EXAMINING ALTERNATIVE THERAPIES
FOR USE IN DIABETES AND
RELATED DISORDERS
This research paper is an overview of some of the Complimentary and Alternative Medicine available for possible future use in the treatment of diabetes and related disorders. Based on the research conducted thus far, it covers some of the uses and toxicity findings and addresses the need for further evaluation in the mainstream medical community.
History of Complimentary and Alternative Medicine in America
The medical marketplace in America has always been diverse and competitive. In the Colonial Era patients sought out a variety of healers, including root-and-herb doctors as well as a broad range of school trained physicians. Since Americans were rural they often treated themselves as well as relying on generational and home recipes or almanacs. In 1806 a farmer turned healer, Samuel Thomson started selling his brand of botanical medicine claiming “Every Man His Own Physician”. Thompson used mainly Lobelia, steam baths and hot pepper as therapies. By the late 1830’s as Thomsonianism declined, two other botanical groups arose, physiomedicalism and eclecticism. Both established medical schools and societies with the Eclectic Medical Institute in Cincinnati, Ohio being one of America’s largest medical schools at mid-century. Eclecticism thrived well into the 20th century. Even more successful was homeopathy developed by a German physician, Samuel Hahnemann brought to the U.S. by German immigrants around 1825. During the second half of the nineteenth century homeopathy was a significant rival to orthodox medicine.
With the growing acceptance of alternative therapies, the American Medical Association (AMA) was formed in 1847 with its code of ethics and barred anyone whose practice was based on exclusive dogma referring to eclecticism, homeopaths and the like. In the late nineteenth century three more alternative therapies arose: Christian Science, osteopathy and chiropractic. In the early 1930’s approximately 20 percent of healers were unorthodox. Throughout the 20th century racial and ethnic issues helped to propagate the alternative medicine movement as not everyone was given the same opportunities for schooling and healing. By the 1960’s and 1970’s the criticism of elitism in orthodox healing gave rise to the supposed gentle and more natural methods of the Native American, Asian and Hispanic cultures healing modalities. In the 1980’s and 1990’s New Age healing became more popular with the increase of chronic diseases especially since orthodox medicine had no cures.
Congress in 1991 created the Office of Alternative Medicine in the National Institutes of Health and in 2000 alternative medicine had become so widely appreciated that over half of American medical schools were offering courses on the subject (Numbers, 2001). Complimentary and Alternative Medicine or CAM generally refers to practices not typically used in conventional medicine and are considered a treatment used in addition to conventional therapies a doctor may prescribe or used instead of conventional methods (Mayo Clinic Staff, 2007).
Spices and Their Uses in Diabetic Issues
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia associated with deficiencies in insulin secretion or function. Diabetes is quite possibly the world’s fastest growing metabolic disease; it is the third most common disease in the world according to World Health Organization data. Diet was the only way to treat diabetes before the introduction of insulin and still is in third world countries with the exception of local cultural therapies. The use of herbs and spices are added to food for flavor and color but their therapeutic use is becoming more common (SRINIVASAN, 2005).
In recent decades, several health beneficial physiological effects of spices have been evidenced based on studies on experimental animals as well as on clinical trials. Among these are the digestive stimulant property, cholesterol lowering potential, anti-lithogenic effect, anti-diabetic influence, antioxidant attribute, anti-inflammatory influence, and anti-mutagenic and anti-carcinogenic effects exerted by several commonly consumed spices. Many of these attributes have the potential of therapeutic application in disease conditions (Srinivasan, 2005, p. 400).
Turmeric/Curcumin
Turmeric comes from the dried root of a plant grown mainly in India and is used as the principle ingredient in curry, a common spice in Indian Cuisine. Curcumin or diferuloylmethane, which gives turmeric its distinct yellow color, has been shown to exhibit many useful properties based on medical studies. In one study conducted in Kyoto, Japan at the Department of Diabetes and Clinical Nutrition, Graduate School of Medicine, mice were used and it was demonstrated that curcumin suppresses hepatic glucose production in an insulin-independent manner in isolated hepatocytes and hepatic glucose output was inhibited. In conclusion of the study the data suggested that curcumin as an anti-hepatotoxic agent might provide a valuable new therapy in the treatment of type 2 diabetes (Fujiwara, Hosokawa, Zhou, Fujimoto, Fukuda, Toyoda, Nishi, Fujita, Yamada, Yamada, Seino, Inagaki, 2008). Another study conducted in India at the University Institute of Pharmaceutical Sciences, Punjab University on Streptozotocin-induced diabetic rats, it was found that curcumin treatment counteracted the hyperglycemia-induced oxidative stress as well as renal dysfunction. Their conclusion was that diabetic neuropathy was ameliorated by the curcumin (Sharma, Kulkarni and Chopra, 2006). In an article in Biochemical Pharmacology it states that “Various preclinical cell culture and animal studies suggest that curcumin has potential as a therapeutic agent in wound healing” (Goel, Kunnumakkara, Aggarwal, 2008, p. 787).
Fenugreek
Fenugreek is a small stony seed from a bean like plant used for cooking and flavoring and is native to India and Southern Europe. “Fenugreek is thought to delay gastric emptying, slow carbohydrate absorption and inhibit glucose transport. It has been shown to increase erythrocyte insulin receptors and improve peripheral glucose utilization, thus showing potential pancreatic as well as extra pancreatic effects” (Shane-McWhorter 2001, P. 200). Based on the limited amount of studies thus far, Fenugreek has demonstrated diminished hyperglycemia in individuals with and without diabetes. Fasting blood glucose, 24h urine sugar excretion, cholesterol and triglyceride levels in diabetics were significantly reduced along with polyuria, polyphagia and polydypsia being improved. This seems to be due to the gum fiber present in the seeds which are rich in protein. Fenugreek included in the diet in amounts of 25-50 g can be an effective supportive therapy in the management of diabetes (Srinivasan, 2005).
Cinnamon
Cinnamon is a spice and comes from a small evergreen tree native to Sri Lanka and India. Cinnamon is one spice claimed as having natural insulin sensitizing effects based on vitro cell line studies with adipocytes as well as in vivo animal studies. The bio active compound methylhydroxychalcone polymer (MHCP) found in cinnamon was thought to mimic insulin. The first in vivo study on cinnamon supplementation in humans by Khan et al. received much media attention and their conclusion was that small amounts of cinnamon was a way to help reduce risk factors associated with diabetes. Although the study was promising it lacked solid evidence that cinnamon supplementation effectively improves fasting blood glucose concentration and/or lipid profile (Vanschoonbeek, Thomassen, Senden, Wodzig,Van Loon, 2006).
In one study, cinnamon was investigated in patients with type 2 diabetes who were postmenopausal. They assessed the effect of 2 & 6 wk supplementation on fasting blood glucose, insulin and HbA1c concentrations and fasting lipid profiles. The study concluded that cinnamon supplementation at 1.5 g/d does not improve fasting blood glucose, oral glucose tolerance, did not affect the lipid profile or measures of whole-body insulin sensitivity in overweight menopausal patients with type 2 diabetes, and cinnamon supplementation should be regarded as not yet proven (Vanschoonbeek, Thomassen, Senden, Wodzig,Van Loon, 2006).
In another study, cinnamon was systematically reviewed in scientific literature for preclinical and clinical efficacy and pharmacological activity. The data found was analyzed and none of the clinical trials were able to demonstrate that cinnamon effectively reduces HbA1c. This study did, however, conclude that cinnamon has antioxidant activity when consumed as a tea. It increases thiols and decreases lipid peroxidation; this in turn may contribute to its anti diabetic effects (Dugoua, Seely, Perri, Cooley, Forelli, Mills, and Koren, 2007)
Other Supplements and their Indications
Linolenic Acid (GLA)
Gamma-Linolenic Acid (GLA) is an omega 6 fatty acid and has been used for diabetic neuropathy and hyperlipidemia. GLA bypasses the need for conversion of linolenic acid (LA) to GLA which helps diabetics because LA conversion is impaired in diabetics. Two main clinical trials in the evaluation of GLA found an improvement in neuropathy symptoms but did not improve the HbA1c. It was noted that it may take several months to see results with GLA and that for maximum absorption it should be taken with food. The initial data was promising (Shane-McWhorter 2001, P. 200).
Milk Thistle
Milk Thistle is native to the Mediterranean, grows most everywhere and standard preparations are extracted from the seeds of the plants. Milk Thistle has been used for various hepatic disorders including hepatotoxicity, but recently its use has been proposed for use in diabetes to diminish insulin resistance. It is thought that milk thistle may benefit patients who have insulin resistance secondary to hepatic damage. One study found that mean daily insulin requirement decreased significantly from 55 units/day at baseline to 42 units/day and HbA1c was diminished after 12 months in diabetic patients with cirrhosis. It is noted that the potential use of Milk Thistle in diabetes is very preliminary (Shane-McWhorter 2001).
Aromatherapy
Aromatherapy is the use of essential oils, which are aromatic plants that are steam distilled and have been used for thousands of years for multiple symptoms. Oils have a fragrance and chemistry leading to a range of feedback affecting a healing response. Recent research indicates that essential oils increase drug permeation signifying that essential oils themselves are absorbed. There is no suggestion of essential oils curing diabetes, only reducing side effects and infection healing rates in diabetics. It is proposed for stress relief in dealing with diabetes and in conjunction with medical treatment for wound healing. When patients are more comfortable this can improve their quality of life (Buckle, 2001)
Contraindications, Safety and Toxicity
While most of the aforementioned natural therapies have benefits in their uses, toxicity and safety are a huge consideration in clinical trials and studies. Patient safety is a foremost topic in the treatment of diseases. Contraindications of the CAM’s cited were extremely rare and further research is obvious needed to establish this area. In the studies it was found that curcumin is extremely safe and well tolerated. “Fenugreek is reported to be absolutely safe for consumption based on a long-term animal study” (Srinivasan, 2005, p. 404). Cinnamon is reported as having several concerns when used in excessive amounts and in the long term like irritation of mucous membranes, allergic reaction, and contact dermatitis. The FDA recognizes cinnamon as safe in when used in amounts commonly found in food (Dugoua, Seely, Perri, Cooley, Forelli, Mills, and Koren, 2007) GLA’s adverse effects were mild like headaches, GI complaints, loose stools, prolonged bleeding and in one case seizures. Milk Thistle had reported adverse effects like loose stools but no adverse drug interactions were noted (Shane-McWhorter 2001, P. 200). Essential oils have toxicity issues depending on the type of oil used and some cannot be used during pregnancy and others cause skin irritations.
Inconclusive Evidence and Lack of Research
Based on the data provided in the research studies and trials cited, the use of alternative therapies for diabetes and related disorders require more research and study by the medical community. The results thus far are at the most hopeful but inconclusive given the number of clinical trials performed to this point. Large and carefully controlled medical studies are costly and directly or indirectly funded by drugs companies and the government which is one reason for the lack of more research. A number of studies are currently under way on CAM ranging from herbs to yoga to determine what is safe and works (Mayo Clinic Staff, 2007).
Conclusion
Throughout history there has always been and seems to be a huge interest by the population in the United States regarding the use of Complimentary and Alternative Medicine in the treatment of disease. Of the aforementioned alternative treatments being explored by the orthodox medical community, Turmeric/Curcumin seems to hold the most promise and appears to be the safest as cinnamon research is inconclusive and the most toxic in large amounts. While there is diversity in treatments available it is confusing for the general population to determine which methods are the best fit. For this reason more medical studies are needed for the protection and benefit of people suffering from disease like diabetes.
References
Buckle, J., (2001). Aromatherapy and diabetes, Diabetes Spectrum, 14, 3, 124-126.
Dugoua, J., Seely, D., Perri, D., Cooley, K., Forelli, T., Mills, E., Koren, G., (2007). From type 2 diabetes to antioxidant activity: A systematic review of the safety and efficacy of common and cassia cinnamon bark, Canadian Journal of Physiology and Pharmacology, 85, 837-847
Fujiwara, H., Hosokawa, M., Zhou, X., Fujimoto, S., Fukuda, K., Toyoda, K., Nishi, Y., Fujita, Y.,Yamada, K., Yamada, Y., Seino, Y., Inagaki, N., (2008). Curcumin inhibits glucose production in isolated mice hepatocytes, Diabetes Research and Clinical Practice, 80, 185-191.
Goel, A., Kunnamakkara, A., Aggarwal, B., (2008). From kitchen to clinic, Biochemical Pharmacology, 75, 787-809.
Numbers, R., Christianson, E., Warner, J., Marks, H., Rogers, N., (2001). The oxford companion to United States history. Paul S. Boyer, ed., USA: Oxford University Press.
Mayo Clinic Staff, (2007). Complimentary and alternative medicine: What is it? Mayo Clinic. Retrieved November 11, 2008. http://www.Mayoclinic.com
Shane-McWhorter, L., (2001). Biological complementary therapies: A focus on botanical products in diabetes, Diabetes Spectrum, 14, 4, 199-208.
Sharma, S., Kulkarni, S., Chopra, K., (2006). Curcumin, the active principle of turmeric (Curcuma Longa), ameliorates diabetic nephropathy in rats, Clinical and Experimental Pharmacology and Physiology, 33, 940-945.
Srinivasan, K., (2005). Plant foods in the management of diabetes mellitus: Spices as beneficial antidiabetic food adjuncts, International Journal of Food Sciences and Nutrition, 9, 399-414.
Vanschoonbeek, K., Thomassen, B., Senden, J., Wodzig, W., Van Loon, L., (2006). Cinnamon supplementation does not improve glycemic control in postmenopausal type 2 diabetes patients, Journal of Nutrition, 977-980.
While all this information is very interesting, my real opinion is that the drug companies dont want any real cures, and prevent much of the research from taking place/or the research has been done but it will not be allowed to be published. There is no money to be made on herbal supplements. It's all about the bottom line and pocketbooks in Corporate America. Note: I received 87% out of 100% possible score on this report. Also Curcumin is an amazing spice from what I have studied and appears to be the wonder spice of the century.
