Diabetes mellitus is the inability of the body to utilize glucose (sugar) for energy, because the body does not produce or use insulin effectively. There are two major categories of diabetes mellitus:
- Type 1 diabetes- (IDDM, insulin dependent diabetes mellitus, or juvenile onset)
- Type 2 diabetes- (NIDDM, non-insulin dependent diabetes, or adult onset).
In type 1 diabetes the pancreas does not produce enough insulin, while in type 2 diabetes the pancreas continues to secrete insulin but cells of the body become resistant to its effects.
Type 2 diabetes is the most common form of diabetes, occurring in over ninety percent of all diabetics. It usually occurs in people over the age of 40, and most often in persons who are overweight. Typically, type 2 diabetes development is gradual, and takes place over many years. It can also develop during pregnancy (gestational diabetes). Gestational diabetes is often treated with insulin and usually disappears after childbirth. However, the patient will remain at an increased risk for developing type 2 diabetes later in life. The cause of type 2 diabetes includes genetic, dietary, and lifestyle factors. Lifestyle practices, such as overeating and lack of exercise increase ones risk for the development of this condition. Type 2 diabetes is most likely to occur in people with a family history of diabetes. 1 in 3 diabetics have a relative with the same type of diabetes. Overweight and obese people over the age of 45 are at increased risk in developing type 2 diabetes. As our society becomes increasingly overweight and obese (64 percent of US adults are now overweight or obese), the prevalence of this condition will continue to rise.
Type 2 diabetes increases the risk of chronic conditions, including; heart disease, stroke, kidney disease, loss of nerve function (peripheral neuropathies ), retinopathy (a disease of the retina) and blindness, immune system problems with increased susceptibility to infections, and circulation problems that can lead to skin ulcers, poor wound healing, and amputation.
Persons with type 2 diabetes often show no signs of the condition for years. When symptoms do occur, they may include;
- Frequent urination
- Unusual thirst and a dry mouth
- Lack of energy and fatigue
- Blurry vision and dizziness
According to the National Center for Health Statistics and the Centers for Disease Control-National Diabetes Fact Sheet (1, 2):
- Approximately 13.4 million Americans have diabetes (6.6% of population)
- In 2001, diabetes accounted for 71,372 deaths in the US
- 65% of deaths among people with diabetes are due to heart disease and stroke
- Diabetes is the 6th leading cause of death in the US
- The total cost of diabetes is 132 billion dollars in the US alone
Type 2 Diabetes is diagnosed by lab tests that determine blood glucose level. Tests may include urine tests, fasting plasma glucose (FPG) or the two-hour plasma glucose (OGTT – oral glucose tolerance test).
Diabetes treatment includes dietary and lifestyle modifications, prescription drug therapy, and nutritional supplements. Type 2 diabetes may be treated with diet and exercise alone, or in combination with oral drugs or insulin injections. About 60 percent of diabetic patients will require oral drug therapy and approximately 40 percent will eventually require insulin injections. To reduce the risk of developing diabetic complications, patients monitor their glucose levels with a blood glucose meter.
Fiber Supplements (Guar Gum, Psyllium, Pectin) A high-fiber diet, including the use of water-soluble fiber such as guar gum (Indian cluster bea plant fiber), pectin (fruit fiber), and psyllium (natural plant fiber), may help type 2 diabetics regulate blood glucose levels, decrease insulin resistance, and manage weight.  Studies suggest that fiber supplements may reduce the number of calories and fat absorbed by the body, help control glucose and insulin effects, increase post-meal satiety (sensation of fullness), and decrease appetite. [4-10] One study has reported that guar consumption reduced insulin dosages and improved blood sugar levels. 
Chromium The trace mineral, chromium, is often low in patients with diabetes, hypoglycemia, and obesity. Chromium can be depleted by eating a diet high in both refined sugar and white flour products, and also by the lack of exercise. Chromium assists in the regulation of blood glucose levels, aids in decreasing insulin resistance, aids in weight loss, and helps to stabilize the body’s metabolism. [12, 13]
Studies have shown that chromium supplementation can decrease fasting blood glucose levels, improve glucose tolerance, lower insulin levels, and decrease total cholesterol and triglyceride levels in patients with diabetes. [14, 15] Diabetic patients can supplement their diets with different forms of chromium, including chromium polynicotinate, chromium picolinate, GTF (glucose tolerance factor) chromium, or chromium-enriched yeasts. 
However, one animal study showed that chromium picolinate supplementation caused chromosomal damage, therefore more studies are needed to determine its absolute safety in diabetics.  Changes in insulin requirements may occur with chromium therapy. Physician monitoring is advisable.
5-Hydroxytryptophan (5-HTP) 5-Hydroxytryptophan (5-HTP), an amino acid precursor to serotonin, may aid weight loss in type 2 diabetics. Low levels of serotonin (an important neurotransmitter) have been linked to carbohydrate craving and may play an integral role in the development of obesity. Studies have shown that 5-HTP supplementation promotes weight loss and decreases carbohydrate intake by promoting post-meal satiety (sensation of fullness) and reducing appetite, thereby leading to reduced intake of food. [18, 19] 5-HTP may help type 2 diabetics control food intake and lose weight. 
Vitamin C Vitamin C is often low in patients with diabetes, since vitamin C transport into cells is facilitated by insulin. [21, 22] Vitamin C lowers blood glucose levels, strengthens capillaries, aids wound healing, protects against free radicals, and strengthens the immune system. Studies have shown that vitamin C supplementation can also reduce sorbitol accumulation and glycosylation of proteins. [23, 25] This is especially significant, since sorbitol accumulation and glycosylation of proteins are linked to diabetic complications including eye and nerve diseases. 
Zinc Zinc levels are often deficient in diabetic patients. Zinc helps regulate insulin metabolism and studies have found that supplementation improves insulin levels and poor wound healing. [27-29]
Cyclo (his-pro) Cyclo (his-pro) extract may positively affect zinc absorption in type 2 diabetics. This is a significant finding, since zinc levels are often deficient in diabetic patients.  Studies show that his-pro supplementation decreases fasting blood glucose levels, lowers insulin levels, decreases cholesterol, and increases zinc levels in type 2 diabetics. [29, 30]
Magnesium Magnesium levels are often low in diabetic patients. Magnesium is involved in glucose metabolism. Studies report that its supplementation may prevent diabetic complications such as retinopathy and heart disease. [31-35]
Alpha-lipoic acid (ALA) Alpha-lipoic acid (ALA) is an antioxidant that may be beneficial in diabetic patients. Studies have determined that ALA supplementation improves insulin and blood sugar levels and may prevent diabetic complications such as retinopathy. [36-42] Changes in blood glucose levels may occur with ALA supplementation, so close monitoring is advisable.
Vanadium Vanadium, a trace mineral, may be extremely beneficial in diabetic patients. Studies have found that vanadium supplementation improves blood glucose levels in type 2 diabetics, and may help slow the destruction of insulin-producing beta cells in the pancreas. [43-48]
Essential Fatty Acids (Evening primrose oil, Borage Oil, Black Currant Oil) Evening primrose oil, which contains gamma-linolenic acid (GLA), an omega-6 fatty acid, may be beneficial in diabetic patients. Because diabetes is associated with a disturbance in GLA metabolism, GLA supplementation, in the form of evening primrose, borage, or black currant oils, may be beneficial for proper nerve function. It may also prevent diabetic complications, like neuropathy. [49-55]
Gymnema Gymnema sylvestre, a native plant found in India, has a long tradition, concerning the treatment of those suffering from diabetes. Studies have found that gymnema supplementation may improve insulin levels, decrease blood glucose, aid in weight loss, and help to regenerate the insulin-producing beta cells in the pancreas. [56-60]
Bitter Melon (Momordica Charantia) Bitter melon, also known as balsam pear or karela fruit, is a tropical fruit found in Asia and South America. This fruit has been traditionally used in the treatment of diabetes. Studies have found that bitter melon contains an insulin-like polypeptide that may decrease blood glucose levels and improve insulin levels. [61, 69]
Bilberry (Vaccinium Myrtillus) Bilberry has a long-standing tradition in the treatment of diabetes. Bilberry flavonoids (anthocyanosides) have potent antioxidant effects. Anthocyanosides may provide for a decrease in blood glucose levels, strengthening capillaries, and assist in the prevention of diabetic complications such as retinopathy. [70, 71]
Biotin Biotin, a vitamin B-complex nutrient, aids in glucose metabolism, improves insulin sensitivity, and increases glucokinase activity; the enzyme responsible for the first step of glucose utilization.  Studies show that biotin supplementation may decrease blood glucose levels and prevent diabetic complications such as neuropathy. [73-76] Due to the changes in the insulin requirements with high dose biotin supplementation, physician monitoring is advisable.
N-acetyl cysteine (NAC) N-acetyl cysteine (NAC), is a potent antioxidant and precursor for the synthesis of glutathione (a detoxifying agent). Supplementation with NAC may have beneficial effects for diabetics, such as preserving beta cell function in the pancreas. 
Coenzyme Q10 (CoQ10) Coenzyme Q10 (CoQ10) is an antioxidant that boosts cellular energy production in the mitochondria, the cell’s energy powerhouse. Supplementation with CoQ10 may have beneficial effects for diabetics, including the preservation of beta cell function in the pancreas and controlling of blood glucose levels. [78, 79] For best results, CoQ10 should be taken with other antioxidants.
Carnosine Carnosine, an amino acid peptide, can reduce the toxic glycosylation of proteins. This is especially significant, as the glycosylation of specific proteins has been linked to diabetic complications, including occular and nervous system diseases.
Silymarin Silymarin, an antioxidant flavonoid derived from the milk thistle herb, may have beneficial effects for diabetics. Supplementation with sylmarin has been found to lower blood glucose levels, improve liver function, and reduce free-radical activity. 
Niacin or niacinamide (Vitamin B3) Niacin, or niacinamide (Vitamin B3), supplementation may be beneficial in diabetic patients. Supplementation with niacinamide can help prevent the development of diabetes, slow the destruction of insulin-producing cells in the pancreas, and lower cholesterol levels. [82, 83] Due to niacin’s side effects at high doses, which include, skin flushing, gastric irritation, nausea, and liver damage, the safest form of niacin is flush-free niacin (inositol hexanicotinate).
Vitamin E Vitamin E may be beneficial in diabetic patients. Studies show that vitamin E supplementation helps to enhance insulin sensitivity and glucose transport, reduces the risk of heart failure, and prevents other diabetic complications. [84-87]
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