complementary and alternative therapies for diabetes

Complementary and Alternative

Therapies for Diabetes

Dr. P.Naina Mohamed PhDPharmacologist

Introduction The therapies which could be combined with conventional

medicine is termed “Complementary Medicine”. “Alternative Medicine” includes therapies that are

used in place of conventional medicine. “Complementary and Alternative Medicine” (CAM)

refers to a wide range of clinical therapies outside the conventional medicine.

“Conventional Medicine” is a type of medicine practiced by medical doctors and by allied health professionals, such as physical therapists, psychologists, and registered nurses. It is also called Western or Allopathic medicine.

“Integrative Medicine” represents a combination of conventional medicine, CAM, and evidence-based medicine.

CAM Use An US study reported that the Complementary and

Alternative Medicine (CAM) use is high and continues to increase.

The most important reason cited by patients for the supplemental CAM use is the perception that CAM is harmless.

CAM use is highest in patients include Female Nonsmokers Physically active Having normal body mass index (BMI) Eating low-fat diets with a high fruit and vegetable content Individuals aged 35 to 54 years with a high level of education.

Types of CAM Practices

Mind-Body and Manipulative Practices

Traditional Medical Systems

"Modern" Medical Systems

Mind and BodyPractices

Acupuncture and Acupressure Yoga Hypnosis Massage Meditation Reflexology Alexander technique Tai chi Spinal manipulation Therapeutic touch Guided imagery Rolfing/structural integration

Traditional Medical Systems

•Ayurvedic medicine •Siddha medicine •Unani medicine •Native American medicine •Tibetan medicine •Traditional Chinese medicine •Curanderismo

"Modern" Medical Systems

•Homeopathy •Naturopathy •Osteopathy •Chiropractic •Anthroposophic medicine

Diabetes Diabetes is a group of metabolic disorders characterized by prolonged

Hyperglycemia (High blood glucose) having symptoms such as Polyuria (Frequent urination), Polydipsia (Increased thirst) and Polyphagia (Increased hunger).

Untreated diabetes can cause Acute complications - Diabetic ketoacidosis and nonketotic hyperosmolar coma Chronic complications - Cardiovascular disease, Stroke, Chronic kidney failure

(Nephropathy), Foot ulcers and damage to the eyes (Retinopathy) Diabetes might be caused either by inadequate insulin production or by

improper body’s response to insulin or both. Failure of Pancreas to produce enough insulin results in to Type 1 diabetes. Type 2 diabetes caused by insulin resistance (cells’ improper response to

insulin) Diabetes can be prevented and treated by

Healthy diet Physical exercise Quit smoking Maintaining a normal body weight

CAM used for Diabetes

Herbal Supplements Bitter melon (Momordica charantia) Fenugreek (Trigonella foenum graecum) Cinnamon Tulsi (Ocimum sanctum) Neem (Azadirachta indica) Onion (Allium Cepa) Garlic (Allium Sativum) Ginseng Aloe vera Fig (Ficus carica) Mango Leaves (Mangifera indica) Eucalyptus globulus Bilberry (Vaccinium myrtillus) Black berry (Syzygium cumini) Banana (Musa sapientum) Gurmar (Gymnema sylvestre)

CAM used for Diabetes

Dietary Suuplements Chromium Vanadium Alpha Lipoic acid

Physical interventions Yoga Acupuncture Hydrotherapy Massage Therapy Aromatherapy Chromotherapy Biofeedback

Bitter gourd or Bitter melon

(Momordica Charantia)

Bitter gourd is believed to posses anti-diabetic, anti-viral, anti-bacterial and anticancer properties.

The active constituents such as charantin, vicine and insulin like polypeptide were found in Bitter gourd extract.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027280/



Fenugreek (Trigonella foenum

graecum)

Fenugreek has shown antioxidant, antidiabetic and hypocholesterolaemic properties.

The active principles of Fenugreek include the alkaloid gonelline, nicotinic acid and coumarin.




Cinnamon

Cinnamon is known to have anti diabetic, anti oxidant, anti inflammatory and anti bacterial properties.

https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-13-102



Tulsi (Ocimum sanctum)

Tulsi has been suggested to possess antidiabetic, antifertility, anticancer, antifungal, antimicrobial, cardioprotective, analgesic, antispasmodic and adaptogenic actions.

Tulsi has been recommended for the treatment of bronchitis, malaria, diarrhea, dysentery, skinalso disease, arthritis, eye diseases, insect bites, etc.

Tulsi leaf contains Eugenol (responsible for the therapeutic potentials), Euginal, Urosolic acid, etc.

http://joe.endocrinology-journals.org/content/189/1/127.full

http://joe.endocrinology-journals.org/content/189/1/127.full

Neem (Azadirachta indica)

Neem has been used to treat diabetes for long.




Onion (Allium Cepa) & Garlic (Allium Sativum)

Onion and Garlic have antidiabetic, antioxidant, antihypertensive and antihyperlipidemic effects.

Sulphur containing compounds Allyl propyl disulfide (APDS) found in onions and Diallyl disulfide (allian) found in garlic.

http://www.academicjournals.org/article/article1380531959_Ozougwu.pdf




Ginseng

Constituents of all ginseng species include ginsenosides, polysaccharides, peptides, polyacetylenic alcohol and fatty acids.

Ginseng has antidiabetic and immunostimulant properties.

http://www.academicjournals.org/journal/JDE/article-full-text-pdf/62262AA1135



Aloe Vera

Aloe gel contains glucomannan, a hydrosoluble fibre which has a glucose lowering effect.

http://www.ncbi.nlm.nih.gov/books/NBK92765/


Fig (Ficus carica)

The leaf contains psoralen, beta-sitosterol, bergapten, and taraxasterol.

http://www.tandfonline.com/doi/abs/10.1076/1388-0209(200007)3831-SFT181



Mango Leaves(Mangifera indica)

Mango has been used as an antidiabetic agent in Ayurvedic and Nigerian folk medicine.

The chemical constituents of the Mango include Mangiferin, isomangiferin, tannins & gallic acid derivatives.

Mango exhibits potent antidiabetic, antihyperlipidemic, antiatherogenic and antioxidant properties.

http://www.phcogrev.com/article.asp?issn=0973-7847;year=2010;volume=4;issue=7;spage=42;epage=48;aulast=Shah



Eucalyptus globulus

The active constituents of Eucalyptus include terpenes and tri-terpenoids, flavonoids, flavanols, gallotannins, quercetin, euglobals, procyanidins, macro carpals.

Biological actions of Eucalyptus include antidiabetic, antibacterial, antioxidant, antiinflammatory, antimalarial and antitumor promoting activities.

http://www.wjgnet.com/1948-9358/full/v4/i5/170.htm

http://www.wjgnet.com/1948-9358/full/v4/i5/170.htm

Bilberry (Vaccinium myrtillus)

Bilberry has been reported to have antidiabetic, anti-inflammatory, antioxidant and antihyperlipidemic effects.

Bilberry is rich in Anthocyanins (cyanidins and delphinidins).http://www.ncbi.nlm.nih.gov/books/NBK92770/


Black berry (Syzygium cumini)

Blackberry fruit contains high levels of anthocyanins and other phenolic compounds.https://www.researchgate.net/publication/51797169_The_Blackberry_Fruit_A_Review_on_Its_Composition_and_Chemistry_Metabolism_and_Bioavailability_and_Health_Benefits

https://www.researchgate.net/publication/51797169_The_Blackberry_Fruit_A_Review_on_Its_Composition_and_Chemistry_Metabolism_and_Bioavailability_and_Health_Benefits




Banana (Musa sapientum)

Banana has been known to have Antidiabetic, Antioxidant, Antiulcer, Hypocholesterolaemic and Antibacterial effects.

http://www.ncbi.nlm.nih.gov/pubmed/23955414

http://www.ncbi.nlm.nih.gov/pubmed/23955414

Gurmar (Gymnema sylvestre)

Gurmar (Gymnema sylvestre) extract has long been used as a treatment for diabetes.


Chromium

Supplemental chromium has been shown to decrease fasting glucose levels, improve glucose tolerance, lower insulin levels and decrease total cholesterol and triglycerides.

Foods rich in chromium include brewer’s yeast, barley flour, broccoli, grape juice, whole wheat, potatoes, garlic, basil, orange juice and red wine.

Chromium depletion can be induced by refined sugars, white flour products, and lack of exercise.



Vanadium

Vanadium was used to control blood glucose levels prior to the discovery of insulin.

http://onlinelibrary.wiley.com/doi/10.1111/j.1464-5491.2004.01381.x/full



Alpha Lipoic Acid

Alpha lipoic acid is an antioxidant. Alpha lipoic acid may be particularly useful in

slowing the development of diabetic complications such as diabetic neuropathy.

A number of experimental and clinical studies have shown that Alpha lipoic acid is useful in heavy metal poisoning, radiation damage, ischemia-reperfusion injury, and diabetes and its various complications.




Yoga

Yoga is an old, traditional, Indian psychological, physical and spiritual exercise regimen.

Yoga has been studied for several decades for its role in the management of Diabetes, Hypertension, Asthma, Obesity and psychiatric illness.




Acupuncture

Acupuncture has been shown useful to treat Diabetes, Chronic pain, etc.

Acupuncture also has an anti-obesity effect.




Hydrotherapy (Hot tub therapy)

Hydrotherapy (Hot tub therapy) found to reduce body weight, mean plasma glucose level and mean glycosylated haemoglobin.Patients should be warned to use water which is not too hot to avoid burning.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249697/


Massage therapy

Massage has been recommended for diabetes for nearly 100 years.

Uncontrolled studies suggest that massage may help normalize blood glucose and symptoms of diabetic neuropathy.

Massage at an insulin injection site can increase serum insulin action significantly.

http://spectrum.diabetesjournals.org/content/14/4/218.full

http://spectrum.diabetesjournals.org/content/14/4/218.full

Aromatherapy

Aromatherapy use essential oils to treat several diseases. Aromatherapy utilize methods such as inhalation, local application and

baths to penetrate the human skin. Aromatherapy can be employed to get relief from numerous ailments

like depression, indigestion, headache, insomnia, muscular pain, respiratory problems, skin ailments, swollen joints, urine associated complications etc.

Consult with diabetic health care team before using any aromatherapy.http://www.sciencedirect.com/science/article/pii/S2221169115001033

Chromotherapy

Chromotherapy involves therapeutic use of colors. According to Chromotherapy, lack of color harmony in the

human system may cause diseases and by the use of colored light to the body, the imbalance can be removed.

According to chromotherapy, diabetes is generally caused by a deficiency of orange and yellow colors in the body.


Biofeedback

Biofeed back is a therapeutic technique involving an instrument that provides information about psychological activity such as skin temperature or muscle tension, with the objective of learning control over maladaptive response to stress.


TIPS on choosing Dietary Supplements

Before considering any dietary supplement, consult with a health care provider.

Do not replace scientifically proven antidiabetics with unproven health products or practices.

Always remember that dietary supplements may interact with medications or other dietary supplements.

Discuss with the health care providers about the current use of any CAM approaches.

Conclusion

Due to lack of strong scientific evidences, CAM should be used for diabetes with caution.

The safely and efficacy of CAM therapies for diabetes need to be further evaluated by well designed and controlled clinical studies.

In addition to conventional therapy, exercise, weight control and nutrition remain key elements of diabetes management.

The American Diabetes Association (ADA) recommends that diabetics should engage in at least 150 minutes of moderate to intense aerobic physical activity weekly.

Being physically active can improve blood sugar, blood pressure, and cholesterol levels, improve body’s ability to use insulin, strengthen heart and bones, keep joints flexible and reduce the risk of falling.

A healthy diet can help to feel better, lose weight and lower the risk of heart disease, stroke, and other diabetes-related conditions.

References Textbook of Complementary and Alternative

Medicine Chun-Su Yuan, Eric J. Bieber

Evidence Based Guide to Complementary and Alternative Medicine Bradly P. Jacobs, Katherine Gundling

Harrison's OnlineFeaturing the complete contents of Harrison's Principles ofInternal Medicine, 18e Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper, Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo, Eds.

CURRENT Medical Diagnosis & Treatment 2013Maxine A. Papadakis, Stephen J. McPhee, Eds. Michael W. Rabow, Associate Ed.

References http://www.ncbi.nlm.nih.gov/pmc/articles/

PMC3249697/ https://nutritionj.biomedcentral.com/articles/

10.1186/1475-2891-13-102 https://nccih.nih.gov/health/diabetes/

supplements http://care.diabetesjournals.org/content/

25/2/324.full.pdf+html http://www.hindawi.com/journals/ecam/

2011/983792/ http://www.academicjournals.org/journal/JDE/

article-full-text-pdf/62262AA1135

complementary and alternative therapies for diabetes

Health & Medicine