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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 - -- -- 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 -~-~---~--~ ~~ THINK IMMUNE. (~rggDI~ Leaders in Neem Therapy ~ , . Traditional Ayurvedic tonic and blood cleanser . Assists glucose level maintenance . Supports proper digestion THINK AGARICUS BIa"'. Our team of health expelts fofn1U- act as building blocks in strengthlated Agaricus Bio to support the ening and enhancing the immune immune system. Studies have sytem*. To find out how Agaricus shown that the Agaricus blazei Bio can help you. please call us at or email us at mushroom helps to increase and (310)727-1565 boost Natllral Killer Cells, which info@at]asworldusa.eom. ,I' ii ~ AtlasWoddUSAInc. www.adasworldusa.com * These Slalementshave not been evaluated hy the FDA. This product is not inlended to diagnose, treat, cure or prevent any dise",c. Circle reader service #43 54 Vitamin Retailer. . Promotes healthy skin . Vegetarianformula SKIN CARE + INTERNALS + PET CARE Organix-South, Inc. Clearwater, www.organixsouth.com 1-800-989- NEEM FL (~ Discover the Power of Neem Circle reader service #44 February 2003 ---- 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 Do You Have Indigestion? Gas? Bloating? Acid Refl ux? As we age, the G.!. tract gets "out of shape" and as a result many digestive disorders occur. Venessa's High-Potency called Digestion Support has 18 ingredients that start relieving indigestion in less Dr. Formula than 20 minutes. Don't live with the intolerable effects of indigestion. Fight back with Dr. Venessa's Digestion Support today! Do You Have Sugar Problems? Sugar Cravings? Carb Overload? Diabetes? Venessa's High-Potency called Sugar Balance Support has 14 fast-acting ingredients that work in less than Dr. Formula 20 minutes to reduce sugar cravings and sugar levels in the bloodstream. Most supplements simply do not have the potency to act this fast. Live well with Dr. Venessa's Sugar Balance Support today! &r?~~~!ct~!S www.DrVenessa.com Visit our website to find a Distributor or to Order Direct call: 1 (800) 477-0031 Circle reader service #45 February 2003 . Vitamin Retailer 55 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 Anti-Aging Solutions ~~ Enriched by Sun Country Naturals phone:8n916.12l2 tax: 480.998.7999 \vw,,"suneountrynaturals.com email: [email protected] Facial Cleanser Wrinkle Serum Nntrltlonal Body Lotion Skin Healing Gel 80z Pump [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 10z Pump Our productsreducefinefacial wrinkles, .firms and restores the youthful appearance of your skin using active, anti-aging ingredients featuring Carnosine, a dipeptide of amino acids that has been.,~hownto be amazingly activeas a skin rejuvenator,alongwithAlpha LipoicAcid, DMAE, Vitamins C-Ester, A and E. [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 Rejuvenating 10z Pump 20z Pump Evening Primrose Oil In a double-blind trial, 6 g per day of evening primrose helped reduce nerve damage in people with both types of diabetes. GLA is essential for producing prostaglandins. It has also been shown to reverse neurological damage in diabetics.22 References: FacialMoisturizer 40z Pump insulin homeostasis. The stud)' rec,ommended regular nut consumption in place of refined grain products or red or processed meats.21 February 2003 -~--- ---~ ---~ - .., 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 Oil Natural of [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 --- ,---- 1M Squalene Capsules Skin Supplement Because Squalane issuch a fine, light 011it is absorbed quickly into the skin without leaving an oily film. Shark LiverExtract Mayumi Squalene oil isextracted from livers of the Aizame Shark, the richest source. AllNatural No Additives Squalane Isnot new to your skin, for it Isproduced by one's own body. However most of us do not synthesize enough of this vital oil; which can lead to rough, dry, scaly, skin, Fortifying Effects Squalene plays an important part within the body's defensive system. Regular doses assures that the body receives all the oil required for optimal functioning. Round the Clock Benefits Use throughout the day and evening to soften dry, scaly skin. Apply under make-up. Also an ideal addition to your night-time facial treatment. Oxygenating Effect The active Ingredient C30 H50, is an unsaturated hydrocarbon with the ability to resupply cells with much needed oxygen. Enhancing energy at the cellular ievel. (1,] 2 oz, & 2.1 7 oz. Bottles) Mayuml TM Hand & Body Skin Therapy Lotion Try the Saualane Difference For intensive skincare treatment year round to soften & soothe dry, rough, skin. An excellent way to relieve sun-burned sensitive skin. (In An 8 oz. Pump) (PRODUCTS NOT TESTED ON ANIMALS) JAPAN HEALTH PRODUCTS, INC. TEL: (800) 441-3788/ Fax: Detoxification I Factor Squalene plays a part in the bodies detoxifying process, protecting us against oxidants which can cause damage to our defensive systems. A Natural Supplement Squalene Isvery popular in Scandinavia and the Orient. Contains no Cholesterol. A or D. (450 mg. Capsules /60 & ]20 Capsule Bottles) (828) 859-6937/ E-mail: [email protected] Circle reader service #48 February 2003 . Vitamin Retailer 59