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Supplements for Diabetes: How to Pick Responsibly
Certain supplements, like vitamin B12 and magnesium, may help diabetes, but others, like fenugreek and those used for weight loss, should be avoided as they may make it harder to control blood sugar.
By Amy Gorin, RDN
Medically Reviewed by Kelly Kennedy, RD
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If you or a loved one has diabetes, you may be wondering if taking supplements can help manage the disease. If you visit any online diabetes forums, you’ll see claims about this or that supplement and how they can help reverse or cure diabetes — and 22 percent of people with diabetes use an herbal therapy, according to the National Health Interview Survey. But what’s the real scoop about the benefits of certain supplements for people with diabetes, as well as which ones are dangerous or simply ineffective?
“Any supplement can be dangerous if not taken correctly,” says Sandra J. Arévalo, MPH, RDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics (AND) and for the American Association of Diabetes Educators, who is based in the Bronx, New York. “Every person with diabetes should check with his or her doctor before starting any supplement. Let the doctor decide if what you're willing to take is safe for you.”
Also ask your doctor about getting your blood levels of nutrients, to get a feel for which supplements may or may not be right for you. “This is the key to truly personalizing and optimizing health, because it allows for a better understanding of which supplements might be most helpful, and at what doses,” says Robin Foroutan, RDN, an integrative dietitian and a spokesperson for the AND, who is based in New York City.
Choosing a Safe Supplement to Keep Diabetes in Control
Before you start shopping for supplements, know that in its 2019Standards of Medical Care, the American Diabetes Association (ADA) highlights that no clear evidence exists to support that either herbal or nonherbal supplementation — including vitamins and minerals — is beneficial for people with diabetes who do not have other deficiencies.
The National Institutes of Health (NIH) does not support such supplement use, either. “In the absence of strong scientific evidence, we do not endorse the use of [supplements, such as chromium, fenugreek, bitter melon, and others, for weight loss],” says Saul Malozowski, MD, PhD, program director for the endocrinology and physiology program within the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases. “Risks and benefits may differ depending on multiple variables, including if the person has other medical conditions.”
If your doctor has given you the go-ahead to take a supplement, you can’t necessarily trust a product’s label or website to give you all the important info you need, either. “The supplement industry is very poorly regulated, so even if consumers are reading labels it may not be enough,” White says. “Many supplements contain ingredients that aren’t listed on the labels, plus there are often purity and dosing discrepancies from bottle to bottle.”
Some supplements could also interfere with your diabetes treatment. You can check out the Natural Medicines Comprehensive Database for potential negative interactions (and of course, ask your doctor or pharmacist, too). While no seal of approval on a supplement is going to relay that a product is safe or effective, it can give assurance that a supplement was manufactured correctly, is not contaminated at a harmful level, and that it contains the ingredients it says it does, according to the NIH’s Office of Dietary Supplements.
A few such third-party verification programs include the NSF International dietary supplement certification, the US Pharmacopeia dietary supplement verification program, and the ConsumerLab.com approved quality product seal.
Supplements to Think Twice About When You Have Diabetes
Certain supplements may be more helpful than others for people with diabetes. For instance, if you’re taking the medication Metformin (glucophage), the drug is linked with possible vitamin B12 deficiency, so you may want to get your vitamin levels tested periodically, especially if you have a condition like peripheral neuropathy.
Many diabetes experts agree that certain supplements, such as magnesium, may be beneficial to people with diabetes. “Magnesium levels are often low in people with diabetes,” says Foroutan. But she warns that not everyone with diabetes should supplement with the mineral. “If your kidney function is compromised, supplementing with magnesium may not be appropriate,” she says.
You may want to think twice about certain supplements. For instance, in its 2019Standards of Medical Care, the ADA advises against routine supplementation of antioxidants, such as vitamin E, vitamin C, and carotene. This is because there’s not enough strong evidence showing a benefit of the supplements, and also because there's concern about the long-term safety of such supplementation.
The ADA also notes that there’s no sufficient evidence to support regular supplementation of micronutrients, such as vitamin D — although the NIH is funding a study of the vitamin to determine whether it helps prevent type 2 diabetes in at-risk people — and spices like cinnamon for better glycemic control in people with diabetes.
“Cassia cinnamon may negatively impact blood sugar and could be problematic for liver health,” notes Dana Angelo White, RD, a professor of athletic training and sports medicine and the supplement compliance administrator at Quinnipiac University in Hamden, Connecticut. “Since more research is needed to determine if cassia cinnamon supplements are truly helpful in diabetes management, I encourage patients to eat cinnamon in foods. It can be added to hot or cold beverages, cereals, baked goods, or even spice rubs for meat, vegetables, and fish.”
Other supplements pose particular risk for people with diabetes. “Fenugreek may lower blood sugar to dangerous levels and can also interact with medications for diabetes,” says White. “It is also contraindicated for people taking anti-coagulants.” Anti-coagulants are drugs that help delay blood clotting and are often given to people with diabetes because they have a higher risk of developing arterial disease.
Some supplements have been found to be ineffective: In a study published in October 2019 in the journal Endocrine Regulations,supplementation of flaxseed oil was found to have no significant impact on insulin resistance or beta cell function.
As for weight-loss supplements,alwaysskip them. “Even though weight loss may be warranted for some patients with diabetes, weight-loss supplements should be avoided at all costs,” says White.
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