I just got diagnosed with type 2 diabetes, and my doctor prescribed metformin. But I’ve heard that gymnema is a natural supplement that lowers blood sugar. Should I try it first?


Gymnema, the extract of the woody shrub Gymnema sylvestre, has shown excellent results in clinical trials for control of blood sugar in people with type 2 diabetes. It's worthy of consideration as an alternative to the prescription medication metformin (Glucophage)—but it's not my first recommendation and not even my first choice for a supplement. Let me explain why. My first recommendation is to realize that any supplement (or drug) should be used in addition to dietary and lifestyle strategies to improve blood sugar control. Foremost is eating a diet that has a low glycemic load, which means that it is low in carbohydrate sources that can raise blood sugar levels. Foods low in glycemic load include most fresh fruits and vegetables, nuts, beans and whole grains. No drug or dietary supplement is going to be effective in the long run unless it is part of a plan that includes a low-glycemic-load diet. And people with diabetes need to get exercise, at least 30 minutes of moderate-intensity exercise, such as brisk walking five days a week. Once you have your diet and lifestyle plan in place, if additional support is needed, it's time to consider dietary supplements. Gymnema extract at a dosage of 200 mg twice daily has been shown to improve blood sugar control. It works by decreasing the absorption of sugar in the intestines and may increase the amount of insulin in the body. However, based upon results from recent clinical trials, I would recommend that you have a discussion with your doctor about a different supplement—berberine, found in plants such as barberry, Oregon grape root and goldenseal. Berberine at a dosage of 500 mg before meals three times daily has been shown to produce results on par with metformin but is generally better tolerated. To learn more, see the Bottom Line article, "Natural Remedy for Diabetes: Berberine." Before you take any supplement, you should discuss it with your medical doctor or naturopathic physician to rule out any possible interactions with other medication.

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