Diabetes runs in my family and has devastated some of my family members. My uncle Guido had one leg amputated as a result of diabetes and it triggered fear in many relatives. It increased my interest in this disorder and became one of my major areas of study.
Today, we know more about what a diet high in simple sugar causes physiologically in diabetics, as well as healthy individuals when endogenous glycation occurs. Glycation is a process where elevated glucose attaches to protein in blood vessels of the body. It poses increased risk of many age-related disorders such as cardiovascular disease, Alzheimer’s and for the diabetic it may contribute to complications of the kidneys, neuropathy and retinal disease.
A product formulator needs to understand this condition and the group of people in this market who desire taking a product that supports healthy blood sugar. Type 2 diabetics may want to venture off their monotonous diet and experiment with dietary supplements to help bring down blood sugar.
A number of years ago, I was doing work for a company that had a blood sugar product in their dietary supplement line. It had ingredients at therapeutic doses that showed in research studies to have a positive effect on the pancreas and reduce blood sugar levels.
When I began to work for the company a customer’s daughter called up and was frantic that her mother took the product along with her insulin and began to experience severe hypoglycemia (low blood sugar) or what is called an insulin reaction. She was extremely tired, irritable, shaky, and was perspiring. Severe hypoglycemia can cause seizures and one to pass out or go into a coma. The daughter was on top of it and discovered her mother was taking the product for only a short time. In addition, the customer did not discuss taking the blood sugar product with her doctor, which often happens.
Marketing and product development had a meeting the same day the daughter’s call came in. The decision was made to revise the label when the next batch of product was to be manufactured with a warning for diabetics, as well as other individuals who had a health condition or were on medication.
There are many different dietary supplement ingredients that support blood sugar levels and it’s difficult to cover them all in this article. We will discuss a few key supplements considered front line defense and then some supporting ingredients that target secondary issues that diabetics have with their blood vessels, eyes and kidneys.
Diet is very important for the type 2 diabetic and more research is underway investigating a low-glycemic-index diet because of the issues of glycation producing advanced glycosylation end products (AGE’s). These compounds are detrimental for the diabetic because they accelerate aging and increase the risk of the secondary symptoms.
The American Diabetic Association recommends a diet that focuses on quality carbohydrates that help to maintain blood sugar levels.1 The diet should include whole grains, vegetables and fruit that have a low carbohydrate component and are high in fiber providing low glycemic index foods. Recently, Dr. Oz gave coconut sugar a thumb’s up because of it has a lower glycemic index than many carbohydrate foods.
There are many different dietary supplements that the formulator may investigate and use in products for blood sugar balance such as alpha-lipoic acid, chromium, vitamins D, E and C, biotin, vitamin B6, vanadium, fiber, fish oil and botanicals like cinnamon, American ginseng, Gymnema silvestre, Momordica charantia (bitter melon), starch blockers, grape seed extract including OPC’s, Pycnogenol, bilberry, resveratrol and fenugreek.
Ingredients that hit that sweet spot
One highlighted botanical is Gymnema sylvestre used traditionally in India and Africa for the gastrointestinal and urinary tracts. Human clinical studies performed in India have shown that 400-800 mg per day of the extract lowers blood sugar levels. There have been companies that have not investigated the research well enough, making claims that the extract inhibits amylase, an enzyme that breaks down sugar. This effect has only been observed when chewing the leaves of the plant and has not been shown to occur from taking the standardized extract in capsules or tablets in the published research.
Omega-3 fatty acids have been studied for decades showing their physiological benefits for the whole body. Diabetics, like many other people may have deficiencies in omega-3s from their diet, it may not be wise to make a direct claim for blood sugar on an omega-3 fatty acid product. The National Institutes of Health performed a meta-analysis, reviewing and reporting studies on omega-3 fatty acid’s importance in preventing or treating many diseases including diabetes. After looking at 18 omega-3 studies on type 2 diabetes or metabolic syndrome, there was no significant effect on fasting blood sugar, glycosylated hemoglobin, triglyceride levels, total cholesterol, HDL cholesterol, or LDL cholesterol compared to the placebo groups. In four studies, plasma insulin or insulin resistance in type II diabetics or metabolic syndrome patients were also not affected (HHS.gov).
Omega-6s are essential, but when observing the American diet one will find that they are in excess. American’s ratio of omega 6s to omega 3s is presently too high; therefore adding more omega 6’s doesn’t change the ratio.
Alpha-lipoic acid is another compound that has some research to show that dosages between 600 and 1,200 mg per day helps to improve insulin sensitivity.2 It is a front runner in research because it is believed to prevent glycation, which was discussed earlier. As you review published studies with alpha-lipoic acid, be cautious since some of the studies have used I.V. instead of oral dosages, which is not useful in supporting claims for oral dose products.
Pycnogenol, a branded extract from the bark of the French Maritime Pine tree, is a great compound to consider for blood sugar formulations because it shows beneficial effects to not only blood sugar, but for those with secondary complications. It has good research in pre-diabetics as well as type 2 diabetes, although the price point may hold some formulators back.3,4
Chromium appears in almost all blood-sugar formulations. Companies have every right to include it since it is an essential component for insulin in the body and helps regulate carbohydrate metabolism. It is easy to talk about chromium in marketing copy as a functional part in the human body. Along with niacin and amino acids, chromium is part of the Glucose Tolerance Factor (GTF), which improves the body’s sensitivity to insulin. Chromium has been used in research studies using dosages of 200 mcg per day, but higher dosages of up to 1,000 mcg daily has been used in diabetics showing it helps to improve insulin sensitivity and glucose tolerance.5,6 One new form of chromium called Zychrome may be worth investigating. It is a chromium dinicocysteinate, which is a patent-pending chromium complex with good research.
Vanadium is a mineral that has been shown to provide support to the pancreas and help stimulate glucose uptake into cells. Bis(maltolato)oxovanadium (BMOV) is an organic complex of vanadium that has supporting research to show it is more readily absorbed in the body than some other sources.
Biotin is a B vitamin that operates in carbohydrate metabolism and may be deficient in diabetics causing issues with blood sugar levels. As one would review, there has been both positive and negative results from the use of biotin. Along with chromium picolinate it has been shown to have beneficial effects on blood sugar levels in type 2 diabetics.7,8,9 As a secondary function, in one double-blind, placebo-controlled study, oral doses of biotin demonstrated to lower elevated triglycerides in both diabetic and nondiabetic subjects.10 The only concern is that the studies used high doses of Biotin and it may not be appropriate to use in a product that a consumer would take on a daily basis for extended periods of time. B vitamins compete with each other for absorption. There has not been any research demonstrating the long term effects on other B vitamins when a single B vitamin is taken in a large dose.
Fiber in its many different forms has been shown to be helpful to the diabetic. It is found in whole grains, fruits and vegetables, but most Americans do not consume enough from their diet.11 Research has shown that a high-fiber diet may prevent type 2 diabetes, lower blood sugar and insulin levels. Soluble fiber has demonstrated in diabetics that it helps to improve glucose tolerance.12 A few of these types of fiber would include glucomannan and psyllium.
Carbohydrate blockers prevent the elevation of blood sugar while starch blockers are compounds that fit into blood sugar support product category because they slow carbohydrate absorption by inhibiting particular enzymes that are necessary for carbohydrate digestion. Starch blockers include alpha-amylase and glucosidase inhibitors. The common white bean (Phaseolus vulgaris) has these effects with support from clinical studies. One particular product is Phase 2 Carb Controller.13,14,15
In addition, there is a new product on the market from brown seaweed, which has clinical research to support its benefits called InSea2. It has been shown to inhibit amylase and glucosidase enzymes.16
Research has shown that starch blockers provided with a starchy meal will reduce the elevation of blood sugar in diabetics, as well as healthy individuals.17,18 In addition, they help to reduce the post-prandial spike in blood glucose levels.
The type of market is extremely important when determining where a blood sugar support product will sell. The buyers of this type of product would normally be more educated and/or they have read more on the topic of diabetes and supplements to purchase this type of product. One would normally see these types of products sold in health food stores, through direct mail catalogs or in a doctor’s product line.
Cinnamon has received much attention after a cinnamon extract demonstrated in a double blind, placebo controlled study to reduce fasting blood sugar in type 2 diabetics.19 Consequently many companies have gotten on the bandwagon with cinnamon powders that have not been shown to be useful accept to sprinkle them on French toast. The simple botanical powders have not been studied in clinical trials and therefore there is not sufficient proof of their benefits to support a structure/function claim.
There are many different useful dietary supplements to support blood sugar levels, but a formulator needs to be wise and use caution as they develop a product. Potential misuse due to a misunderstanding by a consumer with a medical condition indicates that a warning should be placed on the label such as, “Diabetics or individuals with a disease and/or take prescription drugs should not take this product without permission from their physician.” One should have an FDA/FTC attorney review, advise and approve the label and warning.
Editor’s picks—best ingredients for diabetes
Zychrome: 2012 NutrAward winner, courtesy InterHealth, is a complex of chromium, niacin and L-cysteine. This next generation in chromium supports insulin function – tests show it twice as effective as chromium pic.
Pycnogenol: Since 2004, four published studies on the French maritime pine bark have found that an optimal dosage level of 100mg/day decreased blood-sugar levels by slowing carb absorption, improving circulation and lowering ankle swelling. Courtesy Horphag.
InSea2: Two 2011 studies showed this seaweed-derived ingredient led to a 48% better blood-sugar response, 12% improved insulin secretion and 8% drop in insulin sensitivity. From InnoVactiv.
Glucolate: Banaba leaf extract standardized to 1 and 2 percent corosolic acid along with ellagitannins mimic the action of insulin. Safety studies show two thumbs up. From Novel Ingredient Services.
Select suppliers: Diabetes/Blood Sugar
Albion Human Nutrition
Offers Vanadium Nicotinate Glycinate Chelate and Chromium Nicotinate Glycinate Chelate. Case studies suggest that vanadium can help to lower insulin requirements in diabetes patients as well as preserve beta cell function. Chromium is an essential component of insulin.
A.M. Todd Botanical Therapeutics
Offers CinSulin, a branded water extract of cinnamon made with only water, heat and pressure.
Offers Xtend, a branded sucromalt full-calorie, low-glycemic sweetener. Provides balanced energy or blunt glucose response is desired. Sucromalt has a lower glycemic response than sugar and glucose. It is 70 percent as sweet as sugar.
Offers pTeroPure, a highly purified, branded form of pterostilbene. Emerging science links pterostilbene with support of healthy blood glucose levels. Suitable for supplements, beverages and functional foods.
Supplies Chirositol, a carob juice ingredient that contains D-Chiro-Inositol, an important secondary messenger for insulin. Published studies have demonstrated that D-Chiro-Inositol may provide benefits related to insulin management, type 2 diabetes and metabolic syndrome.
Gencor Nutrients, Inc.
Supplies GENCINIA, a branded ingredient derived from Coccinia indica. This native Indian herb has been used in the traditional support of healthy blood glucose levels. Suitable for supplements.
InSea2, a blend of polyphenols derived from two species of brown seaweed, exhibits a dual mechanism of action against the two digestive enzymes involved in the digestion and assimilation of carbohydrates ingested during a meal (amylase and sucrase).
Horphag USA, Inc.
Pycnogenol, a branded extract of French Maritime Pine bark. Has scientific backing for its healthy blood sugar support benefits. Suitable for supplements and functional foods.
InterHealth Nutraceuticals, Inc.
ChromeMate brand chromium polynicotinate may help increase the effectiveness of chromium, an essential trace mineral that may help support blood sugar levels already within normal range.
Hi-maize resistant starch, Hi-maize whole grain corn flour
Maitake SX-Fraction, promotes a healthy immune system, healthy blood pressure and healthy blood sugar levels.
Chromax Chromium Picolinate. Supports healthy blood glucose levels.
Pharmachem Laboratories, Inc.
Phase 2 starch blocker, an extract from the white bean (phaseolus vulgaris). Also supplies Phase 3 sugar controller which helps control weight and blood sugar levels by reducing the body’s ability to absorb and utilize sugar. Phase 3 combines the glucose absorption benefits of L-arabinose, and the insulin control capability of Pharmachem’s patented Food-Bound Chromium.
Silbinol, a natural pterostilbene from the heartwood of Pterocarpus marsupiu, the Indian Kino Tree. Pterostilbene is better absorbed and more biologically active than resveratrol. It has the highest induction of Peroxisome proliferator-activated receptors (PPAR) a nuclear receptor protein significant in lipid metabolism in a comparative study with resveratrol and other stilbenes. Pterostilbene induces release of insulin from the existing cells of the pancreas and significantly increases the serum HDL cholesterol level.
Salba Smart Natural Products, LLC
Salba (Sahi Alba 911 & 912 Registered varieties of Salvia hispanica L. – chia). Studies have shown this ancient whole grain reduces postprandial glycemia in healthy subjects.
Soft Gel Technologies, Inc.
GlucoHelp Softgels, a clinically studied banaba leaf standardized extract for the maintenance of healthy blood glucose levels. Banaba leaves contain significant amounts of corosolic acid, shown to possess anti-diabetic properties. A clinical trial demonstrated significantly reduced blood glucose levels in diabetics and supported small, but significant weight loss.
Loesyn, a proprietary blend of aloe extracts shown in human clinical trials to improve glycemic control. Water soluable and suitable for tablets, capsules and liquids.
XSTO Solutions, LLC
Markets BenfoCare, a branded and trusted source of benfotiamine, a unique fat-soluble form of thiamin, a common B vitamin. BenfoCare supports healthy blood sugar profiles and micro vascular circulation by reducing advanced glycosylation end products and reactive oxygen species.
1. American Diabetic Association (www.diabetes.org, April 10, 2012)
2. Konrad T, Vicini P, Kusterer K, et al. Alpha lipoic acid treatment decreases serum lactate and pyruvate concentrations and improves glucose effectiveness in lean and obese patients with type 2 diabetes. Diabetes Care. 1999;22:280–287.
3. Liu X, Zhou HJ, Rohdewald P. French maritime pine bark extract Pycnogenol® dose-dependently lowers glucose in type II diabetes patients. Diab Care. 2004;27:839.
4. Liu X, Wei J, Tan F, et al. Antidiabetic Effect of Pycnogenol® French Maritime Pine Bark Extract in patients with diabetes type II. Life Sci. 2004;75:2505-2513.
5. Anderson RA, Polansky MM, Bryden NA, et al. Supplemental-chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909–916.The Food and Drug Administration. http://www.cfsan.fda.gov/~dms/dialist.html
6. Gaby AR, Wright JV. Diabetes. In Nutritional Therapy in Medical Practice: Reference Manual and Study Guide. Kent, WA. 1996;54–64 [review].
7. Singer GM, Geohas J. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Diabetes Technol Ther. 2006;8(6):636-643.
8. Geohas J, Daly A, Juturu V, et al. Chromium picolinate and biotin combination reduces atherogenic index of plasma in patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized clinical trial. Am J Med Sci. 2007;333(3):145-153.
9. Albarracin C, Fuqua B, Geohas J, et al. Combination of chromium and biotin improves coronary risk factors in hypercholesterolemic type 2 diabetes mellitus: a placebo-controlled, double-blind randomized clinical trial. J Cardio Metab Syndr. 2007;2(2):91-97.
10. Revilla-Monsalve C, Zendejas-Ruiz I, Islas-Andrade S, et al. Biotin supplementation reduces plasma triacylglycerol and VLDL in type 2 diabetic patients and in nondiabetic subjects with hypertriglyceridemia. Biomed Pharmacother. 2006;60(4):182-185.
11. Jenkins DJ, Kendall CW, Augustin LS, et al. Glycemic index: overview of implications in health and disease. Am J Clin Nutr. 2002;76(1):266S–273S.
12. Weickert MO, Pfeiffer AF. Metabolic effects of dietary fiber consumption and prevention of diabetes. J Nutr. 2008;138 (3):439–442.
13. Barrett ML, Udani JK. A proprietary alpha-amylase inhibitor from white bean (Phaseolus vulgaris): A review of clinical studies on weight loss and glycemic control. Nutr J. 2011:10:24.
14. Preuss HG: Bean amylase inhibitor and other carbohydrate absorption blockers: effects on diabesity and general health. J Am Coll Nutr. 2009; 28:266-276.
15. Celleno L, Vittoria Tolaini M, D'Amore A, et al. A Dietary Supplement Containing Standardized Phaseolus vulgaris Extract Influences Body Composition of Overweight Men and Women. Int J Med Sci. 2007; 4(1):45-52.
16. Lamarche B, Paradis ME, Couture P. Study of the acute impact of polyphenols from brown seaweeds on glucose control in healthy men and women. Presented at the Annual meeting at FASEB, April 2010, Anaheim, CA.
17. Holt PR, Thea D, Yang MY, et al. Intestinal and metabolic responses to an alpha-glucosidase inhibitor in normal volunteers. Metab. 1988;37:1163–1170.
18. Layer P, Rizza RA, Zinsmeister AR, et al. Effect of a purified amylase inhibitor on carbohydrate tolerance in normal subjects and patients with diabetes mellitus. Mayo Clin Proc. 1986;61:442-447.
19. Mang, et al. Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus type 2. European Journal of Clinical Investigation; 2006 May;36(5):340-244.