title: Algorithm for complementary and alternative medicine practice and research in type 2 diabetes.
abstract: 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.
authors.affiliation: Bastyr University, Kenmore, WA 98028, USA. rbradley@bastyr.edu
authors.forename: Ryan
authors.initials: R
authors.lastname: Bradley
authors.forename: Erica B
authors.initials: EB
authors.lastname: Oberg
authors.forename: Carlo
authors.initials: C
authors.lastname: Calabrese
authors.forename: Leanna J
authors.initials: LJ
authors.lastname: Standish
mesh_terms: 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
chemical_list: D000975:Antioxidants; D008903:Minerals; D014815:Vitamins