Herbs may be helpful for Type 2 diabetes

Q: I have a question about herbs that might help lower blood sugar for Type 2 diabetes (non-insulin-dependent). I was interested in trying fenugreek and Gymnema sylvestre. What do you think about them?

A: Many plants have properties that may help lower blood sugar in Type 2 diabetes. Remember, though, that I don't think they are a substitute for conventional treatment, and that it is always important to talk to your doctor before considering them. With that in mind, let's go over the two you mentioned:

Fenugreek. Two studies found that fenugreek seed powder modestly lowered blood sugar in Type 2 diabetes. The caveat is that the studies were short and didn't include a lot of people.

Powdered fenugreek seeds have a high amount of soluble fiber, which helps slow down the rate at which carbohydrates are absorbed from the intestine. Soluble fiber is well-known, even in conventional medicine, to help people with diabetes. It keeps blood sugar from peaking as fast and as high. This means that diabetics don't need to secrete as much insulin to keep up. In addition, fenugreek seeds have a special amino acid known as 4-hydroxyisoleucine. This compound may directly stimulate insulin release from the pancreas, but it seems to depend on how high the blood sugar is.

In case you haven't tried fenugreek, be warned: It has a distinctive bitter taste. One of the chemicals in it, sotolon, is actually used as artificial flavoring for maple syrup. Some people are allergic to it.

Gymnema sylvestre. I love the name of this plant. It has another name too, "Sugar Taste Destroyer," so you can see why people use it for diabetes. For the adventurous among you, try putting a little bit of the powdered leaf on your tongue someday, then eat something sweet. You'll find that you will temporarily lose the ability to taste the sugar. Fascinating.

There is only one study that I know of using gymnema for Type 2 diabetics. They used a specific water-soluble extract of the leaf — called GS4 — for 18 months in addition to conventional treatment, and found that it helped to lower blood sugar.

Five patients were able to come off their medication while staying on the GS4. The downside to this study is that it was small, and there was no control group (a group that didn't do the intervention). Studies without a control group sometimes make results better than they really are because there is nothing to compare them to. Also, as I said above, I don't recommend taking any supplement without reviewing it with your doctor first.

How does gymnema work? Well, that's still being worked out, but some laboratory studies have found that gymnema may reduce the amount of glucose (sugar) people absorb from their intestines. It may also help stimulate growth of the pancreatic beta cells, which are responsible for making insulin. If the latter is true, that would be great since right now we don't have anything in conventional medicine that I know of that helps beta cells grow.

Dr. Astrid Pujari is a Seattle M.D. with an additional degree as a medical herbalist; she practices at the Pujari Center and teaches as part of the residency programs at Virginia Mason and Swedish/Cherry Hill hospitals. Send questions to apujari@seattletimes.com for possible use in future columns. All information is intended for education and not a substitute for medical advice. Consult your doctor before following any suggestions given here.