September 26, 2011
Alpha Lipoic Acid and Type 2 Diabetes
There is growing evidence that Alpha Lipoic Acid (ALA) has beneficial effects on the treatment of Type 2 Diabetes and some of its complications. Its wide-ranging benefits for diabetes include improved glycemic control, improved insulin sensitivity, reduction of oxidative stress, and reduction of neuropathy.
A recent review of ALA for diabetes concluded that the supplement’s side effects were generally limited, and found that it was generally safe for use even by those with impaired kidney or liver function. (NYBC adds only a caution about a potential thyroid issue, especially for those taking higher doses of ALA.)
See the NYBC entry
Reference:
Poh Z, Goh KP. A current update on the use of alpha lipoic Acid in the management of type 2 diabetes mellitus. Endocr Metab Immune Disord Drug Targets. 2009 Dec;9(4):392-398.
December 9, 2010
Acetylcarnitine for cardiovascular health
Acetylcarnitine (or acetyl-l-carnitine) has been studied in recent years for its neuroprotective effects. It is the subject, for example, of some good research on peripheral neuropathy (nerve damage leading to tingling, pain in the hands and feet) in people with HIV.
But we were interested to read about a 2009 report on acetylcarnitine used in a pilot study of people with elevated cardiovascular disease risk. The investigation, which involved 24 weeks of oral acetylcarnitine therapy (1 gram daily), found significant improvement in high blood pressure and glucose control among the study subjects. Since these improvements point to a decrease in cardiovascular disease risk, the investigators suggest that further research be done to see whether long-term acetylcarnitine supplementation can be a good cardioprotective strategy.
Here’s the abstract of the article:
Ameliorating Hypertension and Insulin Resistance in Subjects at Increased Cardiovascular Risk
Effects of Acetyl-L-Carnitine Therapy
Piero Ruggenenti; Dario Cattaneo; Giacomina Loriga; Franca Ledda; Nicola Motterlini; Giulia Gherardi; Silvia Orisio; Giuseppe RemuzziFrom the Unit of Nephrology (P.R., G.R.), Azienda Ospedaliera Ospedali Riuniti, Bergamo, Italy; Clinical Research Center for Rare Diseases “Aldo and Cele Daccò” (P.R., D.C., G.L., F.L., N.M., G.G., S.O., G.R.), Mario Negri Institute for Pharmacological Research, Bergamo, Italy; Institute of Special Medical Pathology (G.L., F.L.), Università degli Studi, Sassari, Italy.
Correspondence to Giuseppe Remuzzi, Mario Negri Institute for Pharmacological Research, Via Gavazzeni 11, 24125 Bergamo, Italy. E-mail gremuzzi@marionegri.it
Insulin resistance, a key component of the metabolic syndrome, is a risk factor for diabetes mellitus and cardiovascular disease. Acetyl-L-carnitine infusion acutely ameliorated insulin sensitivity in type 2 diabetics with insulin resistance. In this sequential off-on-off pilot study, we prospectively evaluated the effects of 24-week oral acetyl-L-carnitine (1 g twice daily) therapy on the glucose disposal rate (GDR), assessed by hyperinsulinemic euglycemic clamps, and components of the metabolic syndrome in nondiabetic subjects at increased cardiovascular risk a priori segregated into 2 groups with GDR 7.9 (n=16) or >7.9 (n=16) mg/kg per minute, respectively. Baseline GDR and systolic blood pressure were negatively correlated (n=32; P=0.001; r=–0.545), and patients with GDR 7.9 mg/kg per minute had higher systolic/diastolic blood pressure than those with higher GDR. Acetyl-L-carnitine increased GDR from 4.89±1.47 to 6.72±3.12 mg/kg per minute (P=0.003, Bonferroni-adjusted) and improved glucose tolerance in patients with GDR 7.9 mg/kg per minute, whereas it had no effects in those with higher GDRs. Changes in GDR were significantly different between groups (P=0.017, ANCOVA). Systolic blood pressure decreased from 144.0±13.6 to 135.1±8.4 mm Hg and from 130.8±12.4 to 123.8±10.8 mm Hg in the lower and higher GDR groups, respectively (P<0.05 for both; P<0.001 overall) and progressively recovered toward baseline over 8 weeks posttreatment. Total and high molecular weight adiponectin levels followed specular trends. Diastolic blood pressure significantly decreased only in those with higher GDRs. Treatment was well tolerated in all of the patients. Acetyl-L-carnitine safely ameliorated arterial hypertension, insulin resistance, impaired glucose tolerance, and hypoadiponectinemia in subjects at increased cardiovascular risk. Whether these effects may translate into long-term cardioprotection is worth investigating.
See the NYBC entry on acetylcarnitine for further information:
http://nybcsecure.org/product_info.php?products_id=118
and acetylcarnitine/Biosint (Italian source):
http://nybcsecure.org/product_info.php?cPath=50&products_id=320
April 19, 2010
“Supplements and Diabetes” and “Diabetes Facts & Figures”
NYBC INFO SHEET ON SUPPLEMENTS STUDIED FOR DIABETES
Below we describe some of the best recent research on supplements as used for the management of diabetes. More extensive information on these supplements, including recommended dosages, can be found on the NYBC website.
Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.
Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins.
Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.
Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”
Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).
Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg/day) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= pain, tingling, numbness in feet and hands). A protocol for diabetic neuropathy using ALA, evening primrose oil and Vitamin C has also been proposed.
Note: NYBC stocks ALA (Montiff) 300mg/60.
Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)
Chromium and Biotin: These two supplements have been proposed as a useful adjunct therapy for poorly controlled diabetes. Chromium is also under investigation for insulin resistance in people with HIV.
Note: NYBC stocks these two supplements from Jarrow.
Reference: Singer, G M, & J Geohas. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus. Diabetes Technol Ther. Dec. 2006.
Bitter Melon: A popular vegetable in Southeast Asia, Bitter Melon (sometimes called Bitter gourd) contains an insulin-like substance that can lower blood sugar in people with Type 2 diabetes. Warning: Bitter Melon may result in hypoglycemia (low blood sugar) if combined with other blood glucose-lowering drugs or supplements.
NYBC stocks Bitter Melon (Zhang).
Reference: “Bitter gourd (Momordica Charantia): A dietary approach to hyperglycemia.” Nutrition Rev. July 2006.
B Vitamins: These are recommended for those taking Metformin, the most widely prescribed oral diabetic drug in the US. Metformin depletes B12, B6 and folic acid, which in turn leads to a build-up of homocysteine, linked to cardiovascular disease.
NYBC stocks B-right (Jarrow).
Reference: Zhao-Wei Ting, R et al. “Risk factors of vitamin B12 deficiency in patients receiving metformin.” Archives of Internal Medicine, Oct. 9, 2006.
IMPORTANT: Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering! As noted above regarding Bitter Melon, there is a risk of dangerous hypoglycemia if multiple blood sugar-lowering agents are used at the same time.
Diabetes Facts and Figures
–Poor diet (processed foods, fast foods, sweetened drinks) and lack of exercise are major factors in recent large increases in Type 2 Diabetes in the US. (The rate of Type 1 Diabetes, which is largely inborn, remains stable.)
–In 2009, 24 million Americans had diabetes. With no changes in diet and exercise rates, the number of US diabetics is projected to double over the next 25 years and the annual costs of treating the disease will rise from $113 billion to $336 billion.
–Minorities are disproportionately affected by diabetes: African-Americans, Hispanics and Native Americans are almost twice as likely as Whites to have diabetes. A main contributing factor for this disparity is limited healthy food choices and an abundance of bad food choices available in minority communities.
–Childhood obesity, closely linked to the development of diabetes, is now considered epidemic in the US, with 40% of US children overweight and 13% obese. The current generation of US children consequently risk having higher rates of cardiovascular disease and other diabetes-related health problems than their parents’ generation.
–The proportion of people with HIV who also have Type 2 Diabetes is increasing. The effects of combination therapies for HIV appear to increase the risk of Type 2 Diabetes; it is estimated that as many as 80% of people with HIV treated with protease inhibitors may develop insulin resistance, a precursor to diabetes (see John G. Ryan, “Increased Risk of Type 2 Diabetes Mellitus with HIV-1 Infection,” in Insulin, Jan. 2010).
–A class of drugs approved by the FDA as second-line treatment of diabetes has shown a dubious safety record. One of them, Avandia, may have caused hundreds of heart attacks per month and as of early 2010 the FDA was considering whether to ask for its withdrawal from the market.
February 22, 2010
Vitamin D deficiency in people with HIV/AIDS
The website aidsmap.com has featured a piece on Vitamin D deficiency among people with HIV in its top stories from this year’s annual Conference on Retroviruses and Opportunistic Infections (CROI, San Francisco, Feb. 2010), one of the main yearly meetings for scientific research on HIV/AIDS. Here’s an excerpt from the report, authored by Derek Thaczuk and published 2/19/2010:
Vitamin D deficiency extremely common among HIV-positive patients in diverse regions
[...]
New analyses have found widespread vitamin D insufficiency among American, Italian and Swiss cohorts of HIV-positive patients. [Note: also reported at CROI was a study looking at health outcomes in Tanzanian women with low vitamin D levels.] These data were presented in a poster session and related discussion at the 17th Conference on Retroviruses and Opportunistic Infections (CROI).Vitamin D deficiency was consistently less frequent in Caucasians than in other races. Otherwise, the studies were not entirely consistent as to other risk factors, such as duration or type of antiretroviral treatment.
At the CROI discussion session on Wednesday, moderator Peter Reiss from the University of Amsterdam began by noting that vitamin D deficiency can result in bone density loss, cardiovascular disease, diabetes and insulin resistance, kidney disease, and other metabolic conditions commonly seen in patients with HIV.
[...]
ConclusionsThese studies add to a growing body of evidence that insufficient or deficient vitamin D levels are extremely prevalent among persons with HIV. While prevalence figures (and the cutoff values used to define them) vary, these studies reported insufficiency rates of 54% to 72%; figures which are generally consistent with other reports. Studies in women linked vitamin D deficiency with risk of bacterial vaginosis, thrush, and other health problems.
The single factor invariably associated with insufficiency or deficiency was non-Caucasian race. Otherwise, reported risk factors were not entirely consistent, although several studies identified NNRTI and/or efavirenz use.
Investigators agreed that vitamin D deficiency is prevalent among HIV-positive individuals, has harmful effects on health, and is easily addressable through supplementation. Remaining research questions include the link between deficiency and clinical health outcomes, the impact of supplementation, the best doses for supplementation, and closer comparisons of deficiency rates in people with HIV and in the general population, where deficiency is also common.
Read the full story at
http://www.aidsmap.com/en/news/A17781D3-3857-455D-B13B-D7628DF427C7.asp
January 27, 2010
Info sheet on “Supplements studied for diabetes/insulin resistance”
NYBC has prepared an updated version of its info sheet on the topic of supplements that have been studied for diabetes or insulin resistance. Here’s the text below:
SUPPLEMENTS STUDIED FOR DIABETES/INSULIN RESISTANCE
Multivitamin/multimineral: Regular use of a multivitamin/multimineral supplement helps people with diabetes maintain good health and reduce infections. Clinical evidence indicates that diabetics have unique nutritional needs, and should take a daily multivitamin to supplement their normal diet.
Note: NYBC stocks Jarrow’s Multi 1-to-3; Douglas Lab’s Added Protection, and SuperNutrition’s family of multivitamins (such as the Opti-Pack).
Reference: Barringer, et al. Effect of a Multivitamin and Mineral Supplement on Infection and Quality of Life. Annals of Internal Medicine. 3/4/2003.
Omega-3 fatty acids (Fish Oil): Many people with diabetes have high blood pressure and elevated cholesterol, which can increase the risk of heart disease and stroke. Omega-3 fatty acids have shown benefit for cardiovascular health in recent randomized controlled clinical trials. The FDA has also approved a health claim for fish oil: “supporting but not conclusive evidence shows that the consumption of EPA and DHA omega-3 fatty acids from fish oil may reduce the risk of coronary heart disease.”
Note: NYBC stocks Max DHA –Omega-3 Fish Oil Purified by Molecular Distillation (Jarrow); and ProOmega –Nordic Naturals (60 softgels or 180 softgels).
Alpha-Lipoic Acid: Alpha-Lipoic Acid (ALA) has the ability to assist with glucose metabolism, and also promotes healthy nerve function. A recent study concluded that ALA (600mg) could be useful in helping to treat the symptoms of diabetes-related neuropathy (= generally, pain, tingling, numbness in feet and hands).
Note: NYBC stocks ALA (Montiff) 300mg/60.
Reference: Ametov et al. The sensory symptoms of diabetic polyneuropathy are improved with alpha-lipoic acid: The SYDNEY Trial. Diabetes Care. 2003, 26 (3)
Other supplements studied for diabetes: Chromium and biotin (these two supplements, taken together, are believed to play an active role in balancing insulin production with glucose uptake). Also: evening primrose oil, resveratrol, bitter melon.
Talk to your doctor before you use these or other supplements. Do not discontinue medications you are taking for diabetes/glucose control without first discussing with your healthcare provider any complementary treatments you are considering!
November 3, 2009
Can carnitine reduce diabetes risk and improve body shape?
We were interested to read about a recent study on carnitine, diabetes risk and body shape in people with HIV, as reported on the CATIE (Canadian AIDS Treatment Information Exchange) website:
Some studies have found less-than-normal levels of carnitine in the blood of HIV positive people. Other studies have found that regular supplementation with carnitine can help to reduce abnormal levels of triglycerides, a fatty substance in the blood. Most of the studies focused on a formulation of carnitine called L-carnitine.
Long-term studies of a different formulation of carnitine—acetyl-L-carnitine—suggest that this substance can help damaged nerves recover from the toxicity of certain anti-HIV drugs such as d4T (Zerit, stavudine) and ddI (Videx EC, didanosine).
Now researchers in Milan, Italy, have conducted a small study with HIV positive volunteers and carnitine, to assess its effects on body composition and other related metabolic parameters. The results from this study suggest the possibility of a decreased risk for diabetes. Furthermore, the research team claims that carnitine supplements increased the fat content in the legs of volunteers. We urge readers to exercise caution when interpreting the results of this small study and we provide critical details later in this CATIE News bulletin.
Read more information on the study at:
http://www.catie.ca/catienews.nsf/00a48c8905294f0b8525717f00661eb8/4c5c394577db43018525763f00731b34!OpenDocument
Read more background information at the NYBC entries:
and
September 26, 2008
Lipodystrophy: some comments from Nelson Vergel
Nelson Vergel, long-time AIDS treatment activist and community expert on lipodystrophy, recently posted a good set of guides to understanding this topic:
–D4T and AZT linked to lipoatrophy; some protease inhibitors linked to insulin resistance, which can be related to higher triglycerides and fat cell size in some patients
–exercise helpful for maintaining lean body mass; anabolic steroids for help in regaining normal weight
–supplements like omega-3/fish oil and niacin to help statins and fibrates to lower bad cholesterol (LDL), triglycerides and increasing good cholesterol (HDL)
Also included in the post are reviews of some regimen-switching strategies to counter lipodystrophy.
“Unfortunately,” Nelson concludes, more research is still needed on “lower glycemic index diets, good comparison data of what happens to visceral fat when different protease inhibitors or non-nucleosides are used with Truvada in naives with low and higher CD4 at baseline, diet/exercise combinations, and other supplements like carnitine and others.”
Read the full entry at thebody.com.
September 23, 2008
“Prevention of Diabetes with Nutritional Supplements”
“Prevention of Diabetes with Nutritional Supplements” is the title of a research project funded in 2007 by the National Center for Complementary and Alternative Medicine (an NIH Center). The researchers at University of California – Davis are investigating alpha lipoic acid and a combination of alpha lipoic acid and the omega-3 fatty acid EPA as means to prevent or delay onset of Type 2 diabetes. The researchers are hypothesizing that the combination of ALA and the omega-3 fatty acid (also known as eicosapentaenoic acid, a component of fish oil supplements) may have effect against insulin resistance associated with adult-onset diabetes, and against impairment of pancreatic function.
See also the NYBC entries on the supplements mentioned in this research:
Arctic Omega fish oil (with EPA)
