Alternative Treatment for Diabetes

Principal Proposed Treatments for Diabetes
References

Diabetes has two forms. In the type that develops early in childhood (type 1), the insulin-secreting cells of the pancreas are destroyed (probably by a viral infection), and blood levels of insulin drop nearly to zero. However, in the adult-onset form (type 2), insulin is often plentiful, but the body does not respond normally to it. (This is only an approximate description of the difference between the two types.) In both forms of diabetes, blood Sugar reaches toxic levels, causing injury to many organs and tissues.

Conventional treatment for childhood-onset diabetes includes insulin injections and careful dietary monitoring. The adult-onset form may respond to lifestyle changes alone, such as increasing exercise, losing weight, and improving diet. Various oral medications are also often effective for adult-onset diabetes, although insulin injections may be necessary in some cases.

Principal Proposed Treatments for Diabetes

Several alternative methods may be helpful when used under medical supervision as an addition to standard treatment. They may help stabilize, reduce, or eliminate medication requirements; reduce the symptoms of diabetic complications; or correct nutritional deficiencies associated with diabetes. However, because diabetes is a dangerous disease with many potential complications, alternative treatment for diabetes should not be attempted as a substitute for conventional medical care.

Treatments for Improving Blood Sugar Control

The following treatments may be able to improve blood Sugar control in type 1 and/or type 2 diabetes.

Note: Keep in mind that if these treatments work, you will need to reduce your medications to avoid hypoglycemia. For this reason, medical supervision is essential.

Chromium: Helpful in Type 2 Diabetes

Chromium is an essential trace mineral that plays a significant role in sugar metabolism. Reasonably good evidence suggests that chromium supplementation may help bring blood sugar levels under control in type 2 diabetes. It may also be helpful for pregnancy-related diabetes.

A 4-month study reported in 1997 followed 180 Chinese men and women with type 2 diabetes, comparing the effects of 1,000 mcg chromium, 200 mcg chromium, and placebo.1 The results showed that HbA1c values (a measure of long-term blood sugar control) improved significantly after 2 months in the group receiving 1,000 mcg, and in both chromium groups after 4 months. Fasting glucose was also lower in the group taking the higher dose of chromium.

Similarly positive results were seen in other small studies.2,3 However, there have also been negative results.4,5

One placebo-controlled study of 30 women with pregnancy-related diabetes found that supplementation with chromium (at a dosage of 4 or 8 mcg chromium picolinate for each kilogram of body weight) significantly improved blood sugar control.6

Chromium might also be helpful for treating diabetes caused by corticosteroid treatment.7,8

The optimum dosage of chromium is not known. The usual recommended therapeutic dosage is 400 to 600 mcg daily (as chromium picolinate). However, one of the recent studies just described used a higher dose.

Since there have been a few worrisome case reports of toxic effects when chromium has been taken at daily doses of 1,200 mcg or higher,9,10 you should consult with your physician on what might be the appropriate dosage for you. Pregnant women should keep in mind that there are also concerns, still fairly theoretical, that chromium picolinate could cause adverse effects on DNA.11

Fenugreek: Appears to Be Helpful

The food spice fenugreek may also help control blood sugar. For millennia, fenugreek has been used both as a medicine and as a spice in Egypt, India, and the Middle East. Numerous animal studies, as well as small-scale trials in humans (none of which were double-blind) involving a total of about 100 people, have found that fenugreek can reduce blood sugar and serum cholesterol levels in people with diabetes.12,13,14 It seems to be helpful in both type 1 and type 2 diabetes.

Dosage Because the seeds of fenugreek are somewhat bitter, fenugreek is best taken in capsule form. The typical dosage is 5 to 30 g 3 times a day with meals, taken indefinitely.

Safety Issues As a commonly eaten food, fenugreek is generally regarded as safe. The only common side effect is mild gastrointestinal distress when it is taken in high doses.

Extracts made from fenugreek have been shown to cause uterine contractions in guinea pigs.15 For this reason, pregnant women should not take fenugreek in doses higher than is commonly used as a spice, perhaps 5 g daily. Safety in young children, nursing women, or those with severe liver or kidney disease has also not been established.

Gymnema: Preliminary Evidence Suggests It Is Effective

A few preliminary studies suggest that the Ayurvedic (Indian) herb gymnema may help improve blood sugar control.16,17,18 In practice, many clinicians report that gymnema is more powerful than the other treatments described in this section. It might be helpful for mild cases of adult-onset diabetes, taken alone or in combination with standard treatment (under a doctor's supervision in either case).

The usual dose of gymnema ranges from 400 to 600 mg daily of an extract standardized to contain 24% gymnemic acids. Because no formal safety studies have been conducted, gymnema should not be taken by young children, pregnant or nursing women, or those with severe kidney or liver disease.

Ginseng: Promising New Evidence

A double-blind study evaluated the effects of ginseng in 36 people newly diagnosed with adult-onset diabetes over an 8-week period.19 The results showed a reduction in glucose levels, improved glycosylated hemoglobin (a measure of long-term blood sugar control), and improved physical capacity. The authors believed that it was the increased activity that improved blood sugar.

Improved blood sugar control was also seen in two small double-blind placebo-controlled trials using American ginseng (Panax quinquefolius).20,21

Although ginseng is generally believed to be safe, safety in young children, pregnant or nursing women, and those with severe kidney or liver disease has not been established. (See the article on ginseng for a more detailed discussion of the potential safety issues associated with this herb.)

Aloe: More Famous for Burns

The succulent aloe plant has been valued since prehistoric times for the treatment of burns, wound infections, and other skin problems. However, recent evidence suggests that oral aloe might be useful for type 2 diabetes.

Evidence from some but not all animal and human studies suggests that aloe gel can improve blood sugar control.22–27

For example, a single-blind placebo-controlled trial evaluated the potential benefits of aloe in either 72 or 40 individuals with diabetes (the study report appears to contradict itself).28 The results showed significantly greater improvements in blood sugar levels among those given aloe over the 2-week treatment period.

Another single-blind placebo-controlled trial evaluated the benefits of aloe in individuals who had failed to respond to the oral diabetes drug glibenclamide.29 Of the 36 individuals who completed the study, those taking glibenclamide and aloe showed definite improvements in blood sugar levels over 42 days as compared to those taking glibenclamide and placebo.

While these are promising results, large studies that are double- rather than single-blind will be needed to establish aloe as an effective treatment for hypoglycemia.

For the treatment of diabetes, a dosage of 1 tablespoon of aloe vera juice twice daily has been used in studies.

Other than occasional allergic reactions, no serious problems have been reported with aloe gel, whether used internally or externally. However, comprehensive safety studies are lacking. Safety in young children, pregnant or nursing women, or individuals with severe liver or kidney disease has not been established.

Vanadium: May Be Helpful, But Presents Risks

Studies in rats with and without diabetes suggest that the mineral vanadium may have an insulin-like effect, reducing blood sugar levels.30–40 Based on these findings, preliminary studies involving human subjects have been conducted, with mostly promising results.41–46 However, this evidence is too limited to be taken as definitive proof. Furthermore, studies in humans and animals suggest that vanadium can cause toxic effects and might accumulate in the body if taken to excess.47–51 Based on these results, high dosages of vanadium can't be considered safe for human use. Taking vanadium at nutritional doses, however, might be helpful to some extent (10 to 30 mcg daily).

Other Treatments That May Help Control Blood Sugar

Preliminary evidence suggests that the herbs bilberry leaf, bitter melon (Momordica charantia), Coccinia indica, garlic, holy basil (Ocimum sanctum), nopal cactus (Opuntia streptacantha), onion, pterocarpus, and salt bush and the supplements CLA (conjugated linoleic acid) and glucomannan might be helpful for diabetes.52–79 Other herbs traditionally used for diabetes that might offer some benefit include Cuminum cyminum (cumin), Azadirachta indica (neem), Musa sapientum L. (banana), Anemarrhena asphodeloides, Catharanthus roseus, Cucumis sativus, Cucurbita ficifolia, Euphorbia prostrata, Guaiacum coulteri, Guazuma ulmifolia, Lepechinia caulescens, Medicago sativa (alfalfa), Phaseolus vulgaris, Psacalium peltatum, Rhizophora mangle, Spinacea oleracea, Tournefortia hirsutissima, and Turnera diffusa.80–88

Preliminary studies indicate that vitamin E may also slightly improve blood sugar control in type 2 diabetes.89,90 (For a discussion of the safety issues and the proper dosage amounts, see the article on vitamin E.) The supplements carnitine, coenzyme Q10, and Lipoic acid (better known as a treatment for complications of diabetes as described under the heading Treating Complications of Diabetes) might also be helpful.91,92,93

If your child has just developed diabetes, the supplement niacinamide—a form of niacin, also called vitamin B3—may prolong what is called the honeymoon period.94 This is the interval during which the pancreas can still make some insulin, and insulin needs are low. By giving your child niacinamide, you may be able to buy some time to allow him or her to adjust to a life of insulin injections.

When used as therapy for a specific disease, niacinamide is taken in dosages much higher than nutritional needs, about 1 to 4 g daily. Because there is a risk of liver inflammation at these dosages, medical supervision is essential.

The supplement biotin is also sometimes said to be helpful in diabetes, for both blood sugar control and reduction of complications, but there is as yet little direct evidence that it works.

Warning: Recent animal studies and case reports have raised concerns that the supplement glucosamine might raise blood sugar levels in individuals with diabetes.95–99

Treating Complications of Diabetes

Several supplements may help prevent or treat some of the common complications of diabetes.

Because atherosclerosis is one of the worst problems associated with diabetes, all the suggestions discussed in the article on atherosclerosis may be useful.

Other herbs and supplements may be helpful for diabetic neuropathy, diabetic retinopathy, and diabetic cataracts, so the treatments discussed in the article on cataracts may also be of use.

Lipoic Acid: Standard German Treatment for Diabetic Neuropathy

Lipoic acid has been widely used in Germany for decades to treat diabetic peripheral neuropathy, a painful nerve condition that often develops after many years of diabetes. However, most of the evidence of its effectiveness for this condition is limited to studies that used the intravenous form of lipoic acid.

This naturally occurring antioxidant may also help prevent and treat cardiac autonomic neuropathy (injury to the nerves controlling the heart).

Lipoic acid is a vitamin-like substance that plays a role in the body's utilization of energy. Because lipoic acid can be synthesized from other substances, it is not considered an essential nutrient. However, in people with diabetes, levels of lipoic acid are reduced,100 which suggests (but definitely does not prove) that supplementation would be helpful.

According to some preliminary evidence, lipoic acid may be more effective if it is combined with GLA (gamma-linolenic acid), another supplement used for diabetic neuropathy.101,102

What Is the Scientific Evidence for Lipoic Acid? There is some evidence that intravenous lipoic acid can reduce symptoms of diabetic peripheral neuropathy, at least in the short term. Oral lipoic acid has not been well evaluated, and the best study of oral lipoic acid found it ineffective for long-term use.

A randomized double-blind placebo-controlled study that enrolled 503 individuals with diabetic neuropathy found that intravenous lipoic acid helped reduce symptoms over a 3-week period, but long-term oral supplementation was not effective.103

A previous double-blind placebo-controlled trial also found short-term benefit with intravenous lipoic acid.104,105

Warning: Do not inject lipoic acid products intended for oral use.

The positive evidence for oral lipoic acid in diabetic peripheral neuropathy is limited to open studies or trials that were too small upon which to base conclusions.106–110

The DEKAN (Deutsche Kardiale Autonome Neuropathie) study followed 73 people with diabetes, who had symptoms of cardiac autonomic neuropathy, for 4 months.111 Treatment with 800 mg of oral lipoic acid daily showed significant improvement compared to placebo and no important side effects.

Dosage The typical dosage of oral lipoic acid for diabetic peripheral neuropathy is 300 to 600 mg daily, divided into 2 or 3 doses. For cardiac autonomic neuropathy, a higher dosage of 800 mg daily has been used in studies.

Because lipoic acid occasionally improves the body's response to insulin, it may be necessary to start with lower doses and gradually increase while monitoring blood sugar levels under a physician's supervision.

Safety Issues Lipoic acid appears to have no significant side effects at dosages up to 1,800 mg daily.112

Safety for young children, women who are pregnant or nursing, or those with severe liver or kidney disease has not been established. It is also possible that lipoic acid might improve blood sugar control in some cases, and therefore require a reduction in diabetes medications.113

GLA (from Evening Primrose): Probably Helpful, but Slow-Acting

The evening primrose is a native American wildflower, named for the late-afternoon opening of its delicate flowers. Perhaps it should be described as a food supplement rather than an herb, for evening primrose oil has been popularized mainly as a source of GLA (gamma-linolenic acid), an essential fatty acid also found in black currant and borage oil.

Although many other kinds of fat are unhealthy, essential fatty acids (EFAs) are as necessary as vitamins. The two main kinds of EFAs are called omega-3 and omega-6 fatty acids. The GLA in evening primrose oil is an omega-6 fatty acid. A growing body of scientific evidence suggests that supplementation with GLA may help relieve symptoms of diabetic neuropathy. Fish oil may be helpful as well.114

What Is the Scientific Evidence for GLA? Many studies in animals have shown that evening primrose oil can protect nerves from diabetes-induced injury.115,116 Good results were also seen in a double-blind study that followed 111 people with diabetes from seven medical centers for a period of 1 year.117 The results showed an improvement in subjective symptoms such as pain and numbness as well as objective signs of nerve injury. Individuals with good blood sugar control improved the most. Earlier double-blind studies also reported positive results.118

Dosage A typical dosage of evening primrose oil for diabetic neuropathy is 4 to 6 g daily. It should be taken with food. Keep in mind that full results may take over 6 months to develop.

Safety Issues Animal studies suggest that evening primrose oil is nontoxic and noncarcinogenic.119 Over 4,000 people have taken GLA or evening primrose oil in scientific studies, and no significant adverse effects have ever been noted.

Early reports suggested the possibility that GLA might worsen temporal lobe epilepsy, but this has not been confirmed.120

Maximum safe dosages in young children, pregnant or nursing women, and those with severe kidney or liver disease have not been established.

Other Treatments to Help Treat Complications of Diabetes

According to a 52-week double-blind trial of 19 individuals with diabetes, acetyl-L-carnitine may help prevent or slow down cardiac autonomic neuropathy (injury to the nerves of the heart caused by diabetes).121

Intriguing evidence suggests that vitamin E may help protect people with diabetes from developing damage to their eyes and kidneys.122 There is also some evidence that vitamin E as well as selenium might be beneficial for diabetic peripheral neuropathy.123,124 The supplement inositol has also been tried as a treatment for complications of diabetes, but the results have been mixed.125,126

Weak evidence suggests that the herb bilberry (120 to 240 mg twice daily of an extract standardized to contain 25% anthocyanosides) may help prevent eye damage caused by diabetes.127,128 (For a more complete discussion of bilberry use and safety issues, see the article on this herb.)

OPCs and ginkgo are said to provide similar benefits, although the evidence for these is weaker than that for bilberry. (See the articles on these substances for more complete discussions.)

Vitamin C is believed to help prevent cataracts in general.129,130 It is not known for sure whether vitamin C produces the same benefit in people with diabetes. However, it has been suggested that vitamin C may actually be especially useful because of its relationship to sorbitol, a sugar-like substance that tends to accumulate in the cells of people with diabetes. Sorbitol is believed to play a role in the development of diabetic cataracts, and vitamin C appears to help reduce sorbitol buildup.131 However, the evidence that vitamin C provides significant benefits by this route is at present indirect and far from conclusive. A daily dose of 500 mg should be safe and sufficient.

Preliminary evidence suggests that oxerutins might also be helpful for reducing foot and ankle swelling in people with diabetes.132 In these trials, oxerutin therapy did not affect blood sugar control.

Warning: There is some evidence that the substance glucosamine, used for arthritis, may increase the risk of diabetic cataracts.133

Treating Nutritional Deficiencies in Diabetes

Both diabetes and the medications used to treat it can cause people to fall short of various nutrients. Making up for these deficiencies (either through diet or the use of supplements) may not help your diabetes, but it should make you a healthier person overall.

Magnesium appears to be the most common mineral deficiency in type 1 diabetes.134,135 People with either type 1 or type 2 diabetes may also be deficient in the mineral zinc.136,137,138 Vitamin C levels have been found to be low in many diabetics on insulin, even though they were consuming seemingly adequate amounts in their diets.139,140,141 Some people with type 1 diabetes appear to be deficient in the amino acid taurine.142 Finally, manganese deficiency reportedly can occur.143

The drug metformin can cause vitamin B12 deficiency.144 Interestingly, taking extra calcium may prevent this.145

Dosage and Safety Issues

So that you do not take unnecessary supplements, you may want to undergo testing to determine whether you are actually deficient in any of these nutrients. However, such testing is expensive. Because these are safe supplements, you may want to take them simply as insurance.

Typical dosages for nutritional correction in diabetes are as follows: magnesium, 350 to 450 mg daily; zinc, 15 to 30 mg daily (combined with 1 to 3 mg daily of copper); vitamin C, 500 mg daily; taurine, 2 to 6 g daily; and manganese, 2 to 5 mg daily. A general multivitamin and mineral may not be a bad idea, either, for there may be many other marginal deficiencies in diabetes. However, if you suffer from diabetic kidney disease, you should not take any supplements except on the advice of a physician.

People with diabetes should not take high doses of niacin, as it can worsen blood sugar control.

Preventing Diabetes

Exciting evidence from a huge study conducted in New Zealand suggests that the supplement niacinamide—a form of niacin, also known as vitamin B3—might be able to reduce the risk of diabetes in children at high risk.146 In this study, more than 20,000 children were screened for diabetes risk by measuring certain antibodies in the blood (ICA antibodies, believed to indicate risk of developing diabetes). It turned out that 185 of these children had detectable levels. About 170 of these children were then given niacinamide for 7 years (not all parents agreed to give their children niacinamide or stay in the study for that long). About 10,000 other children were not screened, but they were followed to see whether they developed diabetes.

The results were very impressive. In the group in which children were screened and given niacinamide if they were positive for ICA antibodies, the incidence of diabetes was reduced by as much as 60%.

These findings suggest that niacinamide is a very effective treatment for preventing diabetes. (It also shows that tests for ICA antibodies can very accurately identify children at risk for diabetes.)

At present, an enormous-scale, long-term trial called the European Nicotinamide Diabetes Intervention Trial is being conducted to definitively determine whether regular use of niacinamide can prevent diabetes. Results from the German portion of the study have been released, and they were not positive;147 however, until the entire study is complete, it is not possible to draw conclusions.

For prevention of diabetes in children, the usual dosage of niacinamide is 25 mg per kilogram body weight per day. There are 2.2 pounds in a kilogram, so a 40-pound child would get about 450 mg daily. For safety information, see the article on vitamin B3.

Warning: Medical supervision is essential before giving your child long-term niacinamide treatment.



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Scientific information is constantly evolving. On this site, we are continually in the process of incorporating new studies and reevaluating old studies. For this reason, the material you see here will change over time. Keep in mind also that this material is not intended to be a substitue for professional medical advice. You should not use this material to diagnose or treat a health condition without consulting with a qualified healthcare provider.



Scientific information is constantly evolving. On this site, we are continually in the process of incorporating new studies and reevaluating old studies. For this reason, the material you see here will change over time. Keep in mind also that this material is not intended to be a substitue for professional medical advice. You should not use this material to diagnose or treat a health condition without consulting with a qualified healthcare provider.






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