Herbal Supplements (Bitter melon (Momordica charantia), Fenugreek (Trigonella foenum graecum), Cinnamon, Tulsi (Ocimum sanctum), Neem (Azadirachta indica), Onion (Allium Cepa), Garlic (Allium Sativum), Ginseng, Aloe vera, Fig (Ficus carica), Mango Leaves (Mangifera indica), Eucalyptus globulus, Bilberry (Vaccinium myrtillus), Black berry (Syzygium cumini), Banana (Musa sapientum) and Gurmar (Gymnema sylvestre), Dietary Suuplements (Chromium, Vanadium and Alpha Lipoic acid) and Physical interventions (Yoga, Acupuncture, Hydrotherapy, Massage Therapy, Aromatherapy, Chromotherapy, Biofeedback) are the common employed CAM practices to treat Diabetes.

1. Complementary and
Alternative Therapies
for Diabetes
Dr. P.Naina Mohamed PhD
Pharm aco lo g ist

2. Introduction
 The therapies which could be combined with
conventional medicine is termed “Complementary
Medicine”.
 “AlternativeMedicine” includes therapies that are
used in place of conventional medicine.
 “ComplementaryandAlternativeMedicine”(CAM)
refers to a wide range of clinical therapies outside
the conventional medicine.
 “ConventionalMedicine” is a type of medicine
practiced by medical doctors and by allied health
professionals, such as physical therapists,
psychologists, and registered nurses. It is also called
Western orAllopathic medicine.
 “IntegrativeMedicine” represents a combination of

3. CAMUse
 An US study reported that the Complementary and
Alternative Medicine (CAM) use is high and continues to
increase.
 The most important reason cited by patients for the
supplemental CAM use is the perception that CAM is
harmless.
 CAM use is highest in patients include
 Female
 Nonsmokers
 Physically active
 Having normal body mass index (BMI)
 Eating low-fat diets with a high fruit and vegetable content

4. Types of CAMPractices
 Mind-Body and Manipulative
Practices
 Traditional Medical Systems
 "Modern"Medical Systems

5. Mind and Body
Practices

 Acupuncture and Acupressure
 Yoga
 Hypnosis
 Massage
 Meditation
 Reflexology Alexander technique
 Tai chi
 Spinal manipulation
 Therapeutic touch
 Guided imagery
 Rolfing/structural integration

6. Traditional Medical Systems

• Ayurvedic medicine
• Siddha medicine
• Unani medicine
• Native American medicine
• Tibetan medicine
• Traditional Chinese medicine
• Curanderismo

7. "Modern"Medical Systems

•Homeopathy
•Naturopathy
•Osteopathy
•Chiropractic
•Anthroposophic medicine

8. Diabetes
 Diabetes is a group of metabolic disorders characterized by prolonged
Hyperglycemia(High blood glucose) having symptoms such as Polyuria
(Frequent urination), Polydipsia(Increased thirst) and Polyphagia
(Increased hunger).
 Untreated diabetes can cause
 Acutecomplications - Diabetic ketoacidosis and nonketotic hyperosmolar
coma
 Chronic complications - Cardiovascular disease, Stroke, Chronic kidney
failure (Nephropathy), Foot ulcers and damage to the eyes (Retinopathy)
 Diabetes might be caused either by inadequate insulin production or by
improper body’s response to insulin or both.
 Failure of Pancreas to produce enough insulin results in to Type1
diabetes.
 Type2diabetes caused by insulin resistance (cells’ improper response to
insulin)
 Diabetes can be prevented and treated by

9. CAMused forDiabetes
 Herbal Supplements
 Bittermelon (Mo m o rdica charantia )
 Fenugreek(Trig o ne lla fo e num g rae cum )
 Cinnamon
 Tulsi (O cim um sanctum )
 Neem(Azadirachta indica )
 Onion (Allium Ce pa)
 Garlic (Allium Sativum )
 Ginseng
 Aloe vera
 Fig (Ficus carica)
 Mango Leaves (Mang ife ra indica)
 Eucalyptus globulus
 Bilberry (Vaccinium myrtillus)
 Blackberry (Syzyg ium cum ini)
 Banana (Musa sapie ntum )
 Gurmar(Gym ne m a sylve stre )

10. CAMused forDiabetes
 Dietary Suuplements
 Chromium
 Vanadium
 Alpha Lipoic acid
 Physical interventions
 Yoga
 Acupuncture
 Hydrotherapy
 Massage Therapy
 Aromatherapy
 Chromotherapy
 Biofeedback

11. Bittergourdo rBittermelon
(Mo m o rdica Charantia )
 Bitter gourd is believed to posses anti-diabetic, anti-viral,
anti-bacterial and anticancer properties.
 The active constituents such as charantin, vicine and
insulin like polypeptide were found in Bitter gourd extract.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4027280/

12. Fenugreek
(Trig o ne lla fo e num
g rae cum )
 Fenugreek has shown antioxidant, antidiabetic and
hypocholesterolaemic properties.
 The active principles of Fenugreek include the alkaloid
gonelline, nicotinic acid and coumarin.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3210251/

13. Cinnamon
 Cinnamon is known to have anti diabetic, anti oxidant, anti
inflammatory and anti bacterial properties.
https://nutritionj.biomedcentral.com/articles/10.1186/1475-2891-1

14. Tulsi
(O cim um sanctum )
 Tulsi has been suggested to possess antidiabetic, antifertility,
anticancer, antifungal, antimicrobial, cardioprotective, analgesic,
antispasmodic and adaptogenic actions.
 Tulsi has been recommended for the treatment of bronchitis, malaria,
diarrhea, dysentery, skinalso disease, arthritis, eye diseases, insect
bites, etc.
 Tulsi leaf contains Eugenol (responsible for the therapeutic
potentials), Euginal, Urosolic acid, etc.

15. Neem
(Az adirachta indica )
 Neem has been used to treat diabetes for long.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC32496

16. Onion (Allium Ce pa) &
Garlic (Allium Sativum )
 Onion and Garlic have antidiabetic, antioxidant,
antihypertensive and antihyperlipidemic effects.
 Sulphur containing compounds Allyl propyl disulfide
(APDS) found in onions and Diallyl disulfide (allian) found
in garlic.
http://

17. Ginseng
 Constituents of all ginseng species include ginsenosides,
polysaccharides, peptides, polyacetylenic alcohol and fatty
acids.
 Ginseng has antidiabetic and immunostimulant properties.
http://www.academicjournals.org/journal/JDE/article-full-text-pdf/6

18. Aloe Vera
 Aloe gel contains glucomannan, a
hydrosoluble fibre which has a glucose
lowering effect.

19. Fig
(Ficus carica)
 The leaf contains psoralen, beta-sitosterol,
bergapten, and taraxasterol.
http://www.tandfonline.com/doi/abs/10.1076/1388-02

20. Mango Leaves
(Mang ife ra indica )
 Mango has been used as an antidiabetic agent in
Ayurvedic and Nigerian folk medicine.
 The chemical constituents of the Mango include
Mangiferin, isomangiferin, tannins & gallic acid derivatives.
 Mango exhibits potent antidiabetic, antihyperlipidemic,
antiatherogenic and antioxidant properties.
http://www.phcogrev.com/article.asp?issn=0973-7847;year=2010;volume=4;is

21. Eucalyptus globulus
 The active constituents of Eucalyptus include terpenes
and tri-terpenoids, flavonoids, flavanols, gallotannins,
quercetin, euglobals, procyanidins, macro carpals.
 Biological actions of Eucalyptus include antidiabetic,
antibacterial, antioxidant, antiinflammatory, antimalarial
and antitumor promoting activities.
http://www.wjgnet.com/1948-9358/full/v4/i5/170.htm

22. Bilberry
(Vaccinium myrtillus)
 Bilberry has been reported to have antidiabetic, anti-
inflammatory, antioxidant and antihyperlipidemic effects.
 Bilberry is rich in Anthocyanins (cyanidins and
delphinidins).
http://www.ncbi.nlm.nih.gov/books/NBK92770/

23. Blackberry
(Syz yg ium cum ini)
Blackberry fruit contains high levels of anthocyanins and
other phenolic compounds.
https://www.researchgate.net/publication/51797169_The_Blackb

24. Banana
(Musa sapie ntum )
 Banana has been known to have Antidiabetic, Antioxidant,
Antiulcer, Hypocholesterolaemic and Antibacterial effects.
http://www.ncbi.nlm.nih.gov/pubmed/23955414

25. Gurmar
(Gym ne m a sylve stre )
 Gurmar (Gymnema sylvestre) extract has long
been used as a treatment for diabetes.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC32
49697/

26. Chromium
 Supplemental chromium has been shown to decrease fasting glucose
levels, improve glucose tolerance, lower insulin levels and decrease
total cholesterol and triglycerides.
 Foods rich in chromium include brewer’s yeast, barley flour, broccoli,
grape juice, whole wheat, potatoes, garlic, basil, orange juice and red
wine.
 Chromium depletion can be induced by refined sugars, white flour
products, and lack of exercise.

27. Vanadium
 Vanadium was used to control blood glucose
levels prior to the discovery of insulin.
http://onlinelibrary.wiley.com/doi/10.1111/j.1464-549

28. Alpha Lipoic Acid
 Alpha lipoic acid is an antioxidant.
 Alpha lipoic acid may be particularly useful in slowing the
development of diabetic complications such as diabetic
neuropathy.
 A number of experimental and clinical studies have shown
that Alpha lipoic acid is useful in heavy metal poisoning,
radiation damage, ischemia-reperfusion injury, and
diabetes and its various complications.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3221300/

29. Yoga
 Yoga is an old, traditional, Indian
psychological, physical and spiritual exercise
regimen.
 Yoga has been studied for several decades for
its role in the management of Diabetes,
Hypertension, Asthma, Obesity and psychiatric
illness.

30. Acupuncture
 Acupuncture has been shown useful to treat
Diabetes, Chronic pain, etc.
 Acupuncture also has an anti-obesity effect.
http://www.academicjournals.org/journal/JDE/article

31. Hydrotherapy
(Hot tub therapy)
Hydrotherapy (Hot tub therapy) found to reduce body
weight, mean plasma glucose level and mean glycosylated
haemoglobin.
Patients should be warned to use water which is not too hot
to avoid burning.

32. Massage therapy
 Massage has been recommended for diabetes for nearly 100 years.
 Uncontrolled studies suggest that massage may help normalize blood
glucose and symptoms of diabetic neuropathy.
 Massage at an insulin injection site can increase serum insulin action
significantly.
http://spectrum.diabetesjournals.org/content/14/4/218.full

33. Aromatherapy
 Aromatherapy use essential oils to treat several diseases.
 Aromatherapy utilize methods such as inhalation, local application and
baths to penetrate the human skin.
 Aromatherapy can be employed to get relief from numerous ailments
like depression, indigestion, headache, insomnia, muscular pain,
respiratory problems, skin ailments, swollen joints, urine associated
complications e tc.
 Consult with diabetic health care team before using any

34. Chromotherapy
 Chromotherapy involves therapeutic use of colors.
 According to Chromotherapy, lack of color harmony in the human
system may cause diseases and by the use of colored light to the
body, the imbalance can be removed.
 According to chromotherapy, diabetes is generally caused by a
deficiency of orange and yellow colors in the body.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249697/

35. Biofeedback
 Biofeed back is a therapeutic technique involving an
instrument that provides information about psychological
activity such as skin temperature or muscle tension, with
the objective of learning control over maladaptive
response to stress.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3249697/

36. TIPS on choosing
Dietary Supplements
 Before considering any dietary supplement,
consult with a health care provider.
 Do not replace scientifically proven antidiabetics
with unproven health products or practices.
 Always remember that dietary supplements may
interact with medications or other dietary
supplements.
 Discuss with the health care providers about the
current use of any CAM approaches.

37. Conclusion
 Due to lack of strong scientific evidences, CAM should be used for
diabetes with caution.
 The safely and efficacy of CAM therapies for diabetes need to be
further evaluated by well designed and controlled clinical studies.
 In addition to conventional therapy, exercise, weight control and
nutrition remain key elements of diabetes management.
 The American Diabetes Association (ADA) recommends that diabetics
should engage in at least 150 minutes of moderate to intense aerobic
physical activity weekly.
 Being physically active can improve blood sugar, blood pressure, and
cholesterol levels, improve body’s ability to use insulin, strengthen
heart and bones, keep joints flexible and reduce the risk of falling.
 A healthy diet can help to feel better, lose weight and lower the risk of
heart disease, stroke, and other diabetes-related conditions.

38. References
 Textbookof Complementary and Alternative Medicine
Chun-Su Yuan, Eric J. Bieber
 Evidence Based Guide to Complementary and Alternative
Medicine
Bradly P. Jacobs, Katherine Gundling
 Harrison's Online
Featuring the complete contents of Harriso n's Principle s o f
Inte rnalMe dicine , 1 8 e
Dan L. Longo, Anthony S. Fauci, Dennis L. Kasper,
Stephen L. Hauser, J. Larry Jameson, Joseph Loscalzo,
Eds.
 CURRENT Medical Diagnosis & Treatment 2013
Maxine A. Papadakis, Stephen J. McPhee, Eds.
Michael W. Rabow, Associate Ed.

39. References
 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3
249697/
 https://nutritionj.biomedcentral.com/articles/10.1
186/1475-2891-13-102
 https://nccih.nih.gov/health/diabetes/supplemen
ts
 http://care.diabetesjournals.org/content/25/2/32
4.full.pdf+html
 http://www.hindawi.com/journals/ecam/2011/98
3792/
 http://www.academicjournals.org/journal/JDE/ar