Diabetes
Natural Treatment | My life as a heretic Doctor | Gimnasia y Actividad fisica |
Natural Treatment
Fighting Diabetes the Natural Way
by Brooke K. Deets
Revised and summary by Dr León Gerner
Obesity and diabetes often go hand-in-hand, and both epidemics are increasing public health concerns in the United States. In today’s fast-paced world, more people consume a poor diet, face excessive stress and don’t get as much physical exercise as is recommended. Fortunately, all three factors are well within a person’s control, which is good news because diabetes (specifically Type II) and prediabetes are first and foremost nutritional diseases. Both respond amazingly well to a combination of proper diet, regular physical activity and the judicious use of certain dietary supplements.
Diabetes is a disabling, deadly disease that is on the rise, particularly in the United States. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), an estimated 18.2 million Americans—6.3 percent of the population—have diabetes; however, an estimated 5.2 million of those have not yet been diagnosed. And the numbers are growing: in 2000, approximately 17 million—or 6.2 percent of the population—were estimated to have diabetes, either diagnosed or not. Overall, diabetes was the sixth leading cause of death in the United States in 2002, and the excessive relative risk for death among people with the disease is about twice that of people without.
Diabetes is actually a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action or both. It brings with it problems associated with blood sugar and insulin, and other serious complications including heart disease and stroke, high blood pressure, blindness, kidney disease, amputations and dental disease. Fortunately, diabetes is often preventable and controllable in many cases. Maintenance of healthy blood sugar levels through a proper diet and regular exercise may control and, in many cases, reverse diabetes.
The body’s ability (or lack thereof) to use insulin is the underlying factor for this metabolic disorder. In a person with a normal metabolism, food is broken down into glucose, a form of sugar found in the blood and one of the body’s main sources of energy. During digestion, glucose is released into the bloodstream and into the body’s cells by way of insulin, where it is used for energy and growth. But when the body cannot properly use insulin (as in Type II) or cannot produce it (as in Type I) to transport glucose into the body’s cells, that glucose builds up in the blood and is excreted through urine. The body is then left without its main source of fuel.
Type I diabetes,
formerly called insulin-dependent diabetes or juvenile-onset diabetes, is an autoimmune disease, in which the immune system turns against the body it is supposed to protect. In the case of Type I diabetes, the immune system attacks and destroys pancreatic beta cells, which are the only cells that make the hormone insulin. Because of this, Type I diabetics must take daily doses of insulin. This form of diabetes may account for 5 percent to 10 percent of diagnosed diabetes cases and most often develops in young children and adults, although disease onset can occur at any time. Men and women are equally impacted by the disease, although Caucasians are more likely to have the disease than non-Caucasians.
Type II, is found in about 90 percent to 95 percent of diagnosed diabetes cases.
This form of diabetes was formerly called non-insulin dependent diabetes or adult-onset diabetes. However, the latter term is considered passé as the incidence of Type II has skyrocketed in all age groups—even children and adolescents are developing the disease more so than in years past.1 Type II diabetes usually begins as insulin resistance, a condition in which the body does not respond to insulin efficiently, and can develop into Type II diabetes over time (although not everyone with insulin resistance will go on to develop diabetes). People over age 40 who are overweight and lead an inactive lifestyle are most at risk for developing Type II diabetes, and in the United States, the disease is most prevalent among non-Caucasians, such as Native Americans, blacks and Hispanics. As previously mentioned, many Type II diabetics are able to control their condition by way of lifestyle interventions such as diet and exercise, but some, like Type I diabetics, must take insulin and/or other medications to control their blood sugar.
Diet specifically plays a role in insulin resistance. For example, high carbohydrate foods, such as breads, sweets and flour- and sugar-based snack foods cause a rapid increase in blood sugar levels. The pancreas responds by pumping out high amounts of blood sugar-regulating insulin, which converts a large portion of the excess sugar (glucose) into glycogen, one of the body’s main sources of energy. But what happens when the glycogen stores are filled to capacity and there is still excess sugar in the blood? Insulin converts the remainder into fat, which is one reason the high amount of refined carbohydrates in the American diet is leading millions of people to become overweight.
And over time, the body’s cells eventually become overwhelmed by so much insulin and actually become resistant to it. The more advanced form of insulin resistance is Syndrome X, which is characterized by insulin resistance, abdominal obesity, high blood pressure and unhealthy cholesterol and triglyceride levels.
Pre-diabetes also plays a major role in the development of the disease. If a person has glucose levels that are above normal but not yet in the diabetic range, she has pre-diabetes and is at increased risk for developing the disease. The two types of pre-diabetes are impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). According to the U.S. Department of Health & Human Services (HHS), 41 million Americans (approximately 40 million adults between the ages of 40 and 74) have pre-diabetes (IFG and/or IGT), which is double the amount previously thought. The new estimate—released April 29—is based on a revised, more accurate definition of prediabetes made by an expert panel at the American Diabetes Association (ADA). Under previous criteria, it had been estimated that approximately 20.1 million Americans in this age group had pre-diabetes. Specifically, ADA changed the definition of “normal” fasting glucose to below 100 mg/dL for the IFG test, when previously it had been 110 mg/dL; now, anyone with a fasting glucose level between 100 and 125 mg/dL is classified as pre-diabetic. ADA did not change the criteria for the IGT test.
“These latest numbers show how urgent the problem really is,” said Health & Human Services Secretary Tommy Thompson. However, experts also pointed out modest diet and exercise can delay, if not prevent, the onset of Type II diabetes in many pre-diabetics.
The Importance of Diet & Exercise
One of the best things a person can do for her health and body is eat a healthful, balanced diet, exercise regularly and get plenty of rest. The same is true for people with normal glucose regulation and for those with pre-diabetes, as it is well known that eating right, exercising and losing weight can help control blood sugar levels and prevent the onset of diabetes.2 Physical exercise is also recommended to realize optimal glucose control benefits in Type II diabetics.3 “Nutrition is the basis,” said Jim Roza, director of quality assurance for Bloomingdale, Ill.-based NOW® Foods. “Many people can control their blood sugar through proper food selection. Additionally, exercise will also help people manage their condition. It requires a shift in eating habits and food selection that requires a life long commitment.” Roza further stated supplementation can also help, although it is not a “magic bullet,” and that supplementation and diet modification go hand in hand. “The publicity given to obesity and the epidemic proportions of diabetes are salient arguments for supplementation. A simple questionnaire that allows consumers to do an introspective analysis of what they’re eating would be a good starting point for creating consumer awareness.”
Learning what types of foods to eat is also a must when managing diabetes or pre-diabetes. Complex carbohydrates, including whole grains, most vegetables and beans, which release sugar slowly into the bloodstream, are the only recommended choice for people managing the disease. Simple carbohydrates are essentially sugars—white sugar, brown sugar, corn syrup and fructose—and are quickly broken down into glucose and enter the bloodstream rapidly, causing a rapid rise in blood glucose, accompanied by a rise in insulin. Refined carbohydrate foods, including white bread, potatoes, rice, fruit juices and snack foods made with refined flour, unfortunately, make up too much of the typical American diet.
Consumption of such foods not only increases obesity levels, but also the risk for developing diabetes. Researchers from the Inter-Medic Medical Group in North Point, Fla., agree, as they found increasing intakes of refined carbohydrates (corn syrup), along with decreasing intakes of fiber, paralleled the increase of Type II diabetes in the United States.4
Fiber has numerous studies backing up its efficacy against diabetes. For example, a study conducted by Finnish researchers found high intake of dietary fiber is associated with enhanced insulin sensitivity, and therefore may have a role in preventing Type II diabetes,5 and researchers from the University of South Carolina, Columbia, also concluded higher intakes of whole grains may increase insulin sensitivity.6 A study conducted at Shanxi Medical University in China tested this theory by feeding fiber to Type II diabetic rats for eight weeks. They found fiber not only increased insulin sensitivity, but also decreased high blood lipid levels and prevented impaired glucose tolerance (IGT), a form of pre-diabetes.7
Watching Weight & Glucose Levels
Obesity is strongly associated with several major health risk factors, including high blood pressure, high cholesterol, asthma, arthritis, poor health status and diabetes.8 And as one of diabetes’ more prominent causative factors, encouraging customers to watch their weight and to lose weight if they are overweight will help them lower the risk of developing diabetes. The Diabetes Prevention Program has shown that losing 5 percent to 7 percent of body weight can actually delay— and possibly prevent—the onset of diabetes in overweight pre-diabetics.
Supplements for Diabetes
Conjugated linoleic acid (CLA) is one supplement that may be helpful for diabetics because of its ability to reduce body fat. Research conducted in Sweden has shown CLA to be quite effective in lowering plasma glucose and adipose (fat) tissue while increasing insulin sensitivity.9
Several vitamins and minerals may also play a role in helping to prevent the disease. For example, a deficiency in vitamin D in early life has been shown to accelerate the onset of Type I diabetes in non-obese diabetic mice,10 and according to researchers at the University of California, Los Angeles, people with hypovitaminosis D (deficient vitamin D status) are at higher risk of insulin resistance and metabolic syndrome (Syndrome X).11 Vitamin E and other antioxidants have also been shown to lend a hand in preventing diabetes.
Adults with metabolic syndrome have been shown to have suboptimal concentrations of several antioxidants, including vitamin C and vitamin E,12 and vitamin E was found to prevent the onset of Type II diabetes among habitual users, according to researchers at the University of South Carolina, Columbia.13
A vitamin-like antioxidant, alpha-lipoic acid (ALA), may improve diabetes by affecting mitochondrial function. In an animal study conducted at the University of Montreal, Canada, ALA supplementation was shown to prevent increases in insulin resistance, glucose levels and blood pressure in control rats.14 And researchers at Mount Zion Hospital in San Francisco recognized ALA helps protect muscle cells from oxidative stress-induced insulin resistance.15
Another powerful antioxidant, the extract of French maritime pine bark (as Pycnogenol® from Natural Health Science) may also help lower blood glucose levels and make blood vessels healthier in Type II diabetics.16 After participating in a monthlong diet and exercise program, 30 subjects were supplemented 50 mg/d of Pycnogenol for three weeks, followed by 100 mg/d of Pycnogenol for three weeks, then 200 mg/d of Pycnogenol for three weeks and finally 300 mg/d of Pycnogenol for three weeks. Researchers found fasting blood glucose was lowered dose-dependently and the maximum decrease of postprandial glucose was achieved with a dose of 200 mg/d.
Minerals
also play an important role in managing diabetes. One mineral in particular, chromium, is necessary for proper insulin function and blood glucose regulation. According to research presented at the 2nd International Congress on Nutrition and Aging, chromium supplementation may be able to reverse diabetes development. The researchers discussed a study of more than 40,000 overweight subjects, where the mineral was shown to improve insulin sensitivity and had a dose-dependent effect on glucose, insulin and insulin sensitivity.
According to Gail Montgomery, president and chief executive officer of Purchase, N.Y.- based Nutrition 21, makers of Chromax® chromium picolinate, a growing body of evidence suggests that low chromium status contributes to the development of insulin resistance and an increased risk of diabetes and heart disease. “Highly processed diets and diets comprised of refined sugars can exacerbate chromium loss. ... [A]nd supplementation is a good way to meet the body’s essential need for this important mineral,” she said. Human research has shown that taking the mineral (as Chromax®) significantly improves glycemic control and serum fasting insulin compared to placebo in Type II diabetics.17 “The essential role that chromium plays as a co-factor in insulin activity makes it a prime candidate for consideration as the number one choice in maintaining healthy insulin function and carbohydrate metabolism,” Montgomery said.
Another form of chromium that has shown potential in helping treat diabetes is chromium nicotinate (as ChromeMate® from Benicia, Calif.-based InterHealth Nutraceuticals Inc.). In this form, chromium is bound to the B-vitamin niacin, which an animal study has shown increases the bioavailability of chromium.18 According to Allondra Stevens, marketing services manager at InterHealth, ChromeMate supplementation is helpful in people with insulin resistance and in people who have diabetes because it potentiates the body’s efficient use of insulin. She also noted zinc is an important trace mineral that has been shown to help regulate blood sugar levels. Research has shown that low dietary intake and blood levels of zinc are associated with diabetes and cardiovascular disease, and supplementation of chromium and zinc, as well as selenium and vanadium, may reduce insulin resistance.19
Vanadium has also shown positive preliminary results for independently regulating glucose control in diabetics.20 A rat study conducted at Istanbul University in Turkey demonstrated this effect. When diabetic rats were given vanadyl sulfate—a particular ion of vanadium—for 60 days, they did not show the increase in blood glucose levels that was apparent in the control group.21
Another mineral that may help protect against Type II diabetes is magnesium. After following approximately 128,000 men and women for an average of 15 years, researchers at Harvard School of Public Health in Boston found a significant inverse association between magnesium intake and diabetes risk.22 Specifically, women with the highest magnesium intake had a 34-percent reduced risk of diabetes compared to women with the lowest magnesium intake, and men with the highest magnesium intake had a 33-percent reduced risk compared to men with the lowest magnesium intake. Another study also conducted at Harvard School of Public Health stated “higher magnesium intake is associated with lower fasting insulin concentrations among women without diabetes. Because lower fasting insulin concentrations generally reflect great insulin sensitivity, these findings provide a mechanism through which higher dietary magnesium intake may reduce the risk of developing Type II diabetes.”23
Botanical supplements
On the botanical front, supplementing with stevia (Stevia rebaudiana), a powder derived from the stevia plant native to Paraguay that is times 300 times sweeter than sugar after processing, may also help diabetics and pre-diabetics control their blood sugar levels. “SweetLeaf Stevia has a glycemic index of zero as well as a zero netcarb and calorie count, making it a safe alternative for consumers, both diabetics and otherwise,” said Aaron Henderson, director of communications and marketing at Mesa, Ariz.-based Wisdom Natural Brands™, makers of SweetLeaf™ Stevia dietary supplements. “Numerous studies potentially demonstrate that stevioside, a component of SweetLeaf Stevia, may help promote healthy blood sugar levels.” A study conducted at Aarhus University Hospital in Denmark supports this theory. Twelve Type II diabetic subjects were supplemented with either 1 g of stevioside or 1 g of maize starch (control) with a meal. After measuring blood samples taken before and four hours after eating the meal, the researchers found stevioside reduced postprandial blood glucose levels, indicating beneficial effects on glucose metabolism and concluded stevioside may be advantageous in the treatment of Type II diabetes.24 And in a diabetic rat model, stevioside was shown to reduce glucagon levels as well as systolic and diastolic blood pressure.25
Herbs
Several herbs may also have sugar regulating properties, such as gymnema (Gymnema sylvestre), bitter melon, black plum, holy basil and cinnamon, according to Grace Ormstein, M.D., medical director and scientific advisor for Himalaya USA, maker of GlucoCare®, an herbal formulation that supports healthy blood sugar levels. “Gymnema has been known as a ‘sugar destroyer’ for more than 2,000 years. When taken internally, it helps control blood sugar levels and sweet cravings,” Ormstein said. “It may also help revive insulin-producing beta cells in the pancreas.” An animal study conducted at the University of Chicago Medical Center found gymnema to have anti-hyperglycemic activity and helps reduce body weight,26 and Indian researchers found doses of gymnema at 50 mg/kg of body weight, 100 mg/kg of body weight and 200 mg/kg of body weight for three weeks suppressed elevated blood glucose and lipid levels in diabetic rats.27
Fenugreek (Trigonella foenum graecum L.) may lend a helping hand in diabetes management for people with Type I and Type II diabetes due to its ability to inhibit glucose uptake, according to researchers at the University of Sana’a in Yemen.28 And in two separate rat models, supplementation of fenugreek leaves significantly improved hyperglycemia, hypoinsulinemia, body weight, liver glycogen and key carbohydrate metabolic enzymes,29 and in Type I diabetic rats, supplementation of 5-percent fenugreek seed powder for 21 days was shown to bring down elevated fasting blood glucose levels to control levels and stabilize glucose homeostasis in the liver and kidneys.30
Another way to help control blood sugar is with supplementation of Panax ginseng berry extract. In a study conducted at the University of Chicago, researchers gave obese, diabetic mice the extract for 12 days. On the last day, the mice became normoglycemic and had significantly improved glucose tolerance. Supplementation also improved serum insulin levels, triggered significant weight loss and reduced plasma cholesterol levels.31
“As with most herbal (natural) products, U.S. consumers are still learning about Eastern modalities and how to safely incorporate them into their health programs,” Ormstein said. “When this happens, I suspect we’ll see a paradigm shift from standard insulin therapy to more natural approaches.”
Complications
Protect Your Heart
Diabetes goes hand-in-hand with serious long-term complications, including heart and blood vessel disease, stroke, high blood pressure, kidney disease, nerve damage, amputations and blindness. In fact, heart disease is the leading cause of diabetes-related deaths and the risk for stroke is two to four times higher among people with diabetes compared to those without. For these reasons, diabetics and those at risk for developing the disease need to pay special attention to their heart and circulatory health.
In terms of vitamins, the B-vitamin folic acid has shown promise in helping to treat Type I diabetes. Researchers from Belgium found a negative correlation between folic acid levels and increased homocysteine levels, a factor in heart disease, in Type I diabetics,32 and Australian researchers found short-term high-dose folic acid supplementation improved endothelial function in children and adolescents with Type I diabetes.33
The heart-healthy, vitamin-like antioxidant coenzyme Q10 (CoQ10) may also help improve endothelial function of the brachial artery in dyslipidemic subjects with Type II diabetes, according to research conducted in Australia.34 And another Australian research team found daily supplementation of 200 mg of CoQ10 for 12 weeks may improve blood pressure, as well as long-term glycaemic control in Type II diabetics.35
Zinc and magnesium are two antioxidant minerals that are important for maintaining a healthy heart. In a Nigerian study of 40 subjects with Type II diabetes and 20 healthy controls, serum concentrations of both zinc and magnesium were significantly lower in subjects with diabetes.36 Fasting blood glucose and total cholesterol were also significantly higher in diabetics than in the non-diabetic controls. The researchers concluded both minerals play a crucial role in the regulation of lipid and carbohydrate metabolism. A study conducted by Turkish researchers, however, found zinc supplementation had no effect on total cholesterol or trigylceride levels in diabetic rats, but magnesium supplementation did.37 They reported oral magnesium supplementation decreased elevated total cholesterol and triglyceride concentrations of diabetic rats to the control level.
A variety of natural products—from vitamins and minerals to herbs and other botanicals—have the power to help prevent diabetes, as well as help manage it. And as science suggests, when combined with a healthy, active lifestyle and diet, the effects can be even more pronounced. So stock a selection of diabetes-related products, such as supplements targeted for the disease, snack foods and drinks specially formulated for diabetics, and fliers and other educational materials consumers can take home to help them better understand how natural products can help improve their condition. (Many supplement/product distributors offer such support material for retailers and consumers at no extra charge.) But, retailers should always be cautious when helping consumers with diabetes and may want to inquire about any recent doctor’s visits and diagnoses found, according to Ormstein. She also added those taking insulin or OHA (oral hypoglycemic agents) should first discuss the use of herbs and natural alternatives with their health care professional.
Diabetes.Treatment. Supplements
References, Bibliography, links and contents were controlled by
Professional Center for Health Education.Montevideo,Uruguay
Director: Prof Dr León Gerner
Colaboración: Evangelina Perez y Patricia Lacuesta
1. McMahon SK et al. “Increase in type 2 diabetes in children and adolescents in Western Australia.” Med J Aust. 180, 9:459-61, 2004. www.mja.com.au.
2. Hu G et al. “Physical activity, body mass index, and risk of Type 2 diabetes in patients with normal or impaired glucose regulation.” Arch Intern Med. 164:892-6, 2004. http://archinte.ama-assn.org.
3. Fenicchia LM et al. “Influence of resistance exercise training on glucose control in women with type 2 diabetes.” Metabolism. 53, 3:284-9, 2004.
4. Gross, LS et al. “Increased consumption of refined carbohydrates and the epidemic of type 2 diabetes in the United States: an ecologic assessment.” Am J Clin Nutr. 79, 5:774-9, 2004. www.ajcn.org.
5. Ylonen K et al. “Associations of dietary fiber with glucose metabolism in nondiabetic relatives of subjects with type 2 diabetes: the Botnia Dietary Study.” Diabetes Care. 26, 7:1979-85, 2003. http://care.diabetesjournals.org.
6. Liese AD et al. “Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study.” Am J Clin Nutr. 78, 5:965-71, 2003. www.ajcn.org.
7. Zhao X et al. “Effect of superior fiber complex on insulin sensitivity index and blood lipids in non-insulin dependent diabetes mellitus rats.” Zhonghua Yu Fang Yi Xue Za Zhi. 36, 3:184-6, 2002.
8. Mokdad AH et al. “Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001.” JAMA. 289, 1:76-9, 2003. www.jama.com.
9. Ryder JW et al. “Isomer-specific antidiabetic properties of conjugated linoleic acid, improved glucose tolerance, skeletal muscle action, and UCP-2 gene expression.” Diabetes. 50, 5:1149-57, 2001. http://diabetes.diabetesjournals.org.
10. Giulietti A et al. “Vitamin D deficiency in early life accelerates Type I diabetes in non-obese diabetic mice.” Diabetologia. 47, 3:451-62, 2004. http://link.springer.de/link/service/journals/00125.
11. Chiu KC et al. “Hypovitaminosis D is associated with insulin resistance and Beta cell dysfunction.” Am J Clin Nutr. 79, 5:820-5, 2004. www.ajcn.org.
12. Ford ES et al. “The metabolic syndrome and antioxidant concentrations: findings from the Third National Health and Nutrition Examination Survey.” Diabetes. 52, 9:2346-52, 2003. http://diabetes.diabetesjournals.org.
13. Mayer-Davis EJ et al. “Plasma and dietary vitamin E in relation to incidence of type 2 diabetes: The Insulin Resistance and Atherosclerosis Study (IRAS).” Diabetes Care. 25, 12:2172-7, 2002. http://care.diabetesjournals.org.
14. Midaoui et al. “Lipoic acid prevents hypertension, hyperglycemia, and the increase in heart mitochondrial superoxide production.” Am J Hypertens. 16, 3:173-9, 2003.
15. Maddux BA et al. “Protection against oxidative stress-induced insulin resistance in rat L6 muscle cells by mircomolar concentrations of alpha-lipoic acid.” Diabetes. 50, 2:404-10, 2001. http://diabetes.diabetesjournals.org.
16. Liu X et al. “French maritime pinebark extract Pycnogenol dose-dependently lowers glucose in type 2 diabetics.” Diabetes Care. 27, 3:839, 2004. http://care.diabetesjournals.org.
17. Ghosh D et al. “Role of chromium supplementation in Indians with type 2 diabetes mellitus.” J Nutr Biochem. 13, 11:690-7, 2002. www.elsevier.com/locate/jnutbio.
18. Olin KL et al. “Comparative Retention/Absorption of 51Chromium (51Cr) from 51Cr Chloride, 51Cr Nicotinate and 51Cr Picolinate in a Rat Model.” Trace Elements and Electrolytes. 11:182-6, 1994.
19. Bagchi D. “Beneficial roles of chromium, selenium, zinc and vanadium on insulin resistant syndrome.” J Am Coll Nutr. 20, 5:581, Abs. 79, 2001.
20. Yeh GY et al. “Systematic review of herbs and dietary supplements for glycemic control in diabetes.” Diabetes Care. 26, 4:1277-94, 2003. http://care.diabetesjournals.org.
21. Yanardag R et al. “Effects of vanadyl sulfate on kidney in experimental diabetes.” Biol Trace Elem Res. 95, 1:73-85, 2003. www.humanapress.com
22. Lopez-Ridaura R et al. “Magnesium intake and risk of Type 2 diabetes in men and women.” Diabetes Care. 27, 1:134-40, 2004. http://care.diabetesjournals.org.
23. Fung TT et al. “The association between magnesium intake and fasting insulin concentration in healthy middle-aged women.” J Am Coll Nutr. 22, 6:533-8, 2003.
24. Antihyperglycemic effects of stevioside in Type 2 diabetic subjects.” Metabolism. 53, 1:73-6, 2004.
25. Jeppesen PB et al. “Antihperglycemic and blood pressure-reducing effects of stevioside in the diabetic Goto-Kakizaki rat.” Metabolism. 52, 3:372-8, 2003.
26. Xie JT et al. “Anti-diabetic effects of Gymnema yunnanense extract.” Pharmacol Res. 47, 4:323-9, 2003.
27. Ananthan R et al. “Effect of Gymnema montanum leaves on serum and tissue lipids in alloxan diabetic rats.” Exp Diabesity Res. 4, 3:183-9, 2003.
28. Al-Habori M et al. “In vitro effect of fenugreek extracts on intestinal sodium-dependent glucose uptake and hepatic glycogen phosphorylase A.” Int J Exp Diabetes Res. 2, 2:91-9, 2001.
29. Devi BA et al. “Supplementation of fenugreek leaves to diabetic rats. Effect on carbohydrate metabolic enzymes in diabetic liver and kidney.” Phytother Res. 17, 10:1231-3, 2003. www.interscience.wiley.com/jpages/0951-418X.
30. Raju J et al. “Trigonellafoenum graecum (fenugreek) seed powder improves glucose homeostasis in alloxan diabetic rat tissues by reversing glycolytic, gluconeogenic and lipogenic enzymes.” Mol Cell Biochem. 224, 1-2:45-51, 2001. www.wkap.nl.
31. Attele AS et al. “Antidiabetic effects of Panax ginseng berry extract and the identification of an effective component.” Diabetes. 51, 6:1851-8, 2002. http://diabetes.diabetesjournals.org.
32. Buysschaert M et al. “Micro- and macrovascular complications and hyperhomocysteinaemia in type 1 diabetic patients.” Diabetes Metab. 27, 6:655-9, 2001.
33. Pena AS et al. “Folic acid improves endothelial function in children and adolescents with type 1 diabetes.” J Pediatr. 144, 4:500-4, 2004. www.mosby.com/jpeds.
34. Watts GF et al. “Coenzyme Q(10) improves endothelial dysfunction of the brachial artery in Type II diabetes mellitus.” Diabetologia. 45, 3:420-6, 2002. http://link.springer.de/link/service/journals/00125.
35. Hodgson JM et al. “Coenzyme Q10 improves blood pressure and glycaemic control: a controlled trial in subjects with type 2 diabetes.” Eur J Clin Nutr. 56, 11:1137-42, 2002. www.naturesj.com/ejcn.
36. Anetor JI et al. “Decreased serum magnesium and zinc levels: atherogenic implications in type-2 diabetes mellitus in Nigerians.” Nutr Health. 16, 4:291-300.
37. Baydas B et al. “Effects of oral zinc and magnesium supplementation on serum thyroid hormone and lipid levels in experimentally induced diabetic rats.” Biol Trace Elem Res. 88, 3:247-53, 2002. www.humanapress.com.