Integrated Diabetes Services 333 E. Lancaster Ave. Suite 204, Wynnewood, PA 19096 USA Email Contact Us - US toll free: 877-735-3648 - Outside US: 011-1-610-642-6055 Fax: (610) 642-8046
There are several reasons a person might want to to use supplements such as med costs being too high, to avoid adverse side effects, suggestion from friends, family, claims made about the supplement, etc. If you find that you’re someone who is interested in using something other than your prescribed medicine here’s some advice from the webinar presented by Lorena Drago, RD, CDE, MS, CDN, LVCYT:
Be aware that dietary supplements do not require FDA approval.
Supplements still contain chemical compound – many want to make the switch with belief its more natural.
Compare the drug to supplement – name, brand name, side effects, cost, effectiveness, precautions.
Make sure you are taking the right doses and are aware of what’s in it and how much. *Supplements are not generally needed for those who have a balanced diet, and some can have harmful side effects, so use them with caution.
2 Resources to learn more about dietary supplements:
Consumer Lab (must pay to use) – Tests all the products – lets you know which are best to use/recommend.
The webinar went over a list of popular supplements taken for glycemic control and cholesterol management. Below you can find the claims, possible risks/benefits, dosage, and key ingredients:
What are the popular supplements that help with glycemic control and cholesterol management?
Below is a list of the claims, possible risks/benefits, dosage, and key ingredients:
Alpha-Lipoic Acid (ALA)
Claims
Promote healthy blood sugar
Reduce the symptoms of peripheral neuropathy
Research and Efficacy
Improved insulin sensitivity in T2D patients and saw a slight A1c decrease
Most studies used mixed isomer forms of ALA-( R ) form is more expensive and is found in foods like spinach, broccoli, tomatoes, Brussel sprouts
Intravenous ALA can improve neuropathy when administered for 3 weeks-oral intake is not as effective
Dosage
600-1200mg (day)
Safety
Skin rash, nausea
Doses up to 2,000mg a day have been well tolerated
Taken 30 minutes before eating or 2 hours after eating to increase bioavailability
Banaba Leaf (coracle acid)
Claims
Lower blood glucose
Help insulin work efficiently
Lower faster and postprandial glucose
Maintain healthy bg levels
Inhibit gluconeogenesis
No adverse effects
Active ingredient studied in humans = coprozoic acid and has shown about a 10-15% decrease 2 hours after dosing in fasting and postmedial glucose
A 30% decrease in glucose was observed with a 48mg dose
*A Patient interested in taking this supplement for hopes of improved management should ensure that it contains coprozoic acid
Bitter Melon
Claims
Glycemic support
weight loss
decreased insulin resistance
inhibits glucose reabsorption
increases insulin secretion and peripheral cell glucose utilization
suppress key enzymes in the gluconeogenic pathways
No standard dose, use various forms of the fruit
Whole plant recommended for T2D patients
Can cause hypoglycemia in children
Stomach discomfort
Cinnamon
Claims
Lower bg in T1 and T2D
Inconsistent results, no adverse effects
Thought- improves insulin sensitivity
Research
Studies have used doses of 1,3, or 6g of cinnamomum cassia
in divided dose (pantry cinnamon) 1g=1/2 teaspoon – unclear of how much and what type- if a patient is going to use it suggested to recommend 6g everyday
Chromium
Claims
Manage glucose and cholesterol
Promotes weight loss
Essential trace mineral
Needed to metabolize glucose
Supplementation may benefit deficient population
Inconclusive effects on blood glucose
Adequate Intake (AI)
Women 19-50: 25mg/day
>50: 20mg/day
Men 19-50: 35mg/day
>50: 30mg/day
Different Types
Food-Chromium chloride-least bio available
Most supplements contain nicotinate
Typical dose
200mg-1,000mg
BMI over 30 should go for a higher dosage
Gymnema (Gurmer) aka sugar destroyer
Claims
Treat blood glucose in T1 and T2D
Decrease fasting bg and insulin dose in T1D
Decrease A1c and lipids in T2D
Dosage
400mg/day (with 24% glycemic acids)
No adverse effects reported
Intravenous 15% decease 6 hours after administration- mist people haven’t used
Dose must correlate with what the studies have shown (likely under-dosing)
Nopol
Claims
Supports healthy blood glucose levels
Contains Fiber
Dose
100-500g/daily of boiled stems
Side effects
Nausea, abdominal fullness, mild diarrhea
Studies
About 18%reduction with about 18oz (the more the better) – inject that daily
Ingest less ex 3oz – still effective but unknown how much
Nopol
Claims
Supports healthy blood glucose levels
Contains Fiber
Dose
100-500g/daily of boiled stems
Side effects
Nausea, abdominal fullness, mild diarrhea
Studies
About 18%reduction with about 18oz (the more the better) – inject that daily
Ingest less ex 3oz – still effective but unknown how much
Functional Foods
Apple Cider Vinegar (ACV)
Claims
Improved diabetes management
Weight loss
Less leg cramps
Improved gastroparesis
Study/dosage
20g in diabetes study and 15ml 2x daily for 12 weeks improved insulin sensitivity
20g ACV with meals increased insulin sensitivity in individuals with insulin resistance
ACV and low cal diet reduced BMI and hip circumference compared to low cal alone and increased HDL and lowered LDL
*Needs 4-8% acidity
Oats
Claims
Improve cardiovascular effects
Decrease cholesterol and LDL total
How much
56-150g of whole oat with 3.6-10g
*Whole oats or steel cut with no additives
Olive Oil
Claims
Decreases risk heart disease
Decrease hypertension
Decrease Cholesterol
Helps Obesity and diabetes
Study
Replacing saturated fat with olive oil can reduce risk for cardiovascular disease
*Should by in dark container rather than clear and glass over plastic
Extra Virgin has more polythelias- want this
Stanols and Sterols (in plants)
Claims
Lowers LDL and total cholesterol about 10-15%
Doses
2.7 to 5.1g per day
May take up to 3 months to improve
Appears safe in doses shown, high levels may interfere with the absorption of fat-soluble vitamins
Omega 3 (fish oil)
Claims
Decrease cholesterol
Decrease triglycerides
Found that fish oil (EPA, DHA) does not reduce heart attack or stroke risk
Generally safe, doses vary 2g may suppress the immune system. Mercury concerns if consumption exceeds 6 ounces per week
Fish oil is best absorbed with fats
RX fish oils are better – EPA and no DHA- reduce TG by 21-33% over 3 months without increasing LDL-C
Total amount EPA and DHA is more important than total amount of oil for triglyceride effects
Functional Beverages (meal replacers)
Claims
Weight loss
Improved T2D management
Increased muscle mass
Meal replacement with a calorie restricted diet reverse T2D in 40% of participants for at least 6 months
Drinking whey protein prior to high glycemic meal improved insulin compared to individuals who did not- glucose levels were 28% lower over a 3-hour period
The most weight loss was seen with soy-based meal replacements
Recommendations
3 fortified meal replacement shakes per day
Whey protein (50g) in 250ml water
If you have any follow-up questions or want some more guidance on using supplements, please go ahead and give the office a call and set up time to speak with one of our dietitians.
Kathryn received her Bachelor of Science in Exercise Physiology from Ave Maria University in Florida and a Master's degree in Clinical Exercise Physiology from West Chester University in Pennsylvania. She is Certified by the American College of Sports Medicine as well as the International Sports Science Association.
Leave A Comment