Complementary Medicine - Cam

Type 2 Diabetes (Holistic)

Topic Contents

Type 2 Diabetes (Holistic)

About This Condition

Also known as adult-onset diabetes, type 2 diabetes can often be managed by carefully monitoring your diet. According to research or other evidence, the following self-care steps may be helpful.

Keep an eye on the GI
Follow a low-glycemic-index diet by avoiding sweet snacks and processed foods, and emphasizing healthy carbohydrates from whole grains, beans, vegetables, and whole fruit, to help keep blood sugar levels stable.
Fight back with fiber
In addition to eating plenty of high-fiber fruits and vegetables, consider using a fiber supplement such as glucomannan or psyllium with meals.
Energize insulin function with weight loss and exercise
Lower your blood sugar and improve insulin function with weight loss and regular exercise.
Check out chromium
Improve glucose tolerance by taking 200 to 1,000 mcg of this essential trace mineral every day.
Improve and protect with ALA
Take 600 to 1,200 mg a day of an alpha lipoic acid supplement to improve insulin sensitivity and help protect against diabetic complications such as nerve damage.
Try a topical ointment
An ointment containing 0.025 to 0.075% capsaicin four times a day might help control nerve pain.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

Aim for a healthy weight
Lose excess weight with a program of healthy eating, regular exercise, and group support to maintain healthy insulin sensitivity and prevent type 2 diabetes.
Get moving
Use regular aerobic and/or strength exercise to maintain healthy insulin sensitivity and prevent type 2 diabetes.
Keep an eye on the GI
Choose carbohydrate foods with a low glycemic index, such as whole grains, beans (legumes), and other high-fiber, unprocessed foods, to stabilize blood sugar and reduce diabetes risk.
Go vegetarian or vegan
Vegetarians have been shown to have a low risk of type 2 diabetes.
Add some olive oil
Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.

About

About This Condition

Diabetes mellitus is an inability to metabolize carbohydrates resulting from inadequate insulin production or utilization. Other forms of diabetes (such as diabetes insipidus) are not included in this discussion.

There are two types of diabetes mellitus, type 1 and type 2. This article concerns type 2 diabetes, which has also been called adult-onset diabetes or non-insulin-dependent diabetes. However, type 2 diabetes may also affect children and may also require treatment with insulin. With type 2 diabetes, the pancreas often makes enough insulin, but the body has trouble using it. Type 2 diabetes frequently responds well to natural therapies.

People with diabetes cannot properly process glucose, a sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, however, the cells of the body can be starved for glucose. People with diabetes are at high risk for heart disease , atherosclerosis , cataracts , retinopathy , stroke , poor wound healing , infections , and damage to the kidneys and nerves. In addition, those with diabetes have a higher mortality rate if they also have high homocysteine levels.¹

Healthy Lifestyle Tips

Everyone with diabetes aged 6 months and older should get a seasonal flu shot. Close household contacts and out-of-home caregivers of people with diabetes should also get the vaccines. People can receive both flu shots at the same time.²

People with diabetes should get the flu “shot" not the nasal spray type of vaccine. The flu shot is given with a needle, usually in the arm. The vaccine used in the shot is made from killed virus; you cannot catch the flu from the flu vaccine.

Most people with type 2 diabetes are overweight.³ Excess abdominal weight does not stop insulin formation,⁴ but it does make the body less sensitive to insulin.⁵ Excess weight can even make healthy people prediabetic,⁶ though weight loss can reverse this problem.⁷ In most studies, type 2 diabetes has improved with weight loss.⁸ ^{, 9} ^{, 10}

Exercise helps decrease body fat and improve insulin sensitivity.¹¹ ^{, 12} People who exercise are less likely to develop type 2 diabetes than those who do not.¹³ However, exercise can induce low blood sugar in diabetics taking blood sugar–lowering medications, or even occasionally increased blood sugar.(¹⁴ Therefore, people with diabetes should never begin an intensive exercise program without consulting a healthcare professional.

Moderate alcohol drinking in healthy people improves glucose tolerance.¹⁵ ^{, 16} ^{, 17} ^{, 18} However, alcohol has been reported to worsen glucose tolerance in the elderly and in people with diabetes in some studies.¹⁹ ^{, 20} People with diabetes who drink have also been reported to have a high risk for eye and nerve damage.²¹ ^{, 22}

Questions remain about where the line should be drawn regarding alcohol intake. For healthy people, light drinking will not increase the risk of diabetes, and may even reduce the risk of developing type 2 diabetes;²³ however, heavy drinking does increase the risk of developing diabetes and should be avoided.²⁴ People with diabetes should limit alcohol intake to two drinks per day. Total avoidance of alcohol in people with diabetes who are not suffering from alcoholism , liver disease (e.g., cirrhosis ), gastritis , ulcers , and other conditions made worse by alcohol might actually be counterproductive. In one report, older people with type 2 diabetes who drank daily, but moderately, had a dramatically lower incidence of deaths from heart disease compared with nondrinkers.²⁵ This outcome is not surprising since moderate alcohol intake is associated with protection from heart disease in most other reports. This finding may be of particular importance because heart disease is the leading killer of people with diabetes. In another study, nondrinkers had a higher incidence of type 2 diabetes than did moderate drinkers.²⁶

People with diabetes who smoke are at higher risk for kidney damage,²⁷ heart disease,²⁸ and other diabetes-linked problems. Smokers are also more likely to develop diabetes,²⁹ so it's important for diabetic smokers to quit.

Although most healthcare professionals agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes, disagreement exists within the medical community regarding the efficacy and necessity of SMBG by people with type 2 diabetes. A controlled clinical trial found that home glucose monitoring strips did not affect the management of type 2 diabetes.³⁰ Moreover, a review of available literature concluded that the efficacy of SMBG in people with type 2 diabetes is questionable and should be tested in a rigorous high-quality trial.³¹ Advocates of SMBG, such as the ADA, have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific goals.³² These observations are well-supported in the medical literature.³³ Detractors point out that indiscriminate use of self-monitoring is of questionable value and adds enormously to healthcare costs.³⁴ The ADA acknowledges that accuracy of SMBG is instrument- and technique-dependent. Errors in technique and inadequate use of control procedures have been shown to lead to inaccurate test results.³⁵ Nevertheless, it is likely that self-monitoring of blood glucose, if used properly, can have a positive effect by increasing a person's involvement in overall diabetes care.³⁶ Pharmacists and healthcare practitioners can teach people with diabetes certain skills that will enhance their ability to properly self-manage blood glucose.

Holistic Options

Acupuncture may be helpful in the treatment of diabetes, or complications associated with diabetes. Preliminary trials have suggested that acupuncture can lower blood sugar and improve insulin production in people with type 2 diabetes,³⁷ ^{, 38} ^{, 39} ^{, 40} but trials on long-term effects have not been concluded. In a preliminary trial, 77% of people suffering from diabetic neuropathy experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many were also able to reduce pain medications, but no long-term change in blood-sugar control was observed.⁴¹ Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment with a significant reduction in symptoms in both controlled and uncontrolled trials.⁴² ^{, 43}

Eating Right

The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.

Recommendation	Why
Add some olive oil	Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance. Diets high in fat, especially saturated fat, worsen glucose tolerance and increase the risk of type 2 diabetes,⁴⁴ ^{, 45} ^{, 46} ^{, 47} an effect that is not simply the result of weight gain caused by eating high-fat foods. Saturated fat is found primarily in meat, dairy fat, and the dark meat and skins of poultry. In contrast, glucose intolerance has been improved by diets high in monounsaturated oils,⁴⁸ ^{, 49} which may be good for people with diabetes.⁵⁰ The best way to incorporate monounsaturates into the diet is to use olive oil, especially extra virgin olive oil, which has high antioxidant values.
Feast on fish	In one study, incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol. Eating fish also may afford some protection from diabetes.⁵¹ Incorporating a fish meal into a weight-loss regimen was more effective than either measure alone at improving glucose and insulin metabolism and high cholesterol.⁵²
Fight back with fiber	Research has shown a high-fiber diet may work better in controlling diabetes than the diet recommended by the American Diabetic Association, and may control blood sugar levels as well as oral diabetes drugs. A high-fiber diet has been shown to work better in controlling diabetes than the diet recommended by the ADA, and may control blood sugar levels as well as oral diabetes drugs.⁵³ In this study, the increase in dietary fiber was accomplished exclusively by eating foods naturally high in fiber—such as leafy green vegetables, granola, and fruit—to a level beyond that recommended by the ADA. No fiber supplements were given. All participants received both the ADA diet (providing 24 grams of fiber per day) and the high-fiber diet (providing 50 grams of fiber per day) for a period of six weeks. After six weeks of following each diet, tests were performed to determine blood glucose, insulin, cholesterol, triglyceride, and other values. When glucose levels were monitored over a 24-hour period, participants eating the high-fiber diet had an average glucose level that was 10% lower than participants eating the ADA diet. Insulin levels were 12% lower in the group eating the high-fiber diet compared to the group eating the ADA diet, indicating a beneficial increase in the body’s sensitivity to insulin. Moreover, people eating the high-fiber diet experienced significant reductions in total cholesterol, triglycerides, and LDL (“bad”) cholesterol compared with those eating the ADA diet. They also had slight decreases (improvements) in glycosylated hemoglobin levels, a measure of long-term blood glucose regulation. High-fiber supplements, such as psyllium ,⁵⁴ guar gum (found in cluster beans),⁵⁵ pectin (from fruit),⁵⁶ oat bran,⁵⁷ and glucomannan ,⁵⁸ ^{, 59} have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.⁶⁰ ^{, 61} A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.⁶² Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats , and whole-grain products.
Go vegetarian or vegan	Vegetarians have been shown to have a low risk of type 2 diabetes, and when people with diabetic nerve damage switch to a vegan diet, improvements have been reported after several days. Vegetarians also eat less protein than do meat eaters. Reducing protein in the diet has lowered kidney damage caused by diabetes and may also improve glucose tolerance.⁶³ ^{, 64} and may also improve glucose tolerance.⁶⁵ However, in a group of 13 obese males with high blood-insulin levels (as is often seen in diabetes), a high-protein, low-carbohydrate diet resulted in greater weight loss and control of insulin levels, compared with a high-carbohydrate diet.⁶⁶ Switching to either a high- or low-protein diet should be discussed with a doctor.
Keep an eye on the GI	Whole grains, beans, vegetables, and fruit help keep blood sugar levels stable because their low glycemic index does not cause blood sugar to spike. The relationship between eating carbohydrates and type 2 diabetes is complex. While eating carbohydrates increases the need for insulin to keep blood sugar normal, diets high in total carbohydrates do not necessarily increase the risk of type 2 diabetes.⁶⁷ ^{, 68} Researchers have found that diets very high in sugar may worsen glucose tolerance in nondiabetic animals and humans.⁶⁹ ^{, 70} However, the amount of sugar used in these studies in proportion to other foods was much larger than is typically found in human diets. Eating carbohydrate-containing foods, whether high in sugar or high in starch (such as bread, potatoes, processed breakfast cereals, and rice), temporarily raises blood sugar and insulin levels.⁷¹ The blood sugar–raising effect of a food, called its “glycemic index,” depends on how rapidly its carbohydrate is absorbed. Many starchy foods have a glycemic index similar to table sugar (sucrose).⁷² People eating large amounts of foods with high glycemic indexes have been reported to be at increased risk of type 2 diabetes. ⁷³ ^{, 74} On the other hand, eating a diet high in carbohydrate-rich foods with low glycemic indexes is associated with a low risk of type 2 diabetes. ⁷⁵ ^{, 76} ^{, 77}Beans, peas, fruit, and oats have low glycemic indexes, despite their high carbohydrate content, due mostly to the health-promoting effects of soluble fiber . Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.⁷⁸ ^{, 79} ^{, 80} Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,⁸¹ as long as blood levels of glucose, triglycerides , and cholesterol are maintained within normal levels. Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high- fiber , whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.⁸²
Limit sugar	Most doctors recommend that people with diabetes eat less sugary foods like snacks and processed foods and replace these foods with high-fiber, whole foods. Diabetes disrupts the mechanisms by which the body controls blood sugar. Until recently, health professionals have recommended sugar restriction to people with diabetes, even though short-term high-sugar diets have been shown, in some studies, not to cause blood sugar problems in people with diabetes.⁸³ ^{, 84} ^{, 85} Currently, the American Diabetic Association (ADA) guidelines do not prohibit the use of moderate amounts of sugar,⁸⁶ as long as blood levels of glucose, triglycerides , and cholesterol are maintained within normal levels. Most doctors recommend that people with diabetes to reduce the amount of sugar eaten in snacks and processed foods, and replace these foods with high- fiber , whole foods. This tends to lower the glycemic index of the overall diet and has the additional benefit of increasing vitamin, mineral, and fiber intake. Other authorities also recommend lowering the glycemic index of the diet to improve the control of diabetes.⁸⁷

Supplements

What Are Star Ratings?

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.

3 Stars Reliable and relatively consistent scientific data showing a substantial health benefit.

2 Stars Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

1 Star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Supplement	Why
3 Stars Alpha Lipoic Acid 600 to 1,200 mg a day	Taking alpha lipoic acid may improve insulin sensitivity and help protect against diabetic complications such as nerve damage. Alpha lipoic acid is a powerful natural antioxidant . Preliminary and double-blind trials have found that supplementing 600 to 1,200 mg of lipoic acid per day improves insulin sensitivity and the symptoms of diabetic neuropathy.⁸⁸ ^{, 89} ^{, 90} ^{, 91} ^{, 92} ^{, 93} ^{, 94} ^{, 95} In a preliminary study, supplementing with 600 mg of alpha lipoic acid per day for 18 months slowed the progression of kidney damage in patients with type 2 diabetes.⁹⁶
3 Stars Brewer’s Yeast 9 grams per day	Chromium-rich brewer’s yeast has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance. Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.⁹⁷ ^{, 98} In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.⁹⁹ ^{, 100} Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.¹⁰¹ Chromium supplements improve glucose tolerance in people with type 2 diabetes,¹⁰² apparently by increasing sensitivity to insulin .¹⁰³ Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy .¹⁰⁴ ^{, 105} Chromium even helps healthy people,¹⁰⁶ although one such report found chromium useful only when accompanied by 100 mg of niacin per day.¹⁰⁷ Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).¹⁰⁸ ^{, 109} A few trials have reported no beneficial effects from chromium supplementation.¹¹⁰ ^{, 111} ^{, 112} All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.¹¹³ Many doctors recommend up to 1,000 mcg per day for people with diabetes.¹¹⁴ Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.
3 Stars Cayenne Topical (Diabetic Neuropathy) Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain	Topically applied capsaicin (from cayenne) may help relieve nerve pain. Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes).¹¹⁵ ^{, 116} Four or more applications per day may be required to relieve severe pain . This should be done only under a doctor’s supervision.
3 Stars Chromium 200 to 1,000 mcg daily	Chromium has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance. Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.¹¹⁷ ^{, 118} ^{, 119}In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.¹²⁰ ^{, 121} Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.¹²² Chromium supplements improve glucose tolerance in people with type 2 diabetes,¹²³ apparently by increasing sensitivity to insulin .¹²⁴ Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy .¹²⁵ ^{, 126} Chromium even helps healthy people,¹²⁷ although one such report found chromium useful only when accompanied by 100 mg of niacin per day.¹²⁸ Chromium may also lower levels of total cholesterol , LDL cholesterol, and triglycerides (risk factors in heart disease ).¹²⁹ ^{, 130} A few trials have reported no beneficial effects from chromium supplementation.¹³¹ ^{, 132} ^{, 133} All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.¹³⁴ Many doctors recommend up to 1,000 mcg per day for people with diabetes.¹³⁵ Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia . Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.
3 Stars Evening Primrose Oil 4 grams daily	Supplementing with evening primrose oil has been found to improve nerve function and to relieve pain symptoms of diabetic neuropathy. Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy.¹³⁶
3 Stars Fenugreek 2.5 to 15 grams daily	Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Animal research suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control. In a controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in blood glucose following the meal. Another controlled trial found that taking 2.5 grams of fenugreek twice a day for three months reduced blood sugar levels in people with mild, but not those with severe, type 2 diabetes. In a double-blind study, 1 gram per day of an extract of fenugreek seeds for two months improved some measures of blood sugar control and insulin function in people with type 2 diabetes.
3 Stars Fiber Talk to your doctor	Taking fiber supplements may help to stabilize your blood sugar. High-fiber supplements, such as psyllium ,¹³⁷ guar gum (found in cluster beans),¹³⁸ pectin (from fruit),¹³⁹ oat bran,¹⁴⁰ and glucomannan ,¹⁴¹ ^{, 142} have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.¹⁴³ ^{, 144} A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.¹⁴⁵ Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats , and whole-grain products.
3 Stars Glucomannan 500 to 700 mg per 100 calories in the diet	Glucomannan delays stomach emptying, leading to more gradual sugar absorption and lower blood sugar levels after meals. Glucomannan is a water-soluble dietary fiber derived from konjac root (Amorphophallus konjac)that delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. ¹⁴⁶ After-meal blood sugar levels are lower in people with diabetes given glucomannan in their food, ¹⁴⁷ and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled clinical trials. ¹⁴⁸ ^{, 149} ^{, 150} One preliminary report suggested that glucomannan may also be helpful in pregnancy-related diabetes. ¹⁵¹ For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research.
3 Stars Magnesium 200 to 600 mg daily	People with type 2 diabetes tend to have low magnesium levels, supplementing with the mineral may restore levels and improve insulin production. People with type 2 diabetes tend to have low magnesium levels.¹⁵² Double-blind research indicates that supplementing with magnesium overcomes this problem.¹⁵³ Magnesium supplementation has improved insulin production in elderly people with type 2 diabetes.¹⁵⁴ However, one double-blind trial found no effect from 500 mg magnesium per day in people with type 2 diabetes, although twice that amount led to some improvement.¹⁵⁵ Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some,¹⁵⁶ but not all, trials.¹⁵⁷ However, in people with type 2 diabetes who nonetheless require insulin, Dutch researchers have reported no improvement in blood sugar levels from magnesium supplementation.¹⁵⁸ The American Diabetes Association acknowledges strong associations between magnesium deficiency and insulin resistance but has not said magnesium deficiency is a risk factor¹⁵⁹ Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200 to 600 mg of magnesium per day. Diabetes-induced damage to the eyes is more likely to occur in magnesium-deficient people with type 1 diabetes.¹⁶⁰ In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with type 1 diabetes.¹⁶¹ The American Diabetes Association admits “strong associations...between magnesium deficiency and insulin resistance” but will not say magnesium deficiency is a risk factor.¹⁶² Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200–600 mg of magnesium per day.
3 Stars Psyllium 5.1 grams daily with meals	Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11 to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared with a placebo.¹⁶³
2 Stars Acetyl-L-Carnitine (Diabetic Neuropathy) 500 to 1,000 mg three times daily	Taking acetyl-L-carnitine may improve symptoms of diabetic neuropathy. In a double-blind study of people with diabetic neuropathy, supplementing with acetyl-L-carnitine was significantly more effective than a placebo in improving subjective symptoms of neuropathy and objective measures of nerve function.¹⁶⁴ People who received 1,000 mg of acetyl-L-carnitine three times per day tended to fare better than those who received 500 mg three times per day.
2 Stars Aloe 1 Tbsp (15 ml) of gel daily	Aloe, either alone or in combination with the oral hypoglycemic drug glibenclamide, has been shown to effectively lower blood sugar in people with type 2 diabetes. Animal research and preliminary controlled human trials have found that Aloe vera, either alone or in combination with the oral hypoglycemic drug glibenclamide, effectively lowers blood sugar in people with type 2 diabetes.¹⁶⁵ ^{, 166} ^{, 167} ^{, 168} The typical amount used in this research was 1 tablespoon (15 ml) of aloe gel per day.
2 Stars American Ginseng 3 grams with or following meals	Supplementing with American ginseng may help improve blood sugar control. In a small preliminary trial, 3 grams of American ginseng was found to lower the rise in blood sugar following the consumption of a high-glucose drink by people with type 2 diabetes.¹⁶⁹ The study found no difference in blood sugar–lowering effect if the herb was taken either 40 minutes before the drink or at the same time. A follow-up to this study found that increasing the amount of American ginseng to either 6 or 9 grams did not increase the effect on blood sugar following the high-glucose drink in people with type 2 diabetes.¹⁷⁰ This study also found that American ginseng was equally effective in controlling the rise in blood sugar whether it was given together with the drink or up to two hours before.
2 Stars Asian Ginseng 200 mg of herbal extract containing approximately 5 to 7% ginsenosides daily	Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes. Asian ginseng is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and to increase the number of insulin receptors.¹⁷¹ ^{, 172} Animal research has also revealed a direct blood sugar–lowering effect of ginseng.¹⁷³ A double-blind trial found that 200 mg of ginseng extract per day improved blood sugar control, as well as energy levels in people with type 2 diabetes.¹⁷⁴
2 Stars Bilberry 160 mg twice per day of an herbal extract containing 25% anthocyanosides	Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy. Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy . One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy.¹⁷⁵
2 Stars Biotin 9 to 16 mg daily	Biotin may improve glucose levels and reduce pain from diabetic nerve damage. Biotin is a B vitamin needed to process glucose. When people with type 2 diabetes were given 9 mg of biotin per day for two months, their fasting glucose levels dropped dramatically.¹⁷⁶ Biotin may also reduce pain from diabetic nerve damage.¹⁷⁷ Some doctors try 9 to 16 mg of biotin per day for a few weeks to see if blood sugar levels will fall.
2 Stars Bitter Melon 50 to 100 ml of juice daily or 5 grams three times daily of powdered fruit	Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes. Whole, fried slices,¹⁷⁸ water extracts,¹⁷⁹ and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes,¹⁸⁰ according to preliminary trials. However, double-blind trials are needed to confirm this potential benefit.
2 Stars Cinnamon 1 to 6 grams daily	Cinnamon may improve glucose utilization in people with type 2 diabetes. Test tube studies have suggested that cinnamon may improve glucose utilization. In a study of people with type 2 diabetes, supplementing with cinnamon in the amount of 1, 3, or 6 grams per day for 40 days was significantly more effective than a placebo at reducing blood glucose levels.¹⁸¹ The reduction averaged 18 to 29% in the three treatments groups, and 1 gram per day was as effective as 3 and 6 grams per day. The benefits of cinnamon for lowering blood sugar levels was confirmed in a double-blind study.¹⁸² However, in two other double-blind studies, cinnamon was not more effective than a placebo.¹⁸³ ^{, 184} The different results in these studies may have been due in part to differences in body weight, initial blood sugar levels, and medication use among the different populations studied.
2 Stars Coenzyme Q10 120 mg daily of a standardized herbal extract	Supplementing with CoQ10 may improve blood sugar metabolism. Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. Animals with diabetes have been reported to be CoQ10 deficient. People with type 2 diabetes have been found to have significantly lower blood levels of CoQ10 compared with healthy people.¹⁸⁵ In one trial, blood sugar levels fell substantially in 31% of people with diabetes after they supplemented with 120 mg per day of CoQ7, a substance similar to CoQ10.¹⁸⁶ The importance of CoQ10 supplementation for people with diabetes remains an unresolved issue, though some doctors recommend approximately 50 mg per day as a way to protect against possible effects associated with diabetes-induced depletion.
2 Stars Crepe Myrtle 32 or 48 mg of an herbal extract standardized to contain 1% corosolic acid	Crepe myrtle has been used in folk medicine to treat diabetes. It appears to work by lowering blood glucose levels. Lagerstroemia speciosa, commonly known as crepe myrtle, grows in various tropical countries and Australia. In folk medicine it has been used to treat diabetes. In a preliminary study of people with type 2 diabetes, supplementing with an extract from the leaves of Lagerstroemia speciosa for two weeks resulted in a fall in blood-glucose levels averaging 20 to 30%.¹⁸⁷ The amount used was 32 or 48 mg of a product standardized to contain 1% corosolic acid (a putative active ingredient). The larger amount was somewhat more effect than the smaller amount. Although these results are promising, additional studies are needed to demonstrate the long-term safety and efficacy of this herbal preparation.
2 Stars Gymnema 800 mg daily of an herbal extract standardized for 25% gymnemic acids	Gymnema may stimulate the pancreas to produce insulin and may help normalize blood sugar control in people with diabetes. Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes. So far, no double-blind trials have confirmed the efficacy of gymnema for people with any type of diabetes. However, a preliminary study of type 2 diabetics reported that 400 mg per day of gymnema extract taken for periods of 18 months or longer resulted in improvement, according to diabetes blood tests, and allowed reduction of diabetic medications.¹⁸⁸ Improvements in blood glucose levels were also seen in patients with type 2 diabetes who received 1 g per day of a specific gymnema extract (Om Santal Adivasi) for two months.¹⁸⁹ In a controlled trial with type 1 (insulin-dependent) diabetics, a similar amount of gymnema extract reduced requirements for insulin.¹⁹⁰ Whether the extract used in these studies was standardized for active constituents is unclear. Recently, a preliminary trial found improved blood sugar levels after three months in a group of type 1 and type 2 diabetics who took 800 mg per day of an extract standardized for 25% gymnemic acids.¹⁹¹ Gymnema is not a substitute for insulin, but insulin amounts may need to be lowered while taking gymnema to avoid hypoglycemia.
2 Stars Hairy Basil 10 grams three times per day with meals	Taking hairy basil may help people with type 2 diabetes control their blood sugar levels. Preliminary trials of leaves and hairy basil seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels. An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides, while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol. The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil would have similar effects.
2 Stars Holy Basil 1,000 to 2,500 mg daily	Taking holy basil may help people with type 2 diabetes control their blood sugar levels. Preliminary trials of holy basil (Ocimim sanctum) leaves and hairy basil (Ocimum canum) seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels.¹⁹² ^{, 193} ^{, 194} An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides,¹⁹⁵ while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol.¹⁹⁶ The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil (Ocimum basilicum) would have similar effects.
2 Stars L-Carnitine 0.25 mg per 2.2 lbs (1 kg) of body weight	Supplementing with L-carnitine may reduce cholesterol and triglyceride levels in people with diabetes. L-carnitine is an amino acid needed to properly utilize fat for energy. When people with diabetes were given DL-carnitine (0.5 mg per 2.2 pounds of body weight), high blood levels of fats—both cholesterol and triglycerides —dropped 25 to 39% in just ten days in one trial.¹⁹⁷
2 Stars Milk Thistle 200 mg per day of silymarin	Supplementing with silymarin (a component of milk thistle) may help lower blood sugar levels. In a double-blind trial, supplementation with 200 mg per day of silymarin (a component of milk thistle) three times per day for four months significantly lowered blood sugar levels compared with a placebo in patients who were taking a blood sugar–lowering drug (glibenclamide).¹⁹⁸
2 Stars Multivitamin (Infection) Follow label instructions	Supplementing with a multivitamin–mineral may give your body the nutrients it needs to help prevent common infections. In a double-blind study, supplementation of middle-aged and elderly diabetics with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.¹⁹⁹
2 Stars Onion 20 grams fresh onion three times per day	Large amounts of onion have been shown to lower blood sugar levels in people with diabetes, possibly by blocking the breakdown of insulin in the liver. Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.²⁰⁰ ^{, 201} ^{, 202} The mechanism of onion’s blood sugar-lowering action is not precisely known, though there is evidence that constituents in onions block the breakdown of insulin in the liver. This would lead to higher levels of insulin in the body.²⁰³
2 Stars Pycnogenol 100 to 150 mg per day	Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes and slow progression of complications such as retinopathy. Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes.²⁰⁴ Double-blind trials have shown that 100 to 125 mg per day of Pycnogenol lowers blood sugar in people with type 2 diabetes, but improvement in measures of long-term blood sugar control has not been consistent.²⁰⁵ ^{, 206} Preliminary and double-blind studies have also shown Pycnogenol (typically 120 to 150 mg per day) slows the progression of diabetic retinopathy and improves vision.²⁰⁷ ^{, 208} ^{, 209} ^{, 210} In a controlled trial of diabetic patients with symptoms of damage to the small blood vessels of the lower legs and feet, 150 mg per day of Pycnogenol improved measures of skin health and blood flow to the feet.²¹¹ In another controlled study, diabetic skin ulcers were treated with standard medications plus either 150 mg per day of Pycnogenol orally, 100 mg pycnogenol topically applied to the ulcers, or a combination of oral and topical Pycnogenol treatment.²¹² All treatments produced complete healing in more subjects after six weeks compared with a control group receiving no Pycnogenol treatment, but the group receiving oral and topical Pycnogenol had the greatest reductions in ulcer size and in pain and other associated symptoms.
2 Stars Vitamin B1 and Vitamin B12 (Diabetic Neuropathy) Refer to label instructions	Taking vitamin B1 combined with vitamin B12 may improve symptoms of diabetic neuropathy. A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.²¹³ However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.²¹⁴ As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.
2 Stars Vitamin B1 and Vitamin B6 (Diabetic Neuropathy) 25 mg daily, with 50 mg of vitamin B6 daily	Taking vitamin B1 combined with vitamin B6 may improve symptoms of diabetic neuropathy. A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.²¹⁵ However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.²¹⁶ As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.
2 Stars Vitamin B12 (Diabetic Neuropathy) Consult a qualified healthcare practitioner	Vitamin B12 is needed for normal nerve cell function, and supplementing with it may improve symptoms of diabetic neuropathy. Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally has reduced symptoms of nerve damage caused by diabetes in 39% of people studied; when given both intravenously and orally, two-thirds of people improved.²¹⁷ In a preliminary trial, people with nerve damage due to kidney disease or to diabetes plus kidney disease received intravenous injections of 500 mcg of methylcobalamin (the main form of vitamin B12 found in the blood) three times a day for six months in addition to kidney dialysis. Nerve pain was significantly reduced and nerve function significantly improved in those who received the injections.²¹⁸ Oral vitamin B12 up to 500 mcg three times per day is recommended by some practitioners.
2 Stars Vitamin B6 1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily	People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance. Many people with diabetes have low blood levels of vitamin B6 .²¹⁹ ^{, 220} Levels are even lower in people with diabetes who also have nerve damage (neuropathy).²²¹ Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy.²²² ^{, 223} Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills.²²⁴ In a trial that included people with type 2 diabetes, 1,800 mg per day of a special form of vitamin B6—pyridoxine alpha-ketoglutarate—improved glucose tolerance dramatically.²²⁵ Standard vitamin B6 has helped in some,²²⁶ but not all, trials.²²⁷
2 Stars Vitamin C 500 mg twice per day	Supplementing with vitamin C may benefit people with type 2 diabetes in several ways, including by reducing sorbitol levels, urinary protein loss, and glycosylation. As with vitamin E, vitamin C may reduce glycosylation.²²⁸ Vitamin C also lowers sorbitol levels in people with diabetes.²²⁹ Sorbitol is a sugar that can accumulate inside the cells and damage the eyes, nerves, and kidneys of people with diabetes. Vitamin C may improve glucose tolerance in type 2 diabetes,²³⁰ ^{, 231} ^{, 232}although not every study confirms this benefit.²³³ Vitamin C supplementation (500 mg twice a day for one year) has significantly reduced urinary protein loss in people with diabetes. Urinary protein loss (also called proteinuria) is associated with poor prognosis in diabetes.²³⁴ Many doctors suggest that people with diabetes supplement with 1 to 3 grams per day of vitamin C. Higher amounts could be problematic, however. In one person, 4.5 grams per day was reported to increase blood sugar levels.²³⁵ One study examined antioxidant supplement intake, including both vitamins E and C, and the incidence of diabetic retinopathy (damage to the eyes caused by diabetes).²³⁶ Surprisingly, people with extensive retinopathy had a greater likelihood of having taken vitamin C and vitamin E supplements. The outcome of this trial, however, does not fit with most other published data and might simply reflect the fact that sicker people are more likely to take supplements in hopes of getting better. For the present, most doctors remain relatively unconcerned about the outcome of this isolated report.
2 Stars Vitamin D 1,332 IU daily	Vitamin D is needed to maintain adequate insulin levels, and supplementing with it may improve blood sugar control in people with type 2 diabetes. Vitamin D is needed to maintain adequate blood levels of insulin.²³⁷ Vitamin D receptors have been found in the pancreas where insulin is made. Some,²³⁸ ^{, 239} ^{, 240} but not all,²⁴¹ ^{, 242} preliminary trials have found that supplementation can improve some measures of blood sugar control in people with type 2 diabetes. In addition, in a preliminary trial supplementation with about 2,000 IU of vitamin D per day for three months significantly improved pain by almost 50% in patients with diabetic neuropathy.²⁴³ Not enough is known about optimal amounts of vitamin D for people with diabetes, and high amounts of vitamin D can be toxic; therefore, people with diabetes considering vitamin D supplementation should talk with a doctor and have their vitamin D status assessed.
2 Stars Vitamin E (Diabetic Neuropathy) 900 IU daily	Vitamin E supplementation may protect against neuropathy. People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.²⁴⁵ ^{, 246} Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,²⁴⁷ ^{, 248} ^{, 249} but not all,²⁵⁰ double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.²⁵¹ ^{, 252} Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent. In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.²⁵³ Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,²⁵⁴ ^{, 255} serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,²⁵⁶ ^{, 257} ^{, 258} ^{, 259} ^{, 260} although not all,²⁶¹ ^{, 262} ^{, 263} studies. In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.²⁶⁴ The reason for the discrepancy between reports is not known. Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).²⁶⁵
2 Stars Vitamin E (Diabetic Retinopathy) 1800 IU daily	Vitamin E supplementation may protect against diabetic retinopathy. People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.²⁶⁶ ^{, 267} Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,²⁶⁸ ^{, 269} ^{, 270} but not all,²⁷¹ double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.²⁷² ^{, 273} Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent. In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.²⁷⁴ Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,²⁷⁵ ^{, 276} serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,²⁷⁷ ^{, 278} ^{, 279} ^{, 280} ^{, 281} although not all,²⁸² ^{, 283} ^{, 284} studies. In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.²⁸⁵ The reason for the discrepancy between reports is not known. Vitamin E appears to lower the risk of cerebral infarction, a type of stroke , in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension ) can benefit from small amounts of vitamin E (50 IU per day).²⁸⁶
2 Stars Zinc 15 to 25 mg per day	People with type 2 diabetes tend to be zinc deficient, supplementing with zinc may help restore levels. People with type 2 diabetes tend to be zinc deficient,²⁸⁷ but some evidence indicates that zinc supplementation does not improve their ability to process sugar.²⁸⁸ Nonetheless, many doctors recommend that people with type 2 diabetes supplement with moderate amounts of zinc (15 to 25 mg per day) as a way to correct the deficit.
1 Star Açaí Refer to label instructions	Açaí is reported to be a traditional remedy for diabetes. Açaí is reported to be a traditional remedy for diabetes. Although oxidative stress may contribute to diabetes²⁸⁹ and anthocyanins may improve insulin secretion,²⁹⁰ there is no published evidence that açaí has any effect on diabetes.
1 Star Amylase Inhibitors Refer to label instructions	Amylase inhibitors, when given with a starchy meal, can reduce the usual rise in blood sugar levels of people with diabetes. Starch blockers are substances that inhibit amylase, the digestive enzyme required to break down dietary starches for normal absorption. Controlled research has demonstrated that concentrated starch blocker extracts, when given with a starchy meal, can reduce the usual rise in blood sugar levels of both healthy people and diabetics.²⁹¹ ^{, 292} ^{, 293} ^{, 294} ^{, 295} While this effect could be helpful in controlling diabetes, no research has investigated the long-term effects of taking starch blockers for this condition.
1 Star Fish Oil Refer to label instructions	Supplementing with fish oil may improve glucose tolerance and symptoms of diabetic neuropathy and nephropathy Glucose tolerance improves in healthy people taking omega-3 fatty acid supplements,²⁹⁶ and some studies have found that fish oil supplementation also improves glucose tolerance,²⁹⁷ high triglycerides ,²⁹⁸ and cholesterol levels in people with type 2 diabetes.²⁹⁹ And in one trial, people with diabetic neuropathy and diabetic nephropathy experienced significant improvement when given 600 mg three times per day of purified eicosapentaenoic acid (EPA)—one of the two major omega-3 fatty acids found in fish oil supplements—for 48 weeks.³⁰⁰ However, other studies have found that type 2 diabetes worsens with fish oil supplementation.³⁰¹ ^{, 302} ^{, 303} ^{, 304} Until this issue is resolved, people with diabetes should feel free to eat fish, but they should consult a doctor before taking fish oil supplements.
1 Star Fructo-oligosaccharides Refer to label instructions	In one trial, supplementing with fructo-oligosaccharides significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes. In a preliminary trial, supplementation with fructo-oligosaccharides (FOS) (8 grams per day for two weeks) significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.³⁰⁵ However, in another trial, supplementing with FOS (15 grams per day) for 20 days had no effect on blood-glucose or lipid levels in people with type 2 diabetes.³⁰⁶ In addition, some double-blind trials showed that supplementing with FOS or galacto-oligosaccharides (GOS) for eight weeks had no effect on blood-sugar levels, insulin secretion, or blood lipids in healthy people.³⁰⁷ ^{, 308} Because of these conflicting results, more research is needed to determine the effect of FOS on diabetes and lipid levels.
1 Star Ginkgo Refer to label instructions	Ginkgo may help prevent and treat early-stage diabetic neuropathy. Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.³⁰⁹
1 Star Goldenseal 1 gram per day of berberine for two months	Preliminary research with berberine (an active compound in goldenseal) for two months lowered blood glucose levels in people with type 2 diabetes. In a preliminary trial, supplementation with 1 gram per day of berberine (one of the active compounds in goldenseal) for two months significantly lowered blood glucose levels in patients with type 2 diabetes.³¹⁰
1 Star Green Coffee Extract Refer to label instructions	Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies. Drinking either regular or decaffeinated coffee has been associated with reduced type 2 diabetes risk in several preliminary human studies.³¹¹ Test tube studies suggest that chlorogenic acid, a primary constituent found in both coffee and in green coffee extract may inhibit glucose production by the liver,³¹² which could theoretically lead to lower blood sugar. An animal study found that green coffee extract also prevented the reduction in insulin sensitivity caused by a high-fat diet.³¹³ No human studies have tested the effect of green coffee extract on reducing risk of diabetes or improving insulin sensitivity, but a double-blind trial found that healthy people who drank a sweetened coffee beverage containing green coffee extract (providing 400 to 450 mg of chlorogenic acids) had lower blood sugar during the following two hours compared to when they drank the same coffee beverage without added green coffee extract.³¹⁴ More research is needed to determine whether green coffee extract can help prevent or treat type 2 diabetes.
1 Star Hibiscus Refer to label instructions	Hibiscus is a traditional remedy in India for diabetes, and is supported by preliminary research. Hibiscus is a traditional remedy in India for diabetes; this treatment is supported by preliminary studies from that country and by animal studies.³¹⁵ ^{, 316} Hibiscus is usually taken as tea, such as 1 to 2 teaspoons (3 to 6 grams) of dried flower infused in to 1 cup (250 ml) three times per day.
1 Star Inositol Refer to label instructions	Supplementing with inositol may improve diabetic neuropathy. Inositol is needed for normal nerve function. Diabetes can cause a type of nerve damage known as diabetic neuropathy. This condition has been reported in some, but not all, trials to improve with inositol supplementation (500 mg taken twice per day).³¹⁷
1 Star Manganese Refer to label instructions	People with diabetes may have low manganese levels, which can contribute to glucose intolerance. Supplementing with the mineral may help. People with diabetes may have low blood levels of manganese.³¹⁸ Animal research suggests that manganese deficiency can contribute to glucose intolerance and may be reversed by supplementation.³¹⁹ A young adult with insulin-dependent diabetes who received oral manganese chloride (3 to 5 mg per day as manganese chloride) reportedly experienced a significant fall in blood glucose, sometimes to dangerously low levels. In four other cases, manganese supplementation had no effect on blood glucose levels.³²⁰ People with diabetes wishing to supplement with manganese should do so only with a doctor’s supervision.
1 Star Medium-Chain Triglycerides Refer to label instructions	Medium-chain triglycerides have been found to lower blood sugar levels and may be useful in treating type 3 diabetes. Based on the results of a short-term clinical trial that found that medium-chain triglycerides (MCT) lower blood glucose levels,³²¹ a group of researchers investigated the use of MCT to treat people with type 2 diabetes mellitus. Supplementation with MCT for an average of 17.5% of their total calorie intake for 30 days failed to improve most measures of diabetic control.³²²
1 Star Mistletoe Refer to label instructions	Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and it may reduce diabetes symptoms. Mistletoe extract has been shown to stimulate insulin release from pancreas cells,³²³ and animal research found that it reduces symptoms of diabetes.³²⁴ No research in humans has yet been published; however, given mistletoe’s worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Traditionally, mistletoe is prepared by soaking 2 to 4 teaspoons (5 to 12 grams) of chopped mistletoe in 2 cups (500 ml) of water overnight. The mixture is drunk first thing in the morning and sweetened with honey if desired. Another batch may be left to steep during the day and drunk at bedtime.
1 Star Olive Leaf Refer to label instructions	Olive leaf extracts have been used experimentally to lower high blood sugar in diabetic animals. Olive leaf extracts have been used experimentally to lower elevated blood-sugar levels in diabetic animals.³²⁵ These results have not been reproduced in human clinical trials.
1 Star Quercetin Refer to label instructions	Quercetin may be helpful for its ability to reduce levels of sorbitol—a sugar that accumulates in cells and damages the nerves, kidneys, and eyes of people with diabetes. Doctors have suggested that quercetin might help people with diabetes because of its ability to reduce levels of sorbitol—a sugar that accumulates in nerve cells, kidney cells, and cells within the eyes of people with diabetes—and has been linked to damage to those organs.³²⁶ Clinical trials have yet to explore whether quercetin actually protects people with diabetes from neuropathy, nephropathy, or retinopathy .
1 Star Reishi Refer to label instructions	Reishi may have some beneficial action in people with diabetes. Animal studies and some very preliminary trials in humans suggest reishi may have some beneficial action in people with diabetes.³²⁷ ^{, 328}
1 Star Selenium, Vitamin A, Vitamin C, and Vitamin E (Diabetic Neuropathy) Refer to label instructions	A combination of the antioxidants selenium, vitamin A, vitamin C, and vitamin E has been shown to improve diabetic retinopathy. Because oxidation damage is believed to play a role in the development of diabetic retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium , 800 IU vitamin E , 10,000 IU vitamin A , and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.³²⁹ People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.
1 Star Taurine Refer to label instructions	Supplementing with taurine may affect insulin secretion and action, and may help protect the eyes and nerves from diabetic complications. Animal studies have shown that supplementing with taurine, an amino acid found in protein-rich food, may affect insulin secretion and action, and may have potential in protecting the eyes and nerves from diabetic complications.³³⁰ However, a double-blind trial found no effect on insulin secretion or sensitivity when men with high risk for developing diabetes were given 1.5 grams per day of taurine for eight weeks.³³¹ In another double-blind trial, taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes.³³²
1 Star Vanadium Refer to label instructions	Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes. Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.³³³ ^{, 334} ^{, 335} Over a six-week period, a small group of people with type 2 diabetes were given 75 to 300 mg of vanadyl sulfate per day.³³⁶ Only in the groups receiving 150 mg or 300 mg was glucose metabolism improved, fasting blood sugar decreased, and another marker for chronic high blood sugar reduced. At the 300 mg level, total cholesterol decreased, although not without an accompanying reduction in the protective HDL cholesterol. None of the amounts improved insulin sensitivity. Although there was no evidence of toxicity after six weeks of vanadyl sulfate supplementation, gastrointestinal side effects were experienced by some of the participants taking 150 mg per day and by all of the participants taking 300 mg per day. The long-term safety of the large amounts of vanadium needed to help people with type 2 diabetes (typically 100 mg per day) remains unknown. Many doctors expect that amounts this high may prove to be unsafe in the long term.
1 Star Vitamin B3 Refer to label instructions	Small amounts of niacin (a form of vitamin B3) may help some people with type 2 diabetes. The intake of large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision.³³⁷ ^{, 338} Smaller amounts (500 to 750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes,³³⁹ though this research remains preliminary.
1 Star Yerba Mate Refer to label instructions	Preliminary research suggests yerba mate (Ilex paraguariensis) tea may improve measures of blood glucose control in people with type 2 diabetes. In a preliminary trial, consumption of mate (Ilex paraguariensis) tea in the amount of 330 ml (about 12 ounces) 3 times per day for 60 days improved measures of blood glucose control in patients with type 2 diabetes.³⁴⁰

References

1. Hoogeveen EK, Kostense PJ, Jakobs C, et al. Hyperhomocysteinemia increases risk of death, especially in type 2 diabetes: 5-year follow-up of the Hoorn Study. Circulation 2000;101:1506–11.

2. Centers for Disease Control and Prevention: "Diabetes Public Health Resource." Accessed October 27, 2010: www.cdc.gov/diabetes/news/docs/flu.htm

3. Isida K, Mizuno A, Murakami T, Shima K. Obesity is necessary but not sufficient for the development of diabetes mellitus. Metabolism 1996;45:1288–95.

4. Casassus P, Fontbonne A, Thibult N, et al. Upper-body fat distribution: a hyperinsulinemia-independent predictor of coronary heart disease mortality. Arterioscler Thromb 1992;1387–92.

5. Karter AJ, Mayer-Davis EJ, Selby JV, et al. Insulin sensitivity and abdominal obesity in African-American, Hispanic, and non-Hispanic white men and women. Diabetes 1996;45:1547–55.

6. Park KS, Hree BD, Lee K-U, et al. Intra-abdominal fat is associated with decreased insulin sensitivity in healthy young men. Metabolism 1991;40:600–3.

7. Long SD, Swanson MS, O’Brien K, et al. Weight loss in severely obese subjects prevents the progression of impaired glucose tolerance to type II diabetes. Diabetes Care 1994;17:372.

8. Pi-Sunyer FX. Weight and non-insulin-dependent diabetes mellitus. Am J Clin Nutr 1996;63(suppl):426S–9S.

9. Wing RR, Marcuse MD, Blair EH, et al. Caloric restriction per se is a significant factor in improvements in glycemic control and insulin sensitivity during weight loss in obese NIDDM patients. Diabetes Care 1994;17:30.

10. Henry RR, Gumbiner B. Benefits and limitations of very-low-calorie diet therapy in obese NIDDM. Diabetes Care 1991;14:802–23.

11. Hersey WC, Graves JE, Pollock ML, et al. Endurance exercise training improves body composition and plasma insulin responses in 70- to 79-year-old men and women. Metabol 1994;43:847–54.

12. Rasmussen OW, Lauszus FF, Hermansen K. Effects of postprandial exercise on glycemic response in IDDM subjects. Diabetes Care 1994;17:1203.

13. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS. Physical activity and reduced occurrence of non-insulin-dependent diabetes mellitus. N Engl J Med 1991;325:147–52.

14. (REF:Bell DSH. Exercise for patients with diabetes—benefits, risks, precautions. Postgrad Med 1992;92:183–96 [review].

15. Kiechl S, Willeit J, Poewe W, et al. Insulin sensitivity and regular alcohol consumption: large, prospective, cross sectional population study Bruneck study. BMJ 1996;313:1040–4.

16. Facchini F, Chen Y-DI, Reaven GM. Light-to-moderate alcohol intake is associated with enhanced insulin sensitivity. Diabetes Care 1994;17:115.

17. Rimm EB, Chan J, Stampfer MJ, et al. Prospective study of cigarette smoking, alcohol use, and the risk of diabetes in men. BMJ 1995;310:555–9.

18. Stampfer MJ, Colditz GA, Willett WC, et al. A prospective study of moderate alcohol drinking and risk of diabetes in women. Am J Epidemiol 1988;128:549–58.

19. Goden G, Chen X, Desantis R, et al. Effects of ethanol on carbohydrate metabolism in the elderly. Diabetes 1993;42:28–34.

20. Ben G, Gnudi L, Maran A, et al. Effects of chronic alcohol intake on carbohydrate and lipid metabolism in subjects with type II (non-insulin-dependent) diabetes. Am J Med 1991;90:70.

21. Young RJ, McCulloch DK, Prescott RJ, Clarke PF. Alcohol: another risk factor for diabetic retinopathy? BMJ 1984;288:1035.

22. Connor H, Marks V. Alcohol and diabetes. A position paper prepared by the Nutrition Subcommittee of the British Diabetic Association’s Medical Advisory Committee and approved by the Executive Council of the British Diabetic Association. Human Nutr Appl Nutr 1985;39A:393–9.

23. Ajani UA, Hennekens CH, Spelsberg A, Manson JE. Alcohol consumption and risk of type 2 diabetes mellitus among US male physicians. Arch Intern Med 2000;160:1025–30.

24. Wei M, Gibbons LW, Mitchell TL, et al. Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care 2000;23:18–22.

25. Valmadrid CT, Klein R, Moss SE, et al. Alcohol intake and the risk of coronary heart disease mortality in persons with older-onset diabetes mellitus. JAMA 1999;282:239–46.

26. Wei M, Gibbons LW, Mitchell TL, et al. Alcohol intake and incidence of type 2 diabetes in men. Diabetes Care 2000;23:18–22.

27. Stegmayr B, Lithner F. Tobacco and end stage diabetic nephropathy. BMJ 1987;295:581–2.

28. Scala C, LaPorte RE, Dorman JS, et al. Insulin-dependent diabetes mellitus mortality—the risk of cigarette smoking. Circulation1990;82:37–43.

29. Rimm EB, Manson JE, Stampfer MJ, et al. Cigarette smoking and the risk of diabetes in women. Am J Public Health 1993;83:211–4.

30. Rindone JP, Austin M, Luchesi J. Effect of home blood glucose monitoring on the management of patients with non-insulin dependent diabetes mellitus in the primary care setting. Am J Manag Care 1997;3:1335–8.

31. Faas A, Schellevis FG, Van Eijk JT. The efficacy of self-monitoring of blood glucose in NIDDM subjects. A criteria-based literature review. Diabetes Care 1997;20:1482–6.

32. [No authors listed.] Position statement: Tests of glycemia in diabetes. American Diabetes Association. Diabetes Care 2000;23(Suppl 1):S80–2.

33. Goldstein DE, Little RR, Lorenz RA, et al. Tests of glycemia in diabetes. Diabetes Care 1995;18:896–909 [review].

34. Gallichan M. Self monitoring of glucose by people with diabetes: evidence based practice. BMJ 1997;314:964–7 [review].

35. Steel LG. Identifying technique errors. Self-monitoring of blood glucose in the home setting. J Gerontol Nurs 1994;20:9–12.

36. Foster SA, Goode JV, Small RE. Home blood glucose monitoring. Ann Pharmacother 1999;33:355–63 [review].

37. Feng M, Li Y, Pang B, et al. Acupuncture combined with application of xiaoke plaster for treatment of 309 cases of diabetes mellitus. J Tradit Chin Med 1997;17:247–9.

38. Chen JF. A hemorrheological study on the effect of acupuncture in treating diabetes mellitus. J Tradit Chin Med 1987;7:95–100.

39. Chen D, Gong D, Zhai Y. Clinical and experimental studies in treating diabetes mellitus by acupuncture. J Tradit Chin Med 1994;14:163–6.

40. Chen JF, Wei J. Changes of plasma insulin level in diabetics treated with acupuncture. J Tradit Chin Med 1985;5:79–84.

41. Abuaisha BB, Costanzi JB, Boulton AJ. Acupuncture for the treatment of chronic painful peripheral diabetic neuropathy: a long-term study. Diabetes Res Clin Pract 1998;39:115–21.

42. Zheg HT, Huang XM, Sun JH. Treatment of diabetic cystopathy by acupuncture and moxibustion. J Tradit Chin Med 1986;6:243–8.

43. Zhang W. Acupuncture for treatment of diabetic urinary bladder neural dysfunction—a report of 36 cases. J Tradit Chin Med 1997;17:211–3.

44. Feskens EJ, Virtanen SM, Rasanen L, et al. Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabetes Care 1995;18:1104–12.

45. Feskens EJ, Kromhout D. Habitual dietary intake and glucose tolerance in euglycaemic men: the Zutphen Study. Int J Epidemiol 1990;19:953–9.

46. Marshall JA, Hoag S, Shetterly S, et al. Dietary fat predicts conversion from impaired glucose tolerance to NIDDM. The San Luis Valley Diabetes Study. Diabetes Care 1994;17:50–6.

47. Marshall JA, Hamman RF, Baxter J. High-fat, low-carbohydrate diet and the etiology of non-insulin-dependent diabetes mellitus: the San Luis Valley Diabetes Study. Am J Epidemiol 1991;134:590–603.

48. Uusitupa M, Schwab U, Makimattila S, et al. Effects of two high-fat diets with different fatty acid compositions on glucose and lipid metabolism in healthy young women. Am J Clin Nutr 1994;59:1310–6.

49. Sarkkinen E, Schwab U, Niskanen L, et al. The effects of monounsaturated-fat enriched diet and polyunsaturated-fat enriched diet on lipid and glucose metabolism in subjects with impaired glucose tolerance. Eur J Clin Nutr 1996;50:592–8.

50. Garg A, Bananome A, Grundy SM, et al. Comparison of a high-carbohydrate diet with a high-monounsaturated-fat diet in patients with non-insulin dependent diabetes mellitus. N Engl J Med 1988;319:829–34.

51. Feskens EJM, Bowles CH, Kromhout D. Inverse association between fish intake and risk of glucose intolerance in normoglycemic elderly men and women. Diabetes Care 1991;14:935–41.

52. Mori TA, Bao DQ, Burke V, et al. Dietary fish as a major component of a weight-loss diet: effect on serum lipids, glucose, and insulin metabolism in overweight hypertensive subjects. Am J Clin Nutr 1999;70:817–25.

53. Chandalia M, Garg A, Lutjohann D, et al. Beneficial effects of high dietary fiber intake in patients with type 2 diabetes mellitus. New Engl J Med 2000;342:1392–8.

54. Rodríguez-Morán M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and glucose-lowering efficacy of plantago psyllium in type II diabetes. Diabetes Its Complications 1998;12:273–8.

55. Landin K, Holm G, Tengborn L, Smith U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 1992;56:1061–5.

56. Schwartz SE, Levine RA, Weinstock RS, et al. Sustained pectin ingestion: effect on gastric emptying and glucose tolerance in non-insulin-dependent diabetic patients. Am J Clin Nutr 1988;48:1413–7.

57. Hallfrisch J, Scholfield DJ, Behall KM. Diets containing soluble oat extracts improve glucose and insulin responses of moderately hypercholesterolemic men and women. Am J Clin Nutr 1995;61:379–84.

58. Doi K, Matsuura M, Kawara A, Baba S. Treatment of diabetes with glucomannan (konjac mannan). Lancet 1979;1:987–8 [letter].

59. Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 2000;23:9–14.

60. Sharma RD, Raghuram TC. Hypoglycaemic effect of fenugreek seeds in non-insulin dependent diabetic subjects. Nutr Res 1990;10:731–9.

61. Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients. Phytother Res 1994;8:83–6.

62. Nuttall FW. Dietary fiber in the management of diabetes. Diabetes 1993;42:503–8.

63. Cohen D, Dodds R, Viberti G. Effect of protein restriction in insulin dependent diabetics at risk of nephropathy. BMJ 1987;294:795–8.

64. Evanoff G, Thompson C, Bretown J, Weinman E. Prolonged dietary protein restriction in diabetic nephropathy. Arch Intern Med 1989;149:1129–33.

65. Gin H, Aparicio M, Potauz L, et al. Low-protein, low-phosphorus diet and tissue insulin sensitivity in insulin-dependent diabetic patients with chronic renal failure. Nephron 1991;57:411–5.

66. Baba NH, Sawaya S, Torbay N, et al. High protein vs high carbohydrate hypoenergetic diet for the treatment of obese hyperinsulinemic subjects. Int J Obes Relat Metab Disord 1999;23:1202–6.

67. Colditz GA, Manson JE, Stampfer MJ, et al. Diet and risk of clinical diabetes in women. Am J Clin Nutr 1992;55:1018–23.

68. Feskens EJ, Bowles CH, Kromhout D. Carbohydrate intake and body mass index in relation to the risk of glucose intolerance in an elderly population. Am J Clin Nutr 1991;54:136–40.

69. Wright DW, Hansen RI, Mondon CE, Reaven GM. Sucrose-induced insulin resistance in the rat: modulation by exercise and diet. Am J Clin Nutr 1983;38:879–83.

70. Reiser S, Hallfrisch J, Fields M, et al. Effects of sugars on indices of glucose tolerance in humans. Am J Clin Nutr 1986;43:151–9.

71. Wolever TMS, Brand Miller J. Sugars and blood glucose control. Am J Clin Nutr 1995;62:212S–7S [review].

72. Wolever TMS, Brand Miller J. Sugars and blood glucose control. Am J Clin Nutr 1995;62:212S–7S [review].

73. Salmeron J, Manson JE, Stampfer MJ, et al. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 1997;277:472–7.

74. Salmeron J, Ascherio A, Rimm EB, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 1997;20:545–50.

75. Feskens EJ, Virtanen SM, Rasanen L, et al. Dietary factors determining diabetes and impaired glucose tolerance. A 20-year follow-up of the Finnish and Dutch cohorts of the Seven Countries Study. Diabetes Care 1995;18:1104–12.

76. Salmeron J, Manson JE, Stampfer MJ, et al. Dietary fiber, glycemic load, and risk of non-insulin-dependent diabetes mellitus in women. JAMA 1997;277:472–7.

77. Salmeron J, Ascherio A, Rimm EB, et al. Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 1997;20:545–50.

78. Colagiuri S, Miller JJ, Edwards RA. Metabolic effects of adding sucrose and aspartame to the diet of subjects with noninsulin-dependent diabetes mellitus. Am J Clin Nutr 1989;50:474–8.

79. Abraira C, Derler J. Large variations of sucrose in constant carbohydrate diets in type II diabetes. Am J Med 1988;84:193–200.

80. Loghmani E, Rickard K, Washburne L, et al. Glycemic response to sucrose-containing mixed meals in diets of children with insulin-dependent diabetes mellitus. J Pediatr 1991;119:531–7.

81. American Diabetes Association. Position Statement: nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 1999;22:S42–5 [review].

82. Brand-Miller J, Foster-Powell K. Diets with a low glycemic index: from theory to practice. Nutr Today 1999;34:64–72 [review].

83. Colagiuri S, Miller JJ, Edwards RA. Metabolic effects of adding sucrose and aspartame to the diet of subjects with noninsulin-dependent diabetes mellitus. Am J Clin Nutr 1989;50:474–8.

84. Abraira C, Derler J. Large variations of sucrose in constant carbohydrate diets in type II diabetes. Am J Med 1988;84:193–200.

85. Loghmani E, Rickard K, Washburne L, et al. Glycemic response to sucrose-containing mixed meals in diets of children with insulin-dependent diabetes mellitus. J Pediatr 1991;119:531–7.

86. American Diabetes Association. Position Statement: nutrition recommendations and principles for people with diabetes mellitus. Diabetes Care 1999;22:S42–5 [review].

87. Brand-Miller J, Foster-Powell K. Diets with a low glycemic index: from theory to practice. Nutr Today 1999;34:64–72 [review].

88. Konrad T, Vicini P, Kusterer K, et al. alpha lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Diabetes Care 1999;22:280–7.

89. Ruhnau KJ, Meissner HP, Finn JR, et al. Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy. Diabet Med 1999;16:1040–3.

90. Ruhnau KJ, Meissner HP, Finn JR, et al. Effects of 3-week oral treatment with the antioxidant thioctic acid (alpha-lipoic acid) in symptomatic diabetic polyneuropathy. Diabet Med 1999;16:1040–3.

91. Reljanovic M, Reichel G, Rett K, et al. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year multicenter randomized double-blind placebo-controlled trial (ALADIN II). Alpha Lipoic Acid in Diabetic Neuropathy. Free Radic Res 1999;31:171–9.

92. Ziegler D, Schatz H, Conrad F, et al. Effects of treatment with the antioxidant alpha-lipoic acid on cardiac autonomic neuropathy in NIDDM patients. A 4-month randomized controlled multicenter trial (DEKAN Study). Diabetes Care 1997;20:369–73.

93. Jacob S, Ruus P, Hermann R, et al. Oral administration of RAC-alpha-lipoic acid modulates insulin sensitivity in patients with type-2 diabetes mellitus: a placebo-controlled pilot trial. Free Radic Biol Med 1999;27:309–14.

94. Ziegler D, Hanefeld M, Ruhnau KJ, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a 7-month multicenter randomized controlled trial (ALADIN III Study). ALADIN III Study Group. Alpha-Lipoic Acid in Diabetic Neuropathy. Diabetes Care 1999;22:1296–301.

95. Ziegler D, Ametov A, Barinov A, et al. Oral treatment with alpha-lipoic acid improves symptomatic diabetic polyneuropathy: the SYDNEY 2 trial. Diabetes Care 2006;29:2365–70.

96. Morcos M, Borcea V, Isermann B, et al. Effect of alpha-lipoic acid on the progression of endothelial cell damage and albuminuria in patients with diabetes mellitus: an exploratory study. Diabetes Res Clin Pract 2001;52:175–83.

97. Herepath WB. Journal Provincial Med Surg Soc 1854:374.

98. Offenbacher EG, Pi-Sunyer FX. Beneficial effect of chromium-rich yeast on glucose tolerance and blood lipids in elderly subjects. Diabetes 1980;29:919–25.

99. Anderson RA. Chromium in the prevention and control of diabetes. Diabetes Metab 2000;26:22–7 [review].

100. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006;29:1826–32.

101. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17:548–55 [review].

102. Evans GW. The effect of chromium picolinate on insulin controlled parameters in humans. Int J Biosocial Med Res 1989;11:163–80.

103. Gaby AR, Wright JV. Diabetes. In Nutritional Therapy in Medical Practice: Reference Manual and Study Guide. Kent, WA: 1996, 54–64 [review].

104. Anderson RA, Polansky MM, Bryden NA, Canary JJ. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr 1991;54:909–16.

105. Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes. J Trace Elem Exptl Med 1999;12:91–8.

106. Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables. Metabolism 1983;32:894–9.

107. Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism 1987;36:896–9.

108. Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994;17:1449–52.

109. Hermann J, Chung H, Arquitt A, et al. Effects of chromium or copper supplementation on plasma lipids, plasma glucose and serum insulin in adults over age fifty. J Nutr Elderly 1998;18:27–45.

110. Sherman L, Glennon JA, Brech WJ, et al. Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. Metabolism 1968;17:439–42.

111. Rabinowitz MB, Gonick HC, Levin SR, Davidson MB. Effects of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Diabetes Care 1983;6:319–27.

112. Uusitupa MI, Kumpulainen JT, Voutilainen E, et al. Effect of inorganic chromium supplementation on glucose tolerance, insulin response, and serum lipids in noninsulin-dependent diabetics. Am J Clin Nutr 1983;38:404–10.

113. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997;46:1786–91.

114. Gaby AR, Wright JV. Nutritional protocols: diabetes mellitus. In Nutritional Therapy in Medical Practice: Protocols and Supporting Information. Kent, WA: 1996, 10.

115. [No authors listed.] Treatment of painful diabetic neuropathy with topical capsaicin. A multicenter, double-blind, vehicle-controlled study. The Capsaicin Study Group. Arch Intern Med 1991;151:2225–9.

116. [No authors listed.] Effect of treatment with capsaicin on daily activities of patients with painful diabetic neuropathy. Capsaicin Study Group. Diabetes Care 1992;15:159–65.

117. Herepath WB. Journal Provincial Med Surg Soc 1854:374.

118. Offenbacher EG, Pi-Sunyer FX. Beneficial effect of chromium-rich yeast on glucose tolerance and blood lipids in elderly subjects. Diabetes 1980;29:919–25.

119. Sharma S, Agrawal RP, Choudhary M, et al. Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. J Trace Elem Med Biol 2011;25:149–53

120. Anderson RA. Chromium in the prevention and control of diabetes. Diabetes Metab 2000;26:22–7 [review].

121. Martin J, Wang ZQ, Zhang XH, et al. Chromium picolinate supplementation attenuates body weight gain and increases insulin sensitivity in subjects with type 2 diabetes. Diabetes Care 2006;29:1826–32.

122. Anderson RA. Chromium, glucose intolerance and diabetes. J Am Coll Nutr 1998;17:548–55 [review].

123. Evans GW. The effect of chromium picolinate on insulin controlled parameters in humans. Int J Biosocial Med Res 1989;11:163–80.

124. Gaby AR, Wright JV. Diabetes. In Nutritional Therapy in Medical Practice: Reference Manual and Study Guide. Kent, WA: 1996, 54–64 [review].

125. Anderson RA, Polansky MM, Bryden NA, Canary JJ. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr 1991;54:909–16.

126. Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes. J Trace Elem Exptl Med 1999;12:91–8.

127. Anderson RA, Polansky MM, Bryden NA, et al. Chromium supplementation of human subjects: effects on glucose, insulin, and lipid variables. Metabolism 1983;32:894–9.

128. Urberg M, Zemel MB. Evidence for synergism between chromium and nicotinic acid in the control of glucose tolerance in elderly humans. Metabolism 1987;36:896–9.

129. Lee NA, Reasner CA. Beneficial effect of chromium supplementation on serum triglyceride levels in NIDDM. Diabetes Care 1994;17:1449–52.

130. Hermann J, Chung H, Arquitt A, et al. Effects of chromium or copper supplementation on plasma lipids, plasma glucose and serum insulin in adults over age fifty. J Nutr Elderly 1998;18:27–45.

131. Sherman L, Glennon JA, Brech WJ, et al. Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. Metabolism 1968;17:439–42.

132. Rabinowitz MB, Gonick HC, Levin SR, Davidson MB. Effects of chromium and yeast supplements on carbohydrate and lipid metabolism in diabetic men. Diabetes Care 1983;6:319–27.

133. Uusitupa MI, Kumpulainen JT, Voutilainen E, et al. Effect of inorganic chromium supplementation on glucose tolerance, insulin response, and serum lipids in noninsulin-dependent diabetics. Am J Clin Nutr 1983;38:404–10.

134. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes. Diabetes 1997;46:1786–91.

135. Gaby AR, Wright JV. Nutritional protocols: diabetes mellitus. In Nutritional Therapy in Medical Practice: Protocols and Supporting Information. Kent, WA: 1996, 10.

136. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabet Med 1990;7:319–23.

137. Rodríguez-Morán M, Guerrero-Romero F, Lazcano-Burciaga G. Lipid- and glucose-lowering efficacy of plantago psyllium in type II diabetes. Diabetes Its Complications 1998;12:273–8.

138. Landin K, Holm G, Tengborn L, Smith U. Guar gum improves insulin sensitivity, blood lipids, blood pressure, and fibrinolysis in healthy men. Am J Clin Nutr 1992;56:1061–5.

139. Schwartz SE, Levine RA, Weinstock RS, et al. Sustained pectin ingestion: effect on gastric emptying and glucose tolerance in non-insulin-dependent diabetic patients. Am J Clin Nutr 1988;48:1413–7.

140. Hallfrisch J, Scholfield DJ, Behall KM. Diets containing soluble oat extracts improve glucose and insulin responses of moderately hypercholesterolemic men and women. Am J Clin Nutr 1995;61:379–84.

141. Doi K, Matsuura M, Kawara A, Baba S. Treatment of diabetes with glucomannan (konjac mannan). Lancet 1979;1:987–8 [letter].

142. Vuksan V, Sievenpiper JL, Owen R, et al. Beneficial effects of viscous dietary fiber from Konjac-mannan in subjects with the insulin resistance syndrome: results of a controlled metabolic trial. Diabetes Care 2000;23:9–14.

143. Sharma RD, Raghuram TC. Hypoglycaemic effect of fenugreek seeds in non-insulin dependent diabetic subjects. Nutr Res 1990;10:731–9.

144. Raghuram TC, Sharma RD, Sivakumar B, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients. Phytother Res 1994;8:83–6.

145. Nuttall FW. Dietary fiber in the management of diabetes. Diabetes 1993;42:503–8.

146. Doi K. Effect of konjac fibre (glucomannan) on glucose and lipids. Eur J Clin Nutr 1995;49(Suppl. 3):S190–7 [review].

147. Melga P, Giusto M, Ciuchi E, et al. Dietary fiber in the dietetic therapy of diabetes mellitus. Experimental data with purified glucomannans. Riv Eur Sci Med Farmacol 1992;14:367–73 [in Italian].

148. Huang CY, Zhang MY, Peng SS, et al. Effect of Konjac food on blood glucose level in patients with diabetes. Biomed Environ Sci 1990;3:123–31.

149. Vuksan V, Jenkins DJ, Spadafora P, et al. Konjac-mannan (glucomannan) improves glycemia and other associated risk factors for coronary heart disease in type 2 diabetes. A randomized controlled metabolic trial. Diabetes Care 1999;22:913–9.

150. Vorster HH, Lotter AP, Odendaal I, et al. Benefits from supplementation of the current recommended diabetic diet with gel fibre. Int Clin Nutr Rev 1988;8:140–6.

151. Cesa F, Mariani S, Fava A, et al. The use of vegetable fibers in the treatment of pregnancy diabetes and/or excessive weight gain during pregnancy. Minerva Ginecol 1990;42:271–4 [in Italian].

152. Paolisso G, Scheen A, D’Onofrio FD, Lefebvre P. Magnesium and glucose homeostasis. Diabetologia 1990;33:511–4 [review].

153. Eibl NL, Schnack CJ, Kopp H-P, et al. Hypomagnesemia in type II diabetes: effect of a 3-month replacement therapy. Diabetes Care 1995;18:188.

154. Paolisso G, Sgambato S, Pizza G, et al. Improved insulin response and action by chronic magnesium administration in aged NIDDM subjects. Diabetes Care 1989;12:265–9.

155. Lima M, Cruz T, Carreiro Pousada J, et al: The effect of magnesium supplementation in increasing doses on the control of type 2 diabetes. Diabetes Care 1998;21:682–6.

156. Paolisso G, Sgambato S, Gambardella A, et al. Daily magnesium supplements improve glucose handling in elderly subjects. Am J Clin Nutr 1992;55:1161–7.

157. Smellie WS, O’Reilly DS, Martin BJ, Santamaria J. Magnesium replacement and glucose tolerance in elderly subjects. Am J Clin Nutr 1993;57:594–6 [letter].

158. de Valk HW, Verkaaik R, van Rijn HJM, et al. Oral magnesium supplementation in insulin-requiring type 2 diabetic patients. Diabet Med 1998;15:503–7.

159. American Diabetes Association. Magnesium supplementation in the treatment of diabetes. Diabetes Care 1992;15:1065–7.

160. McNair P, Christiansen C, Madsbad S, et al. Hypomagnesemia, a risk factor in diabetic retinopathy. Diabetes 1978;27:1075–7.

161. Mimouni F, Miodovnik M, Tsang RC, et al. Decreased maternal serum magnesium concentration and adverse fetal outcome in insulin-dependent diabetic women. Obstet Gynecol 1987;70:85–9.

162. American Diabetes Association. Magnesium supplementation in the treatment of diabetes. Diabetes Care 1992;15:1065–7.

163. Anderson JW, Allgood LD, Turner J, et al. Effects of psyllium on glucose and serum lipid responses in men with type 2 diabetes and hypercholesterolemia. Am J Clin Nutr 1999;70:466–73.

164. Sima AA, Calvani M, Mehra M, Amato A. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception in patients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care 2005;28:89–94.

165. Rajasekaran S, Sivagnanam K, Subramanian S. Hypoglycemic effect of Aloe vera gel on streptozotocin-induced diabetes in experimental rats. J Med Food 2004;7:61–6.

166. Yongchaiyudha S, Rungpitarangs V, Bunyapraphatsara N, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L. juice. I. Clinical trial in new cases of diabetes mellitus. Phytomedicine 1996;3:241–3.

167. Bunyapraphatsara N, Yongchaiyudha S, Rungpitarangsi V, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L juice. II. Clinical trial in diabetes mellitus patients in combination with glibenclamide. Phytomedicine 1996;3:245–8.

168. Vogler BK, Ernst E. Aloe vera: a systematic review of its clinical effectiveness. Br J Gen Pract 1999;49:823–8 [review].

169. Vuksan V, Sivenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L.) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009–13.

170. Vuksan V, Sivenpiper JL, Koo VYY, et al. American ginseng (Panax quinquefolius L.) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med 2000;160:1009–13.

171. Zhang T, Hoshino M, Iguchi K, et al. Ginseng root: Evidence for numerous regulatory peptides and insulinotropic activity. Biomed Res 1990;11:49–54.

172. Suzuki Y, Hikino H. Mechanisms of hypoglycemic activity of panaxans A and B, glycans of Panax ginseng roots: Effects on plasma levels, secretion, sensitivity and binding of insulin in mice. Phytother Res 1989;3:20–4.

173. Waki I, Kyo H, Yasuda M, Kimura M. Effects of a hypoglycemic component of ginseng radix on insulin biosynthesis in normal and diabetic animals. J Pharm Dyn 1982;5:547–54.125.

174. Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 1995;18:1373–5.

175. Scharrer A, Ober M. Anthocyanoside in der Behandlung von Retinopathien. Klin Monatsblatt Augenheilk 1981;178:386–9.

176. Coggeshall JC, Heggers JP, Robson MC, Baker H. Biotin status and plasma glucose in diabetics. Ann NY Acad Sci 1985;447:389–92.

177. Koutsikos D, Agroyannis B, Tzanatos-Exarchou H. Biotin for diabetic peripheral neuropathy. Biomed Pharmacother 1990;44:511–4.

178. Leatherdale BA, Panesar RK, Singh G, et al. Improvement of glucose tolerance due to Momordica charantia (karela). BMJ 1981;282:1823–4.

179. Srivastava Y, Venkatakrishna-bhatt H, Verma Y, et al. Antidiabetic and adaptogenic properties of Momordica charantia extract: An experimental and clinical evaluation. Phytother Res 1993;7:285–9.

180. Welihinda J, Karunanaya E, Sheriff MHB, Jayasinghe K. Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes. J Ethnopharmacol 1986;17:277–82.

181. Khan A, Safdar M, Ali Khan MM, et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26:3215–8.

182. Akilen R, Tsiami A, Devendra D, Robinson N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med 2010;27:1159–67.

183. Vanschoonbeek K, Thomassen BJ, Senden JM, et al. Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients. J Nutr2006;136:977–80.

184. Blevins SM, Leyva MJ, Brown J, et al. Effect of cinnamon on glucose and lipid levels in non insulin-dependent type 2 diabetes. Diabetes Care 2007;30:2236–7.

185. Miyake Y, Shouzu A, Nishikawa M, et al. Effect of treatment of 3-hydroxy-3-methylglutaryl coenzyme I reductase inhibitors on serum coenzyme Q10 in diabetic patients. Arzneimittelforschung 1999;49:324–9.

186. Shigeta Y, Izumi K, Abe H. Effect of coenzyme Q7 treatment on blood sugar and ketone bodies of diabetics. J Vitaminol (Kyoto) 1966;12:293–8.

187. Judy WV, Hari SP, Stogsdill WW, et al. Antidiabetic activity of a standardized extract (Glucosol) from Lagerstroemia speciosa leaves in Type II diabetics. A dose-dependence study. J Ethnopharmacol 2003;87:115–7.

188. Baskaran K, Ahmath BK, Shanmugasundaram KR, Shanmugasundaram ERB. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol 1990;30:295–305.

189. Al-Romaiyan A, Liu B, Asare-Anane H, et al. A novel Gymnema sylvestre extract stimulates insulin secretion from human islets in vivo and in vitro. Phytother Res 2010;24:1370–6.

190. Shanmugasundaram ERB, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose insulin-dependent diabetes mellitus. J Ethnopharmacol 1990;30:281–94.

191. Joffe DJ, Freed SH. Effect of extended release gymnema sylvestre leaf extract (Beta Fast GXR) alone or in combination with oral hypoglycemics or insulin regimens for type 1 and type 2 diabetes. Diabetes In Control Newsletter 2001;76:no page number.

192. Viseshakul D, Premvatana P, Chularojmontri V, et al. Improved glucose tolerance induced by long term dietary supplementation with hairy basal seeds (Ocimum canum Sim) in diabetics. J Med Assoc Thailand 1985;68:408–11.

193. Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther 1996;34:406–9.

194. Rai V, Mani UV, Iyer UM. Effect of Ocimum sanctum leaf powder on blood lipoproteins, glycated protein and total amino acids in patients with non-insulin-dependent diabetes mellitus. J Nutr Environ Med 1997;7:113–8.

195. Rai V, Mani UV. Effect of ocimum sanctum leaf powder on blood lipoproteins. J Nutr Environ Med 1997;7:113–18.

196. Agrawal P, Rai V, Singh RB. Randomized placebo-controlled, single blind trial of holy basil leaves in patients with noninsulin-dependent diabetes mellitus. Int J Clin Pharmacol Ther 1996;34:406–9.

197. Abdel-Aziz MT, Abdou MS, Soliman K, et al. Effect of carnitine on blood lipid pattern in diabetic patients. Nutr Rep Int 1984;29:1071–9.

198. Hussain SA. Silymarin as an adjunct to glibenclamide therapy improves long-term and postprandial glycemic control and body mass index in type 2 diabetes. J Med Food 2007;10:543–7.

199. Barringer TA, Kirk JK, Santaniello AC, et al. Effect of a multivitamin and mineral supplement on infection and quality of life. A randomized, double-blind, placebo-controlled trial. Ann Intern Med2003;138:365–71.

200. Jain RC, Sachdev KN. A note on hypoglycemic action of onion in diabetes. Curr Med Pract 1971;15:901–2.

201. Mathew PT, Augusti KT. Hypoglycaemic effect of onion, Allium cepa Linn, on diabetes mellitus, a preliminary report. Ind J Physiol Pharmacol 1975;19:231–7.

202. Tjokroprawiro A, Pikir BS, Budhiarta AA, et al. Metabolic effects of onion and green beans on diabetic patients. Tohoku J Exp Med 1983;141(suppl):671–6.

203. Sharma KK, Gupta RK, Gupta S, Samuel KC. Antihyperglycemic effect of onion: Effect on fasting blood sugar and induced hyperglycemia in man. Ind J Med Res 1977;65:422–9.

204. Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetic patients. Diabetes Care 2004;27:839 [letter].

205. Liu X, Wei J, Tan F, et al. Antidiabetic effect of Pycnogenol French maritime pine bark extract in patients with diabetes type II. Life Sci 2004;75:2505-13.

206. Zibadi S, Rohdewald PJ, Park D, Watson RR. Reduction of cardiovascular risk factors in subjects with type 2 diabetes by Pycnogenol supplementation. Nutr Res 2008;28:315-20.

207. Schönlau F, Rohdewald P. Pycnogenol for diabetic retinopathy. A review. Int Ophthalmol 2001;24:161-71 [review].

208. Schönlau F, Rohdewald P. Pycnogenol for diabetic retinopathy. A review. Int Ophthalmol 2001;24:161-71 [review].

209. Spadea L, Balestrazzi E. Treatment of vascular retinopathies with Pycnogenol. Phytother Res 2001;15:219-23.

210. Steigerwalt R, Belcaro G, Cesarone MR, et al. Pycnogenol improves microcirculation, retinal edema, and visual acuity in early diabetic retinopathy. J Ocul Pharmacol Ther 2009;25:537-40.

211. Cesarone MR, Belcaro G, Rohdewald P, et al. Improvement of diabetic microangiopathy with pycnogenol: A prospective, controlled study. Angiology 2006;57:431-6.

212. Belcaro G, Cesarone MR, Errichi BM, et al. Diabetic ulcers: microcirculatory improvement and faster healing with pycnogenol. Clin Appl Thromb Hemost 2006;12:318-23.

213. Abbas ZG, Swai ABM. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East African Med J 1997;74:804–8.

214. Stracke H, Lindemann A, Federlin K. A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy. Exp Clin Endocrinol Diabetes 1996;104:311–6.

215. Abbas ZG, Swai ABM. Evaluation of the efficacy of thiamine and pyridoxine in the treatment of symptomatic diabetic peripheral neuropathy. East African Med J 1997;74:804–8.

216. Stracke H, Lindemann A, Federlin K. A benfotiamine-vitamin B combination in treatment of diabetic polyneuropathy. Exp Clin Endocrinol Diabetes 1996;104:311–6.

217. Yamane K, Usui T, Yamamoto T, et al. Clinical efficacy of intravenous plus oral mecobalamin in patients with peripheral neuropathy using vibration perception thresholds as an indicator of improvement. Curr Ther Res 1995;56:656–70 [review].

218. Kuwabara S, Nakazawa R, Azuma N, et al. Intravenous methylcobalamin treatment for uremic and diabetic neuropathy in chronic hemodialysis patients. Intern Med 1999;38:472–5.

219. Wilson RG, Davis RE. Serum pyridoxal concentrations in children with diabetes mellitus. Pathology 1977;9:95–9.

220. Davis RE, Calder JS, Curnow DH. Serum pyridoxal and folate concentrations in diabetics. Pathology 1976;8:151–6.

221. McCann VJ, Davis RE. Serum pyridoxal concentrations in patients with diabetic neuropathy. Aust N Z J Med 1978;8:259–61.

222. Spellacy WN, Buhi WC, Birk SA. Vitamin B6 treatment of gestational diabetes mellitus. Am J Obstet Gynecol 1977;127:599–602.

223. Coelingh HJT, Schreurs WHP. Improvement of oral glucose tolerance in gestational diabetes by pyridoxine. BMJ 1975;3:13–5.

224. Spellacy WN, Buhi WC, Birk SA. The effects of vitamin B6 on carbohydrate metabolism in women taking steroid contraceptives: preliminary report. Contraception 1972;6:265–73.

225. Passariello N, Fici F, Giugliano D, et al. Effects of pyridoxine alpha-ketoglutarate on blood glucose and lactate in type I and II diabetics. Int J Clin Pharmacol Ther Toxicol 1983;21:252–6.

226. Solomon LR, Cohen K. Erythrocyte O2 transport and metabolism and effects of vitamin B6 therapy in type II diabetes mellitus. Diabetes 1989;38:881–6.

227. Rao RH, Vigg BL, Rao KSJ. Failure of pyridoxine to improve glucose tolerance in diabetics. J Clin Endocrinol Metab 1980;50:198–200.

228. Davie SJ, Gould BJ, Yudkin JS. Effect of vitamin C on glycosylation of proteins. Diabetes 1992;41:167–73.

229. Will JC, Tyers T. Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 1996;54:193–202 [review].

230. Eriksson J, Kohvakka A. Magnesium and ascorbic acid supplementation in diabetes mellitus. Ann Nutr Metab 1995;39:217–23.

231. Paolisso G, Balbi V, Volpe C, et al. Metabolic benefits deriving from chronic vitamin C supplementation in aged non-insulin dependent diabetics. J Am Coll Nutr 1995;14:387–92.

232. Dakhale GN, Chaudhari HV, Shrivastava M. Supplementation of vitamin C reduces blood glucose and improves glycosylated hemoglobin in type 2 diabetes mellitus: a randomized, double-blind study. Adv Pharmacol Sci 2011;2011:195271

233. Will JC, Tyers T. Does diabetes mellitus increase the requirement for vitamin C? Nutr Rev 1996;54:193–202 [review].

234. McAuliffe AV, Brooks BA, Fisher EJ, et al. Administration of ascorbic acid and an aldose reductase inhibitor (tolrestat) in diabetes: effect on urinary albumin excretion. Nephron 1998;80:277–84.

235. Branch DR. High-dose vitamin C supplementation increases plasma glucose. Diabetes Care 1999;22:1218 [letter].

236. Mayer-Davis E, Bell RA, Reboussin BA, et al. Antioxidant nutrient intake and diabetic retinopathy. The San Luis Valley Diabetes Study. Ophthalmology 1998;105:2264–70.

237. Labriji-Mestaghanmi H, Billaudel B, Garnier PE, Sutter BCJ. Vitamin D and pancreatic islet function. I. Time course for changes in insulin secretion and content during vitamin deprivation and repletion. J Endocrine Invest 1988;11:577–84.

238. Boucher BJ. Inadequate vitamin D status: does it contribute to the disorders comprising syndrome ‘X’? Br J Nutr 1998;79:315–27 [review].

239. Borissova AM, Tankova T, Kirilov G, et al. The effect of vitamin D3 on insulin secretion and peripheral insulin sensitivity in type 2 diabetic patients. Int J Clin Pract 2003;57:258–61.

240. Nikooyeh B, Neyestani TR, Farvid M, et al. Daily consumption of vitamin D- or vitamin D + calcium-fortified yogurt drink improved glycemic control in patients with type 2 diabetes: a randomized clinical trial. Am J Clin Nutr 2011;93764–71.)

241. Patel P, Poretsky L, Liao E. Lack of effect of subtherapeutic vitamin D treatment on glycemic and lipid parameters in Type 2 diabetes: A pilot prospective randomized trial. J Diabetes 2010;2:36–40.

242. Jorde R, Sneve M, Torjesen P, Figenschau Y. No improvement in cardiovascular risk factors in overweight and obese subjects after supplementation with vitamin D3 for 1 year. J Intern Med 2010;267:462–72

243. Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med 2008;168:771–2.

244. Lee P, Chen R. Vitamin D as an analgesic for patients with type 2 diabetes and neuropathic pain. Arch Intern Med 2008;168:771–2.

245. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99–102.

246. Salonen JT, Nyssonen K, Tuomainen T-P, et al. Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ 1995;311:1124–7.

247. Bierenbaum ML, Noonan FJ, Machlin LJ, et al. The effect of supplemental vitamin E on serum parameters in diabetics, post coronary and normal subjects. Nutr Rep Int 1985;31:1171–80.

248. Paolisso G, D’Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin dependent diabetic patients. Am J Clin Nutr 1993;57:650–6.

249. Paolisso G, D’Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433–7.

250. Tütüncü NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915–8.

251. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291–6.

252. Paolisso G, Gambardella A, Galzerano D, et al. Antioxidants in adipose tissue and risk of myocardial infarction. Lancet 1994;343:596 [letter].

253. Tütüncü NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915–8.

254. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

255. Bursell SE, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type I diabetes. Diabetes Care 1999;22:1245–51.

256. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68–72.

257. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682–90.

258. Paolisso G, D’Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433–7.

259. Jain SK, McVie R, Jaramillo JJ, et al. Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type I diabetic patients. J Am Coll Nutr 1996;15:458–61.

260. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389–94.

261. Reaven PD, Barnett J, Herold DA, Edelman S. Effect of vitamin E on susceptibility of low-density lipoprotein and low-density lipoprotein subfractions to oxidation and on protein glycation in NIDDM. Diabetes Care 1995;18:807.

262. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatineine clearance in patients with type I diabetes. Diabetes Care 1999;22:1245–51.

263. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753–9.

264. Skrha J, Sindelka G, Kvasnicka J, Hilgertova J. Insulin action and fibrinolysis influenced by vitamin E in obese type 2 diabetes mellitus. Diabetes Res Clin Pract 1999;44:27–33.

265. Leppälä JM, Virtamo J, Fogelholm R, et al. Vitamin E and beta carotene supplementation in high risk for stroke: A subgroup analysis of the alpha-tocopherol, beta-carotene cancer prevention study. Arch Neurol 2000;57:1503–9.

266. Knekt P, Reunanen A, Marniumi J, et al. Low vitamin E status is a potential risk factor for insulin-dependent diabetes mellitus. J Intern Med 1999;245:99–102.

267. Salonen JT, Nyssonen K, Tuomainen T-P, et al. Increased risk of non-insulin dependent diabetes mellitus at low plasma vitamin E concentrations: a four year follow up study in men. BMJ 1995;311:1124–7.

268. Bierenbaum ML, Noonan FJ, Machlin LJ, et al. The effect of supplemental vitamin E on serum parameters in diabetics, post coronary and normal subjects. Nutr Rep Int 1985;31:1171–80.

269. Paolisso G, D’Amore A, Giugliano D, et al. Pharmacologic doses of vitamin E improve insulin action in healthy subjects and non-insulin dependent diabetic patients. Am J Clin Nutr 1993;57:650–6.

270. Paolisso G, D’Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433–7.

271. Tütüncü NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915–8.

272. Paolisso G, Di Maro G, Galzerano D, et al. Pharmacological doses of vitamin E and insulin action in elderly subjects. Am J Clin Nutr 1994;59:1291–6.

273. Paolisso G, Gambardella A, Galzerano D, et al. Antioxidants in adipose tissue and risk of myocardial infarction. Lancet 1994;343:596 [letter].

274. Tütüncü NB, Bayraktar M, Varli K. Reversal of defective nerve condition with vitamin E supplementation in type 2 diabetes. Diabetes Care 1998;21:1915–8.

275. Ross WM, Creighton MO, Stewart-DeHaan PJ, et al. Modelling cortical cataractogenesis: 3. In vivo effects of vitamin E on cataractogenesis in diabetic rats. Can J Ophthalmol 1982;17:61.

276. Bursell SE, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatinine clearance in patients with type I diabetes. Diabetes Care 1999;22:1245–51.

277. Ceriello A, Giugliano D, Quatraro A, et al. Vitamin E reduction of protein glycosylation in diabetes. Diabetes Care 1991;14:68–72.

278. Duntas L, Kemmer TP, Vorberg B, Scherbaum W. Administration of d-alpha-tocopherol in patients with insulin-dependent diabetes mellitus. Curr Ther Res 1996;57:682–90.

279. Paolisso G, D’Amore A, Galzerano D, et al. Daily vitamin E supplements improve metabolic control but not insulin secretion in elderly type II diabetic patients. Diabetes Care 1993;16:1433–7.

280. Jain SK, McVie R, Jaramillo JJ, et al. Effect of modest vitamin E supplementation on blood glycated hemoglobin and triglyceride levels and red cell indices in type I diabetic patients. J Am Coll Nutr 1996;15:458–61.

281. Jain SK, McVie R, Smith T. Vitamin E supplementation restores glutathione and malondialdehyde to normal concentrations in erythrocytes of type 1 diabetic children. Diabetes Care 2000;23:1389–94.

282. Reaven PD, Barnett J, Herold DA, Edelman S. Effect of vitamin E on susceptibility of low-density lipoprotein and low-density lipoprotein subfractions to oxidation and on protein glycation in NIDDM. Diabetes Care 1995;18:807.

283. Bursell S-E, Schlossman DK, Clermont AC, et al. High-dose vitamin E supplementation normalizes retinal blood flow and creatineine clearance in patients with type I diabetes. Diabetes Care 1999;22:1245–51.

284. Fuller CJ, Chandalia M, Garg A, et al. RRR-alpha-tocopheryl acetate supplementation at pharmacologic doses decreases low-density-lipoprotein oxidative susceptibility but not protein glycation in patients with diabetes mellitus. Am J Clin Nutr 1996;63:753–9.

285. Skrha J, Sindelka G, Kvasnicka J, Hilgertova J. Insulin action and fibrinolysis influenced by vitamin E in obese type 2 diabetes mellitus. Diabetes Res Clin Pract 1999;44:27–33.

286. Leppälä JM, Virtamo J, Fogelholm R, et al. Vitamin E and beta carotene supplementation in high risk for stroke: A subgroup analysis of the alpha-tocopherol, beta-carotene cancer prevention study. Arch Neurol 2000;57:1503–9.

287. Nakamura T, Higashi A, Nishiyama S, et al. Kinetics of zinc status in children with IDDM. Diabetes Care 1991;14:553–7.

288. Niewoehner CB, Allen JI, Boosalis M, et al. Role of zinc supplementation in type II diabetes mellitus. Am J Med 1986;81:63–8.

289. Maxwell SR, et al. Poor glycaemic control is associated with reduced serum free radical scavenging (antioxidant) activity in non-insulin-dependent diabetes mellitus. Ann Clin Biochem 1997;34( Pt 6):638–44.

290. Jayaprakasam B, Vareed SK, Olson LK, Nair MG. Insulin secretion by anthocyanins and anthocyanidins. J Agric Food Chem 2005;53:28–31.

291. Boivin M, Zinsmeister AR, Go VL, DiMagno EP. Effect of a purified amylase inhibitor on carbohydrate metabolism after a mixed meal in healthy humans. Mayo Clin Proc 1987;62:249–55.

292. Boivin M, Flourie B, Rizza RA, et al. Gastrointestinal and metabolic effects of amylase inhibition in diabetics. Gastroenterology 1988;94:387–94.

293. Lankisch M, Layer P, Rizza RA, DiMagno EP. Acute postprandial gastrointestinal and metabolic effects of wheat amylase inhibitor (WAI) in normal, obese, and diabetic humans. Pancreas 1998;17:176–81.

294. Holt PR, Thea D, Yang MY, Kotler DP. Intestinal and metabolic responses to an alpha-glucosidase inhibitor in normal volunteers. Metabolism 1988;37:1163–70.

295. Layer P, Rizza RA, Zinsmeister AR, et al. Effect of a purified amylase inhibitor on carbohydrate tolerance in normal subjects and patients with diabetes mellitus. Mayo Clin Proc 1986;61:442–7.

296. Zak A, Zeman M, Hrabak P, et al. Changes in the glucose tolerance and insulin secretion in hypertriglyceridemia: effects of dietary n-3 fatty acids. Nutr Rep Int 1989;39:235–42.

297. Popp-Snijders C, Schouten JA, Heine RJ, et al. Dietary supplementation of omega-3 polyunsaturated fatty acids improves insulin sensitivity in non-insulin-dependent diabetes. Diabetes Res 1987;4:141–7.

298. Albrink MJ, Ullrich IH, Blehschmidt NG, et al. The beneficial effect of fish oil supplements on serum lipids and clotting function of patients with type II diabetes mellitus. Diabetes 1986;35 (suppl 1):43A [abstract #172].

299. Wei I, Ulchaker M, Sheehan J. Effect of omega-3 fatty acids (FA) in non-obese non-insulin dependent diabetes (NIDDM). Am Clin Nutr 1988;47:775 [abstract #70].

300. Okuda Y, Mizutani M, Ogawa M, et al. Long-term effects of eicosapentaenoic acid on diabetic peripheral neuropathy and serum lipids in patients with type II diabetes mellitus. J Diabetes Complications 1996;10:280–7.

301. Vandongen R, Mori TA, Codde JP, et al. Hypercholesterolaemic effect of fish oil in insulin-dependent diabetic patients. Med J Aust 1988;148:141–3.

302. Schectman G, Kaul S, Kissebah AH. Effect of fish oil concentrate on lipoprotein composition in NIDDM. Diabetes 1988;37:1567–73.

303. Stackpoole PW, Alig J, Kilgore LL, et al. Lipodystrophic diabetes mellitus. Investigations of lipoprotein metabolism and the effects of omega-3 fatty acid administration in two patients. Metabolism 1988;37:944–51.

304. Glauber H, Wallace P, Griver K, Brechtel G. Adverse metabolic effect of omega-3 fatty acids in non-insulin-dependent diabetes mellitus. Ann Intern Med 1988;108:663–8.

305. Yamashita K, Kawai K, Itakura M. Effect of fructo-oligosaccharides on blood glucose and serum lipids in diabetic subjects. Nutr Res 1984;4:961–6.

306. Roberfroid M. Dietary fibre, inulin and oligofructose. A review comparing their physiological effects. Crit Rev Food Sci Nutr 1993;33:103–48 [review].

307. van Dokkum W, Wezendonk B, Srikumar TS, van den Heuvel. Effect of nondigestible oligosaccharides on large-bowel functions, blood lipid concentrations and glucose absorption in young healthy male subjects. Eur J Clin Nutr 1999;53:1–7.

308. Luo J, Rizkalla SW, Alamowitch C, et al. Chronic consumption of short-chain fructooligosaccharides by health subjects decreased basal hepatic glucose production but had no effect on insulin-stimulated glucose metabolism. Am J Clin Nutr 1996;63:939–45.

309. Koltringer P, Langsteger W, Lind P, et al. [Ginkgo biloba extract and folic acid in the therapy of changes caused by autonomic neuropathy]. Acta Med Austriaca 1989;16:35–7 [in German].

310. Zhang H, Wei J, Xue R, et al. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism 2010;59:285–92

311. Huxley R, Lee CM, Barzi F, et al. Coffee, decaffeinated coffee, and tea consumption in relation to incident type 2 diabetes mellitus: a systematic review with meta-analysis. Arch Intern Med 2009;169:2053–63 [review].

312. Henry-Vitrac C, Ibarra A, Roller M. Contribution of chlorogenic acids to the inhibition of human hepatic glucose-6-phosphatase activity in vitro by Svetol, a standardized decaffeinated green coffee extract. J Agric Food Chem 2010;58:4141-4.

313. Ho L, Varghese M, Wang J, et al. Dietary supplementation with decaffeinated green coffee improves diet-induced insulin resistance and brain energy metabolism in mice. Nutr Neurosci 2012;15:37-45.

314. Thom E. The effect of chlorogenic acid enriched coffee on glucose absorption in healthy volunteers and its effect on body mass when used long-term in overweight and obese people J Int Med Res 2007;35:900-8.

315. Alam MM, Siddiqui MB, Hussain W. Treatment of diabetes through herbal drugs in rural India. Fitoterapia 1990;61:240–2.

316. Sachdewa A, Khemani LD. Effect of Hibiscus rosa sinensis Linn ethanol flower extract on blood glucose and lipid profile in streptozotocin induced diabetes in rats. J Ethnopharmacol 2003;89:61–6.

317. Salway JG, Whitehead L, Finnegan JA, et al. Effect of myo-inositol on peripheral-nerve function in diabetes. Lancet 1978;2:1282–4.

318. Kosenko LG. Concentration of trace elements in the blood of patients with diabetes mellitus. Fed Proc Transl (Suppl) 1965;24:237–8.

319. Baly DL, Schneiderman JS, Garcia-Welsh AL. Effect of manganese deficiency on insulin binding, glucose transport and metabolism in rat adipocytes. J Nutr 1990;120:1075–9.

320. Rubenstein AH, Levin NW, Elliott GA. Hypoglycaemia induced by manganese. Nature (London) 1962;194:188–9.

321. Eckel RH, Hanson AS, Chen AY, et al. Dietary substitution of medium-chain triglycerides improves insulin-mediated glucose metabolism in non-insulin dependent diabetics. Diabetes 1992;41:641–7.

322. Trudy J, Yost RN, Erskine JM, et al. Dietary substitution of medium-chain triglycerides in subjects with non-insulin dependent diabetes mellitus in an ambulatory setting: impact on glycemic control and insulin-mediated glucose metabolism. J Am Coll Nutr 1994;13:615–22.

323. Gray AM, Flatt PR. Insulin-secreting activity of the traditional antidiabetic plant Viscum album (mistletoe). J Endocrinol 1999;160:409–14.

324. Swanson-Flatt SK, Day C, Bailey CJ, Flatt PR. Evaluation of traditional plant treatments for diabetes: Studies in streptozotocin-diabetic mice. Acta Diabetologica Latina 1989;26:51–5.

325. Peirce A. Practical Guide to Natural Medicines. New York: William Morrow and Co., 1999, 469–71.

326. Gaby A. Preventing complications of diabetes Townsend Letter 1985;32:307 [editorial].

327. Van der Hem LG, van der Vliet JA, Bocken CF, et al. Ling Zhi-8: studies of a new immunomodulating agent. Transplantation 1995;60:438–43.

328. Jones K. Reishi mushroom: Ancient medicine in modern times. Alt Compl Ther 1998;4:256–66 [review].

329. Crary EJ, McCarty MF. Potential clinical applications for high-dose nutritional antioxidants. Med Hypotheses 1984;13:77–98.

330. Franconi F, Di Leo MA, Bennardini F, Ghirlanda G. Is taurine beneficial in reducing risk factors for diabetes mellitus? Neurochem Res 2004;29:143–50 [review].

331. Brons C, Spohr C, Storgaard H, et al. Effect of taurine treatment on insulin secretion and action, and on serum lipid levels in overweight men with a genetic predisposition for type II diabetes mellitus. Eur J Clin Nutr 2004;58:1239-47.

332. Nakamura T, Ushiyama C, Suzuki S, et al. Effects of taurine and vitamin E on microalbuminuria, plasma metalloproteinase-9, and serum type IV collagen concentrations in patients with diabetic nephropathy. Nephron 1999;83:361–2.

333. Halberstam M, Cohen N, Schlimovich P, et al. Oral vanadyl sulfate improves insulin sensitivity in NIDDM but not in obese nondiabetic subjects. Diabetes 1996;45:659–66.

334. Boden G, Chen X, Ruiz J, et al. Effects of vanadyl sulfate on carbohydrate and lipid metabolism in patients with non-insulin dependent diabetes mellitus. Metabolism 1996;45:1130–5.

335. Goldfine AB, Patti ME, Zuberi L, et al. Metabolic effects of vanadyl sulfate in humans with non-insulin-dependent diabetes mellitus: in vivo and in vitro studies. Metabolism 2000;49:400–10.

336. Goldfine AB, Patti ME, Zuberi L, et al. Metabolic effects of vanadyl sulfate in humans with non-insulin-dependent diabetes mellitus: In vivo and in vitro studies. Metabolism 2000;49:400–10.

337. Molnar GD, Berge KG, Rosevear JW, et al. The effect of nicotinic acid in diabetes mellitus. Metabolism 1964;13:181–9.

338. Gaut ZN, Pocelinko R, Solomon HM, Thomas GB. Oral glucose tolerance, plasma insulin, and uric acid excretion in man during chronic administration in nicotinic acid. Metabolism 1971;20:1031–5.

339. Clearly JP. The importance of oxidant injury as a cause of impaired mitochondrial oxidation in diabetes. J Orthomolec Med 1988;3:164–74.

340. Klein GA, Stefanuto A, Boaventura BC, et al. Mate tea (Ilex paraguariensis) improves glycemic and lipid profiles of type 2 diabetes and pre-diabetes individuals: a pilot study. J Am Coll Nutr 2011;30:320–32.

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Type 2 Diabetes (Holistic)

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