Written by Lee Siang Chyi & Lee Sze Hui, AA Pharmacist.

Introduction

Diabetes is a disease that occurs when our blood glucose, also known as blood sugar, is too high. Blood glucose is our main source of energy and comes from the food we eat. Insulin, a hormone made by the pancreas, is responsible in transporting glucose into the cells to be used for energy. However, when our body produce insufficient insulin (Type 1 Diabetes) or utilize insulin ineffectively (Type 2 Diabetes), glucose will remain in the blood without outreaching the cells. The build up of glucose in the blood subsequently leads to various health problems including heart diseases and stroke, if not damaging the nerves, kidneys, eyes and foot.

Symptoms

Individuals with high blood glucose will experience symptoms include:

Blurred Vision

Sores that do not heal

Increased thirst and urination

Unexplained weight loss

Increased hunger

Fatigue

Numbness in the feet or hands

Diagnostic Criteria3

 

Normal

Prediabetes***

Diabetes

Fasting blood sugar*

<6.1mmol/L

6.1-6.9mmol/L

>7.0mmol/L

HbA1C**

<5.6%

5.6% to 6.2%

>6.3%

 

*Fasting is defined as no caloric intake for at least 8 hours
**HbA1C test measures average blood glucose for the past 2 to 3 months
***Prediabetes indicates blood sugar level higher than normal but not yet high enough to be diagnosed as diabetes.

Supplements in Regulating Blood Glucose:

1. Cinnamon is commonly used as a spice across the world. Its compound hydroxychalcone seems to stimulate insulin receptors on cells, which improves their ability to absorb blood sugar. Alam and researchers suggest that there is a wide range of cinnamon intake that is beneficial (1g-6g per day) and that intake of <1g daily is likely to be beneficial in controlling blood glucose.

2. Fenugreek, an ancient medicinal herb, may help reducing blood sugar in people with diabetes. It contains alkaloids which increases the serum insulin in our body. Study done by Mehedee and Mustafizur showed that any form of fenugreek (powdered, capsules, solution) helps in reducing blood glucose. Thus, it is believed that fenugreek supplement is safe and more effective in lowering blood sugar than the usual medical care alone.

3. Bitter melon is a popular fruit in the cuisines of Africa, East Asia, India and South America. The fruit contains anti-diabetic properties including charantin, vicine and an insulin-like compound known as polypeptide-p which contribute to blood-lowering effect. Tori Hudson suggests the consumption of bitter melon capsules from 100-200mg 3 times daily for better effects combining with dietary advice, exercise, lifestyle changes and conventional medicine.

Prevention for Further Complications

 

  1. Omega 3 is the good fats found in fish oil capsules. Fish like salmon, trout, herring and sardines have long been touted as heart healthy. Omega 3s are polyunsaturated fatty acids derived from α-linoleic acid (ALA), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This is important for people with diabetes, who are at high risk for heart disease as Omega 3s may reduce inflammation, decrease off-rhythm heartbeats, and discourage artery clogging. The American Heart Association recommends that people with heart disease should go for 1000mg of EPA and DHA daily from fish or supplement. For people with hypertriglyceridemia, 2-4g of EPA and DHA per day is recommended. However, do not take higher doses because these can actually raise fasting blood sugar slightly and bump up levels of artery-clogging LDL cholesterol.
  2. If you’re experiencing pain in fingers, toes, or feet due to diabetes-related nerve damage, an antioxidant supplement calledalpha-lipoic acid (ALA) can help by reduce sensitivity towards pain. Diabetes may cause many kinds of chronic complications such as retinopathy, nephropathy and neuropathy. Neuropathy is the damage of nerve fibers due to high blood glucose. The recommended dosage for ALA to be taken up is 200-600mg daily (1 hour before or 2 hours after eating). Therefore, ALA which is a free radical scavenger, can be regarded as one of the supplementary treatment for neuropathy by reducing oxidative stress.

Reference:

  1. U.S. Department of Health and Human Servies. National Institute of Diabetes and Digestive and Kidney Diseases. Retrieved from https://www.niddk.nih.gov/health-information/diabetes/overview/symptoms-causes
  2. Diabetes Australia. Retrieved from https://www.diabetesaustralia.com.au/what-is-diabetes
  3. Clinical Practical Guidelines (2015). Management of Type 2 Diabetes Mellitus (5th edition). Ministry of Health Malaysia.
  4. Bolin, Q., Kiran, S. P., and Richard A. A. (2010). Cinnamon: potential role in the prevention of insulin resistance, metabolic syndrome, and type 2 diabetes. Journal of Diabetes Science and Technology, 4(3): 685-693.
  5. Alam, K., Mahpara, S., Mohammad, M. A. K., Khan, N. K., and Richard A. A. (2003). Cinnamon improves glucose and lipids of people with Type 2 diabetes. American Diabetes Association.
  6. Arpana, G., Chandrakala, G., Sreenivas, T., Ravi, K. M., Uma, D. P., and Paturi, V. R. (2015). Role of fenugreek in the prevention of type 2 diabetes mellitus in prediabetes. US National Library of Medicine National Institutes of Health.
  7. Mehedee, H., and Mustafizur, R. (2016). Effect of fenugreek on Type 2 diabetic patients. International Journal of Scientific and Research Publications, 6: 251-255.
  8. Jimmy, T. E., Yuk, M. C., Stehphen, W. D., Sanjay, M., Ethan, J. A., and Lalage, A. K. (2014). Potential for improved glycemic control with dietary momordica charantia in patients with insulin resistance and pre-diabetes. International Journal of Environmental Research and Public Health.
  9. Tori, H. (2012). Nutrient profile: bitter melon (momordica charantia). Natural Medicine Journal, 4:10.
  10. Eugene, H., Yujung, Y., Gyuri, K, Yong-ho, L., Hye, J. W., Byung-Wan, L., … Eun Seok Kang. (2016). Effects of omega-3 fatty acid supplementation on diabetic neuropathy progression in patients with diabetes and hypertriglyceridemia. PLOS Biology.
  11. Bucher, H. C., Hengstler, P., Schindler, C., Meier, G. (2002). N-3 polyunsaturated fatty acids in coronary heart disease: a meta-analysis of randomized controlled trials. AM J Med, 112(4): 298-304.
  12. American Heart Association Nutrition C., Lichtenstein, A. H., Appel, L. J., Brands, M., Carnethon, M., Daniels, S. et al. (2006). Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee.
  13. Saeid, G., Mohammad, B., and Ismail, L. (2011). Diabetes and alpha lipoic acid. US National Library of Medicine National Institutes of Health, 2:69.
    Jeongmin, L., and Jae, H. C. (2017). Letter: effects of high dose α-lipoic acid on heart rate variability of type 2 diabetes mellitus patients with cardiac autonomic neuropathy in Korea. Diabetes & Metabolism Journal, 41(5): 417-419.
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