Samantha Harmon, MS, RDN, LDN May 25, 2021 4:34:58 PM

Diabetes Supplements: A Natural Complement to Traditional Diabetes Care

Diabetes supplements can be a valuable tool in a diabetes self-management toolbox. Supplements complement a healthy diet and lifestyle and can improve your body's management of blood sugar levels. Many of the supplements outlined below can also help with heart health and weight management.

The following supplements complement diabetes management in various ways. They can help increase insulin sensitivity (how your body responds to insulin), lower HbA1c, decrease fasting blood sugar levels, or slow gluconeogenesis (the creation of glucose in the body).

Diabetes supplements can also help manage diabetes-related symptoms such as neuropathy (nerve damage). Talk with your doctor, registered dietitian, or endocrinologist before starting any supplements.

 

7 Supplements for Type 2 Diabetes

1. Alpha-Lipoic Acid

Alpha-Lipoic Acid-pills

Alpha-lipoic acid is a powerful antioxidant that is naturally produced in the body. Studies show that this supplement can play an influential role in the prevention and treatment of diabetes.

Historically, alpha-lipoic acid has been used to treat diabetic nerve damage.1  Alpha-lipoic acid helps improve diabetes management through three main pathways:

  • Improving insulin sensitivity
  • Reducing HbA1c
  • Help improve diabetic neuropathy symptoms.2,3

Oral dosage recommendations are 600mg per day.4

 

2. Banaba Leaf

banaba-leaf-diabetes-use

Banaba is a plant native to India, the Philippines, and Southern Asia and historically used in folk medicine practices. Two of the main active compounds in the banaba leaf plant are corosolic and ellagic acids.5 These two acids, along with other elements in the Banaba leaf, have potent properties that help stabilize blood glucose levels through multiple pathways.

Specifically, the leaves of the plant can help lower blood glucose levels.6 Results from a study showed that a daily dosage of 32-48mg, standardized to 1% corosolic acid, can safely be taken daily for up to two weeks to see benefits.7

 

3. Bitter Melon (Bitter Gourd)

bitter-melons-diabetes

Bitter melon is a vine plant indigenous to India, Asia, East Africa, South America, and the Caribbean. It has a long history in different cultures of being used as a medicinal treatment for ailments.8 Today, it is used as a supplement to help improve glucose tolerance in patients with prediabetes and diabetes.

Aside from a supplement, bitter melon is in various recipes from its indigenous countries. The plant is typically consumed once cooked as it can be very bitter when eaten raw. Although not as strong as physician-prescribed metformin (an anti-diabetic medication), bitter melon supplements can also help lower blood glucose levels.9

A protein in the bitter melon plant acts like insulin in the body.10 Studies have used both powder and juice forms of bitter melon in daily doses of 2-4 grams for up to 16 weeks to achieve these results.11

 

4. Cinnamon

cinnamon-sticks

Cinnamon  has a long history in diabetes treatments in some Asian countries. Studies have found that cinnamon can lower glucose levels in addition to improving cholesterol and triglyceride levels.12 This is especially important as having high cholesterol or triglycerides can add further complications to diabetes management. Standardized dosing recommendations are not yet established.

 

5. Chromium

chromium-picolinate-1.jpg

Chromium is an essential mineral used for several functions in the body. One important function is helping insulin use glucose as energy in the body. By helping insulin to transport glucose into the cells, chromium can help lower blood glucose levels.13 Chromium supplements appear to have the greatest impact on diabetes management in patients with existing chromium deficiencies and with poorly controlled diabetes.14,15

These benefits include decreased HbA1C levels, decreased fasting blood glucose, improvements in blood lipid levels, and improvements in insulin sensitivity.16,17 The recommended dietary allowance (RDA) for daily chromium intake is specific to age, sex, pregnancy, and lactation status.

For males ages 19-50, the RDA 35mcg/day, and for males over 50, it is 30 mcg. For women ages 19-50, the daily RDA is 25mcg, and for women over 51, it is 20mcg/day.18

 

6. Nopal (Prickly Pear Cactus)

prickly-pear-cactus-nopal.jpg

Nopal, more commonly known as prickly pear cactus, is a plant indigenous to Mexico and is known for its use in the treatment of diabetes. Prickly pear also has many non-medical historical applications, such as using the plant's cactus spines as needles and the fruits' juice as a dye.19 The fruit has also been used in a variety of culinary dishes such as candies, preserves, and fruit leathers.9

Nopal uses several pathways to help lower blood glucose levels in patients with diabetes.21 This plant has high soluble fiber and pectin content which help lower blood glucose levels.20 Nopal also has strong antioxidant properties that help improve insulin sensitivity in patients with diabetes.4,21

Standardized dosing recommendations have not yet been established.

 

7. Red Yeast Rice

Red Yeast Rice

Red yeast rice has a history that dates back to 800 AD with the Tang Dynasty in China.22 The rice gets its name from the red color it develops after being fermented with Monascus purpureus yeast.22 This fermentation process produces a compound called monacolin K that has incredibly strong cholesterol and triglyceride-lowering properties.23 Studies have found that red yeast rice is similar to physician-prescribed lovastatin in its ability to lower blood lipid levels.24 These impacts are particularly relevant for those with diabetes as managing other health concerns can help with the successful self-management of diabetes.

Red yeast rice may also play an influential role in the prevention of diabetes. One study found that patients who used red yeast rice supplements had lower rates of diabetes when compared to those who used lovastatin.25 Effective dosage amounts are 600mg taken twice daily for up to 4.5 years.24,26

 

Taking Supplements with Diabetes Safety

It is important to talk with your doctor, dietitian, or endocrinologist before beginning any of these supplements to assist with your diabetes management. Some of these supplements can have potentially dangerous hypoglycemic effects when used in combination with other diabetic medications and insulin therapies.

Another key component to adding a supplement to your diabetes self-management is understanding the correct dosage and being aware of any potential negative side effects. Most of these side effects occur with high dosages or improper use with other medications. Be sure to start one supplement at a time and monitor for any adverse reactions or side effects.

If adverse reactions occur, stop taking the supplement and communicate your symptoms with your doctor. Lastly, check the dosage amount per pill on the supplement bottle. Sometimes this will not match the recommended dose amount from your doctor.

The U.S. Food and Drug Administration (FDA) does not approve supplements; therefore, the search for a reliable brand can fall to the consumer.

There are third-party organizations like the U.S. Pharmacopeial Convention and NSF International that independently verify the safety and reliability of supplements.27 To determine if a supplement brand is credible, you can check individual supplement brands and third-party organization's websites to find verified brands.

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and does not constitute medical or other professional advice. These statements have not been evaluated by the Food and Drug Administration (FDA)Further, the products referenced are not intended to diagnose, treat, cure or prevent any disease. 

References

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  2. Rahimlou, M., Asadi, M., Banaei Jahromi, N., & Mansoori, A. (2019). Alpha-lipoic acid (ALA) supplementation effect on glycemic and inflammatory biomarkers: A Systematic Review and meta- analysis. Clinical nutrition ESPEN, 32, 16–28. https://doi.org/10.1016/j.clnesp.2019.03.015
  3. Rochette, L., Ghibu, S., Muresan, A., & Vergely, C. (2015). Alpha-lipoic acid: molecular mechanisms and therapeutic potential in diabetes. Canadian journal of physiology and pharmacology, 93(12), 1021–1027. https://doi.org/10.1139/cjpp-2014-0353
  4. Ziegler, D., Ametov, A., Barinov, A., Dyck, P. J., Gurieva, I., Low, P. A., Munzel, U., Yakhno, N., Raz, I., Novosadova, M., Maus, J., & Samigullin, R. (2006). Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes care, 29(11), 2365–2370. https://doi.org/10.2337/dc06-1216
  5. Miura, T., Takagi, S., & Ishida, T. (2012). Management of Diabetes and Its Complications with Banaba (Lagerstroemia speciosa L.) and Corosolic Acid. Evidence-based complementary and alternative medicine : eCAM, 2012, 871495. https://doi.org/10.1155/2012/871495
  6. Fukushima, M., Matsuyama, F., Ueda, N., Egawa, K., Takemoto, J., Kajimoto, Y., Yonaha, N., Miura, T., Kaneko, T., Nishi, Y., Mitsui, R., Fujita, Y., Yamada, Y., & Seino, Y. (2006). Effect of corosolic acid on postchallenge plasma glucose levels. Diabetes research and clinical practice, 73(2), 174–177. https://doi.org/10.1016/j.diabres.2006.01.010
  7. Judy, W. V., Hari, S. P., Stogsdill, W. W., Judy, J. S., Naguib, Y. M., & Passwater, R. (2003). Antidiabetic activity of a standardized extract (Glucosol) from Lagerstroemia speciosa leaves in Type II diabetics. A dose-dependence study. Journal of ethnopharmacology, 87(1), 115–117. https://doi.org/10.1016/s0378-8741(03)00122-3
  8. Beloin, N.; Gbeassor, M.; Akpagana, K.; Hudson, J.; De Soussa, K.; Koumaglo, K.; Arnason, J. T. (2005). Ethnomedicinal uses of Momordica charantia (Cucurbitaceae) in Togo and relation to its phytochemistry and biological activity. Journal of Ethnopharmacology. 96 (1–2): 49–55. doi:10.1016/j.jep.2004.08.009.
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  10. Joseph, B. & Jini, D. (2013). Antidiabetic effects of momordica charantia (bitter melon) and its medical potency. Asian Pacific Journal of Tropical disease, 3(2), 93-102. https://doi.org/10.1016/S2222-1808(13)60052-3
  11. Inayat U Rahman, Khan, R. U., Khalil Ur Rahman, & Bashir, M. (2015). Lower hypoglycemic but higher antiatherogenic effects of bitter melon than glibenclamide in type 2 diabetic patients. Nutrition journal, 14, 13. https://doi.org/10.1186/1475-2891-14-13
  12. Allen, R. W., Schwartzman, E., Baker, W. L., Coleman, C. I., & Phung, O. J. (2013). Cinnamon use in type 2 diabetes: an updated systematic review and meta-analysis. Annals of family medicine, 11(5), 452–459. https://doi.org/10.1370/afm.1517
  13. Evans, J. L., and Bahng, M. (2014). Non-pharmaceutical Intervention Options for type 2 Diabetes: Diets and Dietary Supplements (Botanicals, Antioxidants, and Minerals), Eds De Groot LJ, Chrousos G, Dungan K, Feingold KR, Grossman A, Hershman JM et al. South Dartmouth MA: MDText.com, Inc.
  14. Paiva, A. N., Lima, J. G., Medeiros, A. C., Figueiredo, H. A., Andrade, R. L., Ururahy, M. A., Rezende, A. A., Brandão-Neto, J., & Almeida, M. d. (2015). Beneficial effects of oral chromium picolinate supplementation on glycemic control in patients with type 2 diabetes: A randomized clinical study. Journal of trace elements in medicine and biology : organ of the Society for Minerals and Trace Elements (GMS), 32, 66–72. https://doi.org/10.1016/j.jtemb.2015.05.006
  15. Rafiei, R., Habyby, Z., Fouladi, L., Najafi, S., Asgary, S., & Torabi, Z. (2014). Chromium level in prediction of diabetes in pre-diabetic patients. Advanced biomedical research, 3, 235. https://doi.org/10.4103/2277-9175.145737
  16. Necyk, C., & Zubach-Cassano, L. (2017). Natural Health Products and Diabetes: A Practical Review. Canadian journal of diabetes, 41(6), 642–647. https://doi.org/10.1016/j.jcjd.2017.06.014
  17. Suksomboon, N., Poolsup, N., & Yuwanakorn, A. (2014). Systematic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. Journal of clinical pharmacy and therapeutics, 39(3), 292–306. https://doi.org/10.1111/jcpt.12147
  18. National Institutes of Health. (2021). Chromium. Office of dietary supplements. https://ods.od.nih.gov/factsheets/Chromium-HealthProfessional/
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  20. Ota, A., & Ulrih, N. P. (2017). An Overview of Herbal Products and Secondary Metabolites Used for Management of Type Two Diabetes. Frontiers in pharmacology, 8, 436. https://doi.org/10.3389/fphar.2017.00436
  21. Leem, K.-H., Kim, M.-G., Hahm, Y.-T., and Kim, H. (2016). Hypoglycemic effect of Opuntia ficus-indica var. saboten is due to enhanced peripheral glucose uptake through activation of AMPK/p38 MAPK pathway. Nutrients 8, 800.
  22. Musselman, M. E., Pettit, R. S., & Derenski, K. L. (2012). A Review and Update of Red Yeast Rice. Journal of Evidence-Based Complementary & Alternative Medicine, 17(1), 33–39. https://doi.org/10.1177/2156587211429703
  23. Heber, D., Lembertas, A., Lu, Q. Y., Bowerman, S., & Go, V. L. (2001). An analysis of nine proprietary Chinese red yeast rice dietary supplements: implications of variability in chemical profile and contents. Journal of alternative and complementary medicine (New York, N.Y.), 7(2), 133–139. https://doi.org/10.1089/107555301750164181 Gerards, M. C., Terlou, R. J., Yu, H., Koks, C. H., &
  24. Gerdes, V. E. (2015). Traditional Chinese lipid-lowering agent red yeast rice results in significant LDL reduction but safety is uncertain - a systematic review and meta-analysis. Atherosclerosis, 240(2), 415–423. https://doi.org/10.1016/j.atherosclerosis.2015.04.004
  25. Chen, T. L., Lin, C. S., Lin, J. A., Yeh, C. C., Sung, L. C., Chang, Y. C., Shih, C. C., & Liao, C. C. (2020). Evaluating Risk of Incident Diabetes Between Patients Who Used Lovastatin and Red Yeast Rice Prescriptions (LipoCol Forte): A Retrospective Cohort Study Based on a Real-World Database. Diabetes, metabolic syndrome and obesity : targets and therapy, 13, 89–98. https://doi.org/10.2147/DMSO.S223833
  26. Sungthong, B., Yoothaekool, C., Promphamorn, S., & Phimarn, W. (2020). Efficacy of red yeast rice extract on myocardial infarction patients with borderline hypercholesterolemia: A meta-analysis of randomized controlled trials. Scientific reports, 10(1), 2769. https://doi.org/10.1038/s41598-020-59796-5
  27. Reaver, A. (2017). Are your supplements safe? Here's how to tell. Inside Tracker. https://blog.insidetracker.com/how-to-know-if-your-supplements-are-safe
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Samantha Harmon, MS, RDN, LDN

Samantha is a registered dietitian nutritionist and Nutrition Programs Manager at Base10 Genetics. She created a nutrition genomics program that combines nutrigenomics, dietitian coaching, and behavior science.

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