Vanadium, which is positioned next to chromium as a transition metal on the periodic table, has also been studied for its effects on glucose metabolism. In one study of subjects who received

150 mg per day or 300 mg per day of vanadyl sulfate for six weeks, there was improvement in three of the five subjects who received 150 mg and in four of the eight subjects who received 300 mg.22 Reductions in fasting glucose and glycosylated hemoglobin were enough to be significant, although not dramatically so. In addition, this work demonstrated that, in skeletal muscle, vanadium also appears to modulate the number of insulin receptors and their phosphorylation. Two other small studies also demonstrated improvement in glycemic control using only 100 mg per day (see Table 11-2 on page 133) of vanadyl sulfate for three or four weeks, and, in both studies, the improvement in blood glucose control continued for periods of two or four weeks after supplementation had ended.23,24 It is important to note that that even the lower doses of vanadyl sulfate (100 mg per day) caused some gastrointestinal intolerance (see Table 11-2 on page 133). A different, organic form of vanadium, bis(maltolato)-oxovanadium (BMOV), has also been shown to be effective in lowering glucose levels, at least in rat models. The dosage of BMOV needed, however, to lower glucose levels effectively, was only half of the dose of vanadyl sulfate required to obtain the same effect. Large doses of vanadyl sulfate have been shown to increase markers of oxidative stress in diabetic animal models. Taking antioxidants in combination with vanadium supplementation may be beneficial.25

There is research showing that magnesium levels tend to be low in subjects with diabetes and that three months of supplementation is adequate for reversing the problem.

B Vitamins

The water-soluble B vitamins are required cofactors for many of the enzymes required for metabolizing glucose via glycolysis and the Kreb's cycle, and a growing body of literature suggests their importance in diabetes. For example, in the case of vitamin B6, a study of the serum levels of 518 patients with diabetes revealed that pyridoxal levels were significantly lower compared to levels in 371 controls, with 25% of the patients with diabetes having levels below the lower limit of the normal range.26 In another study comparing 50 patients with diabetic neuropathy to patients with diabetes but without neuropathy, serum pyridoxal levels were significantly lower in the patients with diabetic neuropathy.27

There are also several studies demonstrating the clinical effects of B vitamins supplementation on diabetes. One study of 24 patients with diabetic neuropathy utilized a treatment with a complex of vitamins B6, B12, and a form of B1 modified to be more lipid soluble. After 12 weeks, there was significant improvement in the nerve conduction velocity of the peroneal nerve and a trend toward improvement in the threshold level of vibration perception.28

One informative study of a B vitamin in diabetes research was done some years ago by researchers who took a small group of patients with type 1 diabetes off insulin treatment and gave them either 16 mg per day of biotin or a placebo.29 Compared to the control group, the mean blood glucose level of the biotin-treated group was significantly lower after one week of treatment (126 mg per dL in the biotin group versus 266 mg per dL in the control group). In examining the levels of tissue biotin compared to plasma biotin among patients with type 1 diabetes and controls without diabetes, it was found that an increasing ratio of tissue biotin to plasma biotin was associated with increasing fasting blood sugar levels in the subjects with diabetes, but not in subjects without the disorder. Perhaps future work will help to confirm that biotin can control blood glucose levels and elucidate the differences in how biotin is utilized in people with or without diabetes.

Niacinamide is also worth specific mention because it has been shown to help prevent type 1 diabetes in laboratory animals. These observations have been noted in at least ten clinical trials of which six were double-blinded. These studies involved patients with type 1 diabetes who had been diagnosed with the disorder five years or less prior to the study. Of the positive studies, some patients with newly diagnosed type 1 diabetes have experienced complete reversal of their diabetes with niacinamide. Other positive findings included prolonged remissions, lower insulin requirements, increased beta-cell function, and enhanced metabolic control.30,31


Rich in the flavonoid (-)-epicatechin, pterocarpus (Pterocarpus marsupium), an Ayurvedic herb, may be helpful for patients with both type 1 and type 2 diabetes. In an animal study, rats whose beta-islet cells were first destroyed with the toxin alloxan and then given large intravenous doses of (-)-epicatechin experienced a return of normal blood glucose levels.32 Histologic examination of pancreas samples showed regeneration of the beta-islet cells. In a human trial in India, among subjects who had been recently diagnosed with type 2 diabetes, 67 of 97 patients studied were able to control blood glucose levels (measured both for fasting and postprandial levels) after 12 weeks of treatment. Doses needed for control ranged between 2- 4 g of extract, and there were no side effects reported.33


In a study of patients with type 1 diabetes given 50 g of defatted fenugreek (Trigonella foenum-gracum) seed powder with both lunch and dinner for 10 days, there was a 54% decrease in 24hour urine glucose excretion. Other benefits from this high source of fiber in this study included

Table 11-3. Select Botanical Considerations for Treating Diabetes




Bitter melon

(Momordica charantia) Fenugreek

(Trigonella foenumgracum) Gymnema

(Gymnema sylvestre) Corosolic acid

(Lagerstroemia speciosa) Pterocarpus

(Pterocarpus marsupium) Puncture vine or tribulus (Tribulus terrestris)

15-50 g per day

15-50 g per day

400 mg of extract 32-48 mg


Start low and work up to higher doses.

Administer in divided doses.

Monitor glucose levels closely.

Adjustment of medicines often needs close attention.

Dose varies depending widely upon the extraction process.

Variable; 250-1,500 mg per day; standardized to 30%-45% steroidal saponins (also known as furostanol).

decreases in total serum cholesterol, low-density lipoprotein, and very low-density cholesterol and triglycerides, while levels of HDL remained unchanged.34 Another study was performed with patients with type 2 diabetes. After two months, fenugreek seed extract supplementation of 1 gm per day was shown to improve glycemic control, decreases insulin resistance, decrease serum triglycerides, and increase HDL cholesterol.35 Animal models have elucidated some of the mechanisms that Fenugreek provides these positive effects. A study with both type 1 and type 2 diabetic rats has shown that supplementation with Fenugreek soluble dietary fiber fraction decreases sugar digestion and absorption. It also increases insulin action peripherally and enhanced total antioxidant status.36

Bitter Melon

Bitter melon (Momordica charantia) has historically been used for blood sugar control. In a small study of nine patients with type 2 diabetes, a simple water extract of the fruit of bitter melon was enough to lower blood glucose levels significantly during a 50 g oral glucose tolerance test. This improvement was not associated with an increase in serum insulin.37 Another study with 100 patients with moderate non-insulin-dependent diabetes examined the efficacy of drinking the aqueous homogenized suspension of bitter melon vegetable pulp. The results showed significant reduction of both fasting and postprandial serum glucose levels in 86% of cases while 5% showed lowering of fasting serum glucose only.38 Animal models have shown that in addition to hypoglycemic activity, whole-plant extracts of Momordica charantia also exert hypotensive action as well.39 Animal models have elucidated some of the mechanisms of bitter melon's anti-diabetic activity. Momordica charantia extract was shown to reduce glycogenesis in liver tissue, enhance insulin secretion by the islets of Langerhans, restore the altered histological architecture of the islets of Langerhans, enhance peripheral glucose utilization, and increase serum protein levels.40


A simple water extract from the leaf of gymnema (Gymnema sylvestre) may hold promise for patients who have either type 1 or type 2 diabetes. Twenty-seven subjects with type 1 diabetes who received 400 mg of gymnema extract per day showed a reduction in the need for insulin as well as decreases in fasting blood glucose, glycosylated hemoglobin, and glycosylated plasma protein levels.41 In a similar study, a water extract at a dose of 400 mg of gymnema extract per day was given to 22 patients with type 2 diabetes for 18 to 20 months. There were, again, significant decreases in the same biomarkers used in the study with patients who have type 1 diabetes.42 One promising aspect of the study with subjects who have type 2 diabetes is that the extract was given safely in conjunction with other conventional medications that the subjects were already using. Five of the 22 subjects were able to discontinue their use of conventional medications and manage their conditions solely with the gymnema extract.


Cinnamon (Cinnamomum cassia) has also been shown to be an effective therapy for diabetes. In a randomized double-blind placebo-controlled study with type 2 diabetic patients, supplementation of cinnamon powder as an aqueous extract equivalent to 3 g per day was given in addition to oral medication. The results showed significantly better reduction in fasting plasma glucose levels in the cinnamon supplemented group (10.3%) than placebo, and the data showed that people with higher initial plasma glucose levels may benefit more from cinnamon intake.43 Another study with type 2 diabetic patients examined the effect of 1, 3, or 6 g of cinnamon supplementation per day on blood glucose and lipids. After 40 days, all three levels of cinnamon reduced the mean fasting serum glucose levels by 18%-29%, triglycerides by 23%-30%, LDL cholesterol by 7%-27%, and total cholesterol by 12%-26%.44 A study was done with healthy individuals supplemented with 6 g of cinnamon added to rice pudding to evaluate changes in the rate of gastric emptying and postprandial glucose levels in this population. The addition of cinnamon to the rice pudding significantly delayed gastric emptying, which may explain, at least partially, the mechanism of the lowered postprandial glucose response.45

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