Diabetes Lecture Material (1) (1) PDF

Botanicals in Type II Diabetes Chris Pickrell, ND, Herbalist, TCM Practitioner Key Actions: Endocrine modulator, Bitter, Alterative As with most chronic conditions of lifestyle, lifestyle, exercise, and diet Key treatment will be the most effective tr...

Botanicals in Type II Diabetes Chris Pickrell, ND, Herbalist, TCM Practitioner Key Actions: Endocrine modulator, Bitter, Alterative As with most chronic conditions of lifestyle, lifestyle, exercise, and diet Key treatment will be the most effective treatments principles: Botanically, combine a strong alterative approach with specific herbs to improve blood sugar and insulin regulation Diabetes can have many variations in its presentation: Follow the Pro tip: symptoms to determine your lead actions and herbs Goat’s Rue (Galega officinalis)  Botanicals in Type II Diabetes FEATURED HERBS IN THIS SECTION Curcuma longa (Turmeric) Cinnamomum zeylanicum (Cinnamon) Trigonella foenum-graecum (Fenugreek) Galega officinalis (Goat’s rue) Arctium lappa (Burdock) Gymnema sylvestre (Gymnema) Berberis vulgaris (Barberry) Momordica charantia (Bitter melon) Taraxacum officinalis folia (Dandelion leaf) Citrus reticulate (Tangerine peel) Urtica dioica folia (Nettle leaf) Gymnema sylvestre (Gymnema) Hibiscus sabdariffa (Hibiscus) OUTCOME MEASURES 1. Normalize blood sugar to non-diabetic levels 2. Eliminate glucose in the urine 3. Normalize HbA1C 4. Resolve current symptoms 5. Prevent further progression RELEVANT BOTANICAL ACTIONS TO CONSIDER PRIMARY SECONDARY or OTHERS TO CONSIDER SUPPORTIVE Endocrine modulator Diuretic Astringent Alterative Hepatic Circulatory Carminative  Botanicals in Type II Diabetes Bitter Melon (Momordica charantia) FEATURED HERBS BY BOTANICAL ACTION Actions Herbs Endocrine Cinnamon (Cinnamomum Burdock (Arctium lappa) modulator zeylanicum) Goat’s rue (Galega officinalis) (specifically Bitter melon (Momordica Gymnema (Gymnema sylvestre) related to charantia) insulin) Barberry (Berberis vulgaris) Golden thread (Coptis sinensis) Hepatic Burdock (Arctium lappa) Bitter melon (Momordica charantia) Barberry (Berberis vulgaris) Diuretic Dandelion leaf (Taraxacum Nettle leaf (Urtica dioica folia) officinalis folia) Astringent Hibiscus (Hibiscus sabdariffa) Tangerine peel (Citrus reticulatae) Circulatory Turmeric (Curcuma longa) Cinnamon (Cinnamomum zeylanicum)  Botanicals in Type II Diabetes Carminative Turmeric (Curcuma longa) Cinnamon (Cinnamomum zeylanicum) Fenugreek (Trigonella foenum- graecum) HERB SELECTION Barberry 20 Goat’s rue 20 Sample Bitter melon 20 Formula Cinnamon 20 Fenugreek 20 100mL Dosage Tincture: 2 tsp, three times a day between meals. Duration Continue for six weeks, monitor and record BS. Expectations If only herbs are used: expect modest improvement or stabilization over about 6 mos. In addition to other therapies: Significant improvement in Fasting glucose and HbA1C are possible Cautions, With any intervention that lowers BS, a hypoglycemic event is possible Contraindications (though unlikely with the above combo). Advise the patient to have candy and Potential or sugary drink on hand during the start of treatment Side Effects Relevant Herb- This combo will have additive effects with other diabetic medications. Drug Interactions Other Effective Add a botanical tea of: Nettle leaf, citrus peel, and hibiscus Therapies Dietary changes and physical activity are critical if real improvement is to be made in preventing the progression of diabetes. Intermittent fasting Warm, well cooked meals rich in healthy oils and protein  Botanicals in Type II Diabetes Botanical Pro Tip Use an as-needed tincture to combat sugar cravings, similar to what is used in smoking or other cravings. Equal parts: Wormwood Lobelia Passiflora 1-2 dropperfuls as often as needed. TCM INTEGRATION – Dampness progressing to Phlegm Type II diabetes is predominately a condition of Dampness. Dampness arises from excessive sugar and calorie intake overwhelming the Spleen, and an underworking of the Spleen due to a lack of physical activity. Clearing Dampness (and more importantly, preventing further accumulation of Dampness) is key to treatment. Both Heat and Cold may also be present. If there is Heat, use hepatics. If there is Cold, warm the Spleen and Kidneys.  Botanicals in Type II Diabetes SELECTED MONOGRAPHS Berberis vulgaris (Barberry) Primary Actions: Cholagogue, antimicrobial, bitter, hepatic, anti-inflammatory, alterative, endocrine modulator (insulin) Constituents: Isoquinoline alkaloids (berberine, hydrastine, berbamine) Indications: General infections, GI infections, hepatic or gallbladder conditions, constipation, type II diabetes, PCOS Cautions/Contraindications: Non-toxic but very strongly bitter. Avoid during pregnancy and lactation. Preg C, Lact SD. Extra Information: Sometimes thought of as a poor cousin to hydrastis, barberry (which is indeed considerably more affordable and less endangered) is a potent antimicrobial and excellent hepatic. Useful as an alterative during and post-infection and useful in stimulating digestion. Though research is still early, barberry is beginning to show promise in the regulation of blood sugar, suggesting possible use in treating type II diabetes and PCOS. Part Used: Root Daily Therapeutic Dose Tincture: 3–9 mL (1:5 in 40%) Daily Therapeutic Dose Infusion or Decoction: 4–6 g dried root Pairs Well With: Bupleurum sinensis in hepatic infections. Galega officinalis in type II diabetes. Chelidonium majus and Peumus boldo in addressing gallstones. Closest Substitute: Berberis aquifolium Cinnamomum zeylanicum (Cinnamon) Primary Actions: Diaphoretic, astringent, antimicrobial, antispasmodic, carminative, endocrine modulator (diabetes) Constituents: Cinnamyl acetaldehyde and ester (only bark), phellandrene (only leaf) Indications: Type II diabetes, diarrhea, nausea, vomiting, URTI Cautions/Contraindications: Considered safe as spice used in food in doses less than 5 g. Generally CI in pregnancy and lactation. Extra Information: An excellent warming carminative, but can be too spicy for some individuals. In TCM, warms the individual, increases flow through the meridians, removes  Botanicals in Type II Diabetes obstructions to the flow of Qi, and reinforces yang. A related (and sweeter tasting) species Cinnamomum cassia has recently been associated with some hepatotoxicity in large amounts, so C. zeylanicum is generally favored for medicinal use. In treating Type II diabetes, Cinnamon has been shown to facilitate glucose transport into the cell Part Used: Bark, occ leaf Daily Therapeutic Dose Tincture: 6–12 mL (1:5 in 40%) Daily Therapeutic Dose Infusion or Decoction: 5–20 g dried bark or powder Pairs Well With: Arctium lappa for warming weak digestion – loose stools. Ginkgo biloba in circulatory formulas. Closest Substitute: Zingiber officinalis Galega officinalis (Goat’s rue) Primary Actions: Galactagogue, hypoglycemic, diaphoretic Constituents: Amines, flavonoids, saponins Indications: Insufficient breast milk production, blood sugar dysregulation, PCOS Cautions/Contraindications: Will augment effects of other hypoglycemic agents. Safety rating during pregnancy and lactation not established. Extra Information: Traditionally used in combinations to stimulate breast milk production. Commonly used in hypoglycemic treatments, possesses a similar mechanism of action to the biguanides. Part Used: Aerial parts Daily Therapeutic Dose Tincture: 12–30 mL (1:5 in 25%) Daily Therapeutic Dose Infusion or Decoction: 6–12 g dried herb Pairs Well With: Momordica charantia, Cinnamomum zeylanicum, and Gymnema sylvestris in formulas for type II diabetes Closest Substitute: Momordica charantia Momordica charantia (Bitter melon) Primary Actions: Endocrine modulator (insulin), bitter Constituents: Steroidal saponins (charantin), polypeptide-p, lectins  Botanicals in Type II Diabetes Indications: Type II diabetes, possibly PCOS Cautions/Contraindications: Considered safe, and consumed as food in many Asian cuisines. Potential to cause hypoglycemic events. Consumption of more than 2–3 of the fruit can cause GI pain and diarrhea. Extra Information: Best used as whole cooked fruit in soups and stews (or decoctions). In the literature, ongoing consumption of approximately one fruit per day (about 25 g) shows reasonable efficacy as an effective oral hypoglycemic agent. Part Used: Fruit Daily Therapeutic Dose Tincture: 6–12 mL (1:5 in 40%) Daily Therapeutic Dose Infusion or Decoction: 12–25 g as whole cooked fruit or as powder Pairs Well With: Galega officinalis, Berberis vulgaris, and Cinnamomum zeylanicum in formulas for type II diabetes Closest Substitute: Gymnema sylvestre