March 30, 2009

30 Min Read
DiabetesA Natural Approach

The press commonly focuses on the negative—it’s easier and creates more sales. Our nation’s financial turmoil, celebrity scandals and sky-high rates of obesity, diabetes and heart-related conditions only skim the surface of America’s woes. But now is also an exciting time: a time of change, which spurs growth; a time of challenge, which builds perseverance; and a time of new innovations. It is a great time to be in the health and nutrition industry. It is booming with new concepts, consumer awareness and intrigue. It is easier to find restaurants and food offerings that cater to vegetarians, vegans, diabetics, lactose intolerants and those just trying to make the right food choices.

Sam Fox, a restaurant entrepreneur with dining rooms populating the Southwest, recently teamed up with Andrew Weil, M.D., to design the menu for his recent restaurant endeavor—True Food Kitchen. The menu offers balanced, nutritious, palatable dishes made with a variety of all-natural ingredients, including organic and locally grown whenever possible. They have 16 vegetarian, six vegan and 10 gluten-free items; the house-made natural sodas and fresh juice drinks are sweetened with either agave nectar or erythritol.

New concepts such as this are sprouting up all over the country as the nation’s eye turns toward natural, healthy ways to approach life through diet, movement and supplementation because sedentary lifestyles, over indulgence and highly processed meals have contributed to the obesity rate leading to larger issues such as diabetes and metabolic syndrome. Americans need to get moving and quit making excuses as to why reruns of Seinfeld and Friends are more important than their health. Obesity is an epidemic sweeping across our culture and sadly, is almost entirely avoidable by making smart choices.

According to the American Diabetes Association, there are 23.6 million children and adults in the United States, or 7.8 percent of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease. A Canadian review noted, “In the United States in the next 50 years, it is projected that the percentage of adults with type 2 diabetes will exceed 30 percent, with the vast majority older than 65 years. It is therefore important to determine the best possible dietary and lifestyle modifications to prevent and control this disease and its associated complications.”1

What is Diabetes?

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life.

In a nondiabetic, glucose (sugar) is absorbed in the bloodstream and insulin from the pancreas transports the glucose into the cells, which, in turn, provide energy; any excess glucose is stored in the liver. In diabetics, the glucose enters the bloodstream and insulin leaves the pancreas to transport the glucose into the cells. Unfortunately, one of two things happens: either the pancreas doesn’t produce enough insulin to transport the glucose (type 1 diabetes and type 2 diabetes) or the cells become resistant to the insulin (type 2 diabetes) stifling the normal process leaving energy levels low, among other things. Type 2 diabetes increases the risk for heart disease, blindness, nerve damage and kidney damage.

Carb Confusion

Diabetes requires an overall reduction in dietary carbohydrate intake. Regulation of carbs is necessary due to the body’s resistance or lack of insulin. However, certain carbohydrates are more acceptable than others. Those low on the glycemic index (GI) digest slower, meaning they don’t create a spike in glucose levels. GI measures how quickly a carbohydrate-containing food raises blood glucose. For diabetics and nondiabetics, it is prudent to keep glucose levels steady by eating low-glycemic foods such as 100-percent, stone-ground whole wheat or pumpernickel bread; oatmeal (rolled or steel-cut); oat bran; muesli; sweet potatoes; peas; and legumes.

A 2008 study confirmed the benefits of a low-carb diet for improving and reversing type 2 diabetes.2 During a 24-week period, 84 community volunteers with obesity and type 2 diabetes were randomized to either a low-carbohydrate, ketogenic diet (less than 20 g/d carbohydrate; LCKD) or a low-glycemic, reduced-calorie diet (500 kcal/d deficit from weight maintenance diet; LGID). Both diets led to improvements in hemoglobin A1c, fasting glucose, fasting insulin and weight loss. The LCKD group had greater improvements in hemoglobin A1c, body weight and high-density lipoprotein (HDL) cholesterol compared to the LGID group. Diabetes medications were reduced or eliminated in 95.2 percent of LCKD versus 62 percent of LGID participants. Dietary modification led to improvements in glycemic control and medication reduction/elimination in motivated volunteers with type 2 diabetes. The diet lower in carbohydrates led to greater improvements in glycemic control and more frequent medication reduction/elimination than the low GI diet.

Not surprisingly, there are times when eating processed white bread is unavoidable. Whether dining out at a restaurant or over at a friend’s house, it is difficult to completely avoid high-GI foods. Phase 2 Carb Controller®, supplied by Pharmachem Labs, is a proprietary, standardized extract of white kidney bean (Phaseolus vulgaris). It has been shown to significantly reduce the GI of white bread and assist with weight management.

In an open-label, six-arm crossover study conducted by Medicus Research including 13 randomized subjects, the GI of Wonder Brand White Bread was significantly reduced by the addition of 3,000 mg of Phase 2 in powder form. Additionally, participants receiving 1,500 mg of Phase 2 for eight weeks versus those receiving an identical placebo twice daily, lost an average of 3.79 lbs. compared to 1.65 lbs., respectively.3 Triglyceride levels in the Phase 2 group were reduced to an average of 26.3 mg/dL, more than three times greater a reduction than observed in the placebo group.

Oceanova developed InSea2™, a blend of purified polyphenols from two species of brown seaweeds. It slows down the digestion of carbohydrates by inhibiting pancreatic alpha-amylase and intestinal alpha-glucosidase enzymes. According to an unpublished, in vitro study, InSea may reduce the rate of glucose absorption by selectively blocking two enzymes that help convert alimentary carbs into single monomers. InSea was also tested in a separate, unpublished animal model against a simulated test meal (starch-oil mixture). The treatment group was administered 7.5 mg/kg of InSea with a test meal, and 12 animals served as an untreated, control group.

Thirty minutes after the test meal, a 90-percent reduction in normal elevation in blood glucose levels was observed in correlation with a 40-percent reduction in peak insulin secretion. Glucose absorption lasted much longer and blood glucose remained well above the basal level. In the control group, glucose absorption occurred during a shorter time period and control animals suffered from postprandial hypoglycemia approximately two hours after the test meal.

Let Them Eat Cake

It’s a myth that sugar is inherently bad for diabetics. Sugar is only one type of carbohydrate—starch, fiber, sugar and sugar alcohols all account for carbohydrates’ profile. As stated above, a low-carb diet approach is encouraged, based on the principle that it’s the amount of carbohydrates that matters, not necessarily sugar intake. However, this does not mean it’s acceptable for a diabetic (or anyone) to eat a piece of pie for breakfast and cookies after lunch and dinner, but occasionally swapping out carbs from pasta or bread for sugar-filled carbs does allow for some variation. With that in mind, there is a better “sweet-tooth” approach to sucrose (table sugar) and other processed sugars.

The nutraceutical world is a well-oiled industry equipped with healthy, natural alternatives to sucrose that don’t increase blood sugar levels and are safe for diabetics. Stevia is 300 times sweeter than sugar, calorie-free and has a negligible effect on blood glucose as well as positive effects on diabetes. In 2008, Cargill partnered up with The Coca-Cola Co. and launched TRUVIA™, composed of rebaudioside A (part of the stevia plant) as an all-natural, zero-calorie sweetener; companies including Blue California, Wisdom Natural Brands and PureCircle also offer GRAS affirmed stevia sweeteners. Stevia had been sold as a dietary supplement in the United States, but rebiana is the first available sweetener derived from stevia. A study published in Metabolism found stevioside, extracted from stevia, lowered blood glucose and decreased systolic blood pressure.4 A combination of stevioside and a dietary supplement of soy protein was potentially an effective treatment for hyperglycemia, hypertension and dyslipidemia.

Sugar alcohols such as erythritol and xylitol are not as sweet as sugar, but they are less caloric and are incompletely absorbed into the bloodstream from the small intestine, resulting in a smaller change in blood glucose than sugar. A study at the Toyama Medical and Pharmaceutical University, Toyama, Japan, found erythritol affects glucose metabolism and reduces lipid peroxidation, which improved the damage caused by oxidative stress involved in the pathogenesis of diabetes.5 And, a single-dose study found erythritol did not exert significant effects on the metabolism of diabetic patients and a daily intake for two weeks had no adverse effect on blood glucose control.6

Cinnamon has a sweet reputation and it’s well earned with its nutritional profile known for positive effects in diabetes. It’s been found to activate peroxisome proliferator-activated receptors (PPARs), which are transcriptional factors involved in the regulation of insulin resistance and adipogenesis.7 In PPAR Research, researchers said, “In vitro studies demonstrate that cinnamon increases the expression of PPARgamma/alpha and their target genes such as LPL, CD36, GLUT4, and ACO in 3T3-L1 adipocyte ... [suggesting] cinnamon in its water extract form can act as a dual activator of PPARgamma and alpha, and may be an alternative to PPARgamma activator in managing obesity-related diabetes and hyperlipidemia.”

In December 2006, 22 subjects with pre-diabetes and the metabolic syndrome were randomly assigned to supplement their diet with either 500 mg/d of Cinnulin PF™ (from Integrity Nutraceuticals International), a water-soluble cinnamon extract or a placebo for 12 weeks.8 Subjects in the Cinnulin PF group had significant decreases in fasting blood glucose, systolic blood pressure and increases in lean mass compared with the placebo group. There was also small, but statistically significant decreases in body fat in the Cinnulin PF group.

A separate study conducted on 15 women with polycystic ovary syndrome randomized participants to daily oral cinnamon or a placebo for eight weeks.9 Comparisons of post-treatment to baseline insulin sensitivity indices showed significant reductions in insulin resistance in the cinnamon group, but not in the placebo group.

And, in the March 2009 issue of the American Journal for Clinical Nutrition, researchers reported ingesting 3 g of cinnamon decreased postprandial serum insulin and increased glucagon-like peptide 1 (GLP-1) concentrations without significantly affecting blood glucose, glucose-dependent insulinotropic polypeptide (GIP), the ghrelin concentration, satiety or gastric emptying rate (GER) in healthy subjects after 60 minutes and 120 minutes.10

Of Course, Fiber

Fiber is a necessary addition to any diet. It is a carbohydrate but it is mandatory for digestion and helps regulate blood glucose levels in addition to its benefits on cholesterol and overall health. Fortunately, fiber is found whole grains, as the ones mentioned above with a low-GI profile.

A Canadian study noted, “Although few data are available regarding the optimal nutritional regimen for the elderly with type 2 diabetes, as a general rule, the use of nutrient-dense, low-GI, high-dietary fiber foods with possibly higher protein intake is recommended.”11 Researchers out of California investigated the effect of five breakfast cereal test meals containing wheat and/or barley with varying amounts of soluble fiber and beta-glucan on glucose and insulin responses in 17 normoglycemic, obese women at increased risk for insulin resistance.12 Acute consumption of 10 g of beta-glucan was able to induce physiologically beneficial effects on postprandial insulin responses in obese women at risk for insulin resistance.

Between June and August 2006, a within-subject, crossover design recruited 23 participants.13 On day one, participants consumed their usual meal; on another day, participants consumed low-GI meals ad libidum. Order of the two days was counterbalanced. During the low-GI day, mean daytime blood glucose values, blood glucose area above 180 mg/dL and high blood glucose index were lower compared to the usual mean day. During the low-GI day, subjects consumed more fiber and less fat; however, there were no differences in energy, carbohydrate or protein intake.

A study at the University of Toronto reported products manufactured with PROMITOR Soluble Corn Fiber™ or PROMITOR Resistant Starch™ (from Tate & Lyle) produced lower glycemic and insulin responses.14 In the clinical study, 12 healthy volunteers were fed seven test beverages containing maize-based fiber ingredients (25 g total carbohydrate) along with two control meals on separate occasions in random order. All the test fibers resulted in significantly lower glycemic and insulinemic responses compared with the control (P<0.05).

Trace Elements

Essential trace elements such as chromium, manganese and zinc are often altered in diabetics. A study published in January 2009 compared the status of these essential trace elements in biological samples of insulin-dependent diabetic mothers (ages 30 to 40 years) and their newly born infants (n=76).15 The mean values of chromium, manganese and zinc in scalp hair and blood samples of diabetic mothers and their infants were significantly lower as compared to the referent mother-infant pairs (P<0.01), while urinary excretion of all these elements were high in diabetic mother-infant pair samples. Researchers concluded, “The deficiencies of essential trace elements, chromium, manganese and zinc in biological samples of diabetic women, may play role in the pathogenesis of diabetes mellitus and impacts on their neonates.”

Chromium itself exhibits anti-diabetic effects. A systematic review published in November 2008 discussed the potential role of alpha-lipoic acid (ALA), chromium, folic acid, isoflavones, magnesium, Pycnogenol, selenium, vitamin C, vitamin E and zinc in the treatment of type 2 diabetes.16 “The review of trials identifies positive effects of these nutrients on various outcome measures relating to insulin resistance and cardiovascular factors. Chromium was the most studied supplement, accounting for 16 of the 50 trials. A majority of the trials found a positive effect of chromium on fasting plasma glucose. Isoflavones were found to have a positive effect on insulin resistance and cardiovascular outcome measures, but only when combined with soy proteins. Vitamin E is reported to reduce oxidative stress at levels of 200 mg/d(-1) or more.”

Results from a study published in 2009 indicated the cardio-protective effect of niacin-bound chromium (NBC) is mediated by increased activation of AMPK, Akt and eNOS resulting in increased translocation of Glut-4 to the caveolar raft fractions thereby alleviating the effects of ischemia/reperfusion (IR) injury in the diabetic myocardium.17 Researchers investigated the effect of NBC (as ChromeMate®, from InterHealth Nutraceuticals) during IR injury in streptozotocin-induced diabetic rats. Rats were randomized into: control (Con); diabetic (Dia) and diabetic rats fed with NBC (Dia+NBC). After 30 days of treatment, the isolated hearts were subjected to 30 minutes of global ischemia followed by two hours of reperfusion. NBC treatment significantly increased left ventricular functions and significantly reduced infarct size and cardiomyocyte apoptosis in Dia+NBC compared with Dia. Increased Glut-4 translocation to the lipid raft fractions was also observed in Dia+NBC compared to Dia.

A study presented at the 10th International Congress of Toxicology in July 2004 demonstrated the safety and efficacy of NBC in ameliorating metabolic disorders that occur due to chromium deficiency. The presentation also cited a three-month, double blind clinical trial conducted in 20 volunteers to evaluate the efficacy and safety of NBC at 300 µg/d. Fasting glucose values were significantly lowered in the NBC-supplemented group while no changes were observed in the placebo group. Mean triglyceride levels reduced from 112 to 108 mg/dl in NBC group and mean Hb1Ac levels also lowered from 8.42 percent to 8.10 percent in the NBC, while Hb1Ac level increased in the placebo group.

Georgetown University used aged, diabetic Zucker fatty rats (ZFR) (70 to 75 weeks) in order to determine whether NBC (as ChromeMate), fraction SX of Maitake mushroom (MSX; as Maitake SX-Fraction®, from Maitake Products) and 60 percent (-)-hydroxycitric acid (HCA-SX; as Super CitriMax®, from InterHealth Nutraceuticals) from Garcinia cambogia, alone or in combination, could affect certain aspects of metabolic syndrome.18 Researchers found treating animals with a combination of these three novel supplements resulted in a lower systolic blood pressure and maintenance of body weight compared to control animals. These results demonstrate that elderly diabetics and even aging individuals might benefit from a similar regimen.

In a double blind, placebo-controlled clinical trial of chromium picolinate (CP), 29 subjects at risk for developing type 2 diabetes were given either 1,000 mcg/d of CP or a placebo for eight months.19 The CP-treated subjects showed a significant improvement in insulin sensitivity at four months and at eight months. These benefits were seen in the absence of significant changes in body fat distribution implying a direct effect on muscle insulin action. Additionally, a separate study divided 20 women with gestational diabetes into two groups: 10 received 4 mcg/kg/d of CP and 10 a dummy pill; 10 additional women received 8 mcg/kg/d of CP.20 After eight weeks, the supplemented groups achieved significantly improved postprandial (after meal) glucose and insulin levels. The authors concluded, “Chromium picolinate supplementation for gestational diabetic women improves glucose tolerance and lowers hyperinsulinemia.”

Zinc is another trace mineral researched for its effect on type 2 diabetes. A prospective study out of Boston found higher zinc intake in women may be associated with a slightly lower risk of type 2 diabetes.21 From 1980 to 2002, dietary intakes of zinc and other nutrients were assessed and updated using of a validated food frequency questionnaire among 82,297 women aged 33 to 60 years. During the 24 years of follow-up, 6,030 incident cases of type 2 diabetes were ascertained. After adjustment of lifestyle and dietary risk factors, the relative risks of type 2 diabetes comparing the highest with the lowest quintiles were 0.90 for total zinc intake and 0.92 for dietary zinc intake from food sources, respectively. An inverse association for dietary zinc to heme iron ratio was also found. After multivariate adjustment of covariates, the relative risks across quintiles of this ratio were 1.0, 0.93, 0.86, 0.82 and 0.72, respectively.

In agreement, another study found zinc supplementation may prevent diabetes in experimental animals.22 Animals were divided into four groups: group I: control (intact) animals; group II: control animals given zinc sulfate; group III: streptozotocin (STZ)-induced diabetic animals; group IV: STZ-induced diabetic animals given zinc sulfate. Zinc supplementation caused a decrease in hyperglycemia, as well as weight increase. Zinc sulfate treatment did not affect the number of somatostatin-immunoreactive cells in the pancreas. More insulin-immunoreactive cells were observed in the pancreatic islets of the diabetic + zinc sulfate group than in the diabetic group, although it was not statistically significant.

Manganese is also used in combat against type 2 diabetes. It has been associated with a decreased risk of diabetic nephropathy in Chinese patients with type 2 diabetes23 and a study at Sindh University, Pakistan, confirmed deficiency and efficiency of some essential trace metals may play a role in the development of diabetes mellitus.24 The study compared the level of essential trace elements, chromium (Cr), copper (Cu), iron (Fe), manganese (Mn), nickel (Ni), and zinc (Zn) in biological samples of 257 patients with diabetes mellitus type 2 and 166 non-diabetic control subjects, age range of 45 to 75 years of both genders. Results showed the mean values of Zn, Mn and Cr were significantly reduced in blood and scalp-hair samples of diabetic patients as compared to control subjects of both genders (P<0.001). The urinary levels of these elements were higher in the diabetic patients than in the age-matched healthy controls. And, high mean values of Cu and Fe were detected in scalp hair and blood from patients versus the non-diabetic subjects, but the differences found in blood samples was not significant (P<0.05).

Specialty Options

As mentioned in the study above, HCA-SX, in combination with maitake mushroom and NBC, lowered blood pressure and helped maintain body weight. As a stand-alone supplement, HCA-SX has also been found to benefit diabetes. In a study at the University of Houston, five-week-old male Zucker rats were supplemented with a vehicle (control) or HCA-SX in drinking water for seven weeks.25 Compared to controls, the levels of malondialdehyde (MDA), protein carbonyl (DNPH), and protein tyrosine nitration (tyr-NO(2) were lower in the liver and kidney of HCA-SX-treated animals. The levels of C-reactive protein and interleukin-6 were lower in the plasma of HCA-SX-supplemented animals compared to controls, as were levels of fasting plasma insulin, glucose and triglycerides. Insulin resistance did not develop in HCA-SX-supplemented rats. Food intake and body weight gain was also lower in rats supplemented with HCA-SX compared to their control counterparts.

An overview in the Journal of Medicine assessed clinical studies that were done to evaluate the safety and efficacy of HCA-SX (as Super CitriMax) over a period of eight weeks conducted in 60 human volunteers.26 Subjects were given a 2,000 kcal/d diet, participated in a 30 minute walking exercise program five days/week and given an oral dose of placebo or 4666.7 mg HCA-SX (providing 2,800 mg HCA) in three equally divided doses 30 to 60 minutes before meals. At the end of eight weeks, body weight and BMI decreased by 5.4 percent and 5.2 percent, respectively. Food intake, total cholesterol, LDL, triglycerides and serum leptin levels were significantly reduced, while HDL and serotonin levels, and excretion of urinary fat metabolites (a biomarker of fat oxidation) significantly increased.

Maitake mushrooms (Grifola frondosa) are not only a tasty food but they support immune health and protect against diabetes. Japanese researchers reported on the anti-diabetic effects of maitake noting when 1 g/d of powdered fruit body of Maitake was given orally to a genetically diabetic mouse (KK-Ay), blood glucose was reduced, in contrast to the control group in which the blood glucose increased with aging as well as levels of insulin and triglyceride in plasma showed a change similar to blood glucose with feeding of maitake.27 Other Japanese researchers claimed the bioactive substances present in Maitake can ameliorate the symptoms of diabetes.28

In a type 2 diabetes animal study, KK-Ay mice were given 450 or 150 mg/kg (-1) of a alpha-glucan (MT-alpha-glucan) from the fruit body of maitake mushrooms.29 The MT-alpha-glucan treatment significantly decreased the body weight, level of fasting plasma glucose, glycosylated serum protein, serum insulin, triglycerides, cholesterol, free fatty acid and malondialdehyde content in livers. It also significantly increased the content of hepatic glycogen, glutathione and the activity of superoxide dismutase (SOD) and glutathione peroxidase (GSHpx). The insulin-binding capacity to liver crude plasma membranes increased and histopathological changes in the pancreas were ameliorated in the treatment group.

In 2002, researchers followed four groups of eight Zucker fatty rats (ZFR) and spontaneously hypertensive rats (SHR) receiving special diets: a baseline diet (BD), BD + whole Maitake mushroom powder (20 percent w/w), BD + fraction ether soluble (ES) (0.10 percent w/w), and BD + water soluble (WS) (0.22 percent w/w).30 Different effects of these dietary regimens on the two rat strains were found. At 35 days, only consumption of the ES diet significantly decreased systolic blood pressure (SBP) in SHR, while only the groups consuming the whole Maitake and WS diets showed significantly decreased SBP. In SHR, glucose, cholesterol, circulating insulin and HbA1C were virtually similar among all dietary groups; but whole Maitake (-22 percent), ES (-120 percent) and WS (-80 percent) diets were associated with decreased triglycerides, and the ES diet with lowered serum creatinine (-29 percent). In ZFR, circulating insulin and HbA1C were significantly decreased in the whole Maitake powder and ES groups, and tended to be lower in the WS group compared to control.

At Georgetown University, SHR were divided randomly into a control group, a group receiving the anti-diabetic drug, pioglitazone, in their diet, and three groups consuming three different concentrations of SX-Fraction (from Maitake Products) in their food.31 SX-Fraction enhanced insulin sensitivity and produced a lower-circulating level of glucose after challenge despite no rise in circulating insulin. Compared to the control, significantly lower circulating glucose levels were seen in the groups consuming pioglitazone and higher doses of SX-fraction at 7.5 minutes after insulin challenge whether or not glucose was given concomitantly.

Pycnogenol®, French maritime pine bark, is well-known for its clinically backed health claims on various conditions, including diabetes. In a double blind, placebo-controlled, randomized, multi-center study, 77 diabetes type 2 patients received 100 mg/d of Pycnogenol (from Horphag Research Ltd.) for 12 weeks, during which a standard anti-diabetic treatment was continued.32

Pycnogenol significantly lowered plasma glucose levels as compared to placebo. HbA1(c) was also lowered; however, the difference as compared to placebo was statistically significant only for the first month. In the Pycnogenol group, endothelin-1 was significantly decreased, while 6-ketoprostaglandin F(1a) in plasma was elevated compared to placebo. Nitric oxide (NO) levels in plasma increased during treatment in both groups, but, differences did not reach statistical significance. Results from an Italian study indicated Pycnogenol may be also useful to prevent diabetic ulcerations by controlling the level of microangiopathy.33

Flavoxine™, from Next Pharamceuticals, is a proprietary combination from the bark of Phellodendron amurense and polymethoxylated flavones extracted from Citrus sinensis.

It too has shown benefits for patients with diabetes. An eight-week, placebo-controlled, randomized, double blind study was conducted with four groups: two capsules, each with 370 mg of NP 06-1 (as Flavoxine) or a placebo was given twice daily to overweight and normal weight subjects diagnosed with primary osteoarthritis (OA) of the knee.34 Eighty subjects were enrolled and 45 subjects completed the study. NP 06-1 administration was associated with a general improvement in lipid levels.

Both the overweight and normal weight treatment groups had significant reductions in triglycerides and LDL cholesterol, as well as a significant increase in HDL cholesterol compared to their respective control groups. Overall, blood pressure decreased in both overweight and normal weight treatment groups compared to respective placebo groups. There was also a significant decrease in fasting glucose levels in the overweight treatment group compared to the start of the study and to the overweight placebo group. There was no change in fasting blood sugar for the normal weight groups. Both overweight and normal weight treatment groups lost a significant amount of weight compared to their respective placebo groups. The overweight treatment group lost an average of 5 percent body weight after eight weeks, which was associated with a significant loss in BMI over time.

Opundia™ is derived from the fruit and pads of Opuntia ficus-indica, a species of cactus from MB North America. In an unpublished animal study a combination of Opuntia ssp. pads extracts and Opuntia ssp. special extract of the fruit had a synergistic effect on blood glucose levels after glucose challenge for the known anti-diabetic drug glyburide (glibenclamide).

The anti-diabetic activity of an extract from the leaves of Lagerstroemia speciosa or banaba, standardized to 1 percent corosolic acid has also been studied. In 2003, subjects received a daily oral dose of Glucofit™ (from Soft Gel Technologies).35 Glucofit at daily dosages of 32 and 48 mg for two weeks showed a significant reduction in the blood glucose levels. In a soft gel capsule formulation, it showed a 30-percent decrease in blood glucose levels compared to a 20-percent drop seen with dry-powder filled hard gelatin capsule formulation (P<0.001).

Another study evaluated the effects of banaba extract on blood glucose levels in 12 subjects.36 Blood glucose was measured at the time of fasting and 30, 60 and 120 minutes after ingesting a starch meal (540 kcal). Then, a soft capsule of banaba extract (as GlucoHelp, from Soft Gel Technologies) with 10 mg of corosolic acid was orally administered every morning for two weeks. A significant inhibitory effect was observed at the each point of fasting and 30, 60 and 120 minutes within one week after administrating the soft capsule. Both weight loss and improved BMI were observed after two weeks.

InsuVital™ is a hydrolysed casein in which DSM Nutritional Products used a proprietary enzyme to cut (hydrolyse) the casein into smaller pieces, also called peptides. The mix of peptides (predominantly small peptides of 2 or 3 amino acids) forms the active part of InsuVital. These peptides can stimulate the secretion of insulin from the pancreas. Clinical trials have shown foods containing InsuVital or InsuVital taken along with a meal stimulate the release of insulin secretion and improve the removal of glucose from the blood.

In one trial, 10 male patients with long-standing type 2 diabetes and 10 healthy controls participated in three trials in which plasma glucose, insulin and amino acid responses were determined after ingesting one of the four different beverages: CHO: 0.7 g/kg carbohydrate; CHO+PRO: 0.7 g/kg carbohydrate with 0.3 g/kg protein hydrolysate; or CHO+PRO+LEU: 0.7 g/kg carbohydrate, 0.3 g/kg protein hydrolysate and 0.1 g/kg free leucine.37

Plasma insulin responses were 141 and 204 percent greater in patients with type 2 diabetes, and 66 and 221 percent greater in the controls in the CHO+PRO and CHO+PRO+LEU trials, respectively, compared with those in the CHO trial (P<0.05). The concomitant plasma glucose responses were 15 and 12 percent lower in the patients with type 2 diabetes, and 92 and 97 percent lower in the control group in the CHO+PRO and CHO+PRO+LEU trials, respectively, compared with those in the CHO trial (P<0.05).

Similarly, a separate trial found ingesting a combination of carbohydrate with a protein hydrolysate and amino acid mixture significantly increased de novo insulin production in patients with a long-term type 2 diabetes.38 Nine healthy control subjects and 10 type 2 diabetic patients participated in two trials in which the plasma insulin response was measured after the ingestion of 0.7 g carbohydrate kg(-1)/h(-1) with or without 0.35 g/kg(-1)/h(-1) of a mixture that contained a protein hydrolysate, leucine and phenylalanine.

Plasma insulin responses were higher by 299 +/- 64 percent and 132 +/- 63 percent in the CHO+PRO trial than in the CHO trial in the diabetic patients and the matched control subjects, respectively (P < 0.001). The subsequent plasma glucose responses were reduced by 28 +/- 6 percent and 33 +/- 3 percent in the CHO+PRO trial than in the CHO trial in the diabetic patients and the matched control subjects, respectively (P<0.001). The reduced plasma glucose response in the diabetic patients was attributed to a 13 +/- 3 percent increase in glucose disposal (P<0.01).

Type 2 diabetes is a manageable disease with lifestyle changes and supplementation. Research proves again and again the benefits of botanicals, vitamins, minerals and many others in the fight for healthy bodies, including diabetic-free bodies.

References on the next page...

References for "Diabetes—A Natural Approach"

  1. JosseAR et al. “Nutritional considerations for older adults with type 2 diabetes” J Nutr Elder. 2008;27(3-4):363-80

    • Westman, E., et al. “The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes” Nutr. Metab. 2008;5:36

    • Udani J, Hardy M, MadsenDC “Blocking carbohydrate absorption and weight loss: a clinical trial using Phase 2 brand proprietary fractionated white bean extract” Altern Med Rev. 2004 Mar;9(1):63-9

    • Dyrskog SE et al. “Preventive effects of a soy-based diet supplemented with stevioside on the development of the metabolic syndrome and type 2 diabetes in Zucker diabetic fatty rats” Metabolism. 2005;54(9):1181-8

    • Yokozawa T, Kim HY, Cho EJ “Erythritol attenuates the diabetic oxidative stress through modulating glucose metabolism and lipid peroxidation in streptozotocin-induced diabetic rats” J Agric Food Chem. 2008;50(19):5485-9

    • Ishikawa M et al. “Effects of oral administration of erythritol on patients with diabetes” Regul Toxicol Pharmacol. 1996;24(2 pt 2):S303-8

    • Sheng X et al. “Improved Insulin Resistance and Lipid Metabolism by Cinnamon Extract through Activation of Peroxisome Proliferator-Activated Receptors” PPAR Res. 2008;2008:581348. Epub 2008 Dec 11

    • ZiegenfussTN et al. “Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women”  J Int Soc Sports Nutr. 2006;3:45-53

    • Jeff G. Wang M.D.et al. “The effect of cinnamon extract on insulin resistance parameters in polycystic ovary syndrome: a pilot study”  Fertility and Sterility 2007;88(1):240-43

    • Joanna Hlebowicz et al. “Effects of 1 and 3 g cinnamon on gastric emptying, satiety, and postprandial blood glucose, insulin, glucose-dependent insulinotropic polypeptide, glucagon-like peptide 1, and ghrelin concentrations in healthy subjects” Am J Clin Nutri. 2009;90:815-21

    • Ibid. Josse AR et al. “Nutritional considerations for older adults with type 2 diabetes” J Nutr Elder. 2008;27(3-4):363-80

    • Kim H et al. “Glucose and insulin responses to whole grain breakfasts varying in soluble fiber, beta-glucan : A dose response study in obese women with increased risk for insulin resistance” Eur J Nutr. 2009 Feb 5. [Epub ahead of print]

    • Rovner AJ, Nansel TR, Gellar L “The Effect of a Low-Glycemic Diet vs a Standard Diet on Blood Glucose Levels and Macronutrient Intake in Children with Type 1 Diabetes” J Am Diet Assoc. 2009;109(2):303-7

    • Cyril W.C. Kendall, PhD et al. “Effect of Novel Maize-based Dietary Fibers on Postprandial Glycemia and Insulinemia” J Am Colle Nutr. 2008;27(6):711-718

    • Afridi HI et al. “Status of essential trace metals in biological samples of diabetic mother and their neonates” Arch Gynecol Obstet. 2009 Jan 24. [Epub ahead of print]

    • Bartlett HE, Eperjesi F “Nutritional supplementation for type 2 diabetes: a systematic review” Ophthalmic Physiol Opt. 2008 Nov;28(6):503-23

    • Penumathsa SV, Thirunavukkarasu M, Samuel SM, et al. Niacin bound chromium treatment induces myocardial Glut-4 Translocation  and caveolar interaction via Akt, AMPK and eNOS phosphorylation in streptozotocin induced diabetic rats after ischemia-reperfusion injury. Biochim Biohphys Acta. 2009;1792:39-48.

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