Alternative Therapies for Diabetes: Evidenced-Based Recommendations
Weight loss, exercise, and some supplements can help lower inflammation, reducing risks of heart disease, cancer and diabetes
Many patients with diabetes take complementary and alternative (CAM) therapies—some to lessen the number of diabetes agents they need and others to treat comorbidities such as peripheral neuropathy or bladder dysfunction. To help physicians better advise patients who ask about these therapies, researchers from the University of Wisconsin published an evidence-based review in the July issue of Journal of Family Practice.
“I expect these recommendations will be easy for physicians to incorporate [into practice] because they are evidence based and serve as safe and effective adjunctive treatments to traditional diabetes care,” said lead author Jacqueline Redmer, MD, MPH, Clinical Instructor in the Department of Family Medicine at the University of Wisconsin School of Medicine and Public Health in Madison. “Pharmaceutical management is important but not enough for patients who wish to achieve optimal health while living with diabetes,” she said.
In addition to physical activity and weight loss as the foundation of treatment plans, Dr. Redmer recommends a low-glycemic index, anti-inflammatory diet. “Not only will this result in improved glycemic control, but eating this type of diet will lower inflammation in the body—the harmful effects [of which] are known to contribute to the development of cardiovascular disease, cancer, autoimmune diseases, and many other conditions,” she said.
Three other practice recommendations emerged from the evidence-based review, according to Dr. Redmer:
- Chromium and fiber supplementation can help stabilize blood sugar levels and may be especially useful for patients who have prediabetes or diet-controlled diabetes and are not yet taking medications.
- Lowering stress hormone levels in the body through adequate sleep, stress reduction, and mind-body practices such as meditation and biofeedback are recommended for all patients with diabetes.
- Acupuncture can help with some of the complications of diabetes including peripheral neuropathy, gastroparesis, and bladder dysfunction.
NCCAM Evidence-Based Studies
National Center for Complimentary and Alternative Medicine (NCCAM) also has been compiling information on CAM therapies for diabetes. In addition to chromium, NCCAM has reviewed alpha-lipoic acid, omega-3 fatty acids,
Alpha-lipoic acid (ALA) has been researched for its effect on insulin sensitivity, glucose metabolism, and diabetic neuropathy. According to NCCAM, some studies have found benefits, but more research is needed. "Because ALA might lower blood sugar too much, people with diabetes who take it must monitor their blood sugar levels very carefully," noted NCCAM.
Omega-3 fatty acids are commonly found in fish, fish oil, vegetable oil (primarily canola and soybean), walnuts, and wheat germ. "Omega-3 fatty acids have been researched for their effect on controlling glucose and reducing heart disease risk in people with type 2 diabetes," noted NCCAM. Studies show that omega-3 fatty acids lower triglycerides, but do not affect blood glucose control, total cholesterol, or HDL (good) cholesterol in people with diabetes. In some studies, omega-3 fatty acids also raised LDL (bad) cholesterol. "Additional research, particularly long-term studies that look specifically at heart disease in people with diabetes, is needed."
Polyphenols—antioxidants found in tea and dark chocolate, are being studied for the effects on vascular health and on the body’s ability to use insulin. In vitro studies found that EGCG, a polyphenol found in green tea, may protect against cardiovascular disease and have a beneficial effect on insulin activity and glucose control. However, a few small clinical trials studying EGCG and green tea in people with diabetes have not shown such effects.
For more information on the NCCM studies, visit http://nccam.nih.gov/health/diabetes/CAM-and-diabetes.htm?nav=gsa