ALTERNATIVE TREATMENTS FOR DIABETES

by Simeon Margolis, MD PhD, and Christopher Saudek, MD

In recent years, a growing interest and market has emerged for the use of "alternative" therapies to manage diabetes. Several natural remedies and nutritional supplements reportedly reduce blood glucose levels. Other techniques are purported to treat or prevent the major complications of diabetes, including peripheral vascular disease and CHD. Following are some of the more common alternative treatments for diabetes. While several of them show enough promise to warrant further study, there is little or no hard medical evidence that any is as effective as insulin or oral diabetes drugs in controlling blood glucose levels or preventing complications. If you wish to consider trying one of these options, do so in addition to, not instead of, your prescribed treatment regimen.

ALPHA-LIPOIC ACID is an antioxidant nutrient that neutralizes free radicals, which damage cells. (Several diabetes complications, including neuropathy and cataracts, may be mediated by such free radicals.) A review article by Lester Packer, PhD, of the University of California at Berkeley, theorizes that alpha-lipoic acid has potential applications for both prevention and treatment of diabetes and its complications. He cites two placebo-controlled, short-term studies in which daily injections of alpha-lipoic acid reduced pain and numbness in people with diabetic neuropathy (though objective measurements showed no improvement in nerve function.) However, little other evidence supports the benefits of alpha-lipoic acid for treating diabetes, and long-term studies are needed to prove its effectiveness.

CHELATION THERAPY--which administers the chelating agent EDTA (ethylene diamine tetra-acetic acid) intravenously in 20 to 30 treatments--is purported to remove plaque from artery walls. Considered the standard treatment for lead poisoning, chelating agents bind to heavy metals and remove them in the urine. Advocates claim that chelation can also treat diabetes complications such as peripheral vascular disease, CHD, and stroke--and is at least as effective as more costly conventional therapies. However, the American Heart Association's Task Force on New and Unestablished Therapies found no scientific evidence to demonstrate any benefit from chelation therapy in treating arteriosclerotic heart disease. And two placebo-controlled studies showed that infusions of EDTA were no more effective than salt water in alleviating symptoms of peripheral vascular disease.

CHROMIUM is an essential mineral found in trace quantities in drinking water and many foods. Necessary in tiny amounts for many bodily processes, chromium increases insulin's effectiveness in making blood glucose available to cells. Growing evidence indicates that deficiencies in chromium can lead to impaired glucose tolerance, and a few studies have suggested that some people with diabetes may benefit from chromium supplements (which usually also contain picolinate, a substance that may increase chromium absorption into the bloodstream.) However, other studies have shown no beneficial effect. One possible reason for the conflicting results: Supplements may only benefit those who are chromium-deficient, a condition rare in the U.S. Currently, no method can reliably measure chromium levels in the body, so it is impossible to determine who may benefit from supplements.

EVENING PRIMROSE OIL, which comes from the seeds of the evening primrose wildflower, contains large amounts of the essential fatty acid gamma-linoleic acid (GLA). One placebo-controlled study published 11 years ago reported that GLA reversed neurological damage in patients with diabetic neuropathy. However, no subsequent research has supported this finding, nor have objective studies substantiated the many other claimed benefits of GLA.

GINKGO BILOBA is the world's oldest living tree species. Extracts of ginkgo leaves are widely used in Europe to treat a variety of conditions, including memory loss, circulatory problems, and diabetes. Believed to work by stimulating blood flow in the body, German studies have found that ginkgo may reduce coldness, numbness, and cramping in the limbs due to peripheral vascular disease.

GYMNEA SYLVESTRE is a common plant in Africa and India. In a branch of alternative medicine known as Ayurvedic medicine, leaves from this plant have been used to manage diabetes for centuries. Although gymnea sylvestre is said to lower blood glucose in rats, there have been no placebo-controlled studies of the plant in people. Other than suppressing the taste of sweet foods, there is no evidence that it helps people with diabetes.

VANADIUM (vanadyl sulfate) is a trace element that appears to exhibit a variety of insulin-like effects. Small studies lasting only a few weeks showed modest reductions in blood glucose levels in people taking vanadium, but further research is needed to demonstrate its long term safety and effectiveness.

VITAMIN E is an antioxidant vitamin that can only be obtained in small amounts in the diet. Population studies have shown a reduction in heart attacks in those taking Vitamin E supplements. Large-scale, placebo-controlled trials are now underway, but none has yet proven that vitamin E supplements reduce CHD or prevent heart attacks.

NOTE: Excerpted with permission from "The Johns Hopkins White Paper on Diabetes," (C) Medletter Associates 1998. Single copies are $19.95 plus shipping and handling, and may be ordered by calling 1-800-829-9170.