Type 1 Diabetes (Holistic)
About This Condition
- Fight back with fiber
Under a doctor's supervision, stabilize your blood sugar by eating fiber from whole grains, beans (legumes), vegetables, and fruit, and consider using a fiber supplement such as psyllium or guar gum
- Go for the chromium
Under the supervision of a doctor, take 200 mcg a day of this essential trace mineral to improve glucose tolerance
- Protect with alpha lipoic acid
Protect against diabetic complications, such as nerve and kidney damage, by taking 600 to 1,200 mg of this supplement per day
About This Condition
Diabetes mellitus is the reduced ability, or inability, to metabolize carbohydrates resulting from inadequate insulin production or utilization. Several types of diabetes exist: type 1, type 2, and gestational. This article concerns type 1 diabetes, in which autoimmune destruction of the beta cells of the pancreas results in insulin deficiency.
People with all forms of diabetes face increased risks of an array of complications due to chronically elevated blood glucose levels (hyperglycemia). Long-term hyperglycemia related to type 1 diabetes increases the risk of cardiovascular disease, stroke, kidney and nerve damage, Alzheimer's disease, poor wound healing, infections, and eye problems including retinopathy and cataracts.1, 2, 3
People with type 1 diabetes need insulin replacement and should work with the doctor prescribing their insulin before using any of the lifestyle or dietary changes mentioned in this article. Any change that makes the body more responsive to insulin could require adjustments in insulin dosage that the treating physician must supervise.4
Healthy Lifestyle Tips
It is recommended that everyone with diabetes aged 6 months and older, as well as their close household contacts and out-of-home caregivers, should be vaccinated against the flu each year.
People with type 1 diabetes who engage in regular exercise have better blood sugar control and require less insulin. They also enjoy better overall health, and may have a lower risk of cardiovascular complications.5 However, in the short term, exercise can induce low blood sugar or, if performed first thing in the morning before eating, high blood sugar.6 Therefore, people with type 1 diabetes should never begin a new exercise program without consulting a healthcare professional.
The American Diabetes Association (ADA) recommends that people with diabetes limit their per day alcohol consumption to one drink for women and two drinks for men.7 The Centers for Disease Control defines one drink as equivalent to a 12 ounce can of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of hard liquor (spirits). In higher amounts, alcohol is likely to be more harmful than beneficial. Drinking alcohol can make it more difficult to regulate blood glucose levels in people with type 1 diabetes.8 Although the evidence is far from conclusive, it appears different types of alcohol have different effects on health for people with type 1 diabetes: regular consumption of spirits was reported to increase risk of microvascular complications such as kidney and eye diseases, while moderate consumption of wine was reported to be protective.9, 10 Since no benefits have been clearly established, it is not advised that people who do not drink alcohol begin doing so simply for its possible health effects. Ask your doctor what is best for you, taking into account your personal medical history.
People with diabetes who smoke are at higher risk for kidney damage, nerve damage, heart disease, and other diabetes-related health problems.11 Therefore, it's important for people with diabetes who smoke to quit.
Most healthcare providers agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes. Advocates of SMBG, such as the ADA, have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific blood glucose and laboratory value goals. Now, technological advances have brought continuous glucose monitoring devices along with continuous subcutaneous insulin infusion pumps that can replace SMBG and insulin injections in order to further refine regulation of blood sugar and insulin levels.12, 13, 14, 15 In the context of rapidly changing technologies for monitoring blood glucose control, it is important to talk with your doctor about what form of glucose monitoring is right for you.
Holistic Options
Acupuncture may be helpful in the management of diabetes, or complications associated with the disease. In a preliminary trial, 77% of people suffering from diabetic nerve damage (neuropathy) experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many also were able to reduce pain medications, but no long-term change in blood-sugar control was observed.16 Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment, with a significant reduction in symptoms in both controlled and uncontrolled trials.17, 18
The right diet is the key to managing many diseases and to improving general quality of life. For this condition, scientific research has found benefit in the following healthy eating tips.
| Recommendation | Why |
|---|---|
| Add some olive oil | Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats is associated with better blood sugar control and cholesterol levels. Changing the overall percentage of calories from fat and carbohydrates in the diets of people with type 1 diabetes can be challenging. However, it is possible to improve the quality of the dietary fat. Increasing monounsaturated fats has been associated with better control of blood sugar and reductions in triglyceride and cholesterol levels in subjects with type 1 diabetes. The best way to incorporate monounsaturated fats into the diet is to use olive oil, especially extra virgin olive oil, which has the highest antioxidant values in addition to monounsaturated fat. Studies have noted that, in people with type 1 diabetes, including olive oil in a meal reduces the after-meal blood glucose spike more than butter. |
| Be GL savvy | Low- and medium-glycemic-load foods like whole grains, beans, vegetables, and fruits are loaded with nutrients and fiber, providing valuable fuel while keeping blood sugar levels stable. Eating a lower glycemic index and glycemic load diet—emphasizing foods that are more slowly digested, absorbed, and metabolized—has been associated with better glucose control in children and adolescents with type 1 diabetes. Nevertheless, those with type 1 diabetes should always discuss changes in their diet with their treating physician. For people who are using intensive insulin therapy, it’s important to be as accurate as possible when counting carbohydrates to determine a pre-meal insulin dose. For example, if the dose of insulin is calculated based on a planned meal containing 60 grams of carbohydrates, eating only 40 grams of carbohydrates will result in hypoglycemia, while eating 80 grams will lead to hyperglycemia. For this reason, experts recommend that carbohydrates be counted very accurately, and that the calculated carbohydrate grams be within 10 grams of the actual meal carbohydrate content. Glycemic load values of foods may prove to be more helpful than carbohydrate content for determining insulin doses in the future. Early research suggests monitoring glycemic load in order to calculate insulin doses may lead to slightly less glucose variability than using carbohydrate counting, but more research is needed to verify this as an effective way to calculate insulin needs. |
| Factor in fat and protein | As much as possible, balance your snacks and meals with carbohydrates, protein, and healthy sources of fat. Including all three macronutrients may help minimize the risk of hypoglycemic events in people who are focused on very tight blood sugar control through intensive insulin therapy. While many people think carbohydrates alone contribute to blood glucose peaks and insulin requirements, in fact, researchers have shown high-protein and high-fat meals cause longer and higher post-meal blood glucose rises and significantly increase insulin requirements in people with type 1 diabetes. Because an unbalanced high-protein diet can aggravate compromised kidney function, people with type 1 diabetes should embark on a high-protein diet only under the supervision of a healthcare provider. |
| Feature fiber | Research indicates a high-fiber diet can help people with type 1 diabetes regulate glucose levels better and lower their risk of hypoglycemia. Eating more fiber is also associated with lower risk of all-cause mortality. People with type 1 diabetes benefit from eating a high-fiber diet. Research has shown eating a low-glycemic-load diet that is high in fiber can reduce blood glucose variability and prevent hypoglycemia in people with type 1 diabetes. Further, fiber comes from foods such as vegetables, fruits, legumes, nuts, seeds, and whole grains, which provide important vitamins, minerals, and phytonutrients and are associated with good overall health. |
| Limit sugar | Most doctors recommend that people with diabetes eat less sugary foods like snacks and processed foods and replace these foods with high-fiber, whole foods. Currently, the American Diabetes Association guidelines do not set specific limits for sucrose—white table sugar—in the diet, because substituting sucrose-containing foods for equal caloric amounts of other carbohydrates may have similar blood glucose effects. However, consumption of sucrose, which is mostly found in less healthy, processed foods, should be minimized to avoid displacing nutrient-dense food choices, such as vegetables, legumes, fruits, and whole grains. All people, including those with diabetes, should follow the American Heart Association guidelines that men eat no more than 150 calories, or approximately nine teaspoons, of added sugar per day, and that women eat no more than 100 calories, or approximately 6 teaspoons, of added sugar per day. |
| Pick a pattern | Consult a knowledgeable healthcare practitioner to identify which dietary pattern will work best for you. Because current research evidence does not show that there is one ideal eating pattern for all people with diabetes, the American Diabetes Association (ADA) recommends that the percentage of calories from carbohydrates, proteins, and fats be based on an individualized assessment of current eating patterns, preferences, and metabolic goals. Other factors, including food access and the availability of healthful foods, traditions, cultural food systems, health beliefs, knowledge of foods that promote health and prevent disease, and resources to buy health-promoting foods, should be considered as well when determining the best eating pattern to foster good glycemic control and promote health for each person with diabetes. A Mediterranean diet eating pattern, vegetarian or vegan diets, low-fat diets, low-carbohydrate diets, and the Dietary Approaches to Stop Hypertension (DASH) diet, have all been shown to be healthful choices for some people with diabetes, under some circumstances. Rather than a particular dietary pattern, the ADA recommends focusing on features these healthy diets have in common, such as being high in non-starchy vegetables and low in sugar and refined grains and emphasizing whole rather than processed foods. Working with a knowledgeable healthcare practitioner before making any major dietary changes can be help individuals identify which heating pattern is likely to be most beneficial. |
| Stay tuned about dairy | The relationship between dairy foods (made from cow’s milk) and type 1 diabetes remains unclear, although there is some evidence that these foods may increase the risk of developing type 1 diabetes. Should children avoid dairy foods, especially early in life, to prevent type 1 diabetes? The relationship between dairy foods and type 1 diabetes risk remains unclear, although there is some evidence that milk consumption might increase the risk of developing type 1 diabetes in children who are genetically susceptible to developing the disease. Researchers noted some time ago that worldwide, in places with higher dairy consumption, children have a significantly higher chance of developing type 1 diabetes compared with areas where less dairy is consumed. Some research indicates that drinking milk may cause susceptible children to make antibodies that attack the pancreas (autoantibodies), causing type 1 diabetes to develop. One long-running double-blind, randomized controlled study has been following infants with a higher than average risk of developing type 1 diabetes due to the presence of genetic factors for the disease. Infants who were unable to consume breast milk for the first six to eight months of life were assigned to receive either regular cow’s milk infant formula or a casein hydrolysate formula. While casein is found in milk, this second formula is considered more digestible and may be less likely to elicit an immune response, because the casein proteins are hydrolyzed or broken down in this product. Although initial findings from this study were promising, the hydrolyzed infant formula was ultimately not been found to reduce the risk of type 1 diabetes autoantibodies after an 11.5 years of follow up. Newer research examining whether a cow’s milk formula that is free of bovine insulin is less likely to trigger autoantibody production in children has reported encouraging findings after three years, but longer observation is needed before conclusions can be reached. Because the evidence is conflicting, there are no official guidelines recommending the avoidance of dairy foods (made from cow’s milk) for children at higher than average risk of developing type 1 diabetes. However, if you have concerns about type 1 diabetes, or have a family history of the disease or other autoimmune conditions, such as rheumatoid arthritis or celiac disease, ask your pediatrician about the pros and cons of keeping dairy foods out of your child’s diet for the first few years of life. Dairy can provide valuable nutrients to a child’s diet, including protein, calcium, and vitamin D, so if you decide to avoid it, work with a registered dietitian who can guide you on how best to replace important nutrients with non-dairy options. |
Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by some in the medical community, and whether studies have found them to be effective for other people.
For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.
3 StarsReliable and relatively consistent scientific data showing a substantial health benefit.
2 StarsContradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
1 StarFor an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.
| Supplement | Why |
|---|---|
3 Stars Alpha-Lipoic Acid 600 to 1,200 mg daily | Supplementing with alpha-lipoic acid may improve the symptoms of diabetic nerve damage (neuropathy). Alpha lipoic acid is an important nutrient for mitochondrial function. It has antioxidant properties and can act as a reducer of oxidized forms of vitamins C and E. A number of placebo-controlled clinical trials have found that supplementing with 600 to 1,200 mg of alpha-lipoic acid per day can improve the symptoms of diabetic nerve damage (neuropathy). Animal studies and early clinical research suggest alpha-lipoic acid may also help prevent diabetes-related damage to the small blood vessels and nerves in the eyes (diabetic retinopathy). |
3 Stars Cayenne Topical (Diabetic Neuropathy) Apply an ointment containing 0.025 to 0.075% capsaicin four times daily to areas of nerve pain | Topically applied capsaicin (from cayenne) has been shown to relieve symptoms of diabetic neuropathy. Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic nerve damage (neuropathy). Four or more applications per day may be required to relieve severe pain. This should be done only under a doctor’s supervision. |
3 Stars Magnesium 200 to 600 mg daily | People with type 1 diabetes tend to have low magnesium levels and supplementing with magnesium may reduce the risk of deficiency-related problems, such as eye damage and neuropathy. People with type 1 diabetes often have low magnesium levels, and low magnesium status is correlated with poor glucose control and increased risk of complications. In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of miscarriages and birth defects associated with type 1 diabetes. Some studies have found that magnesium replenishment using supplements can improve blood glucose control and may reduce the risks of certain diabetes complications, such as cardiovascular disease and neuropathy, in children and adults with type 1 diabetes. Many doctors recommend that adults with type 1 diabetes and normal kidney function supplement with 200 to 600 mg of magnesium per day to maintain normal magnesium status; children with type 1 diabetes may benefit from a lower dose. |
3 Stars Vitamin B12 1,500 micrograms daily | Supplementing with vitamin B12 may improve symptoms of diabetic neuropathy. Vitamin B12, or cobalamin, is needed for normal functioning of nerve cells and is also involved in homocysteine metabolism. People with type 1 diabetes have an increased risk of other disorders that can affect their B12 status, such as autoimmune gastritis, celiac disease, and pernicious anemia. Vitamin B12, taken at a dose of 1,500 micrograms per day for 24 weeks, has been found to reduce symptoms and disability due to diabetic nerve damage (neuropathy). In a preliminary trial that included 544 participants with diabetic neuropathy, supplementing with vitamin B12 (in the form of methylcobalamin) along with folic acid (in the form of methylfolate) and vitamin B6 (in the form of pyridoxal-5-phosphate) for 12 weeks was associated with a 35% drop in symptom scores and a 32% drop in pain scores. A comparison trial in 100 subjects with diabetic neuropathy found injections of B12 were more effective than the commonly used pain medication, nortriptyline, for treating symptoms of diabetic neuropathy. A number of other studies have shown B12, alone and in combination with other treatments such as alpha-lipoic acid and prostaglandin E1, can be beneficial in those with diabetic neuropathy. Oral vitamin B12 up to 1,500 micrograms per day is recommended by some practitioners. |
3 Stars Vitamin B6 100 to 200 mg vitamin B6 daily | People with diabetes may have an increased need for vitamin B6. Supplementing with the vitamin may help maintain normal levels and prevent type 1 diabetes complications. People with type 1 diabetes may have impaired vitamin B6 metabolism, resulting in increased susceptibility to deficiency. Vitamin B6, along with other B vitamins, is critical for homocysteine metabolism and may thereby reduce their risk of vascular complications of diabetes, particularly diabetes-related kidney disease. Research in people with type 1 diabetes showed supplementation with B1, B6, and B12 lowered elevated homocysteine levels and improved kidney function. Vitamin B6 alone, at doses of 100 to 500 mg per day, also improved kidney function in a group of people with type 1 diabetes-related kidney impairment. In children with type 1 diabetes, taking 100 mg of B6 per day for eight weeks led to improvements in blood vessel function. The benefits of B6 in people with diabetes may also be related to its apparent ability to prevent the formation of damaging advanced glycation end-products (AGEs). |
3 Stars Vitamin D Many doctors recommend a dose of 2,000 to 4,000 IU vitamin D daily, especially in the winter months | Vitamin D is needed to support healthy immune and pancreatic function. Supplementing with vitamin D may improve blood sugar control in those with type 1 diabetes, especially in those with low vitamin D levels. Vitamin D is needed to regulate immune activity and research has shown it has an important role in preventing autoimmune diseases, including type 1 diabetes. Vitamin D receptors have been found in the pancreas where insulin is made and some, but not all, preliminary evidence suggests that supplementation might reduce the risk of developing type 1 diabetes. Case reports even suggest a combination of high-dose vitamin D and omega-3 fatty acids may completely reverse the onset of type 1 diabetes. Vitamin D deficiency is common in people with type 1 diabetes and associated with poor glucose control. Supplementation with cholecalciferol (vitamin D3), in doses ranging from 2,000 IU per day to about 6,000 IU per day, has been shown in randomized controlled trials to slow the decline of pancreatic function in people with newly diagnosed type 1 diabetes who have not yet suffered an extensive loss of pancreatic function. Furthermore, the majority of the research shows vitamin D3, in doses ranging from 2,000–10,000 IU per day, improves short and long term glycemic control in people with type 1 diabetes, particularly in those with low vitamin D status, possibly by preserving beta cell function and increasing insulin production. |
2 Stars Acetyl-L-Carnitine (Diabetic Neuropathy) 500 to 1,000 mg three times daily | Taking acetyl-L-carnitine may improve symptoms of diabetic neuropathy. In a double-blind study of people with diabetic nerve damage (neuropathy), supplementing with acetyl-L-carnitine was significantly more effective than a placebo in improving subjective symptoms of neuropathy and objective measures of nerve function. People who received 1,000 mg of acetyl-L-carnitine three times per day tended to fare better than those who received 500 mg three times per day. |
2 Stars Bilberry 160 mg twice daily of an herbal extract containing 25% anthocyanosides | Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy. Animal research suggests bilberry extract may improve glycemic control and lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy. Compounds called anthocyanins, found in bilberry and other dark berries, have strong antioxidant and anti-inflammatory effects that appear to mitigate some of the negative impacts of chronically elevated glucose levels. One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy. |
2 Stars Biotin 16 mg daily | Biotin may improve glucose levels and reduce pain from diabetic nerve damage. Biotin is a B vitamin needed to process glucose. High doses of biotin have been suggested to reverse some of the negative effects of chronic low insulin levels on glucose metabolism. In a pilot trial, people with type 1 diabetes given 16 mg of biotin per day for one week experienced 50% reductions in fasting glucose levels. In a placebo-controlled trial, people with type 1 diabetes treated with biotin at doses of about 2–4 mg per day, depending on body weight, had improvements in blood glucose regulation and blood lipid levels after three months. Case reports suggest biotin may also reduce pain from diabetic nerve damage (neuropathy). Some doctors recommend a trial of 16 mg of biotin daily for a few weeks to see if blood sugar levels decrease. |
2 Stars Chromium 200 mcg daily | Chromium has been shown to help improve glucose tolerance in people with type 1 diabetes. Chromium, a trace mineral that appears to increase the effectiveness of insulin, has been reported to improve blood glucose control in people with various forms of diabetes, including type 1 diabetes. Low chromium levels have been correlated with poor glucose control and human case studies and animal research suggest chromium supplementation may improve glycemic control and prevent some diabetic complications. The typical amount of chromium used in studies is 200 micrograms one to three times per day. Supplementation with chromium could potentially enhance the effects of drugs for diabetes (for example, insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia. Therefore, people with diabetes taking these medications should supplement with chromium only under the supervision of a doctor. |
2 Stars Coenzyme Q10 100 mg daily | Supplementing with CoQ10 may improve blood sugar metabolism. Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. One research team reported that, in study subjects with vascular complications related to type 1 diabetes, adding CoQ10 to standard insulin therapy increased antioxidant status, reduced free radical damage to lipids, and improved blood vessel function. The same research group also reported that CoQ10 supplementation, at the unusually high dose of 1,000 mg per day, improved blood glucose control in those with type 1 diabetes-related kidney dysfunction. However, in a placebo-controlled trial, supplementation with 100 mg of CoQ10 per day for three months neither improved glucose control nor reduced the need for insulin in participants with type 1 diabetes. Although the potential benefits of CoQ10 supplements in treatment of type 1 diabetes remains uncertain, some doctors recommend taking 50–100 mg per day due to its likely ability to protect heart, blood vessel, and kidney health. |
2 Stars Fenugreek 3 tablespoons of fenugreek powder with each meal | Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Fenugreek extract has also been shown to increase the number and function of insulin-producing cells in the pancreas and improve blood sugar control, lipid levels, and antioxidant capacity in animal models of type 1 diabetes. In a controlled study in people with type 1 diabetes, incorporating powdered fenugreek seed into lunch and dinner meals (50 grams per meal) for ten days improved several measures of blood sugar control compared to a similar ten-day diet without added fenugreek. |
2 Stars Fiber Refer to label instructions | Taking fiber supplements may help to stabilize your blood sugar. Dietary fiber has been found to have a small but notable positive impact on blood glucose control in people with type 1 diabetes. Clinical trials in people with type 1 diabetes suggest fiber supplements, when taken before meals, may reduce the post-meal rise in blood sugar. More research is needed to determine if regular use of fiber supplements benefits long-term blood sugar control in type 1 diabetes. |
2 Stars Fish Oil 1,000 mg combined omega-3 fatty acids from fish, or 660 mg EPA alone, daily | Fish oil and its omega-3 fatty acid EPA may improve blood sugar control and help prevent complications of type 1 diabetes. Omega-3 fatty acids from fish are well known to reduce inflammatory immune activity and have beneficial effects in a range of autoimmune conditions. Observational research suggests higher levels during infancy and early childhood may be linked to lower risk of developing type 1 diabetes. One study done in Norway found that babies given cod liver oil regularly during the first year of life had a 26% lower risk of developing type 1 diabetes in childhood. However, not all studies have noted a connection between omega-3 fatty acids and type 1 diabetes risk, and some researchers have proposed the discrepancies may be explained by genetic factors affecting fatty acid metabolism. Higher intake of EPA, an omega-3 fatty acids from fish, has been correlated with better preservation of pancreatic cells that produce insulin and long-term blood glucose control in youth with type 1 diabetes. A small pilot trial found that supplementation with 630 mg of EPA and 330 mg of DHA (another omega-3 fatty acid from fish oil) per day improved blood glucose control in subjects with type 1 diabetes. Furthermore, better omega-3 fatty acid status may be helpful in slowing the progression of diabetes-associated complications such as kidney dysfunction and nerve pain. Although fish oil fatty acids generally have positive effects on triglyceride levels, some studies have found supplemental DHA can increase LDL- and total cholesterol, which may increase cardiac risk. For this reason, some doctors are wary of fish oil supplements for patients with type 1 diabetes and may recommend EPA-only supplements instead. |
2 Stars Gymnema 400 mg daily | Gymnema may help normalize blood sugar control in people with type 1 diabetes. Test tube and animal studies have found several mechanisms by which gymnema (Gymnema sylvestre) may help normalize blood sugar control in people with diabetes, including reducing glucose absorption in the intestines, and stimulating regeneration and activity of pancreatic cells that release insulin. In a controlled trial with people with type 1 diabetes, 400 mg per day of gymnema extract improved blood glucose control and reduced requirements for insulin. Some practitioners recommend using gymnema extracts standardized for their content of active constituents called gymnemic acids. Gymnema is not a substitute for insulin, but insulin amounts may need to be lowered in order to avoid hypoglycemia while taking gymnema. |
2 Stars L-Carnitine 1,500 to 2,000 mg daily | Supplementing with acetyl l-carnitine may reduce symptoms of diabetic neuropathy in people with type 1 diabetes. Acetyl l-carnitine is an amino acid compound used to treat conditions affecting the brain and peripheral nervous system. Research reviews have concluded acetyl l-carnitine, in doses of at least 2 grams per day, can relieve pain and improve nerve function in those with diabetic nerve damage (neuropathy). A preliminary trial found 500 mg of acetyl l-carnitine three times daily for 24 weeks relieved symptoms of diabetic nerve damage (neuropathy) as effectively as vitamin B12. |
2 Stars Sea Buckthorn Refer to label instructions | Animal and preliminary research suggests a connection between sea buckthorn and improved measures of blood sugar control. Sea buckthorn (Hippophae rhamnoides) is a source of antioxidant polyphenols, and laboratory and animal studies suggest extracts from sea buckthorn have a positive impact on carbohydrate and lipid metabolism. In one study, a sea buckthorn extract was found to lower the rise in blood glucose that occurs after a meal in healthy men. In a preliminary trial, children with type 1 diabetes who consumed a concentrated mixture of sea buckthorn berries and blueberries (concentration and relative proportions not stated) for two months had improved blood measures of glucose control. Double-blind research using sea buckthorn alone is needed to confirm these findings and to determine an effective per day amount of sea buckthorn. |
2 Stars Selenium 100 to 200 micrograms daily | Selenium is an important antioxidant that, along with other antioxidant supplements, may help prevent complications in people with type 1 diabetes. Because oxidative damage is believed to play a role in the development of diabetic complications, such as eye damage (retinopathy), kidney damage (nephropathy), and nerve damage (neuropathy), antioxidant nutrients like selenium might play an important preventive role. In a placebo-controlled trial that included people with type 1 and type 2 diabetes and related nephropathy, those given 200 micrograms of selenium per day for 12 weeks had increased antioxidant capacity but no change in markers of kidney function. One doctor reported administering a per day regimen of antioxidants including 500 micrograms selenium, plus 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C, per day for several years to 20 people with diabetic eye damage (retinopathy). During that time, the doctor observed that 19 of the 20 people showed either improvement or no progression of their retinopathy. In a three-month study, taking supplements providing 100 micrograms selenium, 600 mg alpha-lipoic acid, and 1,200 IU vitamin E per day resulted in improvements in neuropathy symptoms in those with long-standing diabetes. People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner. |
2 Stars Taurine 500 mg three times daily | Supplementing with taurine has been found to improve blood vessel function in people with type 1 diabetes. Taurine is an amino acid that is not used in protein synthesis but serves other functions in the body. Because of its role in cardiovascular and nervous system health, it may be an important nutrient for people with type 1 diabetes. A small crossover trial with nine young men with type 1 diabetes found, compared to placebo, supplementing with 500 mg taurine three times per day for two weeks reduced arterial stiffness and increased the blood vessel dilation response to higher blood flow, indicating taurine improved their vascular function. Findings from animal studies suggest taurine supplementation may improve heart and blood vessel dysfunction associated with type 1 diabetes. Evidence from laboratory studies also suggests taurine may prevent or reverse damage to insulin-producing pancreatic cells. Taurine also reduced diabetes-related penile muscle scarring and erectile dysfunction in a rat model of type 1 diabetes. |
2 Stars Vitamin B1 25 mg vitamin B1 with 50 mg of vitamin B6 daily or 600 mg lipid-soluble thiamine (benfotiamine) daily | People with type 1 diabetes may be deficient in vitamin B1. Supplementing with vitamin B1 may restore levels and improve symptoms of diabetic neuropathy. Blood levels of vitamin B1 (thiamine) have been found to be low in people with type 1 diabetes, and low levels are correlated with greater risk of diabetes-related anemia and other complications. Supplementing with B1, along with vitamins B6 and B12, was found to reduce high levels of homocysteine in children type 1 diabetes in one placebo-controlled trial. High homocysteine levels are generally correlated with blood vessel dysfunction and reducing high levels may help prevent vascular complications of diabetes. In this trial, improvement in markers of kidney function were also seen. Several controlled trials have evaluated the effect of benfotiamine, a fat-soluble form of vitamin B1, on diabetic neuropathy in participants with type 1 and type 2 diabetes. In one of these trials, 600 mg per day of benfotiamine was more effective than 300 mg per day or placebo for reducing neuropathic pain after six weeks; in a three-week trial, those receiving 400 mg per day of benfotiamine had greater pain reduction than those receiving placebo. However, 300 mg of benfotiamine daily had no benefits on nerve function relative to placebo in people with type 1 diabetes after 24 months, suggesting this dose may be too low to be helpful. |
2 Stars Vitamin B3 (Niacin) Consult a qualified healthcare practitioner | Taking vitamin B3 (as niacin or niacinamide) might prevent or limit the severity of type 1 diabetes. High doses of niacin (a form of vitamin B3), such as 2 to 3 grams per day, are sometimes recommended to lower high triglyceride and cholesterol levels in people with type 1 diabetes. However, niacin’s ability to reduce cardiovascular risk in the context of type 1 diabetes has not been established. It is important to note that niacin doses this high, particularly in extended release formulations, may cause flushing, stomach upset, and liver toxicity, and should be used by people with diabetes only with medical supervision. Animal research suggests that niacinamide, a form of vitamin B3 with fewer side effects, may prevent toxic damage to the pancreatic cells that make insulin. Although one intriguing study found niacinamide supplementation was associated with a lower incidence of type 1 diabetes in children at high risk, more recent studies have not confirmed a protective effect. A controlled clinical trial in subjects with recently diagnosed type 1 diabetes found the addition of niacinamide (25 mg per day per kg of body weight; approximately 2–3 grams per day) to intensive insulin treatment led to greater improvement in HgA1c over two years, but other clinical trials have found no benefit on glucose metabolism in similar subjects. |
2 Stars Vitamin C 1,000 mg vitamin C plus 400 IU vitamin E daily | Supplementing with vitamin C may benefit people with type 1 diabetes by preventing free radical damage and protecting blood vessels. Vitamin C is important for lowering oxidative stress and preventing oxidative tissue damage linked to high glucose levels in people with diabetes. Vitamin C levels have been found to be lower in people with type 1 diabetes compared to healthy people, and low levels have been correlated with markers of decreased cardiovascular health in those with type 1 diabetes. In addition, because vitamin C uptake by cells is enhanced by insulin and suppressed by high glucose levels, people with type 1 diabetes have more difficulty meeting their cellular and tissue needs for vitamin C. In a placebo-controlled trial, 1,000 mg vitamin C along with 800 IU vitamin E per day for six months improved blood vessel function in participants with type 1 diabetes. Another placebo-controlled trial found the high dose of 6 grams of vitamin C per day for six months improved markers of capillary health. Several studies show vitamin C may protect blood vessels from free radical damage during the vulnerable periods of high blood glucose in subjects with type 1 diabetes. A small one-month study in children with type 1 diabetes found no effect of supplementation with 250 mg per day of vitamin C on vascular health. Another trial in nine type 1 diabetes-affected adolescents investigated doses of vitamin C ranging from 250–750 mg per day, depending on weight, combined with vitamin E for six weeks and saw no change in vascular function. Whether these negative findings reflect study factors such as low dose, short duration, and small number of participants is unclear. |
2 Stars Vitamin E (Diabetic Retinopathy) 1800 IU daily | Supplementing with vitamin E may combat free radicals associated with diabetic retinopathy. People with low blood levels of vitamin E are more likely to develop type 1 diabetes, but no studies have been done using vitamin E supplements to try to prevent type 1 diabetes. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic eye damage and nephropathy, serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,although not all, studies of people with type 1 diabetes. |
2 Stars Vitamin E (Diabetic Nephropathy) 900 to 1,800 IU daily | Vitamin E supplementation may protect against diabetic neuropathy. People with low blood levels of vitamin E are more likely to develop type 1 diabetes, but no studies have been done using vitamin E supplements to try to prevent type 1 diabetes. Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic eye damage and nephropathy, serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence. Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,although not all, studies of people with type 1 diabetes. |
1 Star Açaí Refer to label instructions | Açaí is rich in antioxidants and has been used traditionally to treat diabetes. Açaí is reported to be a traditional remedy for diabetes. Oxidative stress may contribute to diabetes onset and its complications, and açaí is rich in antioxidant polyphenols such as anthocyanins. Studies in people without diabetes show açaí consumption can raise antioxidant status in the body and improve lipid levels and blood vessel function. In animal research, açaí extract reduced diabetes-related kidney damage and dysfunction; however, direct evidence for açaí’s benefits in people with type 1 diabetes is lacking. |
1 Star Amylase Inhibitors Refer to label instructions | Amylase inhibitors, taken with meals, may reduce the usual rise in blood sugar levels in people with diabetes. Substances that inhibit amylase, the digestive enzyme required to break down dietary starches into absorbable glucose units, can reduce the usual post-meal rise in blood sugar levels in both healthy people and people with diabetes. Amylase inhibitors occur naturally in foods such as whole grains and legumes, as well as in many culinary herbs and spices and medicinal herbs, possibly contributing to their anti-diabetic effects. While some food and herbal extracts with amylase-inhibiting effects have shown promise in animal research, their benefits for type 1 diabetes await confirmation in clinical trials. |
1 Star Asian Ginseng Refer to label instructions | Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes. Asian ginseng (Panax ginseng) is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and increase the number of insulin receptors. Asian ginseng and its active constituents have also been found to improve blood glucose control and reduce complications in animal models of type 1 diabetes. Clinical trials in people with type 1 diabetes are needed to confirm these findings. |
1 Star Evening Primrose Oil Refer to label instructions | Evening primrose oil may relieve nerve pain in those with type 1 diabetes. Supplementing with evening primrose oil providing 360–480 mg of gamma-linolenic acid per day for six months has been found in double-blind research to improve nerve function and relieve pain in people with diabetic nerve damage (neuropathy). However, one of the investigators involved in these clinical trials was subsequently found by the professional conduct committee of the General Medical Council (United Kingdom) to have falsified the results of his research. In the absence of more recent clinical trials, it is not clear whether evening primrose oil or GLA is of any value for patients with diabetic neuropathy. |
1 Star Ginkgo Refer to label instructions | Ginkgo may improve metabolism and help prevent complications of type 1 diabetes. Ginkgo (Ginkgo biloba) extract may be useful to people with type 1 diabetes because of its abilities to raise antioxidant capacity and reduce inflammatory signaling. A standardized ginkgo extract was found to improve insulin production and glucose metabolism and decrease triglyceride levels in an animal model of type 1 diabetes. Preliminary evidence from a trial in subjects with long-standing type 1 diabetes suggests it may have a role in protecting vision. Other animal research and a single small, uncontrolled, pilot trial indicate ginkgo may protect nerve function and prove useful for prevention and treatment of diabetic nerve damage (neuropathy). |
1 Star Glucomannan Refer to label instructions | Glucomannan delays stomach emptying, leading to more gradual sugar absorption and possibly lowering insulin requirements for people with type 1 diabetes. Glucomannan is a water-soluble dietary fiber derived from konjac root (Amorphophallus konjac). Glucomannan delays stomach emptying, leading to a more gradual rise in glucose levels after eating carbohydrates. This could result in reduced need for insulin after meals in people with type 1 diabetes. In addition, glucomannan has positive effects on carbohydrate and fat metabolism, as well as the gut microbiota. These properties could lead to benefits in people with type 1 diabetes, but no research has been done to test this possibility. |
1 Star Hibiscus Refer to label instructions | Hibiscus is a traditional remedy in India for diabetes. Hibiscus is a traditional remedy in India for diabetes. Animal research suggests hibiscus extract may stimulate regeneration of pancreatic cells that produce insulin, reduce high glucose and lipid levels, and protect against damage to the heart and kidneys induced by type 1 diabetes. Hibiscus is usually taken as tea, 1 to 2 teaspoons (3 to 6 grams) of dried flower infused into 1 cup (250 ml) of water, three times per day. |
1 Star Inositol Refer to label instructions | Supplementing with inositol may improve diabetic neuropathy. Inositol, particularly in the forms myo-inositol and D-chiro-inositol, has many functions in the body, including assisting in normal cellular responsiveness to insulin. A gene alteration that affects inositol metabolism may be associated with risk of type 1 diabetes and its complications, and people with type 1 and type 2 diabetes have been found to lose more myo-inositol in their urine compared to those without diabetes. In one small pilot trial in seven people with type 1 diabetes, inositol supplementation (500 mg taken twice per day for two weeks) led to improved nerve function; however, two placebo-controlled trials failed to find a benefit. |
1 Star Manganese Refer to label instructions | Supplementing with manganese may increase antioxidant defenses and improve blood sugar control in those with type 1 diabetes. Manganese is involved in the activity of an important antioxidant enzyme system in the body. A genetic variant linked to reduced activity of this enzymes system has been implicated as a factor in the development of type 1 diabetes and its complications. Low blood levels of manganese have been reported in people with type 1 and type 2 diabetes. Animal research suggests that manganese supplementation can improve the functioning of this enzyme system, increase insulin secretion, and improve glucose metabolism. One team of researchers reported on a case of a young adult with insulin-dependent diabetes who received oral manganese (3 to 5 mg per day as manganese chloride) and experienced a significant fall in blood glucose, sometimes to dangerously low levels; however, three other people with type 1 diabetes they treated with manganese supplementation had no change in blood glucose levels. People with type 1 diabetes wishing to supplement with manganese should do so only with a doctor’s close supervision. |
1 Star Mistletoe Refer to label instructions | Mistletoe extract has been found to stimulate insulin release from pancreas cells and improve health in animal models of diabetes. Mistletoe extract has been shown to stimulate insulin release from pancreas cells. Research in type 1 diabetic animals found that treatment with mistletoe extract reduced metabolic disturbances and improved general health. No research in humans has yet been published; however, given mistletoe’s worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Traditionally, mistletoe is prepared by soaking 2 to 4 teaspoons (5 to 12 grams) of chopped mistletoe in 2 cups (500 ml) of water overnight. The mixture is drunk first thing in the morning and sweetened with honey if desired. Another batch may be left to steep during the day and drunk at bedtime. |
1 Star Olive Leaf Refer to label instructions | Olive leaf extracts have been shown to improve blood sugar control in animals with diabetes. Olive leaf extract has been shown to reduce oxidative stress, inflammatory signaling, and autoimmune activity, and to improve glucose metabolism and protect pancreatic cells in animal models of type 1 diabetes. These results have not yet been reproduced in human clinical trials. |
1 Star Onion Refer to label instructions | Research in laboratory animals suggests onion and its active constituents may lower blood glucose levels, raise insulin levels, reduce advanced glycation end-product (AGE) formation, and possibly prevent diabetes complications. Research in laboratory animals suggests onion and its active constituents may lower blood glucose levels, raise insulin levels, reduce advanced glycation end-product (AGE) formation, and possibly prevent diabetes complications. In one preliminary trial, people with type 1 diabetes had lower blood glucose levels four hours after eating about three ounces of raw onion than after receiving water. |
1 Star Quercetin Refer to label instructions | Quercetin has been found to improve blood sugar control and prevent complications of diabetes in animal research. Quercetin has demonstrated multiple actions that may benefit people with type 1 diabetes, including reducing glucose absorption, increasing insulin release, and promoting glucose uptake by cells. Despite a wealth of animal studies indicating its potential in prevention and treatment of diabetes and its complications, clinical trials have not yet been performed to explore whether quercetin actually benefits people with diabetes. |
1 Star Reishi Refer to label instructions | Reishi may improve immune function and has demonstrated benefits in diabetic animals. Animal studies suggest reishi extract may improve immune function and wound healing in the context of type 1 diabetes. Furthermore, reishi has demonstrated anti-diabetic actions, such as lowering high glucose levels and increasing insulin levels, in animal studies. Clinical trials are needed to confirm these effects in humans. |
1 Star Selenium, Vitamin A, Vitamin C, and Vitamin E (Diabetic Retinopathy) Refer to label instructions | Antioxidant nutrients including selenium, vitamin A, vitamin C, and vitamin E may combat free radicals associated with diabetic retinopathy. Because oxidation damage is believed to play a role in the development of diabetic eye damage (retinopathy), antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic eye damage (retinopathy). During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy. People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner. |
1 Star Zinc 15 mg daily | Supplementing with zinc may lower blood sugar levels and improve immune function in people with type 1 diabetes. People with type 1 diabetes may be more likely to be zinc-deficient than their healthy counterparts. Low zinc status leads to impaired immune function and increased oxidative stress and has been linked to poorer glucose control. Zinc supplements have been found to increase antioxidant capacity and reduce lipid peroxidation in people with type 1 diabetes. Despite evidence that zinc may be beneficial in people with type 1 diabetes, some doctors remain skeptical of high doses due to one 1994 study in which zinc supplementation, at a dose of 50 mg per day for 28 days, increased glycosylation (glucose-induced protein damage). This trial is hard to evaluate because zinc supplementation increases the life of blood cells and such an effect artificially increases the lab test results for glycosylation. In fact, laboratory studies suggest zinc can inhibit glycation. Until this issue is resolved, those with type 1 diabetes should consult a doctor before considering high-dose supplementation with zinc. |
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Last Review: 06-08-2015
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