Diabetes
Diabetes: the Four Seasons Naturopathic Approach
There is an increasing role being played by natural and alternative medicines and providers of such treatments in the care of people with diabetes. Fortunately, there is increasing evidence supporting the effective use of many natural medicines. In this article, I will give a brief overview of the range of beneficial natural medicines most often used for the management of people with diabetes – special emphasis will be on those medicines that have supportive research evidence.
Diet, Lifestyle, and Exercise
These are the mainstays in diabetes management. Optimal diet is very important in the treatment of patients with types I and II diabetes. Foods low in glycemic index (averaging 50-55), and low in the glycemic load (less than or equal to 20 grams per meal, or 60-80 grams per day) help in glycemic control, lipid profile, and weight loss. Fiber, especially soluble fibers (eg: glucomannan (from konjac root), psyllium, guar gum, defatted fenugreek seed powder or fiber, seaweed fibers (alginate and carrageenan) and pectin; okra, brussel sprouts, oat bran and some beans) are very important at improving glycemic control, decreasing cholesterol, triglycerides and very low density lipoprotein. Clearly, fiber plays a strong role in helping reduce morbidity since it helps decrease many risk factors associated with heart disease, the biggest killer of those with diabetes. Note that there are a few herbs that can actually raise blood glucose levels (eg: rosemary leaves, mahuang, guarana seeds; certain cocoa, cola and coffee seeds).
Lifestyle factors such as stress can aggravate diabetes. Stress promotes the release of the adrenal gland hormones epinephrine and cortisol, which elevate blood-glucose levels. Research has shown that people who are anxious or experiencing significant levels of stress in their lives can improve their blood-glucose control by learning relaxation training which I encourage and teach in my office.
Exercise is essential in the prevention and treatment of diabetic and pre-diabetic conditions. Exercise has been shown to improve insulin sensitivity, blood-glucose control and is important to attaining and sustaining weight loss. Stretching, aerobic and strength training are all important forms of exercise for people with diabetes. Here’s a sample of some introductory strength exercises from Diabetes Canada.
Nutritional & Herbal Supplements
There are hundreds of different nutritional and herbal medicines that can help people with diabetes (see chart below). Some of the goals of adding such supplements are as follows: to optimize nutrient intake, to decrease after-meal increases in blood-glucose, to improve insulin function and sensitivity and to prevent nutritional or oxidative stress. Note that people with diabetes have an increased need for many nutrients, which have been shown to improve blood-glucose control and prevent or decrease the development of the major complications of diabetes. Such nutrients may include chromium, vitamin C, vitamin E, B-vitamins, manganese, magnesium, potassium, and zinc. Many herbs also help to promote blood-glucose control and insulin sensitivity, in some cases better than medications. The benefits associated with these and other supplements are detailed in the chart below. In general, the primary risk is of acute diabetic complications especially hypoglycemia, as many of the complementary and alternative interventions affect the level of fasting or postprandial blood-glucose and or insulin sensitivity.
Summary
In the end, it is clear that there are viable natural agents in the realm of complementary and alternative medicine which research indicates as being helpful in the management of people with diabetes. For a custom approach, contact our office to arrange a naturopathic assessment – 905-597-7201.
| Nutrient/Herb | Benefits | Risks |
| Chromium | Assists glucose uptake into cells – component of glucose tolerance factor (GTF); decreases fasting glucose, improves glucose tolerance, lowers insulin levels, decreases total cholesterol and triglyceride levels while increasing HDL | No significant adverse reactions |
| Vitamin C | Antioxidant, supports immune system function, and collagen production; mild improvement of glucose control; decreased arterial stiffness and blood pressure; reduces sorbitol production | > 1000 mg doses can cause diarrhea, hyperuricosuria, and hyperoxaluria in healthy individuals |
| Vitamin E | Cell membrane antioxidant; protects from LDL/vascular oxidation; normalizes retinal blood flow and creatinine clearance | Mild blood thinning effect |
| Vitamin C + E | Can reduce elevated urinary albumin | See above |
| Benfotiamine (vitamin B1) | Improves insulin sensitivity | |
| Niacin/niacinamide | Component of GTF; cofactor of enzymes important in fat, carbohydrate, cholesterol and energy metabolism; improves C-peptide release and blood glucose control in type II diabetic patients who previously failed to respond to oral antihyperglycemic drugs | Niacin form can increase blood glucoseNiacin/nicotinic form causes benign vasodilatory or “flushing” effect; large intakes of nicotinic acid (>1000 mg) have been associated with stomach pain, diarrhea, cardiac arrhythmias, itching, nausea, elevated liver enzymes |
| Vitamin B6 | Involved in protein, neurochemical, prostaglandin production; protects against and treats diabetic neuropathy; gestational diabetes | Very high doses of vitamin B6 have been associated with sensory and motor impairment (doses greater than 500mg) |
| Biotin | Utilization of carbohydrates, fats, and amino acids; lowers fasting blood-glucose; diabetic neuropathy; enhances glucokinase | No reported adverse effects |
| Manganese | Cofactor in enzymes controlling blood glucose, energy, thyroid and free radical metabolism | Very high doses can cause headaches, muscle rigidity and irritability |
| Magnesium | Involved in glucose metabolism; improves insulin response and action, glucose tolerance, and RBC membrane fluidity | Respiratory depression at toxic doses. |
| Zinc | Synthesis, secretion, and utilization of insulin | Symptoms of zinc toxicity include gastrointestinal irritation, vomiting, adverse changes in HDL/LDL cholesterol ratios, and impaired immunity |
| Omega-3 Fats | Protects against heart disease in diabetics | Fishy aftertaste; may thin the blood |
| Fiber Supplements | Decreased postprandial blood-glucose elevation; increased insulin sensitivity, diminished appetite, significant weight control, improved bowel movements, and decreased serum cholesterol | Digestive upset if introduced too high too fast |
| Berberine (extract from hydrastis spp, mahonia spp.) | Improves insulin sensitivity, can reduce blood pressure and lipids | Digestive upset, diarrhea |
| Olea Europaea(Olive Leaf) | improves insulin sensitivity and pancreatic beta-cell responsiveness; significantly lowers Hba1c and fasting insulin; lowers blood pressure and lipid peroxidation | No reported adverse effects |
| Touchi Extract (fermented soy) | Reduced postprandial elevations in blood glucose | No reported adverse effects |
| Morus indica (Mulberry) | Reduced fasting blood glucose | No reported adverse effects |
| Gymnema sylvestre | Reduced insulin requirements (type I) and fasting blood glucose levels | Hypoglycemia, monitor liver for inflammation |
| Momordica charantia (Bitter melon) | Lowers blood glucose | Very bitter in taste |
| Panax quinquefolium and Panax ginseng (American and Chinese Ginseng) | Reduced postprandial blood glucose | May elevate blood pressure. May potentiate the monoamine oxidase inhibitor phenelzine (Nardil) to produce manic-like symptoms. May interfere with Warfarin. |
| Trigonella foenum-graecum (Fenugreek) | Reduced fasting blood-glucose and glucose tolerance, reduced LDL and VLDL cholesterol and triglyceride values | |
| Allium cepa (Onion) and Allium sativum (Garlic) | Reduced blood glucose | Gastrointestinal irritation |
| Flavonoids | Diabetic retinopathy and microvascular abnormalities | |
| Resveratrol | Improves insulin sensitivity | |
| Alpha-lipoic acid | Diabetic neuropathy, improves insulin sensitivity | |
| Multivitamin & mineral | Reduced risk of infection in elderly diabetics |