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    Herbs Show Promise for Treating Diabetes Complications

    Until recently most doctors looked on alternative medicine as quackery. However, don't be too surprised if your doctor changes his or her tune. That's because researchers are now looking at the potential of medicinal botanicals for treating a variety of problems -- and they are finding some of them very promising.

    Speaking at the American Diabetes Association's 60th Annual Scientific Sessions in San Antonio, Laura McWhorter, Pharm.D., associate professor and a certified diabetes educator from the University of Utah School of Medicine, admitted that research of most botanicals is still scant and many clinical trials have not followed accepted scientific standards (placebo-controlled, double-bind study model). However, she suggested that physicians take a closer look at herbs and minerals that have shown potential for treating diabetes complications, including: garlic, St. John's Wort, aloe vera, Echinacea, ginkgo biloba, morphrin, ginseng, gumar, gymnen, fenugreek, bitter melon, alpha lipoic acid, chromium, vanadium, primrose oil and bilberry.

    Here's what she had to say about some of the most promising ones.

    Garlic: This is a well-studied herb, known for its ability to boost the immune system and protect against infection. It may have additional benefits for people with diabetes because it can lower total cholesterol levels and may improve the ratio of good and bad cholesterol. It also appears to improve high blood pressure and protect against free radicals. The most common side effect is bad breath. Garlic is a blood thinner so it should not be taken prior to surgery or in combination with other blood-thinning herbs such as ginkgo biloba, high doses of vitamin E or medications such as Coumadin (warfarin), heparin, aspirin and Trental (pentoxifylline).

    St. John's Wort: So named because it blooms around June 24 (the feast day of St. John the Baptist), St. John's Wort is used worldwide to treat depression, so it may be beneficial for people with diabetes who also suffer from depression. It's thought that some of the ingredients are flavinoids. In scientific studies, it's being compared with a group of drugs for depression called seratonin re-uptake inhibitors (SSRIs). Dr. McWhorter stressed that it's important for people to let their doctors know they are taking this drug because it can have adverse effects when taken in combination with other medications. Reportedly, it can cause seratonin syndrome when combined with SSRIs and may decrease blood serum concentrations of other drugs such as protease inhibitors (used to treat HIV) and organ transplant anti-rejection medication. Some women taking birth control pills along with St. John's Wort have reported breakthrough bleeding, and there is concern that it interferes with the effectiveness of oral contraceptives. Additionally, it may cause photosensitivity and increase the risk for cataracts.

    Aloe vera: Digestible aloe vera has been shown in clinical trials to significantly lower serum glucose. Other than an occasional allergic reaction, there are no other known side effects associated with this substance.

    Echinacea: One trial suggested that this herb's water-soluble mechanism reduces fasting glucose levels. While high doses were required for this effect, it didn't appear to adversely affect the liver. There are few reported side effects other than minor gastrointestinal effects, more frequent urination and an occasional allergic reaction.

    Gingko biloba: This herb is being studied intensely for use in treating diabetic neuropathy and for increasing blood flow to limbs. Ginkgo is considered safe, but it does have blood-thinning effects so it shouldn't be taken in combination with other blood thinning agents (see garlic for list).

    Evening primrose oil: Evening primrose oil contains GLA (gamma-linolenic acid), an essential fatty acid or good fat that also appears to help diabetic neuropathy by protecting nerves from diabetic-induced injury. There have been some reports of it causing mild headache, gastrointestinal distress or both, particularly at high doses.

    Ginseng: Different varieties of ginseng grow in Asia, Siberia and North America and may have medicinal effects. Scientific studies indicate that this herb lowers blood sugar levels as well as improves mood, vigor and physical performance. Side effects are rare but some women have reported post-menopausal bleeding and breast tenderness. Ginseng comes from a family of steroids that have various hormonal effects, which can stimulate the central nervous system. This may result in ginseng abuse syndrome, which is characterized by anxiety, insomnia and increased blood pressure. It may also interfere with drug metabolism and have adverse interaction with other medications.

    Gumar: Two small clinical trials indicate that gumar reduces blood glucose levels, possibly by decreasing glucose absorption from the intestines and blocking sweetness cravings. It also causes temporary loss of ability to detect sweetness. There is concern that it may inhibit the absorption of iron and other nutrients, interact adversely with some medications and induce hypoglycemia.

    Gymnemna: Used in India to treat diabetes for centuries, gymnemna appears to lower blood sugar levels. One study indicates that it may cause hypoglycemia. McWhorter noted that this is a very powerful drug and advised that it be taken only under medical supervision.

    Fenugreek: There are several small scientific studies indicating that fenugreek significantly lowers blood sugar by inhibiting glucose transport to delay carbohydrate absorption. However, a high dosage was required for this effect. Because this herb belongs to the peanut family, it could cause a reaction in people allergic to peanuts. It reportedly causes flatulence and is not recommended for pregnant women and people taking anticoagulants. There is also concern it may have adverse interactions with other medications, and it's known to affect the action of oxidase inhibitors, which are used to treat depression.

    Bitter melon: Two small, uncontrolled studies suggest that this fruit significantly lowers blood glucose levels by causing an increase in insulin uptake. You can eat it or drink it as juice, and it's available in powder form. Reported side effects include hypoglycemia, digestive distress similar to fenugreek, headaches, fever, abdominal pain and coma. This fruit is reportedly toxic in children --causing nausea, diarrhea and even death. McWhoter also warned that this fruit is an anti-fertility and abortive agent, which currently is under investigation in China for use as a contraceptive.

    Alpha lipoic acid: Several scientific studies suggest that this vitamin-like antioxidant is beneficial in treating diabetic peripheral neuropathy by preventing free radical and oxidative stress on nerve cells. It may also help prevent and treat cardiac autonomic neuropathy (injury to the nerves that control the heart) and prevent development of cataracts. Reported side effects include diarrhea, skin allergy reaction and hypoglycemia.

    Chromium: This substance probably acts as an insulin sensitizer and may help in weight loss. Reported side effects include an eye disorder called miosis, renal toxicity, skin allergy reactions and intensification of psychiatric disorders. McWhorter does not recommend using it.

    Vanadium: Animal studies suggest that this mineral might have an insulin-like effect that causes a decline in fasting-glucose levels. However, it has been associated with growth of cancer cells and in high dosages may be toxic.

    Bilberry: Bilberry reportedly has been used by pilots to improve night vision. Studies suggest that it also improves retinal damage caused by diabetes and/or hypertension. Bilberry is a food and is considered safe. One study reported a small incidence of mild digestive stress, skin rash and drowsiness. There are no known drug interactions.

    In conclusion, McWhorter stressed that "natural" does not necessarily mean "better". She said more research is needed to prove that these herbs are effective in treating diabetes complications. Additionally, she warned that some of these herbs are very powerful drugs with serious side effects, especially when used in combination with other medications. So if you are considering taking botanicals and minerals for diabetes complications, it's very important to consult your doctor first.


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