Algorithm for complementary and alternative medicine practice and research in type 2 diabetes.

Bastyr University, Kenmore, WA 98028, USA.
The Journal of Alternative and Complementary Medicine (Impact Factor: 1.52). 01/2007; 13(1):159-75. DOI: 10.1089/acm.2006.6207
Source: PubMed

ABSTRACT To develop a model to direct the prescription of nutritional and botanical medicines in the treatment of type 2 diabetes for both clinical and research purposes.
Available literature on nutritional and botanical medicines was reviewed and categorized as follows: antioxidant/anti-inflammatory; insulin sensitizer; and beta-cell protectant/insulin secretagogue. Literature describing laboratory assessment for glycemic control, insulin resistance, and beta-cell reserve was also reviewed and a clinical decision tree was developed.
Clinical algorithms were created to guide the use of nutritional and botanic medicines using validated laboratory measures of glycemic control, insulin sensitivity, and beta-cell reserve. Nutrient and botanic medicines with clinical trial research support include coenzyme Q10, carnitine, alpha-lipoic acid, N-acetylcysteine, vitamin D, vitamin C, vitamin E, chromium, vanadium, omega-3 fatty acids, cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), and gymnema (Gymnema sylvestre).
Clinical algorithms can direct supplementation in clinical practice and provide research models for clinical investigation. Algorithms also provide a framework for integration of future evidence as it becomes available. Research funding to investigate potentially beneficial practices in complementary medicine is critically important for optimal patient care and safety.

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    • "However, recent in-vitro and in-vivo research has discovered new potential properties of several cinnamon species. • The treatment of diabetes (type 2) seems to be the most promising field of research for cinnamon [15] [39] [69] [101] [412]. Although there are conflicting results from two randomized studies, the results from in-vitro and animal studies indicate significant hypoglycemic effects. "
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    • "A large number of natural products from 800 to 1200 plants are currently demonstrating hypoglycemic activity. Research and development efforts in this particular area are largely restricted to traditional medicine and in future research may identify a potent antidiabetic agent (Heber, 2003; Bradley et al., 2007; Rodriguez- Fragoso et al., 2008 "
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