Insulin dose lowering with alternative remedies and nutritional supplements
Feb 20 2014 by
Ray Sahelian, M.D.

Insulin, a hormone released from the pancreas, is the primary substance responsible for maintaining appropriate blood sugar levels. Insulin allows glucose to be transported into cells so that they can produce energy or store the glucose until it's needed. The rise in blood sugar levels after eating or drinking stimulates the pancreas to produce insulin, preventing a greater rise in blood sugar levels and causing them to fall gradually. Because muscles use glucose for energy, blood sugar levels fall during physical activity. See diabetes for a natural way to control this condition and lower the required dosage of insulin for optimal control. There are many medications that are prescribed to patients with high blood sugar levels including Januvia (sitagliptin phosphate) tablets.

Inhalable Insulin
The first inhalable version of insulin won federal approval, giving millions of adult diabetics an alternative to some of the regular injections they now endure. The Food and Drug Administration said the Pfizer Inc. insulin, to be marketed as “Exubera,” is the first new way of delivering insulin since the discovery of the hormone in the 1920s. Pfizer jointly developed the drug and dispenser with Sanofi-Aventis and Nektar Therapeutics.

Inhalable Insulin -  Is it cost effective?
Pfizer Inc's inhaled insulin product Exubera should not be prescribed on Britain's state health service, the country's cost-effectiveness watchdog, NICE, recommended in 2006. Pfizer, the world's biggest pharmaceuticals group, said the preliminary opinion from the National Institute for Health and Clinical Excellence (NICE) was "perverse and short-sighted". Exubera won marketing approval in both Europe and the United States in January, 2006 as a treatment for patients with Type 1 and Type 2 diabetes. But NICE -- whose function is to assess whether treatments are cost effective for the National Health Service -- said it did not offer sufficient benefits over conventional insulin injections to be worth the money. It estimated the cost of using Exubera to be 1,102 pounds ($1,931) per patient a year. That might be justified for people with severe fear of injections, NICE's appraisal committee said, but there was no way of identifying those who would gain sufficient benefit for the technology to be cost effective.

Insulin resistance and how to reduce it
Insulin resistance can be linked to diabetes, hypertension, high cholesterol and triglycerides, cardiovascular disease and other abnormalities. These abnormalities constitute the insulin resistance syndrome. Because insulin resistance usually develops long before these diseases appear, identifying and treating patients with insulin resistance has potentially great preventive value.
     Insulin resistance is a condition in which tissues such as fat and muscle in the body respond poorly to insulin, the major hormone required for glucose metabolism. This condition is present in pre-diabetic states and continues when a person develops diabetes. Research suggests that supplementation with chromium picolinate may help improve insulin resistance. However diet, weight loss, and exercise are the options to reduce insulin resistance.
     Insulin resistance is a state in which a given concentration of insulin produces a less-than-expected biological effect. Insulin resistance has also been arbitrarily defined as the requirement of 200 or more units of insulin per day to attain glycemic control and to prevent ketosis.

Role of sleep
Just one sleepless night can hamper the body's ability to use insulin to process sugar in the bloodstream. I may be no coincidence that while sleep duration has shortened in western societies in the past decade there has also been an increase in cases of insulin resistance and adult-onset diabetes. This is the advantage of getting some physical activity during the day so that you can get a deeper rest overnight.

Stress and Insulin Resistance
Individuals with high stress and high hostility levels have an increased risk of developing insulin resistance, which occurs when the body's response to insulin begins to slow down and blood sugar levels begin to rise. People with insulin resistance have a high risk of developing diabetes.
Insulin resistance is associated with stress and certain personality factors, including hostility.

Symptoms
The syndromes of insulin resistance actually have a broad clinical spectrum, which includes obesity, glucose intolerance, diabetes, and metabolic syndrome X. Many of these disorders are associated with various endocrine, metabolic, and genetic conditions. These insulin resistance syndromes may also be associated with immunological diseases. Syndrome X, the state of insulin resistance also known as metabolic or dysmetabolic syndrome, has drawn the greatest attention because of the public health importance. In an effort to clinically identify patients with insulin resistance, various organizations have developed diagnostic criteria. The most commonly used criteria in the United States are those of the National Cholesterol Education Program / Adult Treatment Panel III (NCEP/ATP III).

Green Tea effect
Randomized controlled trial for an effect of green tea consumption on insulin resistance and inflammation markers.
J Nutr Sci Vitaminol. 2005. Department of Nutritional Sciences, School of Food and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Shizuoka, Japan
To study the effects of the intake of green tea and polyphenols, which are a component of green tea, on insulin resistance and systemic inflammation, a randomized controlled trial was conducted on 66 patients aged 32-73 y (53 males and 13 females) with borderline diabetes or diabetes. Subjects in the intervention group were asked to take a packet of green tea extracts/powder containing 544 mg polyphenols (456 mg catechins) daily, which was a dose that could be taken without difficulty, and were asked to divide the green tea extracts/powder in a packet into 3 or 4 fractions dissolved in hot water everyday and to take a fraction after every meal or snack for 2 mo, in addition to daily food intake. In conclusion, the daily supplementary intake of 500 mg green tea polyphenols did not have clear effects on blood glucose level, Hb A1c level, insulin resistance or inflammation markers. The positive correlation between the level of polyphenol intake and insulin level warrants further studies on the effect of green tea on insulin resistance.

Insulin Allergy
An allergic reaction develops in 2% of patients that use insulin. This ranges in severity from erythema and pruritus to life-threatening anaphylaxis. Allergic reactions to insulin usually occur within a few hours after an injection and are usually due to a local or systemic type I IgE-mediated hypersensitivity reaction. Despite considerable research into the immunogenicity of insulin, this has not yet been clarified completely and allergic reactions to insulin still occur. A blood test for anti-insulin antibodies and intradermal skin tests are indicated. There are several options available for the treatment of insulin allergy and each patient should be evaluated individually.

Insulin and appetite influence
Appetite and satiety are subject to complex regulation, with neuroendocrine mechanisms playing an important role. The central nervous system is attracting increasing attention as a target tissue for many hormones such as leptin, PYY3-36, ghrelin, glucagon-like-peptide 1 and many others. Among its many well-known functions, insulin is also a potent appetite suppressing hormone, and insulin receptors are widely distributed throughout the central nervous system.

Insulin and Alzheimer's Disease
I was directed to your site by one of my patients, and I noticed that someone had asked a question regarding Insulin and Alzheimer's. FYI, there is a growing body of evidence for diabetes as a risk factor for AD. Furthermore, it is known that beta amyloid is degraded by the insulin degrading enzyme (IDE) in the brain, and in those with insulin-resistant diabetes, this means that the excess insulin is preferentially degraded, leaving the beta amyloid to precipitate and form plaques even earlier than one might expect to see them otherwise. Just thought that info might be helpful. The information came from data presented by Dr. Richard Mayeux of Columbia University at the 9th International Conference on Alzheimer's Disease and Related Disorders, Philadelphia, July 2004.
Sincerely,
Amanda G. Smith, MD
Assistant Director, USF Suncoast Alzheimer's and Gerontology Center, Tampa, FL 33617
suncoastalzheimers dotcom

Insulin Questions
I am on insulin and have heard good things about lipoic acid. Can I take insulin and lipoic acid together?
   We are not in a position to advise you on an individual basis, but as a general rule, if the lipoic dosage is low, such as 20 mg or less, then there should be no problems using it with your insulin. If you intend to take more lipoic, you should be monitored by your health care provider since blood sugar may be influenced by lipoic acid.

Is CoQ10 a good supplement for a diabetic on insulin to take?
   No general statements can be made that apply to everyone, but using 30 mg of CoQ10 a few times a week should be fine for most people, including those on insulin, but your doctor needs to approve.

I am curious what supplements are recommended to mitigate insulin insensitivity. I hear that cinnamin tablets are good?
    Cinnamon is a good option, so is alpha lipoic acid, banaba, bitter melon extract.

8th Annual World Congress on Insulin Resistance, Diabetes & Cardiovasular Disease (WCIR) Exploring of new frontiers in metabolism - tomorrow's clinical science today, 2010 Hilton Universal City Los Angeles, California Register NOW EARLY BIRD DISCOUNTCall for Abstracts Topics: Clinical topics may include any aspect of insulin resistance and its relationship to the causation and/or natural history of obesity, diabetes, hypertension, cardiovascular disease, dyslipidemia, gonadal dysfunction such as PCOS, gestational diabetes, other endocrine abnormality, inflammation, endothelial or other vascular dysfunction, liver disease (NAFLD), malignancy, and sleep apnea and other sleep disorders in childhood, adolescence and adulthood.All abstracts will be published in Diabetes & Vascular Disease Research. Awards will be given for the highest-ranking abstracts. The chosen winning abstracts will orally present their research findings during plenary session. This year's congress will focus on Diabetes and Cardiovascular Disease. Here are few Highlights: Dyslipidemia Session Chair: Ronald M. Krauss, MD Berkeley, California The gut in metabolic control- Relationship of the gut, gut hormones IR, energy balance, metabolic diseases Session Chair: Bart Staels, PhDLille, France Pediatrics Session Chairs: Alan R. Sinaiko, MD Minneapolis, Minnesota Sonia Caprio, MD New Haven, Connecticut Brain Relationship: energy balance, metabolic diseases appetite to the gut Session Chair: Suzanne Craft, PhD Seattle, Washington.