Algorithm for complementary and alternative medicine practice and research in type 2 diabetes.
OBJECTIVE
To develop a model to direct the prescription of nutritional and botanical medicines in the treatment of type 2 diabetes for both clinical and research purposes.


METHODS
Available literature on nutritional and botanical medicines was reviewed and categorized as follows: antioxidant/anti-inflammatory; insulin sensitizer; and beta-cell protectant/insulin secretagogue. Literature describing laboratory assessment for glycemic control, insulin resistance, and beta-cell reserve was also reviewed and a clinical decision tree was developed.


RESULTS
Clinical algorithms were created to guide the use of nutritional and botanic medicines using validated laboratory measures of glycemic control, insulin sensitivity, and beta-cell reserve. Nutrient and botanic medicines with clinical trial research support include coenzyme Q10, carnitine, alpha-lipoic acid, N-acetylcysteine, vitamin D, vitamin C, vitamin E, chromium, vanadium, omega-3 fatty acids, cinnamon (Cinnamomum cassia), fenugreek (Trigonella foenum-graecum), and gymnema (Gymnema sylvestre).


CONCLUSIONS
Clinical algorithms can direct supplementation in clinical practice and provide research models for clinical investigation. Algorithms also provide a framework for integration of future evidence as it becomes available. Research funding to investigate potentially beneficial practices in complementary medicine is critically important for optimal patient care and safety.
Bradley
Ryan
R
Bastyr University, Kenmore, WA 98028, USA. rbradley@bastyr.edu
Oberg
Erica B
EB
Calabrese
Carlo
C
Standish
Leanna J
LJ
D000465:Algorithms; D000975:Antioxidants / Q000627:therapeutic use; D000529:Complementary Therapies / Q000379:methods / Q000458:organization & administration*; D018849:Controlled Clinical Trials as Topic; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000628:therapy*; D019587:Dietary Supplements; D029001:Herbal Medicine / Q000379:methods; D006801:Humans; D007333:Insulin Resistance; D008903:Minerals / Q000627:therapeutic use; D008517:Phytotherapy / Q000379:methods; D010946:Plants, Medicinal; D012107:Research Design; D014815:Vitamins / Q000627:therapeutic use
D000975:Antioxidants; D008903:Minerals; D014815:Vitamins