Herbals, Supplements and Diabetes: Round Two
Food Matters Notes
Monday January 15, 2001
Over 40% of Americans use herbals and supplements, yet less than half of them share this information with their health care providers. In 1994, the Dietary Supplement and Health Education Act (DSHEA) was passed by Congress. This legislation moved herbals and other complementary products into the category of "dietary supplements" exempting them from the same stringent approval process that is required for drugs. This means that herbals and supplements do not require proof that they are safe and effective to be marketed. Since individuals with diabetes often take a number of other medications, they should be especially cautious when using complementary therapies because of the potential for serious side effects and drug interactions.
More than 1200 plant compounds have been tested for their ability to lower blood glucose levels, but most of that testing has not been done in humans. Among the most promising of those that have been tested in humans for lowering blood glucose include bitter melon, fenugreek, gymnema sylvestre, and ginseng. Non-plant products thought to lower blood glucose include chromium, vanadium and nicotinamide. Nicotinamide may also potentially prevent Type 1 diabetes due to its protective effect on beta cell function. Other products that may reduce the symptoms of diabetes complications or correct nutritional deficiencies associated with diabetes are alpha lipoic acid, Vitamin E, magnesium and the plant products gamma linolenic acid, ginkgo biloba and garlic.
Until more carefully designed human studies can be completed on these products, it's important to be cautious. The safety and effectiveness of these supplements are largely unproven. A few tips for safe supplement use include:
- Keep your health care team informed about any dietary supplements you may be taking. These products may have side effects and interact with other medical conditions, drugs, nutrients, or complementary therapies.
- Supplements should only be used in addition to, and not as replacements for, the essential elements of your diabetes care regimen, such as meal planning, physical activity, and medications.
- Remember that "natural" does not necessarily mean "safe." Because most herbals and supplements are not subject to rigorous government safety and efficacy testing, they may be potentially more dangerous than conventional forms of medication.
- Do not use herbals or supplements if you are pregnant or breast-feeding. The effects of these products on the baby are unknown. Do not give children herbal supplements without first consulting their pediatrician.
- Do background research on a product before you begin taking it, particularly since many products are very expensive and may provide only questionable health benefits.
- Read labels carefully and look for telephone numbers, addresses and web sites on the labels of products so you can ask questions of the manufacturers. Purchase products that are standardized from companies that meet "Good Manufacturing Practice" (GMP) guidelines, as noted on the product label, to ensure product purity and safety.
- It is usually better to start use with single-ingredient products than multiple-ingredient products because if there were an adverse effect or a worsening of blood glucose it would be difficult to determine which ingredient is responsible. Begin with a small dose of a product and work up to the recommended dose to determine whether the supplement has any effect on blood glucose levels. For some products it may take several weeks to determine whether there is any effect on blood glucose.
- Monitor your blood glucose levels frequently when taking any type of nutritional supplement and share any concerns about changes in blood glucose with your health care team. Remember- taking a pill will not make up for an unhealthy lifestyle.
- Make careful note of any symptoms such as headaches, nausea, or rash that may be side effects from a supplement. If symptoms persist, stop taking the supplement and see your health care team.
- Web Sites:
- The Health Professional's Guide to Popular Dietary Supplements by Allison Sarubin. Published by The American Dietetic Association, 2000.
- Tyler's Honest Herbal by Steven Foster and Varro E. Tyler. Published by The Haworth Herbal Press, 2000.
13 January 2001
Last Updated: Thursday August 29, 2002 21:04:28
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