
VIII. Vanadium l A recent study led further credence to the value of this micronutrient in diabetes l 11 patients with type 2 diabetes received daily vanadyl sulfate for 6 weeks § over two weeks titrated up to 150 mg/d § dosed as 50mg thrice daily with meals l Multiple improvements were noted: § lowering of HbA1c and fructosamine § decreased FBS; evidence of improved insulin sensitivity § fall in total cholesterol and LDL l Vanadyl sulfate appears well tolerated and potentially useful in type 2 diabetes § gradually titrate dosage over 6 wk § target dosage of 150 mg/day l May be a useful short-term strategy § Concerns with long term use: vanadium accumulation and potential for side-effects § This concern has been underscored by the failure to demonstrate vanadium deficiency in patients with diabetes
IX. Chromium l Research has demonstrated that chromium has a variety of salutary effects in glucose metabolism. § These include: l increased number of insulin receptor l improved insulin binding to the receptors l enhanced insulin internalization l augmented beta cell sensitivity § All of this culminates in increases in insulin sensitivity.
l An important study… § 180 Chinese subjects with type 2 DM § Randomized to twice daily regimen of either placebo, 100, or 500 micrograms of chromium picolinate for 4 months. § At four months, HBA1c (average blood sugar indicator) compared to placebo group: l 22% lower in 1000 mcg/d group l 12% lower in 200 mcg/d group § Additionally, improvements in fasting and post meal insulin levels in both chromium groups § Lowered cholesterol in the 1000 mcg/d group
l Chromium Summary § Appears to be a generally safe and reasonable supplement to improve glucose homeostasis § No compelling data supporting its use as a weight reduction aid § May have favorable effects on lipids § Dosage may be best guided by degree of glucose intolerance. Some suggest the following considerations: l 200 mcg/day Cr if mildly glucose intolerant l More than 200 mcg/day in individuals with greater glucose intolerance and/or diabetes l Dosages in the range of 1000 mcg per day may be necessary in some individuals with diabetes
X. Niacinamide (nicotinamide) l An agent of promise in both type 1 and type 2 diabetes l May help preserve insulin-producing capacity in early type 1 diabetes l A provocative study in type 2 diabetes: § 18 patients with type 2 diabetes enrolled in a 6 month single blind study: § All had failed to control their blood sugar with the maximum dosage of standard oral medications (sulphonylureas) § Some randomized to nicotinamide 500 mg TID § Results in those using nicotinamide: l Achieved metabolic control indistinguishable from patients treated with insulin. l increased C-peptide release (an evidence of increased insulin production by the pancreas)
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