Home > Alternative Therapies, Diabetes, Food and Drink > Prescription 2014: Lowering HbA1C Naturally

Prescription 2014: Lowering HbA1C Naturally

April 1, 2014 Written by JP    [Font too small?]

Recently, I saw an advertisement in the Los Angeles Times for a popular medication used to lower hemoglobin A1C, a long-term measure of blood sugar. The ad reads, “If you have type 2 diabetes, your A1C number may be going in the wrong direction. To help change it, ask your doctor if adding Tradjenta may be right for you”. Of course, if you read on you’ll also notice warnings about possible side effects, including cough, diarrhea, potentially life threatening inflammation of the pancreas, runny nose and sore throat. Still, lowering high blood sugar is a valuable endeavor for diabetics and pre-diabetics alike. So, what to do? To answer that question, here are a few suggestions by Dr. Richard Bernstein, a pioneering maverick in the field of integrative-diabetes care, and current studies from the medical literature.

According to the American Diabetes Association, if your HbA1C level is 6.5% or under, your blood glucose average is acceptable. However, what is acceptable is rarely optimal. Dr. Richard Bernstein, a type 1 diabetic and diabetes specialist, recommends a much lower HbA1C level for anyone who wants to avoid diabetes, hastened aging and many of the health conditions afflicting modern man. In fact, he suggests striving for an HbA1C level of about 4.5%. This equates to a fasting blood glucose level of 83 mg/dl. He goes on to recommend that virtually everyone, not just diabetics, keep post-meal, blood sugar elevations to no more than 10 mg/dl. While I agree with this as a general goal, in the majority of cases I don’t think medications are needed to achieve it. What’s more, I would rather my clients maintain a slightly higher blood sugar (preferably 90 mg/dl or under) while doing “all the right things” rather than have optimal blood sugar levels that require the use of questionable medications.

Fortunately, there are quite a few natural ways to improve long term (HbA1C) and short term (postprandial) glucose elevations. Topping the list is a nutrient dense, low carbohydrate diet that is high in healthy fat, moderate in protein and low glycemic carbohydrates*. This is a cornerstone for managing high blood sugar. In this regard, a valuable tip is to replace refined carbohydrates and vegetable oils (rich in omega-6 fatty acids) with monounsaturated fats (avocados, olive oil, nuts) and sources of omega-3 fats (flax seeds, sardines, wild salmon). In addition, foods rich in insoluble and soluble fiber (berries, broccoli, chia seeds, pure cocoa powder) and probiotics (kefir, kimchi, yogurt) have likewise been shown to improve blood glucose control. Herbal remedies, including ginger root (3 grams daily) and green tea not only support healthier HbA1C levels, but also reduce other risk factors associated with diabetes and metabolic syndrome. Last, but hardly least, is staying mentally and physically fit. Activities as diverse as aerobic exercise, laughter therapy and yoga are scientifically documented as reasonable adjuncts and/or alternatives for anyone with high to high-normal blood sugar. Not only do I recommend all of these approaches, but there’s also no need for you to look for “Important Safety Information” that lists all sorts of possible and/or probable side effects.

* For the most part, the diet I advocate is moderate in carbohydrates. It is not a very low or ketogenic eating plan. However, many of the carbohydrates in my preferred diet come in the form of dietary fiber. Most published research indicates that both fiber rich foods and supplements lower post-meal blood sugar.

Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!

To learn more about the studies referenced in today’s column, please click on the following links:

Study 1 – How Dr. Bernstein Whipped His Diabetes … and You Can, Too (link)

Study 2 – Improvements in Glucose Metabolism & Insulin Sensitivity w/ a Low-Carb (link)

Study 3 – Effect of Low-Calorie Versus Low-Carbohydrate Ketogenic Diet in Type 2 (link)

Study 4 – A Randomized Clinical Trial with Two Doses of an Enteral Diabetes (link)

Study 5 – Probiotic Yogurt Improves Antioxidant Status in Type 2 Diabetic Patients … (link)

Study 6 – An Open-Label Study on the Effect of Flax Seed Powder (link)

Study 7 – Does Supplementation w/ Green Tea Extract Improve Insulin Resistance (link)

Study 8 – The Effect of Ginger Powder Supplementation on Insulin Resistance … (link)

Study 9 – Effects of a Laughter and Exercise Program on Physiological and (link)

Study 10 – Effect of 3-Month Yoga on Oxidative Stress in Type 2 Diabetes With or (link)

Replacing Carbohydrates with Nuts Lowers HbA1C

Source: Diabetes Care. 2011 Aug;34(8):1706-11. (link)

Tags: , ,
Posted in Alternative Therapies, Diabetes, Food and Drink

24 Comments & Updates to “Prescription 2014: Lowering HbA1C Naturally”

  1. Paul F. Says:

    Hi JP,

    This article proved to very valuable to several of my friends who are on medications to control their Type 2 diabetes.

    It is very interesting also for me to fend off the risk or pre- diabetes and to achieve my objective of lowering my fasting blood sugar from my current 100 to 115 Mg/Dl to about 85Mg/Dl, and my HbA1C to about 4.5%.

    It occurred to me that consuming 3g of ginger root daily as part of my veggie smoothie, using green tea as the vehicle to blend, may be a good approach worthwhile to try. Of course discipline must be exercised so as a back up I could have 3g of ginger capsules and a cup of green tea to take on the unavoidable no-smoothie days.

    Please give me your judgment on this approach.

    Thank you for providing so many alternatives to tackle this common problem without using medications with potential side effects.



  2. JP Says:

    Hi Paul,

    I think adding ginger and a green tea base to your smoothie may be helpful. A things details to note: 1) The study in question used 1,000 mg of dried ginger with each meal. 3 grams of fresh ginger root isn’t the same as 3 grams of dried ginger because the fresh ginger must factor in its water content. 2) It’s vital that you use low glycemic ingredients in your smoothie – along with the ginger and green tea. Example: celery, chard, fennel, flax seeds, kale, olive oil, pure cocoa powder, spinach, watercress, etc. Your “back up” approach seems like a good idea to me. It’s always good to have a back up plan! 🙂

    Be well!


  3. JP Says:

    Update: Flax seeds lower LDL (“bad”) cholesterol too …


    J Nutr. 2015 Feb 18. pii: jn.114.204594.

    Dietary Flaxseed Independently Lowers Circulating Cholesterol and Lowers It beyond the Effects of Cholesterol-Lowering Medications Alone in Patients with Peripheral Artery Disease.

    BACKGROUND: Dietary flaxseed lowers cholesterol in healthy subjects with mild biomarkers of cardiovascular disease (CVD).

    OBJECTIVE: The aim was to investigate the effects of dietary flaxseed on plasma cholesterol in a patient population with clinically significant CVD and in those administered cholesterol-lowering medications (CLMs), primarily statins.

    METHODS: This double-blinded, randomized, placebo-controlled trial examined the effects of a diet supplemented for 12 mo with foods that contained either 30 g of milled flaxseed [milled flaxseed treatment (FX) group; n = 58] or 30 g of whole wheat [placebo (PL) group; n = 52] in a patient population with peripheral artery disease (PAD). Plasma lipids were measured at 0, 1, 6, and 12 mo.

    RESULTS: Dietary flaxseed in PAD patients resulted in a 15% reduction in circulating LDL cholesterol as early as 1 mo into the trial (P = 0.05). The concentration in the FX group (2.1 ± 0.10 mmol/L) tended to be less than in the PL group (2.5 ± 0.2 mmol/L) at 6 mo (P = 0.12), but not at 12 mo (P = 0.33). Total cholesterol also tended to be lower in the FX group than in the PL group at 1 mo (11%, P = 0.05) and 6 mo (11%, P = 0.07), but not at 12 mo (P = 0.24). In a subgroup of patients taking flaxseed and CLM (n = 36), LDL-cholesterol concentrations were lowered by 8.5% ± 3.0% compared with baseline after 12 mo. This differed from the PL + CLM subgroup (n = 26), which increased by 3.0% ± 4.4% (P = 0.030) to a final concentration of 2.2 ± 0.1 mmol/L.Conclusions: Milled flaxseed lowers total and LDL cholesterol in patients with PAD and has additional LDL-cholesterol-lowering capabilities when used in conjunction with CLMs.

    Be well!


  4. JP Says:

    Update: More support for the use of ginger in type 2 diabetics …


    J Complement Integr Med. 2015 Feb 10.

    The effect of ginger (Zingiber officinale) on glycemic markers in patients with type 2 diabetes.

    Background: Ginger (Zingiber officinale) is one of the functional foods which contains biological compounds including gingerol, shogaol, paradol and zingerone. Ginger has been proposed to have anti-cancer, anti-thrombotic, anti-inflammatory, anti-arthritic, hypolipidemic and analgesic properties. Here, we report the effect of ginger supplementation on glycemic indices in Iranian patients with type 2 diabetes.

    Methods: A double-blind, placebo-controlled, randomized clinical trial was conducted on 20-60 -year-old patients with type 2 diabetes who did not receive insulin. Participants in the intervention and control groups were received 3 g of powdered ginger or placebo (lactose) (in capsules) daily for 3 months. Glycemic indices, total antioxidant capacity (TAC), malondialdehyde (MDA), C-reactive protein (CRP), serum paraoxonase, dietary intake and physical activity were measured at the beginning and end of the study, and after 12 h fasting.

    Results: Comparison of the indices after 3 months showed that the differences between the ginger and placebo groups were statistically significant as follows: serum glucose (-19.41 ± 18.83 vs 1.63 ± 4.28 mg/dL, p < 0.001), HbA1c percentage (-0.77 ± 0.88 vs 0.02 ± 0.16 %, p < 0.001), insulin (-1.46 ± 1.7 vs 0.09 ± 0.34 μIU/mL, p < 0.001), insulin resistance (-16.38 ± 19.2 vs 0.68 ± 2.7, p < 0.001), high-sensitive CRP (-2.78 ± 4.07 vs 0.2 ± 0.77 mg/L, p < 0.001), paraoxonase-1 (PON-1) (22.04 ± 24.53 vs 1.71 ± 2.72 U/L, p < 0.006), TAC (0.78 ± 0.71 vs -0.04 ± 0.29 µIU/mL, p < 0.01) and MDA (-0.85 ± 1.08 vs 0.06 ± 0.08 µmol/L, p < 0.001) were significantly different. Conclusions: This report shows that the 3 months supplementation of ginger improved glycemic indices, TAC and PON-1 activity in patients with type 2 diabetes. Be well! JP

  5. JP Says:

    pdate: Flax oil may protect the brain from stroke damage and possibly promote recovery …


    Nutrition Journal 2015, 14:20

    Oral consumption of α-linolenic acid increases serum BDNF levels in healthy adult humans

    Background aims Dietary omega-6 and omega-3 fatty acids have remarkable impacts on the levels of DHA in the brain and retina. Low levels of DHA in plasma and blood hamper visual and neural development in children and cause dementia and cognitive decline in adults. The level of brain-derived neurotrophic factors (BDNF) changes with dietary omega-3 fatty acid intake. BDNF is known for its effects on promoting neurogenesis and neuronal survival. Methods In this study, we examined the effect of the oral consumption of α-Linolenic acid (ALA) on blood levels of BDNF and Malondialdehyde (MDA) in healthy adult humans. 30 healthy volunteers, 15 men and 15 women, were selected randomly. Each individual served as his or her own control. Before consuming the Flaxseed oil capsules, 5cc blood from each individual was sampled in order to measure the plasma levels of BDNF and MDA as baseline controls. During the experiment, each individual was given 3 oral capsules of flaxseed oil, containing 500mg of alpha linolenic acid, daily for one week. Then, plasma levels of BDNF and MDA were tested. Results The plasma levels of BDNF and MDA significantly (P < 0.05) increased in individuals who received the oral capsules of ALA. Plasma levels of BDNF increased more in the women in comparison with the men. Conclusion ALA treatment could be a feasible approach to reduce size of infarcts in stroke patients. Thus, ALA could be used in adjunction with routine stroke therapies to minimize brain lesions caused by stroke.

    Be well!


  6. JP Says:

    Update 04/24/15:


    Iran J Public Health. 2015 Feb;44(2):228-37.

    Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial.

    BACKGROUND: Diabetes is a global health problem in the world. Probiotic food has anti-diabetic property. The aim of this trial was to determine the effect of probiotic fermented milk (kefir) on glucose and lipid profile control in patients with type 2 diabetes mellitus.

    METHODS: This randomized double-blind placebo-controlled clinical trial was conducted on 60 diabetic patients aged 35 to 65 years.Patients were randomly and equally (n=30) assigned to consume either probiotic fermented milk (kefir) or conventional fermented milk (dough) for 8 weeks. Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study.

    RESULTS: The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01). After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model. Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention.

    CONCLUSION: Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes.

    Be well!


  7. JP Says:

    Update 04/24/15:


    J Diabetes Metab Disord. 2015 Apr 9;14:22. .

    Improvement of glucose and lipid profile status with Aloe vera in pre-diabetic subjects: a randomized controlled-trial.

    BACKGROUND: Pre-diabetes is a disturbing trend in the population, who are at risk of developing type-two diabetes. The aim of this study was to determine the effects use of Aloe vera in different doses on glucose and lipid profile in pre-diabetic subjects.

    METHODS: This study was a double blind randomized controlled trial (72 subjects) with pre-diabetes symptoms in 3 groups consumed capsules twice a day: Aloe vera 300 mg (AL300), 500 mg (AL500) and placebo (PL). Fasting blood glucose (FBS), HbA1C and lipid profile were evaluated in baseline, 4 or 8 weeks. On-way ANOVA, Friedman, Wilcoxon, Kruskal-Wallis , Mann-Whitney and Chi-square tests were used for within or between groups statistical analysis.

    RESULTS: FBS level in group AL300, showed significantly decreased in fourth week after the intervention, compared to PL in the same time (p = 0.001). Also, HbA1C level in this group at the eighth week after the intervention (p = 0.042), had a significant decrease. The levels of Total cholesterol and LDL-C, only in the group AL500 (p < 0.001 and p = 0.01), was significantly reduced, along with HDL-C level improvement just after eight weeks (p = 0.004). Triglyceride level showed a significant decrease (p < 0.045) just after four weeks use of AL500. CONCLUSIONS: The Use of Aloe vera extract in pre-diabetic patients, could revert impaired blood glucose within four weeks, but after eight weeks could alleviate their abnormal lipid profile. Be well! JP

  8. JP Says:

    Update 04/24/15:


    Indian J Clin Biochem. 2015 Apr;30(2):180-6.

    Efficacy of Turmeric as Adjuvant Therapy in Type 2 Diabetic Patients.

    It is known that there is a significant interplay of insulin resistance, oxidative stress, dyslipidemia, and inflammation in type 2 diabetes mellitus (T2DM). The study was undertaken to investigate the effect of turmeric as an adjuvant to anti-diabetic therapy. Sixty diabetic subjects on metformin therapy were recruited and randomized into two groups (30 each). Group I received standard metformin treatment while group II was on standard metformin therapy with turmeric (2 g) supplements for 4 weeks. The biochemical parameters were assessed at the time of recruitment for study and after 4 weeks of treatment. Turmeric supplementation in metformin treated type 2 diabetic patient significantly decreased fasting glucose (95 ± 11.4 mg/dl, P < 0.001) and HbA1c levels (7.4 ± 0.9 %, P < 0.05). Turmeric administered group showed reduction in lipid peroxidation, MDA (0.51 ± 0.11 µmol/l, P < 0.05) and enhanced total antioxidant status (511 ± 70 µmol/l, P < 0.05). Turmeric also exhibited beneficial effects on dyslipidemia LDL cholesterol (113.2 ± 15.3 mg/dl, P < 0.01), non HDL cholesterol (138.3 ± 12.1 mg/dl, P < 0.05) and LDL/HDL ratio (3.01 ± 0.61, P < 0.01) and reduced inflammatory marker, hsCRP (3.4 ± 2.0 mg/dl, P < 0.05). Turmeric supplementation as an adjuvant to T2DM on metformin treatment had a beneficial effect on blood glucose, oxidative stress and inflammation. Be well! JP

  9. JP Says:

    Update 06/16/15:

    Iran J Public Health. 2015 Feb;44(2):228-37.

    Effect of probiotic fermented milk (kefir) on glycemic control and lipid profile in type 2 diabetic patients: a randomized double-blind placebo-controlled clinical trial.

    BACKGROUND: Diabetes is a global health problem in the world. Probiotic food has anti-diabetic property. The aim of this trial was to determine the effect of probiotic fermented milk (kefir) on glucose and lipid profile control in patients with type 2 diabetes mellitus.

    METHODS: This randomized double-blind placebo-controlled clinical trial was conducted on 60 diabetic patients aged 35 to 65 years.Patients were randomly and equally (n=30) assigned to consume either probiotic fermented milk (kefir) or conventional fermented milk (dough) for 8 weeks. Probiotic group consumed 600 ml/day probiotic fermented milk containing Lactobacillus casei, Lactobacillus acidophilus and Bifidobacteria and control group consumed 600 ml/day conventional fermented milk.Blood samples tested for fasting blood glucose, HbA1C, triglyceride (TG), total cholesterol, HDL-C and LDL-C at the baseline and end of the study.

    RESULTS: The comparison of fasting blood glucose between two groups after intervention was statistically significant (P=0.01). After intervention, reduced HbA1C compared with the baseline value in probiotic fermented milk group was statistically significant (P=0.001), also the HbA1C level significantly decreased in probiotic group in comparison with control group (P=0.02) adjusting for serum levels of glucose, baseline values of HbA1c and energy intake according to ANCOVA model. Serum triglyceride, total cholesterol, LDL-cholesterol and HDL- cholesterol levels were not shown significant differences between and within the groups after intervention.

    CONCLUSION: Probiotic fermented milk can be useful as a complementary or adjuvant therapy in the treatment of diabetes.

    Be well!


  10. JP Says:

    Update 06/16/15:


    J Clin Diagn Res. 2015 Apr;9(4):CC01-3.

    Effect of yoga on blood glucose levels in patients with type 2 diabetes mellitus.

    INTRODUCTION: In view of people embracing sedentary life style, and the effectiveness of treatment becoming less, the role of regular exercise especially ‘yoga’ seems to be a beneficial and economical adjuvant in the management of the Type 2 diabetes mellitus (T2DM).

    OBJECTIVES: To assess the beneficial effects of yoga on blood glucose levels in normal and T2DM volunteers.

    MATERIALS AND METHODS: A prospective case-control study was conducted in the Department of Physiology and Diabetic clinic of a tertiary care teaching hospital over period of two years. The study subjects consisted of 30 male diabetic patients attending diabetic clinic and 30 non-diabetic male volunteers constituted control group. The patients in the age group of 36 to 55 years with T2DM of at least one year duration and those on diabetic diet and oral hypoglycemic agents were included in the study group. The age matched healthy male volunteers who had come to join yoga training at yoga centre were included in the control group. All the participants were trained by yoga experts and subjected to regular practice under supervision for six months. In all the participants fasting (FBS) and post-prandial blood sugar (PPBS) was estimated before, during (at three months) and after (six months) yoga training. Paired Student t-test was used to estimate difference in means calculated before and after yoga training in a same group. A p-value of <0.05 was considered as statistically significant.

    RESULTS: The distribution of age, mean height and mean weight among both the groups were comparable. The reduction in mean values of FBS and PPBS at the end of six months was highly significant (p <0.001) in both the groups when compared with the mean values before and during (three months) yoga practice. The reduction in these values at three months during yoga was highly significant in T2DM group when compared with mean values before yoga (p <0.001), but it was insignificant (p<0.05) in control group.

    CONCLUSION: The results of the present study demonstrated that the yoga is effective in reducing the blood glucose levels in patients with T2DM.

    Be well!


  11. JP Says:

    Updated 07/15/15:


    Iran J Public Health. 2014 Dec;43(12):1651-6.

    The Effects of Vitamin D Supplementation on Glucose Control and Insulin Resistance in Patients with Diabetes Type 2: A Randomized Clinical Trial Study.

    BACKGROUND: Vitamin D deficiency is prevalent in diabetes type 2 and this vitamin may be related to insulin action. This randomized controlled trial study was done to evaluate the effect of vitamin D supplementation on glucose control and insulin resistance in patients with diabetes type 2.

    METHODS: Participants of this randomized clinical trial study consisted of 28 patients with type 2 diabetes who received 100 microgram (4000 IU) vitamin D and 30 diabetic patients who received placebo for 2 months between September 2012 and February 2013. The effect of vitamin D on glucose control was assessed by measuring HbA1c and insulin resistance as HOMA-IR at the baseline and the end of the intervention.

    RESULTS: The results showed a significant decrease in HbA1c (from 7.29 ± 0.22 % to 6.76 ± 0.18 %, P<0.001) and insulin concentration (from 8.24 ± 0.97 μIU/mL to 6.55 ± 0.28 μIU/mL, P=0.048), but a non-significant decrease in HOMA-IR in vitamin D group. Also, HDL-C level increased significantly in both of vitamin D (P=0.046) and placebo groups (P=0.028).

    CONCLUSION: It seems that vitamin D supplementation has beneficial effects on glucose homeostasis and can increases insulin sensitivity in diabetic 2 patients.

    Be well!


  12. JP Says:

    Updated 12/28/15:


    Phytother Res. 2015 Dec 21.

    Effect of Black Tea Consumption on Intracellular Cytokines, Regulatory T Cells and Metabolic Biomarkers in Type 2 Diabetes Patients.

    The present study was undertaken to evaluate the effects of black tea intake on inflammatory cytokines and metabolic biomarkers in Type 2 diabetes mellitus (T2DM). Thirty patients with T2DM were randomly assigned either to a High Intake (HI) group, consuming three cups (600 mL) of black tea per day; and a Low Intake (LI) group, administered 1 cup (200 mL) per day, each during a 12-week period. Intracellular cytokine expression, regulatory T cells (Treg), glycemic and lipid profiles were measured at baseline and following the tea intake period. Tea consumption correlated with major effects measured in peripheral blood of subjects that included significantly reduced glycated hemoglobin (HbA1c) levels, along with increased regulatory T cells CD3+ CD4+ CD25+ FOXP3, CD3+ CD4+ IL-10+ cells (an immunosuppressive phenotype), reduced (pro-inflammatory) CD3+ CD4+ IL-17+ cells and reduced Th1-associated CD3+ CD4+ IFN-Υ+ cells. Tea consumption was also observed to abolish the significance of an inverse correlation between total serum cholesterol and representation of CD4+ IL-4+ T cells, which may reflect protection against atopy-related oxidative stress. Outcomes of this study describe both advantages and limitations to consumption of black tea as an aid to sustained health maintenance by persons at-risk for TD2M and related obesity-associated metabolic syndromes.

    Be well!


  13. JP Says:

    Updated 1/18/16:


    Nutr J. 2016 Jan 8;15(1):3.

    Single-blind, placebo controlled randomised clinical study of chitosan for body weight reduction.

    BACKGROUND: Chitosan is a dietary fibre which acts by reducing fat absorption and thus used as a means for controlling weight. Weight loss clinical trial outcomes, however, have contradictory results regarding its efficacy. The primary objective of the present study was to evaluate the efficacy and safety of a chitosan from fungal origin in treatment of excess weight in the absence of dietary restrictions.

    METHODS: A phase IV, randomised, multicentre, single-blind, placebo-controlled, clinical study was conducted by administering chitosan capsules (500 mg, five/day) and indistinguishable placebo capsules as daily supplements to 96 overweight and obese subjects for 90 days. The study participants were divided in 2:1 ratio to receive either chitosan (n = 64) or placebo (n = 32). Efficacy was assessed by measuring body weight, body composition parameters, anthropometric measurements, HbA1C level and lipid profile at day 45 and day 90. Also, short form-36 quality of life (QoL) questionnaire was assessed to evaluate improvement in life-style and dietary habits were recorded for calorie intake. Safety was assessed by evaluating safety parameters and monitoring adverse events.

    RESULTS: The mean changes in body weight were -1.78 ± 1.37 kg and -3.10 ± 1.95 kg at day 45 and day 90 respectively in chitosan group which were significantly different (p < 0.0001) as compared to placebo. BMI was decreased by10.91 fold compared to placebo after 90 day administration. In concert with this, there was also reduction in body composition and anthropometric parameters together with improvement in QoL score. Chitosan was also able to reduce HbA1C levels (below 6 %) in subjects who had initial higher values. The mean caloric intake shows that there was no change in dietary habits of subjects in both groups. Lipid levels were unaffected and all adverse events were mild in nature and unrelated to study treatment. CONCLUSION: Chitosan from fungal origin was able to reduce the mean body weight up to 3 kg during the 90 day study period. Together with this, there was also improvement in body composition, anthropometric parameters and HbA1C, reflecting overall benefits for the overweight individuals. Additionally, there was also improvement in QoL score. It was safe and well tolerated by all subjects. Be well! JP

  14. JP Says:

    Updated 1/30/16:


    Int J Cancer. 2016 Apr 1;138(7):1741-53.

    High hemoglobin A1c levels within the non-diabetic range are associated with the risk of all cancers.

    Previous studies have reported associations between diabetes and cancer risk. However, specific association of hemoglobin A1c (HbA1c) levels with cancer risk remains inconclusive. We followed 29,629 individuals (11,336 men; 18,293 women) aged 46-80 years who participated in the Japan Public Health Center-based prospective study who had HbA1c measurements available and were cancer-free at baseline. Cancer incidence was assessed by systemic surveys. We estimated hazard ratios (HRs) for cancer risk with adjustment for age sex, geographic area, body mass index, smoking status, physical activity, alcohol, coffee, vegetable and total energy consumption, and history of cardiovascular disease. After a median follow-up of 8.5 years, 1,955 individuals had developed cancer. Higher HbA1c levels within both the non-diabetic and diabetic ranges in individuals without known diabetes were associated with overall cancer risk. Compared with individuals without known diabetes and HbA1c levels of 5.0-5.4%, the HRs for all cancers were 1.27 (95% confidence interval, 1.07-1.52); 1.01 (0.90-1.14); 1.28 (1.09-1.49); and 1.43 (1.14-1.80) for individuals without known diabetes and HbA1c levels <5.0%, 5.5-5.9%, 6.0-6.4%, and ≥6.5%, respectively, and 1.23 (1.02-1.47) for individuals with known diabetes. The lowest HbA1c group had the highest risk of liver cancer, and HbA1c levels were linearly associated with the risk of all cancers after excluding liver cancer (P for linear trend, 0.004). In conclusion, our findings corroborate the notion that glycemic control in individuals with high HbA1c levels may be important not only to prevent diabetes but also to prevent cancer.

    Be well!


  15. JP Says:

    Updated 03/05/16:


    Eur J Clin Nutr. 2016 Feb 24.

    Association of adherence to a Mediterranean diet with glycemic control and cardiovascular risk factors in youth with type I diabetes: the SEARCH Nutrition Ancillary Study.

    BACKGROUND/OBJECTIVES: This study aimed to determine the association between a Mediterranean diet and glycemic control and other cardiovascular risk factors among youth with type I diabetes (TID).

    SUBJECTS/METHODS: Incident TID cases aged <20 years at diagnosis between 2002 and 2005 were included. Participants were seen at baseline (N=793), 1-year (N=512) and 5-year follow-up visits (N=501). Mediterranean diet score was assessed using a modified KIDMED index (mKIDMED). Multivariate linear regression and longitudinal mixed model were applied to determine the association between mKIDMED score and log-HbA1c, lipids, blood pressure (BP) and obesity.

    RESULTS: In cross-sectional analyses using baseline data, for individuals with the hemoglobin A1c (HbA1c) of 7.5%, a two-point higher mKIDMED score (1 s.d.) was associated with 0.15% lower HbA1c (P=0.02). A two-point higher mKIDMED score was associated with 4.0 mg/dl lower total cholesterol (TC) (P=0.006), 3.4 mg/dl lower low-density lipoprotein cholesterol (LDL-C) (P=0.004), 3.9 mg/dl lower non-high-density lipoprotein cholesterol (non-HDL-C) (P=0.004) and 0.07 lower LDL-C/HDL-C ratio (P=0.02). Using longitudinal data, a two-point increase in mKIDMED score was associated with 0.01% lower log-HbA1c (P=0.07), 1.8 mg/dl lower TC (P=0.05), 1.6 mg/dl lower LDL-C (P=0.03) and 1.8 mg/dl lower non-HDL-C (P=0.03) than would otherwise have been expected. HbA1c mediated ∼20% of the association for lipids in both cross-sectional and longitudinal models. An unexpected positive association between mKIDMED score and systolic BP was found among non-Hispanic white youth in cross-sectional analyses (P=0.009). Mediterranean diet was not associated with obesity.

    CONCLUSIONS: Mediterranean diet may improve glycemic control and cardiovascular health in TID youth.

    Be well!


  16. JP Says:

    Updated 05/08/16:


    J Altern Complement Med. 2016 May 6.

    Reduction of Fasting Blood Glucose and Hemoglobin A1c Using Oral Aloe Vera: A Meta-Analysis.

    PURPOSE: Diabetes mellitus is a global epidemic and one of the leading causes of morbidity and mortality. Additional medications that are novel, affordable, and efficacious are needed to treat this rampant disease. This meta-analysis was performed to ascertain the effectiveness of oral aloe vera consumption on the reduction of fasting blood glucose (FBG) and hemoglobin A1c (HbA1c).

    METHODS: PubMed, CINAHL, Natural Medicines Comprehensive Database, and Natural Standard databases were searched. Studies of aloe vera’s effect on FBG, HbA1c, homeostasis model assessment-estimated insulin resistance (HOMA-IR), fasting serum insulin, fructosamine, and oral glucose tolerance test (OGTT) in prediabetic and diabetic populations were examined. After data extraction, the parameters of FBG and HbA1c had appropriate data for meta-analyses. Extracted data were verified and then analyzed by StatsDirect Statistical Software. Reductions of FBG and HbA1c were reported as the weighted mean differences from baseline, calculated by a random-effects model with 95% confidence intervals. Subgroup analyses to determine clinical and statistical heterogeneity were also performed. Publication bias was assessed by using the Egger bias statistic.

    RESULTS: Nine studies were included in the FBG parameter (n = 283); 5 of these studies included HbA1c data (n = 89). Aloe vera decreased FBG by 46.6 mg/dL (p < 0.0001) and HbA1c by 1.05% (p = 0.004). Significant reductions of both endpoints were maintained in all subgroup analyses. Additionally, the data suggest that patients with an FBG ≥200 mg/dL may see a greater benefit. A mean FBG reduction of 109.9 mg/dL was observed in this population (p ≤ 0.0001). The Egger statistic showed publication bias with FBG but not with HbA1c (p = 0.010 and p = 0.602, respectively). CONCLUSION: These results support the use of oral aloe vera for significantly reducing FBG (46.6 mg/dL) and HbA1c (1.05%). Further clinical studies that are more robust and better controlled are warranted to further explore these findings. Be well! JP

  17. JP Says:

    Updated 06/27/16:


    J Diabetes Res. 2016;2016:5147468.

    Silymarin in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

    Type 2 diabetes mellitus (T2DM) is associated with increased risk of cardiovascular disease and nephropathy-now the leading cause of end-stage renal disease and dialysis in Europe and the United States. Inflammation and oxidative stress play a pivotal role in the development of diabetic complications. Silymarin, an herbal drug with antioxidant and anti-inflammatory properties, may improve glycemic control and prevent the progression of the complications. In a systematic review and meta-analysis including five randomized controlled trials and 270 patients, routine silymarin administration determines a significant reduction in fasting blood glucose levels (-26.86 mg/dL; 95% CI -35.42-18.30) and HbA1c levels (-1.07; 95% CI -1.73-0.40) and has no effect on lipid profile. Benefits for silymarin on proteinuria and CKD progressions are reported in only one small study and are uncertain. However, being aware of the low quality of the available evidence and elevated heterogeneity of these studies, no recommendation can be made and further studies are needed.

    Be well!


  18. JP Says:

    Updated 06/29/16:


    Mol Nutr Food Res. 2016 Jun 9.

    Effects of n-3 fatty acid supplements on glycemic traits in Chinese type 2 diabetic patients: a double-blind randomized controlled trial.

    SCOPE: To investigate the effects of n-3 fatty acid supplements, both marine and plant-based, on glycemic traits in Chinese type 2 diabetes (T2D) patients.

    METHOD AND RESULTS: In a double-blind randomized controlled trial, 185 recruited Chinese T2D patients were randomized to either fish oil (FO, n = 63), flaxseed oil (FSO, n = 61) or corn oil group (CO, served as control group, n = 61) for 180 days. The patients were asked to take corresponding oil capsules (4 capsules/day), which totally provided 2 g/day of eicosapentaenoic acid + docosahexaenoic acid in FO group and 2.5 g/day of alpha-linolenic acid in FSO group. No group×time interaction was observed for HOMA-insulin resistance, fasting insulin or glucose. Significant group×time interaction (P = 0.035) was observed for glycated haemoglobin (HbA1c), with HbA1c decreased in FO group compared with CO group (P = 0.037). We also found significant group×time interactions for lipid traits, including low-density lipoprotein cholesterol (P = 0.043), total cholesterol (TC) (P = 0.021), total cholesterol/ high-density lipoprotein cholesterol (TC/HDL-C) (P = 0.009) and triacylglycerol (TG) (P = 0.003), with the lipid profiles improved in FO group. No significant effects of FSO on glycemic traits or blood lipids were observed.

    CONCLUSIONS: Marine n-3 PUFA supplements may improve glycemic control and lipid profiles among Chinese type 2 diabetic patients. This article is protected by copyright. All rights reserved.

    Be well!


  19. JP Says:

    Updated 08/21/16:


    Exp Ther Med. 2016 Aug;12(2):1232-1242.

    Therapeutic effects of soluble dietary fiber consumption on type 2 diabetes mellitus.

    Soluble dietary fiber (DF) reduces the risk of developing diabetes and may have therapeutic effects in patients with type 2 diabetes mellitus (DM2). The present study aimed to investigate the effect of soluble DF on metabolic control in patients with DM2. A total of 117 patients with DM2 between the ages of 40 and 70 were assessed. Patients were randomly assigned to one of two groups, and administered extra soluble DF (10 or 20 g/day), or to a control group (0 g/day) for one month. Blood glucose, serum insulin and connecting peptide (C-peptide) levels, and the insulin resistance index, as determined using the homeostatic model assessment method, were measured during fasting and up to 2-h postprandially prior to and following one month of treatment. Other measurements included serum levels of glycated albumin (GA), blood lipid profiles, and an analysis of the blood pressure, body weight and waist/hip ratio of all patients. Following intervention, the levels of 2-h blood glucose, fasting insulin and lipoprotein(a), and the insulin resistance index, were significantly improved in all groups. Furthermore, the fasting blood glucose, 2-h insulin, fasting C-peptide, 2-h C-peptide, GA and triglyceride (TG) levels were significantly improved in the soluble DF groups. The 20 g/day soluble DF group exhibited significantly improved fasting blood glucose and low-density lipoprotein levels, as well as a significantly improved insulin resistance index. In addition, 10 and 20 g/day soluble DF significantly improved the waist and hip circumferences and levels of TGs and apolipoprotein A. The results of the present study suggested that increased and regular consumption of soluble DF led to significant improvements in blood glucose levels, insulin resistance and metabolic profiles, without improving the secretory function of the islets of Langerhans, over a short-term intervention period in patients with DM2.

    Be well!


  20. JP Says:

    Updated 11/21/16:


    Nutr Res. 2016 Oct;36(10):1121-1129.

    Vitamin D supplementation reduces insulin resistance in Japanese adults: a secondary analysis of a double-blind, randomized, placebo-controlled trial.

    Higher circulating 25-hydroxyvitamin D (25[OH]D) concentration has been linked to a lower prevalence of insulin resistance and type 2 diabetes mellitus. However, randomized controlled trials have not clarified the effect of vitamin D supplementation on insulin resistance in healthy adults. The objective of this study was to assess the effect of vitamin D supplementation for 1 year on insulin resistance; the study was a secondary analysis of a clinical trial. We hypothesized that increased 25(OH)D concentration after vitamin D supplementation for 1 year would significantly improve insulin resistance. Ninety-six healthy adults participated in this study, of whom 81 completed the study. The participants randomly received daily either 420 IU vitamin D3 or placebo in a double-blind manner for 1 year. The levels of fasting insulin, glucose, and other parameters were assessed at baseline and after 1 year of intervention. Homeostasis model assessment of insulin resistance index was calculated from insulin and glucose levels. Visceral fat area and physical activity were also investigated. Serum 25(OH)D and 1,25-dihydroxyvitamin D concentrations were significantly increased by approximately 29.5 nmol/L and 7.0 pg/mL, respectively, after 1-year vitamin D supplementation. After vitamin D supplementation, fasting glucose levels and values of homeostasis model assessment of insulin resistance index significantly decreased from 88.3 to 85.3 mg/dL (P < .01) and 1.17 to 0.84 (P < .01), respectively, and the results were independent of physical activity and visceral fat accumulation. In conclusion, the present study showed that vitamin D supplementation for 1 year effectively improves fasting glucose level and insulin resistance in healthy Japanese adults. Be well! JP

  21. JP Says:

    Updated 03/15/17:


    Br J Nutr. 2017 Mar 6:1-9.

    Efficacy of fibre additions to flatbread flour mixes for reducing post-meal glucose and insulin responses in healthy Indian subjects.

    The incidence of type 2 diabetes mellitus (T2DM) is increasing worldwide, including in developing countries, particularly in South Asia. Intakes of foods generating a high postprandial glucose (PPG) response have been positively associated with T2DM. As part of efforts to identify effective and feasible strategies to reduce the glycaemic impact of carbohydrate-rich staples, we previously found that addition of guar gum (GG) and chickpea flour (CPF) to wheat flour could significantly reduce the PPG response to flatbread products. On the basis of the results of an exploratory study with Caucasian subjects, we have now tested the effect of additions of specific combinations of CPF with low doses of GG to a flatbread flour mix for their impacts on PPG and postprandial insulin (PPI) responses in a South-Asian population. In a randomised, placebo-controlled full-cross-over design, fifty-six healthy Indian adults consumed flatbreads made with a commercial flatbread mix (100 % wheat flour) with no further additions (control) or incorporating 15 % CPF in combination with 2, 3 or 4 % GG. The flatbreads with CPF and 3 or 4 % GG significantly reduced PPG (both ≥15 % reduction in positive incremental AUC, P<0·01) and PPI (both ≥28 % reduction in total AUC, P<0·0001) compared with flatbreads made from control flour. These results confirm the efficacy and feasibility of the addition of CPF with GG to flatbread flour mixes to achieve significant reductions in both PPG and PPI in Indian subjects.

    Be well!


  22. JP Says:

    Updated 04/02/17:


    Nutrients 2017, 9(4), 352

    Effects of Higher Dietary Protein and Fiber Intakes at Breakfast on Postprandial Glucose, Insulin, and 24-h Interstitial Glucose in Overweight Adults

    Dietary protein and fiber independently influence insulin-mediated glucose control. However, potential additive effects are not well-known. Men and women (n = 20; age: 26 ± 5 years; body mass index: 26.1 ± 0.2 kg/m2; mean ± standard deviation) consumed normal protein and fiber (NPNF; NP = 12.5 g, NF = 2 g), normal protein and high fiber (NPHF; NP = 12.5 g, HF = 8 g), high protein and normal fiber (HPNF; HP = 25 g, NF = 2 g), or high protein and fiber (HPHF; HP = 25 g, HF = 8 g) breakfast treatments during four 2-week interventions in a randomized crossover fashion. On the last day of each intervention, meal tolerance tests were completed to assess postprandial (every 60 min for 240 min) serum glucose and insulin concentrations. Continuous glucose monitoring was used to measure 24-h interstitial glucose during five days of the second week of each intervention. Repeated-measures ANOVA was applied for data analyses. The HPHF treatment did not affect postprandial glucose and insulin responses or 24-h glucose total area under the curve (AUC). Higher fiber intake reduced 240-min insulin AUC. Doubling the amount of protein from 12.5 g to 25 g/meal and quadrupling fiber from 2 to 8 g/meal at breakfast was not an effective strategy for modulating insulin-mediated glucose responses in these young, overweight adults.

    Be well!


  23. JP Says:

    Updated 05/31/18:


    Iran Biomed J. 2018 May 27.

    The Effects of Lactobacillus casei on Glycemic Response, Serum Sirtuin1 and Fetuin-A Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Trial

    Background: Type 2 diabetes mellitus (T2DM) is related to the gut microbiota with numerous molecular mechanisms. Modulating the gut microbiota by probiotics could be effective in management of T2DM. The aim of the present trial was to evaluate the effect of Lactobacillus casei on glycemic control and serum sirtuin1 (SIRT1) and fetuin-A in patients with T2DM.

    Methods: Forty patients with T2DM (n = 20 for each group) were divided into intervention (probiotic) and placebo groups. The intervention group received a daily capsule containing 108 cfu of L. casei for eight weeks. The patients in placebo group took capsules containing maltodextrin for the same time duration. Anthropometric measurements, dietary intake questionnaires, and blood samples were collected, and the patients were assessed by an endocrinologist at the beginning and at the end of the trial.

    Results: Fasting blood sugar, insulin concentration, and insulin resistance significantly decreased in probiotic group compared with placebo group (-28.32 [-50.23 to -6.41], 0.013; -3.12 [-5.90 to -0.35], 0.028; -32.31 [-55.09 to -9.54], 0.007, respectively). Moreover, HbA1c reduced after intervention, but the reduction was not significant (-0.45 [-0.96 to 0.05], 0.077). In comparison with placebo, the L. casei supplementation significantly increased SIRT1 and decreased fetuin-A levels at the end of the trial (0.52 [0.026 to 1.02], 0.040; -17.56 [-32.54 to -2.58], 0.023, respectively).

    Conclusion: L. casei supplementation affected SIRT1 and fetuin-A levels in a way that improved glycemic response in subjects with T2DM. Affecting the SIRT1 and fetuin-A levels introduces a new known mechanism of probiotic action in diabetes management.

    Be well!


  24. JP Says:

    Updated 06/03/18:


    Int J Yoga. 2018 May-Aug;11(2):122-128.

    Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease.

    Background and Objectives: Coronary artery disease (CAD) is the leading cause of morbidity and mortality worldwide. It has been recognized that stress, diabetes, and hypertension are important in etiology and progression of CAD. This study is to evaluate the role of meditation in improving biochemical parameters such as blood glucose, glycosylated hemoglobin, and serum insulin levels in known CAD patients.

    Material and Methods: Sixty CAD patients are divided into two groups of which one group did meditation and other did not. Blood glucose, glycosylated hemoglobin, and fasting serum insulin levels were measured before and at the end of 6 months of study in both the groups.

    Results: At the end of the study, significant decrease was seen in patients who practiced meditation as compared to other group.

    Conclusion: Meditation may modulate the physiological response to stress through neurohumoral activation, which may be a novel therapeutic target for the treatment of CAD.

    Be well!


Leave a Comment