Type 2 Diabetes Management with the Help of Supplements and their Research
Supporting your body to manage blood glucose levels and inflammatory processes with supplementation can really help your medications be more effective and possibly need less of them, under the supervision of a medical professional.
Type 2 diabetes (T2D) is a chronic condition that affects millions of people worldwide. A condition that is becoming more and more prevalent in younger populations year by year. It is characterized by chronic high blood sugar levels due to the body’s inability to effectively use insulin, a hormone that regulates blood sugar. Managing type 2 diabetes requires a multifaceted approach that includes diet and lifestyle changes.
In addition to these, there are several supplements that can help manage blood glucose levels and symptoms:
Berberine HCL
Berberine is a natural plant compound that has been shown to improve insulin sensitivity, reduce blood sugar levels, and lower cholesterol levels in people with type 2 diabetes. A meta-analysis of 14 clinical trials, totalling 1068 participants, found that berberine significantly reduced fasting blood sugar levels and hemoglobin A1c, a measure of long-term blood sugar control (1). Hemoglobin A1c (HbA1c) is commonly used for the diagnosis of diabetes and provide insight into its management. Berberine has also been shown to have anti-inflammatory and antioxidant effects, which can help reduce the risk of diabetes-related complications (2). It has been seen that Berberine does this is by increasing protein messengers that facilitate receptor expression for insulin.
Alpha-Lipoic Acid
Alpha-lipoic acid is an antioxidant that your body normally makes and also gets from in sources such as organ meats, broccoli, spinach and other vegetables. A meta-analysis of 41 clinical trials (19 of which were of good quality) found that alpha-lipoic acid supplementation significantly reduced fasting blood sugar levels and hemoglobin A1c (3). Another major use of alpha-lipoic acid is for its neuroprotective effects, which can help reduce the risk of diabetes-related nerve damage (4). Diabetic neuropathy is a common complication in T2D, and Alpha-Lipoic acid has shown to also reduce the symptoms of those with already damaged nerves.
Fiber
Fiber is a type of carbohydrate that cannot be digested by the body. It helps slow the absorption of sugar into the bloodstream and can improve blood sugar control in people with type 2 diabetes. Fibre is probably one of the forefront supplements/dietary changes in T2D management. An umbrella review of 16 meta-analyses which encompassed 189 research articles showed lowered risk of developing Type 2 diabetes as well as significantly reduced fasting blood sugar levels and hemoglobin A1c with higher dietary fibre intake (5). In the umbrella review, 11 meta-analyses were done on multiple fibres, showing their effects on fasting glucose levels. Both soluble fibre and β-glucans found in oats and other grains showed best results, especially in participants who were type 2 diabetic. Fiber has also been shown to improve cholesterol levels and promote weight loss, both of which can benefit people with type 2 diabetes as cardiovascular disease risk is also a major concern (6).
Vitamin D
Vitamin D is a fat-soluble vitamin that plays a crucial role in regulating calcium and phosphorus levels in the body. Vitamin D receptors (VDR) are seen in all organ systems and effect overall health much more than once thought. Recent research suggests that vitamin D may also play a role in glucose metabolism and insulin sensitivity. A meta-analysis of 21 observational trials found that there is a higher risk and prevalence of Type 2 diabetes in Vitamin D deficient populations (7). A different meta-analysis of 46 randomized controlled trials showed that vitamin D supplementation was able to significantly reduce fasting glucose levels and HbA1c (8). Additionally, vitamin D has been shown to have anti-inflammatory and immunomodulatory effects, which can help reduce the risk of diabetes-related complications and infections (9). Many individuals in northern climates in addition to living with a chronic metabolic or inflammatory condition are seen to have deficient levels of vitamin d.
Acetyl-L-Carnitine
Acetyl-L-carnitine (ALC) is an amino acid that helps the body produce energy. With most metabolic diseases there is a dysfunction in energy production, and fatigue is usually one of many concerns. ALC has been shown to improve insulin sensitivity and reduce oxidative stress in people with type 2 diabetes. The more oxidative stress in the body the more damage is seen on your body’s cells, which in turn becomes your organs. A meta-analysis of 5 clinical trials found that acetyl-L-carnitine helped in treating insulin resistance in both diabetic and non-diabetic individuals (10). The analysis also showed that the longer the treatment time with Acetyl-L-carnitine the more significant the outcome. Just like ALA, acetyl-L-carnitine has been shown to have neuroprotective effects, which can help reduce the risk of diabetes-related nerve damage and mood disorders (11).
Chromium
Chromium is a trace mineral that plays a role in glucose metabolism. It has been shown to improve insulin sensitivity and reduce blood sugar levels in people with type 2 diabetes. Some other research saw that chromium prevents premature degradation of insulin, allowing it to function for longer (12). There is a meta-analysis of 22 clinical trials on chromium supplementation that shows improved fasting blood sugar levels and hemoglobin A1c (13). Fibre and chromium are commonly used together as they both have effects on cholesterol levels and promoting weight loss (14).
Magnesium
Magnesium is a mineral that plays a part in over 300 enzymatic reactions in the body. Probably one of the most important minerals for the health of diabetic individuals. Next to fibre, magnesium has the second biggest meta-analysis in terms of participant count out of these supplements; much of the research were observational studies done on large populations. In the analysis the 25 clinical trials showed that magnesium has an effect on lowering blood sugar levels, HbA1c and insulin sensitivity (15). Looking further into this meta-analysis it is worth to note that a majority of diabetic people found in these studies were deficient in magnesium and no where near achieving their daily intake of magnesium through diet. Low blood levels of mangnesium are commonly seen in individuals with chronic diseases/conditions. Magnesium has been shown to have anti-inflammatory and antioxidant effects, which can help reduce the risk of diabetes-related complications related to kidney function, vision loss, and nerve damage (15).
In Conclusion
It is important to note that while these supplements have shown promise in managing type 2 diabetes, they should not be used as a substitute for medical treatment. People with type 2 diabetes should always consult with their healthcare provider before starting any new supplement regimen. Self prescribing one or more of these supplements at incorrect dosages can put you at risk for other complications.
Managing type 2 diabetes requires a multifaceted approach that includes diet, exercise, and potentially, supplementation. Berberine HCL, alpha-lipoic acid, fiber, vitamin D, acetyl-L-carnitine, chromium, and magnesium are all supplements that have been shown to improve blood sugar control and reduce the risk of diabetes-related complications. By incorporating one or more of these supplements into a comprehensive diabetes management plan, people with type 2 diabetes may be able to improve their overall health and quality of life.
Dr. Kris Kuciel, ND
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References
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A current update on the use of alpha lipoic acid in the management of type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets. 2018;18(3):266-273.
McRae MP. Dietary fiber intake and type 2 diabetes mellitus: an umbrella review of meta-analyses. J Chiropr Med. 2018;17(1):44-53.
Yao B, Fang H, Xu W, et al. Dietary fiber intake and risk of type 2 diabetes: a dose-response analysis of prospective studies. Eur J Epidemiol. 2014;29(2):79-88.
Song Y, Wang L, Pittas AG, et al. Blood 25-hydroxy vitamin D levels and incident type 2 diabetes: a meta-analysis of prospective studies. Diabetes Care. 2013;36(5):1422-1428.
Farahmand, M.A., Daneshzad, E., Fung, T.T. et al. What is the impact of vitamin D supplementation on glycemic control in people with type-2 diabetes: a systematic review and meta-analysis of randomized controlled trails. BMC Endocr Disord 2023;15(23)
Zittermann A, Ernst JB, Prokop S, et al. Vitamin D supplementation and cardiovascular disease prevention: an update. Trends Cardiovasc Med. 2016;26(8):709-718.
Wu G, Zhang X, Liu W, et al. Acetyl-L-carnitine intake and insulin sensitivity: a systemic review and meta-analysis. Mol Nutr Food Res. 2018;62(14):e1800449.
Veronese N, Stubbs B, Solmi M, et al. Acetyl-L-carnitine supplementation and the treatment for depressive symptoms: a systemic review and meta-analysis. Psychosom Med. 2018;80(2):154-159.
Wang ZQ, Yu Y, Zhang XH, Komorowski J. Chromium-insulin reduces insulin clearance and enhances insulin signaling by suppressing hepatic insulin-degrading enzyme and proteasome protein expression in KKAy mice. Front Endocrinol (Lausanne). 2014;5:99.
Suksomboon N, Poolsup N, Yuwanakorn A. Systemic review and meta-analysis of the efficacy and safety of chromium supplementation in diabetes. J Clin Pharm Ther. 2014;39(3):292-306.
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Veronese N, Dominguez LJ, Pizzol D, Demurtas J, Smith L, Barbagallo M. Oral Magnesium Supplementation for Treating Glucose Metabolism Parameters in People with or at Risk of Diabetes: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials. Nutrients. 2021 Nov 15;13(11):4074.
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