A round-up of studies on integrative therapies for type 2 diabetes

Photo Cred: Nataliya Vaitkevich/Pexels

By Avery St. Onge, Avery St. Onge

Diabetes is among the most common health conditions in the United States, diagnosed in more than 37 million Americans, and threatening to effect over one third of the population who are currently considered prediabetic, according to the Centers for Disease Control and Prevention (CDC).

There are three types of diabetes: type 1, type 2, and gestational, which occurs during pregnancy. By far, the most prevalent form of the illness is type 2, which makes up the diagnoses of 90 to 95 percent of people with diabetes, according to the CDC.

Unlike type 1, which the CDC characterizes as an autoimmune disease with no current cure or mode of prevention, type 2 is largely preventable and reversable. A metabolic disease, type 2 diabetes is fueled by an unhealthy diet and lifestyle in addition to genetic factors, which cause insulin resistance, leading to high blood sugar levels, according to the CDC.

Traditionally, type 2 diabetes is treated with a healthier, low-carb diet as well as including more physical activity into the patient’s life, according to the CDC. Oftentimes patients with type 2 are also prescribed oral medications and/or insulin to help manage blood sugar levels.

Although pharmaceuticals are sometimes needed for patients with type 2 diabetes, studies have shown that integrative treatments can help improve glycated hemoglobin, commonly known as hemoglobin A1C, a measurement of a patient’s blood sugar over the past two or three months, according to the CDC.

The following article summarizes study findings surrounding three aspects of integrative type 2 diabetes interventions: herbal medicine, microbiome health, and mind-body interventions. 

Herbal treatments

The paper, “Herbal Medicine in the Treatment of Patients with Type 2 Diabetes Mellitus,” published in the Chinese Medicine Journal, argued that research increasingly suggests herbal medicine can be effective in treating type 2 diabetes. Conducted by Cheng Lu, MD, professor at the Institute of Basic Research in Clinical Medicine at the China Academy of Chinese Medical Sciences in Beijing, China and colleagues, the study reviewed how herbal medicine can assist in the treatment of type 2 by reducing inflammation, oxidation, glucose effects as well as regulating blood lipid metabolism.

Anti-inflammatory

According to the study, low-grade inflammation is a common manifestation for type 2 diabetes. Type 2 encourages the production of pro-inflammatory cytokines including interleukin-1 β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). These inflammatory cytokines contribute to decreased insulin secretion as they damage pancreas beta cells. In addition, they can cause an increase in glucose extraction, leading to increased insulin resistance, according to the study. The study listed several anti-inflammatory herbal medicines that have shown promising outcomes for patients with type 2 diabetes, among them:

• Memecylon umbellatum
• Lycii Radicis Cortex
• Momordica charantia (bitter melon)
• Ginger

Anti-oxidation

Type 2 diabetics commonly experience oxidative stress, according to the study. Evidence suggests that oxidative stress may be a cause of diabetes as it harms pancreatic cells and contributes to insulin resistance, the authors said. Therefore, treating oxidative stress can help with the management and/or reversal of diabetes. The study listed several potential herbal medicines to reduce oxidative stress, including:

• Tinospora cordifolia
• Stevia
• Jiao-Tai-Wan, a Chinese patent medicine containing:
  • Radix Salviae Miltiorrhizae (Dan Shen)
  • Radix Rehmanniae (Di Huang)
  • Panax ginseng (Ren Shen)
  • coptidis (Huang Lian)
  • Fructus corni (Shan Yu Rou)

Regulating blood lipids

According to the study’s authors, lipid metabolism plays a crucial role in the development of type 2 diabetes. The lipid metabolism disorders known as lipotoxicity worsens pancreatic cell function and insulin resistance, the authors said. In turn, regulating blood lipids can help treat diabetes. The authors suggested that blood lipids can be managed with herbs shown to reduce blood triglyceride (TG), total cholesterol (TC), and low-density lipoprotein (LDL) levels as well as increase high-density lipoprotein (HDL) levels. According to the study, research indicates some herbal medicines can assist in the regulation of blood lipids, among them:

• Morus alba L.
• Qurs Tabasheer, formulation containing:
  • Portulaca oleracea
  • Rosa damascena
  • Punica granatum
  • Bambusa arundinacea
  • Lactuca sativa
• Gallic acid
• Curcumin
• Polygonum hypoleucum Ohwi

Anti-glucose

Managing blood glucose levels is an important aspect of treating diabetes, according to the authors. Chronic hyperglycemia can cause damage to the pancreatic β-cell, decreasing insulin secretion. The study listed several herbal formulas that have been shown to assist in the stabilization of glucose levels in various studies on both humans and animal. The formula’s ingredients included herbs such as:

• Acer pycnanthum
• Lodhrasavam
• chinensis
• alba L. leaves
• Schisandra chinensis Baill
• Psidium guajava L.

The study listed several more herbs that have been shown to help diabetes through improving microbiome health, which evidence suggests can help improve insulin resistance and fasting blood glucose. Some of these herbs included:

• Ephedra sinica
• Roseburia
• Clostridium
• Blautia

The authors concluded the study stating their research suggested herbal medicine can target specific symptoms of type 2 diabetes, treating the disease as a whole. However, they said studies showed treating type 2 with herbal medicine has shortcomings and more research is needed to determine the most effective protocol.

Microbiome health

According to the paper, “Holistic Perspective of the Role of Gut Microbes in Diabetes Mellitus and its Management,” published in World Journal of Diabetes, microbiome health plays a significant role in diabetes.

The literature review explored the connection between improved gut health and anti-diabetic medication efficacy, glucose control, and diabetes complications. It was conducted by Kannayiram Alagiakrishnan, MD, MPH, and Tyler Halverson, MD, MSc, of the department of medicine at the University of Alberta, Edmonton in Alberta, Canada, and colleagues. The authors reviewed studies investigating the specific microbes that contribute to the different forms of diabetes.

According to the paper, evidence suggests that individuals with type 2 have shown an increased level of the bacteria, Proteobacteria and Bacteroides as well as decreased level of Firmicutes. When the gut microbiome is modified, gut dysbiosis occurs. The authors defined this as, “a state of increased or altered prevalence of gut bacteria which might in turn result in many disorders such as gastrointestinal, obesity, diabetes, immunological, and neurobehavioral diseases.” Gut dysbiosis can lead to a host of disorders including gastrointestinal, obesity, diabetes, immunological, and neurobehavioral diseases, according to the paper.

The reason for alterations to the gut microbiome is multifactorial, but according to the authors, some of the same contributors to type 2 diabetes, such as a diet high in carbohydrates, have been shown to cause gut dysbiosis. In addition, the authors said that as well as being a causal component to diabetes, the gut microbiome plays a role in the progression of diabetes as well as associated complications of the disease.

Using a combination of holistic interventions, Alagiakrishnan and Halverson concluded that the gut microbiome of diabetic patients can be restored. The authors listed three treatments evidence suggests may help balance the gut microbiome of patients with diabetes, including:

• Nutritional therapy: A diet full of fruits and vegetables can increase beneficial gut microbes such as A. muciniphila, Lactobacilli, and bifidobacteria.
• No artificial sweeteners: Some researchers suggest no-calorie substitutes lead to an increase in Bacteroides and a reduction in Lactobacillus reuteri, contributing to gut dysbiosis and glucose intolerance.
• Fecal transplant: Some human and animal studies have shown to alter the gut microbiome of participants and improve glucose and metabolic parameters.

Mind-body medicine

According to the literature review, “Alternative Therapies Useful in the Management of Diabetes: A Systematic Review” published in the Journal of Pharmacy & BioAllied Sciences, evidence suggests that there are several psychical interventions that target not only the body but the mind, that can help improve diabetes management.

Led by Awanish Pandey, PhD, who works for the department of pharmacy, at the Institute of Technology and Management, Gorakhpur in Uttar Pradesh, India, used in conjunction with conventional treatments, alternative therapies can help relieve stress and relax diabetics, helping to improve their glucose control.

According to the study’s authors mind-body therapies have been shown to help control the counter-regulatory stress hormones, which can contribute to decreased insulin resistance. These therapies included:

• Yoga
• Acupuncture
• Massage therapy
• Aromatherapy
• Biofeedback
• Hydrotherapy
• Chromotherapy

The authors explained that these therapies have few side effects and when integrated into diabetes care, can be effective at relieving stress and improving glucose control.