Did you know that over 5 million people living in Canada are living with some form of diabetes? While there are various medications available to help manage diabetes and control blood sugars, more and more Canadians are exploring natural, holistic supplements to help manage their blood sugars. 25% to 57% of people with diabetes report using complementary or alternative medicine.
It’s important to consult your health care provider before making any changes to your medication and/or supplement routine. Supplements made with natural ingredients may often seem harmless but they have potential to interact with your medications or pose risks if you have certain medical problems or are going to have surgery. In fact, “natural herbal supplements” are a common cause of liver toxicity. Most supplements haven’t been tested in pregnant women, nursing mothers, or children and therefore, should not be considered safe for these populations.
This is a general review of the latest evidence of the common supplements used for diabetes and it is not meant to provide any specific supplement recommendations for you. Let’s dive into some of the most popular supplements and see if they have any evidence to support their claims!
Can Cinnamon Lower Blood Sugar?
Cinnamon – a common spice we often see in coffees, baked goods like cinnamon rolls, and added into our oatmeal. Cinnamon has been touted as a supplement to help reduce blood sugars.
Safety of Cinnamon Supplement
It’s also important to note that there are many types of cinnamon; cassia cinnamon is the most common type sold in North America and typically used in cooking, while ceylon cinnamon (cinnamomum verum), is native to Sri Lanka. Ceylon cinnamon may be a better supplement option, due to a much lower coumarin content compared to cassia cinnamon.
The majority of people can consume foods or spices with coumarin daily without adverse effects; however, there is a small group of people who are sensitive. For this group, consuming higher levels than would normally be found in food can lead to elevation of liver enzymes, and in severe cases inflammation of the liver. Coumarin has also been investigated as a potential carcinogen (cancer-causing) in animal studies.
Evidence Summary of Cinnamon on Diabetes
In a 2024 systematic review of 3054 adults with type 2 diabetes, cinnamon supplement improved biomarkers of glycemic control (blood sugar, post meal sugar, HgbA1c, insulin resistance). The daily dose of supplemental cinnamon ranged from 120mg-6g, with a duration of from 30 to 120 days. Cinnamon supplement improved the glycemic control, particularly in patients with type 2 diabetes who receive cinnamon supplement as a capsule and at a dose of ≤2 g/day.
Oral cinnamon supplementation (dose 336mg to 1.5g daily for six to 24 weeks) may be beneficial for reducing glucose in women with PCOS according to a 2020 review of 488 women with PCOS; however, the trial populations were mainly from the Middle East.
A 2021 review found that 1 to 2 g/day of cassia cinnamon for 40-90 days did not impact fasting blood glucose of A1C in adults with type 2 diabetes.
Considerations for Using Cinnamon Supplement
The studied dose for blood sugar lowering purposes is 1-2g cinnamon supplement daily (approx. 0.5-1 tsp ground cinnamon) for up to 4 months, taken with carbohydrate containing meals. Choose ceylon cinnamon supplements that have been tested by third parties and has a licensed NPN number, such as these ones listed below:
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Renew Actives Ceylon Cinnamon 600mg
SM Nutrition Ceylon Cinnamon 600mg
Does cinnamon bring down blood sugars?
It’s promising in adults with type 2 diabetes and women with PCOS but further research and more consistent evidence is needed to provide a definite recommendation on the specific type, dosage, duration, and safety of its use.
Is Panax Ginseng effective for Diabetes?
Ginseng is an antioxidant-rich root of plants, that is well known for it’s ability to help with increased energy and reduction in inflammation. Panax ginseng (aka Korean/Chinese/Asian ginseng) and Panax quinquefolius (aka American ginseng) are the most widely available types of ginseng on the market, we are referring to both of these types of ginseng in our review.
Safety of Ginseng Supplement
People who take warfarin should be cautious when taking ginseng products because of a possible decrease in warfarin effect affecting their INRs.
Evidence Summary of Ginseng on Diabetes
Ginseng may have minimal impact on blood sugars, with a possible reduction to fasting blood sugar and insulin resistance in a 2022 systematic review. The studies looked at using ginseng at 0.1-8g over at least 24 weeks in 1295 adults with impaired fasting glucose, prediabetes or type 2 diabetes. Limitations to the studies include small sample sizes (only 1 study had >100 participants), with most of the studies being conducted in Asia, which limits how widely the findings may apply.
Considerations for Using Ginseng Supplement
The typical dose used for blood sugar lowering purposes is 2-3g of ginseng daily for up to 3 months. Choose panax ginseng supplements that have been tested by third parties and has a licensed NPN number, such as these ones listed below:
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Renew Actives Panax Ginseng Capsules 500mg
Organika Korean Red Ginseng 500mg
Herba Korean Red Ginseng Extract 500mg (equivalent to 2.5g)
Does panax ginseng bring down blood sugars?
Maybe in adults with impaired fasting glucose, prediabetes or type 2 diabetes – large scale and longer term studies are needed to provide a definite recommendation on the specific type, dosage, duration, and safety of its use.
Is Berberine Effective for Diabetes Management?
Berberine is a bitter tasting substance found in certain plants and has been researched for the ability to reduce blood sugars without causing hypoglycemia.
Safety of Berberine Supplements
Supplementation with berberine (especially in doses above 0.3g 3 times per day) has been reported to cause gastrointestinal side effects in some people, including diarrhea, constipation, flatulence, and stomach pain. Berberine is known to affect the metabolism of numerous drugs, consult your doctor and/or pharmacist prior to use if you are taking other medications or supplements.
Studies have mostly looked at supplementing with Berberine 12-24 weeks so we need longer studies to determine long term safety and effectiveness.
Evidence Summary of Berberine on Diabetes
Diabetes Canada does not currently support the use of berberine for diabetes, but does acknowledge that it may help lower cholesterol. Since heart disease and diabetes go hand-in-hand, berberine may be a consideration for some people living with diabetes and high cholesterol, to help lower their cholesterol.
In a 2024 umbrella meta-analysis of 15,297 adults with metabolic disorders, such as type 2 diabetes, nonalcoholic fatty liver disease (NAFLD), and polycystic ovary syndrome (PCOS), berberine supplements reduced fasting blood sugar, HgbA1c, insulin, and insulin resistance.
In a 2021 systematic review, berberine has been found to be as effective as metformin in lowering blood sugar. As an additional treatment with blood sugar lowering medications, it showed better results in reducing HbA1c, fasting blood sugar, and post meal blood sugar.
In a 2012 systematic review, berberine has beneficial effects on blood glucose control in the treatment of type 2 diabetic patients and exhibits efficacy comparable with that of conventional diabetes medications.
How to use Berberine Supplements
The typical dose of berberine used to lower blood sugar is 0.5-1.5g daily, divided into 2-3 doses for up to 3 months; dosage should be adjusted based on individual GI tolerance. Berberine should be taken with a meal, or shortly after, to take advantage of the blood glucose and lipid spike associated with eating.
Choose berberine supplements that have been tested by third parties and has a licensed NPN number, such as these ones listed below:
*As an Amazon Associate, we earn from qualifying purchases.*
BioAbsorb Nutraceuticals Berberine
Organika Berberine 500 mg Capsules
Does Berberine bring down blood sugars?
It’s promising but most studies on berberine were conducted among Chinese patients which limited the widespread application of this data. Long term studies are needed to provide recommendations on safety, dosage, duration etc.
Does Aloe Vera Lower Blood Sugar?
Aloe Vera is a tropical or semi tropical plant that is well known for it’s ability to help heal sunburns, but has also been explored for it’s impacts on blood sugar management. There are at least 420 different plant species of Aloe. Aloe vera specifically refers to the Aloe barbadensis Miller plant, which is the most common form used in Aloe-based products.
Commercially, Aloe vera is available in three main forms: gel, latex, and juice (or whole leaf extract). This aloe vera juice is not the same as aloe vera beverages sold in stores, which typically diluted aloe vera in water or other juice such as grapefruit.
Safety of Aloe Vera Supplements
Aloe vera whole leaf extract may have drug interactions with sevoflurane, a general anesthetic, always consult your doctor and/or pharmacist if you make any changes to your medication or supplements. Aloe vera has been associated with cases of acute hepatitis (liver inflammation). International Agency for Research on Cancer states that Aloe vera whole leaf extract is possibly carcinogenic to humans (Group 2B) based on animal studies.
Evidence Summary of Aloe Vera on Diabetes
A 2022 review of four studies (involving 197 people) found that aloe vera, dosage ranged from 1.0 to 1.2 g per day (one study used 150 mL of juice) for 9 -13 weeks, did not have any effect on blood sugar levels or A1C in adults with type 2 diabetes.
The 2018 Diabetes Canada clinical practice guidelines acknowledge that RCTs lasting at least three months have shown that oral Aloe vera lowers A1C by at least 0.5% but the guidelines do not provide a specific recommendation.
In a review from 2016, five studies (involving 415 people with overweight or obesity) with prediabetes or early, untreated type 2 diabetes, found that by taking aloe vera capsules 1-2.8 g/day, juice or powder 0.2 g for 6-12 weeks, helped slightly lower fasting blood sugar and A1C compared to those who didn’t take it. However, the studies were of poor quality.
Does aloe vera bring down blood sugars?
Maybe – further evidence is needed to determine effectiveness and safety of aloe vera supplements for diabetes.
Is Bitter Melon Effective for Diabetes?
Bitter Melon is a common food that is widely consumed in Asian, African and Caribbean cultures, and does provide some benefits when it comes to glycemic control. Bitter melon contains a chemical that may act like insulin.
Safety of Bitter Melon Supplements
Caution should be taken, bitter melon supplements may cause upset stomach and diarrhea.
Evidence Summary of Bitter Melon on Diabetes
A 2024 meta-analysis of 423 adults with type 2 diabetes showed that bitter melon supplements improved several biomarkers of glycemic control (fasting blood sugar, post meal blood sugar, and HgbA1c). The dosage studied was 0.6 – 6 grams from 4 to 16 weeks. However, the certainty of the evidence was low or very low.
Fair evidence from a 2022 review suggests that 1 to 18 g of bitter melon per day taken for 8 to 17 weeks may modestly lower A1C by <0.5% in adults with type 2 diabetes.
The 2018 Diabetes Canada clinical practice guidelines state that evidence has failed to demonstrate that bitter melon can lower A1C by at least 0.5% in individuals with diabetes and that it is known to cause gastrointestinal side-effects.
Considerations for Using Bitter Melon Supplements
Bitter melon supplements has most often been used by adults in doses of 0.5-6 grams daily for up to 16 weeks for the purpose of lowering blood sugar. As it is known to cause GI upset, dosage should be adjusted based on individual tolerance.
Choose bitter melon supplements that have been tested by third parties and has a licensed NPN number, such as these ones listed below:
*As an Amazon associate, we earn from qualifying purchases*
Himalaya Organic Bitter Melon 660mg
Organika Blood Sugar Control (Cr-Bitter Melon) 500mg
Westcoast Naturals Cr-bitter Melon 500mg
Does bitter melon bring down blood sugars?
Maybe – further evidence is needed to provide recommendations on safety, dosage, duration of bitter melon supplements for diabetes.
Are Fenugreek Seeds Effective for Lowering Blood Sugar?
Fenugreek is a herb from the Mediterranean and Western Asia , often used in similar ways to clove. The mechanism by which fenugreek affects blood glucose in humans is unknown. Fenugreek seeds, which smell and taste like maple syrup, have been used in cooking and as medicine. Fenugreek is promoted as a dietary supplement for diabetes, menstrual cramps, and to stimulate milk production during breastfeeding.
Safety of Fenugreek
Fenugreek is typically safe in the amounts found in food and cooking. However, larger doses of fenugreek has been known to cause GI side effects including diarrhea, dyspepsia, abdominal pain, flatulence and hypoglycemia. Cases of liver toxicity have been reported in people taking fenugreek alone or in combination with other herbs. Fenugreek may interact with warfarin and increase bleeding risk.
Evidence Summary of Fenugreek Seeds on Diabetes
In a 2023 meta-analysis of randomized controlled trials, supplementation with fenugreek (500mg to 30g daily dose) in 706 adults with type 2 diabetes or prediabetes, reduced the levels of fasting blood sugar, post meal blood sugar, and HgbA1C in 8-16 weeks.
A 2022 review supports that 1-45g (broad range) of fenugreek seed or seed extra for 8-13 weeks may lower A1C (by as much as 0.5%), the post meal blood sugar (by up to 1mmol/L), and the fasting blood sugar (by <1mmol/L).
The 2018 Diabetes Canada guidelines acknowledge that some trials lasting longer than three months have demonstrated that fenugreek can lower A1C by at least 0.5% but do not include a recommendation as there is not enough evidence about its safety or efficacy.
Considerations for Using Fenugreek Supplements
Fenugreek supplements has most often been used by adults in doses of 0.5-10 grams daily for up to 16 weeks for the purpose of lowering blood sugar. As it is known to cause GI upset, dosage should be adjusted based on individual tolerance and the daily dose can be divided over 2-3 times daily for better tolerance.
Choose fenugreek supplements that have been tested by third parties and has a licensed NPN number, such as these ones listed below:
*As an Amazon associate, we earn from qualifying purchases*
Nature’s Bounty Fenugreek Supplement 610mg
Ayur365 Fenugreek Capsules 500mg
FenFiber | Fenugreek Fiber Supplement 880mg
Does Fenugreek bring down blood sugars?
Maybe – but further research is needed to provide a recommendation on the dosage, duration, safety of fenugreek supplements.
Will Ginger Lower Blood Sugar?
A common ingredient in cooking and in herbal teas, Ginger is a well known root. There have been a number of trials looking at its impact on blood sugars, but so far, the research does not support and positive reduction in A1C long term, or any long term reduction in blood sugars with the use of ginger root.
Safety of Ginger Supplement
Large dose of ginger supplement may cause GI side effects, doses greater than 6 g daily can produce ulcers or gastritis.
Evidence Summary of Ginger on Diabetes
In a 2024 review of 216 adults with type 2 diabetes, supplementation with 1.2-2g of ginger powder for 4-12 weeks had no effect on biomarkers of glycemic control (fasting blood sugar, HgbA1C). However, individual studies reported mixed results, with two studies showing a significant reduction in Fasting blood sugar.
A 2022 review of 561 adults with type 2 diabetes found that a daily dose of 2 to 9 g of ginger extract for 8 to 13 weeks did not impact A1C of fasting blood sugar.
The 2018 Diabetes Canada clinical practice guidelines state that a trial lasting longer than three months has demonstrated that ginger supplement can lower A1C by at least 0.5% but does not provide a recommendation as there is not enough evidence about its safety or efficacy.
Does ginger supplement bring down blood sugars?
Probably not
Is Holy Basil Good for Diabetes?
Holy basil (Tulsi in Hindi) is an aromatic plant in the mint family, native to India and Southeast Asia. Holy basil can often be found in essential oil form and used traditionally as a medicinal herb in Ayurvedic medicine more than 3000 years.
Safety of Holy Basil Supplement
The most commonly reported side effects are nausea and diarrhea.
Evidence Summary of Holy Basil on Diabetes
A 2017 review of 440 adults with type 2 diabetes or metabolic syndrome investigated the effect of holy basil on glycemic outcomes found that 300 mg to 14 g of fresh or powdered holy basil leaves, aqueous holy basil leaves or whole plant extract for 2 to 13 weeks generally improved glycemic control (fasting blood sugar, post meal blood sugar, HgbA1C) compared to placebo or no intervention, but effect sizes and statistical significance were not reported. One of the authors also receives remuneration as a consultant and advisor to Organic India Pty. Ltd., which is a company that manufactures and distributes tulsi products.
There isn’t enough evidence to support it’s use or recommend specific forms, doses or duration of supplementation for diabetes and blood sugar management at this time due to the limited studies available.
Does holy basil bring down blood sugars?
Probably not
How does Marine Collagen Peptides Help with Diabetes?
A hot topic in the last few years, collagen peptides have been explored for many different functions, and now are being explored for diabetes management. Marine collagen peptides are enzymatically hydrolyzed from the skin of chum salmon. Protein is essential in the management of blood sugars, so it makes sense that collagen peptides would be explored for this purpose.
Safety of Marine Collagen Peptides
Hypoglycemia, ketoacidosis and macroangiopathy (damages to the blood vessels) have been reported as adverse effects in one study.
Evidence Summary of Marine Collagen Peptides
Two 2010 trials (same authors) investigating marine collagen peptides on glucose metabolism in 200 Chinese adults (one study on patients with type 2 diabetes and taking diabetes medications and the other study on patients with type 2 diabetes and hypertension on medications) found that, 13 g of marine collagen peptides per day for three months reduced fasting blood glucose by 1.5 to 2.0 mmol/L and HgbA1C by 0.75%. Results may be limited by the small sample sizes, short study durations and the lack of generalizability beyond Chinese adults aged 60 to 70 years with type 2 diabetes and on medications.
The 2018 Diabetes Canada clinical practice guidelines state that a trial lasting longer than three months has demonstrated that marine collagen peptides can lower A1C by at least 0.5% but do not include a recommendation about marine collagen peptide supplementation as there is not enough evidence about its safety or efficacy.
Does marine collagen peptides bring down blood sugars?
Maybe but there has not been many studies looking into this – further evidence is needed to provide a recommendation on dosage, duration and safety of marine collagen peptide supplements for diabetes.
Conclusion
There are many different herbs, spices and “natural ingredients” that are currently being explored for their holistic effect on blood sugar management. It is important to keep up to date with the latest research, evaluate the proper type, dosage, duration and understand the risks associated with using these supplements.
Lifestyle interventions (diet, nutrition and exercise) are often more effective and safe first line of treatment for diabetes, these lifestyle factors should be always considered first before considering adding in supplements. A good question to ask your health care provider is that “Do the risks of using this supplement outweigh the potential benefits?”. We encourage you to discuss your supplement routine with your health care provider to understand what these mean for you.
For more information, or to find out how you can work on a holistic approach at reducing your blood sugars, book an appointment with a BC dietitian today.
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