Nutraceuticals for diabetes and glucose balance

Abstract Diabetes and diabetes-related complications remain a major health issue in the United States and around the world. Despite the discovery and clinical use of modern antidiabetic medicines, 387 million people were living with diabetes in 2014, and this number is expected to grow to 592 million by 2035. To fight this problem, many patients use complementary and alternative medicines to supplement standard therapy. The reasons for this include low cost, easy availability, and the presumption of relatively better safety of nutraceuticals. Over the past three decades, interest in natural solutions to health ailments has grown dramatically across the world, including the United States, and the trend appears to be continuing. In view of such extensive use of nutraceuticals, it is extremely important that adequate and authentic scientific information about their efficacy and safety is available to the public and healthcare professionals in a format similar to that which is available for pharmaceuticals. This chapter provides efficacy and safety information for some of the most common nutraceuticals used as supplements for the management of type II diabetes. Based on a review of the literature, information is presented in an easy-to-follow format with sections included for general introductory overview, bioactive component(s), preclinical efficacy, clinical efficacy, mechanism(s) of action, and margins of safety with respect to the dose suggested for the supplement. Also, the potential for adverse effects related to plant component(s) that may be present, but not desired for efficacy, is discussed where applicable. Steps to mitigate such adverse effects are also discussed. The nutraceuticals discussed in this chapter include cinnamon, fenugreek, Momordica charantia (bitter melon), Gymnema sylvestre (Gur-Mar), ginger (gingerol and shogaol), and others. In addition to herbal nutraceuticals, the beneficial roles of vitamin D, trivalent chromium, and some other compounds used in managing hyperglycemia are discussed.