Natural treatments for diabetes

• PRINCIPAL PROPOSED NATURAL TREATMENTS:

• OTHER PROPOSED NATURAL TREATMENTS:
• HERBS AND SUPPLEMENTS TO USE ONLY WITH CAUTION: Conjugated linoleic acid, Ginkgo biloba, rosemary, selenium

DEFINITION: Treatment of the condition that causes blood sugar to reach toxic levels and to damage tissues and major organs.

Introduction

Diabetes has two forms. Generally speaking, 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 type 2 diabetes, generally developed in adults, insulin remains plentiful, but the body does not respond normally to it. In both forms of diabetes, blood sugar reaches toxic levels, causing injury to many organs and tissues.

Conventional treatment for type 1 diabetes includes insulin injections and careful dietary monitoring. Type 2 diabetes often responds to lifestyle changes alone, such as increasing exercise, losing weight, and improving diet. Various oral medications are also often effective for type 2 diabetes, although insulin injections may be necessary in some cases.

Principal Proposed Natural Treatments

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 or may correct nutritional deficiencies associated with diabetes. Other natural treatments may help prevent and treat complications of diabetes, including diabetic neuropathy, retinopathy, and cataracts. However, diabetes is a dangerous disease with many potential complications and natural treatments for diabetes should not be used as a substitute for conventional medical care. In 2022, the American Diabetes Association reported it had found insufficient evidence to support the use of herbs or spices in the treatment of diabetes. While the natural treatments listed here may provide some benefit, individuals with diabetes should always consult their physician before beginning a new supplement to ensure it will not interfere with vital medications.

Treatments for improving blood sugar control. The following treatments might improve blood sugar control in type 1 or type 2 diabetes or both. However, none of these iare evidence strong. Some research indicates that joining a study tends to improve blood sugar control in people with diabetes, even before any treatment is begun. Presumably, the experience of being enrolled in a trial causes participants to watch their diet more closely. This indicates that for diabetes, as for all conditions, the use of a double-blind, placebo-controlled method is essential. Only if the proposed treatment proves more effective than placebo can it be considered to work in its own right.

For those persons in which a natural treatment for diabetes works, it is essential to reduce their medications to avoid hypoglycemia. For this reason, medical supervision is necessary when beginning a natural treatment.

Chromium.Chromium is an essential trace mineral that plays a significant role in sugar metabolism. Some evidence suggests that chromium supplementation may help bring blood sugar levels under control in type 2 diabetes, but it is far from definitive.

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

A double-blind, placebo-controlled trial of seventy-eight people with type 2 diabetes compared two forms of chromiumbrewer’s yeast and chromium chloridewith a placebo. This rather complex crossover study consisted of four eight-week intervals of treatment in random order. The results of the sixty-seven participants who completed the study showed that both forms of chromium significantly improved blood sugar control. Positive results were also seen in other small, double-blind, placebo-controlled studies of people with type 2 diabetes. However, several other studies have failed to find chromium helpful for improving blood sugar control in type 2 diabetes. These contradictory findings suggest that the benefit, if it exists, is small.

A combination of chromium and biotin might be more effective. Following positive results in a small pilot trial, researchers conducted a double-blind study of 447 people with poorly controlled type 2 diabetes. One-half of the participants were given a placebo, and the rest were given a combination of 600 milligrams (mg) of chromium (as chromium picolinate) and 2 mg of biotin daily. All participants continued to receive standard oral medications for diabetes. During the ninety-day study period, participants who were given the chromium-biotin combination showed significantly better glucose regulation than participants who were given a placebo. The relative benefit was clear in levels of fasting glucose and in levels of hemoglobin A1c (HbA1c), also called glycated hemoglobin.

One placebo-controlled study of thirty women with gestational 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. Pregnant women should only begin chromium supplementation under the advice and supervision of their doctors. Chromium has also shown some promise for helping diabetes caused by corticosteroid treatment.

Ginseng. In double-blind studies performed by a single research group, the use of American ginseng (Panax quinquefolius) appeared to improve blood sugar control. In some studies, the same researchers subsequently reported possible benefits with Korean red ginseng, a specially prepared form of P. ginseng.

A different research group found benefits with ordinary P. ginseng. However, in other studies, ordinary P. ginseng seemed to worsen blood sugar control rather than improve it. Yet another research group found potential benefits. Certain ginsenosidesfound in high concentrations in some American ginseng productsmay lower blood sugar, while othersfound in high concentrations in some P. ginseng productsmay raise it. It has been suggested that because the actions of these various ginseng constituents are not well defined, ginseng should not be used to treat diabetes until more is known.

Aloe. The succulent aloe plant has been valued since prehistoric times as a topical treatment for burns, wound infections, and other skin problems. Some evidence suggests that oral aloe might be useful for type 2 diabetes.

Evidence from two human trials suggests that aloe gelthe gel of the aloe vera plant, and not the leaf skin, which constitutes the drug aloecan improve blood sugar control. A single-blind, placebo-controlled trial evaluated the potential benefits of aloe in the treatment of diabetes. The results showed significantly greater improvements in blood sugar levels among those given aloe over the two-week treatment period.

Another single-blind, placebo-controlled trial evaluated the benefits of aloe in people who had failed to respond to the oral diabetes drug glibenclamide. Of the thirty-six people who completed the study, those taking glibenclamide and aloe showed definite improvements in blood sugar levels over forty-two days compared with those taking glibenclamide and placebo. While these are promising results, large studies that are double-blind rather than single-blind will be needed to establish aloe as an effective treatment for improving blood sugar control. However, experts caution that people already taking diabetes medications should talk to their doctor before using aloe.

Cinnamon.Cinnamon has been widely advertised as an effective treatment for type 2 diabetes and high cholesterol. The primary basis for this claim is a single study performed in Pakistan. In this forty-day study, sixty people with type 2 diabetes were given cinnamon at a dose of one, three, or six grams (g) daily. The results reportedly indicated that the use of cinnamon improved blood sugar levels by 18 to 29 percent, total cholesterol by 12 to 26 percent, LDL cholesterol by 7 to 27 percent, and triglycerides by 23 to 30 percent. These results were said to be statistically significant compared to the beginning of the study and to the placebo group. However, this study has some odd featuresfound no significant difference in benefits between the prescribed doses of cinnamon. This is called lack of a dose-related effect, and it generally casts doubt on the results of a study.

In an attempt to replicate these results, a group of Dutch researchers performed a carefully designed six-week, double-blind, placebo-controlled study of twenty-five people with type 2 diabetes. All participants were given 1.5 g of cinnamon daily. The results failed to show any detectable effect on blood sugar, insulin sensitivity, or cholesterol profile. Furthermore, a double-blind study performed in Thailand, which enrolled sixty people, again using 1.5 g of cinnamon daily, also failed to find a benefit. However, a double-blind study of seventy-nine people who used 3 g instead of 1.5 g daily did find that cinnamon improved blood sugar levels. In addition, a randomized, double-blind, placebo-controlled study of eighty women with polycystic ovary disease evaluated cinnamon for improving blood sugar control. Participants were given 1.5 g of cinnamon daily for twelve weeks. It, too, found evidence of benefit. Regarding type 1 diabetes, a study of seventy-two adolescents failed to find benefits from taking cinnamon at a dose of 1 g daily.

A meta-analysis of all published evidence concluded that cinnamon has no effect on blood sugar levels in people with diabetes. The evidence regarding cinnamon as a treatment for diabetes is highly inconsistent, suggesting that if cinnamon is indeed effective, its benefits are minimal at most. However, some research indicates that cinnamon may help manage complications of diabetes and common comorbidities such as heart disease and stroke. In an eight-week study, two grams of cinnamon daily lowered systolic and diastolic blood pressure in patients with diabetes.

Other treatments studied for their effect on blood sugar control. The food spice fenugreek might also help control blood sugar, but the supporting evidence is weak. In a two-month double-blind study of twenty-five people with type 2 diabetes, the use of fenugreekone gram daily of a standardized extractsignificantly improved some measures of blood sugar control and insulin response compared with placebo. Triglyceride levels decreased, and HDL (good) cholesterol levels increased, presumably because of the enhanced insulin sensitivity. Similar benefits have been seen in animal studies and open human trials. However, it is possible that the effects of fenugreek come from its dietary fiber content.

A few preliminary studies suggest that the Ayurvedic (Indian) herb gymnema may help improve blood sugar control. It might be helpful for mild cases of type 2 diabetes when taken alone or with standard treatment (under a doctor’s supervision in either case).

Studies in rats with and without diabetes suggested that high doses of the mineral vanadium may have an insulin-like effect, reducing blood sugar levels. Based on these findings, preliminary studies involving humans have been conducted. However, of 151 studies reviewed, none was of sufficient quality to judge if vanadium is beneficial in type 2 diabetes. The researchers did find that vanadium was often associated with gastrointestinal side effects. Furthermore, there may be some cause for concern given the high doses of vanadium used in some of these studies. For these reasons, vanadium supplementation is not recommended.

The following herbs are proposed for helping to control blood sugar, but the supporting evidence regarding their potential benefit is, in all cases, at best preliminary; for some, there are as many negative results as positive: agaricus, blazei, cod protein, cayenne, Coccinia indica (also called C. cordifolia), garlic, green tea, guggul, holy basil (Ocimum sanctum), maitake, milk thistle, nopal cactus (Opuntia stredptacantha), onion, oolong tea, oligomeric proanthocyanidins, Salacia oblonga, Salvia hispanica (a grain), and saltbush. Additionally, the supplements arginine, carnitine, coenzyme Q₁₀ (CoQ₁₀), dehydroepiandrosterone (DHEA), glucomannan, lipoic acid, melatonin with zinc, and vitamin E might also help control blood sugar levels to a slight degree.

One placebo-controlled study found hints that the use of medium-chain triglycerides by people with type 2 diabetes might improve insulin sensitivity and aid weight loss. The herb bitter melon (Momordica charantia) is widely advertised as effective for diabetes, but the scientific basis for this claim is limited to animal studies, uncontrolled human trials, and other unreliable forms of evidence. The one properly designed double-blind, placebo-controlled study of bitter melon failed to find benefit. Conjugated linoleic acid (CLA) has shown promise in preliminary trials. However, other studies have found that CLA might worsen blood sugar control.

One study found that insulin metabolism in 278 young, overweight persons improved on a calorie-restricted diet rich in fish oil from seafood or supplements compared with those on a diet low in fish oil. Though preliminary, the results suggest that fish oil may help delay the onset of diabetes in susceptible persons. In another study of fifty people with type 2 diabetes, 2 g per day of purified omega-3 fatty acids (fish oil) was able to significantly lower triglyceride levels. However, it had no effect on blood sugar control.

Other herbs traditionally used for diabetes that were thought to offer some benefit include Anemarrhena asphodeloides, Azadirachta indica (neem), Catharanthus roseus, Cucurbita ficifolia, Cucumis sativus, Cuminum cyminum (cumin), Euphorbia prostrata, Guaiacum coulteri, Guazuma ulmifolia, Lepechinia caulescens, Medicago sativa (alfalfa), Musa sapientum L. (banana), Phaseolus vulgaris, Psacalium peltatum, Rhizophora mangle, Spinacea oleracea, Tournefortia hirsutissima, and Turnera diffusa.

Combination herbal therapies used in Ayurvedic medicine have also shown some promise for improving blood sugar control. One study attempted to test the effectiveness of whole-person Ayurvedic treatment involving exercise, Ayurvedic diet, meditation, and Ayurvedic herbal treatment. However, minimal benefits were seen.

A double-blind study of over two hundred people evaluated the effectiveness of an herbal formula used in traditional Chinese herbal medicine, called the Coptis formula, with and without the drug glibenclamide. The results hint that the Coptis formula may enhance the effectiveness of the drug but that it is not powerful enough to treat diabetes on its own. Another randomized trial, lacking a control group, found no added benefit for Tai Chi in treating blood glucose and cholesterol levels among fifty-three people with type 2 diabetes during six months.

One study claimed to find evidence that creatine supplements can reduce blood sugar levels. However, the results are somewhat questionable because dextrose (a form of sugar) was used as the placebo. In another study, the herb Tinospora crispa did not work, and it showed the potential to cause liver injury.

One study found hints that the supplement DHEA might improve insulin sensitivity. However, a subsequent and more rigorous study failed to find benefits. Relatively weak evidence hints that genistein (an isoflavone extracted from soy) might help control blood sugar.

It has been suggested that if a child has just developed diabetes, the supplement niacinamide (a form of niacin, also called vitamin B₃) might slightly prolong what is called the honeymoon period. This is the interval during which the pancreas can still make some insulin, and the body’s need for insulin injections is low. However, the benefits (if any) appear to be minor. A cocktail of niacinamide plus antioxidant vitamins and minerals has also been tried, but the results were disappointing. Niacinamide has also been tried for preventing diabetes in high-risk children. According to most studies, fructo-oligosaccharides (also known as prebiotics) do not improve blood sugar control in people with type 2 diabetes.

Massage therapy has shown some promise for enhancing blood sugar control in children with diabetes. A review of nine clinical trials found insufficient evidence to support the traditional Chinese practice of qigong as beneficial for the treatment of type 2 diabetes.

Treating Nutritional Deficiencies

Both diabetes and the medications used to treat it can cause people to fall short of various nutrients. Making up for these deficiencies through diet or using supplements may or may not help with diabetes specifically, but it should make a person healthier overall. One double-blind study, for example, found that people with type 2 diabetes who took a multivitamin-multimineral supplement were less likely to develop an infectious illness than those who took placebo.

People with diabetes are often deficient in magnesium, and inconsistent evidence hints that magnesium supplementation may enhance blood sugar control. People with either type 1 or type 2 diabetes may also be deficient in the mineral zinc. Vitamin C levels have been found to be low in many people on insulin, even though these persons were consuming seemingly adequate amounts of the vitamin in their diets. Deficiencies of taurine and manganese have also been reported. The drug metformin can cause vitamin B12 deficiency. Taking extra calcium may prevent this.

Prevention

Niacinamide. Evidence from a large study conducted in New Zealand suggests that the supplement niacinamide might reduce the risk of diabetes in children at high risk. In this study, more than twenty thousand children were screened for diabetes risk by measuring certain antibodies in the bloodICA 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 seven years, as not all parents agreed to give their children niacinamide or to have them stay in the study for that long. About ten thousand other children were not screened, but they were followed to see if they developed diabetes.

The results were positive. 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 almost 60 percent. These findings suggest that niacinamide is an effective treatment for preventing diabetes. The study also indicated that tests for ICA antibodies could very accurately identify children at risk for diabetes.

An even larger study that attempted to replicate these results in Europe (the European Nicotinamide Diabetes Intervention Trial) failed to find benefit. This study screened 40,000 children at high risk and selected 552. The results were negative. The rate of diabetes onset was not statistically different in the group given niacinamide compared with those given a placebo. Another study also failed to find benefit.

Dietary changes. The related terms “glycemic index” and “glycemic load” indicate the tendency of certain foods to stimulate insulin release. It has been suggested that foods that rank high on these scales, such as white flour and sweets, might exhaust the pancreas and lead to type 2 diabetes. For this reason, low-carbohydrate and low-glycemic diets have been promoted to prevent type 2 diabetes. However, the results of studies on this question have been far from definitive.

People who are obese have a far greater tendency to develop type 2 diabetes than those who are a healthy weight. Weight loss, especially when accompanied by an increase in exercise, is an effective step for prevention. One review suggests that a 7 to 10 percent weight decrease is enough to provide significant benefit.

Other natural treatments. Studies investigating the preventive effects of antioxidant supplements have generally been disappointing. In an extremely large double-blind study, the use of vitamin E at a dose of 600 international units every other day failed to reduce the risk of type 2 diabetes in women. Another large study, which enrolled male smokers, failed to find benefit with beta-carotene, vitamin E, or the two taken together. Another large study of female health professionals who were more than forty years old with or at high risk for cardiovascular disease found that long-term supplementationan average of just more than nine yearswith vitamin C, vitamin E, or beta-carotene did not significantly reduce the risk of developing diabetes compared with placebo. In a smaller, but still sizable, trial involving a subgroup of these same women, supplementation with vitamins B₆ and B₁₂ and folic acid also did not reduce the risk of type 2 diabetes.

Several observational studies suggest that vitamin D may also help prevent diabetes. However, studies of this type are far less reliable than double-blind trials. One observational study failed to find that high lycopene consumption reduced the risk of developing type 2 diabetes. A systematic review of fifteen randomized trials comparing vitamin D supplementation to placebo in 40,479 people with type 2 diabetes found that vitamin D may reduce fasting glucose levels but not HbA1c.

Supplements to Use Only with Caution

In a double-blind, placebo-controlled study of sixty overweight men, the use of conjugated linoleic acid (CLA) unexpectedly worsened blood sugar control. These findings surprised researchers who were looking for potential diabetes-related benefits with this supplement. Other studies corroborate this as a potential risk for people with type 2 diabetes and for overweight people without diabetes. Another study, however, failed to find this effect. Nonetheless, people with type 2 diabetes or who are at risk for it should not use CLA except under physician supervision.

Unexpected results also occurred in a study of vitamin E. For various theoretical reasons, researchers expected that the use of vitamin Eeither alpha-tocopherol or mixed tocopherolsby people with diabetes would reduce blood pressure; instead, the reverse occurred. People with diabetes should probably monitor their blood pressure if they take high-dose vitamin E supplements.

There are equivocal indications that the herb Ginkgo biloba might alter insulin release or insulin sensitivity in people with diabetes. If it exists, the effect is rather complex; the herb may cause an increase in insulin output while lowering overall insulin levels through its effects on the liver and perhaps on oral diabetes medications. However, in a systematic review of thirteen research studies involving 1,573 individuals with type 2 diabetes published from 2003 to 2022, Ginko biloba supplements were found to generally offer minimal positive benefits. Researchers observed significantly lower plasma viscosity and hematocrit levels compared to the control groups, but participants’ lipid profiles and glycemic control markers did not see statistically significant improvements. However, few negative effects were observed.

Despite hopes to the contrary, it does not appear that selenium supplements can help prevent type 2 diabetes, but rather might increase the risk of developing the disease. Contrary to earlier concerns, vitamin B₃ (niacin) and fish oil appear to be safe for people with diabetes. A few early case reports and animal studies had raised concerns that glucosamine might be harmful to persons with diabetes, but subsequent studies have tended to allay these worries.

Finally, if any herb or supplement successfully decreases blood sugar levels, this could lead to dangerous hypoglycemia. A doctor’s supervision is strongly suggested.

Bibliography

Ahuja, K. D., et al. “Effects of Chili Consumption on Postprandial Glucose, Insulin, and Energy Metabolism.” The American Journal of Clinical Nutrition, vol. 84, no. 1, 2006, pp. 63–69.

Ajmera, Rachael. "How Cinnamon Lowers Blood Sugar and Helps Diabetes." Healthline, 25 June 2024, www.healthline.com/nutrition/cinnamon-and-diabetes. Accessed 30 Sept. 2024.

Asbaghi, Omid, et al. “Effect of Vitamin E Intake on Glycemic Control and Insulin Resistance in Diabetic Patients: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Nutrition Journal, vol. 22, no. 1, 2023, p. 10, doi:10.1186/s12937-023-00840-1.

George, P. S., et al. “Effect of Vitamin D Supplementation on Glycaemic Control and Insulin Resistance: A Systematic Review and Meta-Analysis.” Diabetic Medicine, vol. 29, no. 8, 2012, pp. E142–50.

Johnson, Jon. "7 Herbs and Supplements for Type 2 Diabetes." Medical News Today, 28 Apr. 2023, www.medicalnewstoday.com/articles/317051#fenugreek. Accessed 30 Sept. 2024.

Lee, M. S., et al. “Qigong for Type 2 Diabetes Care.” Complementary Therapies in Medicine, vol. 17, no. 4, 2009, pp. 236–42.

Li, Y., T. H. Huang, and J. Yamahara. “Salacia Root, a Unique Ayurvedic Medicine, Meets Multiple Targets in Diabetes and Obesity.” Life Sciences, vol. 82, no. 21–22, 2008, pp. 1045–49.

Mackenzie, T., et al. “The Effect of an Extract of Green and Black Tea on Glucose Control in Adults with Type 2 Diabetes Mellitus.” Metabolism, vol. 56, no. 10, 2007, pp. 1340–44.

Pi-Sunyer, F. X. “How Effective Are Lifestyle Changes in the Prevention of Type 2 Diabetes Mellitus?” Nutrition Reviews, vol. 65, no. 3, 2007, pp. 101–10.

Shidfar, F., et al. “Effects of Omega-3 Fatty Acid Supplements on Serum Lipids, Apolipoproteins, and Malondialdehyde in Type 2 Diabetes Patients.” Eastern Mediterranean Health Journal, vol. 14, no. 2, 2008, pp. 305–13.

Shenai, Aiditi. "Aloe Vera for Diabetes: Pros and Cons." Healthifyme, 18 Nov. 2022, www.healthifyme.com/blog/aloe-vera-for-diabetes-pros-and-cons. Accessed 14 Dec. 2022.

Song, Y., et al. “Effects of Vitamins C and E and Beta-Carotene on the Risk of Type 2 Diabetes in Women at High Risk of Cardiovascular Disease.” The American Journal of Clinical Nutrition, vol. 90, no. 2, 2009, pp. 429–37.

Suketha, Kumari, et al. “Reversal of Type 2 Diabetes Mellitus through Integrated Ayurveda Dietary Protocol - A Case Report.” Journal of Ayurveda and Integrative Medicine, vol. 15, no. 4, 2024, p. 100946, doi:10.1016/j.jaim.2024.100946.

"Vitamins, Minerals, and Supplements." American Diabetes Association, diabetes.org/food-nutrition/diabetes-vitamins-supplements. Accessed 30 Sept. 2024.

Ward, N. C., et al. “The Effect of Vitamin E on Blood Pressure in Individuals with Type 2 Diabetes.” Journal of Hypertension, vol. 25, no. 1, 2007, pp. 227–34.

Zou, Huimin, et al. “Effects and Safety of Ginkgo Biloba on Blood Metabolism in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.” Frontiers in Endocrinology, vol. 14, 2023, p. 1231053, doi:10.3389/fendo.2023.1231053.