Download Diabetes? - H and N Herbs

Supplementation
to ManageDiabetes
ByYousry Naguib, Ph.D.
f
D
~
if:
iabetes is a chronic disease
affecting 16 million people in
the U.S., and more than 125
million worldwide. It is the fourth-leading cause of death by disease in the
United States. About two-thirds of the
nearly 16 million people with type II diabetes in the u.S. are overweight, according to the American
Diabetes
Association. The pancreas in diabetic
people produces little or no insulin, the
hormone responsible for facilitating
uptake of glucose by cells to give energy.
There are two main types of diabetes mellitus: adult-onset diabetes,
also called Type II or non-insulindependent
diabetes
mellitus
(NIDDM); and childhood-onset diabetes, also called Type I, or insulindependent diabetes mellitus (IDDM).
In Type I, the pancreas cannot make
the insulin needed to process glucose.
Type I most often occurs in children and
young adults. Individuals suffering from
Type I are totally insulin dependent.
Without regular injections of insulin,
the sufferer lapses into a coma and dies.
Type II accounts for 90 to 95 percent of diabetes, is usually of gradual
onset, and occurs mainly in people over
40. It is a metabolic disorder resulting
from the body's inability to make
enough, or properly use, insulin. Type II
diabetes is nearing epidemic proportions
due to a greater prevalence of obesity.
The combination of dietary measures,
weight reduction, and oral medication
can keep the condition under control for
a period of time, but most people with
Type II ultimately require insulin injections.
Diabetes can bri~g about a variety of
complications, usually progressive and
irreversible. Diabetes may be controlled
with insulin and in some cases through
careful diet. Weightloss is consideredthe
cornerstone of treatment in Type II diabetics because it allows the body to better
use insulin and thus lowers blood sugar.
52
Vitamin Retailer.
February 2003
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Researchers at Harvard found that
more than 90 percent of the 3,300
women who developed diabetes over a
16-year study period were overweight,
inactive, and smokers. The researchers
followed 85,000 female nurses who
were free of heart disease, diabetes,
and cancer at the beginning of the
study. Being overweight or obese was
the most important diabetes risk predictor, followed by lack of exercise.
The study suggests most diabetes can
be prevented through diet and exercise.
It is the
fourth-leading
cause of death by
disease in the
United States.
HERBAL SUPPLEMENTS
Fenugreek
Fenugreek (Trigonella foenumgraecum) has been used for hundreds of years,
as a spice and as a medicinal supplement.
Several studies, including one published
in 1990 in the European Journal of
Clinical Nutrition, suggest that this herb
can lower blood sugar. Researchers found
that type I diabetics who took 50 grams of
fenugreek seed powder twice daily had
significantly lower blood sugar levels than
those taking a placebo.!
In a recent double-blind placebo controlled study, 25 newly diagnosed Type II
diabetics (fasting glucose less than 200
mg/dl) were randomly assigned to receive
1-g daily hydro-alcoholic extract of fenugreek seeds or a placebo for two months.
The fenugreek group had significantly
lower insulin resistence and improved
glycemic controL2
Fenugreek seeds are rich in galactomannan, which are soluble fibers.
Research showed that galactomannan in
fenugreek decreased the hypoglycemic
effect of foods.3 Acatris (Schouten) company has recently introduced an odorless
fenugreek extract under the trade name
FenuLife. Technical Sourcing also introduced a new dietary supplement called
Promilin containing the main bioactive
ingredient 4-hydroxyisoleucine, derived
from fenugreek. Recent findings support
the role of 4-hydroxyisoleucine in supporting blood sugar balance, reducing body fat,
and aiding muscle growth and recovery.4
Bitter melon
Bitter melon (Momordica charantia
Linn.), commonly known as Karela, has
been reported to have hypoglycemic,
antiviral, anti-diabetic, and anti-tumor
activities. In a recent clinical study, Bitter
melon was shown to significantly reduce
both fasting and post-prandial (bloodsugar levels after carbohydrate consumption) serum glucose levels in non-insulin
dependent diabetes mellitus patients.s
Panax Ginseng
Ginseng is traditionally considered a
tonic and has been shown to help lower
blood glucose levels. In a recent randomized placebo controlled study, researchers
in Toronto examined the effects of
American ginseng (Panax quinquefolius)
on the blood sugar levels of 19 subjects.
Ten non-diabetics took 3 g of American
ginseng or placebo, either 40 minutes
before or while ingesting a high-sugar
solution. Nine Type II diabetics received
the same treatments. Taking the ginseng
before the sugar dose led to a significant
reduction in glucose absorption among
both diabetics and the non-diabetics.
When the sugar solution was taken simultaneously with the American ginseng, the
diabetics still experienced a reduction,
whereas the non-diabetics did not.6
~
Diabetes
Garcinia
The South Asian fruit Garcinia
cambogia is about the size of an
orange and looks similar to a small
pumpkin. It contains the popular
weight-loss ingredient hydroxycitric
acid. Hydroxycitric acid derived from
garcinia works at the cellular level to
keep carbohydrates from turning into
fat, and to suppress appetite and to
provide energy.?
Animal studies with hydroxycitric
acid have demonstrated that inhibition
of adenosine triphosphate (ATP) citrate lyase enzyme, an enzyme required
for converting carbohydrates into fat,
leads to a decrease in the synthesis of
both cholesterol and fatty acids.8
Gymnema sylvestre
Gymnema sylvestre is a tropical
plant of the milkweed family native to
India. The leaf is the primary part used
in medicinal purposes. The plant has
been used traditionally for stomach
problems, constipation, and controlling
Hi
Type II diabetes. Gymnema sylvestre
extract suppresses the craving for
sweets and regulates blood sugar levels.
The active ingredient of gymnema is
gymnemic acid, which was found to have
the ability to fill the receptor sites on the
taste buds, thereby preventing the sweet
taste of sugar molecules. Gymnemic acid
also occupies the receptor sites in the
absorptive layers of the intestine, thereby
blocking the absorption of sugar molecules from the intestine.9
In one study, extracts from gymnena
leaves (400 mg/day) were administered
for 18 to 20 months to 22 Type II diabetics taking conventional medication.
All patients showed a significant reduction in blood glucose levels. Five of the
22 maintained their blood glucose levels
without conventional drugs and the dose
was reduced in the others.lO
In another study,extracts of gymnema
were able to double the islet number
(clumps of pancreatic cells) and beta cell
number (insulin-producing cells) in diabetic rat pancreas. The study suggested
that gymnema may improve health of the
pancreas thereby providing a second
mechanism for its action in diabetes.II
Glucosol
Glucosol is a standardized extract
from Lagerstroemia speciosa L. leaves.
Lagerstroemia speciosa is commonly
known as crepe myrtle, and is widely
distributed in tropical countries, such as
the Philippines, India, and China. In the
Philippines a tea from the leaves has
been used as a beverage as well as for
treating diabetes mellitus. The leaves
contain significant amounts of corosolic
acid, which has previously been shown
to possess anti-diabetic properties and
significant amounts of tannins, of which
Lagerstoemin, flosin B, and reginin A
were identified.
The anti-diabetic activity of an
extract
from
the leaves
of
Lagerstroemia speciosa standardized
to 1 percent corosolic acid (Glucosol)
has been demonstrated in a clinical
trial,
sponsored
by Soft Gel
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Technologies, involving Type II diabetics, who received a daily oral dose
of Glucosol in either a soft gel capsule
or powder formulation.
Gotu kola
In a recent clinical trial, gotu kola
(Centella asiatica) was found to improve
existing nerve disease in diabetics. A
total of 340 participants were divided
into three groups: group A, 50 diabetics
with peripheral neuropathy (a distorted
nerve function); group B, 250 diabetics
without signs of neuropathy; and group
C, 40 healthy non-diabetics. Groups A
and B were randomly assigned to take
either 60 mg of gotu kola twice a day or
a placebo, while all in group C took
placebo.
After 12 months,
the
researchers noted that diabetics both
with and without neuropathy had
improved blood flow to the feet and less
ankle swelling, suggesting that the herb
can help treat and prevent neuropathy
complications.12
Stevia
The plant Stevia rebaudiana Bertoni
has been used as a tea for many years in
the treatment of diabetes among Indians
in Paraguay and Brazil. Stevia has no
calories. It stimulates the release of
insulin via a direct action on the pancreatic beta cells and normalizes the
response to glucose, especially in Type
II diabetes.13
Maitake Mushroom
Val ued in both Chinese and
Japanese herbology for 3,000 years, the
maitake mushroom was shown in trials
conducted with genetically diabetic
mice to improve blood sugar levels,
triglycerides, and insulin response.
Following these animal studies, case
studies were conducted at New York
Medical College with five volunteers
diagnosed with Type II diabetes; all
showed declines of more than 30 percent in their fasting blood glucose levels
under a maitake regimen.14
VITAMINS/MINERAL
SUPPLEMENTS
Vitamins B-12 (cyanocobalamine)
and B-6 (pyridoxine) work together
with the amino acid, tryptophan, to help
metabolize glucose in the cells. IS One
milligram of B12 and 10 mg of B6 are
recommended. Diabetics also have
increased free radical oxidation so
adding 100-800 IU of vitamin E gives
antioxidant protection. Vitamin E also
reduces glycosylation (the process of
adding sugar units to proteins) of glycohemoglobin.
Mineral supplements are also recommended to support glucose metabolism, but they are poorly absorbed by
the body; their absorption can be
increased by chelating (binding) the
mineral to an organic substance, in particular amino acids.16 Vanadium has
been shown to have an insulin-mimicking effect in rats. Artificially induced
diabetes in rats can be reversed with
vanadium. Black pepper and dill seed
are the richest sources of vanadium.
Vanadium can be harmful if it is overdosed so it is not recommended in
patients unless they are strictly monitored. The beneficial dose is 250 mcg
three times daily.17
Magnesium modulates glucose
transport and is a cofactor involved in
glucose oxidation. Patients with magnesium deficiencies can have insulin
resistance. Ketoacidosis (the accumulation of ketone molecules, such as
acetone, in body tissues and fluids)
promotes increased urinary loss of
magnesium.IS
Chromium is an essential nutrient
required for proper sugar and fat metabolism. Chromium deficiency is relatively common in Type II diabetics.
Chromium is poorly absorbed, only 2 to
10 percent of dietary intake being
absorbed. Organic chromium, such as
chromium picolinate (Chromax manufactured by Nutrition 21), and niacinbound chromium (ChromeMate made
by InterHealth) is absorbed more efficiently than inorganic chromium such as
chromium chloride.
Chromium supplements have been
successfully used to treat diabetes.
Super CitriMax
(developed
by
InterHealth) is a unique formula of
chromium polynicotinate and extracts of
Garcinia cambogia and Gymnema
sylvestre.
In one study, chromium picolinate
was found to improve glucose tolerance
in Chinese people with NIDDM. One
hundred and eighty Chinese subjects
with Type II diabetes were divided into
three groups of 60 and supplemented
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Diabetes
with placebo, or 100 or 500 mcg of
chromium picolinate, twice daily for
four months. Improvements in the glucose/insulin system were highly significant in the 500 mcg chromium group,
with less or no significant improvements in the other two groups. Plasma
total cholesterol also decreased after
four months in those receiving 500 mcg
chromium picolinate. These results indicate that the beneficial
effects of
chromium in diabetics are observed at
levels higher than the upper limit of the
Estimated Safe and Adequate Daily
Dietary Intake.1S
Another study involving 14 healthy
adults and five diabetic adults showed
that daily supplementation
with 200
mcg of chromium and nicotinic acid
lowered total and LDL cholesterol,
triglycerides,
and glucose concentrations in Type II diabetics. 19
II
OTHER SUPPLEMENTS
Alpha-lipoic acid
Alpha-lipoic acid (ALA) plays key
roles in our health as an antioxidant, and
as a cofactor for a number of vital
enzymes responsible for metabolism of
glucose and fatty acids to cellular energy. ALA also helps regulate blood
sugar, and prevents diabetic retinopathy,
and reduces symptoms of neuropathy.
Studies in Europe showed that taking
600 mg twice a day improved the symptoms of diabetic neuropathy.2o
In a multi-center, double-blind
placebo-controlled study, 328 Type II
diabetics with symptomatic peripheral
neuropathy were randomly assigned to
treatment with intravenous infusion of
ALA or placebo for three weeks.
Symptoms (pain, burning, and numbness in the feet) decreased significantly in the ALA-group taken 600 mg
daily, as compared to the placebo. The
study concluded that intravenous treatment with ALA (600 mg daily) over
three weeks is safe and effective in
reducing symptoms of diabetic peripheral neuropathy.20
Nuts and Peanut Butter
Researchers
in the Harvard
University study cited previously
reported that women who consumed
nuts or peanut butter five times per
week or more had a significantly lower
risk for Type II diabetes- almost 30
and 20 percent, respectively-compared to those who never or rarely ate
nuts or peanut butter. Nuts are high in
unsaturated (polyunsaturated
and
monounsaturated) fat and other nutrients that may improve glucose and
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[2] Gupta A et al. Effect of Trigonella foenumgraecum (fenugreek) seeds on glycemic control
and insulin resistence in type 2 diabetes mellitus: a double blind placebo controlled study. J
Assoc Physicians India 2001;49:1057
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[3] A1i L et al. Characterization
Vitamin Retailer.
of the hypo-
glycemic effects of Trigonella foenum graecum
seed. Planta Med 1995; 61:358
(continuedon page 59)
Circle reader service #46
56
Fiber
Lack of fiber in the American diet is
thought to contribute to the development
of Type II diabetes. Barley or fiber can
help maintain glucose control in diabetes.
It is best when taken with meals because
the fiber prevents the absorption of some
carbohydrates and allows more effective
use of carbohydrates that are absorbed.
Ingesting up to 30 g of both soluble and
non-soluble fiber is recommendedeven in
non-diabetics.23
In a recent study, researchers in
Dallas tested the effects of two diets:
one providing 24 g of fiber per day, and
another providing more than double that
amount. The diets were similar in nutrient levels and calories. After six weeks,
researchers found that subjects on the
higher-fiber diet had lower average
blood glucose levels. The findings suggest that diabetics may be able to reduce
drug intake by eating a fiber-rich diet.24
Green tea extract containing catechins has recently been shown to suppress increases in blood glucose and
insulin following carbohydrate ingestion
in rats. And the predominant active
ingredient was found to be epigallocatechin gallate.25
[1] Sharma RD et al. Effect of fenugreek seeds
on blood glucose and serum lipids in type I diabetes. Eur J Vlin NutI' 1990;44:301
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Evening Primrose Oil
In a double-blind trial, 6 g per day
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of diabetes. GLA is essential for producing prostaglandins. It has also been
shown to reverse neurological damage
in diabetics.22
References:
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insulin homeostasis. The stud)' rec,ommended regular nut consumption
in
place of refined grain products or red
or processed meats.21
February 2003
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---~
---~
-
..,
I
SCIENCE &. NATURE
,
Diabetes
[4] Broca C et al. 4-Hydroxyisoleucine:
experimental evidence of its insulino-tropic
and anti-diabetic properties. Am J Physiol
1999; 277 (4 Pt 1): E617
[5] Ahmad N et al. Effect of Momordica charantia extracts on fasting and post-prandial
serum glucose levels in NIDDM patients.
Bangladesh Med Res Coun Bull 1999; 25:11
[6] Vuksan V et al. American ginseng (Panax
quinquefolius
L) reduces post-prandial
glycemia in non-diabetic subjects and subjects
with type 2 diabetes mellitus. Archives of
Internal Medicine 2000; 160:1013
[7] Sergio W. A natural food, malabar
tamarind, may be effective in the treatment of
obesity. Medical Hypothesis 1988; 27:40
[8] Sullivan AC et al. Lipids 1977; 12:1;
Triscari J and Sullivan AC. Comparative
effects of hydroxycitrate on acetyl CoA carboxylase and fatty acid and cholesterol synthesis in vivo. Lipids 1977; 12:357
[9] Shimizu K et al. J Vet Med Sci 1997; 59:245
[10] Baskaran K et al. Antidiabetic effect of a
leaf extract from Gymnema sylvestre in noninsulin-dependent diabetes mellitus patients. J
Ethnopharmacoll990; 30:295
-,--,
--
PUR
(continued
from page 56)
[11] Shanmugasundaram
Gynrnema
sylvestre
ER. et al. Use of
leaf extract in the control
cardiovascular
of blood glucose in insulin-dependent
diabetes
mellitus. J Ethnopharmacoll990;
30:281
[20] Ruhnau KJ, Ziegler
Medicine 1999; 16:1040
[12] Angiology
S27-S31
[21] Jiang R et al. Nut and peanut butter con-
acts direct-
sumption
and risk of Type 2 diabetes
women. JAm Med Assoc 2002; 288:2554
in
[22] LaValle
to
[13] Jeppesen
2001:52
(SuppI2):
PB et al. Stevioside
ly on pancreatic beta cells to secrete
Metabolism 2000; 49:208
[14] Konno,
S. Maitake
hypoglycemic
effect
SX-fraction:
Possible
on diabetes
Alternative & Complementary
2001;7:366-370.
insulin.
mellitus.
Therapies
Dec.
[15] Mooradian,A.D.,et ill. Selected vitamins and
minerals in diabetes.Diabetes Care 17(5) 464-476
[16] Ashnead,H.D. The Roles of Amino Acid
Chelates in Animal Nutrition Noyes Press,
New Jersey: 1993
[17] LaValle JB. The nutritional solution to
hyperinsulinemia
and diabetes. Natural
Pharmacy 2(3): 20-21,1998
Pharmacy
Squalane
Health
AND
Beauty
FROM
Japan
1998; 2:20
[24] Chandalia
of
M et al. Beneficial
effects
high dietary fiber intake in patients with type
2 diabetes mellitus. New England Journal of
Medicine. 2000; 342
[25] Anderson
RA et al. Tea enhances
insulin
activity. J Agric Food Chem 2002; 50:7182
Yousry Naguib,
Ph.D., is manager
of
technical services at Soft Gel Technologies
Inc., a Los Angeles-based contract manufacturer. Naguib is an author and former
professor at Suez Canal University in
Egypt. He holds fwo u.s. patents.
--
Mayumi
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[19] Thomas VL et al. effect of chromium
nicotinic acid supplementation on selected
TM
solution
and diabetes.
[23] Vinik A. Dietary fiber in management
diabetes. Diabetes Care 11(2):160
[18] Anderson RA et al. Elevated intakes of
supplemental chromium improve glucose and
insulin variables in individuals with type II
diabetes. Diabetes 1997; 46:1786
Mayumi
D et al. Diabetic
JB. The nutritional
hyperinsulinemia
-
E
disease risk factors. Boil Trace
Elem Res 1996; 55:297
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