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Type 2 Diabetes (Holistic)

Type 2 Diabetes (Holistic)

About This Condition

Also known as adult-onset diabetes, type 2 diabetes can often be managed by carefully monitoring your diet. According to research or other evidence, the following self-care steps may be helpful. 
  • Keep an eye on the GI

    Follow a low-glycemic-index diet by avoiding sweet snacks and processed foods, and emphasizing healthy carbohydrates from whole grains, beans, vegetables, and whole fruit, to help keep blood sugar levels stable.

  • Fight back with fiber   

    In addition to eating plenty of high-fiber fruits and vegetables, consider using a fiber supplement such as glucomannan or psyllium with meals.

  • Energize insulin function with weight loss and exercise

    Lower your blood sugar and improve insulin function with weight loss and regular exercise.

  • Check out chromium

    Improve glucose tolerance by taking 200 to 1,000 mcg of this essential trace mineral every day.

  • Improve and protect with ALA

    Take 600 to 1,200 mg a day of an alpha lipoic acid supplement to improve insulin sensitivity and help protect against diabetic complications such as nerve damage.

  • Try a topical ointment

    An ointment containing 0.025 to 0.075% capsaicin four times a day might help control nerve pain.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
  • Aim for a healthy weight

    Lose excess weight with a program of healthy eating, regular exercise, and group support to maintain healthy insulin sensitivity and prevent type 2 diabetes.

  • Get moving

    Use regular aerobic and/or strength exercise to maintain healthy insulin sensitivity and prevent type 2 diabetes.

  • Keep an eye on the GI

    Choose carbohydrate foods with a low glycemic index, such as whole grains, beans (legumes), and other high-fiber, unprocessed foods, to stabilize blood sugar and reduce diabetes risk.

  • Go vegetarian or vegan

    Vegetarians have been shown to have a low risk of type 2 diabetes.

  • Add some olive oil

    Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

About

About This Condition

Diabetes mellitus is an inability to metabolize carbohydrates resulting from inadequate insulin production or utilization. Other forms of diabetes (such as diabetes insipidus) are not included in this discussion.

There are two types of diabetes mellitus, type 1 and type 2. This article concerns type 2 diabetes, which has also been called adult-onset diabetes or non-insulin-dependent diabetes. However, type 2 diabetes may also affect children and may also require treatment with insulin. With type 2 diabetes, the pancreas often makes enough insulin, but the body has trouble using it. Type 2 diabetes frequently responds well to natural therapies.

People with diabetes cannot properly process glucose, a sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, however, the cells of the body can be starved for glucose. People with diabetes are at high risk for heart disease , atherosclerosis , cataracts , retinopathy , stroke , poor wound healing , infections , and damage to the kidneys and nerves. In addition, those with diabetes have a higher mortality rate if they also have high homocysteine levels.1

Healthy Lifestyle Tips

Everyone with diabetes aged 6 months and older should get a seasonal flu shot. Close household contacts and out-of-home caregivers of people with diabetes should also get the vaccines. People can receive both flu shots at the same time.2

People with diabetes should get the flu “shot" not the nasal spray type of vaccine. The flu shot is given with a needle, usually in the arm. The vaccine used in the shot is made from killed virus; you cannot catch the flu from the flu vaccine.

Most people with type 2 diabetes are overweight.3 Excess abdominal weight does not stop insulin formation,4 but it does make the body less sensitive to insulin.5 Excess weight can even make healthy people prediabetic,6 though weight loss can reverse this problem.7 In most studies, type 2 diabetes has improved with weight loss.8 , 9 , 10

Exercise helps decrease body fat and improve insulin sensitivity.11 , 12 People who exercise are less likely to develop type 2 diabetes than those who do not.13 However, exercise can induce low blood sugar in diabetics taking blood sugar–lowering medications, or even occasionally increased blood sugar.(14 Therefore, people with diabetes should never begin an intensive exercise program without consulting a healthcare professional.

Moderate alcohol drinking in healthy people improves glucose tolerance.15 , 16 , 17 , 18 However, alcohol has been reported to worsen glucose tolerance in the elderly and in people with diabetes in some studies.19 , 20 People with diabetes who drink have also been reported to have a high risk for eye and nerve damage.21 , 22

Questions remain about where the line should be drawn regarding alcohol intake. For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes;23 however, heavy drinking does increase the risk of developing diabetes and should be avoided.24 People with diabetes should limit alcohol intake to two drinks per day. Total avoidance of alcohol in people with diabetes who are not suffering from alcoholism , liver disease (e.g., cirrhosis ), gastritis , ulcers , and other conditions made worse by alcohol might actually be counterproductive. In one report, older people with type 2 diabetes who drank daily, but moderately, had a dramatically lower incidence of deaths from heart disease compared with nondrinkers.25 This outcome is not surprising since moderate alcohol intake is associated with protection from heart disease in most other reports. This finding may be of particular importance because heart disease is the leading killer of people with diabetes. In another study, nondrinkers had a higher incidence of type 2 diabetes than did moderate drinkers.26

People with diabetes who smoke are at higher risk for kidney damage,27 heart disease,28 and other diabetes-linked problems. Smokers are also more likely to develop diabetes,29 so it's important for diabetic smokers to quit.

Although most healthcare professionals agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes, disagreement exists within the medical community regarding the efficacy and necessity of SMBG by people with type 2 diabetes. A controlled clinical trial found that home glucose monitoring strips did not affect the management of type 2 diabetes.30 Moreover, a review of available literature concluded that the efficacy of SMBG in people with type 2 diabetes is questionable and should be tested in a rigorous high-quality trial.31 Advocates of SMBG, such as the ADA, have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific goals.32 These observations are well-supported in the medical literature.33 Detractors point out that indiscriminate use of self-monitoring is of questionable value and adds enormously to healthcare costs.34 The ADA acknowledges that accuracy of SMBG is instrument- and technique-dependent. Errors in technique and inadequate use of control procedures have been shown to lead to inaccurate test results.35 Nevertheless, it is likely that self-monitoring of blood glucose, if used properly, can have a positive effect by increasing a person's involvement in overall diabetes care.36 Pharmacists and healthcare practitioners can teach people with diabetes certain skills that will enhance their ability to properly self-manage blood glucose.

Holistic Options

Acupuncture may be helpful in the treatment of diabetes, or complications associated with diabetes. Preliminary trials have suggested that acupuncture can lower blood sugar and improve insulin production in people with type 2 diabetes,37 , 38 , 39 , 40 but trials on long-term effects have not been concluded. In a preliminary trial, 77% of people suffering from diabetic neuropathy experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many were also able to reduce pain medications, but no long-term change in blood-sugar control was observed.41 Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment with a significant reduction in symptoms in both controlled and uncontrolled trials.42 , 43

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation Why
Add some olive oil
Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance.

Diets high in fat, especially saturated fat, worsen glucose tolerance and increase the risk of type 2 diabetes,44 , 45 , 46 , 47 an effect that is not simply the result of weight gain caused by eating high-fat foods. Saturated fat is found primarily in meat, dairy fat, and the dark meat and skins of poultry. In contrast, glucose intolerance has been improved by diets high in monounsaturated oils,48 , 49 which may be good for people with diabetes.50 The best way to incorporate monounsaturates into the diet is to use olive oil, especially extra virgin olive oil, which has high antioxidant values.

Feast on fish
In one study, incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol.

Eating fish also may afford some protection from diabetes.51 Incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol.52

Fight back with fiber
Research has shown a high-fiber diet may work better in controlling diabetes than the diet recommended by the American Diabetic Association, and may control blood sugar levels as well as oral diabetes drugs.

A high-fiber diet has been shown to work better in controlling diabetes than the diet recommended by the ADA, and may control blood sugar levels as well as oral diabetes drugs.53 In this study, the increase in dietary fiber was accomplished exclusively by eating foods naturally high in fiber—such as leafy green vegetables, granola, and fruit—to a level beyond that recommended by the ADA. No fiber supplements were given. All participants received both the ADA diet (providing 24 grams of fiber per day) and the high-fiber diet (providing 50 grams of fiber per day) for a period of six weeks. After six weeks of following each diet, tests were performed to determine blood glucose, insulin, cholesterol, triglyceride, and other values. When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet. Insulin levels were 12% lower in the group eating the high-fiber diet compared to the group eating the ADA diet, indicating a beneficial increase in the body’s sensitivity to insulin. Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (“bad”) cholesterol compared with those eating the ADA diet. They also had slight decreases (improvements) in glycosylated hemoglobin levels, a measure of long-term blood glucose regulation.

High-fiber supplements, such as psyllium ,54 guar gum (found in cluster beans),55 pectin (from fruit),56 oat bran,57 and glucomannan ,58 , 59 have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.60 , 61 A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.62 Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats , and whole-grain products.

Go vegetarian or vegan
Vegetarians have been shown to have a low risk of type 2 diabetes, and when people with diabetic nerve damage switch to a vegan diet, improvements have been reported after several days.

Vegetarians also eat less protein than do meat eaters. Reducing protein in the diet has lowered kidney damage caused by diabetes and may also improve glucose tolerance.63 , 64 and may also improve glucose tolerance.65 However, in a group of 13 obese males with high blood-insulin levels (as is often seen in diabetes), a high-protein, low-carbohydrate diet resulted in greater weight loss and control of insulin levels, compared with a high-carbohydrate diet.66 Switching to either a high- or low-protein diet should be discussed with a doctor.

Keep an eye on the GI
Whole grains, beans, vegetables, and fruit help keep blood sugar levels stable because their low glycemic index does not cause blood sugar to spike.

The relationship between eating carbohydrates and type 2 diabetes is complex. While eating carbohydrates increases the need for insulin to keep blood sugar normal, diets high in total carbohydrates do not necessarily increase the risk of type 2 diabetes.67 , 68 Researchers have found that diets very high in sugar may worsen glucose tolerance in nondiabetic animals and humans.69 , 70 However, the amount of sugar used in these studies in proportion to other foods was much larger than is typically found in human diets.

Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels.71 The blood sugar–raising effect of a food, called its “glycemic index,” depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to table sugar (sucrose).72 People eating large amounts of foods with high glycemic indexes have been reported to be at increased risk of type 2 diabetes. 73 , 74 On the other hand, eating a diet high in carbohydrate-rich foods with low glycemic indexes is associated with a low risk of type 2 diabetes. 75 , 76 , 77Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber .

Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.78 , 79 , 80 Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,81 as long as blood levels of glucose, triglycerides , and cholesterol are maintained within normal levels.

Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high- fiber , whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.82

Limit sugar
Most doctors recommend that people with diabetes eat less sugary foods like snacks and processed foods and replace these foods with high-fiber, whole foods.

Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.83 , 84 , 85 Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,86 as long as blood levels of glucose, triglycerides , and cholesterol are maintained within normal levels.

Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high- fiber , whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.87

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement Why
3 Stars
Alpha Lipoic Acid
600 to 1,200 mg a day
Taking alpha lipoic acid may improve insulin sensitivity and help protect against diabetic complications such as nerve damage.
Alpha lipoic acid is a powerful natural antioxidant . Preliminary and double-blind trials have found that supplementing 600 to 1,200 mg of lipoic acid per day improves insulin sensitivity and the symptoms of diabetic neuropathy.88 , 89 , 90 , 91 , 92 , 93 , 94 , 95 In a preliminary study, supplementing with 600 mg of alpha lipoic acid per day for 18 months slowed the progression of kidney damage in patients with type 2 diabetes.96
3 Stars
Brewer’s Yeast
9 grams per day
Chromium-rich brewer’s yeast has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.

Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.97 , 98 In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.99 , 100 Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.101 Chromium supplements improve glucose tolerance in people with type 2 diabetes,102 apparently by increasing sensitivity to insulin .103 Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy .104 , 105 Chromium even helps healthy people,106 although one such report found chromium useful only when accompanied by 100 mg of niacin per day.107 Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).108 , 109

A few trials have reported no beneficial effects from chromium supplementation.110 , 111 , 112 All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.113 Many doctors recommend up to 1,000 mcg per day for people with diabetes.114

Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.

3 Stars
Cayenne Topical (Diabetic Neuropathy)
Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain
Topically applied capsaicin (from cayenne) may help relieve nerve pain.
Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes).115 , 116 Four or more applications per day may be required to relieve severe pain . This should be done only under a doctor’s supervision.
3 Stars
Chromium
200 to 1,000 mcg daily
Chromium has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.

Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.117 , 118 , 119 In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.120 , 121 Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.122 Chromium supplements improve glucose tolerance in people with type 2 diabetes,123 apparently by increasing sensitivity to insulin .124 Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy .125 , 126 Chromium even helps healthy people,127 although one such report found chromium useful only when accompanied by 100 mg of niacin per day.128 Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).129 , 130

A few trials have reported no beneficial effects from chromium supplementation.131 , 132 , 133 All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.134 Many doctors recommend up to 1,000 mcg per day for people with diabetes.135

Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.

3 Stars
Fenugreek
2.5 to 15 grams daily
Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption.
Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption.136 Animal research suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control.137 , 138In a controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in blood glucose following the meal.139 Another controlled trial found that taking 2.5 grams of fenugreek twice a day for three months reduced blood sugar levels in people with mild, but not those with severe, type 2 diabetes.140 In a double-blind study, 1 gram per day of an extract of fenugreek seeds for two months improved some measures of blood sugar control and insulin function in people with type 2 diabetes.141
3 Stars
Fiber
Talk to your doctor
Taking fiber supplements may help to stabilize your blood sugar.
High-fiber supplements, such as psyllium ,142 guar gum (found in cluster beans),143 pectin (from fruit),144 oat bran,145 and glucomannan ,146 , 147 have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.148 , 149 A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.150 Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats , and whole-grain products.
3 Stars
Glucomannan
500 to 700 mg per 100 calories in the diet
Glucomannan delays stomach emptying, leading to more gradual sugar absorption and lower blood sugar levels after meals.
Glucomannan is a water-soluble dietary fiber derived from konjac root (Amorphophallus konjac)that delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. 151 After-meal blood sugar levels are lower in people with diabetes given glucomannan in their food, 152 and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled clinical trials. 153 , 154 , 155 One preliminary report suggested that glucomannan may also be helpful in pregnancy-related diabetes. 156 For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research.
3 Stars
Magnesium
200 to 600 mg daily
People with type 2 diabetes tend to have low magnesium levels, supplementing with the mineral may restore levels and improve insulin production.

People with type 2 diabetes tend to have low magnesium levels.157 Double-blind research indicates that supplementing with magnesium overcomes this problem.158 Magnesium supplementation has improved insulin production in elderly people with type 2 diabetes.159 However, one double-blind trial found no effect from 500 mg magnesium per day in people with type 2 diabetes, although twice that amount led to some improvement.160 Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some,161 but not all, trials.162 However, in people with type 2 diabetes who nonetheless require insulin, Dutch researchers have reported no improvement in blood sugar levels from magnesium supplementation.163 The American Diabetes Association acknowledges strong associations between magnesium deficiency and insulin resistance but has not said magnesium deficiency is a risk factor164 Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200 to 600 mg of magnesium per day.

Diabetes-induced damage to the eyes is more likely to occur in magnesium-deficient people with type 1 diabetes.165 In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with type 1 diabetes.166 The American Diabetes Association admits “strong associations...between magnesium deficiency and insulin resistance” but will not say magnesium deficiency is a risk factor.167 Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200–600 mg of magnesium per day.

3 Stars
Psyllium
5.1 grams daily with meals
Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol.
Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11 to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared with a placebo.168
2 Stars
Acetyl-L-Carnitine (Diabetic Neuropathy)
500 to 1,000 mg three times daily
Taking acetyl-L-carnitine may improve symptoms of diabetic neuropathy.

In a double-blind study of people with diabetic neuropathy, supplementing with acetyl-L-carnitine was significantly more effective than a placebo in improving subjective symptoms of neuropathy and objective measures of nerve function.169 People who received 1,000 mg of acetyl-L-carnitine three times per day tended to fare better than those who received 500 mg three times per day.

2 Stars
Aloe
1 Tbsp (15 ml) of gel daily
Aloe, either alone or in combination with the oral hypoglycemic drug glibenclamide, has been shown to effectively lower blood sugar in people with type 2 diabetes.
Animal research and preliminary controlled human trials have found that Aloe vera, either alone or in combination with the oral hypoglycemic drug glibenclamide, effectively lowers blood sugar in people with type 2 diabetes.170 , 171 , 172 , 173 The typical amount used in this research was 1 tablespoon (15 ml) of aloe gel per day.
2 Stars
American Ginseng
3 grams with or following meals
Supplementing with American ginseng may help improve blood sugar control.
In a small preliminary trial, 3 grams of American ginseng was found to lower the rise in blood sugar following the consumption of a high-glucose drink by people with type 2 diabetes.174 The study found no difference in blood sugar–lowering effect if the herb was taken either 40 minutes before the drink or at the same time. A follow-up to this study found that increasing the amount of American ginseng to either 6 or 9 grams did not increase the effect on blood sugar following the high-glucose drink in people with type 2 diabetes.175 This study also found that American ginseng was equally effective in controlling the rise in blood sugar whether it was given together with the drink or up to two hours before.
2 Stars
Asian Ginseng
200 mg of herbal extract containing approximately 5 to 7% ginsenosides daily
Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes.
Asian ginseng is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and to increase the number of insulin receptors.176 , 177 Animal research has also revealed a direct blood sugar–lowering effect of ginseng.178 A double-blind trial found that 200 mg of ginseng extract per day improved blood sugar control, as well as energy levels in people with type 2 diabetes.179
2 Stars
Berberine (High Cholesterol)
500 mg of berberine taken twice a day for three months
Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels.
Berberine, a compound found in certain herbs such as goldenseal, barberry, and Oregon grape, has been found to lower serum cholesterol levels. In a study of people with high cholesterol levels, 500 mg of berberine taken twice a day for three months lowered the average cholesterol level by 29%. No significant side effects were reported, except for mild constipation.180
2 Stars
Bilberry
160 mg twice per day of an herbal extract containing 25% anthocyanosides
Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy.
Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy . One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy.181
2 Stars
Biotin
9 to 16 mg daily
Biotin may improve glucose levels and reduce pain from diabetic nerve damage.
Biotin is a B vitamin needed to process glucose. When people with type 2 diabetes were given 9 mg of biotin per day for two months, their fasting glucose levels dropped dramatically.182 Biotin may also reduce pain from diabetic nerve damage.183 Some doctors try 9 to 16 mg of biotin per day for a few weeks to see if blood sugar levels will fall.
2 Stars
Bitter Melon
50 to 100 ml of juice daily or 5 grams three times daily of powdered fruit
Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes.
Whole, fried slices,184 water extracts,185 and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes,186 according to preliminary trials. However, double-blind trials are needed to confirm this potential benefit.
2 Stars
Cinnamon
1 to 6 grams daily
Cinnamon may improve glucose utilization in people with type 2 diabetes.
Test tube studies have suggested that cinnamon may improve glucose utilization. In a study of people with type 2 diabetes, supplementing with cinnamon in the amount of 1, 3, or 6 grams per day for 40 days was significantly more effective than a placebo at reducing blood glucose levels.187 The reduction averaged 18 to 29% in the three treatments groups, and 1 gram per day was as effective as 3 and 6 grams per day. The benefits of cinnamon for lowering blood sugar levels was confirmed in a double-blind study.188 However, in two other double-blind studies, cinnamon was not more effective than a placebo.189 , 190 The different results in these studies may have been due in part to differences in body weight, initial blood sugar levels, and medication use among the different populations studied.
2 Stars
Coenzyme Q10
120 mg daily of a standardized herbal extract
Supplementing with CoQ10 may improve blood sugar metabolism.
Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. Animals with diabetes have been reported to be CoQ10 deficient. People with type 2 diabetes have been found to have significantly lower blood levels of CoQ10 compared with healthy people.191 In one trial, blood sugar levels fell substantially in 31% of people with diabetes after they supplemented with 120 mg per day of CoQ7, a substance similar to CoQ10.192 The importance of CoQ10 supplementation for people with diabetes remains an unresolved issue, though some doctors recommend approximately 50 mg per day as a way to protect against possible effects associated with diabetes-induced depletion.
2 Stars
Crepe Myrtle
32 or 48 mg of an herbal extract standardized to contain 1% corosolic acid
Crepe myrtle has been used in folk medicine to treat diabetes. It appears to work by lowering blood glucose levels.
Lagerstroemia speciosa, commonly known as crepe myrtle, grows in various tropical countries and Australia. In folk medicine it has been used to treat diabetes. In a preliminary study of people with type 2 diabetes, supplementing with an extract from the leaves of Lagerstroemia speciosa for two weeks resulted in a fall in blood-glucose levels averaging 20 to 30%.193 The amount used was 32 or 48 mg of a product standardized to contain 1% corosolic acid (a putative active ingredient). The larger amount was somewhat more effect than the smaller amount. Although these results are promising, additional studies are needed to demonstrate the long-term safety and efficacy of this herbal preparation.
2 Stars
Green Tea
Refer to label instructions
A meta-analysis of several studies found that green tea consumption may improve blood glucose control and insulin sensitivity.
A meta-analysis of 17 randomized controlled trials, including a total of 1,133 subjects (mostly overweight or obese, and/or having type 2 diabetes or borderline diabetes) found that green tea consumption significantly improved blood glucose control and insulin sensitivity.194
2 Stars
Gymnema
800 mg daily of an herbal extract standardized for 25% gymnemic acids
Gymnema may stimulate the pancreas to produce insulin and may help normalize blood sugar control in people with diabetes.
Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes. So far, no double-blind trials have confirmed the efficacy of gymnema for people with any type of diabetes. However, a preliminary study of type 2 diabetics reported that 400 mg per day of gymnema extract taken for periods of 18 months or longer resulted in improvement, according to diabetes blood tests, and allowed reduction of diabetic medications.195 Improvements in blood glucose levels were also seen in patients with type 2 diabetes who received 1 g per day of a specific gymnema extract (Om Santal Adivasi) for two months.196 In a controlled trial with type 1 (insulin-dependent) diabetics, a similar amount of gymnema extract reduced requirements for insulin.197 Whether the extract used in these studies was standardized for active constituents is unclear. Recently, a preliminary trial found improved blood sugar levels after three months in a group of type 1 and type 2 diabetics who took 800 mg per day of an extract standardized for 25% gymnemic acids.198 Gymnema is not a substitute for insulin, but insulin amounts may need to be lowered while taking gymnema to avoid hypoglycemia.
2 Stars
Hairy Basil
10 grams three times per day with meals
Taking hairy basil may help people with type 2 diabetes control their blood sugar levels.
Preliminary trials of leaves and hairy basil seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels. An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides, while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol. The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil would have similar effects.
2 Stars
Holy Basil
1,000 to 2,500 mg daily
Taking holy basil may help people with type 2 diabetes control their blood sugar levels.
Preliminary trials of holy basil (Ocimim sanctum) leaves and hairy basil (Ocimum canum) seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels.199 , 200 , 201 An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides,202 while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol.203 The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil (Ocimum basilicum) would have similar effects.
2 Stars
L-Carnitine
0.25 mg per 2.2 lbs (1 kg) of body weight
Supplementing with L-carnitine may reduce cholesterol and triglyceride levels in people with diabetes.

L-carnitine is an amino acid needed to properly utilize fat for energy. When people with diabetes were given DL-carnitine (0.5 mg per 2.2 pounds of body weight), high blood levels of fats—both cholesterol and triglycerides —dropped 25 to 39% in just ten days in one trial.204

2 Stars
Milk Thistle
200 mg per day of silymarin
Supplementing with silymarin (a component of milk thistle) may help lower blood sugar levels.
In a double-blind trial, supplementation with 200 mg per day of silymarin (a component of milk thistle) three times per day for four months significantly lowered blood sugar levels compared with a placebo in patients who were taking a blood sugar–lowering drug (glibenclamide).205
2 Stars
Multivitamin (Infection)
Follow label instructions
Supplementing with a multivitamin–mineral may give your body the nutrients it needs to help prevent common infections.
In a double-blind study, supplementation of middle-aged and elderly diabetics with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.206
2 Stars
Onion
20 grams fresh onion three times per day
Large amounts of onion have been shown to lower blood sugar levels in people with diabetes, possibly by blocking the breakdown of insulin in the liver.
Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.207 , 208 , 209 The mechanism of onion’s blood sugar-lowering action is not precisely known, though there is evidence that constituents in onions block the breakdown of insulin in the liver. This would lead to higher levels of insulin in the body.210
2 Stars
Pinitol
400 mg of pinitol three times per day
Pinitol, a molecule found in high concentrations in soybeans and other legumes, may decrease fasting blood sugar level, improve insulin sensitivity, and improve a measure of long-term blood sugar control (hemoglobin A1c).
Pinitol, a molecule found in high concentrations in soybeans and other legumes, is believed to enhance the action of insulin. In a double-blind trial, people with type 2 diabetes received 400 mg of pinitol or a placebo three times per day for 12 weeks. Compared with the placebo, pinitol significantly decreased the fasting blood sugar level, improved insulin sensitivity, and improved a measure of long-term blood sugar control (hemoglobin A1c).211
2 Stars
Pycnogenol
100 to 150 mg per day
Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes and slow progression of complications such as retinopathy.

Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes.212 Double-blind trials have shown that 100 to 125 mg per day of Pycnogenol lowers blood sugar in people with type 2 diabetes, but improvement in measures of long-term blood sugar control has not been consistent.213 , 214

Preliminary and double-blind studies have also shown Pycnogenol (typically 120 to 150 mg per day) slows the progression of diabetic retinopathy and improves vision.215 , 216 , 217 , 218 In a controlled trial of diabetic patients with symptoms of damage to the small blood vessels of the lower legs and feet, 150 mg per day of Pycnogenol improved measures of skin health and blood flow to the feet.219 In another controlled study, diabetic skin ulcers were treated with standard medications plus either 150 mg per day of Pycnogenol orally, 100 mg pycnogenol topically applied to the ulcers, or a combination of oral and topical Pycnogenol treatment.220 All treatments produced complete healing in more subjects after six weeks compared with a control group receiving no Pycnogenol treatment, but the group receiving oral and topical Pycnogenol had the greatest reductions in ulcer size and in pain and other associated symptoms.

2 Stars
Vitamin B1 and Vitamin B12 (Diabetic Neuropathy)
Refer to label instructions
Taking vitamin B1 combined with vitamin B12 may improve symptoms of diabetic neuropathy.
A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.221 However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.222 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.
2 Stars
Vitamin B1 and Vitamin B6 (Diabetic Neuropathy)
25 mg of vitamin B1 daily, with 50 mg of vitamin B6 daily
Taking vitamin B1 combined with vitamin B6 may improve symptoms of diabetic neuropathy.

A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.223 However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.224 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.

2 Stars
Vitamin B12 (Diabetic Neuropathy)
Consult a qualified healthcare practitioner
Vitamin B12 is needed for normal nerve cell function, and supplementing with it may improve symptoms of diabetic neuropathy.
Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally has reduced symptoms of nerve damage caused by diabetes in 39% of people studied; when given both intravenously and orally, two-thirds of people improved.225 In a preliminary trial, people with nerve damage due to kidney disease or to diabetes plus kidney disease received intravenous injections of 500 mcg of methylcobalamin (the main form of vitamin B12 found in the blood) three times a day for six months in addition to kidney dialysis. Nerve pain was significantly reduced and nerve function significantly improved in those who received the injections.226 Oral vitamin B12 up to 500 mcg three times per day is recommended by some practitioners.
2 Stars
Vitamin B6
1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily
People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance.

Many people with diabetes have low blood levels of vitamin B6 .227 , 228 Levels are even lower in people with diabetes who also have nerve damage (neuropathy).229 Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy.230 , 231 Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills.232 In a trial that included people with type 2 diabetes, 1,800 mg per day of a special form of vitamin B6—pyridoxine alpha-ketoglutarate—improved glucose tolerance dramatically.233 Standard vitamin B6 has helped in some,234 but not all, trials.235

2 Stars
Vitamin C
500 mg twice per day
Supplementing with vitamin C may benefit people with type 2 diabetes in several ways, including by reducing sorbitol levels, urinary protein loss, and glycosylation.

As with vitamin E, vitamin C may reduce glycosylation.236 Vitamin C also lowers sorbitol levels in people with diabetes.237 Sorbitol is a sugar that can accumulate inside the cells and damage the eyes, nerves, and kidneys of people with diabetes. Vitamin C may improve glucose tolerance in type 2 diabetes,238 , 239 , 240although not every study confirms this benefit.241 Vitamin C supplementation (500 mg twice a day for one year) has significantly reduced urinary protein loss in people with diabetes. Urinary protein loss (also called proteinuria) is associated with poor prognosis in diabetes.242 Many doctors suggest that people with diabetes supplement with 1 to 3 grams per day of vitamin C. Higher amounts could be problematic, however. In one person, 4.5 grams per day was reported to increase blood sugar levels.243

One study examined antioxidant supplement intake, including both vitamins E and C, and the incidence of diabetic retinopathy (damage to the eyes caused by diabetes).244 Surprisingly, people with extensive retinopathy had a greater likelihood of having taken vitamin C and vitamin E supplements. The outcome of this trial, however, does not fit with most other published data and might simply reflect the fact that sicker people are more likely to take supplements in hopes of getting better. For the present, most doctors remain relatively unconcerned about the outcome of this isolated report.

2 Stars
Vitamin D (Diabetic Neuropathy)
2,000 IU of vitamin D per day for three months
In a preliminary trial, supplementing with vitamin D per day significantly improved pain by almost 50% in patients with diabetic neuropathy.
A preliminary trial supplementation with about 2,000 IU of vitamin D per day for 3 months significantly improved pain by almost 50% in patients with diabetic neuropathy.245
2 Stars
Vitamin D
1,332 IU daily
Vitamin D is needed to maintain adequate insulin levels, and supplementing with it may improve blood sugar control in people with type 2 diabetes.
Vitamin D is needed to maintain adequate blood levels of insulin.246 Vitamin D receptors have been found in the pancreas where insulin is made. Some,247 , 248 , 249 but not all,250 , 251 preliminary trials have found that supplementation can improve some measures of blood sugar control in people with type 2 diabetes. In addition, in a preliminary trial supplementation with about 2,000 IU of vitamin D per day for three months significantly improved pain by almost 50% in patients with diabetic neuropathy.252 Not enough is known about optimal amounts of vitamin D for people with diabetes, and high amounts of vitamin D can be toxic; therefore, people with diabetes considering vitamin D supplementation should talk with a doctor and have their vitamin D status assessed.
2 Stars
Vitamin E (Diabetic Neuropathy)
900 IU daily
Vitamin E supplementation may protect against neuropathy.

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.253 , 254 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,255 , 256 , 257 but not all,258 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.259 , 260 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.261 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,262 , 263 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,264 , 265 , 266 , 267 , 268 although not all,269 , 270 , 271 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.272 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).273

2 Stars
Vitamin E (Diabetic Retinopathy)
1800 IU daily
Vitamin E supplementation may protect against diabetic retinopathy.

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.274 , 275 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,276 , 277 , 278 but not all,279 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.280 , 281 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.282 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,283 , 284 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,285 , 286 , 287 , 288 , 289 although not all,290 , 291 , 292 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.293 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).294

2 Stars
Zinc
15 to 25 mg per day
People with type 2 diabetes tend to be zinc deficient, supplementing with zinc may help restore levels.
People with type 2 diabetes tend to be zinc deficient,295 but some evidence indicates that zinc supplementation does not improve their ability to process sugar.296 Nonetheless, many doctors recommend that people with type 2 diabetes supplement with moderate amounts of zinc (15 to 25 mg per day) as a way to correct the deficit.
1 Star
Açaí
Refer to label instructions
Açaí is reported to be a traditional remedy for diabetes.
Açaí is reported to be a traditional remedy for diabetes. Although oxidative stress may contribute to diabetes297 and anthocyanins may improve insulin secretion,298 there is no published evidence that açaí has any effect on diabetes.
1 Star
Amylase Inhibitors
Refer to label instructions
Amylase inhibitors, when given with a starchy meal, can reduce the usual rise in blood sugar levels of people with diabetes.

Starch blockers are substances that inhibit amylase, the digestive enzyme required to break down dietary starches for normal absorption. Controlled research has demonstrated that concentrated starch blocker extracts, when given with a starchy meal, can reduce the usual rise in blood sugar levels of both healthy people and diabetics.299 , 300 , 301 , 302 , 303 While this effect could be helpful in controlling diabetes, no research has investigated the long-term effects of taking starch blockers for this condition.

1 Star
Evening Primrose Oil
4 grams daily
Supplementing with evening primrose oil has been found to improve nerve function and to relieve pain symptoms of diabetic neuropathy.
Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy.304 However, the principal investigator who conducted these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of the research.305 Therefore, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy.
1 Star
Fish Oil
Refer to label instructions
Supplementing with fish oil may improve glucose tolerance and symptoms of diabetic neuropathy and nephropathy
Glucose tolerance improves in healthy people taking omega-3 fatty acid supplements,306 and some studies have found that fish oil supplementation also improves glucose tolerance,307 high triglycerides ,308 and cholesterol levels in people with type 2 diabetes.309 And in one trial, people with diabetic neuropathy and diabetic nephropathy experienced significant improvement when given 600 mg three times per day of purified eicosapentaenoic acid (EPA)—one of the two major omega-3 fatty acids found in fish oil supplements—for 48 weeks.310 However, other studies have found that type 2 diabetes worsens with fish oil supplementation.311 , 312 , 313 , 314 Until this issue is resolved, people with diabetes should feel free to eat fish, but they should consult a doctor before taking fish oil supplements.
1 Star
Fructo-oligosaccharides
Refer to label instructions
In one trial, supplementing with fructo-oligosaccharides significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.
In a preliminary trial, supplementation with fructo-oligosaccharides (FOS) (8 grams per day for two weeks) significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.315 However, in another trial, supplementing with FOS (15 grams per day) for 20 days had no effect on blood-glucose or lipid levels in people with type 2 diabetes.316 In addition, some double-blind trials showed that supplementing with FOS or galacto-oligosaccharides (GOS) for eight weeks had no effect on blood-sugar levels, insulin secretion, or blood lipids in healthy people.317 , 318 Because of these conflicting results, more research is needed to determine the effect of FOS on diabetes and lipid levels.
1 Star
Ginkgo
Refer to label instructions
Ginkgo may help prevent and treat early-stage diabetic neuropathy.
Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.319
1 Star
Goldenseal
1 gram per day of berberine for two months
Preliminary research with berberine (an active compound in goldenseal) for two months lowered blood glucose levels in people with type 2 diabetes.
In a preliminary trial, supplementation with 1 gram per day of berberine (one of the active compounds in goldenseal) for two months significantly lowered blood glucose levels in patients with type 2 diabetes.320
1 Star
Green Coffee Extract
Refer to label instructions
Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies.
Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies.321 Test tube studies suggest that chlorogenic acid, a primary constituent found in both coffee and in green coffee extract may inhibit glucose production by the liver,322 which could theoretically lead to lower blood sugar. An animal study found that green coffee extract also prevented the reduction in insulin sensitivity caused by a high-fat diet.323 No human studies have tested the effect of green coffee extract on reducing risk of diabetes or improving insulin sensitivity, but a double-blind trial found that healthy people who drank a sweetened coffee beverage containing green coffee extract (providing 400 to 450 mg of chlorogenic acids) had lower blood sugar during the following two hours compared to when they drank the same coffee beverage without added green coffee extract.324 More research is needed to determine whether green coffee extract can help prevent or treat type 2 diabetes.
1 Star
Hibiscus
Refer to label instructions
Hibiscus is a traditional remedy in India for diabetes, and is supported by preliminary research.
Hibiscus is a traditional remedy in India for diabetes; this treatment is supported by preliminary studies from that country and by animal studies.325 , 326 Hibiscus is usually taken as tea, such as 1 to 2 teaspoons (3 to 6 grams) of dried flower infused in to 1 cup (250 ml) three times per day.
1 Star
Inositol
Refer to label instructions
Supplementing with inositol may improve diabetic neuropathy.
Inositol is needed for normal nerve function. Diabetes can cause a type of nerve damage known as diabetic neuropathy. This condition has been reported in some, but not all, trials to improve with inositol supplementation (500 mg taken twice per day).327
1 Star
Manganese
Refer to label instructions
People with diabetes may have low manganese levels, which can contribute to glucose intolerance. Supplementing with the mineral may help.
People with diabetes may have low blood levels of manganese.328 Animal research suggests that manganese deficiency can contribute to glucose intolerance and may be reversed by supplementation.329 A young adult with insulin-dependent diabetes who received oral manganese chloride (3 to 5 mg per day as manganese chloride) reportedly experienced a significant fall in blood glucose, sometimes to dangerously low levels. In four other cases, manganese supplementation had no effect on blood glucose levels.330 People with diabetes wishing to supplement with manganese should do so only with a doctor’s supervision.
1 Star
Medium-Chain Triglycerides
Refer to label instructions
Medium-chain triglycerides have been found to lower blood sugar levels and may be useful in treating type 3 diabetes.
Based on the results of a short-term clinical trial that found that medium-chain triglycerides (MCT) lower blood glucose levels,331 a group of researchers investigated the use of MCT to treat people with type 2 diabetes mellitus. Supplementation with MCT for an average of 17.5% of their total calorie intake for 30 days failed to improve most measures of diabetic control.332
1 Star
Mistletoe
Refer to label instructions
Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and it may reduce diabetes symptoms.
Mistletoe extract has been shown to stimulate insulin release from pancreas cells,333 and animal research found that it reduces symptoms of diabetes.334 No research in humans has yet been published; however, given mistletoe’s worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Traditionally, mistletoe is prepared by soaking 2 to 4 teaspoons (5 to 12 grams) of chopped mistletoe in 2 cups (500 ml) of water overnight. The mixture is drunk first thing in the morning and sweetened with honey if desired. Another batch may be left to steep during the day and drunk at bedtime.
1 Star
Olive Leaf
Refer to label instructions
Olive leaf extracts have been used experimentally to lower high blood sugar in diabetic animals.
Olive leaf extracts have been used experimentally to lower elevated blood-sugar levels in diabetic animals.335 These results have not been reproduced in human clinical trials.
1 Star
Quercetin
Refer to label instructions
Quercetin may be helpful for its ability to reduce levels of sorbitol—a sugar that accumulates in cells and damages the nerves, kidneys, and eyes of people with diabetes.
Doctors have suggested that quercetin might help people with diabetes because of its ability to reduce levels of sorbitol—a sugar that accumulates in nerve cells, kidney cells, and cells within the eyes of people with diabetes—and has been linked to damage to those organs.336 Clinical trials have yet to explore whether quercetin actually protects people with diabetes from neuropathy, nephropathy, or retinopathy .
1 Star
Reishi
Refer to label instructions
Reishi may have some beneficial action in people with diabetes.

Animal studies and some very preliminary trials in humans suggest reishi may have some beneficial action in people with diabetes.337 , 338

1 Star
Taurine
Refer to label instructions
Supplementing with taurine may affect insulin secretion and action, and may help protect the eyes and nerves from diabetic complications.
Animal studies have shown that supplementing with taurine, an amino acid found in protein-rich food, may affect insulin secretion and action, and may have potential in protecting the eyes and nerves from diabetic complications.339 However, a double-blind trial found no effect on insulin secretion or sensitivity when men with high risk for developing diabetes were given 1.5 grams per day of taurine for eight weeks.340 In another double-blind trial, taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes.341
1 Star
Vanadium
Refer to label instructions
Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.
Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.342 , 343 , 344 Over a six-week period, a small group of people with type 2 diabetes were given 75 to 300 mg of vanadyl sulfate per day.345 Only in the groups receiving 150 mg or 300 mg was glucose metabolism improved, fasting blood sugar decreased, and another marker for chronic high blood sugar reduced. At the 300 mg level, total cholesterol decreased, although not without an accompanying reduction in the protective HDL cholesterol. None of the amounts improved insulin sensitivity. Although there was no evidence of toxicity after six weeks of vanadyl sulfate supplementation, gastrointestinal side effects were experienced by some of the participants taking 150 mg per day and by all of the participants taking 300 mg per day. The long-term safety of the large amounts of vanadium needed to help people with type 2 diabetes (typically 100 mg per day) remains unknown. Many doctors expect that amounts this high may prove to be unsafe in the long term.
1 Star
Vitamin B3
Refer to label instructions
Small amounts of niacin (a form of vitamin B3) may help some people with type 2 diabetes.
The intake of large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision.346 , 347 Smaller amounts (500 to 750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes,348 though this research remains preliminary.
1 Star
Yerba Mate
Refer to label instructions
Preliminary research suggests yerba mate (Ilex paraguariensis) tea may improve measures of blood glucose control in people with type 2 diabetes.
In a preliminary trial, consumption of mate (Ilex paraguariensis) tea in the amount of 330 ml (about 12 ounces) 3 times per day for 60 days improved measures of blood glucose control in patients with type 2 diabetes.349

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