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    Type 2 Diabetes (Holistic)

    Type 2 Diabetes (Holistic)

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    About This Condition

    Also known as adult-onset diabetes, type 2 diabetes can often be managed by carefully monitoring your diet. According to research or other evidence, the following self-care steps may be helpful. 
    • Keep an eye on the GI

      Follow a low-glycemic-index diet by avoiding sweet snacks and processed foods, and emphasizing healthy carbohydrates from whole grains, beans, vegetables, and whole fruit, to help keep blood sugar levels stable.

    • Fight back with fiber   

      In addition to eating plenty of high-fiber fruits and vegetables, consider using a fiber supplement such as glucomannan or psyllium with meals.

    • Energize insulin function with weight loss and exercise

      Lower your blood sugar and improve insulin function with weight loss and regular exercise.

    • Check out chromium

      Improve glucose tolerance by taking 200 to 1,000 mcg of this essential trace mineral every day.

    • Improve and protect with ALA

      Take 600 to 1,200 mg a day of an alpha lipoic acid supplement to improve insulin sensitivity and help protect against diabetic complications such as nerve damage.

    • Try a topical ointment

      An ointment containing 0.025 to 0.075% capsaicin four times a day might help control nerve pain.

    These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
    • Aim for a healthy weight

      Lose excess weight with a program of healthy eating, regular exercise, and group support to maintain healthy insulin sensitivity and prevent type 2 diabetes.

    • Get moving

      Use regular aerobic and/or strength exercise to maintain healthy insulin sensitivity and prevent type 2 diabetes.

    • Keep an eye on the GI

      Choose carbohydrate foods with a low glycemic index, such as whole grains, beans (legumes), and other high-fiber, unprocessed foods, to stabilize blood sugar and reduce diabetes risk.

    • Go vegetarian or vegan

      Vegetarians have been shown to have a low risk of type 2 diabetes.

    • Add some olive oil

      Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance.

    These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

    About

    About This Condition

    Diabetes mellitus is an inability to metabolize carbohydrates resulting from inadequate insulin production, absence of insulin production, or impaired utilization of insulin. Other forms of diabetes (such as diabetes insipidus and gestational diabetes) are not included in this discussion.

    There are several types of diabetes mellitus including type 1, type 2, and gestational diabetes, as well as diabetes insipidus, and a more recently recognized form of adult-onset diabetes called latent autoimmune diabetes in adults (LADA).1 This article concerns type 2 diabetes, which has also been called adult-onset diabetes or non-insulin-dependent diabetes. However, type 2 diabetes also may affect children and may also require treatment with insulin. With type 2 diabetes, the pancreas often makes enough insulin, particularly when a person is first diagnosed, but the body has trouble using it. Type 2 diabetes frequently responds well to natural therapies; however, if the condition is not well managed, the body may be unable to continue to make adequate insulin, requiring treatment with insulin. For many people with type 2 diabetes, lifestyle changes and/or oral glucose lowering medications are able to keep the condition well-managed.

    People with diabetes cannot properly process glucose, the main sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, the cells of the body are starved for glucose, because without insulin, glucose cannot enter cells. People with diabetes are at increased risk for heart disease , atherosclerosis , cataracts , retinopathy , stroke , poor wound healing , infections , and damage to the kidneys and nerves. In addition, those with diabetes have a higher mortality rate if they also have high homocysteine levels.2 The risk of diabetes-related health complications can be decreased with proper blood sugar management and a healthy lifestyle.

    Healthy Lifestyle Tips

    Everyone with diabetes aged 6 months and older should get a seasonal flu shot. Close household contacts and out-of-home caregivers of people with diabetes should also get the vaccine.3

    People with diabetes should get the flu "shot," not the nasal spray type of vaccine. The flu shot is given with a needle, usually in the arm. The vaccine used in the shot is made from killed virus; you cannot catch the flu from the flu vaccine. In addition to the seasonal flu vaccine, people with type 2 diabetes should follow updated Centers for Disease Control and Prevention guidelines regarding pneumococcal vaccines (PCV13 and PPSV23) in older adults.4

    Most people with type 2 diabetes are overweight.5 Excess abdominal weight does not stop insulin formation,6 but it does make the body less sensitive to insulin.7 Excess weight can even make healthy people prediabetic,8 though weight loss can reverse this problem.9 Once type 2 diabetes is present, weight loss will not completely cure or reverse the disease. However, in most studies, type 2 diabetes improves with weight loss.10 , 11 , 12 meaning weight management should be a key component of any type 2 diabetes management plan.

    Exercise helps decrease body fat and improve insulin sensitivity.13 , 14 People who exercise are less likely to develop type 2 diabetes than those who do not.15 However, exercise can induce low blood sugar in diabetics taking blood sugar-lowering medications, or even occasionally increased blood sugar.16 Therefore, people with diabetes should never begin an intensive exercise program without consulting a healthcare professional. However, the latest diabetes guidelines highlight the harm of prolonged sitting, and recommend that all individuals with diabetes break up extended periods of sedentary time (more than 90 min).17

    Drinking moderate amounts of alcohol in healthy people improves glucose tolerance.18 , 19 , 20 , 21 However, alcohol has been reported to worsen glucose tolerance in the elderly and in people with diabetes in some studies.22 , 23 People with diabetes who drink have also been reported to have a high risk for eye and nerve damage.24 , 25

    Questions remain about where the line should be drawn regarding alcohol intake. For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes;26 however, heavy drinking does increase the risk of developing diabetes and should be avoided.27 People with diabetes should limit alcohol intake to two drinks per day for men, and one drink per day for women. The Centers for Disease Control define one drink as equivalent to a 12 ounce can of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of hard liquor. In one report, older people with type 2 diabetes who drank daily, but moderately, had a dramatically lower incidence of death from heart disease compared with nondrinkers.28 This outcome is not surprising since moderate alcohol intake is associated with protection from heart disease in most other reports. This finding may be of particular importance because heart disease is the leading killer of people with diabetes. In another study, nondrinkers had a higher incidence of type 2 diabetes than did moderate drinkers.29 However, alcohol consumption has numerous downsides as well, including risk of addiction and increased risk of several types of cancer. For this reason, it is not advised that people who do not drink begin doing so simply for heart-protective benefits. However, if you currently drink moderately (one drink per day for women, two drinks per day for men), it is likely safe, and possibly beneficial to continue to do so. Ask your doctor what is best for you, taking into account your personal medical history, and remember that beyond moderate drinking, alcohol will be more harmful than beneficial.

    People with diabetes who smoke are at higher risk for kidney damage,30 heart disease,31 and other diabetes-related problems. Smokers are also more likely to develop diabetes,32 so it's important for diabetic smokers to quit. Current diabetes guidelines advise against using e-cigarettes as an alternative to smoking or to facilitate smoking cessation.33

    Although most healthcare professionals agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes, disagreement exists within the medical community regarding the efficacy and necessity of SMBG by people with type 2 diabetes. A controlled clinical trial found that home glucose monitoring strips did not affect the management of type 2 diabetes.34 Moreover, a review of available literature concluded that the efficacy of SMBG in people with type 2 diabetes is questionable and should be tested in a rigorous high-quality trial.35 Advocates of SMBG, such as the American Diabetes Association (ADA), have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific goals.36 These observations are well-supported in the medical literature.37 Detractors point out that indiscriminate use of self-monitoring is of questionable value and adds enormously to healthcare costs.38 The ADA acknowledges that accuracy of SMBG is instrument- and technique-dependent. Errors in technique and inadequate use of control procedures have been shown to lead to inaccurate test results.39 Nevertheless, it is likely that self-monitoring of blood glucose, if used properly, can have a positive effect by increasing a person's involvement in their diabetes care.40 Pharmacists and healthcare practitioners can teach people with diabetes certain skills that will enhance their ability to properly self-manage blood glucose.

    One way to accomplish SMBG is to utilize a technique called continuous glucose monitoring (CGM). CGM can be undertaken either with or without an insulin pump, which is a device that delivers rapid- or short-acting insulin 24 hours a day through a catheter placed under the skin. CGM typically is integrated into pump function, but if a pump is not being used, CGM can be accomplished with a tiny sensor inserted under the skin to check glucose levels in tissue fluid. The sensor stays in place for several days to a week, and then must be replaced. It's important to note that implementation of CGM should not be attempted unless a patient has a high level of readiness to tackle this challenge. If CGM is undertaken, providing ongoing CGM support is critical to success.

    The American Diabetes Association now recommends a pre-meal blood glucose target of 80-130 mg/dL, rather than 70-130 mg/dL.41 This better reflects new information comparing actual average glucose levels with A1C targets. This information will help guide patients who are practicing SMBG.

    Holistic Options

    Acupuncture may be helpful in the management of diabetes, or complications associated with the disease. Preliminary trials have suggested that acupuncture can lower blood sugar and improve insulin production in people with type 2 diabetes,42 , 43 , 44 , 45 but trials on long-term effects have not been concluded. In a preliminary trial, 77% of people suffering from diabetic neuropathy experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many also were able to reduce pain medications, but no long-term change in blood-sugar control was observed.46 Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment with a significant reduction in symptoms in both controlled and uncontrolled trials.47 , 48

    Eating Right

    The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

    Recommendation Why
    Ask an expert
    An individualized nutrition management plan, preferably provided by a registered dietitian who is knowledgeable and skilled in providing diabetes Medical Nutrition Therapy, is critical to managing type 2 diabetes well. This will help address individual nutrition needs, take into account personal and cultural preferences, help maintain the pleasure of eating, and provide practical tools for day-to-day meal planning.
    Comprehensive group diabetes education programs, including nutrition therapy or individualized education sessions, can significantly improve the ability of people with diabetes to manage glucose properly. With appropriate diabetes nutrition education and support, A1C levels may be decreased by as much as 2% for people with type 2 diabetes.
    Be flexible
    The American Diabetes Association takes the position that there is not a one-size-fits-all eating pattern for individuals with diabetes, because a variety of eating patterns have been shown to be effective in managing diabetes.49
    Many eating patterns have been shown to be good choices for managing type 2 diabetes, including the Mediterraneandiet and the Dietary Approaches to Stop Hypertension (DASH) diet, as well as plant-based (vegan or vegetarian), lower-fat, and lower-carbohydrate patterns.
    Be GL savvy
    Whole grains, beans, vegetables, and fruit are healthy foods for everyone, and this includes people with diabetes. These foods are loaded with nutrients and fiber, providing valuable fuel that will keep blood sugar levels stable.
    Substituting low-glycemic load (GL) foods for higher-GL foods may modestly improve glycemic control, though studies on this question provide a complicated picture. Low-GL foods also tend to be high in fiber, and many studies have not controlled for the independent effects of fiber on blood glucose levels. Further, studies have used inconsistent definitions of "low" and "high" when defining glycemic load foods, and have not controlled for how mixtures of different foods affect the overall glycemic load of the diet and blood glucose control. However, most foods that rank low on glycemic load are healthy for other reasons; they provide valuable nutrients to the diet, and help people minimize eating less-healthy, processed foods.
    Feast on fish
    Research has found that eating fish may improve cardiovascular health in people with type 2 diabetes. This is important because heart disease is common among people with diabetes, and is a leading cause of death in this group.
    In a randomized crossover trial among post-menopausal women with type 2 diabetes, eating fish providing 3 or more grams of omega-3 fats per day significantly improved markers of vascular endothelial function; better endothelial function is associated with a reduced risk of heart disease.
    Feature more fiber
    According to a comprehensive research review on the connection between dietary fiber and diabetes, eating plenty of cereal grain fiber may significantly reduce the risk of developing type 2 diabetes.50
    People with diabetes should consume at least the amount of fiber and whole grains recommended for the general public. Research is mixed regarding the benefits of fiber for lowering or managing blood glucose levels; however, eating more fiber is associated with a lower risk of death due to any cause (all-cause mortality). Further, fiber comes from foods such as vegetables, fruit, legumes, nuts, seeds, and whole grains, which are associated with good health for other reasons. For example, these foods also provide important vitamins, minerals, and phytonutrients. If that isn't reason enough, consider this: fiber-rich diets, particularly those that contain plenty of cereal grain fiber, may even reduce the risk of developing type 2 diabetes in the first place.
    Limit sugar
    Most doctors recommend that people with diabetes eat less sugary foods like snacks and processed foods and replace these foods with high-fiber, whole foods.
    Currently, the American Diabetes Association (ADA) guidelines do not set specific limits for sucrose-white table sugar-in the diet, because substituting sucrose-containing foods for an equal (caloric) amount of other carbohydrates may have similar blood glucose effects. However, consumption of sucrose, which is found mostly in less healthy, processed food items, should be minimized to avoid displacing nutrient-dense food choices, such as vegetables, legumes, fruit, and whole grains. All people, including those with diabetes, should follow the American Heart Association guidelines that men eat no more than 150 calories, or approximately nine teaspoons, of added sugar per day, and that women eat no more than 100 calories, or approximately 6 teaspoons, of added sugar per day.
    Switch up the fat
    Replacing saturated fat with monounsaturated fatty acids (MUFA), which are found predominantly in olive oil, and also nuts and seeds, may improve insulin sensitivity and minimize the accumulation of unhealthy fat around the mid-section.

    Having a higher waist circumference increases the risk of developing type 2 diabetes; however, the type of fat you eat may help you stay healthy, regardless of your waistline size. Among a group of 1,114 older adults (ages 58 to 78), researchers found that a combination of low dietary saturated fat intake and high cardiorespiratory fitness, plus ample amounts of dietary fiber, helped maintain normal glucose metabolism, even in adults with larger waist sizes. Saturated fat is found primarily in meat, high-fat dairy, fried foods, and the dark meat and skins of poultry. When you begin to decrease the saturated fat in your diet, pay close attention to how you replace it. Replacing that saturated fat with monounsaturated fatty acids (MUFA), which are found predominantly in olive oil, and also nuts and seeds, may improve insulin sensitivity and minimize the accumulation of unhealthy fat around the mid-section (central fat distribution). Other clinical trial data supports the benefits of a MUFA-rich diet. Researchers randomly placed men and women on one of three diets, all of which had the same amount of protein: 1) A MUFA diet that had a moderate fat content (35-45% of calories) and was high in monounsaturated fatty acids, which made up greater than 20% of calories; 2) A Low Fat diet with 20-30% of calories from fat, and 3) A control diet with 35% of energy as fat, and greater than 15% of calories from saturated fat. After six months, only people assigned to eat the MUFA diet had significantly reduced fasting blood glucose and insulin levels, and experienced improvements in markers of insulin resistance.

    Supplements

    What Are Star Ratings?

    Our proprietary "Star-Rating" system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

    For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

    3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

    2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

    1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

    Supplement Why
    3 Stars
    Alpha Lipoic Acid
    600 to 1,200 mg a day
    Taking alpha lipoic acid may improve insulin sensitivity and help protect against diabetic complications such as nerve damage.
    Alpha lipoic acid is a powerful natural antioxidant . Preliminary and double-blind trials have found that supplementing 600 to 1,200 mg of lipoic acid per day improves insulin sensitivity and the symptoms of diabetic neuropathy. In a preliminary study, supplementing with 600 mg of alpha lipoic acid per day for 18 months slowed the progression of kidney damage in patients with type 2 diabetes.
    3 Stars
    Brewer's Yeast
    9 grams per day
    Chromium-rich brewer's yeast has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.

    Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer's yeast (9 grams per day) can be useful in treating type 2 diabetes. In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes. Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance. Chromium supplements improve glucose tolerance in people with type 2 diabetes, apparently by increasing sensitivity to insulin . Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy . Chromium even helps healthy people, although one such report found chromium useful only when accompanied by 100 mg of niacin per day. Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).

    A few trials have reported no beneficial effects from chromium supplementation. All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used. Many doctors recommend up to 1,000 mcg per day for people with diabetes.

    Supplementation with chromium or brewer's yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer's yeast only under the supervision of a doctor.

    3 Stars
    Cayenne Topical (Diabetic Neuropathy)
    Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain
    Topically applied capsaicin (from cayenne) may help relieve nerve pain.
    Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes). Four or more applications per day may be required to relieve severe pain . This should be done only under a doctor's supervision.
    3 Stars
    Chromium
    200 to 1,000 mcg daily
    Chromium has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.

    Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer's yeast (9 grams per day) can be useful in treating type 2 diabetes. In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes. Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance. Chromium supplements improve glucose tolerance in people with type 2 diabetes, apparently by increasing sensitivity to insulin . Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy . Chromium even helps healthy people, although one such report found chromium useful only when accompanied by 100 mg of niacin per day. Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).

    A few trials have reported no beneficial effects from chromium supplementation. All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used. Many doctors recommend up to 1,000 mcg per day for people with diabetes.

    Supplementation with chromium or brewer's yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer's yeast only under the supervision of a doctor.

    3 Stars
    Fenugreek
    2.5 to 15 grams daily
    Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption.
    Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Animal research suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control.In a controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in blood glucose following the meal. Another controlled trial found that taking 2.5 grams of fenugreek twice a day for three months reduced blood sugar levels in people with mild, but not those with severe, type 2 diabetes. In a double-blind study, 1 gram per day of an extract of fenugreek seeds for two months improved some measures of blood sugar control and insulin function in people with type 2 diabetes.
    3 Stars
    Fiber
    Talk to your doctor
    Taking fiber supplements may help to stabilize your blood sugar.
    High-fiber supplements, such as psyllium , guar gum (found in cluster beans), pectin (from fruit), oat bran, and glucomannan , have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day. A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes. Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats , and whole-grain products.
    3 Stars
    Glucomannan
    500 to 700 mg per 100 calories in the diet
    Glucomannan delays stomach emptying, leading to more gradual sugar absorption and lower blood sugar levels after meals.
    Glucomannan is a water-soluble dietary fiber derived from konjac root (Amorphophallus konjac)that delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. After-meal blood sugar levels are lower in people with diabetes given glucomannan in their food, and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled clinical trials. One preliminary report suggested that glucomannan may also be helpful in pregnancy-related diabetes. For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research.
    3 Stars
    Magnesium
    200 to 600 mg daily
    People with type 2 diabetes tend to have low magnesium levels, supplementing with the mineral may restore levels and improve insulin production.

    People with type 2 diabetes tend to have low magnesium levels. Double-blind research indicates that supplementing with magnesium overcomes this problem. Magnesium supplementation has improved insulin production in elderly people with type 2 diabetes. However, one double-blind trial found no effect from 500 mg magnesium per day in people with type 2 diabetes, although twice that amount led to some improvement. Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some, but not all, trials. However, in people with type 2 diabetes who nonetheless require insulin, Dutch researchers have reported no improvement in blood sugar levels from magnesium supplementation. The American Diabetes Association acknowledges strong associations between magnesium deficiency and insulin resistance but has not said magnesium deficiency is a risk factor Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200 to 600 mg of magnesium per day.

    Diabetes-induced damage to the eyes is more likely to occur in magnesium-deficient people with type 1 diabetes. In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with type 1 diabetes. The American Diabetes Association admits "strong associations...between magnesium deficiency and insulin resistance" but will not say magnesium deficiency is a risk factor. Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200-600 mg of magnesium per day.

    3 Stars
    Psyllium
    5.1 grams daily with meals
    Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol.
    Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11 to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared with a placebo.
    2 Stars
    Acetyl-L-Carnitine (Diabetic Neuropathy)
    500 to 1,000 mg three times daily
    Taking acetyl-L-carnitine may improve symptoms of diabetic neuropathy.

    In a double-blind study of people with diabetic neuropathy, supplementing with acetyl-L-carnitine was significantly more effective than a placebo in improving subjective symptoms of neuropathy and objective measures of nerve function. People who received 1,000 mg of acetyl-L-carnitine three times per day tended to fare better than those who received 500 mg three times per day.

    2 Stars
    Aloe
    1 Tbsp (15 ml) of gel daily
    Aloe, either alone or in combination with the oral hypoglycemic drug glibenclamide, has been shown to effectively lower blood sugar in people with type 2 diabetes.
    Animal research and preliminary controlled human trials have found that Aloe vera, either alone or in combination with the oral hypoglycemic drug glibenclamide, effectively lowers blood sugar in people with type 2 diabetes. The typical amount used in this research was 1 tablespoon (15 ml) of aloe gel per day.
    2 Stars
    American Ginseng
    3 grams with or following meals
    Supplementing with American ginseng may help improve blood sugar control.
    In a small preliminary trial, 3 grams of American ginseng was found to lower the rise in blood sugar following the consumption of a high-glucose drink by people with type 2 diabetes. The study found no difference in blood sugar-lowering effect if the herb was taken either 40 minutes before the drink or at the same time. A follow-up to this study found that increasing the amount of American ginseng to either 6 or 9 grams did not increase the effect on blood sugar following the high-glucose drink in people with type 2 diabetes. This study also found that American ginseng was equally effective in controlling the rise in blood sugar whether it was given together with the drink or up to two hours before.
    2 Stars
    Asian Ginseng
    200 mg of herbal extract containing approximately 5 to 7% ginsenosides daily
    Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes.
    Asian ginseng is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and to increase the number of insulin receptors. Animal research has also revealed a direct blood sugar-lowering effect of ginseng. A double-blind trial found that 200 mg of ginseng extract per day improved blood sugar control, as well as energy levels in people with type 2 diabetes. Similar improvements in blood sugar control were found in another double-blind study in which 5 grams per day of ginseng was taken for 12 weeks.
    2 Stars
    Berberine (High Cholesterol)
    500 mg of berberine taken twice a day for three months
    Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels.
    Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels. In a study of people with high cholesterol levels, 500 mg of berberine taken twice a day for three months lowered the average cholesterol level by 29%. No significant side effects were reported, except for mild constipation.
    2 Stars
    Bilberry
    160 mg twice per day of an herbal extract containing 25% anthocyanosides
    Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy.
    Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy . One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy.
    2 Stars
    Biotin
    9 to 16 mg daily
    Biotin may improve glucose levels and reduce pain from diabetic nerve damage.
    Biotin is a B vitamin needed to process glucose. When people with type 2 diabetes were given 9 mg of biotin per day for two months, their fasting glucose levels dropped dramatically. Biotin may also reduce pain from diabetic nerve damage. Some doctors try 9 to 16 mg of biotin per day for a few weeks to see if blood sugar levels will fall.
    2 Stars
    Bitter Melon
    50 to 100 ml of juice daily or 5 grams three times daily of powdered fruit
    Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes.
    Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes, according to preliminary trials. However, double-blind trials are needed to confirm this potential benefit.
    2 Stars
    Cinnamon
    1 to 6 grams daily
    Cinnamon may improve glucose utilization in people with type 2 diabetes.
    Test tube studies have suggested that cinnamon may improve glucose utilization. In a study of people with type 2 diabetes, supplementing with cinnamon in the amount of 1, 3, or 6 grams per day for 40 days was significantly more effective than a placebo at reducing blood glucose levels. The reduction averaged 18 to 29% in the three treatments groups, and 1 gram per day was as effective as 3 and 6 grams per day. The benefits of cinnamon for lowering blood sugar levels was confirmed in a double-blind study. However, in two other double-blind studies, cinnamon was not more effective than a placebo. The different results in these studies may have been due in part to differences in body weight, initial blood sugar levels, and medication use among the different populations studied.
    2 Stars
    Coenzyme Q10
    120 mg daily of a standardized herbal extract
    Supplementing with CoQ10 may improve blood sugar metabolism.
    Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. Animals with diabetes have been reported to be CoQ10 deficient. People with type 2 diabetes have been found to have significantly lower blood levels of CoQ10 compared with healthy people. In one trial, blood sugar levels fell substantially in 31% of people with diabetes after they supplemented with 120 mg per day of CoQ7, a substance similar to CoQ10. The importance of CoQ10 supplementation for people with diabetes remains an unresolved issue, though some doctors recommend approximately 50 mg per day as a way to protect against possible effects associated with diabetes-induced depletion.
    2 Stars
    Crepe Myrtle
    32 or 48 mg of an herbal extract standardized to contain 1% corosolic acid
    Crepe myrtle has been used in folk medicine to treat diabetes. It appears to work by lowering blood glucose levels.
    Lagerstroemia speciosa, commonly known as crepe myrtle, grows in various tropical countries and Australia. In folk medicine it has been used to treat diabetes. In a preliminary study of people with type 2 diabetes, supplementing with an extract from the leaves of Lagerstroemia speciosa for two weeks resulted in a fall in blood-glucose levels averaging 20 to 30%. The amount used was 32 or 48 mg of a product standardized to contain 1% corosolic acid (a putative active ingredient). The larger amount was somewhat more effect than the smaller amount. Although these results are promising, additional studies are needed to demonstrate the long-term safety and efficacy of this herbal preparation.
    2 Stars
    Green Tea
    Refer to label instructions
    A meta-analysis of several studies found that green tea consumption may improve blood glucose control and insulin sensitivity.
    A meta-analysis of 17 randomized controlled trials, including a total of 1,133 subjects (mostly overweight or obese, and/or having type 2 diabetes or borderline diabetes) found that green tea consumption significantly improved blood glucose control and insulin sensitivity.
    2 Stars
    Gymnema
    800 mg daily of an herbal extract standardized for 25% gymnemic acids
    Gymnema may stimulate the pancreas to produce insulin and may help normalize blood sugar control in people with diabetes.
    Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes. So far, no double-blind trials have confirmed the efficacy of gymnema for people with any type of diabetes. However, a preliminary study of type 2 diabetics reported that 400 mg per day of gymnema extract taken for periods of 18 months or longer resulted in improvement, according to diabetes blood tests, and allowed reduction of diabetic medications. Improvements in blood glucose levels were also seen in patients with type 2 diabetes who received 1 g per day of a specific gymnema extract (Om Santal Adivasi) for two months. In a controlled trial with type 1 (insulin-dependent) diabetics, a similar amount of gymnema extract reduced requirements for insulin. Whether the extract used in these studies was standardized for active constituents is unclear. Recently, a preliminary trial found improved blood sugar levels after three months in a group of type 1 and type 2 diabetics who took 800 mg per day of an extract standardized for 25% gymnemic acids. Gymnema is not a substitute for insulin, but insulin amounts may need to be lowered while taking gymnema to avoid hypoglycemia.
    2 Stars
    Hairy Basil
    10 grams three times per day with meals
    Taking hairy basil may help people with type 2 diabetes control their blood sugar levels.
    Preliminary trials of leaves and hairy basil seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels. An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL ("bad") cholesterol, and triglycerides, while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol. The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil would have similar effects.
    2 Stars
    Holy Basil
    1,000 to 2,500 mg daily
    Taking holy basil may help people with type 2 diabetes control their blood sugar levels.
    Preliminary trials of holy basil (Ocimim sanctum) leaves and hairy basil (Ocimum canum) seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels. An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL ("bad") cholesterol, and triglycerides, while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol. The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil (Ocimum basilicum) would have similar effects.
    2 Stars
    L-Carnitine
    0.25 mg per 2.2 lbs (1 kg) of body weight
    Supplementing with L-carnitine may reduce cholesterol and triglyceride levels in people with diabetes.

    L-carnitine is an amino acid needed to properly utilize fat for energy. When people with diabetes were given DL-carnitine (0.5 mg per 2.2 pounds of body weight), high blood levels of fats-both cholesterol and triglycerides -dropped 25 to 39% in just ten days in one trial.

    2 Stars
    Milk Thistle
    200 mg per day of silymarin
    Supplementing with silymarin (a component of milk thistle) may help lower blood sugar levels.
    In a double-blind trial, supplementation with 200 mg per day of silymarin (a component of milk thistle) three times per day for four months significantly lowered blood sugar levels compared with a placebo in patients who were taking a blood sugar-lowering drug (glibenclamide).
    2 Stars
    Multivitamin (Infection)
    Follow label instructions
    Supplementing with a multivitamin-mineral may give your body the nutrients it needs to help prevent common infections.
    In a double-blind study, supplementation of middle-aged and elderly diabetics with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.
    2 Stars
    Onion
    20 grams fresh onion three times per day
    Large amounts of onion have been shown to lower blood sugar levels in people with diabetes, possibly by blocking the breakdown of insulin in the liver.
    Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes. The mechanism of onion's blood sugar-lowering action is not precisely known, though there is evidence that constituents in onions block the breakdown of insulin in the liver. This would lead to higher levels of insulin in the body.
    2 Stars
    Pinitol
    400 mg of pinitol three times per day
    Pinitol, a molecule found in high concentrations in soybeans and other legumes, may decrease fasting blood sugar level, improve insulin sensitivity, and improve a measure of long-term blood sugar control (hemoglobin A1c).
    Pinitol, a molecule found in high concentrations in soybeans and other legumes, is believed to enhance the action of insulin. In a double-blind trial, people with type 2 diabetes received 400 mg of pinitol or a placebo three times per day for 12 weeks. Compared with the placebo, pinitol significantly decreased the fasting blood sugar level, improved insulin sensitivity, and improved a measure of long-term blood sugar control (hemoglobin A1c).
    2 Stars
    Pycnogenol
    100 to 150 mg per day
    Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes and slow progression of complications such as retinopathy.

    Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes. Double-blind trials have shown that 100 to 125 mg per day of Pycnogenol lowers blood sugar in people with type 2 diabetes, but improvement in measures of long-term blood sugar control has not been consistent.

    Preliminary and double-blind studies have also shown Pycnogenol (typically 120 to 150 mg per day) slows the progression of diabetic retinopathy and improves vision. In a controlled trial of diabetic patients with symptoms of damage to the small blood vessels of the lower legs and feet, 150 mg per day of Pycnogenol improved measures of skin health and blood flow to the feet. In another controlled study, diabetic skin ulcers were treated with standard medications plus either 150 mg per day of Pycnogenol orally, 100 mg pycnogenol topically applied to the ulcers, or a combination of oral and topical Pycnogenol treatment. All treatments produced complete healing in more subjects after six weeks compared with a control group receiving no Pycnogenol treatment, but the group receiving oral and topical Pycnogenol had the greatest reductions in ulcer size and in pain and other associated symptoms.

    2 Stars
    Vitamin B1 and Vitamin B12 (Diabetic Neuropathy)
    Refer to label instructions
    Taking vitamin B1 combined with vitamin B12 may improve symptoms of diabetic neuropathy.
    A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks. However, since this was a trial conducted among people in a vitamin B1-deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks. As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.
    2 Stars
    Vitamin B1 and Vitamin B6 (Diabetic Neuropathy)
    25 mg of vitamin B1 daily, with 50 mg of vitamin B6 daily
    Taking vitamin B1 combined with vitamin B6 may improve symptoms of diabetic neuropathy.

    A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks. However, since this was a trial conducted among people in a vitamin B1-deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks. As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.

    2 Stars
    Vitamin B12 (Diabetic Neuropathy)
    Consult a qualified healthcare practitioner
    Vitamin B12 is needed for normal nerve cell function, and supplementing with it may improve symptoms of diabetic neuropathy.
    Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally has reduced symptoms of nerve damage caused by diabetes in 39% of people studied; when given both intravenously and orally, two-thirds of people improved. In a preliminary trial, people with nerve damage due to kidney disease or to diabetes plus kidney disease received intravenous injections of 500 mcg of methylcobalamin (the main form of vitamin B12 found in the blood) three times a day for six months in addition to kidney dialysis. Nerve pain was significantly reduced and nerve function significantly improved in those who received the injections. Oral vitamin B12 up to 500 mcg three times per day is recommended by some practitioners.
    2 Stars
    Vitamin B6
    1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily
    People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance.

    Many people with diabetes have low blood levels of vitamin B6 . Levels are even lower in people with diabetes who also have nerve damage (neuropathy). Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy. Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills. In a trial that included people with type 2 diabetes, 1,800 mg per day of a special form of vitamin B6-pyridoxine alpha-ketoglutarate-improved glucose tolerance dramatically. Standard vitamin B6 has helped in some, but not all, trials.

    2 Stars
    Vitamin C
    500 mg twice per day
    Supplementing with vitamin C may benefit people with type 2 diabetes in several ways, including by reducing sorbitol levels, urinary protein loss, and glycosylation.

    As with vitamin E, vitamin C may reduce glycosylation. Vitamin C also lowers sorbitol levels in people with diabetes. Sorbitol is a sugar that can accumulate inside the cells and damage the eyes, nerves, and kidneys of people with diabetes. Vitamin C may improve glucose tolerance in type 2 diabetes,although not every study confirms this benefit. Vitamin C supplementation (500 mg twice a day for one year) has significantly reduced urinary protein loss in people with diabetes. Urinary protein loss (also called proteinuria) is associated with poor prognosis in diabetes. Many doctors suggest that people with diabetes supplement with 1 to 3 grams per day of vitamin C. Higher amounts could be problematic, however. In one person, 4.5 grams per day was reported to increase blood sugar levels.

    One study examined antioxidant supplement intake, including both vitamins E and C, and the incidence of diabetic retinopathy (damage to the eyes caused by diabetes). Surprisingly, people with extensive retinopathy had a greater likelihood of having taken vitamin C and vitamin E supplements. The outcome of this trial, however, does not fit with most other published data and might simply reflect the fact that sicker people are more likely to take supplements in hopes of getting better. For the present, most doctors remain relatively unconcerned about the outcome of this isolated report.

    2 Stars
    Vitamin D (Diabetic Neuropathy)
    2,000 IU of vitamin D per day for three months
    In a preliminary trial, supplementing with vitamin D per day significantly improved pain by almost 50% in patients with diabetic neuropathy.
    A preliminary trial supplementation with about 2,000 IU of vitamin D per day for 3 months significantly improved pain by almost 50% in patients with diabetic neuropathy.
    2 Stars
    Vitamin D
    1,332 IU daily
    Vitamin D is needed to maintain adequate insulin levels, and supplementing with it may improve blood sugar control in people with type 2 diabetes.
    Vitamin D is needed to maintain adequate blood levels of insulin. Vitamin D receptors have been found in the pancreas where insulin is made. Some, but not all, preliminary trials have found that supplementation can improve some measures of blood sugar control in people with type 2 diabetes. In addition, in a preliminary trial supplementation with about 2,000 IU of vitamin D per day for three months significantly improved pain by almost 50% in patients with diabetic neuropathy. Not enough is known about optimal amounts of vitamin D for people with diabetes, and high amounts of vitamin D can be toxic; therefore, people with diabetes considering vitamin D supplementation should talk with a doctor and have their vitamin D status assessed.
    2 Stars
    Vitamin E (Diabetic Neuropathy)
    900 IU daily
    Vitamin E supplementation may protect against neuropathy.

    People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes. Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most, but not all, double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes. Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

    In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy, serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

    Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many, although not all, studies.

    In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes. The reason for the discrepancy between reports is not known.

    Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).

    2 Stars
    Vitamin E (Diabetic Retinopathy)
    1800 IU daily
    Vitamin E supplementation may protect against diabetic retinopathy.

    People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes. Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most, but not all, double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes. Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

    In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy, serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

    Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many, although not all, studies.

    In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes. The reason for the discrepancy between reports is not known.

    Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).

    2 Stars
    Zinc
    15 to 25 mg per day
    People with type 2 diabetes tend to be zinc deficient, supplementing with zinc may help restore levels.
    People with type 2 diabetes tend to be zinc deficient, but some evidence indicates that zinc supplementation does not improve their ability to process sugar. Nonetheless, many doctors recommend that people with type 2 diabetes supplement with moderate amounts of zinc (15 to 25 mg per day) as a way to correct the deficit.
    1 Star
    Açaí
    Refer to label instructions
    Açaí is reported to be a traditional remedy for diabetes.
    Açaí is reported to be a traditional remedy for diabetes. Although oxidative stress may contribute to diabetes and anthocyanins may improve insulin secretion, there is no published evidence that açaí has any effect on diabetes.
    1 Star
    Amylase Inhibitors
    Refer to label instructions
    Amylase inhibitors, when given with a starchy meal, can reduce the usual rise in blood sugar levels of people with diabetes.

    Starch blockers are substances that inhibit amylase, the digestive enzyme required to break down dietary starches for normal absorption. Controlled research has demonstrated that concentrated starch blocker extracts, when given with a starchy meal, can reduce the usual rise in blood sugar levels of both healthy people and diabetics. While this effect could be helpful in controlling diabetes, no research has investigated the long-term effects of taking starch blockers for this condition.

    1 Star
    Evening Primrose Oil
    4 grams daily
    Supplementing with evening primrose oil has been found to improve nerve function and to relieve pain symptoms of diabetic neuropathy.
    Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy. However, the principal investigator who conducted these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of the research. Therefore, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy.
    1 Star
    Fish Oil
    Refer to label instructions
    Supplementing with fish oil may improve glucose tolerance and symptoms of diabetic neuropathy and nephropathy
    Glucose tolerance improves in healthy people taking omega-3 fatty acid supplements, and some studies have found that fish oil supplementation also improves glucose tolerance, high triglycerides , and cholesterol levels in people with type 2 diabetes. And in one trial, people with diabetic neuropathy and diabetic nephropathy experienced significant improvement when given 600 mg three times per day of purified eicosapentaenoic acid (EPA)-one of the two major omega-3 fatty acids found in fish oil supplements-for 48 weeks. However, other studies have found that type 2 diabetes worsens with fish oil supplementation. Until this issue is resolved, people with diabetes should feel free to eat fish, but they should consult a doctor before taking fish oil supplements.
    1 Star
    Fructo-oligosaccharides
    Refer to label instructions
    In one trial, supplementing with fructo-oligosaccharides significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.
    In a preliminary trial, supplementation with fructo-oligosaccharides (FOS) (8 grams per day for two weeks) significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes. However, in another trial, supplementing with FOS (15 grams per day) for 20 days had no effect on blood-glucose or lipid levels in people with type 2 diabetes. In addition, some double-blind trials showed that supplementing with FOS or galacto-oligosaccharides (GOS) for eight weeks had no effect on blood-sugar levels, insulin secretion, or blood lipids in healthy people. Because of these conflicting results, more research is needed to determine the effect of FOS on diabetes and lipid levels.
    1 Star
    Ginkgo
    Refer to label instructions
    Ginkgo may help prevent and treat early-stage diabetic neuropathy.
    Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.
    1 Star
    Goldenseal
    1 gram per day of berberine for two months
    Preliminary research with berberine (an active compound in goldenseal) for two months lowered blood glucose levels in people with type 2 diabetes.
    In a preliminary trial, supplementation with 1 gram per day of berberine (one of the active compounds in goldenseal) for two months significantly lowered blood glucose levels in patients with type 2 diabetes.
    1 Star
    Green Coffee Extract
    Refer to label instructions
    Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies.
    Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies. Test tube studies suggest that chlorogenic acid, a primary constituent found in both coffee and in green coffee extract may inhibit glucose production by the liver, which could theoretically lead to lower blood sugar. An animal study found that green coffee extract also prevented the reduction in insulin sensitivity caused by a high-fat diet. No human studies have tested the effect of green coffee extract on reducing risk of diabetes or improving insulin sensitivity, but a double-blind trial found that healthy people who drank a sweetened coffee beverage containing green coffee extract (providing 400 to 450 mg of chlorogenic acids) had lower blood sugar during the following two hours compared to when they drank the same coffee beverage without added green coffee extract. More research is needed to determine whether green coffee extract can help prevent or treat type 2 diabetes.
    1 Star
    Hibiscus
    Refer to label instructions
    Hibiscus is a traditional remedy in India for diabetes, and is supported by preliminary research.
    Hibiscus is a traditional remedy in India for diabetes; this treatment is supported by preliminary studies from that country and by animal studies. Hibiscus is usually taken as tea, such as 1 to 2 teaspoons (3 to 6 grams) of dried flower infused in to 1 cup (250 ml) three times per day.
    1 Star
    Inositol
    Refer to label instructions
    Supplementing with inositol may improve diabetic neuropathy.
    Inositol is needed for normal nerve function. Diabetes can cause a type of nerve damage known as diabetic neuropathy. This condition has been reported in some, but not all, trials to improve with inositol supplementation (500 mg taken twice per day).
    1 Star
    Manganese
    Refer to label instructions
    People with diabetes may have low manganese levels, which can contribute to glucose intolerance. Supplementing with the mineral may help.
    People with diabetes may have low blood levels of manganese. Animal research suggests that manganese deficiency can contribute to glucose intolerance and may be reversed by supplementation. A young adult with insulin-dependent diabetes who received oral manganese chloride (3 to 5 mg per day as manganese chloride) reportedly experienced a significant fall in blood glucose, sometimes to dangerously low levels. In four other cases, manganese supplementation had no effect on blood glucose levels. People with diabetes wishing to supplement with manganese should do so only with a doctor's supervision.
    1 Star
    Medium-Chain Triglycerides
    Refer to label instructions
    Medium-chain triglycerides have been found to lower blood sugar levels and may be useful in treating type 3 diabetes.
    Based on the results of a short-term clinical trial that found that medium-chain triglycerides (MCT) lower blood glucose levels, a group of researchers investigated the use of MCT to treat people with type 2 diabetes mellitus. Supplementation with MCT for an average of 17.5% of their total calorie intake for 30 days failed to improve most measures of diabetic control.
    1 Star
    Mistletoe
    Refer to label instructions
    Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and it may reduce diabetes symptoms.
    Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and animal research found that it reduces symptoms of diabetes. No research in humans has yet been published; however, given mistletoe's worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Traditionally, mistletoe is prepared by soaking 2 to 4 teaspoons (5 to 12 grams) of chopped mistletoe in 2 cups (500 ml) of water overnight. The mixture is drunk first thing in the morning and sweetened with honey if desired. Another batch may be left to steep during the day and drunk at bedtime.
    1 Star
    Olive Leaf
    Refer to label instructions
    Olive leaf extracts have been used experimentally to lower high blood sugar in diabetic animals.
    Olive leaf extracts have been used experimentally to lower elevated blood-sugar levels in diabetic animals. These results have not been reproduced in human clinical trials.
    1 Star
    Quercetin
    Refer to label instructions
    Quercetin may be helpful for its ability to reduce levels of sorbitol-a sugar that accumulates in cells and damages the nerves, kidneys, and eyes of people with diabetes.
    Doctors have suggested that quercetin might help people with diabetes because of its ability to reduce levels of sorbitol-a sugar that accumulates in nerve cells, kidney cells, and cells within the eyes of people with diabetes-and has been linked to damage to those organs. Clinical trials have yet to explore whether quercetin actually protects people with diabetes from neuropathy, nephropathy, or retinopathy .
    1 Star
    Reishi
    Refer to label instructions
    Reishi may have some beneficial action in people with diabetes.

    Animal studies and some very preliminary trials in humans suggest reishi may have some beneficial action in people with diabetes.

    1 Star
    Taurine
    Refer to label instructions
    Supplementing with taurine may affect insulin secretion and action, and may help protect the eyes and nerves from diabetic complications.
    Animal studies have shown that supplementing with taurine, an amino acid found in protein-rich food, may affect insulin secretion and action, and may have potential in protecting the eyes and nerves from diabetic complications. However, a double-blind trial found no effect on insulin secretion or sensitivity when men with high risk for developing diabetes were given 1.5 grams per day of taurine for eight weeks. In another double-blind trial, taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes.
    1 Star
    Vanadium
    Refer to label instructions
    Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.
    Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes. Over a six-week period, a small group of people with type 2 diabetes were given 75 to 300 mg of vanadyl sulfate per day. Only in the groups receiving 150 mg or 300 mg was glucose metabolism improved, fasting blood sugar decreased, and another marker for chronic high blood sugar reduced. At the 300 mg level, total cholesterol decreased, although not without an accompanying reduction in the protective HDL cholesterol. None of the amounts improved insulin sensitivity. Although there was no evidence of toxicity after six weeks of vanadyl sulfate supplementation, gastrointestinal side effects were experienced by some of the participants taking 150 mg per day and by all of the participants taking 300 mg per day. The long-term safety of the large amounts of vanadium needed to help people with type 2 diabetes (typically 100 mg per day) remains unknown. Many doctors expect that amounts this high may prove to be unsafe in the long term.
    1 Star
    Vitamin B3 (Niacin)
    Refer to label instructions
    Small amounts of niacin (a form of vitamin B3) may help some people with type 2 diabetes.
    The intake of large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision. Smaller amounts (500 to 750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes, though this research remains preliminary.
    1 Star
    Yerba Mate
    Refer to label instructions
    Preliminary research suggests yerba mate (Ilex paraguariensis) tea may improve measures of blood glucose control in people with type 2 diabetes.
    In a preliminary trial, consumption of mate (Ilex paraguariensis) tea in the amount of 330 ml (about 12 ounces) 3 times per day for 60 days improved measures of blood glucose control in patients with type 2 diabetes.

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