Certain conditions, like diabetes, insulin resistance and metabolic syndrome, can lead to elevated blood glucose levels. Left unchecked, elevated blood glucose levels can lead to severe health implications.
“When high blood glucose levels remain high and largely uncontrolled for a long period of time, the result can be a variety of serious complications,” explained Gene Bruno, senior director of formulation, NutraScience Labs. “These complications include, but are not limited to, neuropathy (pain in the hands and feet), high blood pressure, cholesterol and triglyceride levels, peripheral vascular disease (including pain when walking and foot ulcers), retinopathy (the leading cause of blindness worldwide) and weight gain and/or obesity.”
High blood glucose levels are undetectable in most cases, further raising the alarm for consumers at risk.
“Unlike hypoglycemia that poses an immediate risk (of diabetic coma, and even death), high blood glucose poses a risk over longer periods of time by damaging structures of the body,” said Jocelyn Bérubé, M.Sc., executive vice president – scientific & regulatory affairs, InnovActiv. “For example, high blood glucose will lead to the formation of glycated proteins (a good example being glycated hemoglobin), leading to a loss of function of these proteins.”
She cited collagen as an example, “which may become glycated when blood glucose is too high.” Glycated collagen loses fluidity compared with native collagen and can trigger inflammatory and oxidative processes within blood vessel walls, she said.
Fortunately, there are many ways to positively support blood glucose levels. As noted by Shaheen Majeed, president worldwide, Sabinsa, these include:
- Enhancing insulin secretion from existing beta-cells and regeneration of beta-cells of the pancreas.1
- Stimulating glucose-dependent insulin secretion.
- Inhibiting the activities of blood sugar modulating enzymes, such as alpha-amylase and sucralose.
- Inhibiting sodium glucose cotransporters, which play a key role in the reabsorption of glucose in the kidney by catalyzing the active transport of glucose into the bloodstream.2
- Inhibiting alpha-glucosidase, which delays digestion and, in turn, slows the absorption of carbohydrates in the small intestine, preventing increased blood glucose concentration after a carbohydrate load.1
Many natural ingredients are scientifically supported to positively affect various mechanisms to support healthy blood glucose levels.
These include longtime category champions chromium and cinnamon.
Bruno pointed to clinical research supporting chromium’s effects. One randomized, placebo-controlled study of 180 men and women with type 2 diabetes found chromium at doses of 200 mcg/d or 1,000 mcg/d had significant beneficial effects on A1C (a blood test for type 2 diabetes and prediabetes), glucose, insulin and cholesterol, with greater effects reported with the higher dose.3 Another study showed taking chromium picolinate orally can decrease fasting blood glucose, decrease A1C levels, decrease triglyceride levels and increase insulin sensitivity in people with type 2 diabetes.4
“Chromium is an essential trace mineral whose function in the body is to work with insulin to help transport glucose and maintain healthy glucose levels,” Bruno said.
A placebo-controlled, double-blind study of 79 patients sought to determine the effects of a water-soluble cinnamon extract on glycemic control in type 2 diabetics.5 Subjects were given 336 mg/d of a water-soluble cinnamon extract (corresponding to 3 g of cinnamon powder) or a placebo for four months. Those using the cinnamon experienced a significant 10.3% reduction in fasting blood sugar, compared to a non-significant 3.4% reduction in the placebo group.
In another placebo-controlled, double-blind study, 21 adults with metabolic syndrome (i.e., prediabetes) were given a water-soluble cinnamon extract (500 mg/d) or a placebo for 12 weeks.6 Results showed 83% of those given the extract experienced a significant decrease (about 8%) in fasting blood sugar, compared to only 33% in the placebo group who experienced a decrease. In addition, the cinnamon subjects also experienced a significant alteration in body composition—a decrease in body fat of 0.7%, and an increase in muscle mass of 1.1%.
“The smell and taste of cinnamon in a warm, gooey cinnamon bun is probably enjoyable to just about everyone you know,” Woodman said. “Unfortunately, the gooey bun is not a particularly good choice for diabetics, but it turns out that the cinnamon may actually provide some significant health benefits.”
A standardized, proprietary extract of brown seaweeds (InSea2, from InnoVactiv) has been shown in clinical trials to reduce the spike in blood glucose levels that occurs after a meal,7 supporting its approval of two claims from Health Canada for 1) the maintenance of healthy blood glucose levels and 2) the reduction of glycemic index of ingested foods.
A recent trial published in 2019 evaluated InSea2’s ability to support glycemic function in individuals with challenged glucose metabolism.8 For the trial, 65 dysglycemic patients were randomized to placebo or InSea2 for six months. Endothelial markers were evaluated at baseline, three months and six months. Researchers recorded a reduction in several markers and reported 18.2% of patients returned to a normal glycemic status in the supplemented group versus zero patients in the placebo group. “This six-month trial confirmed that controlling blood glucose and insulin responses after meal may have a profound impact on preserving optimal glycemic health over prolonged periods of time,” Bérubé explained.
Benefits of InSea2 are attributed to its ability to inhibit carb digestive enzymes alpha-amylase and alpha-glucosidase.9 “Together, these two enzymes convert sugar and complex carbohydrates to glucose in our intestinal tract,” Bérubé said. “Normally, these enzymes will convert carbs to glucose in about 20 minutes after meal, so all that glucose floods our bloodstream rapidly and generates large glucose spike. By blocking these enzymes, InSea2 allows a more gradual absorption of glucose in the bloodstream, which can then be managed with a smaller insulin release.”
The mineral zinc plays an important role in cellular function as an intracellular signaling molecule.10 Dysfunctional zinc signaling has been linked to a variety of health problems and diseases, including stunted growth, immunodeficiency and neuronal and sensory issues.
Also acting as an insulin mimetic, zinc has been shown to support glucose homeostasis. In a recent in vitro study in mouse and human skeletal muscle cells, subjects were treated with zinc, insulin or a combination of the two and glucose uptake was monitored.11 Researchers reported a significant induction of glucose consumption in mouse and human skeletal muscle cells when treated with zinc alone, and concluded, “Zinc acts as an insulin mimetic, activating key molecules implicated in cell signaling to maintain glucose homeostasis in mouse and human skeletal muscle cells.”
A 2017 review further supports zinc for “therapeutic insight or utility in the management and/or treatment of insulin resistance” based on its ability to modulate glucose transport, glycogen synthesis and lipogenesis; to inhibit gluconeogenesis and lipolysis; and to regulate key elements of the insulin signaling pathway.12 Researchers suggested zinc could be involved in the activation of cellular insulin signaling cascade that enables glycemic control. The review also suggests the zinc transporter ZnT8 may play a key role in providing the insulin mimetic effect of zinc in the body.
A 2018 Nutrients publication drew on the China Nutritional Transition Cohort Survey data set to examine the relationship between zinc and metabolic syndrome factors, and found adequate dietary zinc was associated with lower fasting blood glucose levels.13
Another mineral linked to glucose support is magnesium.
Stephen Ashmead, senior fellow, Balchem Corp., pointed to an analysis of postpartum glucose tolerance in Korean women who had gestational diabetes showing women who had the lowest serum magnesium levels also had the highest risk of developing type 2 diabetes later in life. The research suggests magnesium is an important factor in the etiology of type 2 diabetes.14
“Nielson suggested that a plausible mechanism is that the decreased magnesium intake induces an inflammatory response through multiple pathways,”15 Ashmead explained. “Magnesium is a physiological calcium channel blocker and when there is a deficit of magnesium, cellular calcium increases and may result in triggering cascade of event.”
Balchem Corp. offers its line of Albion Minerals, which are highly bioavailable glycine chelates. Zinc bisglycinate and magnesium bisglycinate are important nutritional minerals that are supportive of healthy glucose levels.
Sabinsa, Majeed said, takes inspiration from Ayurvedic medicine in its portfolio of blood sugar-management ingredients. “Because Ayurvedic practitioners through the ages were very knowledgeable on blood sugar management, and we take inspiration from them and add modern science, Sabinsa has several standardized phytoextracts in its product portfolio with valid scientific substantiation for blood sugar support,” he said.
He pointed to various ingredients that improve glucose utilization in the cells by acting as insulin sensitizers, including Pterocarpus marsipium water extract (Pterosol, from Sabinsa),16 Pterocarpus marsupium extract (Silbinol, from Sabinsa)17 and Momordica charantia extract (Momordicin, from Sabinsa).18 “Along with having an effect on glucose levels, most of these products influence the lipid levels, health of pancreatic beta cells, and increase the antioxidant status, thus improving the overall condition of the diabetic,” he added.
A propriety red yeast rice extract (an extract of fermented products of Monascus purpureus NTU 568 as ANKASCIN 568-R, from Sunway Biotech) has been shown to significantly reduce fasting blood glucose after 12 weeks of supplementation.19 For the study, 39 subjects with a fasting blood glucose level between 100 and 180 mg/dL and glycated hemoglobin (HbA1c) level of <9% were randomly divided into placebo and experimental groups. After 12 weeks, changes in fasting blood glucose levels showed that ANKASCIN 568 plus had a more favorable effect than the placebo. Compared to baseline, a statistically significant decrease of 9.3% was observed in fasting blood glucose levels. Even after a four-week washout period, fasting blood glucose levels were lower than the starting levels.
The product contains high levels of two active compounds, monascin and ankaflavin, which are the yellow pigments naturally produced by Monascus species.
Abscisic acid (ABA), a plant hormone found naturally in fruits and vegetables, plays an important role in human glucose metabolism.
“ABA may be nature’s way of helping us utilize natural carbohydrates in our diet,” said Guy Woodman, general manager, Euromed. “It has been estimated that 92% of the U.S. population consumes an inadequate amount of dietary fresh fruit and vegetables (4.5 servings daily) necessary to obtain an optimal intake of the dietary phytochemical, ABA.”
Euromed’s ABAlife, a novel extract of dried fig fruit providing a standardized level of ABA, at a dose of 200 mg reduced glycemic and insulinemic responses by about 25% in healthy individuals.20 “In a two-step process ABA promotes glucose uptake into cells by increasing the amount of the glucose transport protein, Glut4, at cellular membranes,” Woodman explained. “This increases glucose utilization in cells and reduces blood glucose levels.” ABAlife is protected by two U.S. patents for structure-function claims in dietary supplements associated with maintenance of healthy blood sugar levels.
A proprietary lemon flavonoid blend (as Eriomin, from Ingredients by Nature) provides a “triple-pronged approach” to prediabetes prevention by addressing the cyclical interaction of blood glucose levels with insulin sensitivity, inflammation levels and oxidative stress, said Rob Brewster, president of Ingredients by Nature, citing 2019 clinical research.21
In the 2019 publication, 103 prediabetes patients were randomized to receive either 200 mg Eriomin, 400 mg Eriomin, 800 mg Eriomin or placebo for 12 weeks. Patients were assessed for biochemical, metabolic, inflammatory, hepatic, renal, anthropometric markers, blood pressure, and dietary parameters. Results showed short-term intervention with Eriomin at all doses benefited glycemic control, reduced systemic inflammation and oxidative stress, and reversed the prediabetic condition in 24% of the evaluated patients.
“As blood glucose levels rise, the body can have trouble maintaining a normal range of inflammation and antioxidant activity,” Brewster said. “As oxidative stress and inflammation become worse it creates a cycle of elevated glucose levels and thereby affecting antioxidant activity and inflammation once again. By addressing each of these prediabetic factors, Eriomin is able to halt the cycle and help maintain proper glucose levels.”
- Thule P. “Mechanisms of current therapies for diabetes mellitus type 2.” Adv Physiol Educ. 2012 Dec;36(4):275–283.
- Beiteslshees A, Leslie B, Taylor S. “Sodium–Glucose Cotransporter 2 Inhibitors: A Case Study in Translational Research.” Diabetes. 2019;68(6):1109-1120.
- Anderson RA et al. “Elevated intakes of supplemental chromium improve glucose and insulin variables in individuals with type 2 diabetes.” Diabetes. 1997;46:1786-91.
- Rabinovitz H et al. “Effect of chromium supplementation on blood glucose and lipid levels in type 2 diabetes mellitus elderly patients.” Int J Vitam Nutr Res. 2004;74:178-82.
- Mang B et al. “Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2.” European Journal of Clinical Investigation. 2006;36:340–344.
- Ziegenfguss TN et al. “Effects of a Water-Soluble Cinnamon Extract on Body Composition and Features of the Metabolic Syndrome in Pre-Diabetic Men and Women.” Journal of the International Society of Sports Nutrition. 2006;3(2):45-53.
- Paradis ME, Couture P, Lamarche B. “A randomised crossover placebo-controlled trial investigating the effect of brown seaweed (Ascophyllum nodosum and Fucus vesiculosus) on postchallenge plasma glucose and insulin levels in men and women.” App Phys Nutr Met. 2011 Dec;36(6):913-919.
- 6-Derosa G et al. “Ascophyllum nodosum and Fucus vesiculosus on glycemic status and on endothelial damage markers in dysglicemic patients.” Phytother Res. 2019;33(3):791-797.
- Roy MC et al. “Effect of a commercially-available algal phlorotannins extract on digestive enzymes and carbohydrate absorption in vivo.” Food Res Intl. 2011 Nov 44(9):3026-9.
- Fukada T et al. “Zinc homeostasis and signaling in health and diseases.” J Biol Inorg Chem. 2011 Oct;16(7):1123–1134.
- Norouzi S et al. “Zinc stimulates glucose oxidation and glycemic control by modulating the insulin signaling pathway in human and mouse skeletal muscle cell lines.” PLoS One. 2018;13(1):e0191727.
- Norouzi S et al. “Zinc transporters and insulin resistance: therapeutic implications for type 2 diabetes and metabolic disease.” J Biomed Sci. 2017;24:87.
- Wang Y et al. “Dietary Zinc Intake and Its Association with Metabolic Syndrome Indicators among Chinese Adults: An Analysis of the China Nutritional Transition Cohort Survey 2015.” Nutrients. 2018;10:572.
- Yang SJ et al. “Serum magnesium level is associated with type 2 diabetes in women with a history of gestational diabetes mellitus.” J Korean Med Sci. 2014 Jan; 29(1): 84–89.
- Nielsen f. “Magnesium deficiency and increased inflammation: Current perspectives.” J Inflammation Research. 2018;11:25-34.
- Mishra A et al. “Antidiabetic activity of heart wood of Pterocarpus marsupium Roxb. and analysis of phytoconstituents.” Indian J Exp Biol. 2013 May;51(5):363–74.
- Tastekin B et al. “Therapeutic Potential of Pterostilbene and Resveratrol on Biomechanic, Biochemical, and Histological Parameters in Streptozotocin-Induced Diabetic Rats.” Evid Based Complement Alternat Med. 2018;2018:9012352.
- Cortez-Navarrete et al. “Momordica charantia administration improves insulin secretion in Type 2 Diabetes Mellitus.” J Med Food. 2018 Jul;21(7):672-677.
- Wang YR et al. “A randomized, double-blind clinical study to determine the effect of ANKASCIN 568 plus on blood glucose regulation.” Journal of Food and Drug Analysis. 2017;25(2):409-416.
- Atkinson FS et al. “Abscisic Acid Standardized Fig (Ficus carica) Extracts Ameliorate Postprandial Glycemic and Insulinemic Responses in Healthy Adults.” Nutrients. 2019 Jul 31;11(8).
- Ribeiro CB et al. “Effectiveness of Eriomin® in managing hyperglycemia and reversal of prediabetes condition: A double‐blind, randomized, controlled study.” Phytotherapy Research. 2019. DOI: 10.1002/ptr.6386