Complementary and Alternative Medicine for Diabetes
While diabetes is a chronic disease with no known cure, some individuals with diabetes are
looking for alternative methods of treating this disease, mostly because of the side effects of
traditional medicine. This article discusses the most common alternative treatments and/or
dietary supplements utilized and/or the ones that are studied the most often. Use of
complementary and alternative medicine in diabetes is controversial and is not without risk.
Acupuncture
Acupuncture is a procedure in which a practitioner inserts needles into designated points on the
skin. Some scientists believe that acupuncture triggers the release of the body’s natural
painkillers. Acupuncture is shown to offer relief from chronic pain, and was shown in some
Chinese studies to improve blood sugar in approximately two thirds of the patients studied.
Alpha-lipoic acid
Alpha-lipoic acid (ALA), also known as lipoic acid or thioctic acid, is a chemical that is similar
to a vitamin. It is an antioxidant—a substance that prevents cell damage caused by substances
called free radicals in a process called oxidative stress. High levels of blood glucose are one
cause of oxidative stress. ALA is found in some foods, such as liver, spinach, broccoli, and
potatoes. ALA also is made in the laboratory. ALA supplements are marketed as tablets or
capsules.
It is theorized that ALA is possibly beneficial because of its antioxidant activity. The evidence
on ALA for type 2 diabetes and obesity is limited. A number of small studies in animals and in
people have shown hints of beneficial effects. In a few of these studies, some possible benefit
from ALA was seen in glucose uptake in muscle, sensitivity of the body to insulin, diabetic
neuropathy, and/or weight loss. More research is needed to document if ALA has any benefit for
diabetes and to better understand how ALA works.
It appears that ALA is safe for the general adult population, but people with diabetes need to
know that ALA might lower blood sugar too much, so they would need to monitor their blood
sugar level carefully. ALA also may lower blood levels of minerals, such as iron; interact with
some medicines, such as antacids; and decrease the effectiveness of some anticancer drugs.
Other possible side effects of ALA include headache, skin rash, and stomach upset.
Biofeedback
Biofeedback and relaxation therapy help patients change their physical and mental responses to
stress, which both play roles in controlling blood glucose levels. This alternative therapy
emphasizes relaxation and stress-reduction techniques. Guided imagery is a relaxation technique
used by some professionals who use biofeedback. With guided imagery, a person thinks of
peaceful mental images, such as ocean waves. A person also may include the images of
controlling or curing a chronic disease, such as diabetes. People using this technique believe their
condition is eased with these positive images.
In a study reported in Diabetes Care in 2005, researchers found that the people who took
biofeedback and relaxation therapy had much lower short-term and long-term blood glucose
levels, compared to people who completed the education sessions. They also lowered their
muscle tension, depression, and anxiety more than the people in the education session. In
addition, individuals who took part in biofeedback and relaxation therapy were able to maintain
better glucose levels for longer times. When the researchers checked up with individuals 2
months after the study, they found that the people who took biofeedback and relaxation therapy
continued to manage their glucose levels better than the people who took the education sessions.
Chromium
Chromium is a metal and an essential trace mineral. Chromium is found in some foods, such as
meats, animal fats, fish, brown sugar, coffee, tea, some spices, whole-wheat and rye breads, and
brewer’s yeast. It is marketed in supplement form (capsules and tablets) as chromium picolinate,
chromium chloride, and chromium nicotinate. For several years, researchers have studied and
debated the benefit of added chromium for diabetes. Several studies report that chromium
supplementation may improve diabetes control. Chromium is needed to make glucose tolerance
factor, which helps insulin improve its action. Because of insufficient information on the use of
chromium to treat diabetes, no recommendations for supplementation exist yet.
At low doses, it appears that short-term use of chromium is safe in the general adult population.
However, chromium can add to insulin in its effects on blood sugar, which might cause blood
sugar to go too low. Possible side effects at low doses include weight gain, headache, insomnia,
skin irritation, sleep problems, and mood changes. High doses can cause serious side effects. The
foremost concern for persons with diabetes who use chromium is the development of kidney
problems. Other possible effects include vomiting, diarrhea, bleeding into the gastrointestinal
tract, and worsening of any behavioral or psychiatric problems.
Coenzyme Q10
Coenzyme Q10 is a cofactor used in oxidative respiration. Supplementation of coenzyme Q10 is
especially popular for cardiovascular diseases. Trials of patients with type 2 diabetes produced
no strong evidence for glycemic control with coenzyme Q10 supplementation.
Ginseng
Ginseng is a collective name for a variety of different plant species. Some studies have shown
some glucose-lowering effects in fasting and postprandial (after meal) blood glucose levels, as
well as in A1c levels. However, larger and more long-term studies are needed before general
recommendations for use of ginseng are made. Researchers also have determined that the amount
of glucose-lowering compound in ginseng plants varies widely. Because of poor standardization
in the herbal industry, it is unknown if these findings will hold true for all American ginseng
products. It also is not known if the same outcome will result from different species of ginseng,
such as Chinese or Japanese.
Ginseng can potentially augment the effect of prescription drugs used to lower blood sugar,
causing a dangerous decrease in blood sugar. Adverse effects with concurrent use of oral
antidiabetic drugs, such as warfarin, heparin, aspirin, and nonsteroidal anti-inflammatory drugs
(NSAIDs) are another possibility.
Magnesium
Magnesium is a mineral. Foods high in magnesium include green-leafy vegetables, nuts, seeds,
and some whole grains. Various supplemental forms of magnesium are marketed as tablets,
capsules, or liquids. Magnesium has many important functions in the body, including helping the
heart, nerves, muscles, and bones, handling glucose, and making proteins.
Although studies have looked at the relationship between magnesium and diabetes for decades, it
is not yet fully understood. Studies suggest that a deficiency in magnesium may worsen blood
glucose control in type 2 diabetes. Scientists believe that a deficiency of magnesium interrupts
insulin secretion in the pancreas and increases insulin resistance in the body’s tissues. Evidence
suggests that a deficiency of magnesium may contribute to certain diabetes complications. A
recent analysis showed that people with higher dietary intakes of magnesium (through
consumption of whole grains, nuts, and green-leafy vegetables) had a decreased risk of type 2
diabetes.
It appears that magnesium supplements are safe for most adults at low doses, but may become
unsafe at high doses, causing problems such as nausea, diarrhea, loss of appetite, muscle
weakness, difficulty breathing, extremely low blood pressure, irregular heart rate, and confusion.
Magnesium can interact with and affect the action of certain drugs, including some antibiotics,
drugs to prevent osteoporosis, certain high blood pressure medicines (calcium channel blockers),
muscle relaxants, and diuretics.
Omega-3 fatty acids
Omega-3 fatty acids, known as omega-3s, are a group of polyunsaturated fatty acids that come
from food sources, such as fish, fish oil, some vegetable oils (primarily canola and soybean),
walnuts, wheat germ, and certain dietary supplements. As supplements, omega-3s are marketed
as capsules or oils, often as fish oil.
Omega-3s are important for a number of bodily functions, including moving calcium and other
substances in and out of cells, the relaxation and contraction of muscles, blood clotting,
digestion, fertility, cell division, and growth. Omega-3s are of interest for diabetes primarily
because having diabetes increases a person’s risk for heart disease and stroke. However, omega3s are not recommended at this time for the treatment of diabetes or to help lower or control
blood sugars.
A 2001 analysis was published of 18 randomized placebo-controlled trials on fish oil
supplementation in type 2 diabetes. The authors found that fish oil lowered triglycerides and
raised low-density lipoprotein (LDL) cholesterol, but had no significant effect on fasting blood
glucose, A1c, total cholesterol, or high-density lipoprotein (HDL) cholesterol. Another analysis,
published in 2004 by the Agency for Healthcare Research and Quality, looked at 18 studies on
omega-3 fatty acids for a number of measurable outcomes in type 2 diabetes.
It appears that omega-3s are safe for most adults at low to moderate doses. However, some
questions about safety exist about fish oil supplements, because certain species of fish sometimes
are contaminated with substances from the environment, such as mercury, pesticides, or
polychlorinated biphenyl (PCB). Fish oil is on the list of food substances that the US Food and
Drug Administration considers as “generally recognized as safe.” Fish oil in high doses can
possibly interact with, and affect the action of, certain medications, including blood-thinning
drugs and drugs for high blood pressure. Potential side effects of fish oil include a fishy
aftertaste, belching, stomach disturbances, and nausea.
Vanadium
Vanadium is a compound found in tiny amounts in plants and animals. Early studies showed that
vanadium normalized blood glucose levels in animals with type 1 and type 2 diabetes. A recent
study found that when people with diabetes were given vanadium, they developed a modest
increase in insulin sensitivity and were able to decrease their insulin requirements. Currently the
goal in research is to understand how vanadium works in the body, discover potential side
effects, and establish safe dosages.
References and recommended readings
Birdee GS, Yeh G. Complementary and alternative medicine therapies for diabetes: a clinical
review. Clinical Diabetes [serial online]. 2010;28:147-155. Available at:
http://clinical.diabetesjournals.org/content/28/4/147.full. Accessed July 28, 2012.
National Diabetes Center Information Clearinghouse (NDIC). Complementary and alternative
medical therapies for diabetes. Available at:
http://diabetes.niddk.nih.gov/dm/pubs/alternativetherapies. Accessed July 28, 2012.
Review Date 7/12
D-0618