Supplements for Type 2 Diabetes Mellitus: An Overview of Benefits and Recommendations
Type 2 diabetes mellitus (T2DM) and related/predisposing conditions (insulin resistance, prediabetes, visceral obesity) have reached epidemic levels. In these metabolic conditions, various dietary supplements, lifestyle improvements, and pharmacological therapy where appropriate, can be beneficial. Among these are fibers, polyphenols, berberine, probiotics, phytosterols, chromium, and Omega-3 fatty acids.
Fibers, both soluble and insoluble, represent the edible part of plants resistant to digestion and absorption in the small intestine and therefore fermented in the colon. A fiber-rich diet (30 g/day), found in legumes, vegetables, and fruits and/or provided through supplements, has beneficial effects on short-term, medium-to-long-term glycemic control, fasting, and postprandial phases in individuals with prediabetes or T2DM. The most commonly used fiber supplements contain beta-glucans, psyllium, guar gum, glucomannan, and pectins (7-20 g/day).
Polyphenols (flavan-3-ols, epigallocatechins, isoflavones, resveratrol, etc.) are a series of molecules found in plant-based foods and beverages, with multiple phenolic groups that can also form complex structures with high molecular weight, available in concentrated form in dietary supplements. Polyphenol intake improves various cardiometabolic parameters, reducing the risk of T2DM and cardiovascular diseases.
Berberine, an isoquinoline alkaloid found in various plants, including Berberis aristata, improves hepatic glucose utilization/absorption, reduces blood glucose, and positively modulates intestinal microbiota. The recommended dose is 0.5 g/day.
Probiotics of the Lactobacillus and Bifidobacterium genera, alone or in combination with berberine, positively affect glycemic control in patients with T2DM.
Phytosterols (sterols and stanols), present in plant-based foods and in concentrated form in supplements, alongside hypocholesterolemic properties, also have positive actions for T2DM, obesity, and arterial hypertension (1.5-2.5 g/day).
Trivalent chromium (Chromium III) is an essential micronutrient, and one of its forms, chromium picolinate, taken as a supplement, has been effective in improving glycemic conditions in patients with metabolic syndrome and T2DM.
Omega-3 fatty acids (DHA, Docosahexaenoic acid; EPA, Eicosapentaenoic acid), possessing functional, antioxidant, and anti-inflammatory activities at the cellular and metabolic levels, have positive effects on inflammation, reducing triglyceridemia, and improving glycemic control in patients with T2DM. Their bioavailability depends on the chemical form (esterified, free, incorporated into triglycerides, phospholipids) and dosage (800-1,000 mg x 2-3/day).
Given the increasing prevalence of T2DM and related conditions, the availability of supplements represents an important tool for prevention, as well as potential co-treatment with medications.
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