Controlling diabetes, alt med approach

Shannon Bennett · Sep 25, 2006

I have a family member who recently was diagnosed with type 2 diabetes and as a consequence have started doing considerable research n the subject. I plan to import the studies here first then move the appropriate posts to the First Nations forum as suggested by Snowy.

The first is an herb that shows great promise in controlling blood sugar. It also shows evidence of rebuilding pancreatic beta cells.

http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-gymnema.html

BackgroundReturn to top

<ITEM>Preliminary human evidence suggests that gymnema may be effective in the management of blood sugar levels in type 1 and type 2 diabetes, as an adjunct to conventional drug therapy, for up to 20 months. Gymnema appears to lower serum glucose and glycosylated hemoglobin (HbA1c) levels following chronic use, but may not have significant acute effects. High-quality human trials are lacking in this area. Some of the available research has been conducted by authors affiliated with manufacturers of gymnema products.</ITEM>

SynonymsReturn to top

<ITEM>Asclepiadaceae , Asclepias geminata roxb., Gemnema melicida , GS4 (water soluble extract of the leaves), gur-mar, gurmar, gurmarbooti, Gymnema inodum , kogilam, mangala gymnema, merasingi, meshashringi, meshavalli, periploca of the woods, periploca sylvestris, podapatri, Proβeta®, ram's horn, small Indian ipecac, sarkaraikolli, sirukurinja.</ITEM>

EvidenceReturn to top

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
<TABLE class=minusOne cellSpacing=1 cellPadding=5 width="75%" border=1><TBODY><TR><TH scope=col>Uses based on scientific evidence</TH><TH scope=col noWrap>Grade<SUP>*</SUP></TH></TR><TR><TD>Diabetes
<DESCRIPTION>Animal studies report that gymnema can lower blood sugar levels. Preliminary human research reports that gymnema may be beneficial in patients with type 1 or type 2 diabetes when it is added to diabetes drugs being taken by mouth or to insulin. Further studies of dosing, safety, and effectiveness are needed before a strong recommendation can be made.</DESCRIPTION>
</TD><TD>B</TD></TR><TR><TD>High cholesterol
<DESCRIPTION>Reductions in levels of serum triglycerides, total cholesterol, and low-density lipoprotein ("bad cholesterol") have been observed in animal studies. Preliminary research in people with type 2 diabetes reports decreased cholesterol and triglyceride levels. Better evidence is needed before a clear conclusion can be drawn.</DESCRIPTION>
</TD><TD>C</TD></TR></TBODY></TABLE>

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.
Grading rationale

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
<CONDITIONNOEVIDENCE>Antimicrobial, aphrodisiac, cancer, cardiovascular disease, constipation, cough, digestive stimulant, diuresis, gout, high blood pressure, laxative, liver disease, liver protection, malaria, obesity, rheumatoid arthritis, snake venom antidote, stomach ailments, uterine stimulant, weight loss.

</CONDITIONNOEVIDENCE>

DosingReturn to top

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.
Standardization
<ITEM>Standardization involves measuring the amount of certain chemicals in products to try to make different preparations similar to each other. It is not always known if the chemicals being measured are the "active" ingredients. At least one manufacturer offers an extract of gymnema standardized to 25% gymnemic acid, but this extract has not been thoroughly studied.</ITEM>

<ITEM>An extract from gymnema, labeled GS4, has been used in human research. GS4 has since been patented as the product Proβeta®. According to the makers of Proβeta®, the preparation is standardized to a specific biological result, as measured by a test developed by the company, which evaluates "pancreotropic®" effects.</ITEM>

Adults (18 years and older)
<ITEM>Type 1 diabetes: 200 milligrams of extract GS4 taken by mouth, twice daily, under careful continuation of insulin has been studied.</ITEM>

<ITEM>Type 2 diabetes: 200 milligrams of extract GS4 taken by mouth, twice daily, or 2 milliliters of an aqueous decoction (10 grams of shade-dried powdered leaves per 100 milliliters), three times daily has been studied.</ITEM>

<ITEM>Note: The manufacturer PharmaTerra recommends the dose for their product Proβeta® (GS4) to be two 250 milligram capsules taken twice daily at mealtimes (for adults weighing more than 100 pounds), or one 250 milligram capsule taken twice daily at mealtimes (for adults weighing less than 100 pounds).</ITEM>

Children (younger than 18 years)
<ITEM>There is not enough scientific evidence to safely recommend gymnema for use in children.</ITEM>

SafetyReturn to top

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.
Allergies
<ITEM>Allergy to gymnema may occur. In theory, allergic cross-reactivity may exist with members of the Asclepiadaceae (milkweed) family.</ITEM>

Side Effects and Warnings
<ITEM>Aside from lowered blood sugar and increased effects of anti-diabetic drugs following chronic use of gymnema, no significant adverse effects have been reported with the herb, in several studies up to 20 months long. Caution is advised in patients with diabetes or low blood sugar, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a qualified healthcare professional, and medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels.</ITEM>

<ITEM>Gymnema is reported to suppress the ability to detect sweet tastes, due to the component gurmarin. This phenomenon prompted the Hindi name gurmar or "sugar destroyer."</ITEM>

Pregnancy and Breastfeeding
<ITEM>Gymnema should not be used during pregnancy or breastfeeding due to lack of reliable safety information.</ITEM>

InteractionsReturn to top

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.
Interactions with Drugs
<ITEM>Based on human and animal studies, gymnema may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary. Based on human and animal studies, gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with drugs that lower cholesterol such as "statins" (HMGCoA reductase inhibitors) like lovastatin (Mevacor®) or atorvastatin (Lipitor®).</ITEM>

Interactions with Herbs and Dietary Supplements
<ITEM>Based on human and animal studies, gymnema may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment. Possible examples include: Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, horse chestnut seed extract (HCSE), marshmallow, milk thistle, Panax ginseng, rosemary, Siberian ginseng, stinging nettle and white horehound. Based on human and animal studies, gymnema may lower blood cholesterol levels. Therefore, increased effects may occur if taken in combination with herbs or supplements that lower cholesterol such as fish oil, garlic, guggul, or niacin.</ITEM>

Interactions with Foods
<ITEM>Based on animal study, absorption of oleic acid (a fatty acid) may be decreased by gymnema. It is unknown whether gymnema has these effects in humans, or affects the absorption of other nutritionally important lipids or fat-soluble vitamins (A, D, E, K).</ITEM>

Methodology Return to top

<ITEM>This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Theresa Davies-Heerema, PhD (Boston School of Medicine); Ivo Foppa, MD, ScD (University of South Carolina); Paul Hammerness, MD (Harvard Medical School); Catherine Ulbricht (Massachusetts General Hospital); Ethan Basch, MD (Memorial Sloan Kettering Cancer Center).</ITEM>

Methodology details

Selected references Return to top

<LI class=minusTwo>Ananthan R, Latha M, Pari L, et al. Effect of Gymnema montanum on blood glucose, plasma insulin, and carbohydrate metabolic enzymes in alloxan-induced diabetic rats. J Med Food 2003;6(1):43-49. <LI class=minusTwo>Ananthan R, Baskar C, NarmathaBai V, et al. Antidiabetic effect of Gymnema montanum leaves: effect on lipid peroxidation induced oxidative stress in experimental diabetes. Pharmacol Res 2003;48(6):551-556. <LI class=minusTwo>Baskaran K, Ahamath B, Shanmugasundaram K, et al. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharm 1990;30:295-305. <LI class=minusTwo>Brala P, Hagen R. Effects of sweetness perception and caloric value of a preload on short term intake. Physiol Behav 1983;30:1-9. <LI class=minusTwo>Chattopadhyay RR. Possible mechanism of antihyperglycemic effect of Gymnema sylvestre leaf extract, Part I. Gen Pharm 1998;31(3):495-496. <LI class=minusTwo>Cicero AF, Derosa G, Gaddi A. What do herbalists suggest to diabetic patients in order to improve glycemic control? Evaluation of scientific evidence and potential risks. Acta Diabetol 2004;41(3):91-98. <LI class=minusTwo>Gholap S, Kar A. Effects of Inula racemosa root and Gymnema sylvestre leaf extracts in the regulation of corticosteroid induced diabetes mellitus: involvement of thyroid hormones. Pharmazie 2003;58(6):413-415. <LI class=minusTwo>Grover JK, Yadav S, Vats V. Medicinal plants of India with anti-diabetic potential. J Ethnopharmacol 2002;81(1):81-100. <LI class=minusTwo>Jiang H. [Advances in the study on hypoglycemic constituents of Gymnema sylvestre (Retz.) Schult]. Zhong Yao Cai 2003;26(4):305-307. <LI class=minusTwo>Kamei K, Takano R, Miyasaka A, et al. Amino acid sequence of sweet-taste-suppressing peptide (gurmarin) from the leaves of Gymnema sylvestre. J Biochem 1992;111:109-112. <LI class=minusTwo>Khare AK, Tondon RN, Tewari JP. Hypoglycaemic activity of an indigenous drug (Gymnema sylvestre, "Gurmar") in normal and diabetic persons. Indian J Physiol Pharm 1983;27:257-258. <LI class=minusTwo>Kothe A, Uppal R. Antidiabetic effects of Gymnema sylvestre in NIDDM - a short study. Indian J Homeopath Med 1997;32(1-2):61-62, 66. <LI class=minusTwo>Lawless HT. Evidence for neural inhibition in bittersweet taste mixtures. J Comp Physiol Psychol 1979;93(3):538-547. <LI class=minusTwo>Meiselman HL, Halperin BP. Human judgments of Gymnema sylvestre and sucrose mixtures. Physiol Behav 1970;5(8):945-948. <LI class=minusTwo>Meiselman HL, Halpern BP. Effects of Gymnema sylvestre on complex tastes elicited by amino acids and sucrose. Physiol Behav 1970;5(12):1379-1384. <LI class=minusTwo>Min BC, Sakamoto K. Influence of sweet suppressing agent on gustatory brain evoked potentials generated by taste stimuli. Appl Human Sci 1998;17(1):9-17. <LI class=minusTwo>Murakami N, Murakami T, Kadoya M, et al. New hypoglycemic constituents in "gymnemic acid" from Gymnema sylvestre. Chem Pharm Bull 1996;44(2):469-471. <LI class=minusTwo>Porchezhian E, Dobriyal RM. An overview on the advances of Gymnema sylvestre: chemistry, pharmacology and patents. Pharmazie 2003;58(1):5-12. <LI class=minusTwo>Preuss HG, Bagchi D, Bagchi M, et al. Effects of a natural extract of (-)-hydroxycitric acid (HCA-SX) and a combination of HCA-SX plus niacin-bound chromium and Gymnema sylvestre extract on weight loss. Diabetes Obes Metab 2004;6(3):171-180. <LI class=minusTwo>Satdive RK, Abhilash P, Fulzele DP. Antimicrobial activity of Gymnema sylvestre leaf extract. Fitoterapia 2003;74(7-8):699-701. <LI class=minusTwo>Shanmugasundaram ERB, Rajeswari G, Baskaran K, et al. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharm 1990;30(3):281-294. <LI class=minusTwo>Shanmugasundaram KR, Panneerselvam C, Samudram P, et al. The insulinotropic activity of Gymnema sylvestre, R. Br. An Indian medical herb used in controlling diabetes mellitus. Pharmacol Res Commun 1981;13(5):475-486. <LI class=minusTwo>Shapiro K, Gong WC. Natural products used for diabetes. J Am Pharm Assoc (Wash ) 2002;42(2):217-226. <LI class=minusTwo>Shimizu K, et al. Suppression of glucose absorption by extracts from the leaves of Gymnema inodorum. J Vet Med Sci 1997;59:753-757. <LI class=minusTwo>Simons CT, O'Mahony M, Carstens E. Taste suppression following lingual capsaicin pre-treatment in humans. Chem Senses 2002;27(4):353-365. <LI class=minusTwo>Warren RP, Warren RM, Weninger MG. Inhibition of the sweet taste by Gymnema sylvestre. Nature 1969;223(201):94-95. <LI class=minusTwo>Xie JT, Wang A, Mehendale S, et al. Anti-diabetic effects of Gymnema yunnanense extract. Pharmacol Res 2003;47(4):323-329. <LI class=minusTwo>Ye W, Liu X, Zhang Q, et al. Antisweet saponins from Gymnema sylvestre. J Nat Prod 2001;64(2):232-235.
Yeh GY, Eisenberg DM, Kaptchuk TJ, et al. Systematic review of herbs and dietary supplements for glycemic control in diabetes. Diabetes Care 2003;26(4):1277-1294.

September 01, 2005.

<TABLE class=minusTwo cellSpacing=0 cellPadding=0 border=0><TBODY><TR><TD vAlign=top width=1>

</TD><TD vAlign=top width="100%">This evidence-based monograph was prepared by the Natural Standard Research Collaboration. The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Talk to your health care provider before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Copyright© 2005 Natural Standard (www.naturalstandard.com). All Rights Reserved. </TD></TR></TBODY></TABLE>

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

http://www.supplementwatch.com/suplib/supplement.asp?DocId=1157

<TABLE width=560 border=0><TBODY><TR><TD vAlign=top align=middle width=560 bgColor=#292644><TABLE cellSpacing=0 cellPadding=0 width="100%" bgColor=#ffffff border=0><TBODY><TR><TD colSpan=2>

</TD></TR><!-- <tr><td colspan="3" align="center">

</td></tr> --><TR><TD class=boxTop colSpan=2></TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Description</TD><TD class=FieldText width="80%">Gymnema is a plant used medicinally in India and Southeast Asia for treatment of “sweet urine” or what we refer to in the West as diabetes or hyperglycemia. In ancient Indian texts, gymnema is referred to as gurmar, which means “sugar killer” in Sanskrit. Gymnema leaves, whether extracted or infused into a tea, suppress glucose absorption and reduce the sensation of sweetness in foods – effects which may deliver important health benefits for individuals who want to reduce blood sugar levels or body weight. </TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Claims</TD><TD class=FieldText width="80%">Reduces blood sugar levels
Lowers blood cholesterol levels
Balances insulin levels
Promotes weight loss
</TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Theory</TD><TD class=FieldText width="80%">Gymnema sylvestre leaves contain gymnemic acids, which are known to suppress transport of glucose from the intestine into the blood stream and a small protein, gurmar, that can interact with receptors on the tongue to decrease the sensation of sweetness in many foods. This dual action has been shown to reduce blood sugar and cholesterol levels in diabetic animals and humans and may provide some benefits in terms of regulating appetite control and food cravings. </TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Scientific Support</TD><TD class=FieldText width="80%">The hypoglycemic (blood sugar lowering) effect of gymnema has been known for centuries. Modern scientific methods have isolated at least nine different fractions of gymnemic acids which possess hypoglycemic activity. The effect of gymnema extract on lowering blood levels of glucose, cholesterol and triglycerides is fairly gradual – typically taking a few days to several weeks. Very high doses of the dried gymnema leaves may even help to repair the cellular damage that causes diabetes (by helping to regenerate the insulin producing beta-cells in the pancreas). Several human studies conducted on gymnema for treatment of diabetes have shown significant reduction in blood glucose, glycosylated hemoglobin (an index of blood sugar control) and insulin requirements (so insulin therapy could be reduced). Gymnema appears to increase the effectiveness of insulin rather than causing the body to produce more – although the precise mechanism by which this occurs remains unknown. As with other natural ingredients for control of blood sugar and insulin levels, such as banaba leaf, a common “side effect” is weight loss – probably due to a combination of appetite suppression and control of food cravings (especially for carbohydrates and sweets). </TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Safety</TD><TD class=FieldText width="80%">At typical recommended doses (see below), dietary supplements containing gymnema are not associated with significant adverse side effects. Mild gastrointestinal upset may occur if gymnema is taken on an empty stomach – so consumption with meals is recommended. Caution is urged, however, with extremely high doses, which may have the potential to induce hypoglycemia (abnormally low blood sugar) in susceptible individuals. In those individuals with active diabetes, it is recommended to consult your personal physician before and during use of gymnema, as alterations to your dosage of insulin or other anti-diabetic medications may be warranted. Certain medications, including antidepressants (St. John’s wort) and salicylates (white willow and aspirin) can enhance the blood sugar-lowering effects of gymnema sylvestre, whereas certain stimulants such as ephedra (Ma Huang) may reduce its effectiveness. </TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Value</TD><TD class=FieldText width="80%">As a dietary supplement to enhance control of blood glucose and insulin, gymnema sylvestre appears to be effective – particularly in the case of individuals with diabetes or hyperglycemia (elevated blood sugar). As an agent to promote weight loss, gymnema may help control appetite and carbohydrate cravings – effects which may be helpful in some individuals attempting weight loss. </TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> Dosage</TD><TD class=FieldText width="80%">Most human studies have been conducted in diabetic patients and have used 400mg of gymnema extract per day in conjunction with conventional oral anti-diabetic medications to lower blood glucose and reduce insulin requirements. In non-diabetics, smaller doses may be effective in helping to control blood sugar and insulin fluctuations – and the associated swings in appetite and food cravings. Because it acts gradually, gymnema extract should be consumed regularly with meals for several days/weeks and can be taken for months/years with no significant side effects.</TD></TR><TR><TD class=BlueBorder vAlign=top width="20%"> References</TD><TD class=FieldText width="80%">1. Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, Shanmugasundaram ER. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol. 1990 Oct;30(3):295-300. 2. Chattopadhyay RR. Possible mechanism of antihyperglycemic effect of Gymnema sylvestre leaf extract. Gen Pharmacol. 1998 Sep;31(3):495-6. 3. Fushiki T, Kojima A, Imoto T, Inoue K, Sugimoto E. An extract of Gymnema sylvestre leaves and purified gymnemic acid inhibits glucose-stimulated gastric inhibitory peptide secretion in rats. J Nutr. 1992 Dec;122(12):2367-73. 4. Khare AK, Tondon RN, Tewari JP. Hypoglycaemic activity of an indigenous drug (Gymnema sylvestre, 'Gurmar') in normal and diabetic persons. Indian J Physiol Pharmacol. 1983 Jul-Sep;27(3):257-8. 5. Miyasaka A, Imoto T. Electrophysiological characterization of the inhibitory effect of a novel peptide gurmarin on the sweet taste response in rats. Brain Res. 1995 Apr 3;676(1):63-8. 6. Murakami N, Murakami T, Kadoya M, Matsuda H, Yamahara J, Yoshikawa M. New hypoglycemic constituents in "gymnemic acid" from Gymnema sylvestre. Chem Pharm Bull (Tokyo). 1996 Feb;44(2):469-71. 7. Okabayashi Y, Tani S, Fujisawa T, Koide M, Hasegawa H, Nakamura T, Fujii M, Otsuki M. Effect of Gymnema sylvestre, R.Br. on glucose homeostasis in rats. Diabetes Res Clin Pract. 1990 May-Jun;9(2):143-8. 8. Ota M, Shimizu Y, Tonosaki K, Ariyoshi Y. Role of hydrophobic amino acids in gurmarin, a sweetness-suppressing polypeptide. Biopolymers. 1998 Mar;45(3):231-8. 9. Ota M, Shimizu Y, Tonosaki K, Ariyoshi Y. Synthesis, characterization, and sweetness-suppressing activities of gurmarin analogues missing one disulfide bond. Biopolymers. 1998 Aug;46(2):65-73. 10. Shanmugasundaram ER, Gopinath KL, Radha Shanmugasundaram K, Rajendran VM. Possible regeneration of the islets of Langerhans in streptozotocin-diabetic rats given Gymnema sylvestre leaf extracts. J Ethnopharmacol. 1990 Oct;30(3):265-79. 11. Shanmugasundaram ER, Rajeswari G, Baskaran K, Rajesh Kumar BR, Radha Shanmugasundaram K, Kizar Ahmath B. Use of Gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol. 1990 Oct;30(3):281-94. 12. Shanmugasundaram KR, Panneerselvam C, Samudram P, Shanmugasundaram ER. The insulinotropic activity of Gymnema sylvestre, R. Br. An Indian medical herb used in controlling diabetes mellitus. Pharmacol Res Commun. 1981 May;13(5):475-86. 13. Shimizu K, Abe T, Nakajyo S, Urakawa N, Atsuchi M, Yama****a C. Inhibitory effects of glucose utilization by gymnema acids in the guinea-pig ileal longitudinal muscle. J Smooth Muscle Res. 1996 Oct;32(5):219-28. 14. Shimizu K, Iino A, Nakajima J, Tanaka K, Nakajyo S, Urakawa N, Atsuchi M, Wada T, Yama****a C. Suppression of glucose absorption by some fractions extracted from Gymnema sylvestre leaves. J Vet Med Sci. 1997 Apr;59(4):245-51. 15. Shimizu K, Ozeki M, Tanaka K, Itoh K, Nakajyo S, Urakawa N, Atsuchi M. Suppression of glucose absorption by extracts from the leaves of Gymnema inodorum. J Vet Med Sci. 1997 Sep;59(9):753-7. 16. Srivastava Y, Nigam SK, Bhatt HV, Verma Y, Prem AS. Hypoglycemic and life-prolonging properties of Gymnema sylvestre leaf extract in diabetic rats. Isr J Med Sci. 1985 Jun;21(6):540-2. 17. Suttisri R, Lee IS, Kinghorn AD. Plant-derived triterpenoid sweetness inhibitors. J Ethnopharmacol. 1995 Jun 23;47(1):9-26. 18. Yoshikawa M, Murakami T, Kadoya M, Li Y, Murakami N, Yamahara J, Matsuda H. Medicinal foodstuffs. IX. The inhibitors of glucose absorption from the leaves of Gymnema sylvestre R. BR. (Asclepiadaceae): structures of gymnemosides a and b. Chem Pharm Bull (Tokyo). 1997 Oct;45(10):1671-6. 19. Yoshikawa M, Murakami T, Matsuda H. Medicinal foodstuffs. X. Structures of new triterpene glycosides, gymnemosides-c, -d, -e, and -f, from the leaves of Gymnema sylvestre R. Br.: influence of gymnema glycosides on glucose uptake in rat small intestinal fragments. Chem Pharm Bull (Tokyo). 1997 Dec;45(12):2034-8.</TD></TR></TBODY></TABLE></TD></TR></TBODY></TABLE>

Mingus · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Cinnamon is known to regulate sugar in the blood, what do you think about Shannon ?

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2259215&dopt=Abstract

<DT><TABLE cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD><INPUT type=checkbox value=2259215 name=uid>1: J Ethnopharmacol. 1990 Oct;30(3):265-79.</TD><TD align=right>Related Articles,<SCRIPT language=JavaScript1.2></SCRIPT><SCRIPT language=JavaScript1.2></SCRIPT> Links </TD></TR></TBODY></TABLE><DD>
[SIZE=+1]Possible regeneration of the islets of Langerhans in streptozotocin-diabetic rats given Gymnema sylvestre leaf extracts.[/SIZE]

Shanmugasundaram ER, Gopinath KL, Radha Shanmugasundaram K, Rajendran VM.

Department of Biochemistry, University of Madras, India.

Two water soluble extracts, GS3 and GS4, obtained from the leaves of Gymnema sylvestre, were tested in streptozotocin treated rats for their effects on blood glucose homeostasis and pancreatic endocrine tissue. In the diabetic rats, fasting blood glucose levels returned to normal after 60 days of GS3 and after 20 days of GS4 oral administration. Blood collected during the conduct of oral glucose tolerance tests was used to assay for serum insulin. GS3 and GS4 therapy led to a rise in serum insulin to levels closer to normal fasting levels. In diabetic rat pancreas, both GS3 and GS4 were able to double the islet number and beta cell number. This herbal therapy appears to bring about blood glucose homeostasis through increased serum insulin levels provided by repair/regeneration of the endocrine pancreas.

PMID: 2259215 [PubMed - indexed for MEDLINE]</DD>

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Mingus, I am going to add data on cinnamon after I do the gymnema and the chromium. I consider them to be higher on the list than cinnamon.

Mingus said:
Cinnamon is known to regulate sugar in the blood, what do you think about Shannon ?

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

http://scholar.google.com/scholar?hl=en&lr=&q=cache:dJYEmxD_IJkJ:www.himalayahealthcare.com/pdf_files/diabecon019.pdf+gymnema+sylvestre,+pancreatic+beta+cells

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<NOBR>[Indian Journal Physiol. Pharmacol. (1995): (39), 2, 95-100]</NOBR>
<NOBR>Effect of D-400, a Herbal Formulation, on Blood Sugar of Normal and </NOBR>
<NOBR>Alloxan-induced Diabetic Rats </NOBR>
<NOBR>Anturlikar, S.D., Gopumadhavan, S., Chauhan, B.L. and Mitra, S.K. </NOBR>
<NOBR>R&D Centre, The Himalaya Drug Co., Bangalore, India. </NOBR>
<NOBR>ABSTRACT </NOBR>
<NOBR>Blood sugar levels of normal rats treated with D-400 showed significant reduction (p<0.05)</NOBR>
<NOBR>as compared to control groups. The fall was seen at one month and remained so uptill 3 </NOBR>
<NOBR>months. Hyperglycemic response to adrenaline was significantly lowered (p<0.05) following </NOBR>
<NOBR>D-400 treatment. D-400 potentiated the hypoglycemia following tolbutamide treatment. Blood </NOBR>
<NOBR>sugar remained persistently low in tolbutamide plus D-400 treated group after 3 and 4 hours </NOBR>
<NOBR>(p<0.05). In the alloxan-induced diabetic rats, a significant lowering of blood and urinary </NOBR>
<NOBR>sugar was noticed on day 20, 30 and 40 following treatment with D-400 (p<0.05). Liver </NOBR>
<NOBR>glycogen depletion was significantly inhibited in the D-400 treated group (p<0.025). D-400 </NOBR>
<NOBR>has significantly potentiated (p<0.05) the hypoglycemic action of insulin in alloxan-induced </NOBR>
<NOBR>diabetic rats. </NOBR>
<NOBR>Key words: D-400; alloxan diabetes; blood and urine sugar; adrenaline; tolbutamide; insulin </NOBR>
<NOBR>interaction </NOBR>
<NOBR>INTRODUCTION </NOBR>
<NOBR>Diabetes mellitus was known to ancient Indian physicians as ‘Madhumeha’. Since, so many </NOBR>
<NOBR>herbal products including several metals and minerals have been described for the care of </NOBR>
<NOBR>Diabetes mellitus in ancient literature (1). Ayurveda has been the first to give an elaborate </NOBR>
<NOBR>description of this disease, its clinical features and the patterns, and its management by herbal </NOBR>
<NOBR>or herbomineral drugs. It is seen that certain resistant cases of diabetes who do not respond </NOBR>
<NOBR>well to modern medicines like Chlorpropamide, Tolbutamide and Glibenclamide respond very </NOBR>
<NOBR>well when treated with herbal preparations, alone or in combination with other oral </NOBR>
<NOBR>hypoglycemic agents. </NOBR>
<NOBR>Herbs have been shown to have hypoglycemic action in animals and humans (2, 3, 4). D-400 </NOBR>
<NOBR>is a formulation of herbal ingredients known for hypoglycemic action (5, 6). </NOBR>
<NOBR>The main ingredients of D-400 are: </NOBR>
<NOBR>Gymnema sylvestre </NOBR>
<NOBR>30 mg (7) </NOBR>
<NOBR>Eugenia jambolana</NOBR>
<NOBR>20 mg (8,10) </NOBR>
<NOBR>Tinospora cordifolia</NOBR>
<NOBR>10 mg (9) </NOBR>
<NOBR>Pterocarpus marsupium</NOBR>
<NOBR>20 mg (10) </NOBR>
<NOBR>Momordica charantia </NOBR>
<NOBR>20 mg (11,12) </NOBR>
<NOBR>Ocimum sanctum</NOBR>
<NOBR>10 mg (13) </NOBR>
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<NOBR>Shilajeet</NOBR>
<NOBR>30 mg (14) </NOBR>
<NOBR>Some plant extracts have been shown to curb the rise of blood sugar caused by Pituitary </NOBR>
<NOBR>hormones (4). Gymnema sylvestre (leaf extract) contains gymnemic acid, which is said to </NOBR>
<NOBR>inhibit the adrenohypophyseal stress response (15), and the hyperglycaemic response to </NOBR>
<NOBR>adrenaline (16) and growth hormone (17). It may also help by increasing peripheral utilisation </NOBR>
<NOBR>of glucose. Tinospora cordifolia also increases peripheral utilisation of glucose (18), inhibits </NOBR>
<NOBR>hepatic glucose release caused by adrenaline (19). Pterocarpus marsupium has been reported </NOBR>
<NOBR>to block glucose absorption from gut (20). Pterocarpus extract has been reported to promote </NOBR>
<NOBR>beta-cell regeneration in pancreas (21). Momordica charantia has been shown to increase </NOBR>
<NOBR>peripheral utilisation of glucose (22) as well as to potentiate tolbutamide effects (23). It is also </NOBR>
<NOBR>been shown to have hypoglycaemic effect similar to that of insulin dependent diabetes </NOBR>
<NOBR>mellitus patients (24). Shilajeet has anabolic and pancreatotrophic effects (14). </NOBR>
<NOBR>Animal toxicity studies and phase I clinical trials in healthy male medical students have </NOBR>
<NOBR>confirmed the safety of D-400 (25, 26). </NOBR>
<NOBR>In this study, in addition to establishing the hypoglycemic action of the preparation, an </NOBR>
<NOBR>attempt is made to find out the possible mode of action. </NOBR>
<NOBR>METHODS </NOBR>
<NOBR>Rats of original Wistar strain bred in our laboratory for over 45 generations were used in this </NOBR>
<NOBR>study. Experiments were carried out in male and female rats 2.5 to 3 months old and weighing </NOBR>
<NOBR>between 175-250 gm. They were allowed to get acclimatized to a standard laboratory diet </NOBR>
<NOBR>(Hindustan Lever Ltd.) and constant room temperature at 22</NOBR>
<NOBR>o</NOBR>
<NOBR>C - 24</NOBR>
<NOBR>o</NOBR>
<NOBR>C with 12 hour day and </NOBR>
<NOBR>night cycle. Drinking water was allowed ad libitum. </NOBR>
<NOBR>The study was placebo-controlled and the effect of D-400 was evaluated in normal and </NOBR>
<NOBR>alloxan-induced diabetic rats. In normal and diabetic rats the study was further subdivided </NOBR>
<NOBR>into four parts and two parts respectively. The detailed procedure for each part is follows: </NOBR>
<NOBR>1. In normal rats:</NOBR>
<NOBR>(a) Effect of D-400 on blood sugar in normal rats: The effect of D-400 on fasting blood sugar </NOBR>
<NOBR>was studied in normal male and female rats following 90 days of treatment. In this </NOBR>
<NOBR>experiment, 50 rats (20 M + 30 F) were divided into two groups of 25 each (10M + 15F) </NOBR>
<NOBR>in a randomize manner. Group I rats received 10 ml/kg body weight of tap water once a </NOBR>
<NOBR>day orally for 90 days and served as controls. Group II rats received 2 gm/kg body weight </NOBR>
<NOBR>of D-400 fine powder in the form of an aqueous suspension once a day orally for 90 days </NOBR>
<NOBR>and served as test animals. Fasting blood was sampled by tail nipping for determination of </NOBR>
<NOBR>the glucose levels before, and 30 and 90 days after assigned treatment. Glucose was </NOBR>
<NOBR>determined by using dextrostix strips and a Glucometer (Ames Co.). </NOBR>
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<NOBR>(b) Interaction with Adrenaline in normal rats: In this experiments, on day 0, fasting blood </NOBR>
<NOBR>sugar (FBS) of 8 rats were determined. 100 µg of adrenaline was injected subcutaneously </NOBR>
<NOBR>to each rat and blood sugar levels monitored at 30, 60, 90, 120, 180 and 240 minutes. </NOBR>
<NOBR>After basal blood sugar profile following adrenaline, the rats received D-400 treatment </NOBR>
<NOBR>once a day orally for 21 days at a dose of 2 gm/kg. On day 21, following overnight fast, </NOBR>
<NOBR>the blood sugar levels were assessed as on day 0. </NOBR>
<NOBR>(c) Interaction with Tolbutamide in normal rats: The hypoglycemic effect of tolbutamide was </NOBR>
<NOBR>studied before and after D-400 treatment. Six rats were used for this experiment. On day </NOBR>
<NOBR>0, fasting blood sugar (FBS) was determined and 250 mg/kg body weight of tolbutamide </NOBR>
<NOBR>was administered orally to each rats as an aqueous suspension. Blood sugar was </NOBR>
<NOBR>determined at every one hour for 4 hours following administration of tolbutamide. After </NOBR>
<NOBR>basal blood sugar profile following tolbutamide, the rats were administered 2 gm/kg body </NOBR>
<NOBR>weight of D-400 aqueous suspension once a day orally for 21 days. On day 21, blood </NOBR>
<NOBR>sugar levels were assessed as on day 0.</NOBR>
<NOBR>(d) Interaction with Insulin in normal rats: The hypoglycemic effect of insulin was studied </NOBR>
<NOBR>before and after D-400 treatment in normal rats. On day 0, in 8 rats followed by fasting </NOBR>
<NOBR>blood sugar (FBS), 0.25 IU of insulin was injected intravenously and blood sugar was </NOBR>
<NOBR>determined at 30, 60, 90, 120, 180 and 240 minutes. The same rats then received 2 gm/kg </NOBR>
<NOBR>body weight of D-400 once a day orally for 21 days. On day 21, following overnight fast, </NOBR>
<NOBR>the blood sugar levels, were assessed as on day 0.</NOBR>
<NOBR>2. In alloxan-induced diabetic rats: </NOBR>
<NOBR>(e) Effect of D-400 on blood and urine sugar in alloxan-induced diabetic rats: The </NOBR>
<NOBR>hypoglycemic effect of D-400 was evaluated in alloxan-induced diabetic rats. Sixteen </NOBR>
<NOBR>female rats were used in this experiment and fasting blood sugar (FBS) was determined </NOBR>
<NOBR>after overnight fast with free access to water. Following this, alloxan monohydrate was </NOBR>
<NOBR>given intravenously at a dose of 50 mg/kg body weight and stable hyperglycemia was </NOBR>
<NOBR>confirmed on day 8. Out of 16 rats, only 12 rats responded to alloxan monohydrate and </NOBR>
<NOBR>were divided into two groups of 6 each. Rats in Group I received tap water at a dose of 10 </NOBR>
<NOBR>ml/kg body weight once a day orally for 42 days, while Group II rats received 2 gm/kg </NOBR>
<NOBR>body weight of D-400. In both groups, after overnight fast, blood and urine sugar were </NOBR>
<NOBR>monitored on days 20, 30 and 40. On day 42, after an overnight fast, the rats were </NOBR>
<NOBR>sacrificed for liver glycogen estimation (21). </NOBR>
<NOBR>(f) Interaction with Insulin in alloxan-induced diabetic rats: The hypoglycemic effect of D-</NOBR>
<NOBR>400 along with insulin was studied in alloxan-induced hyperglycemic rats. Six rats were </NOBR>
<NOBR>taken for this experiment. 50 mg/kg body weight of alloxan monohydrate was given </NOBR>
<NOBR>intravenously. After confirming stable hyperglycemia on day 8, 0.5 IU of insulin was </NOBR>
<NOBR>given intravenously and blood sugar determined at 30, 60, 90, 120, 180 and 240 minutes. </NOBR>
<NOBR>The same procedure was repeated after D-400 treatment at a dose of 2 gm/kg body weight </NOBR>
<NOBR>once a day orally for 21 days. </NOBR>
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<NOBR>RESULTS </NOBR>
<NOBR>1. In normal rats: </NOBR>
<NOBR>(a) The aqueous suspension of D-400 exerted a significant hypoglycemic effect on day 30 in </NOBR>
<NOBR>both male and female rats. No further lowering of blood sugar was noticed following 90 </NOBR>
<NOBR>days of D-400 treatment (Fig. 1). </NOBR>
<NOBR>(b) Hyperglycemic response to adrenaline at 2 and 3 hours significantly lowered following </NOBR>
<NOBR>D-400 treatment. The total area under the time curve concentration (AUC) was reduced </NOBR>
<NOBR>significantly as compared to day 0 profile (Fig. 2). </NOBR>
<NOBR>Fig. 2: Mean blood sugar levels following</NOBR>
<NOBR>adrenaline injection before and after D-400</NOBR>
<NOBR>treatment in normal male rats (n=8). </NOBR>
<NOBR>Fig. 1: Mean fasting blood sugar (mg%)</NOBR>
<NOBR>before, 30 and 90 days after D-400 treatment</NOBR>
<NOBR>in normal male and female rats (n=25). </NOBR>
<NOBR>(c) Tolbutamide 250 mg/kg caused a </NOBR>
<NOBR>peak fall in blood sugar levels at 2 </NOBR>
<NOBR>hours that normalized at 4 hours. </NOBR>
<NOBR>Following D-400 treatment for 21 </NOBR>
<NOBR>days, the blood sugar was further </NOBR>
<NOBR>decreased at 3 hours and remained </NOBR>
<NOBR>so at 4 hours. The difference was </NOBR>
<NOBR>significant at both the time points as </NOBR>
<NOBR>compared to tolbutamide alone (Fig. </NOBR>
<NOBR>3). </NOBR>
<NOBR>Fig. 3: Hypoglycemic effect of tolbutamide before and</NOBR>
<NOBR>after D-400 treatment in normal male rats (n=6</NOBR>
<NOBR>(d) In normoglycemic rats, interaction </NOBR>
<NOBR>of insulin with D-400 on blood </NOBR>
<NOBR>sugar profile elicited comparatively </NOBR>
<NOBR>same findings. </NOBR>
<NOBR>). </NOBR>
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<NOBR>2. In alloxan-induced diabetic rats: </NOBR>
<NOBR>(e) D-400 treatment significantly lowered the blood and urine sugar on days 20, 30 and 40 </NOBR>
<NOBR>(Figs. 4 and 5) as compared to placebo and correlated well with liver glycogen levels on </NOBR>
<NOBR>day 43 (Fig. 6). </NOBR>
<NOBR>Fig. 5: Mean urine sugar excretion (mg%)</NOBR>
<NOBR>and effect of D-400 treatment in alloxan-</NOBR>
<NOBR>induced diabetic rats (n=6). </NOBR>
<NOBR>Fig. 4: Mean FBS (mg%) levels on days 20, 30</NOBR>
<NOBR>and 40 following D-400 treatment in alloxan-</NOBR>
<NOBR>induced diabetic rats (n=6). </NOBR>
<NOBR>(f) In hyperglycemic rats, D-400 has significantly potentiated the hypoglycemic effect of </NOBR>
<NOBR>insulin at 90, 120, 180 and 240 minutes (Fig. 7). </NOBR>
<NOBR>Fig. 7: Blood sugar levels following insulin</NOBR>
<NOBR>injection before and after D-400 treatment in</NOBR>
<NOBR>alloxan-induced diabetic rats (n=6). </NOBR>
<NOBR>Fig. 6: Effect of D-400 treatment on liver</NOBR>
<NOBR>glycogen in alloxan-induced diabetic rats</NOBR>
<NOBR>(n=6). </NOBR>
<NOBR>DISCUSSION </NOBR>
<NOBR>In the present study, D-400 exhibit a small but significant hypoglycemic effect in normal rats. </NOBR>
<NOBR>The hypoglycemic effect of D-400 on fasting blood sugar levels was attained after 20 days of </NOBR>
<NOBR>treatment and did not decrease further even upto 90 days. This may be due to the fact that, </NOBR>
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<NOBR>these being normal animals in whom carbohydrate metabolism was already in homeostasis, </NOBR>
<NOBR>further fall beyond certain limits was not possible. This is a desirable feature. </NOBR>
<NOBR>In another experiment, the hyperglycemic response to adrenaline was reduced following </NOBR>
<NOBR>D-400 treatment in rats. Adrenaline is known to cause suppression of insulin release via </NOBR>
<NOBR>alpha-receptors therapy raising blood sugar levels. It appears that D-400 may possess the </NOBR>
<NOBR>ability to stimulate the pancreas, thereby antagonizing the effect of adrenaline and resulting in </NOBR>
<NOBR>raising the level of circulating insulin. This in turn decreases blood sugar levels. </NOBR>
<NOBR>D-400 prolonged the hypoglycemic effect of tolbutamide in normal rats. This could be due to </NOBR>
<NOBR>the action of D-400 on liver glycogen thereby preventing the hepatic glycogenolysis, which is </NOBR>
<NOBR>further substantiated by the rise in liver glycogen levels in diabetic rats treated with D-400. </NOBR>
<NOBR>This prevention of glycogenolysis by D-400 must have counteracted the rise in blood sugar </NOBR>
<NOBR>two hours after tolbutamide administration. </NOBR>
<NOBR>In alloxan-induced diabetic rats, D-400 produced a significant hypolycemic effect and </NOBR>
<NOBR>reduced urinary sugar excretion. The hypoglycemic effect of insulin was enhanced and the </NOBR>
<NOBR>liver glycogen store was significantly higher following treatment with D-400. All these </NOBR>
<NOBR>findings suggest that D-400 may be acting through some mechanism, viz. improvement in the </NOBR>
<NOBR>receptor responsiveness to insulin causing increased glucose uptake by the tissues. Hence, </NOBR>
<NOBR>further studies are essential to substantiate the present findings and also to establish the </NOBR>
<NOBR>probable mechanism of action of D-400 distinctly. </NOBR>
<NOBR>REFERENCES </NOBR>
<NOBR>1. </NOBR>
<NOBR>Nadkarni AK. In: Indian Material Medica, Vol. 1 and 2. Popular Prakashan, Bombay, </NOBR>
<NOBR>1992. </NOBR>
<NOBR>2. </NOBR>
<NOBR>Ajgaonkar SS. Ancient Indian Medicine and Diabetes Mellitus in developing countries. </NOBR>
<NOBR>(Ed.) JS Bajaj, Interprint, New Delhi. 1984: pp 3-10. </NOBR>
<NOBR>3. </NOBR>
<NOBR>Upadhyay P, Pandey K. Ayurvedic approach to diabetes mellitus and its management </NOBR>
<NOBR>by indigenous resources. In: Diabetes mellitus in developing countries. 1984; 375-377. </NOBR>
<NOBR>4. </NOBR>
<NOBR>Gupta SS. Prospects and perspectives of natural plant products in Medicine. Indian J of </NOBR>
<NOBR>Pharmacology 1994; 26: 1-12. </NOBR>
<NOBR>5. </NOBR>
<NOBR>Dubey GP, Aruna Agrawal, Alok Singh. Evaluation of D-400, an indigenous herbal </NOBR>
<NOBR>preparation, in Diabetes Mellitus. Ind J Int Med 1993; 3: 183-186. </NOBR>
<NOBR>6. </NOBR>
<NOBR>Satyavathi GV, Gupta AK, Tandon N. Medicinal plants of India, Vol. 1&2, ICMR, </NOBR>
<NOBR>1987. </NOBR>
<NOBR>7. </NOBR>
<NOBR>Baskaran K, Kizar Ahamath B, Radha Shanmugasundaram K, Shanmugasundaram</NOBR>
<NOBR>ERB. Antidiabetic effect of a leaf extract from Gymnema sylvestre in non-insulin-</NOBR>
<NOBR>dependent diabetes mellitus patients. J Ethnopharmacol 1990; 30: 295-305. </NOBR>
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<NOBR>Nadkarni AK. In: Indian Material Medica, Vol. 1, 517; Popular Prakashan, Bombay, </NOBR>
<NOBR>1992. </NOBR>
<NOBR>9. </NOBR>
<NOBR>Gupta SS, Verma SCL, Garg VP, Mahesha Rai. Anti-diabetic effects of Tinospora </NOBR>
<NOBR>cordifolia. Effect on fasting blood sugar level, glucose tolerance and adrenaline induced </NOBR>
<NOBR>hyperglycaemia. Ind Jour Med Res 1967; 55(7): 733-745. </NOBR>
<NOBR>10. Sepha GC, Bose SW. Clinical observations on the antidiabetic properties of </NOBR>
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<NOBR>11. Gupta SS, Seth CB. Effect of Momordica charantia Linn on glucose tolerance in albino </NOBR>
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<NOBR>12. Kedar P, Chakrabarti CH. Effect of bittergourd seed and glibenclamide in streptozotocin </NOBR>
<NOBR>induced diabetes mellitus. Ind Jour Exp Biol 1982; 20: 232-235. </NOBR>
<NOBR>13. Chattopadhyay RR. Hypoglycemic effect of Ocimum sanctum leaf extract in normal and </NOBR>
<NOBR>streptozotocin diabetic rats. Indian J of Exp Biol 1993; 31: 891-893. </NOBR>
<NOBR>14. Gupta SS. Prospects and perspectives of natural plant products in Medicine. Indian J </NOBR>
<NOBR>Pharmacol 1994; 26: 5. </NOBR>
<NOBR>15. Gupta SS, Variyar MC. Inhibitory effect of Gymnema sylvestre (Gurmar) on adreno-</NOBR>
<NOBR>hypophyseal activity in rats. Indian J Med Sci 1961; 15: 656-659. </NOBR>
<NOBR>16. Gupta SS. Inhibitory effect of Gymnema sylvestre on adrenaline induced </NOBR>
<NOBR>hyperglycaemia in rats. Indian J Med sci 1961; 15: 833. </NOBR>
<NOBR>17. Gupta SS, Variyar MC. Experimental studies on pituitary diabetes Part IV. Effect of </NOBR>
<NOBR>Gymnema sylvestre and Coccinia indica against the hyperglycaemic response of </NOBR>
<NOBR>Somatotropin and Corticotropin hormones. Indian J Med Res 1964; 52: 200-207. </NOBR>
<NOBR>18. Gupta SS, Verma SCL, Garg VP, Rai M. Anti-diabetic effects of Tinospora cordifolia-</NOBR>
<NOBR>Part I. Effect on fasting blood sugar level, glucose tolerance and adrenaline induced </NOBR>
<NOBR>hyperglycaemia. Indian J Med Res 1967; 55: 733-745. </NOBR>
<NOBR>19. Gupta SS, Valaderus JRE, Garg VP, Mahesh Rai. Further observation on the diabetic </NOBR>
<NOBR>effects of Tinospora cordifolia and Casearia esculenta. Indian J Physiol Pharmacol</NOBR>
<NOBR>1967; 56: 11. </NOBR>
<NOBR>20. Gupta SS. Effect of Gymnema sylvestre and Pterocarpus marsupium on glucose </NOBR>
<NOBR>tolerance in albino rats. Indian J Med Sci 1963; 6: 501-505. </NOBR>
<NOBR>21. Chakravarti BK, Gupta S, Gambhir SS, Gode KD. Pancreatic beta-cell regeneration a </NOBR>
<NOBR>novel anti-diabetic mechanism of Pterocarpus marsupium. Indian J Pharmacol 1980; </NOBR>
<NOBR>12: 123-125. </NOBR>
<NOBR>22. Gupta SS, Seth CB. Effect of Momordica charantia Linn (Karela) on glucose tolerance </NOBR>
<NOBR>in albino rats. J Indian Med Assoc 1962; 39: 581-584. </NOBR>
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<NOBR>23. Kulkarni RD, Gaitonde BB. Potentiation of tolbutamide action by Jasad bhasma and </NOBR>
<NOBR>Karela (Momordica charantia). Indian J Med Res 1962; 50: 715. </NOBR>
<NOBR>24. Baldwa VS, Goyal RK, Bhandari CM, Pangariya. A clinical trial of insulin obtained </NOBR>
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<NOBR>Med J 1976; 16: 54. </NOBR>
<NOBR>25. Mohan AR, Chauhan BL, Mitra SK, Kulkarni RD. Safety, efficacy and tolerability of </NOBR>
<NOBR>D-400, an Ayurvedic hypoglycaemic formulation, in healthy male medical students. </NOBR>
<NOBR>Current Medical Practice (In Press). </NOBR>
<NOBR>26. Yajnik VH, Acharya HK, Vithlani MP, Yajnik NV. Efficacy and safety of D-400, A </NOBR>
<NOBR>herbal fromulation, in diabetic patients. The Indian Practitioner 1993; Vol. XLVI, No. </NOBR>
<NOBR>12: 917-922. </NOBR>

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Cautions

Using gymnema alone has shown indication of raising blood pressure.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9550454&dopt=Citation

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<DL><DT><TABLE cellSpacing=0 cellPadding=0 width="100%"><TBODY><TR><TD><INPUT type=checkbox value=9550454 name=uid>1: J Am Coll Nutr. 1998 Apr;17(2):116-23.</TD><TD align=right>Related Articles,<SCRIPT language=JavaScript1.2></SCRIPT><SCRIPT language=JavaScript1.2></SCRIPT> Links </TD></TR></TBODY></TABLE><DD>

[SIZE=+1]Comparative effects of chromium, vanadium and gymnema sylvestre on sugar-induced blood pressure elevations in SHR.[/SIZE]

Preuss HG, Jarrell ST, Scheckenbach R, Lieberman S, Anderson RA.

Department of Medicine, Georgetown University Medical Center, Washington, DC 20007, USA.

OBJECTIVE: Effects on systolic blood pressure (SBP) of ingesting three agents reported to influence insulin metabolism, i.e., chromium polynicotinate, bis(maltolato)oxovanadium (BMOV), and the herb, Gymnema sylvestre, were assessed simultaneously in spontaneously hypertensive rats (SHR). METHODS: In the first study, SHR were fed either a starch, sugar, or sugar diet containing chromium polynicotinate, bis(maltolato)oxovanadium (BMOV), or G. sylvestre. Tail SBP was estimated indirectly and various blood chemistries were measured. TBARS formation was determined in hepatic and renal tissue. In a second study, tail SBP was measured in SHR ingesting diets containing different concentrations of BMOV. RESULTS: Compared to starch, SHR consuming sucrose showed a significant elevation of SBP within days that was maintained for the duration of study. Addition of chromium polynicotinate to the sucrose diet at the beginning of study prevented the sucrose-induced elevation of SBP for 2 weeks, but SBP rose significantly after that. BMOV at high concentrations overcame the sucrose-induced rise in SBP and even decreased SBP below values seen in SHR eating the starch diet, but marked weight loss was noted. A second study examined different concentrations of BMOV. At 0.01% w/w concentration of BMOV, SBP was still significantly decreased, even though SHR did not lose body weight (BW) early on. SHR consuming G. sylvestre showed no change or even elevated SBP. Hepatic thiobarbituric acid reacting substances (TBARS) formation, an estimate of lipid peroxidation, was decreased by chromium polynicotinate and BMOV, and renal TBARS by chromium polynicotinate. Circulating cholesterol concentrations were decreased in the SHR consuming G. sylvestre. CONCLUSIONS: Chromium decreases the portion of SBP elevated by high sucrose intake as shown previously, but high levels of sucrose ingestion can eventually overcome this. BMOV overcame sucrose-induced elevation of SBP as well as some of the "genetic hypertension." Different from chromium, this decrease was not overcome by high levels of dietary sucrose. The significant lowering of cholesterol with G. sylvestre ingestion indicates some effect on metabolism, but G. sylvestre did not lower and even raised SBP.

MeSH Terms:

Angiosperms/therapeutic use*
Animals
Blood Glucose/metabolism
Blood Pressure
Body Weight
Chromium/therapeutic use*
Comparative Study
Dietary Sucrose*
Hemoglobin A, Glycosylated/metabolism
Hypertension/chemically induced
Hypertension/prevention & control*
Insulin/blood
Male
Phytotherapy*
Rats
Rats, Inbred SHR
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.
Starch/administration & dosage
Thiobarbituric Acid Reactive Substances/metabolism
Vanadium/therapeutic use*

Substances:

Blood Glucose
Dietary Sucrose
Hemoglobin A, Glycosylated
Thiobarbituric Acid Reactive Substances
Insulin
Chromium
Vanadium
Starch

PMID: 9550454 [PubMed - indexed for MEDLINE] </DD></DL>

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Chromium plays a role in blood sugar but, the role is still poorly understood. There is no argument against the need for chromium in the human body or that it does play a role in sugar regulation. There is some conflicting data regarding whether supplementing with additional chromium is effective in reducing the blood sugar levels. Chinese researcher says it does and one important double-blind study in the US could not duplicate the results using a slightly different test. However, within the second test the researchers did give a few caveats, the first was the diabetics tested were in poor control of their diabetes, also, they suggested American diabetics may get more chromium naturally in their diets therefore the results may be skewed, and finally, because the diabetics were uncontrolled in this test they may have a greater need of chromium than did those in the first test.

The following link is very long so I will not import the entire document. I suggest that if interested you follow the links as they offer a significant amount of information.

http://www.jacn.org/cgi/content/full/17/6/548

Chromium, Glucose Intolerance and Diabetes

</NOBR><NOBR>Richard A. Anderson, PhD, FACN<SUP></SUP></NOBR>

[SIZE=-1]Nutrient Requirements and Functions Laboratory, Beltsville Human, Nutrition Research Center, US Department of Agriculture, ARS, Beltsville, Maryland [/SIZE]
[SIZE=-1]Address reprint requests to: Richard A. Anderson, PhD, FACN, USDA, ARS, BHNRC, NRFL, Bldg 307, Rm. 224, BARC-East, Beltsville, MD 20705-2350[/SIZE]

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</TD><TH vAlign=center align=left width="95%">[SIZE=+2]ABSTRACT [/SIZE]</TH></TR></TBODY></TABLE><TABLE cellPadding=5 align=right border=1><TBODY><TR><TH align=left>[SIZE=-1]

TOP

ABSTRACT

INTRODUCTION

CHROMIUM ESSENTIALITY IN HUMANS

SUGGESTED AND/OR ESTIMATED SAFE...

CHROMIUM SUPPLEMENTATION IN...

CHROMIUM AND BLOOD LIPIDS

CHROMIUM AND DIABETES

WHY AREN?T ALL THE...

CHROMIUM: MODE OF ACTION

SAFETY OF SUPPLEMENTAL CHROMIUM

SUMMARY

REFERENCES
[/SIZE]

</TH></TR></TBODY></TABLE>
Within the last 5 years chromium (Cr) has been shown to play<SUP> </SUP>a role in glucose intolerance, Type 2 diabetes mellitus (Type<SUP> </SUP>2 DM), and gestational diabetes. In addition, diabetes and the<SUP> </SUP>neuropathy of a patient on home parenteral nutrition were alleviated<SUP> </SUP>when supplemental Cr was added to total parenteral nutrition<SUP> </SUP>(TPN) solutions. In a study conducted in China that has been<SUP> </SUP>supported by studies in the United States, supplemental Cr as<SUP> </SUP>Cr picolinate improved the blood glucose, insulin, cholesterol,<SUP> </SUP>and hemoglobin A<SUB>1C</SUB> in people with Type 2 DM in a dose dependent<SUP> </SUP>manner. Follow-up studies of >1 year have confirmed these<SUP> </SUP>studies. The requirement for Cr is related to the degree of<SUP> </SUP>glucose intolerance: 200 ?g/day of supplemental Cr is<SUP> </SUP>adequate to improve glucose variables of those who are mildly<SUP> </SUP>glucose intolerant. However, people with more overt impairments<SUP> </SUP>in glucose tolerance and diabetes usually require more than<SUP> </SUP>200 ?g/day. Daily intake of 8 ?g of Cr per kg body<SUP> </SUP>weight was also more effective than 4 ?g/kg in women with<SUP> </SUP>gestational diabetes. The mechanism of action of Cr involves<SUP> </SUP>increased insulin binding, increased insulin receptor number,<SUP> </SUP>and increased insulin receptor phosphorylation. In summary,<SUP> </SUP>supplemental Cr has been shown to have beneficial effects without<SUP> </SUP>any documented side effects on people with varying degrees of<SUP> </SUP>glucose intolerance ranging from mild glucose intolerance to<SUP> </SUP>overt Type 2 DM.<SUP> </SUP>

Key words: chromium, diabetes, glucose tolerance, trace elements, insulin

Key teaching points:<SUP> </SUP>
? Chromium alleviates glucose intolerance.<SUP> </SUP>
? Chromium alleviates Type 2 DM and gestational diabetes.<SUP> </SUP>
? Chromium increases insulin receptor phosphorylation.<SUP> </SUP>? Chromium is a safe nutrient supplement.<SUP> </SUP>

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Linus Pauling Institute
Micronutrient Research for Optimum Health

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Micronutrient Information Center

http://www.flutrackers.com/forum/Chromium

Although trivalent chromium is recognized as a nutritionally essential mineral, scientists are not yet certain exactly how it functions in the body. The two most common forms of chromium are trivalent chromium (III) and hexavalent chromium (VI). Chromium (III) is the principal form in foods, as well as the form utilized by the body. Chromium (VI) is derived from chromium (III) by heating at alkaline pH and is used as a source of chromium for industrial purposes. It is a strong irritant and is recognized as a carcinogen when inhaled. At low levels, chromium (VI) is readily reduced to chromium (III) by reducing substances in foods and the acidic environment of the stomach, which serve to prevent the ingestion of chromium (VI) (1-3).

Function

A biologically active form of chromium participates in glucose metabolism by enhancing the effects of insulin. Insulin is secreted by specialized cells in the pancreas in response to increased blood glucose levels, for example, after a meal. Insulin binds to insulin receptors on the surface of cells, activating those receptors and stimulating glucose uptake by cells. Through its interaction with insulin receptors, insulin provides cells with glucose for energy and prevents blood glucose levels from becoming elevated. In addition to its effects on carbohydrate (glucose) metabolism, insulin also influences the metabolism of fat and protein. A decreased response to insulin or decreased insulin sensitivity may result in impaired glucose tolerance or type 2 diabetes, also known as non-insulin dependent diabetes mellitus (NIDDM). Type 2 diabetes is characterized by elevated blood glucose levels and insulin resistance (3).
The precise structure of the biologically active form of chromium is not known. Recent research suggests that a low-molecular-weight chromium-binding substance (LMWCr) may enhance the response of the insulin receptor to insulin. The following is a proposed model for the effect of chromium on insulin action (diagram). First, the inactive form of the insulin receptor is converted to the active form by binding insulin. The binding of insulin by the insulin receptor stimulates the movement of chromium into the cell and results in binding of chromium to apoLMWCr, a form of the LMWCr that lacks chromium. Once it binds chromium the LMWCr binds to the insulin receptor and enhances its activity. The ability of the LMWCr to activate the insulin receptor is dependent on its chromium content. When insulin levels drop due to normalization of blood glucose levels, the LMWCr may be released from the cell in order to terminate its effects (4).
Nutrient interactions
Iron
Chromium competes for one of the binding sites on the iron transport protein, transferrin. However, supplementation of older men with 925 mcg of chromium/day for 12 weeks did not significantly affect measures of iron nutritional status (5). A study of younger men found an insignificant decrease in transferrin saturation with iron after supplementation of 200 mcg of chromium/day for 8 weeks, but no long-term studies have addressed this issue (6). Iron overload in hereditary hemochromatosis may interfere with chromium transport by competing for transferrin binding. This has led to the hypothesis that decreased chromium transport might contribute to the diabetes associated with hereditary hemochromatosis (3).
Vitamin C
Chromium uptake is enhanced in animals when given at the same time as vitamin C (1). In a study of three women, administration of 100 mg of vitamin C together with 1 mg of chromium resulted in higher plasma levels of chromium than 1 mg of chromium without vitamin C (3).

Carbohydrates
Diets high in simple sugars (e.g., sucrose), compared to diets high in complex carbohydrates (e.g., whole grains), increase urinary chromium excretion in adults. This effect may be related to increased insulin secretion in response to the consumption of simple sugars compared to complex carbohydrates (3).

Deficiency

Chromium deficiency was reported in three patients on long-term intravenous feeding who did not receive supplemental chromium in their intravenous solutions. These patients developed evidence of abnormal glucose utilization and increased insulin requirements that responded to chromium supplementation. Additionally, impaired glucose tolerance in malnourished infants responded to an oral dose of chromium chloride. Because chromium appears to enhance the action of insulin and chromium deficiency has resulted in impaired glucose tolerance, chromium insufficiency has been hypothesized to be a contributing factor to the development of Type 2 diabetes (3, 7)
Several studies of male runners indicated that urinary chromium loss was increased by endurance exercise, suggesting that chromium needs may be greater in individuals who exercise regularly (8). In a more recent study, resistive exercise (weight lifting) was found to increase urinary excretion of chromium in older men. However, chromium absorption was also increased, leading to little or no net loss of chromium as a result of resistive exercise (9).
At present, research on the effects of inadequate chromium intake and risk factors for chromium insufficiency are limited by the lack of sensitive and accurate tests for determining chromium nutritional status (1, 3).
The Adequate Intake (AI)
Because there was not enough information on chromium requirements to set a recommended dietary allowance (RDA), the Food and Nutrition Board set an adequate intake level (AI) based on the chromium content in normal diets (3).

Adequate Intake (AI) for Chromium

</TD></TR><TR><TD width="25%">Life Stage </TD><TD width="25%">Age </TD><TD align=middle width="25%">Males (mcg/day) </TD><TD align=middle width="25%">Females (mcg/day) </TD></TR><TR><TD width="25%">Infants </TD><TD width="25%">0-6 months </TD><TD align=middle width="25%">0.2</TD><TD align=middle width="25%">0.2</TD></TR><TR><TD width="25%">Infants </TD><TD width="25%">7-12 months </TD><TD align=middle width="25%">5.5</TD><TD align=middle width="25%">5.5</TD></TR><TR><TD width="25%">Children </TD><TD width="25%">1-3 years </TD><TD align=middle width="25%">11</TD><TD align=middle width="25%">11</TD></TR><TR><TD width="25%">Children</TD><TD width="25%"> 4-8 years </TD><TD align=middle width="25%">15</TD><TD align=middle width="25%">15</TD></TR><TR><TD width="25%">Children </TD><TD width="25%">9-13 years </TD><TD align=middle width="25%">25</TD><TD align=middle width="25%">21</TD></TR><TR><TD width="25%">Adolescents </TD><TD width="25%">14-18 years </TD><TD align=middle width="25%">35</TD><TD align=middle width="25%">24</TD></TR><TR><TD width="25%">Adults </TD><TD width="25%">19-50 years </TD><TD align=middle width="25%">35</TD><TD align=middle width="25%">25</TD></TR><TR><TD width="25%">Adults </TD><TD width="25%">51 years and older </TD><TD align=middle width="25%">30</TD><TD align=middle width="25%">20</TD></TR><TR><TD width="25%">Pregnancy </TD><TD width="25%">18 years and younger </TD><TD align=middle width="25%">-</TD><TD align=middle width="25%">29</TD></TR><TR><TD width="25%">Pregnancy </TD><TD width="25%">19 years and older</TD><TD align=middle width="25%">-</TD><TD align=middle width="25%">30</TD></TR><TR><TD width="25%">Breastfeeding </TD><TD width="25%">18 years and younger </TD><TD align=middle width="25%">-</TD><TD align=middle width="25%">44</TD></TR><TR><TD width="25%">Breastfeeding </TD><TD width="25%">19 years and older</TD><TD align=middle width="25%">-</TD><TD align=middle width="25%">45</TD></TR></TBODY></TABLE></CENTER>

Disease Prevention

Impaired glucose tolerance and type 2 diabetes mellitus
In 12 out of 15 controlled studies of people with impaired glucose tolerance, chromium supplementation was found to improve some measure of glucose utilization or to have beneficial effects on blood lipid profiles (10). Impaired glucose tolerance refers to a metabolic state between normal glucose regulation and overt diabetes. Generally, blood glucose levels are higher than normal, but lower than those accepted as diagnostic for diabetes. Impaired glucose tolerance is associated with increased risk for cardiovascular diseases but is not associated with the other classic complications of diabetes. About 25% to 30% of individuals with impaired glucose tolerance eventually develop type 2 diabetes (11). Generally, chromium supplementation at doses of about 200 mcg/day, in a variety of forms for two to three months were found to be beneficial. The reasons for the variation or lack of effect in some studies are not clear, but chromium depletion is not the only known cause of impaired glucose tolerance. Additionally, the lack of an accurate measure of chromium nutritional status prevents researchers from identifying those individuals who are most likely to benefit from chromium supplementation (1, 12).
Cardiovascular disease
Impaired glucose tolerance and type 2 diabetes are associated with adverse changes in lipid profiles and increased risk of cardiovascular diseases. Studies examining the effects of chromium supplementation on lipid profiles have been notable for their inconsistent results. While some studies have observed reductions in serum total cholesterol, LDL-cholesterol, and triglyceride levels or increases in HDL-cholesterol levels, others have observed no effect. Such inconsistent responses of lipid and lipoprotein levels to chromium supplementation may reflect differences in chromium nutritional status. It is possible that only those individuals with insufficient chromium will experience beneficial effects on lipid profiles due to chromium supplementation (1, 2, 10)
Health claims
Increases muscle mass
Claims that chromium supplementation increases lean body mass and decreases body fat are based on the relationship between chromium and insulin action (see Function). In addition to affecting glucose metabolism, insulin is known to affect fat and protein metabolism. At least 12 placebo-controlled studies have compared the effect of chromium supplementation (200-1,000 mcg as chromium picolinate/day) with or without an exercise program on lean body mass and measures of body fat. In general, those studies that have used the most sensitive and accurate methods of measuring body fat and lean mass (dual energy x-ray absorbtiometry or DEXA and hydrodensitometry or underwater weighing) do not indicate a beneficial effect of chromium supplementation on body composition (2, 10).

Promotes weight loss
Controlled studies of chromium supplementation (200-400 mcg as chromium picolinate/day) have demonstrated little if any beneficial effect on weight or fat loss (13), and claims of weight loss in humans appear to be exaggerated. In 1997 the U.S. Federal Trade Commission (FTC) ruled that there is no basis for claims that chromium picolinate promotes weight loss and fat loss in humans.(2, 10, 12)

Disease Treatment

Type 2 diabetes mellitus
Type 2 diabetes is characterized by elevated blood glucose levels and insulin resistance. Although insulin levels in type 2 diabetics may be higher than in healthy individuals, the physiological effects of insulin are reduced. Because chromium is known to enhance the action of insulin, the relationship between chromium nutritional status and type 2 diabetes has generated considerable scientific interest. Individuals with type 2 diabetes have been found to have higher rates of urinary chromium loss than healthy individuals, especially those with diabetes of more than 2 years duration (14). Prior to 1997, well-designed studies of chromium supplementation in individuals with type 2 diabetes showed no improvement in blood glucose control, though they provided some evidence of reduced insulin levels and improved blood lipid profiles (15). In 1997, the results of a placebo-controlled trial conducted in China indicated that chromium supplementation might be beneficial in the treatment of type 2 diabetes (16). One hundred eighty participants took either a placebo, 200 mcg/day, or 1,000 mcg/day of chromium in the form of chromium picolinate. At the end of four months, blood glucose levels were 15%-19% lower in those that took 1,000 mcg/day compared with those that took a placebo. Blood glucose levels in those that took 200 mcg/day did not differ significantly from those that took a placebo. Insulin levels were lower in those who took either 200 mcg/day or 1,000 mcg/day. Glycosylated hemoglobin levels, a measure of long-term control of blood glucose, were also lower in both chromium-supplemented groups, but they were lowest in the group taking 1,000 mcg/day. Because the chromium nutritional status of the Chinese participants was not evaluated, and the prevalence of obesity was much lower than is typically associated with type 2 diabetics in the U.S., extrapolation of these results to a U.S. population is difficult. However, the findings in the Chinese population emphasize the need for large-scale randomized controlled trials of chromium supplementation for type 2 diabetes in the U.S (15).
Gestational diabetes
Few studies have examined the effects of chromium supplementation on gestational diabetes. Gestational diabetes occurs in about 2% of pregnant women and usually appears in the second or third trimester of pregnancy. Blood glucose levels must be tightly controlled to prevent adverse effects on the developing fetus. After delivery, glucose tolerance generally reverts to normal. However, 30% to 40% of women who have had gestational diabetes develop type 2 diabetes within 5 to 10 years. An observational study in pregnant women did not find serum chromium levels to be associated with measures of glucose tolerance or insulin resistance in late pregnancy, although serum chromium levels may not reflect tissue chromium levels (17). Women with gestational diabetes whose diets were supplemented with 4 mcg of chromium per kilogram of body weight daily as chromium picolinate for 8 weeks had decreased fasting blood glucose and insulin levels compared with those who took a placebo. However, insulin therapy rather than chromium picolinate was required to normalize severely elevated blood glucose levels (2, 18).

Sources

Food sources
The amount of chromium in foods is variable, and it has been measured accurately in relatively few foods. Presently, there is no large database for the chromium content of foods. Processed meats, whole grain products, ready-to-eat bran cereals, green beans, broccoli, and spices are relatively rich in chromium. Foods high in simple sugars, such as sucrose and fructose, are not only low in chromium but have been found to promote chromium loss (2). Estimated average chromium intakes in the U.S. range from 23-29 mcg/day for adult women and 39-54 mcg/day for adult men (3). The chromium content of some foods is listed below in micrograms (mcg) (19). Because chromium content in different batches of the same food has been found to vary significantly, the information in the table below should serve only as a guide to the chromium content of foods.

<CENTER><TABLE cellPadding=2 width="100%" border=1><TBODY><TR><TD width="33%">Food</TD><TD width="33%">Serving</TD><TD align=middle width="34%">Chromium (mcg)</TD></TR><TR><TD width="33%">Broccoli</TD><TD width="33%">1/2 cup</TD><TD align=middle width="34%">11.0</TD></TR><TR><TD width="33%">Green beans</TD><TD width="33%">1/2 cup</TD><TD align=middle width="34%">1.1</TD></TR><TR><TD width="33%">Potatoes</TD><TD width="33%">1 cup, mashed</TD><TD align=middle width="34%">2.7</TD></TR><TR><TD width="33%">Grape juice</TD><TD width="33%">8 fl. ounces</TD><TD align=middle width="34%">7.5</TD></TR><TR><TD width="33%">Orange juice</TD><TD width="33%">8 fl. ounces</TD><TD align=middle width="34%">2.2</TD></TR><TR><TD width="33%">Beef</TD><TD width="33%">3 ounces</TD><TD align=middle width="34%">2.0</TD></TR><TR><TD width="33%">Turkey breast</TD><TD width="33%">3 ounces</TD><TD align=middle width="34%">1.7</TD></TR><TR><TD width="33%">Turkey ham (processed)</TD><TD width="33%">3 ounces</TD><TD align=middle width="34%">10.4</TD></TR><TR><TD width="33%">Waffle</TD><TD width="33%">1 (~2.5 ounces)</TD><TD align=middle width="34%">6.7</TD></TR><TR><TD width="33%">Bagel</TD><TD width="33%">1</TD><TD align=middle width="34%">2.5</TD></TR><TR><TD width="33%">English muffin</TD><TD width="33%">1</TD><TD align=middle width="34%">3.6</TD></TR><TR><TD width="33%">Apple w/ peel</TD><TD width="33%">1 medium</TD><TD align=middle width="34%">1.4</TD></TR><TR><TD width="33%">Banana</TD><TD width="33%">1 medium</TD><TD align=middle width="34%">1.0</TD></TR></TBODY></TABLE></CENTER>

Supplements
Chromium (III) is available as a supplement in several forms: chromium chloride, chromium nicotinate, chromium picolinate, and high-chromium yeast. They are available as stand-alone supplements or in combination products. Doses typically range from 50 to 200 mcg of elemental chromium (20). Chromium nicotinate and chromium picolinate may be more bioavailable than chromium chloride (10). In much of the research on impaired glucose tolerance and type 2 diabetes, chromium picolinate was the source of chromium. However, some concerns have been raised over the long-term safety of chromium picolinate supplementation (see Safety).

Safety

Toxicity
Hexavalent chromium or chromium (VI) is a recognized carcinogen. Exposure to chromium (VI) in dust is associated with increased incidence of lung cancer and is known to cause inflammation of the skin (dermatitis). In contrast, there is little evidence that trivalent chromium or chromium (III) is toxic to humans. Because no adverse effects have been convincingly associated with excess intake of chromium (III) from food or supplements, the Food and Nutrition Board (FNB) of the Institute of Medicine did not set a tolerable upper level of intake (UL) for chromium. Because information is limited, the FNB acknowledged a potential for adverse effects of high intakes of supplemental chromium (III) and advised caution (3).
Most of the concerns regarding the long-term safety of chromium (III) supplementation arise from several studies in cell culture, suggesting chromium (III), especially in the form of chromium picolinate, may increase DNA damage (21-23). Presently, there is no evidence that chromium (III) increases DNA damage in living organisms (3), and a study in 10 women taking 400 mcg/day of chromium as chromium picolinate found no evidence of increased oxidative damage to DNA as measured by antibodies to an oxidized DNA base (24).
Several studies have demonstrated the safety of daily doses of up to 1,000 mcg of chromium for several months (16, 25). However, there have been a few isolated reports of serious adverse reactions to chromium picolinate. Kidney failure was reported five months after a six-week course of 600 mcg of chromium/day in the form of chromium picolinate (26), while kidney failure and impaired liver function were reported after the use of 1,200-2,400 mcg/day of chromium in the form of chromium picolinate over a period of four to five months (27). Individuals with pre-existing kidney or liver disease may be at increased risk of adverse effects and should limit supplemental chromium intake (3).
Drug interactions
Little is known about drug interactions with chromium in humans. Large doses of calcium carbonate or magnesium hydroxide-containing antacids decreased chromium absorption in rats. Aspirin and indomethacin (a non-steroidal anti-inflammatory drug) increased chromium absorption in rats (1).

Linus Pauling Institute Recommendation

The lack of sensitive indicators of chromium nutritional status in humans makes it difficult to determine the level of chromium intake most likely to promote optimum health. Following the Linus Pauling Institute recommendation to take a multivitamin/multimineral supplement containing 100% of the daily values (DV) of most nutrients will generally provide 60-120 mcg/day of chromium, well above the adequate intake level of 20 to 25 mcg/day for adult women and 30 to 35 mcg for adult men.
Adults over the age of 65
Although the requirement for chromium is not known to be higher for older adults, one study found that chromium concentrations in hair, sweat, and urine decreased with age (28). Following the Linus Pauling Institute recommendation to take a multivitamin/multimineral supplement containing 100% of the daily values (DV) of most nutrients should provide sufficient chromium for most older adults.
Because impaired glucose tolerance and type 2 diabetes are associated with potentially serious health problems, individuals considering high-dose chromium supplementation to treat either condition should do so in collaboration with a qualified health care provider.

Written by:
Jane Higdon, Ph.D.
Linus Pauling Institute
Oregon State University

Reviewed by:
Richard A. Anderson, Ph.D.
Lead Scientist
Beltsville Human Nutrition Research Center
Beltsville, Maryland

Disclaimer

The Linus Pauling Institute Micronutrient Information Center provides scientific information on health aspects of micronutrients and phytochemicals for the general public. The information is made available with the understanding that the author and publisher are not providing medical, psychological, or nutritional counseling services on this site. The information should not be used in place of a consultation with a competent health care or nutrition professional.
The information on micronutrients and phytochemicals contained on this Web site does not cover all possible uses, actions, precautions, side effects, and interactions. It is not intended as medical advice for individual problems. Liability for individual actions or omissions based upon the contents of this site is expressly disclaimed.

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Cinnamon, reduces blood glucose.

http://care.diabetesjournals.org/cgi/content/abstract/26/12/3215%20

<TABLE cellSpacing=0 cellPadding=0><TBODY><TR><TD><HR noShade SIZE=1>Clinical Care/Education/Nutrition
Original Article

</TD></TR></TBODY></TABLE>
Cinnamon Improves Glucose and Lipids of People With Type 2 Diabetes

</NOBR><NOBR>Alam Khan, MS, PHD<SUP>1</SUP><SUP>,2</SUP><SUP>,3</SUP></NOBR>, <NOBR>Mahpara Safdar, MS<SUP>1</SUP><SUP>,2</SUP></NOBR>, <NOBR>Mohammad Muzaffar Ali Khan, MS, PHD<SUP>1</SUP><SUP>,2</SUP></NOBR>, <NOBR>Khan Nawaz Khattak, MS<SUP>1</SUP><SUP>,2</SUP></NOBR> and <NOBR>Richard A. Anderson, PHD<SUP>3</SUP></NOBR>

[SIZE=-1]<SUP>1</SUP> Department of Human Nutrition, NWFP Agricultural University, Peshawar, Pakistan
<SUP>2</SUP> Post Graduate Medical Institute, Hayatabad Medical Complex, Peshawar, Pakistan
<SUP>3</SUP> Nutrients Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center, Beltsville, Maryland [/SIZE]
[SIZE=-1]Address correspondence and reprint requests to Dr. Richard A. Anderson, Nutrient Requirements and Functions Laboratory, Beltsville Human Nutrition Research Center, Bldg. 307, Rm. 224, Beltsville, MD 20705. E-mail: Anderson@307.bhnrc.usda.gov<SCRIPT type=text/javascript></SCRIPT> [/SIZE]
OBJECTIVE?The objective of this study was to determine<SUP> </SUP>whether cinnamon improves blood glucose, triglyceride, total<SUP> </SUP>cholesterol, HDL cholesterol, and LDL cholesterol levels in<SUP> </SUP>people with type 2 diabetes.<SUP> </SUP>
RESEARCH DESIGN AND METHODS?A total of 60 people with<SUP> </SUP>type 2 diabetes, 30 men and 30 women aged 52.2 ? 6.32<SUP> </SUP>years, were divided randomly into six groups. Groups 1, 2, and<SUP> </SUP>3 consumed 1, 3, or 6 g of cinnamon daily, respectively, and<SUP> </SUP>groups 4, 5, and 6 were given placebo capsules corresponding<SUP> </SUP>to the number of capsules consumed for the three levels of cinnamon.<SUP> </SUP>The cinnamon was consumed for 40 days followed by a 20-day washout<SUP> </SUP>period.<SUP> </SUP>
RESULTS?After 40 days, all three levels of cinnamon reduced<SUP> </SUP>the mean fasting serum glucose (18?29%), triglyceride<SUP> </SUP>(23?30%), LDL cholesterol (7?27%), and total cholesterol<SUP> </SUP>(12?26%) levels; no significant changes were noted in<SUP> </SUP>the placebo groups. Changes in HDL cholesterol were not significant.<SUP> </SUP>
CONCLUSIONS?The results of this study demonstrate that<SUP> </SUP>intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose,<SUP> </SUP>triglyceride, LDL cholesterol, and total cholesterol in people<SUP> </SUP>with type 2 diabetes and suggest that the inclusion of cinnamon<SUP> </SUP>in the diet of people with type 2 diabetes will reduce risk<SUP> </SUP>factors associated with diabetes and cardiovascular diseases.<SUP> </SUP>


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J. Am. Coll. Nutr., April 1, 2006; 25(2): 144 - 150.
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Niko · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Shannon,

Bless you! My mom has been struggling to control her type 2 diabetes and I have been looking at alternatives. Problem is, I don't know what sources to trust. Thank you posting the abstracts.

BTW, shouldn't breaking your right arm fix your dyslexia :smartass: We love ya anyway. You could type with your toes or nose and I'd still read what you have to impart

Shannon Bennett · Sep 25, 2006

Re: Controlling diabetes, alt med approach

*snort* It hasn't worked to correct the dyslexia so far. LOL

Niko said:
Shannon,

Bless you! My mom has been struggling to control her type 2 diabetes and I have been looking at alternatives. Problem is, I don't know what sources to trust. Thank you posting the abstracts.

BTW, shouldn't breaking your right arm fix your dyslexia :smartass: We love ya anyway. You could type with your toes or nose and I'd still read what you have to impart

Tomorrow I will tackle the following as the arm allows.

momordica charantia also called karela (bitter melon)
Opuntia (prickly pear cactus)
alpha lipoloic acid
fenugreeek
vanadium

Christian Rivers · Sep 25, 2006

Re: Controlling diabetes, alt med approach

Walking is an excellent intervention for type II diabetes and its complications.
Be sure to attend to foot care. Some work suggests 15 minutes a day is good program. Here is just one abstract off of PubMed. This study used 60 minutes 3x per week. ....

Diabetes Care. 2003 Jan;26(1):24-9.

Randomized controlled community-based nutrition and exercise intervention
improves glycemia and cardiovascular risk factors in type 2 diabetic patients in
rural Costa Rica.

Goldhaber-Fiebert JD, Goldhaber-Fiebert SN, Tristan ML, Nathan DM.

Harvard Medical School, Boston, Massachusetts 02115, USA. sgf@post.harvard.edu

OBJECTIVE: The prevalence of type 2 diabetes, especially in developing
countries, has grown over the past decades. We performed a controlled clinical
study to determine whether a community-based, group-centered public health
intervention addressing nutrition and exercise can ameliorate glycemic control
and associated cardiovascular risk factors in type 2 diabetic patients in rural
Costa Rica. RESEARCH DESIGN AND METHODS: A total of 75 adults with type 2
diabetes, mean age 59 years, were randomly assigned to the intervention group or
the control group. All participants received basic diabetes education. The
subjects in the intervention group participated in 11 weekly nutrition classes
(90 min each session). Subjects for whom exercise was deemed safe also
participated in triweekly walking groups (60 min each session). Glycosylated
hemoglobin, fasting plasma glucose, total cholesterol, triglycerides, HDL and
LDL cholesterol, height, weight, BMI, and blood pressure were measured at
baseline and the end of the study (after 12 weeks). RESULTS: The intervention
group lost 1.0 +/- 2.2 kg compared with a weight gain in the control group of
0.4 +/- 2.3 kg (P = 0.028). Fasting plasma glucose decreased 19 +/- 55 mg/dl in
the intervention group and increased 16 +/- 78 mg/dl in the control group (P =
0.048). Glycosylated hemoglobin decreased 1.8 +/- 2.3% in the intervention group
and 0.4 +/- 2.3% in the control group (P = 0.028). CONCLUSIONS: Glycemic control
of type 2 diabetic patients can be improved through community-based,
group-centered public health interventions addressing nutrition and exercise.
This pilot study provides an economically feasible model for programs that aim
to improve the health status of people with type 2 diabetes.
-C R-

sharon sanders · Aug 30, 2007

PLoS - Grain, Bran, & Germ Intake Reduce Risk of Diabetes Type 2

PLoS - Grain, Bran, & Germ Intake Reduce Risk of Diabetes Type 2

Grain, Bran, and Germ Intake and Risk of Type 2 Diabetes: A Prospective Cohort Study and Systematic Review
Jeroen S. L. de Munter<SUP>1,</SUP><SUP>2</SUP>, Frank B. Hu<SUP>1,</SUP><SUP>3,</SUP><SUP>4</SUP>, Donna Spiegelman<SUP>3,</SUP><SUP>5</SUP>, Mary Franz<SUP>1</SUP>, Rob M. van Dam<SUP>1,</SUP><SUP>2,</SUP><SUP>4</SUP><SUP>*</SUP>
1 Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, United States of America, 2 Institute of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands, 3 Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, United States of America, 4 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, 5 Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts, United States of America

"...Whole grain intake is inversely associated with risk of type 2 diabetes, and this association is stronger for bran than for germ. Findings from prospective cohort studies consistently support increasing whole grain consumption for the prevention of type 2 diabetes...."

http://medicine.plosjournals.org/perlserv/?request=get-document&doi=10.1371/journal.pmed.0040261

sharon sanders · Feb 13, 2008

Re: Controlling diabetes, alt med approach

<arttitle>Brown rice lowers risk of diabetes</arttitle>
13 Feb 2008, 0423 hrs IST

,

Kounteya Sinha

,

TNN

SMS NEWS to 58888 for latest updates

<table border="0" cellpadding="0" cellspacing="0" width="100%"><tbody><tr><td align="left" valign="top"> NEW DELHI: A simple change in your diet can now lower your cholesterol level and protect you against cardiovascular disease, type 2 diabetes, metabolic syndrome and breast and colon cancer.
Doctors, nutritionists and dieticians are now increasingly recommending brown rice as an excellent source of all-round nutrition. Experts say the difference between brown rice and the more popular white rice is not just the colour. White rice actually lacks the necessary quantities of over a dozen important nutrients, including vitamin E, thiamin, niacin, vitamin B1, B3, B6, folacin, potassium, magnesium and iron.

Rice goes through a number of procedures before it's ready for cooking. After harvesting, the seeds are run through a rice huller/husker for milling to remove the outer grain husks. What remains is brown rice. To create white rice, the inner husk is removed and the grain is polished. But this entire procedure actually destroys 67% of the rice's vitamin B3, 80% of its vitamin B1, 90% of its vitamin B6, half of its manganese, half of its phosphorus, 60% of the iron and all of its dietary fibre and essential fatty acids.

Speaking to TOI, V K Arora, CEO of LT Overseas, a company making brown rice, claimed, "Brown rice is a healthy and wholesome meal while white rice is simply a refined starch that is almost entirely bereft of its original nutrients."

Medical experts tend to agree. Charu Dua, dietician with Max Hospital, Saket, said, "More fibre would mean more satiety or feeling of fullness. Because fibre is grossly lacking in white rice, we tend to eat more of it. After about three hours we feel hungry once again. This increases calorie intake, leading to weight gain. We are now asking patients to shift to brown rice." Experts say one cup (195 grams) of cooked long grain brown rice contains 84 mg of magnesium while one cup of white rice contains 19 mg.

Manganese is necessary for a healthy nervous system and in the production of cholesterol, which is used by the body to produce sex hormones.

Also when the bran layer is removed to make white rice, the oil in the bran is removed. Studies have shown that rice bran oil helps lower LDL cholesterol or the bad cholesterol.

R&D head of LT Overseas Kaizar Colombowala said, "Women who eat whole grains like brown rice tend not to add weight. Brown rice minimises colon cancer risk, lowers cholesterol level and provides significant cardiovascular benefits for post-menopausal women. It's a good source of fibre that reduces high cholesterol levels and prevents atherosclerosis and breast cancer." What's more Brown rice can remain in storage for six months under normal conditions.

kounteya.sinha@timesgroup.com

http://timesofindia.indiatimes.com/articleshow/msid-2778152,prtpage-1.cms

</td></tr></tbody></table>

JohnW · Feb 13, 2008

Re: Controlling diabetes, alt med approach

As a type II diabetic, I can confirm the benefits of a low glycemic index diet.

http://www.hsph.harvard.edu/nutritionsource/carbohydrates.html

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