Managing Type 2 Diabetes

How important is managing type 2 diabetes? Poorly controlled cases are associated with a shockingly wide range of life-threatening complications, including blindness, kidney failure, amputations, heart attacks, and dementia.

According to a study recently conducted in UK, more than 80,000 people who gave up low-fat, high carbohydrate diets found that after ten weeks their blood-glucose levels dropped.

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An astonishing 40 percent of U.S. adults will develop diabetes in their lifetime.[1] Type 2 diabetes mellitus is a chronic disease that results primarily from abdominal obesity, which leads to resistance to the hormone insulin. Poorly controlled type 2 diabetes is associated with a shockingly wide range of life-threatening complications, including blindness, kidney failure, amputations, heart attacks, and dementia.[3] Obviously, managing type 2 diabetes is a critical challenge.

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Top-Researched Natural Treatments for Managing Type 2 Diabetes

Diet and lifestyle interventions are the cornerstone of diabetes care. No conventional drug therapies or dietary supplements can overcome the toll that poor diet and lifestyle choices take on diabetes.

There are many therapeutic ways of eating that effectively treat diabetes, including vegetarian, vegan, low-carb, Paleo, and low-glycemic-load diets.[4-7] Some of most satiating diabetes eating plans, however, are relatively low in carbohydrates and have a low glycemic load—that is, they don’t spike blood sugar and insulin levels.

The SweetLife Diabetes Health Center’s­ low-carb diet, which was created by functional medicine practitioners, limits carbs to 50 to 100 grams per day, or about 15 to 20 percent of daily caloric intake. Fiber has a negligible impact on blood sugar and can be counted as half (6 g of fiber = 3 g of carbs).

Contrary to popular belief, the best low-carb diets for diabetes are not high in protein. Too much protein is easily converted to sugar and stored as fat, especially in people with insulin resistance. Excess protein also raises insulin levels, which further aggravates insulin resistance. Optimal daily protein intake depends on fitness level and blood sugar control, but should typically account for 15 to 25 percent of daily caloric intake.

A Word on Fats in Our Diet

Fat makes up 55 to 70 percent of daily caloric intake in this type of low-carb diet. Don’t let that scare you. Eating healthy fats will not make you fat if they are not combined with refined carbohydrates or overeating.

Unlike protein and carbs, fat has almost no impact on blood sugar and insulin release, and it slows sugar and protein absorption to help regulate blood sugar levels. Focus on monounsaturated fats from olive oil; omega-3 fats from fish, nuts, seeds, and grass-fed meat; and medium-chain fatty acids from coconut oil, which actually stimulates fat burning.

Dr. Loren Cordain’s Paleo diet is another effective option. The Paleo diet focuses on lean or grass-fed meats, lots of non-starchy veggies, moderate amounts of healthy fats, and some fresh fruit and starchy roots and tubers.

Paleo-type diets generally eliminate all grains, legumes, dairy, refined sugars, refined oils, and processed food. In a small study, the Paleo diet was more satiating and superior to a standard diabetes diet for lowering average blood sugar (hemoglobin A1c), triglycerides, diastolic blood pressure, weight, and waist circumference.[8,9]

Both these dietary approaches focus on meals cooked from scratch using real, whole, fresh foods. Even conservative medical journals such as the Lancet confirm that the quality of foods is more crucial than is the quantity for type 2 ­diabetes treatment.[4] That means that calories don’t matter as much as what you’re eating.

Managing Type 2 Diabetes: Do Supplements Help?

Berberine has long been used by the Chinese to treat type 2 diabetes and is increasingly being used in Western natural and integrative medicine. A review of 27 trials found that berberine plus diet and exercise has many benefits:10

  • It lowers blood sugar levels (fasting glucose, glucose after meals, and average glucose as measured by hemoglobin A1c) just as much as prescription medications.
  • It is as effective as lipid-lowering drugs for decreasing total and LDL cholesterol.
  • It lowers triglycerides and increases HDL cholesterol.
  • It lowers blood pressure better than medication alone.

Notably, no serious adverse reactions were reported in the 27 trials. Take 500 to 1,000 mg of berberine HCl twice daily.

PGX (or polyglycoplex), taken before meals, lowers blood sugar and insulin, and reduces sugar and fat absorption into the bloodstream, helping to control appetite, weight, blood sugar, and cholesterol.[11,12] When sprinkled on foods, it lowers the glycemic index.[13]

Take 5 grams before meals with a glass of water, or sprinkle 5 grams on food before eating.

L-carnitine improves insulin sensitivity and cholesterol in type 2 diabetics.[14] It lowers fasting glucose levels by an average of 14 mg/dl and LDL cholesterol by 9 mg/dl in people with type 2 diabetes.[15] In people with non-alcoholic fatty liver disease, which is very common in diabetics, L-carnitine plus diet reduces blood sugar and lipids and improves insulin sensitivity, inflammatory biomarkers, and liver structure and function more than diet alone.16 It’s also been shown to lower blood pressure in addition to treating blood sugar and insulin regulation in people at high risk for cardiovascular disease.[17]

Take 1 gram of acetyl-L-carnitine twice a day.

Alpha lipoic acid is a naturally occurring potent antioxidant compound that improves blood sugar and insulin regulation when taken at a dose of 1,200 mg daily.[19] It helps prevent the damage that leads to diabetic peripheral neuropathy,[18] decreases neuropathy pain, and helps prevent it from progressing.[20,21] The supplement also helps improve erectile function in men with type 2 diabetes.[22] Alpha lipoic acid is considered safe and well-tolerated.[23]

Take 600 mg alpha lipoic acid twice a day.

Fenugreek (Trigonella foenum-graecum) contains compounds that improve glucose tolerance and insulin action and lower inflammation and blood lipids.[24]
Take 10 grams of powdered fenugreek seeds per day soaked in hot water or encapsulated,[25] or take 1 to 2 grams a day of a fenugreek seed extract.[26 Smaller doses of fenugreek powder and extract may also be therapeutic when combined with other botanical medicines.

Gymnema (Gymnema sylvestre) interferes with the ability to taste sweetness. In animal studies, gymnema leaf extract consistently lowers blood sugar, increases insulin secretion from the pancreas, and prevents glucose absorption through the intestines.[27] Human studies are still fairly limited, but preliminary (uncontrolled) human studies in type 2 diabetics reported that gymnema leaf extracts decrease blood glucose levels and allow a reduction of diabetic medications.[28-30]

Choose an extract that is standardized to contain 25 percent gymnemic acids and take 400 mg twice daily. Lower amounts may also be beneficial if the gymnema is standardized to a higher percentage of gymnemic acids or if it is taken in combination with other botanical medicines, such as fenugreek and bitter melon. To curb sugar cravings by temporarily blocking the ability to perceive sweetness, open a capsule and put a small amount of the powder on your tongue, or place a few drops of gymnema tincture on your tongue.

Bitter melon (Momordica charantia) is one of the most popular herbs for treating diabetes in Asia and studies confirming the safety and efficacy of bitter melon fruit juice, powders, and extracts for diabetes treatment are accumulating. Bitter melon juice powder effectively reduced hemoglobin A1c in a recent study, although not as effectively as the drug glyburide.

It also had favorable effects on cholesterol, triglycerides, and biomarkers for atherosclerosis, whereas glyburide did not.[31] While no serious side effects during clinical study period have been reported, in some patients, headache, dizziness, stomach pain, and bloating have occurred.[32]

Take 2 to 4 grams of bitter melon fruit juice powder per day, in divided doses. Lower doses of bitter melon fruit extracts may also be beneficial, especially when used in combination with other botanical extracts, such as Gymnema and fenugreek.

Cinnamon improves insulin sensitivity. Taking just one or two grams (one-quarter to one-half teaspoon) of cinnamon daily lowers hemoglobin A1C in type 2 diabetics.[33,34]

Other Nutrients Important in Managing Type 2 Diabetes

Vitamins and minerals, especially chromium35 and biotin,[36] play essential roles in carbohydrate metabolism and are crucial for optimal blood sugar management and diabetes control. Many type 2 diabetics are low in a number of micronutrients because of the metabolic dysfunctions associated with the disease and the fact that many common diabetes drugs induce micronutrient deficiencies, such as metformin-induced folic acid and vitamin B12 deficiencies.[37-39]

Many high-potency multivitamin and mineral supplements, especially those formulated specifically for those with diabetes, contain therapeutic doses of chromium, biotin, and other key nutrients for proper blood sugar metabolism. They also contain antioxidant vitamins and minerals to help protect the tissues from excess blood sugar and oxidative stress. Regular use of such a multivitamin/mineral formula is recommended.

What to Try First

Begin with your food. Choose one of the diets discussed above—a low-carb or Paleo diet—or any other low-glycemic load diet, such as The Blood Sugar Solution diet by functional medicine practitioner Dr. Mark Hyman. What matters most is eating real, whole foods and avoiding refined and processed foods. The best approach is to learn as much as possible about nutrition and cooking, and to remember to take things day by day, meal by meal, continually re-committing to making food choices that support health.

Next, add the following three supplements:

  1. A multivitamin/mineral, preferably high potency (such as those requiring multiple tablets or capsules per day)
  2. A combination formula that contains some of the botanical extracts listed above, such as berberine, fenugreek, gymnema, and bitter melon. The amounts of each ingredient may be different than those recommended here, but such a formula is a good place to start, especially if you are new to supplements or your budget doesn’t allow for more.
  3. PGX. Take before meals, as described above.

Natural therapies and lifestyle changes are the most powerful ways to treat the root causes of diabetes and achieve safe, lasting results. Working with a practitioner trained in naturopathic, integrative, or functional medicine is highly recommended, especially if you take diabetes medications, since your dose may need to be adjusted to prevent hypoglycemia. (You can find a practitioner in our online directory.) Do not decrease or discontinue any prescription medications unless you’re working in conjunction with your doctor. The latest science shows you can heal from this modern plague. Get started today.


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2. JAMA. 2014 May 7; 311(17): 1778–1786.
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Originally published in 2016, this post is regularly updated.

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