Dietary And Plant Supplements In Diabetes

The approach to any chronic disease, including diabetes, is not simple for those affected or for their families. It is common to look for alternatives to traditional treatments that improve or facilitate the day-to-day management of the disease.

The very difficulty of controlling the disease, the frustration due to the lack of results or the need to notice a rapid improvement pushes many patients to seek help from this type of supplements.

According to recently published data, almost half of all Americans of legal age use some type of dietary supplement. People with diabetes become a target population for many of these products. It is a chronic, diet-related disease that will have more than 380 million people affected worldwide by 2025. As always, commercial interests may influence the advertising of some products over and above their real benefits.

In relation to nutritional supplementation there is a maxim: a varied and balanced diet provides all the nutrients necessary for the development and maintenance of an optimal state of health. At this point, anyone can ask themselves the following questions: Is my diet sufficiently varied and balanced? How can I know? It is accepted that there are certain situations in which special attention should be paid to nutrition. Thus, during pregnancy, folic acid or iodine supplements are recommended, or those who follow a dietary pattern with little animal protein may need vitamin B12 supplements. Similarly, it is common to find nutritional deficits in elderly people and in those who follow weight loss diets, because in one way or another the intake of nutrients may be less than necessary. This may be the case for many people with diabetes, and the place where nutritional supplements could be of use.

Dietary supplements to improve diabetes? What the science says.

The beneficial effect of dietary supplements and herbal supplements for diabetes management is in question. For some they may be of great use, while for others they are only attributed to the so-called placebo effect, whereby an improvement in health status is produced by the mere fact of receiving a treatment, even if the treatment itself is totally ineffective.

But how do we know if science has proven the usefulness (or uselessness) of any of these supplements? It is very easy to get carried away by phrases such as: “a study says that taking X is good for lowering blood sugar”. Surely any reader has heard or read comments like this. There are different types of studies, some only report things while others are the ones that actually prove them. And in the case of reading: “8 studies say that taking X is good for lowering sugar”? Neither. Quantity does not indicate quality.

Understanding and being able to judge studies is a job reserved for specialists in the field. That is why we turn to the Scientific Societies in each field, which evaluate the studies published for each topic in question and give us the recommendations to follow.

In the case of diabetes, the American Diabetes Association is one of the reference bodies, publishing annually its recommendations on the treatment of diabetes based on research and scientific consensus. Among these recommendations, those on the effect of diet in people with diabetes are especially recognized. In the guidelines published in this year 2014, reference is again made to the use of dietary supplements or vegetable-based preparations in people with diabetes. Some of the recommendations included in these guidelines are summarized below:

  • Omega 3: the recommendation to supplement with omega 3 fatty acids in people with diabetes for the prevention or treatment of cardiovascular problems is not recognized. In addition, no improvements are obtained on blood glucose levels in patients with diabetes.
  • Vitamins and minerals: Routine supplementation with vitamins or minerals is not recommended for people with diabetes. The situation is different for some population groups with a higher risk of nutritional deficits, such as pregnant or lactating women, the elderly, vegetarians or those who follow restrictive diets. In these cases, vitamin and mineral supplementation may be necessary on an almost regular basis.
  • Antioxidants: despite the enormous interest shown by many researchers, a good risk-benefit ratio is not currently recognized with antioxidant supplementation, and the long-term safety of taking vitamin E, C or carotene supplements is unclear.
  • Cinnamon: it is a very common food in our Mediterranean cuisine. However, there is not enough information about the benefits of the use of cinnamon or other medicinal herbs.

It is true that there are many other supplements, such as Ginseng, Aloe Vera or Stevia that are related or have been related to an improvement in blood glucose values. At the moment, the published studies are not enough to establish a recommendation because, in all cases, not only their benefit but also their safety must be demonstrated.

In this regard, the American Diabetes Association points out the difficulty in evaluating the benefit-risk ratio of these supplements, since in many cases they do not contain a stable dose of the active ingredient. In other words, there is no rigorous control over the concentrations that herbal supplements or herbal extracts contain. This fact makes it very difficult to attribute beneficial effects and, more dangerously, may increase the risk of side effects associated with some of them. It is especially important to advise all people with diabetes to inform their physicians about the type of dietary supplements they are taking. This will enable them to take into account the needs of each individual and the possible interactions that may occur with the drugs used.

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