Herbs and Diabetes Mellitus: Ways To Improve Diabetic Control

Diabetes mellitus represents the most common endocrine disease in people worldwide. Lifestyle changes may be combined with medications, including insulin therapy, to help control the disease and prevent complications. However, many people with diabetes want to do more to improve their health. Some reach for herbs and other plant-based products to help better their diabetic control. Research about various herbs, vegetables, and additional options is limited to animal and small sample-size human studies.

Data suggests that adding cinnamon, fenugreek, ginger, ginseng, and potentially other herbs and spices to one’s diet potentially improves diabetic control when used in combination with medical management and lifestyle changes.

Type 2 diabetes mellitus and herbs

Diabetes mellitus (DM), a global health threat, affects over 420 million people worldwide. Sadly, this number continues to rise in all countries and socioeconomic classes. Traditional management of DM includes lifestyle changes, including healthier food and beverage choices, weight management, obesity reduction, and regular exercise. Medications may be necessary for those with insufficient lifestyle changes to manage the disease further.

More and more people are looking for non-medicinal means to improve health outcomes. Those with pre-diabetes (fasting sugar levels above normal without symptoms) and those with active type 2 DM (decreased insulin production +/- insulin resistance) may also look to alternatives to either help delay the onset of active disease or help manage clinical conditions. These alternatives may include using certain herbs in one’s diet, which provide potential alternative therapies and may help control DM.

Benefits of herbs

Herbs have numerous properties that may enhance overall wellness. Some potentially medicinal plants have been touted as anti-hyperglycemic (prevent high blood sugars), antidiabetic, and anti-lipemic (prevent high fatty levels in the blood), may lower blood glucose levels (hypoglycemic inducing properties), and some may mimic insulin’s effects.

Be aware that more than 800 plants have been identified as possibly useful in managing diabetes. However, only about an eighth of these substances have scientific studies evaluating them — varying in study size, reproducibility, and generalizability. Furthermore, most are animal studies, with few human studies to further clarify benefits. To date, scientific evidence doesn’t suggest herbs alone can prevent DM onset or complications associated with DM. However, using herbs in combination with lifestyle changes and/or medications may aid in regulation.

Side effects of herbs

Generally, when taken alone, single herbs are considered safe with minimal risks when consumed in normal quantities. However, when taking higher doses or mixing with other ingredients or supplements, all bets are off. Furthermore, some combinations may interfere with medications for DM and other conditions, leading to increased side effect risks.

Combining an herb with specific drugs can alter various parameters, including the drug’s absorption into the body, how it is distributed, how effectively the liver or kidneys clear it, and even how it is metabolized. Herbs may antagonize (work against) a medication, synergize (work with the med to create a stronger effect more than simply adding the two results together), or be additive (effect of the herb and medication taken independently sum together).

So, even if the evidence supports the use of possible herbs, ensure that any supplements are safe and that the product is third-party tested and evaluated for safety and purity. Discuss herbal usage with a physician. Furthermore, if using herbs/supplements to manage a life-altering disease like DM, be sure to get regular doctor evaluations and get routine bloodwork to monitor parameters like A1C (a person’s blood sugar averages over a 2–3 month period) to make sure consequences aren’t developing.

Further investigation is needed to help evaluate the potential risks and side effects of using herbs alone or in combination with medications for diabetes and other diseases.

Protective herbs in DM management

Can herbs help with diabetes? When added to one’s diet, many herbs may help lessen the risk of high blood sugar spikes. In conjunction with a modified diet, exercise, and various medications, herbs may help improve glycemic (blood sugar) control and cholesterol and triglyceride levels in some individuals. However, herbs should only be part of managing the disease, not the sole means for treating it.

Beneficial herbs and spices for diabetes

Some studies show that common herbs help blood sugar management and indirectly assist DM management by favorably increasing insulin production and lowering glucose levels, among other plausible pathways.

Herbs mentioned in the literature include cinnamon (Cinnamomum cassia), gurmar (Gymnema sylvestre), fenugreek (Trigonella foenum graecum), ginger (Zingiber officinale Roscoe), milk thistle (Silybum marianum), Holy basil (Ocimum sanctum) and American ginseng (Panax quinquefolius).

Additional items studied for diabetic management improvements include fruits, extracts, minerals, vitamins, electrolytes, and vegetables. Early research has evaluated all of the following for potential diabetic management benefits, including

Since studies are still in their infancy, proper dosages and frequency of administration of various herbs, even those with studies confirming possible benefits, are not yet known. Thus, consult a healthcare professional about doses and possible product recommendations. Some formulations may be more beneficial than others.

Cinnamon

Chinese cinnamon (Cinnamomum cassia), not the more commonly found grocery store versions, true cinnamon (Cinnamomum zeyanicum or Cinnamomum verum), has been most notably studied for its potential antidiabetic effects. Cinnamon, used worldwide, likely aids in lowering fasting blood glucose, cholesterol, and triglyceride levels while potentially increasing the body’s sensitivity to insulin. It also may positively impact those with insulin resistance. Current research suggests that while this spice is beneficial in lowering various levels, it doesn’t improve a person’s A1C levels.

Though generally considered safe, there is a potential for liver toxicity in patients with underlying liver disease and at higher doses. Other side effects have yet to be observed, and more research is needed.

Gurmar

Gurmar (Gymnema sylvestre), commonly found in India, Africa, and Australia, may increase insulin secretion, aid in pancreatic islet cell regeneration (cells that produce insulin), prevent intestinal sugar absorption, and increase the use of enzymes to aid in metabolism. Studies suggest use may lower after eating blood sugar levels while also reducing A1C. However, longer-term studies with larger sample sizes are needed to confirm these benefits.

To date, no side effects have been confirmed, though theoretically, when combined with medications that lower blood sugar, we could see evidence of too-low glucose levels (hypoglycemia).

Fenugreek

Fenugreek (Trigonella foenum graecum), an herb similar to clover common in traditional Chinese medicine, has been used worldwide. It is considered one of the oldest plants used for medicinal purposes and is one of the most well-researched herbs.

With increasing investigations, studies suggest that among its many potential health benefits, it aids in diabetic management. Studies show reductions in fasting glucose, A1C, and post-eating glucose levels and in lowering cholesterol and lipids (fat). Still, more research on this herb’s diabetic effects on the human side is needed to confirm benefits, as most studies are still only in animals (e.g., dogs, rats) or have too small sample sizes to make broad recommendations for use.

Some safety concerns have manifested because the herb has been studied significantly for other health benefits. Because of the type of plant it is derived from, use it with caution for those with a peanut allergy. Furthermore, it has antiplatelet activity (platelets help clot one’s blood); thus, taking it with anticoagulant drugs could increase one’s risk of bleeding. Finally, early studies suggest that there could be additive effects when used with some diabetic medicines, causing a higher risk of low blood sugar.

Ginger

Through limited animal studies, ginger (Zingiber officinale Roscoe) has been shown to have multiple potential health benefits. Often used to aid in GI upset, ginger may further decrease cholesterol and blood sugar levels, improving DM management.

Milk thistle

Milk thistle (Silybum marianum) is a well-known herb commonly used in managing various liver diseases, with numerous high-level evidence-based research studies supporting its use. Early diabetic research shows this herb helps lower fasting blood sugars and decrease daily insulin requirements. Furthermore, long-term use may aid in reducing A1C levels. Studies also suggest improved cholesterol and triglyceride levels.

Overall, milk thistle is safe in animals and humans. Drug interactions may occur theoretically and lead to hypoglycemia, but this hasn’t been demonstrated clinically. There is a potential for additional, non-diabetic drug interactions as well. However, further research is needed to evaluate both safety and overall benefits.

American ginseng

For American ginseng (Panax quinquefolius), animal and small studies in human medicine suggest that this subspecies of the herb may increase insulin secretion and decrease carbohydrate absorption/digestion. While in some studies, no effect (positive or negative) was observed, others showed reduced A1C, fasting, and post-prandial (post-eating) blood sugar levels. Thus, additional research is needed to determine the risks and benefits.

Garlic

Often utilized as a cooking herb, garlic, and related Allium species are vegetables. Various possible benefits have been seen in animal studies, suggesting that garlic may improve insulin sensitivity and lower blood fat (lipid) levels. However, further research is needed.

Alternative medicine and DM therapy

If taking herbs to address possible medical conditions, such as DM, always inform healthcare providers and ensure routine evaluations to prevent negative health outcomes such as ill effects on kidneys, eyes, and the nervous system.

Alternative therapies can be beneficial alone or in combination with traditional treatments (such as medications, e.g., insulin). However, research is limited; thus, be careful when choosing herbs or supplements with specific herbs. If still demonstrating symptoms of DM, talk with a physician, as the herbs and other means of regulating the disease may not be sufficient. You may need to include traditional therapies to control disease and prevent common negative consequences.

We need more research

The National Center for Complementary and Integrative Health, a National Institutes of Health division, currently doesn’t recommend specific herbs or supplements because the evidence is considered too weak. More research is needed for definite recommendations for or against supplements, herbs, and other holistic interventions.

Diabetes mellitus is a serious condition requiring a close-knit relationship with one's physician. Education, lifestyle changes, medications, and other steps may be needed to ensure one doesn't develop complications from the disease. While herbs may aid in diabetes regulation, some early studies suggest they may be beneficial when combined with traditional therapies and lifestyle changes. However, relying solely on herbs to treat a disease could compromise health.