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Herbs and Supplements: Do We Know What Our Patients are Taking?

Jun 17, 2014

More than a decade ago, it seemed like every magazine and newspaper I picked up was featuring a new herbal supplement for some chronic disease prevention and treatment. Interest appeared to wane for a few years, but there is a documented resurgence. I feel almost overwhelmed with advertisements and articles touting the benefits of new supplements. I’m in awe at the number of products lining store shelves.

As I prepared to write this blog today, there was an advertisement for a new supplement for diabetes prevention and treatment in my mailbox and a new journal article on dietary weight loss supplements on my desk.  It appears to be time to revisit this topic and recognize how many of our patients are reportedly taking supplements.

According to the National Center for Complementary and Alternative Medicine, nearly 40 percent of Americans use health care approaches that are not considered mainstream medicine  http://nccam.nih.gov/health/whatiscam .  More than 50 percent of people with diabetes have been reported to take nutritional supplements, and persons with type 2 diabetes more than twice as likely than those with type 1 diabetes. 

When questioning my diabetes patients about supplement use, alpha lipoic acid, cinnamon, chromium, ginkgo biloba and garlic are frequently mentioned.  My challenge is to help determine if the product is appropriate or potentially dangerous.

When trying to find answers, it is a challenge to find consistent evidence based on research, particularly within the gold standard of a double-blinded randomized control trial.

So where to go for help?

  • Complementary and Alternative Medicine (CAM) Supplement Use in People with Diabetes: Clinicians Guide (ADA) is an easy read and covers some of the more common supplements.
  • American Diabetes Association® Guide to Herbs and Nutritional Supplements reports on herbs and supplements for diabetes; potential pros and cons
  •  The National Center for Complementary and Alternative Medicine (www.nccam.nih.gov) is an easy-to-access resource.
  • Yeh, GY et al. Systematic review of herbs and dietary supplements for glycemic control in diabetes.  Diabetes Care.  2003:26:1277-1294 might also provide you with insight.

It’s important to recognize that all products that change the way our body works are drugs, whether they come from “natural” or synthetic sources.  Herbal products and supplements have little production and marketing oversight and must be proven to be detrimental prior to being removed from the market place – they do not have to prove that they actually work.  Let’s help our patients understand if their herbal and supplemental products have the potential to augment a healthy diet, be neutral or have the potential for harm especially when combined with other medication they may be taking.

Are you asking your patients which supplements they are taking and why?  Are you assessing whether they are healthful, harmful or just extra money many patients can ill afford?

If this is a topic you are interested in, stay tuned.  AADE will sponsor a webinar on herbal supplements and type 2 diabetes in August!  Click here for more information.

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