Diabetes is a condition that causes your blood sugar (glucose) to get too high. This happens when your pancreas produces little or no insulin – a hormone that is important for regulating blood sugar levels.
There are two types of diabetes:
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type 1 – Your body makes too little insulin or no insulin at all.
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type 2 – Your body either produces too little insulin, or your tissues are not sensitive enough to the effects of insulin.
Management and treatment of diabetes requires a combination of healthy eating, regular exercise, and medication, including insulin. Vitamins and supplements are becoming increasingly popular as complementary supplements to tried-and-tested diabetes treatments. However, there is limited research to confirm their beneficial effects on diabetes management – and no solid evidence.
diabetes
Graphic: Ben Hudson
Pharmacist and nutrition therapist Deborah Grayson of Practice with Confidence says that any supplement that increases your body’s sensitivity to insulin, or lowers your blood sugar levels, can interact with diabetes medications.
This can lead to poor blood sugar control, and complications from diabetes may become worse.
Grayson recommends you consult with your doctor, pharmacist, or a registered nutrition therapist before taking supplements with your traditional diabetes medication.
vitamin b12
Vitamin B12 deficiency often occurs when metformin is taken to control type 2 diabetes. Vitamin B12 deficiency can lead to memory problems and peripheral neuropathy – a condition that affects nerve signals between your brain and spinal cord.
Grayson says: “If you suspect this may be the case it is recommended to have a blood test to check your vitamin B12 levels.”
magnesium
Low levels of magnesium are often associated with high blood sugar levels in people with diabetes. For this reason, magnesium It is believed to help insulin work better.
Grayson says: “Magnesium supplementation can lower blood pressure and cause diarrhea, depending on what form it is taken. Metformin – a drug used in the treatment of diabetes – can affect the absorption and retention of magnesium, especially if it is causing diarrhea.”
zinc
Zinc is thought to promote insulin production, and improve its interaction with your body’s cells. It may also reduce inflammation, and protect your pancreas – the organ that makes insulin.
Grayson says: “Despite these reported benefits, there is a possibility that zinc may cause nausea in some people. It may also inhibit the absorption of medications – including antibiotics and thyroid treatments. It should be taken at least 2 hours before or after antibiotics, and 4 hours before or after thyroid medication.”
selenium
A powerful antioxidant, selenium is believed to protect your pancreas from damage, increasing its ability to produce adequate insulin.
Grayson says: “Selenium can be toxic if taken in excess of the recommended daily dose – a maximum of 200 micrograms.”
vitamin D
Vitamin D deficiency has been linked to an increased chance of developing type 2 diabetes. Vitamin D is made by your body in the summer, but you may need to take supplements during the winter.
vitamin C
Vitamin C may have positive effects on blood sugar control and insulin sensitivity. It may also reduce inflammation and oxidative stress that may contribute to the development of type 2 diabetes.
Grayson warns that getting too much vitamin C can cause diarrhea — especially at doses of 1 gram or more.
inositol
Inositols are compounds that improve insulin sensitivity and play a role in regulating human reproduction.
Myo-inositol is a supplement that works in a similar manner to metformin. It reduces glucose absorption in your digestive system and increases glucose transport into cells by improving insulin sensitivity.
Grayson says: “Myo-inositol can increase your chance of hypoglycemia. It can also cause digestive upset — like diarrhea and bloating.”
berberine
Berberine may increase insulin secretion, and reduce glucose production and fat storage in your liver.
Grayson says: “Berberine may increase your chance of hypoglycaemia, and also thins the blood. It should not be taken if you are taking any medications to thin your blood.”
alpha lipoic acid
Alpha lipoic acid may protect the beta-cells in your pancreas that are important for insulin production.
It may also help your blood sugar reach these cells to reduce insulin resistance, improve blood glucose control, and reduce the chance of diabetes complications, says Grayson.
Grayson says: “Alpha lipoic acid can cause hypoglycemia, thin the blood, and affect thyroid hormone levels.”
Gymnema
Research shows that gymnema may curb sugar cravings, reduce high blood sugar levels, and aid in weight loss.
Grayson says: “Gymnema can cause hypoglycemia and it may also interfere with the way your liver breaks down medication. Check with a health care professional to make sure your medication will not be affected.”
Chromium
Chromium may increase insulin sensitivity and help maintain blood sugar control.
Grayson says: “Chromium is relatively safe to take in doses of 100-200 micrograms.”
Medicine
People with type 1 diabetes need to take insulin – either through injections or through an insulin pump. It helps manage blood sugar levels and reduces the chances of serious short-term and long-term complications.
People with type 2 diabetes will be encouraged to adopt healthy lifestyle changes. If this is not enough, medication will be recommended.
Grayson highlights some of the most commonly prescribed treatments:
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metformin – Slows glucose absorption, reduces liver glucose production, and improves insulin sensitivity.
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sulfonylurea -The most common drug in this class is gliclazide, which increases insulin production and release from the pancreas, with hypoglycaemia as a possible side effect.
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DPP-4 inhibitor – Include sitagliptin and linagliptin, which increase insulin and reduce hepatic glucose production in response to high blood sugar.
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SGLT2 inhibitors – Also known as gliflozin, such as dapagliflozin, these medications help remove excess glucose through your urine, and may reduce the chance of kidney damage in type 2 diabetes.
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GLP-1 analogs -Drugs like semaglutide and dulaglutide mimic a natural protein that helps the body control blood sugar. GLP-1 analogs are usually given by injection.
a healthy diet
Diabetes UK says that by eating a balanced diet, most people can get all the nutrients they need without additional dietary supplements.
Grayson agrees that healthy eating is important for keeping your body running smoothly — especially if you have diabetes.
“When thinking about diet with diabetes, it is important to reduce the potential for blood sugar spikes by choosing complex carbohydrates,” she advises. “Choose whole grains instead of pasta, rice, bread and cakes which are loaded with simple starches that spike blood sugar quickly.”
Eating a balanced ratio of complex carbohydrates with adequate protein and healthy fats helps keep blood sugar stable for longer periods of time and increases satiety.
“If you do eat sweets, make sure it’s accompanied by a balanced meal to minimize the impact on your glucose levels,” advises Grayson. “Limit your number of treats to one or two a week.”
regular exercise
Regular exercise also helps improve insulin sensitivity and stabilize your blood sugar.
Grayson says: “A 30-minute walk a day can help keep your blood sugar under control. Combining this with a better-balanced diet can also help with weight management to reduce the chance of diabetes complications.”
