The biggest recent change in insulin came with the development of recombinant DNA technology that allowed synthesis of a “human” type of insulin from bacteria and yeast rather than relying on animal pancreatic tissue for extraction. Currently insulin must be injected via syringe, pump, or insulin pen. Insulin types are classified not by their source; but rather by how fast they start to work and how long their effects last.
Intensive insulin therapy has been made possible largely through the development of breakthrough immediate-acting insulins (insulin lispro [Humalog] and insulin aspart [Novolog]) as well as a novel very-long-acting insulin (insulin glargine [Lantus}). Lantus provides a near-constant (basal) release of insulin for one full day. Intensive insulin therapy requires much more frequent testing of blood glucose and frequent injections, the timing and the dose of insulin can be easily adjusted to accommodate daily variations in the diabetic’s eating and exercise schedule and food intake. The decision to use multiple injections of insulin versus an insulin pump depends on the preference of the patient and the ability of the health care provider and diabetes teaching unit to provide the necessary resources and support.
The insulin pump approximates the natural levels of insulin in the best of currently available techniques, but it is not without drawbacks. The device must be worn constantly and can be in irritation. Also, the risk of hypoglycemia is greater. The wearer must be highly motivated, able to operate the pump, willing to test blood glucose frequently, and astute enough to know when a problem is developing
One of the key advantages of the insulin pen is convenience and is usually a strong motivator to make the switch from the syringe-and-needle approach. It is inconspicuous, quick, and easy. It is also less painful because smaller-gauge needles are used. Use of an insulin pen or pump requires the user to recognize factors that may cause a change in their blood sugar levels.
The therapy goals for individuals with type 1 diabetes with supportive natural products involves:
- Preserving beta cell function and possibly reversing the autoimmune process
- Enhancing the effectiveness of insulin therapy to allow for lower dosages
- Reducing after-meal elevations in blood sugar levels
The key to stopping type 1 diabetes is to start therapy as soon as possible after the diagnosis or within the first year at the latest. The two key supplements are the niacinamide form of vitamin B3 and green tea extract or the herb Pterocarpus marsupium. Niacinamide has been shown to prevent some of the immune-mediated destruction of the pancreatic beta cells and may actually help reverse the process. The plant pterocarpus has a long history of use in India as a treatment for diabetes.
Individuals with poorly controlled type 1 diabetes should consider taking biotin, Gymnema sylvestre, or Korean ginseng extract to try to improve insulin utilization. Biotin is a B vitamin that functions in the manufacture and use of carbohydrates, fats, and amino acids. Biotin supplementation has been shown to enhance insulin sensitivity and increase the activity of the enzyme glucokinase, the enzyme responsible for the first step in the use of glucose by the liver.
Gymnema is another plant from India that has long been used as a treatment for diabetes. It has been shown to enhance glucose control in diabetic dogs and rabbits. There is evidence in animal studies that gymnema promotes regeneration of the insulin-producing beta cells in the pancreas. No side effects have been reported from gymnema extract; however, diabetics on insulin should be careful to monitor blood sugar when beginning this product because insulin dosages may have to be decreased to avoid hypoglycemia.
Part 9: Natural Products for Type 2 Diabetes
Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)