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Published by Bebe Stefanescu

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Published by: Bebe Stefanescu on Oct 26, 2010
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Natural Remedies
Vitamins that may be helpful
A variety of vitamins, minerals, amino acids, and other supplements may help with symptoms and deficiencies associated
with diabetes.
Multiple VitaminMineral Supplement
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.78
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.79 80 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.81 82 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.83 Chromium supplements improve glucose tolerance
in people with type 2 diabetes,84 apparently by increasing sensitivity to insulin.85 Chromium improves the processing of
glucose in people with prediabetic glucose intolerance and in women with diabetes associated with
pregnancy.86 87Chromium even helps healthy people,88 although one such report found chromium useful only when
accompanied by 100 mg of niacin per day.89 Chromium may also lower levels of total cholesterol, LDL cholesterol, and
triglycerides (risk factors in heart disease).90 91
A few trials have reported no beneficial effects from chromium supplementation.92 93 94 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.95 Many doctors recommend up to 1,000 mcg per day for people with diabetes.96
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.
People with type 2 diabetes tend to have low magnesium levels.97 Double-blind research indicates that supplementing with
magnesium overcomes this problem.98 Magnesium supplementation has improved insulin production in elderly people with
type 2 diabetes.99 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.100 Elders without diabetes can also produce more insulin as
a result of magnesium supplements, according to some,101 but not all, trials.102 However, in people with type 2 diabetes who
nonetheless require insulin, Dutch researchers have reported no improvement in blood sugar levels from magnesium
supplementation.103 The American Diabetes Association acknowledges strong associations between magnesium deficiency
and insulin resistance but has not said magnesium deficiency is a risk factor104 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.105 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.106The American Diabetes Association admits strong
associations...between magnesium deficiency and insulin resistance but will not say magnesium deficiency is a risk
factor.107 Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200
600 mg of magnesium per day.
Alpha lipoic acid
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.108 109 110 111 112 113 114 115 In a preliminary study, supplementing with 600 mg ofalpha lipoic acid per day for 18
months slowed the progression of kidney damage in patients with type 2 diabetes.116
Evening primrose oil
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.117
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.1 1 8 After-meal blood sugar levels are lower in people with diabetes given glucomannan in their
food,1 1 9 and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled
clinical trials. 120 121 122 One preliminary report suggested that glucomannan may also be helpful in pregnancy-related
diabetes.1 2 3 For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories in the diet has been used
successfully in controlled research.
Vitamin E
People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.124 125Vitamin E
supplementation has improved glucose tolerance in people with type 2 diabetes in most,126 127128 but not all,129 double-blind
trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.130 131 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.132 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic
retinopathy and nephropathy,133 134 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,135 136 137 138 139although not all,140 141 142 studies.
In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.143 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).144
Vitamin C
As with vitamin E, vitamin C may reduce glycosylation.145 Vitamin C also lowers sorbitol levels in people with
diabetes.146 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,147 148although not every study confirms this
benefit.149 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.150 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.151
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).152 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
B Vitamins
Many people with diabetes have low blood levels of vitamin B6.153 154 Levels are even lower in people with diabetes who also
have nerve damage (neuropathy).155 Vitamin B6 supplementation has improved glucose tolerance in women with diabetes
caused by pregnancy.156 157 Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control
pills.158 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.159 Standard vitamin B6 has helped in some,160 but not all,
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.162However, 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.163 As a result, some
doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake
remains unknown.
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.164 Biotin may also reduce pain from diabetic nerve
damage.165 Some doctors try 9 to 16 mg of biotin per day for a few weeks to see if blood sugar levels will fall.
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.166 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.167 Oral vitamin B12 up to 500 mcg three times per day is
recommended by some practitioners.
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.168 169 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,170 though this research remains
Coenzyme Q10
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.171 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 CoQ10.172 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.
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.173
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.174 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.
People with type 2 diabetes tend to be zinc deficient,175 but some evidence indicates that zinc supplementation does not
improve their ability to process sugar.176 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.
Because oxidation damage is believed to play a role in the development of diabetic retinopathy, antioxidant nutrients might
be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A,
and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people
showed either improvement or no progression of their retinopathy.177 People who wish to supplement with more than 250
mcg of selenium per day should consult a healthcare practitioner.
Vitamin D
Vitamin D is needed to maintain adequate blood levels of insulin.178 Vitamin D receptors have been found in the pancreas
where insulin is made, and preliminary evidence suggests that supplementation can improve some measures of blood sugar
control in people with type 2 diabetes.179 180 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.
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).181
Animal studies have shown that supplementing with taurine, an amino acid found in protein-rich food, may affect insulin

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