Diabetes mellitus is among the fastest-growing conditions in the world, and in Australia, a new case is diagnosed every 5 minutes. Many people with this illness are now taking diet supplements in an attempt to prevent this condition. A new study published in the journal Pharmaceutical Medicine from the University of South Australia shows that many of these so-called nutraceuticals can help treat diabetes and reduce the impact of other factors that increase the risk of developing this condition.
Nutraceuticals. Image Credit: Shutterstock
The study defines nutraceuticals as “defined as food products, extracts or food derivatives such as vitamins, herbs, amino acids, minerals and enzymes that can potentially exhibit pharmaceutical benefit in addition to their nutritional value.” Nutraceuticals are important as a possible health intervention, since they are already widely used by the general population in developed countries. In fact, says researcher Evangeline Mantzioris, nutraceuticals are taken by over 40% of the adult population in Australia. Some studies show that they may help in some chronic conditions, either to improve the efficacy of the primary medication or to prevent or counteract the adverse effects.
The perceived advantages of nutraceuticals are their availability over the counter, their supposed low cost in many cases, and their accessibility. However, these very characteristics can be their downside, as well, since all of them are not equally effective. One study shows that actually more money is spent on alternative and complementary medicine than on prescription medicines! The poor regulatory framework with respect to these supplements makes it more difficult for patients to know which one they should actually use. And the huge volume of misinformation floating around the Internet doesn’t help.
Diabetes mellitus is a lifelong condition, in most cases, brought on by the body’s inability to utilize glucose adequately, resulting in high blood sugar levels that serve both as a characteristic marker and the primary reason for poor health outcomes. The reason for the abnormal glucose processing is a functional or physical lack of insulin activity, insulin being the pancreatic hormone that is chiefly responsible for stimulating the uptake of glucose from the blood into the body cells.
There are two types, type I which is present from early childhood and is due to a lack of insulin production because of the destruction of the insulin-producing beta-cells in the pancreas. Type II is a largely preventable condition, in 60% of people, caused by abnormal weight gain, a sedentary lifestyle, and poor eating patterns, which lead to a constant and eventually unmanageable load on the insulin-producing cells. in addition, other metabolic and hormonal abnormalities are often found in these patients, such as insulin resistance in the fat cells, which prevents their proper response to available insulin. Paradoxically, therefore, insulin levels are often higher than normal even as blood sugar levels soar.
There are about 420 million diabetics in the world, and they require about $1 trillion for their health-related expenditure. Diabetics are prone to vascular complications such as blindness, heart disease and amputations.
Obesity is linked to higher rates of type II diabetes, cardiovascular disease, high blood pressure, high blood lipids, and a higher overall mortality. Hypertension itself poses the risk of cardiovascular disease, kidney disease and death. High LDL cholesterol also pushes up cardiovascular mortality.
The study and its findings
The current study was meant to review the available evidence, to show which nutraceuticals among a selected few were most effective in managing diabetes, obesity, high blood pressure, high blood lipids, and chronic inflammatory conditions.
The study showed that cinnamon is not very effective in lowering fasting blood glucose consistently in type II diabetes, while resveratrol has a two-pronged action: it lowers blood glucose and improves insulin resistance, making the peripheral tissues more sensitive to the actions of insulin. Meanwhile, curcumin reduces insulin resistance in both the pre-diabetic and type II diabetic patient and seems to be more effective in preventing diabetes.
However, green tea, green coffee extract, and gamboge (Garcinia cambogia) had no weight-lowering effect that could be detected by the experiment.
Garlic and beetroot juice could be useful in reducing hypertension when taken in conjunction with standard antihypertensives, especially in people with chronic disease who took the supplements over a longer period and at a higher dose.
For cardiovascular disease, they found that phytosterols could cause a small reduction in LDL levels when taken along with statins, while curcumin might reduce statin-associated muscle symptoms.
Fish oil and glucosamine/chondroitin sulfate supplements for inflammatory conditions have not been tested in high-quality randomized controlled trials, which limits the evidence available. Most studies report no difference from placebo. Curcumin did have an anti-inflammatory effect, however.
The researchers say that nutraceuticals can certainly be used for their natural health-promoting benefits, such as reducing the occurrence of high blood sugar levels. However, a healthy diet and lifestyle are the most important things that can reduce the risk of diabetes. Studies on nutraceuticals are hampered by a number of factors which limit their generalizability and make recommendations difficult. High quality studies would be beneficial, in uncovering the diverse mechanisms through which they act, the optimal dosage, and best combinations, for different patient populations.
Mantzioris says, “People should invest in a diet filled with whole foods – vegetables and fruits, cereals, lean meats, fish, eggs, nuts and seeds, as well as dairy foods. However, if you are considering nutraceuticals to manage or prevent diabetes, we always recommend speaking with your doctor. There is still a lot we need to learn about them.”
Bergamin, A., Mantzioris, E., Cross, G. et al. Nutraceuticals: Reviewing their Role in Chronic Disease Prevention and Management, Pharm Med (2019) 33: 291. https://doi.org/10.1007/s40290-019-00289-w