Herbal and Dietary Supplements for Type 2 Diabetes Management Reviewed

the MPR take:

The safety and efficacy of herbal and dietary products in managing patients with type 2 diabetes is reviewed in a new article published in the Journal of the American Pharmacists Association.  Based on the research, the strongest evidence for lowering blood glucose was seen with alpha-lipoic acid (ALA) and fenugreek.  In clinical trials, patients given ALA were shown to have significant reductions in fasting blood glucose and 2-hour postprandial glucose levels. While some studies have confirmed the effectiveness of ALA in treating diabetic peripheral neuropathy (DPN), it should be noted that other studies have shown no benefit in DPN. Fenugreek has been shown to significantly reduce A1C in clinical trials and is considered a safe and effective option for patients with type 2 diabetes. Because fenugreek is a fiber-rich plant, it may interfere with absorption of some drugs; coadministration of medications should be separated by at least 2 hours.  There is good evidence to support the use of ivy gourd and gymnema. While the exact mechanism of action is unclear, ivy gourd has been shown to reduce both fasting and postprandial blood glucose, however more data is needed before it can be recommended.  Gymnema appears to be a safe supplement and could possibly be recommended for glycemic lowering, but more trials need to be conducted in type 2 diabetes patients.  While there is evidence suggesting that vitamin E may help prevent both type 1 and type 2 diabetes, high-dose supplementation has also been linked to an increased risk of death from all causes.  Because of potential adverse effects, recommendation of vitamin E should be done cautiously, taking into account concomitant medications (anticoagulants) and medical conditions (bleeding disorders, congenital heart defects, Alzheimer’s disease).

The herbal and dietary supplement market has grown exponentially over the past decade as Americans increasingly use such agents for generalized health and the prevention and treatment of chronic disease states.