Tips for the Savy & Safe Diabetes Supplement

There are reasons why people want to use supplements for diabetes. Diabetes is one of the few conditions that will actually respond well to alternative herbs and supplements. They are accessed easily because you can get them without prescriptions.

 It is really important to have awareness about the regulatory standards of diabetes supplements. The Tainted Dietary Supplements and Foods warning put out by the FDA lists diabetes supplements as a product category to watch for along with sexual enhancement, weight loss, and body building. Neither food nor drugs, dietary supplements fall under the umbrella of food products but into their own unique category. In 1994, Congress passed the Dietary Supplement Health and Education Act (DSHEA) for regulating dietary supplements. They are not subject to the same regulatory standards and oversight by the FDA as prescription medications.

While drugs are generally considered unsafe by the FDA until clinical trials have proven their safety and efficacy, dietary supplements are generally considered safe until proven unsafe. They cannot, however, “contain anything that may have a ‘significant or unreasonable risk of injury’ when the supplement is used as directed on the label.” The Food Safety Modernization Act (FSMA), signed into law in 2011, provides the FDA with “new enforcement authorities designed to achieve higher rates of compliance with prevention- and risk-based food safety standards. Standardized cGMPs give the FDA a basis by which to “deem any dietary supplement that ‘has been prepared, packed, or held under conditions that do not meet good manufacturing practice regulations’ to be adulterated.

It is important to consult with a health care provider whether it is me or your doctor because natural does not mean without risks. These supplements are not inert. They still have the potential to cause adverse effects. This information is not comprehensive of everything, but for some examples

Pregnant women should not take Hibiscus, Fenugreek or Bittermelon (among others not listed)

Hibiscus Tea- danger to pregnant women

Fenugreek- Birth defect

Bitter Melon- leads to miscarriage

Many drugs are metabolized by the p450 enzymatic pathways in the liver and they could possibly result in drug interactions and toxicity. For an example

 Chromium that interacts with many medications include antacids, beta-blockers, corticosteroids, H2 receptor antagonists, nicotinic acid, and nonsteroidal anti-inflammatory drugs

Milk Thistle & Berberine are excellent supplements, but you need to know that they process through the liver.

Supplements can affect a multitude of other things in the body as well. For examples:

Biotin- interferes with thyroid tests, it can falsely lower level of enzymes that are used to test for heart attacks in the ER, COVID testing can also be affected.

Fenugreek- causes GI distress

Ginseng can increase blood pressure and thin the blood

Low blood sugar can be caused by almost all of them, of course.

These are the general principles when applying a product to yourself:

1.      Think about the whole diet

2.      Check with your doctor before using it especially if you have any medical conditions, over age 65, taking prescriptions or undergoing surgery.

3.      Report any adverse event ot the FDA. by calling 1-800-FDA-1088

4.      Who is the information from?

5.      Was there any testing done to confirm what is in it?

6.      What is the purpose of the information? It is a red flag if someone selling something.

7.      Ask: Is it to good to be true?

8.      Think twice about chasing the latest headline for a “quick fix.”

In one study of 333 hospitalized patients, only 6% of all supplement users were asked about their supplements and even less of them were the supplements documented on the record.

There are reasons that a patient do not tell his doctors about supplements. Number one, Maybe he doesn’t realize that it matters because they were not asked about them. Number two, he may not be willing to disclose the use of a supplement because he may anticipate a physician’s negative response, or they may hold personal beliefs about the supplements. he may need that special relationship to feel like he has the permission to discuss supplements.

A third, potential challenge is the limited amount of time to discuss them within the time constraints of office visits because = there are multiple other problems being addressed. You may wonder if it is worth it to schedule another office visit to discuss the use of supplements because you  do not know if your doctor can contribute beneficial information. As a forewarning, it is difficult to find a health care provider who is educated on supplements. They receive little to no training on them, there are thousands to know, and often they do not have knowledge of them, especially if the provider is not specializing in diabetes. If you want to use supplements or have questions, schedule with me at Evolve Diabetes.

There is a huge amount of information on the web and much of it is conflicting. You may need help to sort the reliable information from the questionable. Information will likely be very generalized and not easy to interpret to apply to yourself, but if you would like to check out for safe resources for supplement information, then  this information may help.

 ConsumerLab.com promotes itself as a “leading provider of consumer information and independent evaluation of products that affect health and nutrition.” Manufacturers pay a testing fee.If a product “passes,” it will appear in the CL’s website listing of the product review and may carry the CL Seal of Approval. It is funded by private investors rather than the supplement industry. That could be bad and good. It tests from a selection of top selling brands.

https://www.consumerlab.com

It will test for identity and potency, but not for effectiveness. Basically, it will tell you “Does the product contain what the label says?” Is it ginseng or something else?

In the United States, herbal preparations are not classified as drugs, but dietary supplement and are covered by the Dietary Supplement and Health Education Food Act of 1994. Manufacturers are only required to provide the FDA evidence of safety and efficacy before marketing the product if it is a new dietary ingredient, and the FDA cannot remove the product from the market until it is proven unsafe.

U.S. FDA

https://www.fda.gov/food/information-consumers­ using-dietary-supplements/tips-dietary­ supplement-users

https://www.fda.gov/food/food-labeling-nutrition/

label-claims-conventional-foods-and-dietary­ supplements

T

he National Center for Complementary and Integrative Health, National Institutesof Health    provides a good overview of the clinical trial process, with information on clinical trials of complementary and alternative medicine. It is useful especially for those who want to join a clinical trial.

National Center for Complementary and Integrative Health, National Institutesof Health    https://nccih.nih.gov

MedlinePlus, National Library of Medicine https://medlineplus.gov

Office of Dietary Supplements, National Institutes of Health https://ods.od.nih.gov

Natural Medicines https://naturalmedicines.therapeuticresearch.com (information and interaction checker- requires subscription)

Places to check for medication interactions:

Medscape.   https://www.medscape.com (requires account)

Epocrates

https://www.epocrates.com (requires subscription)

Natural Medicines https://naturalmedicines.therapeuticresearch.com (information and interaction checker- requires subscription)