Sunday, January 29, 2012

Dietary Supplements for Type 2 Diabetes

Besides medication and lifestyle changes, certain dietary supplements can help control symptoms of type 2 diabetes. Read on to learn which ones the latest research found most effective and what you should know before taking supplements...

Some people with diabetes take dietary supplements in efforts to improve their blood glucose control, manage symptoms and lessen the risk of developing serious complications such as heart problems.

Here’s what’s currently known about a few of the supplements used for diabetes – especially those that have been tested in clinical trials.

Alpha-lipoic acid (ALA, also known as lipoic acid or thioctic acid) is an antioxidant – a substance that protects against cell damage.

ALA is found in certain foods, such as liver, spinach, broccoli and potatoes.

Some people with type 2 diabetes take ALA supplements in the hope of lowering blood glucose levels by improving the body’s ability to use insulin.

Others use ALA to prevent or treat diabetic neuropathy (a nerve disorder that can lead to pain, numbness and serious health problems).
Supplements are marketed as tablets or capsules.

ALA has been researched for its effect on insulin sensitivity, glucose metabolism and diabetic neuropathy.

Some studies have found benefits, but more research is needed.

In some supplements, ALA is paired with L-carnitine, an amino acid that may help diabetics handle glucose.

Studies on rats have found that the two substances could have added health benefits when taken together.

Because ALA might lower blood sugar too much, people with diabetes who take it must monitor their blood sugar levels very carefully.

Chromium is an essential trace mineral – that is, the body requires small amounts of it to function properly.

Some people with diabetes take chromium in an effort to improve their blood glucose control.
Chromium is found in many foods, but usually only in small amounts; relatively good sources include meat, whole grain products, and some fruits, vegetables and spices.

In supplement form (capsules and tablets), it’s sold as chromium picolinate, chromium chloride and chromium nicotinate.

Chromium supplementation has been researched for its effect on glucose control in people with diabetes.

Study results have been mixed. Some researchers have found benefits, but many of the studies haven’t been well designed.

Additional, high-quality research is needed.

At low doses (usually about 50-400 micrograms per day), short-term use of chromium appears to be safe for most adults.

But people with diabetes should be aware that chromium might cause blood sugar levels to go too low.

High doses can cause serious side effects, including kidney problems – an issue of special concern to people with diabetes.

Omega-3 fatty acids are polyunsaturated fatty acids that come from foods such as fish, fish oil, vegetable oil (primarily canola and soybean), walnuts and wheat germ. Omega-3 supplements are available as capsules or oils (such as fish oil).
Omega-3s are important in a number of bodily functions, including the movement of calcium and other substances in and out of cells, the relaxation and contraction of muscles, blood clotting, digestion, fertility, and cell division and growth.

In addition, omega-3s are thought to protect against heart disease, reduce inflammation and lower triglyceride levels.

Omega-3 fatty acids have been researched for their effect on controlling glucose and reducing heart disease risk in people with type 2 diabetes.

Studies show that they lower triglycerides but don’t affect blood glucose control, total cholesterol or HDL (good) cholesterol in people with diabetes.

In some studies, they also raised LDL (bad) cholesterol.

Additional research, particularly long-term studies that look specifically at heart disease in people with diabetes, is needed.

Omega-3s appear to be safe for most adults at low-to-moderate doses (usually about 1-3 grams per day).

Safety questions have been raised about fish oil supplements, because some species of fish can be contaminated by substances such as mercury, pesticides or PCBs. (Many brands are filtered for these impurities.)

In high doses, fish oil can interact with certain medications, including blood thinners and drugs used for high blood pressure.
Polyphenols – antioxidants found in tea, dark chocolate and dark-colored fruits, among other dietary sources – are being studied for possible effects on vascular health (including blood pressure) and on the body’s ability to use insulin.

Laboratory studies suggest that EGCG, a polyphenol found in green tea, may protect against cardiovascular disease and have a beneficial effect on insulin activity and glucose control.

However, a few small clinical trials studying EGCG and green tea in people with diabetes have not shown such effects.

No adverse effects of EGCG or green tea were discussed in these studies. Green tea is safe for most adults when used in moderate amounts.

However, green tea contains caffeine, which can cause, in some people, insomnia, anxiety or irritability, among other effects.

Green tea also has small amounts of vitamin K, which can make anticoagulant drugs, such as warfarin, less effective.
Other supplements are also being studied for diabetes-related effects.

For example:

Preliminary research has explored the use of garlic for lowering blood glucose levels, but findings have not been consistent.

Studies of the effects of magnesium supplementation on blood glucose control have had mixed results, although researchers have found that eating a diet high in magnesium may lower the risk of diabetes.

There is not enough evidence to evaluate the effectiveness of coenzyme Q10 supplementation as an alternative therapy for diabetes; studies of its ability to affect glucose control have had conflicting findings.

Researchers are studying whether the herb ginseng and the trace mineral vanadium might help control glucose levels.

Some people with diabetes may also try botanicals such as prickly pear cactus, gurmar (Gymnema sylvestre), Coccinia indica, aloe vera, fenugreek and bitter melon to control their glucose levels.

However, there’s limited research on the effectiveness of these botanicals for diabetes.
If You Have Diabetes and Are Thinking About Using a Dietary Supplement:

Tell your health care providers about any complementary and alternative practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Medicines for diabetes and other health conditions may need to be adjusted if a patient is also using a dietary supplement.

Women who are pregnant or nursing, or people who are thinking of using supplements to treat a child, should consult their health care provider before using any dietary supplement.

Don’t replace scientifically proven diabetes treatments with alternative treatments that are unproven.The consequences of not following your prescribed medical regimen for diabetes can be very serious.

Be aware that the label on a dietary supplement bottle may not accurately reflect what’s inside. Some tests of supplements have found that the contents didn’t match the dose on the label, and some herbal supplements have been found to be contaminated.

Adapted from “Diabetes and CAM: A Focus on Dietary Supplements” by the National Center for Complementary and Alternative Medicine, a division of the National Institutes of Health.
Here are more resources:

The National Center for Complementary and Alternative Medicine provides information on supplements and other alternative treatments, including publications and searches of federal databases of scientific and medical literature.

The National Diabetes Information Clearinghouse responds to inquiries, offers diabetes publications and makes referrals.

For an alphabetical list of publication topics, go to www.diabetes.niddk.nih.gov/dm/a-z.asp.

The National Diabetes Education Program is sponsored by the National Institutes of Health and the Centers for Disease Control and Prevention, with many federal, state and local partners. Its services include information and publications on diabetes.

Learn more about how women with diabetes can benefit from supplements for diabetes here.

And don’t forget to check out our Diabetes Health Center.

How Much Do You Know About Diabetes?
In the United States alone, 23.6 million people have diabetes. And 5.6 million of them don’t even know it. Unfortunately, misinformation about diabetes is rampant – and mixing up the facts about this disease can have dire consequences.

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