Supplement Question(s)

Hi there! I don't really feel that supplements and vitamins are all that alternative (considering they are pretty essential to general well-being), but I figured this would be the most appropriate area to post my questions.

I have a friend who was diagnosed T1 in December and I was diagnosed T1 about a week and a half ago. I'm working on dialing in my insulin regimen/management and feel that's got to be my foundation for management, as it is for nearly all PWD's.

However, my friend sent over a list of supplements that he's been very happy with and I was wondering if I could get some input/advice/experience from anyone who's tried these. Part of me wonders if he isn't just experiencing his honeymoon phase (and that these supplements are extending that period) - he also runs a LOT, so that's a huge factor, as well. In other words, I know that the impact of any treatment depends greatly on the patient, but if there are any studies that support these claims I would love to know about those along with personal experiences, as well!

Thanks in advance!

- chromium picolinate
- lipoic acid
- magnesium (chelated)
- niaminicide - 3g a day
- gymnema sylvestre

I take chromium, magnesium, and cinnamon--all of which are supposed to help regulate blood glucose. Been taking them for over a year, based on a doctor's recommendation. Have they worked? I really have no idea. When I first took the chromium I did notice that my BG was dropping more than it had. bBt that's really anecdotal--don't notice that any more. I also started working out almost daily at that time (I'm 48 and have had T1 for 40 years) and my health has never been better than it is now. Also lost about 35 lbs. I have looked for conclusive research (about T1 and these supplements) in medical literature, etc. but have really found nothing. I see supplements like the ones you mentioned as a part of an over-all fitness strategy. I feel like wheat germ (folic acid) has increased my energy. But honestly: nothing has been as noticeably effective for me as an intense work-out schedule and watching my carb intake. I take these supplements with a "they can't hurt" philosophy. If you find out more, please let me know.

Thanks Earldog.

That's kind of the feeling I have even as someone considering these supplements - "they can't hurt." That being said, there are probably people for whom certain supplements are essential - it just might be that they have a greater impact on them than they do other people - just in the same way certain foods affect different PWD's in different ways.

Exercise has benefited me in physical/mental ways more than anything I've done in my life - I can't imagine that changing a whole lot now on account of my D - I'm guessing the benefits of exercise and diet will remain the same, I just need to take additional steps to account for those factors that I didn't have to before.

I'll keep you posted on what I find out!

I think in general most supplements can't hurt, but there are a few that supposedly can raise blood sugar levels. So be careful. Yes, your friend is likely experiencing his honeymoon at this point and that, not the supplements, have resulted in better control.

That all said....as a veteran T1, here are the things that have helped me the most with BG control:

  • Testing, testing, testing (and then logging and tracking those results)
  • Sticking to a relatively low-carb diet. While we like to think we can "eat anything," my feeling is that I really can't. And I'm ok with that. I allow for the occasional treat, but generally keep my carbs around 90-125 g/day. Anything more than this and my BGs get more wacky and variable.
  • Avoiding bread, pasta, rice and grains as much as possible. It is easy? No, but it is possible. And it makes me feel better. I occasionally indulge in sushi, but all that rice takes me for a wild ride.
  • Limiting alcohol consumption. I have, at most, a couple of beers or glasses of wine a week. Most folks with T1 experience a huge spike and then a huge crash when drinking alcohol. Not that you can't drink, but just know what your personal limit is before your BG goes on a wild ride.
  • Eating lots of veggies. Personally, I think this is the best way to get all the essential vitamins and nutrients you need. Your body was designed to get what it needs from food, not supplements. Avoiding processed foods and increasing the veggies helps with this.
  • Exercise, exercise, exercise. Back when I was a kid, insulin was not that good; we had NPH and Regular and a few other moderate-acting insulins. But they took a long time to work and were unpredictable. So, it wasn't an uncommon practice to go outside and run around when BGs were high in order to get them down. Phil Southerland (the bike racer and founder of Team Type 1) writes about this in his book. I still use this approach -- I exercise as much as I can.

Yes, these are probably things that EVERYONE should be doing -- but the cool thing about being T1 is that you can see a much more immediate result in your health from doing these things. Personally, I feel like having T1D has made me a MUCH healthier person than I would have been otherwise. It keeps me focused and aware of what I'm putting into my body.

Slightly off topic, I know, but my point is that I think spending your time, effort, and money on these things is much more important and will do more for your control than supplements. That's just my opinion.

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Thanks!

Your last point is really how I feel about health in general. Supplements, for me, have generally been something that I view as, well, supplemental to exercise and diet: the real foundations of healthy living. In short, I feel that I'd be better off exercising and eating right without taking supplements and vitamins than the other way around.

Without boring you with all the details, I've had my issues with weight, was able to lose a lot, but as work has become a bigger part of my life I've had times where my physical activity level has just stopped altogether and I've ended up getting most of my food delivered or picked up on the way home - not healthy.

Ironically, one of my goals for this Spring was to force myself to eat, exercise, and work on a more balanced and fixed schedule as well as get back to eating in a healthy way. Looks like I don't have to force myself since my T1 will be doing a fair amount of that for me!! :)

I've got a meeting with my CDE on Thursday that I'm really looking forward to - and I think my next big step will be starting to figure out how exercise affects my BG. Who knows, though, these supplements or others may well become a part of my regimen once I start getting my hands around the key pieces of the puzzle.

MBP:

All your points are dead-on as far as I'm concerned. (I, too, am a sushi fan and have found a nearby place that will use brown rice for their nigiri which really helps!).
I too am from the NPH days and though we didn't have blood testers at home back then, I imagine my average during the day was well above 200, despite being an active kid.
But it cannot be said enough how much exercise helps. The "Diabetic Athlete's Handbook" by Sheri Colberg has some great practical advice about controlling BG when working out and how different resistance training/weight-lifting is from cardio in terms of glucose control. But both are really essential, I think.
Finally, in terms of alcohol, I find that a nice scotch and soda water is preferable to a beer or wine in trying to keep within a good BG range. I only indulge in one or two on special occasions.
Again, great comments.
thanks.
ETD

I use Alpha Lipoic Acid Sustained Release 300 mg 2 tablets 3 x a day. I also take Evening Primrose Oil along with it to enhance it's insulin mimetic effect. I have found that it does reduce the amount of insulin that I need to use.

I also take ZMA, a version of magnesium at night. It helps sleep and also helps the body do recovery and repair work while you sleep.

I have heard good things about chromium picolinate, and gymnema sylvestre. I took chromium picolinate for a while, but didn't notice anything different when I took it. My doctor said it's something that you can have too much of, and recommended I let it go.

Here's a quote from Dr. Bernstein's book about the use of ALA.

INSULIN-MIMETIC AGENTS

In addition to the insulin sensitizers, there are some substances sold in the United States as dietary supplements that are effective for helping to control blood sugars. Many studies in Germany have demonstrated this effect from alpha lipoic acid, or ALA. A 2001 study showed it to work in muscle and fat cells by mobilizing and activating glucose transporters—in other words, it works like insulin, or is an insulin mimetic. German studies have also shown that its effectiveness in mimicking the effects of insulin is greatly enhanced when used with equivalent amounts of evening primrose oil, another dietary supplement. ALA and evening primrose oil are no substitute, however, for injected insulin—they are at best a fraction as potent. Still, their combined effectiveness is significant.

Additionally, ALA is perhaps the most potent antioxidant on the market and has certain cardiovascular benefits similar to those claimed for vitamin E, but more notable. Many of the cardiologists who were taking vitamin E ten years ago are now taking ALA. I’ve been taking it myself for about four years. When I began, I promptly found that I had to lower my insulin doses by about one-third. ALA and evening primrose oil do not appear to mimic one important property
of insulin—they don’t appear to facilitate fat storage. They are both available without prescription from health food stores and from some pharmacies. They have the potential to cause hypoglycemia in diabetics who inject insulin if they don’t adjust their insulin dosages accordingly. I have never seen them cause hypoglycemia, however, when they are not used with injected insulin.

Other German studies have shown dramatic improvements in diabetic neuropathy (nerve damage) when alpha lipoic acid is administered intravenously in large doses over several weeks. Given its antioxidant and likely anti-inflammatory properties, this isn’t that surprising. But it falls under the category of “Don’t Try This at Home.” Alpha lipoic acid, like high-dose vitamin E and metformin, can impede glycosylation and glycation of proteins, both of which cause many diabetic complications when blood sugars are elevated. I prefer a brand of alpha lipoic acid called Alpha Lipoic Sustain 300. This is manufactured by Jarrow Formulas, phone (800) 726-0886, and is available from Trotta’s Pharmacy, (877) 987-6882, many health food stores, and over the Internet. This particular brand has two advantages— it is soluble in both water and lipids (fats), and it is timed release, so that it lasts many hours. I usually recommend two 300 mg tablets every 8 hours or so, with two 500 mg capsules of evening primrose oil at the same times. If an insulin-resistant patient is already taking insulin, I will start her on half this dose once daily and observe blood glucose profiles and lower insulin dose as I raise alpha lipoic acid and evening primrose oil. Again, it’s all trial and error.

I eat a lot of spinach and broccoli and blow off supplements. I have a fair heap of carrots too, and then Propel and Gatorade as well. Eggs probably 6-7 days/ week. No supplements No neuropathy, etc.

I don't feel supplements are "essential to well-being". I think supplements are useful when there is a deficiency either in natural processes or in diet and exercise. I think supplements became popular around the same time our typical diet became pretty lousy. If we eat a diet of natural foods, plentiful fresh vegetables, etc., we shouldn't need supplements. I also tend to be a bit cynical as they are very subject to popularity fads and a lot of money is being made convincing us we can't possibly exist without something we existed without just fine before.

As for alcohol, I don't find any effect from a glass or two of wine, especially with food. Beer I find pretty high carb and even one can jack up my blood sugar sometimes. If I drink a bit more at a party or such then I do notice some lows.

Really interesting! Thanks for sharing that.

I'm starting to head in the same direction as far as my diet goes, as well. I've definitely embraced broccoli, spinach, leafy greens, and even cauliflower as great, easy veggies that have low carb counts.

I'm also coming around to the fact that eggs are going to replace a lot of my traditional breakfast options, too.

My overall carb intake is still pretty substantial - my CDE said not to rock the boat too much in terms of changing my ways, but I have cut out all heavily processed/really fast acting carbs - mostly been eating brown rice for dinner.

I love carrots but they remain a little bit of a question mark - still not sure how much I need to correct for them at this point.

Any knowledge re benfotiamine?