canadian diabetes association clinical practice guidelines natural health products in type 2...

Canadian Diabetes Association Clinical Practice Guidelines

Natural Health Products in Type 2 Diabetes

Chapter 21

Richard Nahas, Jeannette Goguen

guidelines.diabetes.ca | 1-800-BANTING (226-8464) | diabetes.caCopyright © 2013 Canadian Diabetes Association

Natural Health Product Checklist

ASK about natural health products being used to

treat diabetes

BE AWARE that no natural health products are

proven and some may be harmful

2013


Commonly Used by Patients, Poorly Understood by Practitioners

Concerns • Purity • Standardization• Contamination • Lack of evidence for efficacy

and safety

Prospects• May have some effect• May be sources of future

therapies (eg. metformin from French lilac)


Some Have Shown Benefit in Small Trials

• Coccinia cordifolia (ivy gourd)• Ganoderma lucidum (reishi mushroom)• Salacia reticulata • Soybean-derived pinitol extract• Touchi soybean extract• Pterocarpus marsupium (Indian kino tree)• Etc...

↓ A1C by ≥0.5% in trials lasting ≥3 months in T2DM


• Citrullus colocynthis (bitter cucumber) can induce diarrhea

• Momordica charantia (bitter melon) is an abortifacient

• Hypericum perforatum (St. John’s wort) alters drug metabolism

But Some Have Been Harmful


1. Natural health products are not recommended

for glycemic control for individuals with diabetes,

as there is insufficient evidence at this time

regarding efficacy and safety [Grade D, Consensus]

Recommendation 1


Recommendation 2

2. Healthcare providers should ask about the use

of natural health products [Grade D, Consensus]


CDA Clinical Practice Guidelines

http://guidelines.diabetes.ca – for professionals

1-800-BANTING (226-8464)

http://diabetes.ca – for patients

http://guidelines.diabetes.ca/

http://diabetes.ca/

canadian diabetes association clinical practice guidelines natural health products in type 2...

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