Introduction: Embracing Herbal Solutions in Diabetes Care

The management of diabetes involves multifaceted approaches, including lifestyle modifications, medication, and dietary adjustments. Herbal supplements offer potential benefits that many find attractive. However, integrating these into a diabetes care regimen requires understanding their mechanisms, effectiveness, and how to use them safely alongside traditional treatments.

Understanding Herbal Supplements for Diabetes

Herbal supplements are derived from plants and used primarily for their medicinal properties. They are available in various forms, such as teas, pills, powders, and extracts, and can complement diabetes treatment by offering additional health benefits.

Role in Diabetes Management: Herbal supplements can influence blood sugar levels through various mechanisms, including improving insulin sensitivity, enhancing pancreatic function, or increasing glucose uptake.

Considerations: It’s crucial to consider the scientific validity behind each supplement and its safety profile, especially regarding interactions with other diabetes medications.

Top Herbal Supplements for Diabetes Management

This section provides a detailed look at several widely used herbal supplements, examining the scientific evidence supporting their use and practical advice on their consumption.

1. Cinnamon

Benefits: Cinnamon is reputed to help reduce blood glucose levels and improve insulin sensitivity. It contains compounds that mimic insulin, improving glucose uptake by cells.

Scientific Backing: Studies like those published in the Journal of Diabetes Science and Technology have shown that cinnamon can lower fasting blood glucose levels.

How to Use: Incorporate small amounts of cinnamon into your diet by adding it to yogurt, smoothies, or whole-grain bread.

2. Fenugreek

Benefits: Fenugreek seeds are high in soluble fiber, which slows down carbohydrate digestion and absorption, helping to decrease blood glucose levels.

Scientific Backing: Research indicates that fenugreek can significantly improve glycemic control, with a study in the Journal of Medicinal Food demonstrating its efficacy.

How to Use: Fenugreek seeds can be soaked in water overnight and included in salads or taken as a supplement before meals.

3. Gymnema Sylvestre

Benefits: Known as the “sugar destroyer,” Gymnema can reduce sugar cravings and help lower blood sugar levels.

Scientific Backing: Studies suggest that Gymnema Sylvestre can enhance insulin production and potentially regenerate insulin-secreting cells.

How to Use: It is available in supplement form or as a tea. It’s advisable to start with a low dose to assess tolerance.

4. Bitter Melon

Benefits: Bitter melon acts on several fronts: it improves insulin secretion, enhances glucose uptake, and inhibits glucose formation in the liver.

Scientific Backing: According to research, bitter melon can improve blood sugar control in people with Type 2 diabetes.

How to Use: Bitter melon can be juiced or cooked as part of a meal. Supplements are also available but should be used under medical supervision.

Evaluating the Effectiveness and Safety of Herbal Supplements

Clinical Evidence

Despite promising studies, more large-scale, long-term clinical trials are needed to confirm the effectiveness and safety of many herbal supplements.

Regulatory Considerations

The FDA does not strictly regulate herbal supplements, which can lead to issues with quality and consistency. Opt for products certified by recognized bodies like USP (United States Pharmacopeia) or NSF International, ensuring they meet high quality standards.

Potential Interactions

Some herbal supplements can interact with conventional diabetes medications, potentially leading to hypoglycemia or other adverse effects. Always discuss new supplements with a healthcare provider to ensure they’re safe for use with your existing medications.

Conclusion: Integrating Herbal Supplements Wisely into Diabetes Management

While herbal supplements offer potential benefits for diabetes management, they should be used judiciously and in conjunction with conventional treatment strategies. By staying informed and consulting healthcare providers, individuals with diabetes can safely explore herbal supplements as part of a comprehensive approach to diabetes care.

“We envision a pill that a patient can take before a meal that transiently coats the gut to replicate the effects of surgery,” said co-senior author Jeff Karp, PhD, a bioengineer and principal investigator at BWH. “Over the last several years, we’ve been working with our surgical colleagues on this idea and have developed a material that meets an important clinical need.”

Surgery in a Pill

They selected a commonly used FDA-approved drug in the treatment of gastrointestinal ulcers known as sucralfate. The team modified the substance into a novel material that can coat the lining of the intestine. The engineered compound, referred to as LuCI (Luminal Coating of the Intestine), can be made into a dry powdered form that can be encapsulated as a pill.

The researchers found that once in the intestine of rats, LuCI can coat the gut, forming a thin layer to limit contact by the nutrients and lowers blood glucose response after a meal. After a meal, blood sugar levels rise and can stay elevated over time. However, one hour after LuCI was administered to the rats, the response to glucose was lowered by 47 percent. The team found that this response was temporary, and after three hours, the effect essentially disappeared.

The team is now testing the effect of short- and long-term use of LuCI in diabetic and obese rodent models. They also plan to advance some of their pilot studies showing that LuCI can be used to deliver drugs, including proteins directly to the gastrointestinal tract.

“Gastric bypass is one of the best studied surgeries in the world, and we know that it can lead to many benefits including positive effects for blood pressure, sleep apnea and certain forms of cancer, and a remarkably fast and weight-independent improvement in diabetes,” said Tavakkoli, co-senior author of the study. “Having a transient coating that could mimic the effects of surgery would be a tremendous asset for patients and their care providers.”

“What we’ve developed here is essentially, ‘surgery in a pill,'” said co-lead author Yuhan Lee, PhD, a materials scientist in the BWH Division of Engineering in Medicine. “We’ve used a bioengineering approach to formulate a pill that has good adhesion properties and can attach nicely to the gut in a preclinical model. And after a couple of hours, its effects dissipate.”

What is Cinnamon?

Cinnamon is a strong smelling spice which comes from the branches of the cinnamon tree. It is harvested from the inner bark and is usually ground and added to food and drinks for its aromatic and sweet tasting properties. It’s commonly used in baking, but can be added to coffee or a number of dishes. It has been used for many different medicinal practices throughout its history.

Supporting Evidence For Cinnamon as a Diabetes Treatment

In 2003 a study published in Diabetes Care suggested that cinnamon could reduce cholesterol and improve glucose function in those suffering from the disease.  Since people with diabetes have a higher chance of developing cardiovascular issues, the authors of the study recommended that inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.

Another study published in 2009 found that a 500 mg capsule of cinnamon taken twice a day for 3 months improved hemoglobin A1C levels (average blood glucose over the previous two to three months) in people with poorly controlled type 2 diabetes (who have hemoglobin A1C levels more than 7%).

A Chinese study in 2012 showed that cinnamon supplementation is able to significantly improve blood glucose control in Chinese patients with type 2 diabetes.

Interestingly, a study done at 3 primary care clinics at a United States military base published in Journal of the American Board of Family Medicine showed that cinnamon supplements are most effective in people who have poorly controlled blood sugars at the beginning of the treatment.

How Does Cinnamon Help Diabetes?

The main argument for cinnamon as a treatment for diabetes has been that it can have a beneficial effect on glucose control. In 2000, a study published in the Agricultural Research Magazine suggested that eating or drinking one gram of cinnamon each day could significantly increase insulin sensitivity, and therefore could be used to treat diabetes. More importantly, the authors of the article even argued that cinnamon might have the power to not only manage the disease, but actually reverse it either significantly or completely.

In 2007, a study in The American Journal of Clinical Nutrition was published, which once again advocated the use of cinnamon as diabetes treatment. The theory behind this assertion is that cinnamon increases the time it takes for the digestive system to process food, and therefore limits the amount of glucose which the body is exposed to over time.

Problems with Use of Cinnamon for Diabetes

Results need to be replicated:

One of the reasons that cinnamon is not widely accepted as a treatment for diabetes yet, is because there are not very large studies showing clearly that cinnamon for diabetes helps controlling blood sugars, at least not in everyone. A small number of studies does not mean that the results are guaranteed. Also, all the studies done so far are short term studies. We need to see if these results will be sustained over a prolonged periods of use. So, before anyone starts claiming that cinnamon is a miracle cure, we need to wait for large scale studies showing its benefit.

Toxicity of Cinnamon:

Even if there is some evidence that cinnamon can help to manage type 2 diabetes, the spice can actually be hazardous. The main concern here is coumarin, a naturally occurring ingredient found in Cassia cinnamon, the most common variety of the spice sold in Europe and the U.S. In high-enough doses, coumarin can cause liver damage in a small group of sensitive individuals. That is the reason Danish regulators are cracking down on a beloved treat we know as cinnamon swirls!

Most of the research showing that cinnamon can lower blood sugar has utilized cassia cinnamon. The extracts that are sold in health food stores are also primarily derived from cassia cinnamon. But cassia cinnamon from China, Vietnam or Indonesia contains coumarin. This compound is a natural component of the cassia spice. It is found in varying amounts in different brands. So it important to know where your supplements are manufactured before using them.

Health food stores now sell cinnamon extracts that have been purified so that there is no coumarin. One such brand of water-soluble cinnamon extract is Cinnulin PF.  A typical one-capsule serving of Cinnulin PF contains 150 milligrams of a water-soluble Cinnamomum burmannii extract that, according to the manufacturers, has been filtered to include only the type-A polymers associated with the benefits linked to whole cinnamon.

Is Cinnamon Beneficial For Anyone With Type 2 Diabetes?

Based on the research done so far, cinnamon is most effective in people with type 2 diabetes who have poorly controlled diabetes in spite of following the diet, exercise and medications.

“This study has the potential to gain better quality of life for patients with prediabetes and reduced capacity to regulate blood sugar levels, especially for those who have difficulties performing voluntary exercise,” said Elisabet Stener-Victorin, Ph.D., associate professor and study author at the Department of Physiology and Pharmacology and Reproductive Endocrinology and Metabolism, Karolinska Institutet, in Stockholm, Sweden.

The scientists used a cohort of overweight and obese women with and without PCOS. Changes in blood sugar levels were measured during and after 45 minutes of acupuncture. Blood glucose regulation was improved in both women with and without PCOS after 45 minutes of treatment. Researchers also used a group of rats to investigate the mechanism leading to blood glucose uptake. They found that electroacupuncture causing muscle contractions activates the autonomic nervous system in rats and that the blood glucose-regulating effect was reversed by administering drugs that block the autonomic receptors. This study has important clinical implications for patients with prediabetes and a reduced ability to regulate blood sugar levels.

“Acupuncture is tried and true, for at least certain symptoms,” said Thoru Pederson, Ph.D., Editor-in-Chief of The FASEB Journal. “Here we have a new possibility centered on a disease of massive morbidity.”

DermalAbyss is a proof-of-concept that presents a novel approach to bio-interfaces in which the body surface is rendered an interactive display. Traditional tattoo inks are replaced with biosensors whose colors change in response to variations in the interstitial fluid. It blends advances in biotechnology with traditional methods in tattoo artistry.

Using a liquid with biosensors instead of traditional ink, scientists want to turn the surface of the human skin into an “interactive display” – an idea that makes this proof-of-concept an exciting one to watch. Technology like this could become a revolutionary new way to monitor health.

Researchers investigated four biosensors, reacting to three pieces of biochemical information in body fluid and changes colors: The pH sensor changes between purple and pink, the glucose sensor shifts between blue and brown; the sodium and a second pH sensor fluoresce at a higher intensity under UV light.

The Dermal Abyss creates a direct access to the compartments in the body and reflects inner metabolic processes in a shape of a tattoo. It could be used for applications in continuously monitoring such as medical diagnostics, quantified self, and data encoding in the body.

Currently, during daily activities and before eating, diabetics need to monitor their glucose levels by piercing the skin, 3 to 10 times per day. With Dermal Abyss, we can imagine the future where the painful procedure is replaced with a tattoo, of which the color from pink to purple based on the glucose levels. Thus, the user could monitor the color changes and the need of insulin.

The researchers have tested the inks on patches of pig skin, using injections to change the levels of the fluids to be detected. Several injections in the skin were done in order to understand the visibility and functionality of the biosensors.

This is how the technology works-

Before this amazing technology can be approved in humans, it will need to go through several stages of testing, probably in animals first and then eventually in people. Things to look out for are toxicities of these inks.

There’s also the question of how to make sure the tattoo indicators are as accurate as possible. In a medical situation, you’d want that colour-changing ‘interface’ to be as reliable as a blood test, and we’re definitely not there yet.

“It will take a long time for anything practical to go to market, but it [the technology] evokes imaginations and opens up possibilities,” Liu told CBS News.

Well, maybe. Growing evidence suggests that the method by which blood sugar is lowered may make a big difference in heart risk. That has raised a medical dilemma affecting tens of millions of people with Type 2 diabetes — and for the doctors who treat them.

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Patients should not stop or change their diabetes medicines without first talking to their health care professional. Doing so can lead to uncontrolled blood sugar levels that can be harmful. Over time, this can cause serious problems, including blindness, nerve and kidney damage, and heart disease. Patients taking canaglifozin should notify their health care professionals right away if they notice any new pain or tenderness, sores or ulcers, or infections in their legs or feet.

Health care professionals should follow the recommendations in the canagliflozin drug labels. Monitor patients for the signs and symptoms described above and advise patients to seek medical advice if they experience them.

Canagliflozin is a prescription medicine used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It belongs to a class of drugs called sodium-glucose cotransporter-2 (SGLT2) inhibitors. Canagliflozin lowers blood sugar by causing the kidneys to remove sugar from the body through the urine. It is available as a single-ingredient product under the brand name Invokana and also in combination with the diabetes medicine metformin under the brand name Invokamet.

In the ongoing Canagliflozin Cardiovascular Assessment Study (CANVAS) clinical trial, the trial’s independent data monitoring committee (IDMC) identified an increased risk of leg and foot amputations.

The amputations occurred about twice as often in patients treated with canagliflozin compared to patients treated with placebo, which is an inactive treatment.

An interim analysis showed that over a year’s time, the risks of amputation for patients in the trial were equivalent to:

• 7 out of every 1,000 patients treated with 100 mg daily of canagliflozin
• 5 out of every 1,000 patients treated with 300 mg daily of canagliflozin
• 3 out of every 1,000 patients treated with placebo

Patients in the CANVAS trial have been followed for an average of 4.5 years to date. The IDMC has recommended, based on an overall assessment, that the CANVAS trial continue.

The IDMC has also reported that a second, similar trial evaluating canagliflozin, the CANVAS-R trial, has not shown the same risks of increased leg and foot amputations to date. Patients in the CANVAS-R trial have been followed for an average of 9 months.

FDA continues to evaluate this safety issue and will update the public when they have more information. FDA is urging health care professionals and patients to report side effects involving canagliflozin or other medicines to the FDA MedWatch program.

Source: FDA

Legumes are a food group rich in B vitamins, contain different beneficial minerals (calcium, potassium and magnesium) and sizeable amounts of fiber and are regarded as a low-glycemic index food, which means that blood glucose levels increase only slowly after consumption. Due to these unique nutritional qualities, eating legumes regularly can help improve human health. In fact, the Food and Agriculture Organization of the United Nations (FAO) declared 2016 as the international year of legumes to raise people’s awareness of their nutritional benefits.

Although legumes have long been though to offer protection against type 2 diabetes (which is a significant health problem worldwide affecting more than 400 million adults in 2015), to date there has been little research to confirm this association.

Lentils are the Winners

To increase the general level of knowledge in this area, researchers from the URV’s Human Nutrition Unit in collaboration with other research groups in the PREDIMED study evaluated the association between the consumption of the different sub-types of non-soy legumes and the risk of type 2 diabetes among individuals at high cardiovascular risk. They also evaluated the effect of replacing other protein- and carbohydrate-rich foods with legumes on the development of the disease.

Researchers analysed 3349 participants at high risk of cardiovascular disease but without type 2 diabetes at the beginning of the PREDIMED study. After 4 years of follow-up, the results have revealed that compared to individuals with a lower consumption of total legumes — lentils, chickpeas, beans and peas- (12.73 grams/day, approximately equivalent to 1.5 servings per week of 60g of raw legumes), individuals with a higher consumption (28.75 grams/day, equivalent to 3,35 servings/week) had a 35% lower risk of developing type 2 diabetes. Of the different subtypes of legume, lentils in particular were associated with a lower risk of type 2 diabetes.

Those participants who had a higher consumption of lentils during the follow-up (nearly 1 serving/week) compare to those individuals with a lower consumption (less than half a serving per week), had a 33% lower risk of developing the disease.

The researchers also found that the effect of replacing half a serving/day of foods rich in protein or carbohydrates, including eggs, bread, rice and baked potato, for half a serving/day of legumes was also associated with a lower risk of type 2 diabetes incidence.

The researchers highlight the importance of consuming legumes to prevent chronic diseases such as diabetes, but state that further research must be conducted in other populations to confirm these results.

Source: https://www.eurekalert.org/pub_releases/2017-03/uriv-tco033017.php