Toward practical prevention of type 2 diabetes.
Even in individuals who are unwilling to make prudent changes in their diets and sedentary habits, the administration of certain nutrients and/or drugs may help to prevent or postpone the onset of type 2 diabetes. The evident ability of fiber-rich cereal products to decrease diabetes risk, as documented in prospective epidemiological studies, may be mediated primarily by the superior magnesium content of such foods. High-magnesium diets have preventive (though not curative) activity in certain rodent models of diabetes; conversely, magnesium depletion provokes insulin resistance. Epidemiology also strongly suggests that regular moderate alcohol consumption has a major favorable impact on diabetes risk, particularly in women; this may reflect a direct insulin-sensitizing effect on muscle and, in women, a reduced risk for obesity. Chromium picolinate can also aid muscle insulin sensitivity, and initial reports suggest that it is an effective therapy for type 2 diabetes. High-dose biotin has shown therapeutic activity in diabetic rats and in limited clinical experience; increased expression of glucokinase in hepatocytes may mediate this benefit. Other nutrients that might prove to aid diabetic glycemic control, and thus have potential for prevention, include coenzyme Q and conjugated linoleic acids (CLA). Since the nutrients cited here - including ethanol in moderation - appear to be quite safe and (with the exception of CLA) quite affordable, supplementation with these nutrients may prove to be a practical strategy for diabetes prevention. Drugs such as metformin and troglitazone, which are expensive and require regular physician monitoring to avoid potentially dangerous side-effects, would appear to be less practical options from cost-effectiveness, convenience and safety standpoints, given the fact that the population at-risk for diabetes is huge.
McCarty
M F
MF
Pantox Laboratories, San Diego, USA.
D000818:Animals; D001710:Biotin / Q000008:administration & dosage / Q000627:therapeutic use; D002118:Calcium / Q000378:metabolism; D002839:Chromans / Q000627:therapeutic use; D003067:Coenzymes; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism / Q000503:physiopathology / Q000517:prevention & control*; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008274:Magnesium / Q000627:therapeutic use; D008297:Male; D008687:Metformin / Q000627:therapeutic use; D051381:Rats; D012307:Risk Factors; D013844:Thiazoles / Q000627:therapeutic use; D045162:Thiazolidinediones; D000077288:Troglitazone; D014451:Ubiquinone / Q000031:analogs & derivatives / Q000627:therapeutic use; D017962:alpha-Linolenic Acid / Q000627:therapeutic use
D002839:Chromans; D003067:Coenzymes; D013844:Thiazoles; D045162:Thiazolidinediones; D017962:alpha-Linolenic Acid; D014451:Ubiquinone; D000431:Ethanol; D001710:Biotin; D008687:Metformin; C024989:coenzyme Q10; D008274:Magnesium; D000077288:Troglitazone; D002118:Calcium