Insulin-Dependent Diabetes Mellitus (IDDM, Type I DM) also known as juvenile-onset diabetes, is characterized by a full physiological need for insulin, which is patient administered via injection. In this form of diabetes, the patient demonstrates a full pancreatic destruction of insulin secreting beta cells.

Non-Insulin Dependent Diabetes Mellitus (NIDDM, Type II DM) also known as adult-onset diabetes is the most common form of the disease. It claims an estimated 90% of all cases reported. This form is generally associated with obesity. Treatment typically consists of weight loss, diet modification and one of the sulfonylurea agents such as chlorpropamide, glyburide or glipizide.

Gymnema Sylvestre: An Ayurvedic Tool

The leaf extract of Gymenma sylvestre (GSE), a plant indigenous to the forests of India and Nepal, has demonstrated great promise in the treatment of type I and type II diabetes.

Studies performed on diabetic rats have shown the herbal extract to double the number of pancreatic islet and beta cells. Blood glucose normalization via increased insulin production was achieved through repair and/or regeneration of pancreatic tissues.

In one study, conducted on twenty-seven IDDM patients, GSE significantly reduced the dose requirement for insulin and also demonstrated a near normalization of serum lipids. Again, GSE?s proposed mechanism of action was via the repair and/or regeneration of pancreatic beta cells.

In another study performed with twenty-two NIDDM individuals on conventional oral sulfonylurea anti-hyperglycemic agents (such as glyburide, glipizide), GSE were administered for 18-20 weeks as an adjunct, at a dosage of 400 mg per day. Blood values during GSE supplementation demonstrated a significant reduction of glucose, glycosylated hemoglobin, and glycosylated plasma proteins. Of the twenty-two individuals studied, five were able to discontinue the use of pharmaceuticals and maintain glucose homeostatsis SOLELY from GSE.

Big Research on a Little Nutrient

As the American populace becomes more sedentary and thus more obese, diabetes is steadily on the rise. So, potential new therapies are being studied. One particularly promising compound is the trace element vanadium. Research conducted almost one hundred years ago by French physician B. Lyonnet demonstrated that when a vanadium salt was administered to diabetic subjects, the concentration of glucose in urine dropped sharply. Within the past 20 years a resurgence of vanadium research has taken place in areas such as pharmacodynamics and toxicity.

Although many published studies have verified the insulin-mimetic effects of vanadium, it?s total biological role in human nutrition is still poorly understood.

Various studies on vanadium, such as those preformed on streptozocin-induced diabetes in rats, resulted in a normalization in blood glucose levels. Stimulation of glucose oxidation and adipoyte transport has been demonstrated via vanadium by several experiments, as well as enhancement of glycogen synthesis and inhibition of hepatic gluconeogenesis. Investigators also believe vanadium to be responsible for the phosphoryation of the insulin receptor, resulting in activitation and glucose sensitivity.

It has been demonstrated that the inorganic vanadate 5+ salt forms have great potential for toxicity (primarily manifesting as elevation of hepatic enzymes, neuropathy and renal damage) in long term treatment. These negative aspects were also observed with vanadyl sulfate, even at clinical doses. Other forms of the element were studied for gut absorption, bioavailability, and dose-to-efficacy toxicity.

Vanadium as bis(maltolato)oxovanadium (BMOV) was shown to have a NO POTENTIAL FOR TOXICITY at therapeutic doses when administered for a prolonged period. This was due to increased absorption and a higher rate of clearance and excretion than other forms of vanadium. The increased bioavailability of BMOV thus resultes in a lesser need for the element to achieve glucose stability and a reduction and/or elimination of toxicity potential.

BMOV is widely considered by scientific studies to be the preferred choice of the element for long term therapy of various hyperglycemic conditions.

Magnesium: Insulin Potentiation

Magnesium may be the most important mineral in the diabetic condition. Bith NIDDM and IDDM individuals have been demonstrated to respond positively when supplemented with magnesium (either as intravenous or oral).

Marked improvement was observed in areas such as blood glucose stablility and drug (both insulin and oral) potency requirement. Unfortunately, the potential for hypomagnesaemia among diabetic patients can be greater than other minerals deficiencies including chromium and vanadium. This may be partly due to a variety of exogenous factors shch as prescription diuretics (i.e., hydrachlorothiazide and furosemide) and poor diet.

The significance of magnesium in the diabetic condition is gaining greater acceptance in orthodox medicine. This is partly due to the insulin resistance phenomenon (a.k.a. Syndrome X) and cardiac risk.

Magnesium has been shown to play a major role in various biochemical mechanisms that directly impact glucose utilization. Studies have shown magnesium supplementation to increase insulin sensitivity, establishing a rationale in Syndrome X therapy. Stimulation of glycogenesis, glycolysis and oxygen utilization (resulting in enhanced insulin bioavailability) are the primary dynamics of the magnesium ion. Once again, magnesium emerges as a critical factor in the nutritional approach to chronic degenerative disease.

Nutrient Catalysts: Pyridoxine and Alpha-Lipoic Acid

Pyridoxine and alpha-lipoic acid (a B-vitamin like compound classified as a metavitamin) can be of benefit to the diabetic sufferer on many different levels. Pyridoxine, either as HCI or the coenzyme phosphorolated form, has been demonstrated to assist with glucose metabolism. This mechanism is likely due to its catalystic effects with magnesium, positively effecting glycogensis and oxygen utilization.

Pyridoxine supplementation, as well as other B complex vitamins, also greatly reduces the potential for the various neuropathies classically associated with the diabetic patient.

One considered an obscure biological compound, alpha-lipoic acid has truly ?come-of-age?. This metavitamin has had a long history of use throughout Europe and is primarily dispensed for hepatic disorders, peripheral neuropathy, heavy metal toxicity and mushroom poisoning. Scientific studies have demonstrated that alpha-lipoic acid increases glucose tolerance and glucose metabolism via potentiation of the Kreb cycle. Within the past several years, alpha-lipoic acid has also been demonstrated to have extremely potent anti-oxidant activity, especially toward free-radicals which have an affinity for lipid molecules. Alpha-lipoic acid may truly be one of the most important ?metavitamins? for the diabetic sufferer.

Conclusion: A three-Fold Approach

Gymnema sylvestre, vanadium complex (BMOV), magnesium, pyridoxine, and alpha-lipoic acid may perhaps be the protocol of choice for the nutritional treatment of both NIDDM and IDDM.

This "tri-directional" procedure recognizes the three major factors of the disease: stimulation of insulin via pancreatic beta/islet cells: mimicking of insulin by an exogenous substance: and the potentiation of bioavailability of endogenous insulin.

Mitch Chavez, B.SC., C.N. is a Certified Nutritionist with an undergraduate in nutrition science with emphasis on nutritional biochemistry. He is an independent technical consultant to the natural products industry and Director of Education for Progressive Apothecary, a professional products distributor exclusively for practioners of natural medicine.

In addition to his position with Progressive Apothecary, he is the Vice President and Director of Research and Development of Nutraceutical Research Laboratories and Chief Science Officer for Integrative Medical Research, Ltd., both makers/suppliers of cutting-edge nutriyionals for physicans specializing in complementary and integrative medicine.

Mr. Chavez has had numerous articles puvblished in both lay magazines and peer reviewed journals regarding nutritional supplemention and product formula rationale. He has also lectured internationally by invitation to medical schools at a post-graduate level concerning nutritional biochemistry and botanical medicine.

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