Dietary Supplements in the Management of Diabetes: Risks and Benefits
A wide range of products claiming to lower blood sugar are marketed to the public. Individuals with diabetes are 1.6 times more likely to use complementary and alternative medicine than those without diabetes according to a recent study published in the April, 2008 supplement to the Journal of the American Dietetic Association (JADA). Reasons for using alternative medicine have been reported to include:
• Troublesome side-effects from conventional drug therapy
• A need for more personal control over one’s care plan
• The increasing cost of prescription drugs
• Dissatisfaction with conventional health care providers
• The ability to spend quality time with alternative practitioners, i.e. doctors do not spend enough time educating and talking to their patients so patients choose to go to those who will spend the time.
Several problematic areas may come up with the use of alternative therapies and pharmacists and Registered Dietitians are uniquely poised to address issues such as potential side-effects, drug interactions, lack of product standardization and the need for evidence-based information on the supplements being used.
This study looked at the most popular supplements used for blood sugar control including bitter melon, cinnamon, chromium, aloe vera, fenugreek, gymnema, ginseng, and nopal. The conclusion was that there are ingredients in these supplements that are pharmacologically active and supplements are not required to undergo the same stringent approval process that is required for medications. Patients should be made aware that these products may contain contaminants or inappropriate amounts of active ingredients and dosage standardization may not be available. A full evidence grade for each of the products discussed in this study is available in table format in the original article.
Reference: Geil, P, Shane-McWhorter, L. Dietary Supplements in the Management of Diabetes: Potential Risks and Benefits. Journal of the American Dietetic Association. 2008;108 (4), S59-S65.
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
Dan responds:
Posted: July 1st, 2008 at 3:15 pm →
From diseaseproof.com:
The DASH Diet is Good…
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Okay, I go to admit. I couldn’t remember what the DASH diet is, so, I ran it through Wikipedia and here’s what came up:
Dietary Approaches to Stop Hypertension or the DASH diet is a diet promoted by the National Heart, Lung, and Blood Institute (part of the NIH, an organisation part of the government of the USA) to control hypertension. A major feature of the plan is limiting intake of sodium, and it also generally encourages the consumption of nuts, whole grains, fish, poultry, fruits and vegetables while lowering the consumption of red meats, sweets, and sugar. It is also “rich in potassium, magnesium, and calcium, as well as protein and fiber.”
The DASH diet is based on NIH studies that examined three dietary plans and their results. None of the plans were vegetarian, but the DASH plan incorporated more fruits and vegetables, low fat or nonfat dairy, beans, and nuts than the others studied. Not only does the plan emphasize good eating habits, but also suggests healthy alternatives to “junk food” and discourages the consumption of processed foods.
Doesn’t sound too bad—pretty Fuhrman-friendly—maybe that’s why the DASH diet has been shown to cute the risk of heart disease. Ed Edelson of HealthDay News reports:
The DASH — Dietary Approaches to Stop Hypertension — study, reported in the same issue of Archives of Internal Medicine, is the first to look at the diet’s effect on the incidence of heart disease and stroke, said study author Teresa T. Fung, an associate professor of nutrition at the Simmons College School for Health Studies in Boston.
“Previously, the benefits that were reported were for hypertension [high blood pressure],” Fung said. “No previous study looked at cardiovascular endpoints such as heart disease and stroke.”
The study reported on 88,517 female nurses aged 34 to 59 who started with no evidence of cardiovascular disease or diabetes in 1980. In the 24 years that followed, the one-fifth of women in the group whose diets were most similar to that recommended in DASH — low in animal protein, moderate in low-fat dairy products and high in plant proteins — were 24 percent less likely to develop coronary heart disease and 18 percent less likely to have a stroke than the one-fifth of women with the lowest DASH scores.
While the study was not the kind of carefully controlled trial that gets the highest regard in research, it carries a message, Fung said. “This report actually shows that those people whose diet resembles the DASH diet reduce the risk of actual cardiovascular disease,” she said.
Now, I’m certainly not going to abandon my nutritarian lifestyle for the DASH, but, the benefits of cutting salt, limiting saturated fat, and eating lots of fruits and veggies are truly undeniable. From Dr. Fuhrman’s book Eat for Health:
As the consumption of animal products, saturated fat, and processed foods drops down to low levels in a population’s diet, heart disease goes to lower and lower levels, reaching less than one percent of the total cause of death. Eating a diet lower in saturated fat and higher in fruits and vegetables dramatically reduces the occurrence of the clots that cause heart disease and embolic strokes. However, hemorrhagic strokes are not caused by atherosclerosis—the buildup of fatty substances in arteries—and the resultant clots. These strokes are caused by a hemorrhage or rupture in a blood vessel wall that has been weakened by years of elevated blood pressure as a result of chronic high salt intake. The weakened wall ruptures and lets blood flow into and damage brain tissue…
…When a diet is high in fatty animal products and high in salt, the thickened blood vessel walls caused by the unhealthful, heart-attack-promoting diet actually protect against the occurrence of this more uncommon cause of strokes. In medical studies, higher cholesterol levels are associated with increased risk of other strokes…
…A recent study looked at the effects of a diet with more fruits and vegetables combined with a low saturated fat intake. It showed a 76 percent reduction in heart-disease-related deaths for those consuming more than five servings of fruits and vegetables per day and less than 12 percent of calories from saturated fat, compared to those with less vegetation and more saturated fat.1 Even this small increase in vegetation and mild reduction in saturated fats showed a dramatic reduction in heart-disease-related deaths.
I’ll think of the DASH as just that, a short little burst of health, but eating a vegetable-based nutrient-dense diet—THAT’S FOR THE LONG HAUL!
1. Tucker KL, Hallfrisch J, Qiao N, et al. The combination of high fruit and vegetable and low saturated fat intakes is more protective against mortality in aging men than is either alone: the Baltimore Longitudinal Study of Aging. J Nutr. 2005;135(3):556-561.
Written By:Sara
On April 16, 2008 10:22 PM
I agree the DASH diet is good cmpared to the usual American diet but a nutrient dense vegetable based diet is far better.
Dan responds:
Posted: July 1st, 2008 at 3:17 pm →
Also, I know of a doctor whose wife had her diabetes reversed utilizing this DASH diet.