Internal Med Medical News about complementary and alternative medicine; type 2 diabetes

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Complementary and alternative medicine for the treatment of type 2 diabetes
Canadian Family Physician, 06/10/09

Nahas R et al. - Changes in HbA1c values are most often used to evaluate hypoglycemic effects. It is important to consider that the life span of a red blood cell is 120 days. Therefore, studies investigating diabetes management should involve HbA1c measurements and should be of at least 4 months’ duration. Most of these trials were of insufficient duration to evaluate this outcome. None of the research examined has addressed the potential effect of CAM interventions on cardiovascular outcomes. This is important because better glycemic control might not always lead to real-world clinical benefits. It is also important because some interventions can improve other cardiovascular risk factors. Overall, there is a paucity of research evaluating CAM therapies that are commonly used to treat type 2 DM. This should be a high priority for CAM researchers and funding agencies.

Chromium (200 to 1000 µg per day) is the only complementary and alternative medicine intervention with level 1 evidence to support its use in diabetes management, but a large-scale clinical trial is needed to confirm these findings.
Small studies indicate that Gymnema sylvestre improves HbA1c levels. Larger studies are required to confirm these promising findings.
Cinnamon probably lowers blood glucose levels, but its effects on HbA1c levels are unknown.
Bitter melon has a long history of traditional use, but preliminary evidence suggests its benefits might be limited.
Vanadium is poorly understood, has potential adverse side effects, and should probably be avoided. Green tea, fenugreek, and fibre can be recommended on account of their other health benefits, but evidence that they improve glycemic control is limited and conflicting.