From Berberine to Vitamin D: Top Supplements for T2DM

on Sep 20, 2023| Modified on Jan 01, 2024
Diabetes Supplements

Type 2 Diabetes Mellitus (T2DM) affects approximately 11.3% of the US population or an estimated 28.7 million people. In contrast, prediabetes affects approximately 96 million American adults, which is more than one in three; of these, about 80% are unaware that they are prediabetic. These basic and straightforward statistics make it abundantly clear just how much of a health problem diabetes is.

When you consider the known complications of diabetes, the seriousness of the problem becomes more apparent, and it is a severe problem indeed when you consider what those diabetic complications are.

Diabetic Complications

The following is an incomplete list of diabetic complications, which seems to grow with the increasing length of the disease.

1. Cardiovascular Disease (CVD), including heart disease, hypertension, and stroke, among others. An almost double risk for diabetics.

2. Diabetic Neuropathy (DN) and nerve damage in many body areas, including the digestive system. These can lead to pain throughout the body and digestive issues such as constipation, diarrhea, nausea, and abdominal discomfort.

3. Diabetic Retinopathy (DR), which can lead to poor vision and blindness.

4. Loss of Muscle function.

5. Chronic Kidney Disease (CKD)

6. Digestion Issues

7. Erectile Dysfunction (ED) and or loss of libido in men and women.

8. Infection in various areas of the body, including diabetic skin ulcers, which often have a very hard time healing and can become seriously infected and cause gangrene and possibly amputation in more serious cases.

9. Dental Issues affecting both gums and teeth.

10. Osteoporosis and Frailty

11. Loss of reflexes.

12. Nerve Damage that results in Foot Ulcers.

13. Bladder issues such as difficulty in emptying the bladder or incontinence.

14. Autonomic Neuropathy, which can lead to problems with sweating, heart rate, and blood pressure.

15. Nerve damage can also lead to hearing problems as the high glucose levels damage nerves throughout the body.

16. Skin problems include dryness, slow wound healing, and skin infections.

17. Increased risk of falls.

18. Sleep Apnea

19  Cognitive Impairment, including increased risk for Alzheimer's disease, other forms of dementia and Parkinson's disease.

20. Diabetes Distress, which can result in anxiety and depression.

21. Anemia

Clearly, from the above, you can see the importance of doing your utmost to thwart T2DM early on before the complications pile up because each new complication brings further complications and health issues. As a basic example, kidney damage can eventually result in having to have dialysis multiple times per week, having to drastically alter your diet,  insomnia, hypertension, hypotension, itching, anemia, muscle cramps, pericarditis and bone diseases, to name only a few, while the underlying disease (T2DM) is still smoldering away.

Much of the damage and problems listed above are caused by the constantly elevated glucose levels seen in diabetics as well as the elevated oxidative stress levels and inflammation associated with those high glucose levels.

So, three very important targets in diabetes are elevated glucose levels, elevated oxidative stress (OS) levels, and elevated inflammation levels, with elevated glucose levels being the primary target and elevated OS and inflammation being secondary targets.

Disclaimer:

Since T2DM is a serious disease, you must consult your doctor and healthcare professional to ensure that the supplements below will be safe for you and compatible with all medications you are taking or plan to take.

Top Supplements for Diabetes Type II

So, having these three targets in mind, I will discuss supplements that have shown the ability to ameliorate these three. Since I want to mention several supplements, I will allocate one study or article for each supplement to limit the length of this writing. I will discuss these supplements' abilities to alter the abovementioned three targets.

1. Berberine

2. Vitamin K2M7

3. Magnesium Glycinate

4. Amla Extract

5. Taurine

6. Vitamin D

Berberine

The first supplement I would like to discuss is Berberine. Berberine has shown the ability to inhibit all three targets in diabetes and has shown synergy with common diabetes medications such as Metformin. The following link to a new RCT study (September 2023) discusses some of the effects of berberine in prediabetics :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10483788/

Here is a relevant study quote :

' After 12 weeks, berberine (HIMABERB®) intervention in individuals with prediabetes significantly reduced glycemic control markers, with mean FPG and 2 h-OTGG being reduced to below prediabetic thresholds, supporting the investigation of the use of HIMABERB® for delaying progression to diabetes mellitus. '

It is important to emphasize that the dose used in this study is considered as standard berberine dosing based on previous studies, 1500 mg/day in three divided doses of 500 mg at breakfast, lunch and dinner. It is also important to note that berberine after just 12 weeks of use was able to move the participants from the prediabetic range to the normal range.

Vitamin K2 Menaquinone 7

This next study discusses the use and effectiveness of vitamin K2 Menaquinone 7 in diabetics and diabetic model mice  to significantly lower fasting serum glucose,  insulin and HbA1c during the 6 month study at just 90 mcg/day, a fairly low dose in relation to common K2 supplements which are generally 100 mcg, 200 mcg, 300 mcg or 600 mcg from retail suppliers :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10163743/

Here is a relevant study quote describing  how vitamin K2 works to try and alter the gut microbiome in order to significantly improve glucose control :

' In conclusion, combining the existing studies on vitamin K2, our findings revealed MK-7 is a beneficial nutrient for both the host and the gut microbiota. Moreover, the microbiota and its metabolites are key intermediates factors in MK-7 intervention that regulate host glucose metabolism and insulin sensitivity. Given that metabolic diseases can lead to a reduction in VK2-producing microbes, this gut-derived evidence may facilitate the clinical implementation of vitamin K2 as an effective postbiotic for diabetes management. '

It is worth mentioning that there is currently significant evidence for the use of prebiotics, probiotics, synbiotics, and in this case, postbiotic (K2M7), fermented foods and drinks (Kefir) as beneficial in managing diabetes.

Magnesium

Next up is magnesium in an optimally bioavailable form such as magnesium glycinate, magnesium citrate, magnesium taurate and magnesium malate. The following  meta analysis discusses the benefits of magnesium in prediabetics and diabetics :

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8619199/

Here is a relevant quote from the meta-analysis of multiple studies :

' Compared with placebo, Mg supplementation reduced fasting plasma glucose in people with diabetes. In people at high risk of diabetes, Mg supplementation significantly improved plasma glucose per se, and after a 2 h oral glucose tolerance test. Furthermore, Mg supplementation demonstrated an improvement in insulin sensitivity markers. In conclusion, Mg supplementation appears to have a beneficial role and improves glucose parameters in people with diabetes. Moreover, our work indicates that Mg supplementation may improve insulin-sensitivity parameters in those at high risk of diabetes. '

Interestingly in hundreds of other studies, magnesium has also shown multiple other health benefits, including an inverse association between cardiovascular disease and magnesium intake. Magnesium citrate can also help with diabetes-associated constipation, but should be alternated with other bioavailable forms of magnesium, such as magnesium glycinate, once the constipation is managed.

Amla Extract

Amla Has shown its hypoglycemic effects and hypolipidemic effects in multiple studies plus it has shown the potential to have a positive impact on diabetic complications as discussed in the following  review of multiple studies :

https://www.mdpi.com/1661-3821/3/3/26

Here is a relevant quote from the comprehensive review of Amla for diabetes:

' E. officinalis (Amla) is an important traditionally used medicinal plant well-known for its anti-diabetic activities. At present, increasing shreds of evidence show that EOF can alleviate the symptoms of diabetes with obvious hypoglycemic and hypolipidemic effects. Moreover, EOF is efficacious in managing the course of diabetic complications that are mostly unresponsive to anti-diabetic drugs. The anti-diabetic activities of EOF appear to be achieved by multidirectional mechanisms including antioxidant activities, inhibition of poly(ADP-ribose) polymerase/ poly(ADP-ribose) glycohydrolase (PARP/PARG) activation, inhibition of carbohydrate-metabolizing enzymes, regulation of glucose homeostasis, alleviation of mitochondrial dysfunction, inhibition of polyol pathway, inhibition of advanced glycation end products (AGEs) formation, and regeneration and rejuvenation of β-cells. '

It is also worth mentioning that Amla fights against the other two targets, oxidative stress (OS) as well as elevated inflammation. Here is another study quote describing the antioxidative stress effects of Amla:

' β-glucogallin (a significant component of amla extract) has many phytopharmaceutical activities, mainly due to its antioxidant properties. β-glucogallin has been reported to upregulate antioxidant enzymes such as GSH, catalase, and SOD. Its free-radical-scavenging property was shown to offer protection in several diseases including diabetes [49]. β-glucogallin is a potent and selective inhibitor of the enzyme aldose reductase, which is responsible for developing oxidative stress and secondary complications in diabetes. Inhibitory efficacy of β-glucogallin was demonstrated in vitro and in lens tissues in an ex vivo model. '

Amla can also synergistically increase the blood glucose-lowering effect of the common diabetic prescription medication, Metformin.

Taurine

Taurine has been shown to reduce fasting blood glucose in diabetics at 3 grams per day in a randomized, double blind, placebo controlled trial (RCT). In the following RCT it was also shown to reduce MDA (a marker for oxidative stress), TNF-alpha and hs-CRP (markers of inflammation) significantly.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6990511/

Here is a relevant quote from the RCT :

' The findings of this study showed that taurine supplementation improved some oxidative stress indices and inflammatory biomarkers in patients with T2DM. '

In a similar study also using 3 grams of taurine :

https://pubmed.ncbi.nlm.nih.gov/32472292/

A relevant study quote :

' At the end of the study, levels of FBS (p = 0.01), insulin (p = 0.01), HOMA-IR (p = 0.003), TC (p = 0.013), and LDL-C (p = 0.041) significantly decreased in the taurine group compared to the placebo group. '

Although 3 grams may seem like a large dose, other studies use taurine at 6 grams per day. Buying taurine in bulk powder makes it easy to take, as it can be easily dissolved in a juice such as orange juice or other juice and has little to no taste. It is also less expensive to buy in bulk powder form.

Vitamin D

Vitamin D deficiency and insufficiency is thought to be a contributing factor for prediabetes and diabetes. In the following review and meta analysis of multiple RCTs, vitamin D supplementation reduced the risk for diabetes as discussed here :

https://pubmed.ncbi.nlm.nih.gov/36745886/

Here is a relevant quote from the review and meta-analysis:

' Among participants assigned to the vitamin D group who maintained an intratrial mean serum 25-hydroxyvitamin D level of at least 125 nmol/L (≥50 ng/mL) compared with 50 to 74 nmol/L (20 to 29 ng/mL) during follow-up, cholecalciferol reduced risk for diabetes by 76% (hazard ratio, 0.24 [CI, 0.16 to 0.36]), with a 3-year absolute risk reduction of 18.1% (CI, 11.7% to 24.6%). Vitamin D increased the likelihood of regression to normal glucose regulation by 30% (rate ratio, 1.30 [CI, 1.16 to 1.46]). There was no evidence of difference in the rate ratios for adverse events (kidney stones: 1.17 [CI, 0.69 to 1.99]; hypercalcemia: 2.34 [CI, 0.83 to 6.66]; hypercalciuria: 1.65 [CI, 0.83 to 3.28]; death: 0.85 [CI, 0.31 to 2.36]). '

So this study seems to show that the dose is not what is important but rather getting the vitamin D level to greater than 50 ng/ml minimum and keeping it up there. The study participants who were able to do that showed the benefit of vitamin D reducing the risk for diabetes by 76%.

The health value of vitamin D does not stop there as hundreds of studies have shown. Importantly vitamin D has shown synergy with other supplements such as magnesium, taurine, berberine and vitamin K2 which in the context of this article is very important.

Dosing

The following dosing is based on the study dosing, but consulting with your doctor is mandatory to ensure proper dosing for you and your safety and compatibility with all of your medications.

1. Berberine - 1500 mg total per day in three divided doses of 500 mg at breakfast, lunch, and dinner.

2. Vitamin K2 M7 - 200 to 300 mcg per day. Both sizes are commonly available in a small soft gel for easy swallowing.

3. Magnesium - Maximum allowable dose of elemental magnesium. Men : 400 - 420 mg/day Women: 310 - 320 mg/day. This generally requires 3 capsules of magnesium glycinate per day.

4. Amla Extract - 1000 mg per day in two divided doses of 500 mg each, such as with breakfast and dinner.

5. Taurine - 3 grams per day in three doses of 1 gram each dissolved in juice. This dose has been used in multiple studies.

6. Vitamin D - Whatever dose is needed to reach a 25 OH d level of at least 51 ng/ml.

The above supplements have supportive studies and are commonly available at a reasonable cost and may be all that is needed to manage type 2 diabetes in many people effectively.

Many other supplements have shown varying degrees of benefit for diabetes and its complications, such as astaxanthin, chromium, cinnamon, probiotic yogurt, kefir, melatonin, ginger extract, r-alpha lipoic acid, vanadium, vitamin B6, synbiotics, hesperidin + diosmin, ACV, benfotiamine, green tea extract, curcumin, NAC, prickly pear cactus etc.

I have previously written another article about insulin resistance, which is often a major contributing factor in diabetes and many other diseases. Supplements that help alleviate insulin resistance are often useful for diabetes and or diabetes complications. Here is a link to that article:

https://www.earthclinic.com/cures/insulin-resistance.html

Conclusion

T2DM causes many additional complications, and controlling high glucose levels, oxidative stress and inflammation early on in the disease process shows significant potential to ameliorate or prevent these serious complications and manage T2DM while significantly improving quality of life and affording other potential health benefits. I have outlined six supplements that have shown the potential to effectively manage T2DM and its many complications, while some supplements have shown synergy with standard diabetic medications. The above-mentioned supplements are very likely to confer other health benefits unrelated to diabetes, a definite plus!

  Art


Question or Comment for Art? Please write him here and he will reply to your post!

Related Links:

Diabetes Type II and Berberine: Dosage and Research
Diabetic Neuropathy Remedies
Magnesium for Diabetes Type II
Natural Remedies for Diabetes Type II




Article Feedback

1 User Review
5 star (1) 
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Posted by Kik (Boston, MA ) on 11/23/2023
★★★★★

Hello Art,

Thank you for a well researched and very helpful article. I am currently taking Vit D3+K2 and Magnesium as I am aware of the multitude of health benefits they provide. However, I haven't even heard of Amla and am very encouraged to add this to my supplements as I have high levels of inflammation and oxidative stress. Thank you again for this wonderful article.

Replied by Art
(California)
11/24/2023
2211 posts

Kik,

Thank you for saying so and you are very welcome!

Art


Article Updates

2 User Reviews
5 star (2) 
  100%

Posted by Art (California) on 01/01/2024 2211 posts
★★★★★

Happy New Year all!

Since the holidays are now over and people realize that they may have overdone it during the holiday season in terms of eating and especially larger than usual consumption of sweets, I thought it might be a good time to update this article on type 2 diabetes mellitus (T2DM).

In the recent study link (10/23) below, it further highlights the importance of vitamin K2 in people with diabetes by showing that when compared to healthy controls, people with T2DM have very significantly lower levels of vitamin K2:

https://pubmed.ncbi.nlm.nih.gov/38096508/

Here is an important quote from the abstract of the study that people with T2DM should be very aware of :

The mean±Standard Deviation (SD) of vitamin K2 levels for the type 2 diabetes group were (185.13±30.08) pg/ml, with a highly significant decrease (p<0.001) when compared with the control group (303.91±58.60) pg/ml. The HbA1c, cholesterol, TG, and LDL-C level for the type 2 diabetes group highly significant increase (p<0.001) when compared with the control while HDL-C decreased when compared with the control group. The current study concluded that: Vitamin K2 levels showed a highly significant decrease in patients with uncontrolled type 2 diabetes mellitus when compared with those in the control group. Vitamin K2 levels play an important role in improving glycated haemoglobin and lipid profiles in patients with type 2 diabetes mellitus.

This is just further evidence of the value of vitamin K2 in people with diabetes. The above readings show a mean 118 pg/ml lower level of vitamin K2 in the diabetic group compared to the healthy control group. (185.13±30.08) pg/ml vs (303.91±58.60) pg/ml.

Art


Article Updates
Posted by Earth Clinic on 09/25/2023
★★★★★

Don't miss reading Art's latest article on 6 top supplements for managing T2DM!

https://www.earthclinic.com/cures/supplements-for-type-2-diabetes-mellitus-guide.html

Thank you so much, Art!



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