• Blood Sugar Control: Aloe, Chromium (Alone or With Biotin), Ginseng
• To Correct Nutritional Deficiencies: Calcium, Magnesium, Manganese, Taurine, Vitamin B12, Vitamin C, Zinc
• Complications of Diabetes: See associated article
• Blood Sugar Control: Arginine, Ayurvedic Combination Herbal Therapies, Berberine (Goldenseal), Black Tea, Biotin, Bitter Melon, Caiapo, Carnitine, Cayenne, Cinnamon, Cod Protein, Coenzyme Q10 (CoQ10), Coccinia indica, DHEA, Fenugreek, Garlic, Genistein, Glucomannan, Green Tea, Guggul, Gymnema, Holy Basil, Lipoic Acid, Magnesium, Medium-Chain Triglycerides (MCTs), Melatonin, Milk Thistle, Niacinamide, Nopal Cactus, Onion, Ooolong Tea, OPCs, Pterocarpus, Salacia oblonga, Salvia Hispanica, Salt Bush, Traditional Chinese Herbal Medicine, Vanadium, Vitamin E, Zinc
Diabetes has two forms. 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 (usually developing in adults) insulin remains plentiful, but the body does not respond normally to it. (This is only an approximate description of the difference between the two types.) 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 may respond 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 correct nutritional deficiencies associated with diabetes. However, because diabetes is a dangerous disease with many potential complications, alternative treatment for diabetes should not be attempted as a substitute for conventional medical care.
Other natural treatments may be helpful for preventing and treating complications of diabetes, such as peripheral neuropathy, cardiac autonomic neuropathy, retinopathy, and cataracts. See the article on Complications of Diabetes for more information.
Treatments for Improving Blood Sugar Control
The following treatments might be able to improve blood sugar control in type 1 and/or type 2 diabetes. However, for none of these is the evidence strong. One point to keep in mind is that the mere fact of joining a study tends to improve blood sugar control in people with diabetes, even before any treatment is begun!219 Presumably, the experience of being enrolled in a trial causes participants to watch their diet more closely. This serves to indicate, however, that for diabetes, as for all conditions, use of 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.
Another point to keep in mind is this: If any natural treatment for diabetes actually works, you will need to reduce your medications to avoid hypoglycemia. For this reason, medical supervision is essential.
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 4-month study reported in 1997 followed 180 Chinese men and women with type 2 diabetes, comparing the effects of 1,000 mcg chromium, 200 mcg chromium, and placebo.1 The results showed that HbA1c values (a measure of long-term blood sugar control) improved significantly after 2 months in the group receiving 1,000 mcg, and in both chromium groups after 4 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 78 people with type 2 diabetes compared two forms of chromium (brewer's yeast and chromium chloride) against placebo.2 This rather complex crossover study consisted of four 8-week intervals of treatment in random order. The results in the 67 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.139,148,180,182 However, several other studies have failed to find chromium helpful for improving blood sugar control in type 2 diabetes.4-5,169, 201 These contradictory findings suggest that the benefit, if it really exists, is small.
A combination of chromium and biotin might be more effective. Following positive results in a small pilot trial,200 researchers conducted a double-blind study of 447 people with poorly controlled type 2 diabetes.209 Half the participants were given placebo and the rest were given a combination of 600 mg chromium (as chromium picolinate) along with 2 mg of biotin daily. All participants continued to receive standard oral medications for diabetes. Over the 90-day study period, participants given the chromium/biotin combination showed significantly better glucose regulation than those given placebo. The relative benefit was clear in levels of fasting glucose as well as in HgA1c.
One placebo-controlled study of 30 women with gestational diabetes (diabetes during pregnancy) 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.6
For more information, including dosage and safety issues, see the full Chromium article.
In double-blind studies performed by a single research group, use of American ginseng (Panax quinquefolius) appeared to improve blood sugar control.18,19 In some but not all studies, the same researchers subsequently reported possible benefit with Korean red ginseng, a specially prepared form of Panax ginseng.150, 170,183
A different research group found benefits with ordinary Panax ginseng.17 However, in other studies (conducted by the research group mentioned in the previous paragraph), ordinary Panax ginseng seemed to worsen blood sugar control rather than improve it.149,171 Yet another group found potential benefit.195 It seems possible that certain ginsenosides (found in high concentrations in some American ginseng products) may lower blood sugar while others (found in high concentration in some Panax ginseng products) may raise it. It has been suggested that since the actions of these various ginseng constituents are not well defined at this time, ginseng should not be used to treat diabetes until more is known.172
For more information, including dosage and safety issues, see the full Ginseng article.
The succulent aloe plant has been valued since prehistoric times as a topical treatment for burns, wound infections, and other skin problems. However, recent evidence suggests that oral aloe might be useful for type 2 diabetes.
Evidence from two human trials suggests that aloe gel can improve blood sugar control.
A single-blind, placebo-controlled trial evaluated the potential benefits of aloe in either 72 or 40 people with diabetes. (The study report appears to contradict itself).21 The results showed significantly greater improvements in blood sugar levels among those given aloe over the 2-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.22 Of the 36 people who completed the study, those taking glibenclamide and aloe showed definite improvements in blood sugar levels over 42 days as compared to those taking glibenclamide and placebo.
While these are promising results, large studies that are double- rather than single-blind will be needed to establish aloe as an effective treatment for improving blood sugar control.
Note that in the above we are referring to the gel of the aloe vera plant, and not the leaf skin (the latter is drug aloe, not aloe gel). However, some confusion has been introduced by the fact that some leaf skin may find its way into gel products, and that could be the actual active ingredient in aloe gel regarding diabetes.23,24 It is possible, therefore, that completely pure aloe gel might not work!
For more information, including dosage and safety issues, see the full Aloe article.
Cinnamon has been widely advertised as an effective treatment for type 2 diabetes as well as high cholesterol. The primary basis for this claim is a single study performed in Pakistan.153 In this 40-day study, 60 people with type 2 diabetes were given cinnamon at a dose of 1, 3, or 6 g daily. The results reportedly indicated that use of cinnamon improved blood sugar levels by 18% to 29%, total cholesterol by 12% to 26%, LDL (“bad”) cholesterol by 7% to 27%, and triglycerides by 23% to 30%. These results were said to be statistically significant as compared to the beginning of the study and to the placebo group.
However, this study has some odd features. The most important is that it found no significant difference in benefit between the various 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 6-week, double-blind, placebo-controlled study of 25 people with type 2 diabetes.173 All participants were given 1.5 g of cinnamon daily. The results failed to show any detectible effect on blood sugar, insulin sensitivity, or cholesterol profile. Furthermore, a double-blind study performed in Thailand enrolling 60 people, again using 1.5 g of cinnamon daily, also failed to find benefit.218 On the other hand, a double-blind study of 79 people that used 3 g instead of 1.5 g daily did find that cinnamon improved blood sugar levels.174 In addition, a very small study evaluated cinnamon for improving blood sugar control in women with polycystic ovary disease, and it too found evidence of benefit.205
Regarding type 1 diabetes, a study of 72 adolescents failed to find benefit with cinnamon taken at a dose of 1 g daily.204
A meta-analysis (formal statistical review) of all published evidence concluded that, thus far, cinnamon has not yet been shown to have any effect on blood sugar levels in people with diabetes.222
The bottom line: 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.
For more information, see the full Cinnamon article.
Other Treatments That May Help Control Blood Sugar
The food spice fenugreek might also help control blood sugar, but the supporting evidence is weak. In a 2-month, double-blind study of 25 people with type 2 diabetes, use of fenugreek (1 g daily of a standardized extract) significantly improved some measures of blood sugar control and insulin response as compared to placebo.9 Triglyceride levels decreased and HDL (“good”) cholesterol levels increased, presumably due to the enhanced insulin sensitivity. Similar benefits have been seen in animal studies and open human trials as well.10-12 However, it is possible that the effects of fenugreek are simply due to its dietary fiber content.
A few preliminary studies suggest that the Ayurvedic (Indian) herb gymnema may help improve blood sugar control.13-16 It might be helpful for mild cases of type 2 diabetes when taken alone or in combination with standard treatment (under a doctor's supervision in either case).
Studies in rats with and without diabetes suggest that high doses of the mineral vanadium may have an insulin-like effect, reducing blood sugar levels.25-35 Based on these findings, preliminary studies involving human subjects have been conducted, with some promising results.36-41 However, of 151 studies recently reviewed, none were of sufficient quality to judge whether or not vanadium is at all beneficial in type 2 diabetes.226 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.
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 highly preliminary. For some, there are as many negative results as positive.
- Agaricus Blazei202
- Berberine (Goldenseal)
- Black tea211,223
- Caiapo144, 156
- Cod protein215
- Coccinia indica (also known as Coccinia cordifolia)50,225
- Green tea211,221
- Holy basil (Ocimum sanctum)58-59
- Milk thistle197
- Nopal cactus (Opuntia stredptacantha)60-65
- Oolong tea155
- Salacia oblonga188,214,227
- Salvia hispanica (a grain)217
- Salt bush48-49, 55-57
Additionally, the supplements arginine,71,185 carnitine,89 coenzyme Q10(CoQ10),91 DHEA, glucomannan,66-67,143 lipoic acid,92 melatonin combined with zinc,194 and vitamin E87-88,154,175 might also help control blood sugar levels, at least slightly.44, 140
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.51-53,68,69,141 The one properly designed (eg, double-blind, placebo-controlled) study of bitter melon failed to find benefit.208
Conjugated linoleic acid (CLA) has shown promise in preliminary trials.73 However, other studies have found that CLA might worsen blood sugar control. ( See Supplements to Use Only with Caution for more information.)
One study found that insulin metabolism in 278 young, overweight subjects improved on a calorie-restricted diet rich in fish oil from seafood or supplements compared to those on a diet low in fish oil. Though highly preliminary, the results suggest that fish oil may help delay the onset of diabetes in susceptible individuals.228 In another study of 50 people with type 2 diabetes, 2 g per day of purified omega-3-fatty acids (fish oil) was able to significantly lower triglycerides levels.229 However, it had no effect on blood sugar control.
Other herbs traditionally used for diabetes that might possibly 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.75-83
Combination herbal therapies used in Ayurvedic medicine have also shown some promise for improving blood sugar control.84-86,159 One study attempted to test the effectiveness of whole-person Ayurvedic treatment, involving exercise, Ayurvedic diet, meditation and Ayurvedic herbal treatment.193 However, minimal benefits were seen at most.
A double-blind study of more than 200 people evaluated the effectiveness of a combination herbal formula used in traditional Chinese herbal medicine (Coptis Formula).145 This study evaluated Coptis Formula with and without the drug glibenclamide. The results hint that Coptis Formula may enhance the effectiveness of the drug, but that it is not powerful enough to treat diabetes on its own.
One study claimed to find evidence that creatine supplements can reduce levels of blood sugar.206 However, because dextrose (a form of sugar) was used as the “placebo” in this trial, the results are somewhat questionable.
In one study, the herb Tinospora crispa did not work, and showed the potential to cause liver injury.160
It has been suggested that if your 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.93 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.94 (Niacinamide has also been tried for preventing diabetes in high risk children. See Preventing Diabetes below.)
Treating Nutritional Deficiencies in Diabetes
Both diabetes and the medications used to treat it can cause people to fall short of various nutrients. Making up for these deficiencies (either through diet or the use of supplements) may or may not help your diabetes specifically, but it should make you a healthier person overall.
People with diabetes are often deficient in magnesium,3,95,96 and inconsistent evidence hints that magnesium supplementation may enhance blood sugar control.142,190 People with either type 1 or type 2 diabetes may also be deficient in the mineral zinc.97-99 Vitamin C levels have been found to be low in many people on insulin, even though they were consuming seemingly adequate amounts of the vitamin in their diets.100-102 Deficiencies of taurine103 and manganese have also been reported.104
Evidence from a large study conducted in New Zealand suggested that the supplement niacinamide—a form of niacin, also known as vitamin B3—might be able to reduce the risk of diabetes in children at high risk.107 In this study, more than 20,000 children were screened for diabetes risk by measuring certain antibodies in the blood (ICA 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 7 years (not all parents agreed to give their children niacinamide or have them stay in the study for that long). About 10,000 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%.
These findings suggest that niacinamide is an effective treatment for preventing diabetes. (The study also indicates that tests for ICA antibodies can very accurately identify children at risk for diabetes.)
However, an even larger study that attempted to replicate these results in Europe (The European Nicotinamide Diabetes Intervention Trial, or ENDIT) failed to find benefit. This study screened 40,000 children at high risk, and selected 552.108,187 The results, unfortunately, were negative. Rate of diabetes onset was not statistically different in the group given niacinamide as compared to those given placebo. Another study also failed to find benefit.186 At present, therefore, hopes are dimming for this approach.
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 tend to exhaust the pancreas, and therefore lead to type 2 diabetes. For this reason, low-carbohydrate and low glycemic-index diets have been promoted for the prevention of type 2 diabetes. However, the results from studies on this question have been contradictory, and far from definitive.113-127
There is no question, however, that people who are obese have a far greater tendency to develop type 2 diabetes than those who are relatively slim; therefore, weight loss (especially when accompanied by increase in exercise) is clearly an effective step for prevention.128,161, 207 One review suggests that a weight decrease of 7%-10% is enough to provide significant benefit.207
Other Natural Treatments
In an extremely large double-blind study, use of vitamin E at a dose of 600 IU every other day failed to reduce risk of type 2 diabetes in women.191 Another very large study, this one enrolling male smokers, failed to find benefit with beta-carotene, vitamin E, or the two taken together.224
Supplements to Use Only With Caution
In a double-blind, placebo-controlled study of 60 overweight men, use of conjugated linoleic acid (CLA) unexpectedly worsened blood sugar control.135 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.162-164 Another study, however, failed to find this effect.196 Nonetheless, at present people with type 2 diabetes or 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 use of vitamin E (either alpha tocopherol or mixed tocopherols) by people with diabetes would reduce blood pressure; instead, the reverse occurred.199 For this reason, 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 might alter insulin release or insulin sensitivity in people with diabetes.135,165,184 The effect, if it exists at all, appears to be rather complex; the herb may cause some increase in insulin output, and yet might actually lower insulin levels overall through its effects on the liver and perhaps on oral medications used for diabetes. Until this situation is clarified, people with diabetes should use ginkgo only under the supervision of a physician.
For information on other herbs and supplements that may interact adversely with drugs used by people with diabetes, see the individual drug articles in the Drug Interactions section of this database.
A few early case reports and animal studies had raised concerns that glucosamine might be harmful for individuals with diabetes, but subsequent studies have tended to allay these worries.130-134,166-168,198,216
Finally, if any herb or supplement does in fact successfully decrease blood sugar levels, this could potentially lead to dangerous hypoglycemia. A doctor's supervision is strongly suggested
2. Bahijiri SM, Mira SA, Mufti AM, et al. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Saudi Med J. 2000;21:831-837.
5. Trow LG, Lewis J, Greenwood RH, et al. Lack of effect of dietary chromium supplementation on glucose tolerance, plasma insulin and lipoprotein levels in patients with type 2 diabetes. Int J Vitam Nutr Res. 2000;70:14-18.
9. Gupta A, Gupta R, Lal B. Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double-blind, placebo-controlled study. J Assoc Physicians India. 2001;49:1057-1061.
13. Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, et al. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol. 1990;30:295-305.
14. Shanmugasundaram ER, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol. 1990;30:281-294.
16. Joffe DJ, Freed SH. Effect of extended release Gymnema sylvestre leaf extract alone or in combination with oral hypoglycemics or insulin regimens for Type 1 and Type 2 diabetes. Diabetes Control Newsl. 2001;76:1-4.
18. Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med. 2000;160:1009-1013.
19. Vuksan V, Xu Z, Jenkins AL, et al. American ginseng (Panax quinquefolium L.) improves long term glycemic control in type 2 diabetes. Poster presented at: 60th scientific sessions of the American Diabetes Association; June 9-13, 2000; San Antonio, TX.
20. Sievenpiper JL, Stavro MP, Leiter LA, et al. Variable effects of ginseng: American ginseng (Panax quinquefolius L.) with a low ginsenoside content does not affect postprandial glycemia in normal subjects [abstract]. Diabetes. 2001;50(suppl 2):Abst #1771-PO.
22. Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, et al. Antidiabetic activity of Aloe vera L. juice II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomedicine. 1996;3:245-248.
31. Challiss RA, Leighton B, Lozeman FJ, et al. Effects of chronic administration of vanadate to the rat on the sensitivity of glycolysis and glycogen synthesis in skeletal muscle to insulin. Biochem Pharmacol. 1987;36:357-361.
34. Myerovitch J, Farfel A, Sack J, et al. Oral administration of vanadate normalizes blood glucose levels in streptozocin-treated rats. Characterization and mode of action. J Biol Chem. 1987;262:6658-6662.
37. Cohen N, Halberstam M, Shlimovich P, et al. Oral vanadyl sulfate improves hepatic and peripheral insulin sensitivity in patients with non-insulin-dependent diabetes mellitus. J Clin Invest. 1995;95:2501-2509.
43. Teixeira CC, Pinto LP, Kessler FHP, et al. The effect of Syzygium cumini (L.) skeels on post-prandial blood glucose levels in non-diabetic rats and rats with streptozotocin-induced diabetes mellitus. J Ethnopharmacol. 1997;56:209-213.
49. Earon G, Stern E, Lavosky H. Successful use of Atriplex hamilus in the treatment of type 2 diabetic patients. Controlled clinical research report on the subject of Atriplex. Jerusalem: Hebrew University; 1989. (Unpublished.)
54. Cignarella A, Nastasi M, Cavalli E, et al. Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate. Thromb Res. 1996;84:311-322.
55. Adler JH, Lazarovici G, Marton M, et al. The diabetic response of weanling sand rats (Psammomys obesus) to diets containing different concentrations of salt bush (Atriplex halimus).Diabetes Res. 1986;3:169-171.
59. Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther. 1996;34:406-409.
61. Frati-Munari AC, Del Valle-Martinez LM, Ariza-Andraca CR, et al. Hypoglycemic action of different doses of nopal (Opuntia streptacantha Lemaire) in patients with type II diabetes mellitus [in Spanish; English abstract]. Arch Invest Med (Mex). 1989;20:197-201.
64. Frati-Munari AC, de Leon C, Ariza-Andraca R, et al. Effect of a dehydrated extract of nopal (Opuntia ficus indica Mill.) on blood glucose [in Spanish; English abstract]. Arch Invest Med (Mex). 1989;20:211-216.
65. Frati Munari AC, Quiroz Lazaro JL, Altamirano Bustamante P, et al. The effect of various doses of nopal (Opuntia streptacantha Lemaire) on the glucose tolerance test in healthy individuals [in Spanish; English abstract]. Arch Invest Med (Mex). 1988;19:143-148.
66. Vuksan V, Jenkins DJ, Spadafora P, et al. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care. 1999;22:913-919.
68. Ahmad N, Hassan MR, Halder H, et al. Effect of Momordica charantia (Karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients. Bangladesh Med Res Counc Bull. 1999;25:11-13.
69. Jayasooriya AP, Sakono M, Yukizaki C, et al. Effects of momordica charantia powder on serum glucose levels and various lipid parameters in rats fed with cholesterol-free and cholesterol-enriched diets. J Ethnopharmacol. 2000;72:331-336.
73. Belury MA, Mahon A, Shi L. Role of conjugated linoleic acid (CLA) in the management of type 2 diabetes: evidence from Zucker diabetic (fa/fa) rats and human subjects. Paper presented at: 220th ACS National Meeting; August 20-24,2000; Washington, DC. Abstract AGFD 26.
74. Riserus U, Arner P, Brismar K, et al. Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome. Diabetes Care. 2002;25:1516-1521.
84. Shekhar KC, Achike FI, Kaur G, et al. A preliminary evaluation of the efficacy and safety of Cogent db (an ayurvedic drug) in the glycemic control of patients with type 2-diabetes. J Altern Complement Med. 2002;8:445-457.
86. Mohan V. Evaluation of Diabecon (D-400) as an antidiabetic agent—A double blind placebo controlled trial in NIDDM patients with secondary failure to oral drugs. Indian Journal of Clinical Practice. 1998;8:9,18.
88. Paolisso G, D'Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin-dependent diabetic patients. Am J Clin Nutr. 1993;57:650-656.
90. Singh RB, Niaz MA Rastogi SS, et al. Effect of hydrosoluble coenzyme Q10 on blood pressures and insulin resistance in hypertensive patients with coronary artery disease. J Human Hypertens. 1999;13:203-208.
92. Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Radic Biol Med. 1999;27:309-314.
94. Ludvigsson J, Samuelsson U, Johansson C, et al. Treatment with antioxidants at onset of type 1 diabetes in children: a randomized, double-blind placebo-controlled study. Diabetes Metab Res Rev. 2001;17:131-136.
98. Blostein-Fujii A, DeSilvestro RA, Frid D, et al. Short-term zinc supplementation in women with non-insulin-dependent diabetes mellitus: effects on plasma 5'- nucleotidase activities, insulin-like growth factor I concentrations, and lipoprotein oxidation rates in vitro. Am J Clin Nutr. 1997;66:639-642.
100. Cunningham JJ, Ellis SL, McVeigh KL, et al. Reduced mononuclear leukocyte ascorbic acid content in adults with insulin-dependent diabetes mellitus consuming adequate dietary vitamin C. Metabolism. 1991;40:146-149.
103. Franconi F, Bennardini F, Mattana A, et al. Plasma and platelet taurine are reduced in subjects with insulin-dependent diabetes mellitus: effects of taurine supplementation. Am J Clin Nutr. 1995;61:1115-1119.
109. Ludvigsson J, Samuelsson U, Johansson C, et al. Treatment with antioxidants at onset of type 1 diabetes in children: a randomized, double-blind placebo-controlled study. Diabetes Metab Res Rev. 2001;17:131-136.
117. Bennett PH, Knowler WC, Baird HR, Butler WJ, Pettitt DJ, Reid JM. Diet and the development of noninsulin-dependent diabetes mellitus: an epidemiological perspective. In: Pozza G, et al, eds. In: Diet, Diabetes, and Atherosclerosis. New York: Raven Press, 1984:109-199.
127. van Dam RM, Visscher AW, Feskens EJ, et al. Dietary glycemic index in relation to metabolic risk factors and incidence of coronary heart disease: the Zutphen Elderly Study. Eur J Clin Nutr. 2000;54:726-731.
131. Patti ME, Virkamaki A, Landaker EJ, et al. Activation of the hexosamine pathway by glucosamine in vivo induces insulin resistance of early postreceptor insulin signaling events in skelatal muscle. Diabetes. 1999;48:1562-1571.
132. Virkamaki A, Yki-Jarvinen H. Allosteric regulation of glycogen synthase and hexokinase by glucosamine-6-phosphate during glucosamine-induced insulin resistance in skeletal muscle and heart. Diabetes. 1999;48:1101-1107.
135. Kudolo GB. The effect of three- month ingestion of Ginko Biloba extract (EGb 761) on pancreatic b-cell function in response to glucose loading in individuals with non-insulin dependent diabetes mellitus. J Clin Pharmacol. 2001;41:600-611.
136. Grundy SM, Vega GL, McGovern ME, et al. Efficacy, safety, and tolerability of once-daily niacin for the treatment of dyslipidemia associated with type 2 diabetes: results of the assessment of diabetes control and evaluation of the efficacy of niaspan trial. Arch Intern Med. 2002;162:1568-1576.
137. Elam MB, Hunninghake DB, Davis KB, et al. Effect of niacin on lipid and lipoprotein levels and glycemic control in patients With diabetes and peripheral arterial disease. The ADMIT Study: a randomized trial. JAMA. 2000;284:1263-1270.
142. Rodriguez-Moran M, Guerrero-Romero F. Oral magnesium supplementation improves insulin sensitivity and metabolic control in type 2 diabetic subjects: a randomized double-blind controlled trial. Diabetes Care. 2003;26:1147-1152.
144. Ludvik BH, Mahdjoobian K, Waldhaeusl W, et al. The effect of Ipomoea batatas (Caiapo) on glucose metabolism and serum cholesterol in patients with type 2 diabetes: a randomized study. Diabetes Care. 2002;25:239-240.
145. Vray M, Attali JR. Randomized study of glibenclamide versus traditional Chinese treatment in type 2 diabetic patients. Chinese-French Scientific Committee for the Study of Diabetes. Diabete Metab. 1995;21:433-439.
147. Barringer TA, Kirk JK, Santaniello AC, et al. Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003;138:365-371.
148. Houweling ST, Kleefstra N, Jansman GA, et al. Effects of chromium treatment in patients with poorly controlled, insulin-treated Type 2 diabetes mellitus [abstract 756]. 18th International Diabetes Federation Congress, Paris, August 24-29, 2003.
149. Sievenpiper JL, Arnason JT, Leiter LA, et al. Null and opposing effects of Asian ginseng (Panax ginseng CA Meyer) on acute glycemia: results of two acute dose escalation studies. J Am Coll Nutr. 2003;22:524-532.
150. Vuksan V, Sievenpiper JL, Sung MK, et al. Safety and efficacy of Korean Red Ginseng Intervention (SAEKI): results of a randomized, double-blind, placebo-controlled crossover trial in type 2 diabetes [abstract 587P]. American Diabetes Association 63rd Annual Scientific Sessions. New Orleans, LA, June 13-17, 2003.
151. Imparl-Radosevich J, Deas S, Polansky MM, et al. Regulation of PTP-1 and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signaling. Horm Res. 1998;50:177-182.
152. Onderoglu S, Sozer S, Erbil KM, et al. The evaluation of long-term effects of cinnamon bark and olive leaf on toxicity induced by streptozotocin administration to rats. J Pharm Pharmacol. 1999;51:1305-1312.
160. Sangsuwan C, Udompanthurak S, Vannasaeng S, et al. Randomized controlled trial of Tinospora crispa for additional therapy in patients with type 2 diabetes mellitus. J Med Assoc Thai. 2004;87:543-546.
161. Lindstrom J, Eriksson JG, Valle TT, et al. Prevention of diabetes mellitus in subjects with impaired glucose tolerance in the Finnish Diabetes Prevention Study: results from a randomized clinical trial. J Am Soc Nephrol. 2003;14:S108-113.
162. Moloney F, Yeow TP, Mullen A, et al. Conjugated linoleic acid supplementation, insulin sensitivity, and lipoprotein metabolism in patients with type 2 diabetes mellitus. Am J Clin Nutr. 2004;80:887-895.
163. Riserus U, Arner P, Brismar K, et al. Treatment with dietary trans10cis12 conjugated linoleic acid causes isomer-specific insulin resistance in obese men with the metabolic syndrome. Diabetes Care. 2002;25:1516-1521.
164. Riserus U, Vessby B, Arner P, et al. Supplementation with trans10 cis12-conjugated linoleic acid induces hyperproinsulinaemia in obese men: close association with impaired insulin sensitivity. Diabetologia. 2004 May 28. [Epub ahead of print]
165. Sugiyama T, Kubota Y, Shinozuka K, et al. Ginkgo biloba extract modifies hypoglycemic action of tolbutamide via hepatic cytochrome P450 mediated mechanism in aged rats. Life Sci. 2004;75:1113-1122.
166. Scroggie DA, Albright A, Harris MD. The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Arch Intern Med. 2003;163:1587-1590.
168. Tannis AJ, Barban J, Conquer JA. Effect of glucosamine supplementation on fasting and non-fasting plasma glucose and serum insulin concentrations in healthy individuals. Osteoarthritis Cartilage. 2004;12:506-511.
169. Kleefstra N, Houweling ST, Jansman FG, et al. Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2006;29:521-525.
170. Sievenpiper JL, Sung MK, Di Buono M, et al. Korean red ginseng rootlets decrease acute postprandial glycemia: results from sequential preparation- and dose-finding studies. J Am Coll Nutr. 2006;25:100-107
171. I Sievenpiper JL, Arnason JT, Leiter LA, et al. Decreasing, null and increasing effects of eight popular types of ginseng on acute postprandial glycemic indices in healthy humans: the role of ginsenosides. J Am Coll Nutr. 2004;23:248-58.
176. Luo J, Van Yperselle M, Rizkalla SW, et al. Chronic consumption of short-chain fructooligosaccharides does not affect basal hepatic glucose production or insulin resistance in type 2 diabetics. J Nutr. 2000;130:1572-1577.
177. Alles MS, de Roos NM, Bakx JC, van de Lisdonk E, Zock PL, Hautvast GA. Consumption of fructooligosaccharides does not favorably affect blood glucose and serum lipid concentrations in patients with type 2 diabetes. Am J Clin Nutr. 1999;69:64-69.
180. Pei D, Hsieh CH, Hung YJ, et al. The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Metabolism. 2006;55:923-927.
182. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care. 2006;29:1826-1832.
183. Vuksan V, Sung MK, Sievenpiper JL, et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: Results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis. 2006 Jul 21. [Epub ahead of print]
184. Kudolo GB, Wang W, Elrod R, et al. Short-term ingestion of Ginkgo biloba extract does not alter whole body insulin sensitivity in non-diabetic, pre-diabetic or type 2 diabetic subjects-A randomized double-blind placebo-controlled crossover study. Clin Nutr. 2005 Nov 14. [Epub ahead of print]
185. Lucotti PC, Setola E, Monti LD, et al. Beneficial effects of oral l-arginine treatment added to a hypocaloric diet and exercise training program in obese, insulin resistant type 2 diabetic patients Am J Physiol Endocrinol Metab. 2006 Jun 13. [Epub ahead of print]
186. Cabrera-Rode E, Molina G, Arranz C, et al. Effect of standard nicotinamide in the prevention of type 1 diabetes in first degree relatives of persons with type 1 diabetes. Autoimmunity. 2006;39:333-340.
187. Gale EA, Bingley PJ, Emmett CL, et al. European Nicotinamide Diabetes Intervention Trial (ENDIT): a randomised controlled trial of intervention before the onset of type 1 diabetes. Lancet. 2004;363:925-931.
188. Collene AL, Hertzler SR, Williams JA, et al. Effects of a nutritional supplement containing Salacia oblonga extract and insulinogenic amino acids on postprandial glycemia, insulinemia, and breath hydrogen responses in healthy adults. Nutrition. 2005;21:848-854.
189. Heacock PM, Hertzler SR, Williams JA, et al. Effects of a medical food containing an herbal alpha-glucosidase inhibitor on postprandial glycemia and insulinemia in healthy adults. J Am Diet Assoc. 2005;105:65-71.
190. Song Y, He K, Levitan EB, et al. Effects of oral magnesium supplementation on glycaemic control in Type 2 diabetes: a meta-analysis of randomized double-blind controlled trials. Diabet Med. 2006;23:1050-1056.
196. Syvertsen C, Halse J, Hoivik HO, et al. The effect of 6 months supplementation with conjugated linoleic acid on insulin resistance in overweight and obese. Int J Obes (Lond). 2006 Oct 10. [Epub ahead of print]
197. Huseini HF, Larijani B, Heshmat R, et al. The efficacy of Silybum marianum (L.) Gaertn. (silymarin) in the treatment of type II diabetes: a randomized, double-blind, placebo-controlled, clinical trial. Phytother Res. 2006 Oct 30. [Epub ahead of print]
198. Muniyappa R, Karne RJ, Hall G, et al. Oral glucosamine for 6 weeks at standard doses does not cause or worsen insulin resistance or endothelial dysfunction in lean or obese subjects. Diabetes. 2006;55:3142-3150.
199. Ward NC, Wu JH, Clarke MW, et al. The effect of vitamin E on blood pressure in individuals with type 2 diabetes: a randomized, double-blind, placebo-controlled trial. J Hypertens. 2007;25:227-234.
200. Singer GM, Geohas J. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006;8:636-643.
201. Kleefstra N, Houweling ST, Bakker SJ, et al. Chromium treatment has no effect in patients with type 2 diabetes mellitus in a western population: a randomized, double-blind, placebo-controlled trial. Diabetes Care. 2007 Feb 15. [Epub ahead of print]
202. Hsu CH, Liao YL, Lin SC, et al. The mushroom agaricus blazei murill in combination with metformin and gliclazide improves insulin resistance in type 2 diabetes: a randomized, double-blinded, and placebo-controlled clinical trial. J Altern Complement Med. 2007;13:97-102.
203. Basu R, Man CD, Campioni M, et al. Two years of treatment with dehydroepiandrosterone does not improve insulin secretion, insulin action, or postprandial glucose turnover in elderly men or women. Diabetes. 2007;56:753-766.
206. Gualano B, Novaes RB, Artioli GG, et al. Effects of creatine supplementation on glucose tolerance and insulin sensitivity in sedentary healthy males undergoing aerobic training. Amino Acids. 2007 Mar 30. [Epub ahead of print]
208. Dans AM, Villarruz MV, Jimeno CA, et al. The effect of Momordica charantia capsule preparation on glycemic control in type 2 Diabetes Mellitus needs further studies. J Clin Epidemiol. 2007;60:554-559.
209. Albarracin CA, Fuqua BC, Evans JL, et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes Metab Res Rev. 2007 May 16. [Epub ahead of print]
210. Atteritano M, Marini H, Minutoli L, et al. Effects of the phytoestrogen genistein on some predictors of cardiovascular risk in osteopenic, postmenopausal women: a 2-years randomized, double-blind, placebo-controlled study. J Clin Endocrinol Metab. 2007 May 22. [Epub ahead of print]
211. Fukino Y, Ikeda A, Maruyama K, et al. Randomized controlled trial for an effect of green tea-extract powder supplementation on glucose abnormalities. Eur J Clin Nutr. 2007 Jun 6. [Epub ahead of print
212. Han JR, Deng B, Sun J, et al. Effects of dietary medium-chain triglyceride on weight loss and insulin sensitivity in a group of moderately overweight free-living type 2 diabetic Chinese subjects. Metabolism. 2007;56:985-991.
215. Ouellet V, Marois J, Weisnagel SJ, et al. Dietary cod protein improves insulin sensitivity in insulin-resistant men and women: a randomized controlled trial. Diabetes Care. 2007 Aug 6. [Epub ahead of print]
216. Albert SG, Fishman Oiknine R, Parseghian S, et al. The effect of glucosamine on serum high density lipoprotein cholesterol and apolipoprotein AI levels in people with diabetes mellitus. Diabetes Care. 2007 Aug 6. [Epub ahead of print]
217. Vuksan V, Whitham D, Sievenpiper JL, et al. Supplementation of conventional therapy with the novel grain salba (Salvia hispanica L.) improves major and emerging cardiovascular risk factors in type 2 diabetes: results of a randomized controlled trial. Diabetes Care. 2007 Aug 8. [Epub ahead of print]
220. Sobenin IA, Nedosugova LV, Filatova LV, et al. Metabolic effects of time-released garlic powder tablets in type 2 diabetes mellitus: the results of double-blinded placebo-controlled study. Acta Diabetol. 2007 Sep 6. [Epub ahead of print]
221. Mackenzie T, Leary L, Brooks WB. The effect of an extract of green and black tea on glucose control in adults with type 2 diabetes mellitus: double-blind randomized study. Metabolism. 2007;56:1340-1344.
224. Kataja-Tuomola M, Sundell JR, Mannisto S, et al. Effect of alpha-tocopherol and beta-carotene supplementation on the incidence of type 2 diabetes. Diabetologia. 2007 Nov 10. [Epub ahead of print]
228. Ramel A, Martinez A, Kiely M, et al. Beneficial effects of long-chain n-3 fatty acids included in an energy-restricted diet on insulin resistance in overweight and obese European young adults. Diabetologia. 2008 May 20.
229. Shidfar F, Keshavarz A, Hosseyni S, et al. Effects of omega-3 fatty acid supplements on serum lipids, apolipoproteins and malondialdehyde in type 2 diabetes patients. East Mediterr Health J. 2008;14:305-313.
Last reviewed July 2008 by EBSCO CAM Review Board
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2011 EBSCO Publishing All rights reserved.