c r e a t i n g h e a l t h n o w

US FIGHTS DIABETES....

12/9/2004 - The US health department yesterday announced a national action plan to stem the rising tide of diabetes, providing supplement manufacturers with plenty of marketing opportunities.

The HHS is describing the initiative as a “step-by-step guide to activities and resources against a disease that affects more than 18 million Americans”.

"The most effective way to bring this problem under control is for government, business, health care providers, schools, communities and the media, as well as people with diabetes and their families to work together," said HHS secretary Tommy Thompson.

The diabetes action plan focuses on specific, attainable action steps such as reducing fat consumption, taking the stairs instead of the elevator and getting screened for diabetes.

The HHS is putting a certain emphasis on the role of the food industry, suggesting the need, for example, for healthy food in vending machines and cafeterias.

The global incidence of the risk factors that cause diabetes, collectively known as the ‘metabolic syndrome’, is soaring. The clinical conditions linked to the metabolic syndrome are obesity, type 2 diabetes, abnormal blood fats and raised blood pressure. Each of these conditions is a risk-factor for the metabolic syndrome in its own right, but if individuals have more than one of these conditions the risk is multiplied.

In most cases, development of the metabolic syndrome is caused by eating too much of the wrong kind of foods and taking too little exercise.

Further research into the impact of diet on these risk factors could however help supplement and functional food makers offer products designed to reduce risk for some of the thousands forecast to develop the disease.

And while there is little evidence so far to support either the safety or efficacy of nutritional supplements in helping to improve diabetes-related conditions, there are some foods and nutrients, such as dark chocolate and magnesium, that warrant further investigation, Dr Michael Quon, chief of the diabetes unit of the US National Center for Complementary and Alternative Medicine (NCCAM) told NutraIngredients.com earlier this year.

Some supplement companies though are convinced their supplement products do help at least those showing early symptoms of diabetes.

Degussa Food Ingredients, for instance, announced last month that it had created a double-fermented wheat product, to be rolled out in Europe, North America and Asia, will be offered as a powder blend, tablets or as a functional food ingredient for beverages, dairy and dessert-type products.

The company is also waiting for results of a human trial on a new herbal extract, said to improve insulin sensitivity. The herbal could launch in the first half of next year.

And, at the beginning of the year, Nutrition 21 submitted a qualified health claim linking chromium picolinate with a reduced risk of insulin resistance, type 2 diabetes and related disease conditions to the FDA. The FDA extended the review period for the claim by 90 days eralier this week.

Trials by the company have found daily supplementation of up to 1,000 mcg of chromium, as chromium picolinate alone or in combination with other therapies, helps reduce the risk of type 2 diabetes and other health conditions associated with insulin resistance.

The rapidly growing incidence of type 2 diabetes in the US (almost 1 million new cases of diabetes are diagnosed every year) has encouraged Nutrition 21 to focus on chromium's effects on insulin over recent months.

Approximately 95 million Americans have some degree of insulin resistance, according to the firm, which holds patents for the therapeutic use of chromium picolinate in addressing insulin resistance and type 2 diabetes.

Pre-diabetes conditions are rising in parallel to the increasing incidence of obesity, now thought to affect more than 1 billion adults overweight, with at least 300 million of them clinically obese. An estimated 24 per cent of the US adult population has metabolic syndrome, a collection of risk factors for type 2 diabetes.

FIGHT CHILDHOOD OBESITY TO HELP PREVENT DIABETES, SAY WHO & IDF

World Health Organization - International Diabetes Federation

Joint Media Release WHO/IDF/81
11 November 2004

Geneva - Worldwide, it is estimated that more than 22 million children under five years old are obese or overweight, and more than 17 million of them are in developing countries. Each of these children is at increased risk of developing type 2 diabetes (which used to be known as mature-onset diabetes), say the World Health Organization (WHO) and the International Diabetes Federation (IDF).

"Tackling childhood obesity now is a highly effective way of preventing diabetes in the future," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health, in the lead-up to World Diabetes Day on 14 November 2004.

Chronic diseases such as diabetes, heart disease, cancer and stroke are a barrier to economic development. While undernutrition continues to be a key concern, particularly in developing countries, governments are also facing up to the fact that many children in all regions of the world have poor eating habits and are not getting enough exercise.

Globally, an estimated 10% of school-aged children, between five and 17 years old, are overweight or obese, and the situation is getting worse. In the United States, for example, the rate of obesity and overweight among children and adolescents aged 6 to 18 years increased to more than 25% in the 1990s from 15% in the 1970s.

Such increases are not restricted to developed countries. In China, the rate of overweight and obesity observed in a study of urban schoolchildren increased from almost 8% in 1991 to more than 12% six years later. In Brazil, the rate of overweight and obesity among children and adolescents 6 to 18 years old more than tripled from 4% in the mid 1970s to over 13% in 1997.

The link between obesity and diabetes is well-established. Around 90% of people with diabetes have type 2 diabetes and of these the vast majority are overweight or obese. "Overweight and obesity increase the risk of many chronic diseases, including type 2 diabetes, heart disease, stroke and some cancers. Unless we address the underlying causes of the obesity epidemic it has the potential to overwhelm health systems throughout the world," said Dr Le Galès-Camus. "The direct health care costs of diabetes already account for between 2.5% and 15% of annual health care budgets."

WHO is working with its Member States throughout the world to implement the Global Strategy on Diet, Physical Activity and Health, which was adopted at the May 2004 World Health Assembly.

The strategy recommends a comprehensive range of changes at the individual, community, national and international levels which, if effectively implemented, have the potential to turn around the obesity epidemic. The strategy addresses changes needed in lifestyles that have been linked to the increase in overweight and obese children over the last twenty years.

Increased availability and promotion of foods high in fat and sugar mean that children no longer eat the way their parents did. Nor do they do the same amount of physical activity. In each country the situation is different, but the reasons why children are less active than a generation ago include increased urbanization and mechanization, changes to transport systems and increased hours spent in front of TVs and computers.

Yet small changes can make a big difference. In Singapore, nutrition education in class, combined with a school environment offering healthy foods and drinks, and special attention for students who were already overweight or obese, resulted in a significant decline in the number of obese students. In the UK, limiting access to sweet, fizzy drinks at a group of primary schools resulted in slimmer children. Other studies have demonstrated success by increasing physical activity in school, making changes to school lunches, limiting hours spent watching TV and providing health education.

Professor Pierre Lefèbvre, President of IDF, underlined the need for urgent action. "Children and adolescents who are overweight tend to grow into overweight adults. Poor habits of nutrition and lack of physical activity are likely to endure, putting today's young people at risk of type 2 diabetes in the future. Even in childhood, overweight and obesity lead to higher levels of blood glucose (sugar), lipid (fat) and blood pressure. In many populations, doctors are seeing increasing numbers of adolescents with type 2 diabetes, a disease that in the past was not normally seen until middle or older age."

Diabetes is a chronic condition that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. People who have type 1 diabetes produce very little or no insulin and require daily injections of insulin to survive. People with type 2 diabetes cannot use insulin effectively. They can sometimes manage their condition with lifestyle measures alone, but oral drugs are often required and, less frequently insulin, in order to achieve good metabolic control. Type 2 diabetes used to be known as non-insulin dependent diabetes or mature onset diabetes.

WHO and IDF are working together to raise awareness about diabetes worldwide. Their joint project, Diabetes Action Now, is supported by a World Diabetes Foundation grant to IDF and by WHO funds.

For more information, please contact Amanda Marlin, WHO/Geneva, Telephone: + 41 22 791 2443, Mobile phone: + 41 76 367 1522, email: marlina@who.int, Anne Pierson - or Lorenzo Piemonte, International Diabetes Federation, Brussels, Telephone: + 322 543 1623, Mobile phone: +32 475 343 788

All WHO Press Releases, Fact Sheets and Features as well as other information on this subject can be obtained on Internet on the WHO home page: http://www.who.int/

Cinnamon solution for diabetes

9/23/2004 - Nutritional supplements supplier Hero Nutritionals has launched a dietary supplement from a water extract of cinnamon, which is designed to promote glucose metabolism by increasing insulin sensitivity.

Water extract of cinnamon has been found in studies by the USDA to promote glucose metabolism in diabetics and reduce LDL cholesterol levels in individuals with type 2 diabetes.
"Cinnulin PF is a water extract of cinnamon which contains active compounds to help control glucose levels without the harmful toxins found in whole cinnamon or fat-soluble extracts," said Dr. Richard Anderson, research scientist at USDA. "That makes CinnaBeticII safe for long-term use in managing symptoms associated with diabetes."

A recent study published in Diabetes Care magazine revealed that individuals treated with cinnamon for a period of 40 days showed decreases in fasting glucose levels of 18 - 29 percent, cholesterol decreases of 12 -26 percent, and decreases in triglycerides of 23 - 30 percent (Khan, A, et al. Diabetes Care 26:3215-3218, 2003).

Moreover, according to recent USDA research spearheaded by Dr. Anderson, the water extraction process leaves type-A polymers responsible for glucose metabolism intact, while removing potentially dangerous compounds found in cinnamon (Anderson, R, et al. J. Agric. Food Chem. 52:65-70, 2004).

"CinnaBeticII offers diabetes sufferers an all-natural, clinically proven safe and effective means to help manage blood glucose metabolism and reduce cholesterol levels," said Jennifer Hodges, founder and CEO of Hero Nutritionals.

Diabetes increased by one-third during the 1990s, due to the prevalence of obesity and an aging population. There are currently more than 194 million people with diabetes worldwide but if nothing is done to slow the epidemic, the number will exceed 333 million by 2025, according to the International Diabetes Federation.

Diabesity

by Kim Schoenhals

Diabetes Facts · Diabesity References

The overwhelming number of Americans who are obese is coupled with an equally startling number of Americans who are being diagnosed with Type II diabetes. Because the link between diabetes and obesity is so strong, the combination has been termed "diabesity." Although the numbers are growing, not all hope is lost. There are several dietary, lifestyle and supplemental options available for reducing the risk of developing Type II diabetes, even in this day and age of fast food and channel surfing.

Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both," according to the National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK), a branch of the National Institutes of Health (NIH). Simply put, diabetes is a metabolic disorder in which food is inefficiently converted into energy. Diabetes is generally diagnosed in two forms: Type I and Type II.

Type I diabetes occurs when the body's immune system attacks the pancreas, which is responsible for making the insulin that regulates blood glucose (blood sugar). This form of diabetes is most commonly diagnosed during childhood, hence its former moniker "juvenile-onset diabetes." Type I diabetes, which is treated with daily insulin injections, accounts for 5 percent to 10 percent of all diagnosed diabetes cases, according to NIDDK.

Type II diabetes, on the other hand, accounts for approximately 90 percent of all diabetes cases. Type II is known as non-insulin-dependent (formerly adult-onset) diabetes. "It usually begins as insulin resistance, a disorder in which the cells do not use insulin properly," NIDDK noted. While the need for insulin increases, the pancreas has a harder time producing it.

Type II diabetes has reached pandemic proportions in the United States, according to Earl Mindell, R.Ph., Ph.D., author of Earl Mindell's Natural Remedies for 101 Ailments (Basic Health Publications, 2002). The increasing number of diabetics in the United States is arguably due to poor diet and nutrition, as well as a cultural sedentary lifestyle. "When you have 37 million people now out of the approximately 300 million in the United States and Puerto Rico, you have 10 percent of the population with diabetes, and [experts] expect it to double within the next 10 years," Mindell said. "That's pretty frightening, and it's getting younger. So what can you do about it? Diet and weight are the biggest things."

According to researchers from the Harvard School of Public Health in Boston, the Western diet that consists of highly processed sugars and carbohydrates, red meat and fried foods is associated with a "substantially increased risk" for Type II diabetes in men. However, a "prudent" diet consisting of vegetables, fruit, fish, poultry and whole grains is generally associated with a decreased risk, as is regular exercise.1

As for obesity, body weight is the No. 1 predictor of Type II diabetes: an estimated 80 percent of all Type II diabetics are overweight. However, losing weight can significantly reduce the risk of Type II diabetes. The Diabetes Prevention Program at the Department of Health and Human Services (HHS) found that diet and exercise resulting in a 5-percent to 7-percent loss of body weight lowered the incidence of Type II diabetes by 58 percent.

There are several red flags that can crop up to indicate Type II diabetes may become a problem in the foreseeable future. "Pre-diabetes," as it was labeled by NIDDK, is a condition in which blood glucose levels are higher than normal, but not yet diabetic. Pre-diabetes affects an estimated 16 million Americans, according to NIDDK, and it sharply increases the risk of developing Type II diabetes. HHS-supported research showed that most people with pre-diabetes will develop diabetes within a decade unless they change their diet and level of physical activity.

"The good news is if you have pre-diabetes, you can do something about it," HHS Secretary Tommy Thompson said in a press release from NIDDK. "We want people to know that pre-diabetes is a serious condition that can be reversed or alleviated with modest changes in their daily routines--such as eating fewer calories and walking regularly for exercise."

Another indicator of a potential Type II diabetes diagnosis is metabolic syndrome--characterized by abdominal obesity, elevated triglyceride levels, low levels of high-density lipoprotein (HDL or "good") cholesterol, high blood pressure and high blood sugar. Researchers who analyzed data from the Third National Health and Nutrition Examination Survey found that 21.8 percent of 8,814 men and women exhibited at least three symptoms of metabolic syndrome. Age was a significant indicator for the presence of more than three symptoms. Almost half (43.5 percent) of the oldest participants in this study (aged 60 to 69) had at least three symptoms of metabolic syndrome, while only 6.7 percent of the younger participants (aged 20 to 29) did. "These results from a representative sample of U.S. adults show that the metabolic syndrome is highly prevalent," the researchers concluded. "The large numbers of U.S. residents with the metabolic syndrome may have important implications for the health care sector."2

Because Type II diabetes generally begins as insulin resistance and is associated with obesity and a poor diet, nutritional and dietary changes may improve the body's resistance to insulin and reverse the final outcome of Type II diabetes. In the case of pre-existing diabetes, diet and lifestyle changes may improve glucose tolerance, as well as reduce the risk of chronic disease states that are associated with Type II diabetes. Currently, there are several dietary supplements touted for being able to accomplish these goals, and the research behind these ingredients is promising.

Assorted Antioxidants

Diabetes is often associated with conditions such as heart disease, diabetic retinopathy (which can lead to blindness), immune deficiencies and kidney disease. Many of these complications are arguably caused, in part, by free radical damage. For this reason, antioxidants are often thought to be helpful for diabetes patients. Additionally, in the process of normalizing insulin and glucose regulation, antioxidants become especially important. "When you start to [normalize insulin and glucose regulation], your need for antioxidants is greater than ever," Mindell said. "So, a complete multivitamin/mineral that's rich in antioxidants is essential."

The always popular antioxidant vitamin C is thought to be useful for diabetics, as the nutrient is typically found at low levels in those who have Type II diabetes.3 In addition, it is thought that the high blood sugar levels associated with diabetes may cause a deficiency of vitamin C in the body's immune cells, which could affect the patient's ability to heal.4

Taking a vitamin C supplement can improve plasma levels of the nutrient, according to researchers from the Heart Protection Study Collaborative Group. They saw a one-third increase in plasma vitamin C with supplementation in adults who had heart disease or diabetes. In addition, researchers noted that plasma alpha-tocopherol (an isomer of vitamin E) levels doubled with vitamin C supplementation.5

Vitamin E supplementation may have similar effects. When combined with insulin treatment, vitamin E supplementation may increase plasma vitamin C and E levels in patients with Type II diabetes.6

Another antioxidant, coenzyme Q10 (CoQ10), is a fat-soluble, vitamin-like compound that is thought to play a role in insulin production. In fact, a deficiency of CoQ10 may impair the function and activity of glycerol-3-phosphate dehydrogenase (G3PD), an enzyme that helps control insulin production. G3PD is not as efficient in Type II diabetics as it is in non-diabetics.7

CoQ10 is probably most well-known for its application in protecting against heart disease, which is common in diabetes cases. CoQ10 supplementation has been suggested as a helpful complementary therapy for patients with diabetes-associated heart disease, although diabetics who took 100 mg/d of CoQ10 did not exhibit a change in metabolism.8

On the bright side, CoQ10 supplementation may reduce the risk of developing Type II diabetes by enhancing the body's production of cellular energy, according to researchers from Bastyr University in Kenmore, Wash. They noted there is a link between the various hang-ups in energy production--such as genetic disturbances in mitochondrial DNA or malfunctions in mitochondrial function--and Type II diabetes.9

Alpha-lipoic acid (ALA) is an antioxidant substance produced by the body that may affect insulin and blood sugar metabolism in Type II diabetics.10 Also known as alpha-lipoate or thiotic acid, ALA may also improve glucose metabolism.11

An antioxidant mineral, selenium is commonly deficient in the immune cells of Type II diabetics.12 Selenium supplementation is thought to stave off free radical damage commonly associated with Type II diabetes, thereby protecting against chronic disease. Animal research conducted in Turkey indicated that selenium, when given in combination with vitamin E, protected against oxidative damage to the blood, liver and muscle.13

Two more minerals that have antioxidant powers are zinc and chromium. Supplementation with 30 mg/d of zinc and 400 mcg/d of chromium (as chromium pidolate) demonstrated antioxidant effects in individuals with Type II diabetes. Researchers concluded these results were particularly important in light of the negative outcomes associated with oxidative stress in people with diabetes.14

Zinc deficiency is associated with a number of metabolic disorders, including impaired glucose tolerance, insulin degradation, decreased insulin potency and reduced pancreatic insulin content.15 In clinical studies, zinc supplementation improved diabetic animals' and humans' glucose tolerance.16,17

The various forms of trivalent chromium (chromium III, not to be confused with the toxic hexavalent chromium, chromium VI, that was featured in Erin Brockovich) have been studied extensively in terms of improving insulin regulation. In fact, chromium's primary function in the body is to support the effects of insulin and enhance glucose, amino acid and fat metabolism.

"[Chromium] seems to overcome insulin resistance," said Harry G. Preuss, M.D., M.A.C.N., C.N.S., professor of physiology, medicine and pathology at Georgetown University in Washington, D.C. "We have shown that time and again by different means. If you take enough [chromium], it overcomes insulin resistance. ... Many people feel the effect you're getting--overcoming insulin resistance with chromium--is due to overcoming a chromium deficiency. I've argued it may be over and beyond that as well. I think taking a little extra chromium could have--and then we get into semantics--a 'pharmacologic' effect. But in any sense, taking chromium can overcome insulin resistance, which is associated with a lot of problems: heart disease, diabetes, obesity, lipid problems, cholesterol problems."

Chromium deficiency, which is more likely to occur in the elderly and athletes, can also develop from consuming a high intake of simple sugars and refined foods over a long period of time. These simple sugars and carbs can increase the amount of chromium passed in the urine, thereby promoting chromium deficiency.

One form of trivalent chromium thought to support blood sugar regulation is chromium picolinate. Human subjects taking chromium picolinate supplements (as Chromax®, manufactured by Purchase, N.Y.-based Nutrition 21) exhibited significant drops in fasting blood sugar and serum insulin levels, as well as serum cholesterol levels.18 Because of its effects on insulin levels, chromium picolinate may also be useful for pre-diabetes. Supplementation with chromium picolinate (as Chromax) was found to increase insulin sensitivity by an average of 40 percent in overweight, non-diabetic volunteers.19

Niacin-bound chromium, also known as chromium polynicotinate or chromium nicotinate, is another trivalent variety of the mineral that has been studied for its possible use against Type II diabetes, insulin resistance and obesity. "Chromium polynicotinate seems to have a critical role in the proper use of sugar and may help lower blood sugar levels in people--especially those with Type II diabetes," wrote Peter A. Lodewick, M.D., in A Diabetic Doctor Looks at Diabetes: His and Yours (Southern Publishers Group, 1997). "In addition, many recent studies have demonstrated that its other important effects might include raising good HDL while lowering total blood cholesterol, lowering body fat while increasing lean body muscle mass, and reversing vascular disease."

Research combining the use of niacin-bound chromium (as ChromeMate®, manufactured by InterHealth Nutraceuticals in Benicia, Calif.) with an exercise regimen demonstrated the treatment induced weight loss and lowered insulin response to an oral glucose load in overweight women.20

Brewer's yeast is another dietary source of chromium studied in human subjects with Type II diabetes. Researchers have found brewer's yeast supplementation improved subjects' glucose control.21

Vitamins & Minerals

In addition to those nutrients that have antioxidant properties, there are several vitamins and minerals that are able to promote good health and potentially stave off insulin resistance and diabetes. "We are trained in America to be sickness experts: We know everything about sickness, nothing about health," Mindell said. "This is one of the few countries where if you are interested in your health, you are called a 'nut'--a health nut. But if you're a sickie and take every drug in the book, you are part of the establishment. And that's changing a little bit because it's very expensive to be sick. Now, what can you do to better your health? The No. 1 thing: We should all be taking a multiple vitamin and mineral."

Some of the B vitamins have been studied especially for their role in insulin and glucose regulation. Niacin (vitamin B3), for example, may protect circulatory health in diabetics. While supplementation with niacin has been discouraged in Type II diabetics because high doses may worsen glycemic control, low-dose niacin therapy (1,000 to 1,500 mg/d) might alleviate diabetic dyslipidemia, a condition characterized by high triglyceride levels, low HDL levels, small and dense LDL particles, and high free fatty acid levels.22 Similar results were found by researchers in California. Niacin was deemed an effective treatment for diabetic dyslipidemia, although researchers stated niacin therapy should be used as a complement to traditional therapies such as oral hypoglycemic (glucose-lowering) medication or insulin treatment.23

Similar to hypoglycemic agents, the water-soluble B vitamin biotin may also have a glucose-lowering effect. In an animal model, biotin supplementation was found to decrease glucose levels after a meal, as well as improve glucose tolerance and insulin resistance.24 Human subjects in Japan also demonstrated this effect of biotin supplementation. Patients with Type II diabetes demonstrated significant drops in their fasting glucose levels after taking 3 mg of biotin three times per day.25

Aside from vitamins, there are a couple of minerals also purported to relieve symptoms of insulin resistance and diabetes. Magnesium, for example, is thought to be involved in glucose metabolism and insulin secretion, and low magnesium levels are known to aggravate diabetic conditions. Magnesium deficiency occurs in approximately 25 percent of diabetic patients.

The trace mineral vanadium--the active and absorbable forms of which are vanadium pentoxide and vanadyl sulfate--has been given attention recently for its potential application in the realm of diabetes treatment. Animal research has demonstrated that supplementation with vanadyl sulfate or other vanadium compounds may be useful for treating diabetes by normalizing glucose levels.26 Another study indicated vanadium supplementation may induce these beneficial effects for up to 20 weeks after therapy is stopped. Researchers surmised the vanadium supplements somehow protect pancreatic cells.27

A human study of Type II diabetes indicated oral vanadyl sulfate (50 mg twice daily for four weeks) induced a nearly 20-percent drop in fasting blood glucose levels.28 In another study, supplementation with 100 mg of vanadyl sulfate daily for three weeks resulted in improved insulin sensitivity.29

From the Garden

While micronutrients are essential to the body's process of regulating insulin and glucose levels, several herbs and plant-derived compounds are thought to assist and even improve these same processes. In addition, some botanicals may also reduce the risks of diabetes-associated chronic disease.

Ginseng, for example, is thought to reduce risk factors for heart disease, as well as improve several symptoms of diabetes. Ginseng is an adaptogen that works on a cellular level to rid the body of toxins and restore normal body function. The active constituents of ginseng, which are triterpenoid saponins called ginsenosides, are thought to be responsible for the herb's pharmacological activity. Two varieties of ginseng that have been studied in the realm of diabetes care include Panax quinquefolius (American) and Panax ginseng (Asian).

American ginseng is thought to reduce hyperlipidemia and hypertension, as well as reduce insulin resistance.30 American ginseng supplementation was also found to improve the increase in glucose levels typically seen after food intake. Researchers stated the herb improved patients' glycemic response to food, and this response was seen regardless of the dose size or when the supplement was taken with respect to a meal.31

Asian ginseng--and its active constituent ginsenoside Re--is thought to prevent high blood sugar levels and protect against obesity, as demonstrated in animal research. Investigators found that ginseng supplementation improved glucose tolerance and reduced serum insulin levels, and extract-treated mice developed normal glucose levels after 12 days of therapy.32

Another botanical that may be useful against diabetes is fenugreek (Trigonellafoenum graecum). Diabetic animals given fenugreek achieved normal antioxidant levels and had reduced diabetes-associated oxidative damage.33 In addition, fenugreek supplementation may improve glycemic control and decrease insulin resistance in cases of mild Type II diabetes.34

An extract of Lagerstroemia speciosa L. is said to benefit diabetics by helping with weight management and by controlling plasma glucose. Animal research demonstrated that supplementation with the extract had a beneficial effect on female diabetic mice.35 Additional research with Type II diabetic animals indicated supplementation with the extract lowered blood sugar levels.36

A botanical used in Ayurveda for more than 2,000 years, gymnema (Gymnema sylvestre, Gymnema inodorum) is called "Gurmar" in Indian, meaning "sugar destroyer." It attained this name because chewing the leaves neutralizes the taste buds, thereby taking away the ability to taste sugar. For this reason, gymnema is sometimes recommended for weight loss because it is said to alleviate sugar cravings.

Gymnema is also suspected to have applications in diabetes and pre-diabetes, and it may increase insulin secretion. "We suggest that a person take gymnema as an adjuvant therapy [for diabetes] and monitor blood sugar levels to measure the response to gymnema," said P.K. Davé, president of Albany, N.Y.-based Nature's Formulary. "If the product works so well that conventional medication dosage can be reduced--and yes, there is evidence of this--we advise that this be done under the direction and supervision of a doctor."

Gymnemic acids derived from Gymnema inodorum are thought to suppress the elevation of blood glucose levels by inhibiting glucose uptake in the intestine.37 Similarly, animal research conducted in Japan demonstrated that consuming gymnemic acid IV--an extract of Gymnema sylvestre--reduced blood glucose levels in diabetic mice within 24 hours while it did not affect the blood glucose levels of healthy mice. In addition, the diabetic mice given the extract exhibited increased plasma insulin levels.38

In vitro research further elucidated the role gymnema plays in regulating insulin and glucose levels. Pancreas cell lines treated with an alcoholic extract of Gymnema sylvestre released more insulin than untreated cells.39

Similar to the gymnemic acids that can be extracted from gymnema, flavonoids can be extracted from various plants. Flavonoids are water-soluble pigments found in plants, and they are known antioxidants. In addition, several flavonoids have been suggested as potentially beneficial for diabetics.

The anthocyanosides found in bilberry are known for their benefits in heart and eye health. However, research out of France indicated that perhaps anthocyanosides can slow kidney damage in diabetic patients by reducing the amount of albumin (a serum protein) that escapes from leaky capillaries-- a condition commonly associated with diabetes. The French animal study indicated that diabetic rats supplemented with bilberry anthocyanosides had less albumin leakage than diabetic rats that were not given supplements.40

Grape seed extract also contains a group of flavonoids, which are known as proanthocyanidins. Researchers at Georgetown University in Washington investigated the effects of grape seed extract (as ActiVin, the patent for which is owned by San Joaquin Valley Concentrates in Modesto, Calif.), as well as niacin-bound chromium (as ChromeMate), for its effects on insulin resistance. They found the proanthocyanidin extract induced an improvement of insulin sensitivity and stopped free radicals from forming.41

Another group of flavonoids--the isoflavones found in soy--may be of potential use for diabetic patients. Soy isoflavones are also classified as phytoestrogens, similar to the lignans found in flaxseed, and both have been studied under the umbrella of diabetes care. A research review written by Sam J. Bhathena, Ph.D., and colleagues at the Phytonutrients Laboratory of the U.S. Department of Agriculture indicated daidzein and genistein (soy isoflavones), and matairesinol and secoisolariciresinol (flaxseed lignans) have anti-obesity and anti-diabetes actions.

"Nutritional intervention studies performed in animals and humans suggest that the ingestion of soy protein associated with isoflavones and flaxseed rich in lignans improves glucose control and insulin resistance," Bhathena and his colleagues wrote in a paper that has been submitted for review to the American Journal of Clinical Nutrition. "In animal models of obesity and diabetes, soy protein has been shown to reduce serum insulin and insulin resistance. In studies of human subjects with or without diabetes, soy protein also appears to moderate hyperglycemia and reduce body weight, hyperlipidemia and hyperinsulinemia, supporting their beneficial effects in obesity and diabetes. ... Isoflavones and lignans appear to act through various mechanisms that modulate pancreatic insulin secretion or through antioxidative actions."

Fats: The Good and the Bad

The word "fat" invariably brings to mind a negative image, and when the word is part of a food label, many consumers are turned off by its presence. The National Academy of Sciences issued a report in September saying no amount of trans-fat is healthy for human consumption, and it is well-known that saturated fat intake is a risk for heart disease. In addition, "bad" fat intake may up one's odds of developing Type II diabetes.

Researchers at the Harvard School of Public Health evaluated the Health Professionals Follow-Up Study--a cohort of 42,504 men--and found saturated and total fat intake increased diabetes risk. Specifically, processed meats were the suggested culprit behind a high risk of Type II diabetes.42

While some fats are undoubtedly bad for human health, there are several fats that are thought to improve heart, brain and metabolic health. Fatty acids, for example, are an important part of normal body function.

The human body can produce all but two groups of fatty acids--omega-3s and omega-6s--which are known as essential fatty acids (EFAs) because they must be obtained through the diet. These so-called "good" fats are suspected to improve the odds against developing Type II diabetes.

Researchers in Massachusetts learned that taking omega-3 and omega-6 long-chain EFA supplements suppressed the development of diabetes. Animals that were given the omega-3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), as well as the omega-6s gamma-linolenic acid (GLA) and arachidonic acid (AA), were less likely to develop chemical-induced diabetes than the animals receiving no supplements. The EFA regimen was also found to restore the animals' antioxidant status to normal range.43

DHA has also been studied independently for pre-diabetes. Overweight, pre-diabetic subjects who took DHA supplements for 12 weeks had significantly improved insulin sensitivity. "Although these are very preliminary results from a small number of subjects, we were encouraged by the findings and plan to test the effect of DHA on a larger population," said Yvonne Denkins, Ph.D., lead investigator, in a press release from the Pennington Biomedical Research Center, in Baton Rouge, La. Denkins presented her findings in New Orleans at Experimental Biology 2002.

GLA has also been linked to improved insulin resistance, and levels of this EFA may determine diabetes risk as early as the fetal stage. The highest concentrations of insulin were seen in 7-year-old children who had both a low birth weight and a low GLA concentration.44

Evening primrose oil, which contains GLA, has also been studied in the realm of diabetes. Evening primrose oil supplementation was found to completely prevent the restriction of a metabolic pathway that is present in diabetes.45

In addition to the essential fatty acids, there are several non-essential fatty acids that are produced in small amounts in the body and may be useful for preventing diabetes and insulin resistance. Oleic acid, an omega-9 long-chain fatty acid, may inhibit the production of glucose. Animal research indicated oleic acid supplementation significantly increased insulin response to oral glucose.46 In addition, supplemental oleic acid may lead to a reduction in food intake.47

An Ongoing Battle

The battle to overcome Type II diabetes and pre-diabetes can only be won with proper knowledge. The science behind various diet and lifestyle choices, as well as the nutrients in dietary supplements, offers a light at the end of the tunnel. Type II diabetes is not unstoppable, and there are several ways to ensure and maintain good health.

The myriad options in the dietary supplement industry may seem a bit daunting to consumers, who are bombarded with hundreds of products and promises for good health. And yet, many consumers prefer to be in charge of their own health care, seeking out the latest research and products for their own benefit.

"While company literature and industry consumer information Web sites display the disclaimer 'Please see a physician before...,' the health food store consumer is looking for a natural alternative to either supplement or replace conventional medicines," Davé said. "I am sure this aspect is not new to retailers. Despite DSHEA [the Dietary Supplement Health and Education Act], retailers get put in the position of answering the question, 'What do you have for diabetes?'"

This is where having third-party literature on-hand is helpful. An up-to-date literature section allows customers to browse scientific information to make an informed decision about what supplements to buy. "Each health food store should have a good part of their store as a health information area where they're bringing this information to the public," Mindell said. "The retailer's responsibility, if they want to stay in business, is to become a health information center."

Gaining the proper knowledge is only the first step in a consumer's life-long journey to consistent health and wellness. Eating a healthy diet and sticking with an exercise routine are essential to preventing or reducing the deleterious effects of Type II diabetes. Once diabetes is established, it is forever, according to Mindell, and lifestyle changes are not to be taken lightly. "It's not going to be a week or a weekend, you have to do it every day, every meal," Mindell said. "If you're a diabetic, you're always a diabetic. And if you let yourself go, sooner or later you'll have problems with your eyesight, congestive heart failure, sexual dysfunction. It's a terrible thing that can be prevented."

Editor's notes: Some content for this story was sourced from Intramedicine (www.intramedicine.com).

Diabetes Facts

73% of people with diabetes have high blood pressure.
17 million people have diabetes (6.2% of the population).
11.1 million have been diagnosed with diabetes.
5.9 million people are undiagnosed.
1 million new cases of diabetes are diagnosed each year.
7 million age 65 or over (20.1% of all people in this age group) have diabetes.
Source: The Centers for Disease Control and Prevention, National Diabetes Fact Sheet, 2002.

Diabesity References

1. van Dam RM et al. “Dietary patterns and risk for Type 2 diabetes mellitus in U.S. men.” Ann Intern Med, 136:201-9, 2002.

2. Ford ES et al. “Prevalence of the metabolic syndrome among U.S. adults.” JAMA, 287, 3:356-9, 2002.

3. Sinclair AJ et al. “Low plasma ascorbate levels in patients with type 2 diabetes mellitus consuming adequate dietary vitamin C.” Diabet Med, 11, 9:893-8, 1994.

4. Pecoraro RE, Chen MS. “Ascorbic acid metabolism in diabetes mellitus.” Ann N Y Acad Sci, 498:248-58, 1987.

5. Heart Protection Study Collaborative Group. “MRC/BHF Heart Protection Study of antioxidant vitamin supplementation in 20,536 high-risk individuals: a randomized placebo-controlled trial.” Lancet, 360, 9326:23-33, 2002.

6. Park S, Choi SB. “Effects of alpha-tocopherol supplementation and continuous subcutaneous insulin infusion on oxidative stress in Korean patients with type 2 diabetes.” Am J Clin Nutr, 75, 4:728-33, 2002.

7. McCarty MF. “Can correction of sub-optimal coenzyme Q status improve beta-cell function in type II diabetics?” Med Hypotheses, 52, 5:397-400, 1999.

8. Eriksson JG et al. “The effect of coenzyme Q10 administration on metabolic control in patients with type 2 diabetes mellitus.” Biofactors, 9, 2-4:315-8, 1999.

9. Lamson DW, Plaza SM. “Mitochondrial factors in the pathogenesis of diabetes: a hypothesis for treatment.” Altern Med Rev, 7, 2:94-111, 2002.

10. Nagamatsu M et al. “Lipoic acid improves nerve blood flow, reduces oxidative stress, and improves distal nerve conduction in experimental diabetic neuropathy.” Diabetes Care, 18:1160-7, 1995.

11. Khanna S et al. “Cytokine-induced glucose uptake in skeletal muscle: redox regulation and the role of alpha-lipoic acid.” Am J Physiol, 276, 5 pt 2:R1327-33, 1999.

12. Ekmekcioglu C et al. “Concentrations of seven trace elements in different hematological matrices in patients with type 2 diabetes as compared to healthy controls.” Biol Trace Elem Res, 79, 3:205-19, 2001.

13. Naziroglu M, Cay M. “Protective role of intraperitoneally administered vitamin E and selenium on the antioxidative defense mechanism in rats with diabetes induced by streptozotocin.” Biol Trace Elem Res, 79, 2:149-59, 2001.

14. Anderson RA et al. “Potential antioxidant effects of zinc and chromium supplementation in people with type 2 diabetes mellitus.” J Am Coll Nutr, 20, 3:212-8, 2001.

15. Song MK et al. “Animal prostate extract ameliorates diabetic symptoms by stimulating intestinal zinc absorption in rats.” Diabetes Res, 31:157-70, 1996.

16. Tobia MH. “The role of dietary zinc in modifying the onset and severity of spontaneous diabetes in the BB Wistar rat.” Mol Genet Metab, 63, 3:205-13, 1998.

17. Gupta R. “Oral zinc therapy in diabetic neuropathy.” J Assoc Physicians India, 46, 11:939-42, 1998.

18. Anderson RA et al. “Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes.” Diabetes, 46, 11:1786-91, 1997.

19. Cefalu WT et al. “Effect of chromium picolinate on insulin sensitivity in vivo.” J Trace Elem Experimental Med, 12:71-83, 1999.

20. Crawford V et al. “Effects of niacin-bound chromium supplementation on body composition in overweight African-American women.” Diabetes, Obes Metab, 1:1-7, 1999.

21. Bahijri SM, Mufti AM. “Beneficial effects of chromium in people with type 2 diabetes, and urinary chromium response to glucose load as a possible indicator of status.” Biol Trace Elem Res, 85, 2:97-109, 2002.

22. Grundy SM et al. “Efficacy, safety and tolerability of once-daily niacin for the treatment of dyslipidemia associated with type 2 diabetes: results of the assessment of diabetes control and evaluation of the efficacy of niaspan trial.” Arch Intern Med, 162, 14:1568-76, 2002.

23. Pan J et al. “Niacin treatment of the atherogenic lipid profile and Lp(a) in diabetes.” Diabetes Obes Metab, 4, 4:255-61, 2002.

24. Reddi A et al. “Biotin supplementation improves glucose and insulin tolerances in genetically diabetic KK mice.” Life Sci, 42, 13:1323-30, 1988.

25. McCarty MF. “High-dose biotin, an inducer of glucokinase expression, may synergize with chromium picolinate to enable a definitive nutritional therapy for type II diabetes.” Med Hypotheses, 52, 5:401-6, 1999.

26. Sakurai H. “A new concept: the use of vanadium complexes in the treatment of diabetes mellitus.” Chem Rec, 2, 4:237-48, 2002.

27. Cam MC et al. “Partial preservation of pancreatic beta cells by vanadium: evidence for long-term amelioration of diabetes.” Metabolism, 46, 7:769-78, 1997.

28. Boden F et al. “Effects of vanadyl sulfate on carbohydrate and lipid metabolism in patients with non-insulin dependent diabetes mellitus.” Metabolism, 45, 9:1130-5, 1996.

29. Cohen N et al. “Oral vanadyl sulfate improves hepatic and peripheral insulin sensitivity in patients with non-insulin dependent diabetes mellitus.” J Clin Invest, 95, 6:2501-9, 1995.

30. Vuksan V et al. “Konjac-Mannan and American ginseng: emerging alternative therapies for type 2 diabetes mellitus.” J Am Coll Nutr, 20, 5 Suppl:370S-380S; discussion 381S-383S, 2001.

31. Vuksan V et al. “Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes.” Diabetes Care, 23, 9:1221-6, 2000.

32. Attele AS et al. “Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component.” Diabetes, 51, 6:1851-8, 2002.

33. Genet S et al. “Alterations in antioxidant enzymes and oxidative damage in experimental diabetic rat tissues: effect of vanadate and fenugreek (Trigonellafoenum graecum).” Mol Cell Biochem, 236, 1-2:7-12, 2002.

34. Gupta A et al. “Effect of Trigonella foenum-graecum (fenugreek) seeds on glycaemic control and insulin resistance in type 2 diabetes mellitus: a double blind placebo controlled study.” J Assoc Physicians India, 49:1057-61, 2001.

35. Suzuki Y et al. “Antiobesity activity of extracts from Lagerstroemia speciosa L. leaves on female KK-Ay mice.” J Nutr Sci Vitaminol (Tokyo), 45, 6:791-5, 1999.

36. Kakuda T et al. “Hypoglycemic effect of extracts from Lagerstroemia speciosa L. leaves in genetically diabetic KK-AY mice.” Biosci Biotechnol Biochem, 60, 2:204-8, 1996.

37. Shimizu K et al. “Suppression of glucose absorption by extracts from the leaves of Gymnema inodorum.” J Vet Med Sci, 59, 9:753-57, 1997.

38. Sugihara Y et al. “Antihyperglycemic effects of gymnemic acid IV, a compound derived from Gymnema sylvestre leaves in streptozotocin-diabetic mice.” J Asian Nat Prod Res, 2, 4:321-7, 2000.

39. Persaud SJ et al. “Gymnema sylvestre stimulates insulin release in vitro by increased membrane permeability.” J Endocrinol, 163, 2:207-12, 1999.

40. Cohen-Boulakia F et al. “In vivo sequential study of skeletal muscle capillary permeability in diabetic rats: effect of anthocyanosides.” Metabolism, 49, 7:880-5, 2000.

41. Preuss HG et al. “Protective effects of a novel niacin-bound chromium complex and a grape seed proanthocyanidin extract on advancing age and various aspects of syndrome X.” Ann N Y Acad Sci, 957:250-9, 2002.

42. van Dam RM et al. “Dietary fat and meat intake in relation to risk of type 2 diabetes in men.” Diabetes Care, 25, 3:417-24, 2002.

43. Krishna MI, Das UN. “Prevention of chemically induced diabetes mellitus in experimental animals by polyunsaturated fatty acids.” Nutrition, 17, 2:126-51, 2001.

44. Rump P et al. “Components of the insulin resistance syndrome in seven-year-old children: relations with birth weight and the polyunsaturated fatty acid content of umbilical cord plasma phospholipids.” Diabetologia, 45, 3:349-55, 2002.

45. Jack A et al. “Effects of diabetes and evening primrose oil treatment on responses of aorta, corpus cavernosum and mesenteric vasculature in rats.” Life Sci, 71, 16:1863, 2002.

46. Minami A et al. “Effect of eicosapentaenoic acid ethyl ester v. oleic acid-rich safflower oil on insulin resistance in type 2 diabetic model rats with hypertriacylglycerolaemia.” Br J Nutr, 87, 2:157-62, 2002.

47. Silvana O et al. “Central administration

Fighting Diabetes the Natural Way

by Brooke K. Deets

References

Obesity and diabetes often go hand-in-hand, and both epidemics are increasing public health concerns in the United States. In today’s fast-paced world, more people consume a poor diet, face excessive stress and don’t get as much physical exercise as is recommended. Fortunately, all three factors are well within a person’s control, which is good news because diabetes (specifically Type II) and prediabetes are first and foremost nutritional diseases. Both respond amazingly well to a combination of proper diet, regular physical activity and the judicious use of certain dietary supplements.

Diabetes is a disabling, deadly disease that is on the rise, particularly in the United States. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), an estimated 18.2 million Americans—6.3 percent of the population—have diabetes; however, an estimated 5.2 million of those have not yet been diagnosed. And the numbers are growing: in 2000, approximately 17 million—or 6.2 percent of the population—were estimated to have diabetes, either diagnosed or not. Overall, diabetes was the sixth leading cause of death in the United States in 2002, and the excessive relative risk for death among people with the disease is about twice that of people without.

Diabetes is actually a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both. It brings with it problems associated with blood sugar and insulin, and other serious complications including heart disease and stroke, high blood pressure, blindness, kidney disease, amputations and dental disease. Fortunately, diabetes is often preventable and controllable in many cases. Maintenance of healthy blood sugar levels through a proper diet and regular exercise may control and, in many cases, reverse diabetes.

The body’s ability (or lack thereof) to use insulin is the underlying factor for this metabolic disorder. In a person with a normal metabolism, food is broken down into glucose, a form of sugar found in the blood and one of the body’s main sources of energy. During digestion, glucose is released into the bloodstream and into the body’s cells by way of insulin, where it is used for energy and growth. But when the body cannot properly use insulin (as in Type II) or cannot produce it (as in Type I) to transport glucose into the body’s cells, that glucose builds up in the blood and is excreted through urine. The body is then left without its main source of fuel.

Type I diabetes, formerly called insulin-dependent diabetes or juvenile-onset diabetes, is an autoimmune disease, in which the immune system turns against the body it is supposed to protect. In the case of Type I diabetes, the immune system attacks and destroys pancreatic beta cells, which are the only cells that make the hormone insulin. Because of this, Type I diabetics must take daily doses of insulin. This form of diabetes may account for 5 percent to 10 percent of diagnosed diabetes cases and most often develops in young children and adults, although disease onset can occur at any time. Men and women are equally impacted by the disease, although Caucasians are more likely to have the disease than non-Caucasians.

The more common kind of diabetes, Type II, is found in about 90 percent to 95 percent of diagnosed diabetes cases. This form of diabetes was formerly called non-insulin dependent diabetes or adult-onset diabetes. However, the latter term is considered passé as the incidence of Type II has skyrocketed in all age groups—even children and adolescents are developing the disease more so than in years past.1 Type II diabetes usually begins as insulin resistance, a condition in which the body does not respond to insulin efficiently, and can develop into Type II diabetes over time (although not everyone with insulin resistance will go on to develop diabetes). People over age 40 who are overweight and lead an inactive lifestyle are most at risk for developing Type II diabetes, and in the United States, the disease is most prevalent among non-Caucasians, such as Native Americans, blacks and Hispanics. As previously mentioned, many Type II diabetics are able to control their condition by way of lifestyle interventions such as diet and exercise, but some, like Type I diabetics, must take insulin and/or other medications to control their blood sugar.

Diet specifically plays a role in insulin resistance. For example, high carbohydrate foods, such as breads, sweets and flour- and sugar-based snack foods cause a rapid increase in blood sugar levels. The pancreas responds by pumping out high amounts of blood sugar-regulating insulin, which converts a large portion of the excess sugar (glucose) into glycogen, one of the body’s main sources of energy. But what happens when the glycogen stores are filled to capacity and there is still excess sugar in the blood? Insulin converts the remainder into fat, which is one reason the high amount of refined carbohydrates in the American diet is leading millions of people to become overweight.

And over time, the body’s cells eventually become overwhelmed by so much insulin and actually become resistant to it. The more advanced form of insulin resistance is Syndrome X, which is characterized by insulin resistance, abdominal obesity, high blood pressure and unhealthy cholesterol and triglyceride levels.

Pre-diabetes also plays a major role in the development of the disease. If a person has glucose levels that are above normal but not yet in the diabetic range, she has pre-diabetes and is at increased risk for developing the disease. The two types of pre-diabetes are impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). According to the U.S. Department of Health & Human Services (HHS), 41 million Americans (approximately 40 million adults between the ages of 40 and 74) have pre-diabetes (IFG and/or IGT), which is double the amount previously thought. The new estimate—released April 29—is based on a revised, more accurate definition of prediabetes made by an expert panel at the American Diabetes Association (ADA). Under previous criteria, it had been estimated that approximately 20.1 million Americans in this age group had pre-diabetes. Specifically, ADA changed the definition of “normal” fasting glucose to below 100 mg/dL for the IFG test, when previously it had been 110 mg/dL; now, anyone with a fasting glucose level between 100 and 125 mg/dL is classified as pre-diabetic. ADA did not change the criteria for the IGT test.

“These latest numbers show how urgent the problem really is,” said Health & Human Services Secretary Tommy Thompson. However, experts also pointed out modest diet and exercise can delay, if not prevent, the onset of Type II diabetes in many pre-diabetics.

The Importance of Diet & Exercise

One of the best things a person can do for her health and body is eat a healthful, balanced diet, exercise regularly and get plenty of rest. The same is true for people with normal glucose regulation and for those with pre-diabetes, as it is well known that eating right, exercising and losing weight can help control blood sugar levels and prevent the onset of diabetes.2 Physical exercise is also recommended to realize optimal glucose control benefits in Type II diabetics.3 “Nutrition is the basis,” said Jim Roza, director of quality assurance for Bloomingdale, Ill.-based NOW® Foods. “Many people can control their blood sugar through proper food selection. Additionally, exercise will also help people manage their condition. It requires a shift in eating habits and food selection that requires a life long commitment.” Roza further stated supplementation can also help, although it is not a “magic bullet,” and that supplementation and diet modification go hand in hand. “The publicity given to obesity and the epidemic proportions of diabetes are salient arguments for supplementation. A simple questionnaire that allows consumers to do an introspective analysis of what they’re eating would be a good starting point for creating consumer awareness.”

Learning what types of foods to eat is also a must when managing diabetes or pre-diabetes. Complex carbohydrates, including whole grains, most vegetables and beans, which release sugar slowly into the bloodstream, are the only recommended choice for people managing the disease. Simple carbohydrates are essentially sugars—white sugar, brown sugar, corn syrup and fructose—and are quickly broken down into glucose and enter the bloodstream rapidly, causing a rapid rise in blood glucose, accompanied by a rise in insulin. Refined carbohydrate foods, including white bread, potatoes, rice, fruit juices and snack foods made with refined flour, unfortunately, make up too much of the typical American diet.

Consumption of such foods not only increases obesity levels, but also the risk for developing diabetes. Researchers from the Inter-Medic Medical Group in North Point, Fla., agree, as they found increasing intakes of refined carbohydrates (corn syrup), along with decreasing intakes of fiber, paralleled the increase of Type II diabetes in the United States.4

Fiber has numerous studies backing up its efficacy against diabetes. For example, a study conducted by Finnish researchers found high intake of dietary fiber is associated with enhanced insulin sensitivity, and therefore may have a role in preventing Type II diabetes,5 and researchers from the University of South Carolina, Columbia, also concluded higher intakes of whole grains may increase insulin sensitivity.6 A study conducted at Shanxi Medical University in China tested this theory by feeding fiber to Type II diabetic rats for eight weeks. They found fiber not only increased insulin sensitivity, but also decreased high blood lipid levels and prevented impaired glucose tolerance (IGT), a form of pre-diabetes.7

Watching Weight & Glucose Levels

Obesity is strongly associated with several major health risk factors, including high blood pressure, high cholesterol, asthma, arthritis, poor health status and diabetes.8 And as one of diabetes’ more prominent causative factors, encouraging customers to watch their weight and to lose weight if they are overweight will help them lower the risk of developing diabetes. The Diabetes Prevention Program has shown that losing 5 percent to 7 percent of body weight can actually delay— and possibly prevent—the onset of diabetes in overweight pre-diabetics.

Conjugated linoleic acid (CLA) is one supplement that may be helpful for diabetics because of its ability to reduce body fat. Research conducted in Sweden has shown CLA to be quite effective in lowering plasma glucose and adipose (fat) tissue while increasing insulin sensitivity.9

Several vitamins and minerals may also play a role in helping to prevent the disease. For example, a deficiency in vitamin D in early life has been shown to accelerate the onset of Type I diabetes in non-obese diabetic mice,10 and according to researchers at the University of California, Los Angeles, people with hypovitaminosis D (deficient vitamin D status) are at higher risk of insulin resistance and metabolic syndrome (Syndrome X).11 Vitamin E and other antioxidants have also been shown to lend a hand in preventing diabetes.

Adults with metabolic syndrome have been shown to have suboptimal concentrations of several antioxidants, including vitamin C and vitamin E,12 and vitamin E was found to prevent the onset of Type II diabetes among habitual users, according to researchers at the University of South Carolina, Columbia.13

A vitamin-like antioxidant, alpha-lipoic acid (ALA), may improve diabetes by affecting mitochondrial function. In an animal study conducted at the University of Montreal, Canada, ALA supplementation was shown to prevent increases in insulin resistance, glucose levels and blood pressure in control rats.14 And researchers at Mount Zion Hospital in San Francisco recognized ALA helps protect muscle cells from oxidative stress-induced insulin resistance.15

Another powerful antioxidant, the extract of French maritime pine bark (as Pycnogenol® from Natural Health Science) may also help lower blood glucose levels and make blood vessels healthier in Type II diabetics.16 After participating in a monthlong diet and exercise program, 30 subjects were supplemented 50 mg/d of Pycnogenol for three weeks, followed by 100 mg/d of Pycnogenol for three weeks, then 200 mg/d of Pycnogenol for three weeks and finally 300 mg/d of Pycnogenol for three weeks. Researchers found fasting blood glucose was lowered dose-dependently and the maximum decrease of postprandial glucose was achieved with a dose of 200 mg/d.

Minerals also play an important role in managing diabetes. One mineral in particular, chromium, is necessary for proper insulin function and blood glucose regulation. According to research presented at the 2nd International Congress on Nutrition and Aging, chromium supplementation may be able to reverse diabetes development. The researchers discussed a study of more than 40,000 overweight subjects, where the mineral was shown to improve insulin sensitivity and had a dose-dependent effect on glucose, insulin and insulin sensitivity.

According to Gail Montgomery, president and chief executive officer of Purchase, N.Y.- based Nutrition 21, makers of Chromax® chromium picolinate, a growing body of evidence suggests that low chromium status contributes to the development of insulin resistance and an increased risk of diabetes and heart disease. “Highly processed diets and diets comprised of refined sugars can exacerbate chromium loss. ... [A]nd supplementation is a good way to meet the body’s essential need for this important mineral,” she said. Human research has shown that taking the mineral (as Chromax®) significantly improves glycemic control and serum fasting insulin compared to placebo in Type II diabetics.17 “The essential role that chromium plays as a co-factor in insulin activity makes it a prime candidate for consideration as the number one choice in maintaining healthy insulin function and carbohydrate metabolism,” Montgomery said.

Another form of chromium that has shown potential in helping treat diabetes is chromium nicotinate (as ChromeMate® from Benicia, Calif.-based InterHealth Nutraceuticals Inc.). In this form, chromium is bound to the B-vitamin niacin, which an animal study has shown increases the bioavailability of chromium.18 According to Allondra Stevens, marketing services manager at InterHealth, ChromeMate supplementation is helpful in people with insulin resistance and in people who have diabetes because it potentiates the body’s efficient use of insulin. She also noted zinc is an important trace mineral that has been shown to help regulate blood sugar levels. Research has shown that low dietary intake and blood levels of zinc are associated with diabetes and cardiovascular disease, and supplementation of chromium and zinc, as well as selenium and vanadium, may reduce insulin resistance.19

Vanadium has also shown positive preliminary results for independently regulating glucose control in diabetics.20 A rat study conducted at Istanbul University in Turkey demonstrated this effect. When diabetic rats were given vanadyl sulfate—a particular ion of vanadium—for 60 days, they did not show the increase in blood glucose levels that was apparent in the control group.21

Another mineral that may help protect against Type II diabetes is magnesium. After following approximately 128,000 men and women for an average of 15 years, researchers at Harvard School of Public Health in Boston found a significant inverse association between magnesium intake and diabetes risk.22 Specifically, women with the highest magnesium intake had a 34-percent reduced risk of diabetes compared to women with the lowest magnesium intake, and men with the highest magnesium intake had a 33-percent reduced risk compared to men with the lowest magnesium intake. Another study also conducted at Harvard School of Public Health stated “higher magnesium intake is associated with lower fasting insulin concentrations among women without diabetes. Because lower fasting insulin concentrations generally reflect great insulin sensitivity, these findings provide a mechanism through which higher dietary magnesium intake may reduce the risk of developing Type II diabetes.”23

On the botanical front, supplementing with stevia (Stevia rebaudiana), a powder derived from the stevia plant native to Paraguay that is times 300 times sweeter than sugar after processing, may also help diabetics and pre-diabetics control their blood sugar levels. “SweetLeaf Stevia has a glycemic index of zero as well as a zero netcarb and calorie count, making it a safe alternative for consumers, both diabetics and otherwise,” said Aaron Henderson, director of communications and marketing at Mesa, Ariz.-based Wisdom Natural Brands™, makers of SweetLeaf™ Stevia dietary supplements. “Numerous studies potentially demonstrate that stevioside, a component of SweetLeaf Stevia, may help promote healthy blood sugar levels.” A study conducted at Aarhus University Hospital in Denmark supports this theory. Twelve Type II diabetic subjects were supplemented with either 1 g of stevioside or 1 g of maize starch (control) with a meal. After measuring blood samples taken before and four hours after eating the meal, the researchers found stevioside reduced postprandial blood glucose levels, indicating beneficial effects on glucose metabolism and concluded stevioside may be advantageous in the treatment of Type II diabetes.24 And in a diabetic rat model, stevioside was shown to reduce glucagon levels as well as systolic and diastolic blood pressure.25

Several herbs may also have sugarregulating properties, such as gymnema (Gymnema sylvestre), bitter melon, black plum, holy basil and cinnamon, according to Grace Ormstein, M.D., medical director and scientific advisor for Himalaya USA, maker of GlucoCare®, an herbal formulation that supports healthy blood sugar levels. “Gymnema has been known as a ‘sugar destroyer’ for more than 2,000 years. When taken internally, it helps control blood sugar levels and sweet cravings,” Ormstein said. “It may also help revive insulin-producing beta cells in the pancreas.” An animal study conducted at the University of Chicago Medical Center found gymnema to have anti-hyperglycemic activity and helps reduce body weight,26 and Indian researchers found doses of gymnema at 50 mg/kg of body weight, 100 mg/kg of body weight and 200 mg/kg of body weight for three weeks suppressed elevated blood glucose and lipid levels in diabetic rats.27

Fenugreek (Trigonella foenum graecum L.) may lend a helping hand in diabetes management for people with Type I and Type II diabetes due to its ability to inhibit glucose uptake, according to researchers at the University of Sana’a in Yemen.28 And in two separate rat models, supplementation of fenugreek leaves significantly improved hyperglycemia, hypoinsulinemia, body weight, liver glycogen and key carbohydrate metabolic enzymes,29 and in Type I diabetic rats, supplementation of 5-percent fenugreek seed powder for 21 days was shown to bring down elevated fasting blood glucose levels to control levels and stabilize glucose homeostasis in the liver and kidneys.30

Another way to help control blood sugar is with supplementation of Panax ginseng berry extract. In a study conducted at the University of Chicago, researchers gave obese, diabetic mice the extract for 12 days. On the last day, the mice became normoglycemic and had significantly improved glucose tolerance. Supplementation also improved serum insulin levels, triggered significant weight loss and reduced plasma cholesterol levels.31

“As with most herbal (natural) products, U.S. consumers are still learning about Eastern modalities and how to safely incorporate them into their health programs,” Ormstein said. “When this happens, I suspect we’ll see a paradigm shift from standard insulin therapy to more natural approaches.”

Protect Your Heart

Diabetes goes hand-in-hand with serious long-term complications, including heart and blood vessel disease, stroke, high blood pressure, kidney disease, nerve damage, amputations and blindness. In fact, heart disease is the leading cause of diabetes-related deaths and the risk for stroke is two to four times higher among people with diabetes compared to those without. For these reasons, diabetics and those at risk for developing the disease need to pay special attention to their heart and circulatory health.

In terms of vitamins, the B-vitamin folic acid has shown promise in helping to treat Type I diabetes. Researchers from Belgium found a negative correlation between folic acid levels and increased homocysteine levels, a factor in heart disease, in Type I diabetics,32 and Australian researchers found short-term high-dose folic acid supplementation improved endothelial function in children and adolescents with Type I diabetes.33

The heart-healthy, vitamin-like antioxidant coenzyme Q10 (CoQ10) may also help improve endothelial function of the brachial artery in dyslipidemic subjects with Type II diabetes, according to research conducted in Australia.34 And another Australian research team found daily supplementation of 200 mg of CoQ10 for 12 weeks may improve blood pressure, as well as long-term glycaemic control in Type II diabetics.35

Zinc and magnesium are two antioxidant minerals that are important for maintaining a healthy heart. In a Nigerian study of 40 subjects with Type II diabetes and 20 healthy controls, serum concentrations of both zinc and magnesium were significantly lower in subjects with diabetes.36 Fasting blood glucose and total cholesterol were also significantly higher in diabetics than in the non-diabetic controls. The researchers concluded both minerals play a crucial role in the regulation of lipid and carbohydrate metabolism. A study conducted by Turkish researchers, however, found zinc supplementation had no effect on total cholesterol or trigylceride levels in diabetic rats, but magnesium supplementation did.37 They reported oral magnesium supplementation decreased elevated total cholesterol and triglyceride concentrations of diabetic rats to the control level.

So just what does all this mean for the retailer? It means a variety of natural products—from vitamins and minerals to herbs and other botanicals—have the power to help prevent diabetes, as well as help manage it. And as science suggests, when combined with a healthy, active lifestyle and diet, the effects can be even more pronounced. So stock a selection of diabetes-related products, such as supplements targeted for the disease, snack foods and drinks specially formulated for diabetics, and fliers and other educational materials consumers can take home to help them better understand how natural products can help improve their condition. (Many supplement/product distributors offer such support material for retailers and consumers at no extra charge.) But, retailers should always be cautious when helping consumers with diabetes and may want to inquire about any recent doctor’s visits and diagnoses found, according to Ormstein. She also added those taking insulin or OHA (oral hypoglycemic agents) should first discuss the use of herbs and natural alternatives with their health care professional.

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"Fighting Diabetes the Natural Way" References

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3. Fenicchia LM et al. “Influence of resistance exercise training on glucose control in women with type 2 diabetes.” Metabolism. 53, 3:284-9, 2004.

4. Gross, LS et al. “Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment.” Am J Clin Nutr. 79, 5:774-9, 2004. www.ajcn.org.

5. Ylonen K et al. “Associations of dietary fiber with glucose metabolism in nondiabetic relatives of subjects with type 2 diabetes: the Botnia Dietary Study.” Diabetes Care. 26, 7:1979-85, 2003. http://care.diabetesjournals.org.

6. Liese AD et al. “Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study.” Am J Clin Nutr. 78, 5:965-71, 2003. www.ajcn.org.

7. Zhao X et al. “Effect of superior fiber complex on insulin sensitivity index and blood lipids in non-insulin dependent diabetes mellitus rats.” Zhonghua Yu Fang Yi Xue Za Zhi. 36, 3:184-6, 2002.

8. Mokdad AH et al. “Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.” JAMA. 289, 1:76-9, 2003. www.jama.com.

9. Ryder JW et al. “Isomer-specific antidiabetic properties of conjugated linoleic acid, improved glucose tolerance, skeletal muscle action, and UCP-2 gene expression.” Diabetes. 50, 5:1149-57, 2001. http://diabetes.diabetesjournals.org.

10. Giulietti A et al. “Vitamin D deficiency in early life accelerates Type I diabetes in non-obese diabetic mice.” Diabetologia. 47, 3:451-62, 2004. http://link.springer.de/link/service/journals/00125.

11. Chiu KC et al. “Hypovitaminosis D is associated with insulin resistance and Beta cell dysfunction.” Am J Clin Nutr. 79, 5:820-5, 2004. www.ajcn.org.

12. Ford ES et al. “The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey.” Diabetes. 52, 9:2346-52, 2003. http://diabetes.diabetesjournals.org.

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Prevention.com Article about Diabetes

Diabetes

Both type 1 and type 2 diabetes lead to too much sugar in the blood. This raises the risk of kidney failure, blindness, and even amputation if high sugar levels damage nerves in the feet and legs.

Nutritional therapy for diabetes helps lower blood sugar level. Vitamin and mineral supplements can't take the place of a healthy diet. Prevention recommends nine servings of fruits and vegetables a day, whole grains, low-fat or fat-free dairy, lower-fat protein, and heart-protective fats rich in omega-3 fatty acids (found in fish such as salmon, in canola oil, and in flaxseeds and walnuts).

That said, supplements can help as "extra insurance." Here's what we recommend:

Prescription for Healing
These nutrients may be helpful additions to diabetes treatment:*

Nutrient: Calcium
Daily amount: 500-1,000 mg. Take 500 mg if you're under 50. Take 1,000 mg if you're 50 or older.

Nutrient: Vitamin C
Daily amount: 100-500 mg

Nutrient: Vitamin E
Daily amount: 100-400 IU

* plus a multivitamin/mineral supplement that contains 100% of the Daily Value for most nutrients

Calcium ensures good B12 levels. Vitamin B12 helps the body break down carbohydrates and fats, and is important for nervous system function and blood cell formation. Some antidiabetes drugs may cause B12 to work less effectively, but taking calcium supplements can ensure that B12 levels stay high enough.

Vitamin C saves cells. If blood sugar is high enough to leak into the urine, vitamin C is leached from the body with it. Vitamin C lowers glucose levels and helps insulin work better.

Vitamin E saves hearts. Vitamin E strengthens immunity and plays a key role in preventing infections. Vitamin E also helps people with diabetes whose risk of heart disease is two to four times greater than normal.

Chromium helps regulate blood sugar. This trace mineral has been shown to improve the body's ability to regulate blood sugar. A daily multivitamin/mineral supplement will provide all that you need to maintain your chromium level.

DIABETES

Diabetes
The following information is taken from the booklet
HTN's Pak-of Life and Ellagic Acid
by Dr. Kurt D. Grange, Ph.D., N.D.
Dr. Grange is a Nutritional Biophysiologist, educator and international lecturer on human anatomy, physiology, kinesiologoy, biochemistry and sports medicine. He has traveled extensively giving lectures and seminars to health care professionals and health conscious groups on complementary medicine and the use of nutritional supplements. He also evaluates personal health and nutrition by doing live blood cell evaluations using a multi-phase darkfield microscope.
Dr. Grange has a Bachelor of Science Degree with dual majors in Physical Education and Health from the University of Utah and a Master of Science in Biophysiology and a National Certificate as an Athletic Medical Trainer from the University of California at Riverside. He has a Master of Science in Holistic Nutrition, a Ph.D. in Nutrition and a Doctor of Naturopathy from Clayton University.
He serves as a department chairman for math and science in the state of Nevada and has spent the last thirty years teaching anatomy and physiology to premedical students.
Thousands of people, men, women, and children will get diabetes, go blind, have amputations and other devastating complications. Diabetes kills more than AIDS or breast cancer. It killed over 200,000 people in this country last year alone. That's one in every 17 people.
Information from the American Diabetes Association
Diabetes is serious. A tragedy. A very costly battle. That's why you need to know the following:
"Type II Diabetes is not a disease. It is the lack of a natural ingredient known as GTF Chromium." — Walter Mertz, M.D.
Director USDA Human Nutrition Research Center, 1959 Adult onset diabetes is characterized by insulin resistance. Since the discovery of Glucose Tolerance Factor (GTF), many middle age insulin resistant disorders have been alleviated by taking a chromium supplement in this GTF form. GTF Chromium is significantly more effective than any other form of chromium tested. Not all chromium is GTF. Many popular chromium supplements have been found to be totally ineffective at potentiating insulin function (diabetes).
If you are insulin resistant, be sure to check your blood sugar levels several times a day, at least 1/2 hour after you take nutritional supplements and if necessary, adjust your insulin intake accordingly, under your doctor's guidance and direction.
Reference: "The Chromium Connection," by Betty Kamen, Ph.D.
Fourth printing, 1996 "Nutrition News," 1993 Vol. XVII, No. 8,
InterHealth Nutraceuticals, Inc., publication on Chromate®
Dr. Walter Mertz, former director of the USDA Human Nutrition Research Center and discoverer of biologically active chromium, identified niacin-bound chromium as the active chromium ingredient in Brewer's yeast.
Chromium is an essential trace element required for normal protein, fat, and carbohydrate metabolism. It is important for energy production and plays a role in regulating appetite, reducing sugar craving, and increasing lean body mass. Chromium helps insulin metabolize fat, turn protein into muscle, and convert sugar into energy.
Part of the reason chromium is so necessary is that it contains a special bioactive formulation called Glucose Tolerance Factor. GTF facilitates normal insulin function thereby enhancing glucose, amino acid, and fat metabolism. Chromium has been shown to reduce levels of harmful LDL cholesterol (a form of cholesterol that has been linked to heart disease) and increase beneficial HDL cholesterol. Chromium supplementation can increase lean muscle mass while decreasing body fat. Experiments have shown that chromium can prevent and even reverse atherosclerosis.
The dietary chromium intake of most people is considerably less than the minimum suggested required amount. Research shows that chromium levels decrease with age and that chromium deficiency may be a wide-spread problem in today's population. A lack of chromium can impair insulin function and inhibit protein synthesis and energy production. Chromium deficiency can lead to Type II diabetes and heart disease. Chromium deficiency is thought to contribute to glucose intolerance and unhealthy blood, liver, and kidney lipid amounts.
The consumption of refined foods, especially simple sugars, increases the problem since these foods are not only low in chromium but also increase loss of chromium through the urine. Many people, such as athletes, diabetics, breast feeding mothers, and the elderly are especially at risk of chromium deficiency. Chromium loss increases with pregnancy, strenuous exercise, infection, physical trauma and mental stress.
Chromium has been shown to play a role in Type II diabetes mellitus, gestational diabetes, and steroid-induced diabetes. In addition, it has been established that chromium has beneficial effects on people with varying degrees of glucose intolerance diabetes and hypoglycemia.
The relationship of insulin, glucose, and chromium, in a very simplified explanation, is that glucose is used by cells to create energy, insulin is used by the body to transport glucose to the cell, and chromium's GTF factor is what actually allows the insulin and glucose into the cell. You can have enough blood sugar (glucose), but if you don't have insulin, it doesn't get to the cells. You can have enough glucose and insulin, but if the cells don't have GTF chromium available, the glucose and insulin can't enter the cells to be used for energy. In which case, the glucose is rerouted to the liver where it is converted into fat. It has been found that many adult onset (Type II) diabetics are chromium deficient not insulin deficient.
HTN uses only ChromeMate® in its products.
Independent university studies have found ChromeMate's patented oxygen-coordinated chromium-niacin complex to be over 18 times more potent than all other forms of niacin-bound chromium.
ChromeMate® is a unique form of naicin-bound chromium (chromium polynicotinate) which dramatically increases the effectiveness of chromium throughout the body. It has been found to be the most efficient chromium available for controlling blood sugar, alleviating Type II diabetes, reducing hypertension, decreasing fat thereby reducing weight, and increasing lean body mass. It accomplishes this by leveling out the highs and lows of carbohydrates in the diet, allowing for a steady infusion of available blood glucose for continuous prolonged energy expenditure.
The two other common forms of dietary chromium found in supplements are chromium picolinate and chromium chloride. A university of California study reported that the ChromeMate® form of chromium is over 300% more bioavailable than chromium picolinate and almost 700% more bioavailable than chromium chloride. In addition, recent studies suggest that the use of chromium picolinate might be a cancer threat due to its ability to cause chromosomal changes and DNA damage within cells. In order for the chromium to become bound with niacin for absorbtion and use, it must break away from the picolinate, leaving the picolinate as a free radical to attack the system. This is not a problem when chromium polynicotinate is used. Even high doses of ChromeMate® chromium polynicotinate have been shown to be completely safe and nontoxic to the body.
It has been found that the combination of ChromeMate® plus exercise in obese women resulted in significant weight loss and decreased sugar dependency while lowering sugar-induced high blood pressure. Taking the correct daily amount of chromium in the form of ChromeMate® can help you maintain normal insulin functions, promote healthy blood sugar and cholesterol levels, maintain cardiovascular health, control body weight, enhance lean body mass, convert sugar into energy, and maintain a healthy active live.
With skyrocketing health costs, prevention seems to be the way to go. Today's nutrient-starved diet insures us a one-way ticket to the hospital, the surgeon's knife, endless drug prescriptions and a parade of medical bills guaranteed to drain even the most wealthy.
The main question is why are we treating nutritional deficiencies with drugs?
A strong association exists between chromium deficiency, elevated insulin, high blood cholesterol levels, atheroscelerosis, diabetes and obesity. Since even the government says the majority of us don't get enough chromium in our diets, since some of us may have difficulty converting or absorbing simple chromium compounds and since niacin-bound chromium is an extremely active GTF form, augmenting our diets with niacin-bound chromium supplement (ChromeMate®) makes good sense.
HTN products containing Chromate®:
OptiBerry ATX-OPC 60 - 5000mcg Chromate® per 2 capsules
M2000 Series Products - 1000mcg Chromate® per capsule
Endura-Max - 1000mcg Chromate® per capsule

 
This product has not been evaluated by the Food and Drug Administration and is not claimed to treat, cure or prevent any illness or disease.