Diabetes and blood sugar

Diabetes is a metabolic disorder. There are three types of diabetes but not all of them have insulin issues. However, the most prevalent type is Diabetes Mellitus – type I and II, which do have problems with insulin.

  1. In type I pancreatic Beta cells don’t make enough or any insulin and there is a loss or lack of Beta cells which are the pancreatic cells that make the insulin. Type I is seen early in life. Both the immune system and stress have also been shown to cause beta cell death in the pancreas.
  2. In type II various cells in the body are resistant to whatever level of insulin is available. Type II is generally seen later in life (around 40+)
  3. Another form is Diabetes Insipidus. The cause is most often the Lack of antidiuretic hormone (ADH) also known as vasopressin.

The two main symptoms are the same for all three forms of diabetes – excessive thirst (polydipsia) and excessive urination(polyuria). I will only discuss diabetes mellitus and the insulin/sugar issues associated with this disease.

So what is insulin’s role in the body? Various cells in body take up and use glucose for energy but insulin is needed to make the glucose channels open and let glucose into the cells. The pancreas creates insulin along with other hormones that regulate the level of insulin in the blood at any given time. When we eat we can cause a rapid rise in glucose in the body and the pancreas responds by releasing insulin. Glucose that is not used is stored in the liver as glycogen.

There are two ways to get glucose in the body. What we eat is broken down in the GI tract to the constituents the body needs such as glucose. The GI tract, including the intestines, is actually a tube that is surrounded by the body. The GI tract is a tube running through the middle of the body from the mouth to the anus – but for nutrients to get into the body the compounds must be absorbed through the walls of the GI tract into the blood stream. Once in the blood stream, compounds like glucose, travel through the blood to cells of the body to be used as needed. The other way we get glucose, under normal conditions, is from the liver which stores excess glucose and in times of need it can release the stored glucose or it can create new glucose.

However, when cells become insensitive to the insulin, or there is too little insulin, less glucose gets into the cells. If glucose can’t get into the cells and if the liver cannot store all of it, the level in the blood will rise overwhelming the kidneys filtering system leaving glucose in the urine.  It used to be how people knew you had diabetes – sweet urine. High glucose in the blood can lead to high blood pressure and hardening of the arteries. It can also lead to very dry skin due to loss of fluids as the kidneys try to eliminate the excess glucose.

There are several herbs that can actually help support blood glucose regulation.*  However, not all have clear scientific evidence as to their mechanism of action. Herbs can help prevent the onset of disease if started before major issues arise. I believe that herbs could be the first line of defense instead of the drugs that may cause some serious side effects. Herbs can’t cure but they can often do well enough to slow down progression of issues. Most herbs have few side effects and often those are not serious. However, no one should be using herbs without at least letting their physician know what they are doing. Herbs can interact with meds so working with an herbalist is also a good idea.

The following are a few herbs that have been used and/or Studied for Diabetes. I have bolded those with some reasonable evidence of their efficacy.

  • Gymnema sylvestra – good scientific evidence (B) Gymnema sylvestra  B for both Type I and II
  • Ginseng – good scientific evidence (B)
  • Bitter Melon (B)
  • Berberine C (found in several plants exp. goldenseal)
  • Turmeric/Curcumin: (lack of evidence)
  • Ginkgo biloba – unclear (C for diabetic neuropathy)
  • Aloe Vera – (C) (unclear)
  • Fenugreek – unclear (though found to be safe for diabetics)##
  • Garlic – D
  • (Only given a rating if there is sufficient human evidence for or against the herb. Most data is from animal studies.)

The evidence classification was designed by the Natural Standard – the authority on integrative medicine and the main database for  pharmacists.

A (Strong Scientific Evidence)

B (Good Scientific Evidence)

C (Unclear or conflicting scientific evidence)

D (Fair Negative Scientific Evidence)

F (Strong Negative Scientific Evidence)

These classifications can change based on findings from new studies and clinical trials##.

##For example, a meta-analysis of 10 clinical trials fenugreek demonstrated the ability of fenugreek to lower both glucose and A1c.(neelakantan 2014) Therefore, although more trials are needed, I believe it’s rating needs to be raised. In fact I have a client that has seen her glucose drop a good 30 points and her A1c from 5.9 to 5.7 using our Glucose Support Tea which includes fenugreek among other herbs.

The above list is not comprehensive by any means, but it would make this article too long to discuss more than a couple of herbs so I will only describe the first two herbs, Gymnema Silvestre and Ginseng (Panax Ginseng specifically). Herbs that have less than a B rating may not afford enough benefit to make it worth discussing.

Gymnema sylvestre: (B)
Activities observed in studies

• Lowers blood sugar

• Suppresses “sweet” taste of food (if leaves are eaten)

• Increased regeneration of beta cells in rats (Ahmed 2010)(Snigur 2008)

• Glucose uptake inhibitor

• Gut glycosidase inhibitor+

• Lowers cholesterol; LDL, VLDL, triglycerides

• Antimicrobial

• Weight loss effects

 

+Glycosidase breaks down sugar to smaller units for absorption in the GI tract – antidiabetic drugs such as: acarbose and miglitol work to inhibit glycosidase and Gymnema does the same thing.

Best to use a standardized extract: example- 400mg standardized to 25% gymnemic acids

Interactions: may potentiate antidiabetic, -lipid lowering, and -anti-obesity agents (drugs or herbs/supplements)

 

Panax Ginseng: (B)There are several varieties of ginseng, and although they are all somewhat alike they are not identical and each one has a slightly different effect. Panax ginseng is by far the most potent in dealing with sugar/insulin imbalances.*

Activities observed in studies (Vukson et al. and Ma et al.)

• Decreases Glucose production in the Liver

• Decreases Glucose absorption in intestines

• Increases Insulin production in the pancreas

• Increases Insulin secretion in the pancreas

• Decreases Insulin resistance

• Increases Glucose uptake in adipose tissue and skeletal muscle

 

There are several ginsenosides which are the most studied component of ginseng. (Re, Rd, Rb1, Rb2, Rd to name a few)

Not all studies show the same results – more studies are needed to develop a definitive understanding of Ginseng’s effects.

Chart adapted from Tang & Go 2009: I added Gymnema to the pancreas list.

Hypoglycemic

Herbs

Insulin Secretion Glucose Absorption Glucose Production Glucose Uptake Glucose uptake
Pancreas Intestines Liver Skeletal Muscles Skin
Ginseng Myrcia Berberine Ginseng Ginseng
Bitter Melon Snagzhi Fenugreek leaves Bitter Melon Bitter Melon
Aloes Cinnamon  Cinnamon
Gymnema

The chart shows how and where herbs can impact the glucose and/or insulin much like the medications do . Herbs tend to be less harmful to the body and I recommend discussing using herbs with your doctor before starting on serious medications.

Note:Herbs should be discontinued two weeks before surgery.

 

References: 

  • Ahmed AB, Rao AS, Rao MV.In vitro callus and in vivo leaf extract of Gymnema sylvestre stimulate beta-cells regeneration and anti-diabetic activity in Wistar rats. Phytomedicine. 2010 Jul 26.
  • Ma SW, Benzie IF, Chu TT, Fok BS, Tomlinson B, Critchley LA. Effect of Panax ginseng supplementation on biomarkers of glucose tolerance, antioxidant status and oxidative stress in type 2 diabetic subjects: results of a placebo-controlled human intervention trial. Diabetes Obes Metab. 2008;10:1125–1127. doi: 10.1111/j.1463-1326.2008.00858.x.
  • Neelakantan N1Narayanan Mde Souza RJvan Dam RM.Effect of fenugreek (Trigonella foenum-graecum L.) intake on glycemia: a meta-analysis of clinical trials. Nutr J. 2014 Jan 18;13:7. doi: 10.1186/1475-2891-13-7
  • Snigur GL, Samokhina MP, Pisarev VB, Spasov AA, Bulanov AE.[Structural alterations in pancreatic islets in streptozotocin-induced diabetic rats treated with of bioactive additive on the basis of Gymnema sylvestre] Morfologiia. 2008;133(1):60-4.
  • Tang G,Go VL. Hypoglycemic herbs and their action mechanisms. Chin Med. 2009 Jun 12;4:11. doi: 10.1186/1749-8546-4-11.
  • Vuksan V, Sung MK, Sievenpiper JL, Stavro PM, Jenkins AL, Di Buono M, Lee KS, Leiter LA, Nam KY, Arnason JT, et al. Korean red ginseng (Panax ginseng) improves glucose and insulin regulation in well-controlled, type 2 diabetes: results of a randomized, double-blind, placebo-controlled study of efficacy and safety. Nutr Metab Cardiovasc Dis. 2008;18:46–56. doi: 10.1016/j.numecd.2006.04.003.

These are only a few references out of hundreds. Both Gymnema and Ginseng have been used for centuries in India and China respectively. I also have personal experience with Gymnema and it’s ability to lower glucose. I have had three clients plus myself on Gymnema and we have all seen a serious decrease in blood glucose. *The FDA has not evaluated these findings or statements.