Introduction
Worldwide Prevalence of Diabetes
History of Diabetes
Diabetes-Related Complications
CAM Therapy and Popularity
Compliance with Ethics Guidelines
Implications of CAM Therapy for Diabetes Treatment
Frequently Used CAM Therapies for Diabetes
Name | Active constituents | Beneficial effects/hypothesized mechanism of action | Side effects/drug interactions and contradictions | References |
---|---|---|---|---|
Bitter melon (Momordica charantia) | Momordin, charantin, polypeptide P, vicine | Hypoglycemic action, insulin mimetic, enhances glucose uptake by tissues, inhibition of glucose producing enzymes, enhances glucose oxidation (G6PDH pathway) | Gastrointestinal discomfort, hypoglycemic coma, favism, hemolytic anemia in persons with G-6PDH deficiency, abortifacient activity of α and β momorcharin, hypoglycemia when used with sulfonylureas | |
Fenugreek (Trigonella foenum- graecum) | Saponins, glycosides Seeds contain: alkaloids, 4-hydroxyisoleucine, fenugreekine | Insulin secretagog, hypoglycemic activity, lipid-lowering effects, increase HDL cholesterol, Slows carbohydrate absorption and delays gastric emptying, inhibits glucose transport, increases insulin receptors, improves utilization of peripheral glucose | Diarrhea, gas, uterine contractions, allergic reactions, drug interaction with hypoglycemic agents, anticoagulant drugs, MAO inhibitors, contraindicated in pregnancy | |
Panex ginseng, P. quiquefolius (Ginseng) | Ginsenosides | Insulin mimetic, hypoglycemic action, enhances psycho-physiological performance, stimulates immune system, may decrease carbohydrate absorption in portal circulation, may increase glucose transport and uptake, may modulate insulin secretion, alters hepatic glucose metabolism | Estrogenic effect with breast tenderness, amenorrhea, vaginal bleeding and impotence, hypertension, insomnia, interacts with anticoagulant and antiplatelet medications; hypoglycemic agents; corticosteroids; oral contraceptives; digoxin; MAO inhibitors and tricyclic antidepressants; diuretics | |
Ginkgo (Ginkgo biloba) | Flavonoids (ginkgo-flavone glycosides), terpenoids (ginkgolides and bilobalides) | Inhibit the platelet-activating factor, useful in cerebrovascular insufficiency and peripheral vascular disease, antioxidant, neuroprotective | Transient headaches, cross allergenicity with poison ivy, interacts with anticoagulants, SSRI, MAO inhibitors | |
Aloe vera
| Glucomannan | Fiber may promote glucose uptake, pharmacokinetic interaction (CYP3A4), pharmacodynamic interaction (enhancement in adipose tissue insulin signaling pathway) | Abdominal pain, laxative component induces diarrhea, additive hypoglycemia if combined with secretagogs, drug interactions with sevoflurane, pioglitazone, repaglinide | |
Cinnamomum zeylanicum
| Compound similar to procyanidin type-A polymers, coumarins | Increases insulin sensitivity by increasing PPAR (alpha and gamma) expression, increases cellular glucose entry by enhanced insulin receptor phosphorylation and translocation of GLUT4 glucose transporter to the plasma membrane, promotes glycogen synthesis | Skin irritations if used topically, interacts with secretagogs and cause hypoglycemia, coumarins possess anticoagulant, carcinogenic, and hepatotoxic properties | |
Gymnema sylvestre
| Gymnemosides, saponins, stigmasterol, and amino acid derivatives (e.g., betaine, choline, and trimethylamine) | Insulin secretagog, increases glucose uptake promoting enzymes, stimulates and increase beta cell number | May cause hypoglycemia when combined with secretagogs | |
Opuntia streptacantha (Nopal) | Mucopolysaccharide Fibers, pectin | Slow carbohydrate and lipid absorption, possibly increases insulin sensitivity | Diarrhea, nausea, abdominal fullness, increases stool volume, drug interaction—improved blood glucose and insulin with sulfonylureas (without hypoglycemia) | |
Coccinia indica (ivy gourd) | Pectin, triterpenes | Insulin mimetic, hypoglycemic activity, helps lower elevated levels of glucose-6-phosphatase and lactase dehydrogenase | Allergenic plant components may cause hypoglycemia when combined with secretagogs |
Name | Beneficial effects/hypothesized mechanism of action | Side effects/potential drug interactions and contradictions | References |
---|---|---|---|
Chromium | Lipid-lowering effects, insulin-sensitizing effect by decreasing tyrosine phosphatase activity or direct effect on insulin receptor by increasing tyrosine kinase activity at the insulin receptor may promote glucose transport | Renal toxicity and dermatological reactions, potential hypoglycemia with secretagogs, steroids may decrease chromium levels, vitamin C may increase chromium absorption | |
Omega-3 fatty acid/fish oil | Lowers triglycerides, antiinflammatory, antiplatelet, hypotensive, slight increase in blood glucose | High intake might cause bleeding, fish meat to be eaten with caution because of contamination with high levels of methyl mercury; may increase LDL, drug interactions with anticoagulant and antihypertension drugs | |
Alpha-lipoic acid | Improves insulin resistance and increase glucose effectiveness | Can affect thyroid function in patients with thyroid disease, might produce allergic skin reactions, abdominal pain, nausea, vomiting, diarrhea, and vertigo | |
Coenzyme Q10 | Improvement in pain and paraesthesia in diabetic neuropathy | No effect on blood glucose, additive effects with antihypertensive drugs | |
Magnesium | Insulin secretagog, essential in glucose metabolism, prevent diabetic complications, increased insulin sensitivity | Diarrhea, abdominal cramping, magnesium toxicity in individuals with renal failure, antibiotics, drug interactions with drugs to prevent osteoporosis, calcium channel blockers, muscle relaxants, diuretics | |
Zinc | Improves insulin levels, lipid-lowering effects, improves weight loss, metalloenzyme activitor | Nausea, vomiting, reduce absorption of folic acid, tetracyclines and copper, reduce the effect of therapies that rely on dopamine receptor antagonists | |
Vanadium | Insulin mimetic, increase insulin sensitivity | Prolonged high doses may cause renal toxicity, gastrointestinal upset |