Supplements Linked to Risks for People With Diabetes

Concerns have been raised about the safety of certain dietary supplements for people with diabetes, as some products may interact with medications or affect blood sugar control. Regulatory agencies and medical organizations have highlighted the lack of consistent quality and evidence for many supplements used by individuals with diabetes.

St. John’s Wort has been documented to interfere with the breakdown of diabetes medications, which can reduce their effectiveness and cause fluctuations in blood glucose. High doses of niacin, also known as vitamin B3, have been linked to increased blood sugar and difficulty maintaining optimal A1c levels in people with diabetes.

Ginseng is another supplement that may lower blood sugar, and when used alongside diabetes medications, it can increase the risk of hypoglycemia. Oral aloe vera has also been associated with drops in blood sugar and a higher risk of hypoglycemia, as well as possible gastrointestinal side effects.

Cinnamon, which contains coumarin, may interact with blood sugar-lowering medications and, in large amounts, can cause liver damage. Supplements such as berberine, chromium, and alpha-lipoic acid have also been identified as potentially lowering blood sugar, which could lead to hypoglycemia when combined with diabetes treatments.

What the numbers show

• High-dose niacin is linked to higher blood sugar and A1c in diabetes
• Most supplements are not reviewed by the FDA before sale
• High doses of chromium picolinate have been associated with kidney and liver issues

Berberine may help lower blood glucose, reduce insulin resistance, and improve lipid metabolism in people with type 2 diabetes, but it can also cause gastrointestinal side effects and interact with other medications. Chromium picolinate has been reported to impact insulin levels and blood glucose control, and high doses have been associated with kidney failure and liver disease.

The American Association of Clinical Endocrinology has advised caution when using unregulated nutritional supplements due to the inconsistent composition and potential for harm. Most dietary supplements are not subject to FDA approval before they are marketed, which can result in variable quality and composition.

According to the American Diabetes Standards of Care, there is no evidence supporting the use of most supplements for improving diabetes or its complications. The standards recommend that individuals with diabetes exercise caution and consult healthcare professionals before using supplements.

Supplements marketed for blood sugar control, such as cinnamon, berberine, chromium, and alpha-lipoic acid, may lower blood sugar but can also increase the risk of hypoglycemia when combined with prescribed diabetes medications. The potential for interactions and adverse effects highlights the importance of professional guidance in diabetes management.

* This article is based on publicly available information at the time of writing.