Nutritional Approaches for Combating
Insulin Resistance and Diabetes

By Melissa Diane Smith
© Copyright 2003 by Melissa Diane Smith

This article was first published in the online newsletter, June 2003, Issue 155.

Diet, stress reduction and physical activity go a long way toward promoting healthy blood sugar and insulin levels. However, nutrient supplements can further enhance blood sugar and insulin function and provide health benefits far beyond simply preventing nutrient deficiencies in those with prediabetes and diabetes.

Helpful Minerals
Chromium is an essential trace mineral that does an incredibly important job: It helps insulin work more efficiently. This benefits not just people with (type 2) diabetes, but also people with prediabetes and diabetes.

Chromium picolinate is the form of chromium that stands out in the research. In one well-designed 1997 study involving 180 people with diabetes, the group that took 1,000 mcg chromium (as chromium picolinate) per day experienced what can only be described as "spectacular" results -- a drop in blood sugar, insulin and hemoglobin A1c levels to near normal after just four months! This is something that medications could not achieve.

A follow-up study with 833 people with diabetes who took 500 mcg chromium (as chromium picolinate) per day found similar drops in blood sugar levels. In addition, more than 85 percent of the patients reported improvements in the common diabetic symptoms of excessive thirst, frequent urination and fatigue.

Chromium supplements help in cases of prediabetes, too. A study directed by William Cefalu, M.D., of Wake Forest University, monitored individuals at risk-people who were moderately obese and had a family history of diabetes. Some people received a placebo; others, 1,000 mcg of chromium (as chromium picolinate) daily. After four months of treatment with chromium, insulin resistance was reduced by 40 percent.

Biotin is a member of the B vitamin family of nutrients that also has been shown in some experiments to aid in managing blood sugar. Researchers have found that combining biotin with chromium picolinate can offer extra blood sugar management support for those with diabetes.

Magnesium and zinc are two other minerals that are critical for healthy insulin function. Low dietary intakes of either mineral are associated with increased risks of both diabetes and cardiovascular disease (the number one complication of people with diabetes). In one study of nonobese elderly subjects, magnesium supplements (400 mg elemental magnesium per day) improved insulin response and action, and glucose handling. Supplementation with zinc has an additional benefit: it boosts immunity in a number of important ways. People with diabetes, as most of us know, are more susceptible to illness. So, with more than half of all Americans not consuming the Recommended Daily Allowances of magnesium and zinc (320 mg magnesium for women; 420 mg for men and 12 mg zinc for women and 15 mg for men), supplementation with these nutrients, even if just in a multivitamin-multimineral supplement, is often warranted and helpful.

Beneficial Antioxidants
Antioxidants, including well-known vitamin C and vitamin E and the less-well-known alpha-lipoic acid, are other supplement standouts for diabetes and prediabetes. People with diabetes have increased "oxidative stress"-that means they have higher levels of dangerous free radicals without adequate levels of antioxidants to counteract them. This causes damage in the body. Oxidative or free radical stress is associated with the onset of diabetes and the development of devastating complications, including eye diseases, kidney damage and nerve damage. But this doesn't have to happen. It's easy to turn the tide in favor of fewer free radicals and more antioxidants and two simple ways to do that is to eat a blood-sugar-balancing diet rich in non-starchy vegetables to take supplements of antioxidants.

Vitamin C, perhaps the most well-known antioxidant, does much to protect our health. As the body's principal water-soluble antioxidant, vitamin C quenches the hydroxyl free radical, considered the most dangerous of all free radicals. It also reduces the formation of advanced glycation end products (AGEs), which, as the acronym suggests, age cells. And it slows the conversion of glucose to sorbitol, another type of sugar that is a big contributor to diabetic complications.

In addition, supplemental vitamin C seems to edge out some of the glucose in the system or improve its disposal. In one study, 2,000 mg daily lowered both blood sugar and hemoglobin A1c levels. Another study found the same dose of supplemental vitamin C normalized insulin's response to glucose.

Vitamin E is the body's principal fat-soluble antioxidant. It is incorporated into cell membranes and protects cells from free radical damage. The vitamin also limits the formation of AGEs, such as hemoglobin A1c-the standard marker that people with diabetes measure to see that their condition is being controlled.

In addition, vitamin E can lower blood glucose levels and make insulin work more normally. In one study, a regimen of 600 IU of vitamin E daily for two weeks lowered blood sugar levels and free radical formation among people with diabetes.

Supplemental vitamin E also is important because it protects against cardiovascular disease, the number one cause of death in people with diabetes. In 1993, Harvard University researchers reported in the New England Journal of Medicine that 100 IU (international units) of vitamin E dramatically reduced the risk of coronary heart disease in both men and women.

Unlike vitamin C and vitamin E, alpha-lipoic acid (or lipoic acid or thioctic acid, as it is also called) is a vitamin-like substance you may never have heard of. That's unfortunate because it has widespread antioxidant abilities and is considered the "universal antioxidant." It's also regularly used as a major treatment for diabetic nerve complications in Germany.

Like the team member who can play both offense and defense, alpha-lipoic acid can act as an antioxidant itself and as protector of other antioxidants: It helps directly or indirectly regenerate other antioxidants-vitamins E and C, coenzyme Q10, and glutathione. In addition, alpha-lipoic acid functions as two different but related antioxidants. Its original form, alpha-lipoic acid, neutralizes certain free radicals, whereas a form it's converted to in the body, dihydrolipoic acid, quenches other free radicals. And unlike vitamins C and E, it can act in both the fatty and watery parts of the body.

Alpha-lipoic acid also is therapeutic for diabetes because it lowers blood sugar and insulin levels, reduces insulin resistance, and improves insulin sensitivity. Supplements of 600 mg, taken twice daily, can lower glucose and improve the efficiency of its burning. High doses of alpha-lipoic acid have also been found to improve insulin sensitivity-that is, insulin's effectiveness-by an average of 27 percent in overweight diabetic patients. Sushil K. Jain, Ph.D., of the Louisiana State University Medical Center, Shreveport, has demonstrated how alpha-lipoic acid raises levels of glucose-burning enzymes and doubles cells' ability to burn glucose. In addition, alpha-lipoic acid reduces levels of hemoglobin A1c, a marker of protein glycation (sugar-damaged proteins that age cells).

One of the common complications of diabetes is neuropathy (damage to nerve cells), and alpha-lipoic acid is a superior treatment for this condition. Research indicates that alpha-lipoic acid protects against nerve damage in several ways. High glucose levels characteristic of diabetes are potent generators of free radicals, and as a blood-sugar balancer, alpha-lipoic acid restores normal glucose levels. As an antioxidant and regenerator of antioxidants, alpha-lipoic acid also directly and indirectly reduces the free radical damage nerve cells are subject to. Alpha-lipoic acid also increases blood circulation, so more nutrients (and antioxidants) can be delivered to nerve cells, and it increases nerve conduction-that is, the speed of transmitted nerve signals.

AgainstThe Grain Nutrition

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