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June 2004

By Lyle MacWilliam, BSc, MSc, FP

The Role of Supplements
Beyond a healthy diet, considerable evidence demonstrates the efficacy of daily nutritional supplementation as a way to prevent and treat diabetes. The following dietary supplements have been found to be particularly beneficial:

Alpha-lipoic acid enhances the breakdown of glucose through intervention at several points along the central metabolic pathway. Supplementation provides a significant boost in glucose disposal and insulin sensitivity.44

Biotin assists in the metabolism of fats, proteins, and carbohydrates, and directly influences blood glucose levels by enhancing glucokinase activity.45 (Glucokinase is an enzyme that controls the first step of glucose oxidation.) Supplementation at high levels significantly improves glucose control and reduces the risk of diabetic neuropathy.46

L-carnitine deficiency is common in diabetics and is associated with cataract formation and cardiomyopathy (weakening of the heart muscle). Supplementation improves insulin sensitivity, in-creases glucose storage, and optimizes carbohydrate metabolism.47 Carnitine also appears to protect against diabetic neuropathy by lowering sorbitol levels in nerve cells.

Carnosine, an amino acid peptide, prevents cross-linking of glucose with proteins (glycation) and arrests the formation of advanced glycation end-products in the cell.48 Glycation accelerates the aging process and is problematic in diabetics. Carnosine also bolsters proteolytic (protein-destroying) pathways to dispose of damaged proteins created through glycation.

Chromium is essential in modulating glucose metabolism and boosting glucose sensitivity.49 It enhances insulin-dependent transport of glucose into the cell, likely by facilitating the binding of insulin to the receptor site. Supplementation at 1000 micrograms per day has been found to markedly reduce insulin resistance.50 As over 90% of adults are deficient in chromium, daily supplementation is warranted.

Coenzyme Q10, an important component of the cell’s central metabolic pathway, enhances cellular energy production and protects cells from damage by free radicals. Japanese researchers cite its ability to boost respiratory chain function in pancreatic beta cells and improve glycemic control.51

Magnesium lowers blood glucose, increases insulin sensitivity, reduces stress response (which promulgates diabetes), and assists in the maintenance of healthy beta cells.52 Low magnesium status is common among type II diabetics53 and is believed to disrupt insulin secretion and the hormone’s capacity to transport glucose. Supplementation has been found to increase the number and sensitivity of cellular insulin receptors50 and to mitigate carbohydrate intolerance.45

N-acetyl-L-cysteine protects pancreatic beta cells from oxidative damage. Free radicals flourish in fatty tissue and when circulating glucose levels are high (two conditions common in insulin resistance syndrome and diabetes). Supple-mentation with N-acetyl-L-cysteine lowers blood sugar levels, protects beta cells from glucose toxicity, and suppresses beta cell death.54

Vitamin C (ascorbic acid) lowers blood glucose, inhibits glycation,55 prevents the accumulation of sorbitol (which causes cataracts), and synergizes and replenishes other antioxidants. By reducing the level of C-reactive protein, ascorbic acid helps quench the inflammatory response in diabetics and lowers cardiovascular risk. Because vitamin C is the principal antagonist for the excessive free-radical activity observed in diabetes, its presence is critical.45 As most diabetics are deficient in this important nutrient, supplementation is essential.

Vitamin E (alpha-tocopherol), a potent lipid-phase antioxidant, quenches lipid peroxidation, increases insulin sensitivity, and enhances glucose transport. High-dose vitamin E supplementation at 1200 milligrams per day has been found to reduce vascular inflammation and lower C-reactive protein levels.56

Vitamin K appears to play an important role in the regulation of blood sugar57 and the reduction of interleukin-6 (IL-6), an inflammatory marker for diabetes; however, people on anticoagulant drugs, such as Coumadin®, should not take vitamin K.

Insulin resistance and diabetes can also be treated successfully with plant-based remedies indigenous to many native cultures. Several herbal remedies are remarkably effective and, unlike drug therapies, have few or no side effects. Hormone therapies, using testosterone and dehydroepiandrosterone (DHEA), show considerable promise.

For a detailed description of these complementary therapies, readers are encouraged to consult the protocols in the Life Extension Foundation’s Disease Prevention and Treatment book,58 as well as Michael Murray’s excellent treatise in his book, Healing Power of Herbs.59


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