Herbs for Diabetes, Are supplements safe? by WebMD

When 40-something Jeff Cottingham was diagnosed with type 2 diabetes, his doctor immediately started him on drugs to control his blood sugar. But Cottingham worried.

Some drugs for diabetes can have dangerous side effects. In a striking example, on March 21, 2000, the U.S. Food and Drug Administration (FDA) removed one of the most widely prescribed diabetes drugs, Rezulin (troglitazone), from the market after it was linked to 90 cases of liver failure and 63 deaths.

Already concerned about such problems two years ago, the Aptos, Calif., resident began taking Sweet Eze, a mixture of herbs and minerals sold for diabetes. The supplement seemed to work wonders for the self-described "old hippie."

His level of glycosylated hemoglobin (HbA1c) -- a protein that reflects blood glucose levels over the past two to three months -- plummeted from 11 to well below the danger threshold of 6. "I feel great," says Cottingham, who has experienced no side effects from the supplement. "I'm completely off diabetes medications now."

A success story? Perhaps. But experts advise caution. For one thing, because Sweet Eze contains six different ingredients -- and because the severity of diabetes symptoms can fluctuate on their own -- it's hard to say what exactly is responsible for Cottingham's improvement.

For another, supplements carry their own risks. Some products don't contain the ingredients listed on their labels. Others come mixed with dangerous -- and unlisted -- ingredients. And scientists are just beginning to verify which ones actually work.

1. Doing Ginseng Justice

June 16, 2003 (New Orleans) -- The herb red ginseng may help normalize blood sugar levels in people with diabetes, two new studies suggest.

But before you rush to health-food stores to stock up on the popular herb, be aware that there is no way to know if the product you buy will be as effective as the preparation used in the studies, researchers caution.

University of Toronto investigators presented both studies here this weekend at the American Diabetes Association's 63rd Scientific Sessions.

Since normalizing blood sugar levels is a critical goal of diabetes treatment, ginseng could someday be an important strategy in managing patients, says Fran Kaufman, MD, president of the American Diabetes Association.


Better Blood Sugar

In one study, people with type 2 diabetes who consumed ginseng and a highly viscous fiber similar to pectin had a notable reduction in blood sugar levels, reports Alexandra Jenkins, a PhD candidate at the University of Surrey, U.K.

The study enrolled 30 people with diabetes in whom medication helped to control -- but did not normalize -- blood sugar levels. The participants received either capsules containing ground, North American-grown ginseng and a highly viscous fiber, or dummy capsules, three times a day for 12 weeks.

After a four-week break, the participants switched to the alternate regimen; those who had received the ginseng capsules then took placebo and vice versa.

Blood samples taken before and after each 12-week period showed that hemoglobin A1C -- a standard measure of blood sugar levels -- dropped into the normal range when participants were taking the ginseng capsules, but not when they were taking placebo, the study showed.

The herbal preparation appeared to be safe, with no adverse effects.

Moreover, ginseng appears to have an effect beyond medication, the American Diabetes Association's Kaufman says, suggesting the two approaches are complementary in treating diabetes.

The Chinese, who use ginseng root to treat a variety of ailments, have been in medicine for 5,000 years, she says. "Just as acupuncture has been proven to have a role in Western medicine, so, too, will ginseng. We need to think globally."


Improved Insulin Performance

In the second study, Korean red ginseng improved insulin sensitivity when compared with placebo, says John L. Sievenpiper, a PhD candidate at the University of Toronto.

One of the key abnormalities behind type 2 diabetes is that the body's tissues are not responsive enough to insulin so they don't process it properly. Ginseng, he says, appears to help the patients process better the insulin they have.

"There is no doubt that natural products such as ginseng have a role in controlling the body's defective response to insulin," says Kaufman, who is also head of the Center for Diabetes at Children's Hospital in Los Angeles.

According to the American Diabetes Association, poor control of blood sugar can lead to severely debilitating and even fatal complications including heart disease, stroke, blindness, and kidney disease.


Not Standard Treatment -- Yet

But exactly how best to incorporate ginseng into diabetes treatment still needs to be determined, Kaufman says, noting that both trails were small.

Sievenpiper agrees. "These are preliminary, short-term studies that indicate a need for more research. They are not a reason to take ginseng," he said.

And because of poor regulation, standardization, and labeling in the herbal industry, there is no way to know if one product will work as well as another, Sievenpiper says.

Most importantly, he says, people with diabetes should be sure to tell their doctor if they are taking ginseng because lowering blood sugar too much can be dangerous.

2. Fenugreek Findings

Meanwhile, other scientists are studying fenugreek seeds, a folk remedy for diabetes. Several studies, including one published in 1990 in the European Journal of Clinical Nutrition suggest that this herb can lower blood sugar . Researchers found that type 1 diabetics who took 50 grams of fenugreek seed powder twice daily had significantly lower blood sugar levels than those who took a placebo.

Little is known about how other herbs might help control diabetes. Stevia and bilberry have been studied in animal experiments, but have yet to undergo large, controlled human studies. The reputation of two other herbs, gymnome and jambul, rests on anecdotal evidence alone.

The ADA steers people away from herbal remedies altogether. "The regulation of herbs isn't very good," says Anne Daly, MS, RD, a diabetes educator with the organization. "And we can't be sure that all supplements are equivalent.

Some herbal diabetes products have turned out to be downright dangerous
In February 2000, the FDA recalled five Chinese herbal products after discovering that they contained various amounts of two prescription diabetes drugs, phenformin and glyburide. Phenformin was withdrawn from the U.S. market 20 years ago after it caused serious side effects, including several deaths.