Looking for more than traditional western medicine to treat your diabetes? Here are some suggestions, but remember to consult your doctor first.

By Martin Downs
WebMD Feature

Reviewed By Brunilda Nazario

Alternative or complementary treatments spark the interest of many people with diabetes. The prospect of having better control over blood sugar levels or being less dependent on insulin injections by taking herbal supplements or vitamins is certainly attractive.

But do any of the things often touted as alternative diabetes treatments really work?

First, anyone interested in going down this road should consider the difference between the terms "alternative" and "complementary." When it comes to managing diabetes, the latter is the term experts prefer. "Alternative" implies that you ditch one treatment in favor of another. Rather, if you want to look into taking supplements, you should do so as a possible complement to the treatment program your doctor has prescribed.

Many herbs and vitamins have shown some promise for diabetes, but the scientific evidence for their safety and efficacy is too uncertain for experts to make recommendations about most of them.

That doesn't mean that doctors are closed-minded about the possibilities. "It's not as if we know everything we need to know," says Nathaniel Clark, MD, spokesman for the American Diabetes Association. "There's always a need for new therapies and new approaches."

Herbal Potential

Testimonials to the medicinal powers of various herbs -- not only in advertising, but also in millennia-old traditions of Eastern medicine -- are as abundant as the flora themselves. But modern medicine demands proof, and as herbal medicine gains popularity, scientists are busy testing the possible benefits of herbs for treating many diseases. Diabetes is no exception.

A recent study found that cinnamon can increase metabolism of blood glucose by triggering insulin release. In that study, as little as one-quarter teaspoon a day produced significant reductions in all patients' blood sugar levels. The cinnamon also improved the blood levels of fats called triglycerides.

Some of the herbs that have been studied include:

Aloe vera
Coccinia indica (ivy gourd)
Garlic
Ginseng
Gymnema sylvestre
Ocimum sanctum (holy basil)
Fenugreek
Fig leaf
Milk thistle
Momordica charantia
Prickly pear cactus

According to a review of past studies on these herbs published in the April issue of the journal Diabetes Care, all of them have shown promise for helping to regulate blood sugar levels. Nevertheless, none of the evidence counts as solid proof. The studies reviewed had shortcomings that leave the results open to question. In short, more research is needed.

In the meantime, remember: If you do try any of these, it's important that you share this information with your heath-care provider.

"I always partner up with my patients and let them tell me what they're interested in, and then we have an open discussion," says Patricia Geil, a dietitian in Lexington, Ky., and spokeswoman for the American Association of Diabetes Educators.

Clark's view is essentially the same. "My approach with patients is they're free to give it a try," he says -- provided that it's safe to take.

Can Herbs and Diabetes Drugs Mix?

Safety doesn't seem like a big issue with some of the herbs that might be helpful in diabetes. Garlic and fenugreek, of course, are common culinary seasonings. And the studies on herbs examined in the Diabetes Care review showed no serious side effects.

Nevertheless, it may be possible for complementary treatments to have bad interactions with prescription diabetes drugs. For example, if they actually work, your blood sugar levels could drop too far, causing hypoglycemia. For that reason, Geil tells people trying out supplements to test their blood sugar more often than they would otherwise. And try only one herb at a time. That way, you'll be better able to judge whether it seems to be working for you.

George B. Kudolo, PhD, a researcher at the University of Texas Health Sciences Center, is currently researching the interaction between three prescription diabetes drugs -- Glucotrol, Actos, and Glucophage -- with ginkgo biloba, in a study funded by the National Center for Complementary and Alternative Medicine (NCCAM).

In an earlier study, Kudolo found that ginkgo may be helpful to people with diabetes because it thins the blood, which can lower blood pressure and improve circulation. High blood pressure and poor circulation often accompany type 2 diabetes.

"We found that ginkgo was doing exactly the same thing that aspirin does," Kudolo says. Aspirin is known to be beneficial for people with heart disease or at risk for heart disease. Like aspirin, however, ginkgo may be dangerous when taken with prescription blood thinners.

Kudolo has also found that ginkgo can cause an increase in the production of insulin, although it apparently doesn't cause blood sugar levels to drop as a result. He suspects that the cause of this imbalance may interfere with the way some diabetes drugs work.

Vitamins and Minerals

The ADA recommends vitamin and mineral supplements for people with diabetes only if they may be deficient in them. For example, a daily multivitamin may be particularly helpful for those with diabetes who are

Elderly
Pregnant or lactating
Vegetarians
On low-calorie diets

The benefit of megadoses of vitamins is highly uncertain, according to the ADA's January 2003 position statement.

But it is important for your diet to contain all the vitamins you need. "I find, for most of my patients, it's very difficult for them to eat in the way I would love them to," Geil says. "I have no problems with a multivitamin and mineral supplement."

As for minerals, chromium has been much touted as a complementary diabetes treatment. The body needs this mineral to regulate blood sugar, but the ADA says taking a chromium supplement wouldn't do most people with diabetes any good. Research shows that chromium supplements can help those who have too little chromium, but most don't have a deficiency.

What's more, Geil says, "It's very difficult to determine chromium deficiency from lab work. We just don't have good testing for it right now."

Beyond Blood Sugar

Martin Stevens, MD, a researcher at the University of Michigan, recently finished a study (also funded by NCCAM) of the effects of Reiki, a traditional Eastern healing art, on people suffering from painful diabetic neuropathy.

Reiki is similar to therapeutic touch, but it's not hands-on. It's based on the idea of manipulating energy fields that practitioners believe surround the body in order to relieve pain or cure illness.

At present, Stevens and his colleagues are analyzing data gathered in the study, and they hope to present results at next year's annual ADA meeting. "There is a suggestion that there was a benefit, at least in some of the patients," Stevens says.

He says he thinks that Reiki could, in theory, act on the brain's pain centers and alter one's perception of pain. That could be seen in imaging studies of the brain, using technology such as MRI or CAT scans.

"We can actually directly test that, and we propose to do that if this study proves to be positive," Stevens says.

SOURCES: Nathaniel Clark, MD, national vice president for clinical affairs, American Diabetes Association. Patricia Geil, RD, spokeswoman, American Association of Diabetes Educators. George B. Kudolo, PhD, associate professor of clinical lab science, University of Texas Health Sciences Center. Martin Stevens, MD, associate professor, division of endocrinology and metabolism, University of Michigan Medical School. Yeh, G. Diabetes Care, April 2003; vol 26: pp 1277-1291. Position Statement. Diabetes Care, January 2003; vol 26, supplement 1: pp 551-561.

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