By Ashleigh Smith
Date: 30 September 2015
If you have diabetes, your main aim as part of your treatment is to control your blood glucose levels to prevent the long term complications associated with uncontrolled diabetes. After making the necessary dietary changes to ensure you are following a healthy balanced diet, including at least 30 minutes of exercise on most days and medication (if applicable). What other options are there to help you control your blood glucose levels?
If you search google, there are a multitude of articles on different ingredients, supplements and potions all said to help control your blood glucose levels. But how do we know they actually work? Is there research to back up their efficacy and what are the dangers associated with taking these ingredients?
Cinnamon is a well-known spice that has been used medicinally for thousands of years. There are two types of cinnamon, Cinnamomum zeylanicum and Cinnamon cassia. The Cassia is the varietal often promoted for its glucose lowering effect. When searching on google, there are numerous articles that state studies that show the beneficial effect of cinnamon, however if you dig a little deeper and look at research from journals and evidence based nutrition organisations, these effects are hard to prove. Leach et al (2012) conducted a systematic review on all studies up until 2012 that assessed cinnamon intake, all species, in type 1 and type 2 diabetics. After assessing 577 participants, from 10 randomised control trials, they concluded that “there is insufficient evidence to support the use of cinnamon in type 1 or type 2 diabetes mellitus”. This view is supported by the American Dietetic Association (ADA) and PEN (Practice-based Evidence in Nutrition). Although there maybe are no beneficial effects on your blood glucose levels, cinnamon tastes delicious and is a perfect addition to your cooking and a great way to flavour for your oats without adding sugar and salt, we recommend trying the new FUTURELIFE® Smart Oats Apple Cinnamon variant.
- Apple cider Vinegar
Apple cider Vinegar is another one of those ingredients that is said to have many benefits from cleaning, to weight loss, and use in conditions such as diabetes, heartburn and sore throat. If you look at diabetic chat rooms, people promote its blood glucose lowering effect when taken with meals. It is said that apple cider vinegar exerts its effects by preventing the complete digestion of carbohydrates, delaying gastric emptying or increasing the uptake of glucose by bodily tissues. In a review by Petsiou et al (2014), they concluded that there was some evidence to support the use of vinegar as a complementary treatment in patients with glucose abnormalities, however more long term and large scale research needs to be conducted. In another study reported in Diabetes care in 2004, when vinegar was included as part of their treatment regime, 19% of individuals with type 2 diabetes had improved insulin sensitivity and 34% in those with pre-diabetes. Although it may seem to be beneficial, apple cider vinegar not only tastes horrendous but it is acidic, therefore it has been known to affect your tooth enamel and oesophagus. It may also cause hypo’s so consult your doctor or health professional before taking apple cider vinegar to lower you blood glucose levels.
Chromium is an essential trace element that is used by our body for normal bodily functions and can be found in a wide range of foods. Examples include brewer’s yeast, green beans, broccoli, whole-grain products such as oats and barley, high-bran breakfast cereals, coffee, nuts, egg yolk and meat. Chromium plays an important role in the metabolism of carbohydrates, fats, proteins and insulin. There is a lot of research out there about its role in the management of blood glucose levels. Some studies are in support of its use and show that intake of chromium results in a reduction in HbA1c, while others show no effect. The Food and Drug Administration (FDA) concluded from their research that “only one study suggests that chromium picolinate may reduce the risk of insulin resistance… however existence of such a relationship between chromium picolinate and either insulin resistance or type 2 diabetes is highly uncertain”. The ADA and European Food Safety Authority (EFSA) showed the opposite, concluded that there was evidence to show that there is a cause and effect relationship between the dietary intake of chromium and its role in normal macronutrient metabolism and the maintenance of normal blood glucose concentrations. The dosage varies from study to study therefore it is important to consult your doctor before chromium supplementation is taken in large doses and for extended periods. However chromium is found in a large number of foods, therefore including chromium rich foods as part of your diet is a great way to ensure you are getting enough. Did you know that FUTURELIFE® Smart Oats and FUTURELIFE® Zero with Oats are both high in chromium? You can get 30 % of your RDA for chromium in just one 50 g portion.
Fenugreek is a herb that has a multitude of uses, such as a spice in Indian cuisine, flavouring agent in products and use as is in ancient medicine which is claimed to help with many conditions from loss of appetite and other gastrointestinal issues, to heart disease (atherosclerosis) and diabetes. Fenugreek, when mixed into a meal is proposed to slow gastric emptying and the absorption of sugars, inhibit glucose transport and stimulate insulin, therefore helping to control blood glucose levels. Research on the use of Fenugreek as a way to lower blood glucose levels is conflicting. Some studies show that fenugreek, in the form of seeds (extracted seed powder, gum isolate and whole cooked), resulted in a lower glucose levels after a meal, however the leaves and degummed seeds had no effect. In patients with Type 2 diabetes, studies reported that fenugreek reduced HbA1c levels by ≥0.5% when taken for a duration of three months or more. It is important to note that many of the studies had small samples sizes, poor study design and authors recommended more research on this topic. No side effects were noted in any of these studies so including fenugreek in your meal will not only add flavour but may exert a beneficial effect on your blood glucose levels.
Garlic (Allium sativum) is a common ingredient used to flavour foods worldwide as well as for its medical properties. Garlic is often researched for its antioxidant and cardiovascular effect, however research on its effect on blood glucose is not so well known. The mechanism by which garlic is said to exert its glucose lowering effects results from greater insulin secretion, slowed insulin breakdown and improved glycogen storage. Research on this topic shows conflicting views. The glucose lowering effect of garlic was observed in one study of 60 non-diabetics, assessing garlics effect on blood clotting, but when tested on type 2 diabetics, no improvement was found after 1 month of garlic supplementation. Like fenugreek supplementation, no adverse effects were observed in those taking garlic supplementation however including it in its raw form may leave you with bad breath.
- Aloe Vera
Aloe Vera is a plant that resembles a cactus, its leaves are well known for use on burns, in wound healing, skin moisturising and as a powerful laxative to treat constipation. Aloe vera is consumed as a gel mixed in liquid or taken in supplement form. Aloe vera leaves are said to contain glucomannan, which is a water soluble fibre that is said to cause its hypoglycaemic effects. In a study by Yongchaiyudha et al (1996), authors found that when patients drank aloe vera twice a daily, blood sugar and triglyceride levels decreased. In another study, HbA1c level also improved. It is important to consider that although beneficial effects were found, most of the research was conducted by the same author. PEN stated “that there is some evidence to show that aloe vera gel has a glycaemic effect, but more studies are required to confirm the potential benefit of this dietary supplement in the management of diabetes”. Possible sides of aloe vera include diarrhoea and cramping so consult your doctor before taking this as a supplement to help improve your blood glucose.
After reading this you will see that there is little scientific information that supports the use of these products in managing your blood glucose levels and that more research is needed. Remember that there is no magic pill or quick fix out there when it comes to managing your diabetes and therefore blood glucose levels. Dietary management, including exercise and medication are still the number one methods of treatment when it comes to effectively managing your blood glucose levels. If however you decide to try any of these methods, please consult your doctor as there maybe side effects or drug interactions to consider. For more information on diabetes or our FUTURELIFE® products please visit our website at http://www.futurelife.co.za.
- Leach MJ, et al. Cinnamon for diabetes mellitus. Cochrane Database of Systemic Reviews. 2012. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007170.pub2/abstract;jsessionid=AEEE7F7D451ABA170D1B330D0BC61A58.d02t04. Accessed 29 September 2015.
- Yeh GY, Eisenberg DM, Kaptchuk TJ, Phillips RS: Systematic review of herbs and dietary supplements for glycaemic control in diabetes. Diabetes Care 26:1277–1294, 2003
- Diabetes – Dietary Supplements: Key Practice Points. Practice-based Evidence in Nutrition (PEN). Accessed at http://www.pennutrition.com/
- Petsiou EI, Mitrou PI, Raptis SA, Dimitriadis GD. Effect and mechanisms of action of vinegar on glucose metabolism, lipid profile, and body weight. Nutrition Reviews. 2014. Volume 72, Issue 10, pages 651–661, Accessed on 29th September 2015. http://nutritionreviews.oxfordjournals.org/content/72/10/651
- Johnston CS, Kim CM , Buller AJ. Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects With Insulin Resistance or Type 2 Diabetes. Diabetes Care. 2004 Jan;27(1):281-2.
- Chromium and blood glucose control, what does the research say? By Ashleigh Smith, Futurelife dietician. https://www.facebook.com/futurelifeza/posts/993233387388528
- Yongchaiyudha S, Rungpitarangsi V, Bunyapraphatsara N, Chokechaijaroenporn O. Antidiabetic activity of Aloe vera L. juice. I. Clinical trial in new cases of diabetes mellitus. Phytomedicine 3:241–243, 1996
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