by Dr. Alex Heyne Contributor

Natural Alternatives to Metformin and Managing Diabetes

Metformin – a widely used medication for managing type 2 diabetes, acts by decreasing glucose production in the liver and improving insulin sensitivity in peripheral tissues, thus lowering blood sugar levels.

Some individuals may seek natural alternatives to metformin due to concerns about potential side effects or desire for a natural approach to health. TCM utilizes various herbs and formulas to address not only symptoms, but also underlying imbalances contributing to diabetes.

This blog will discuss TCM’s comprehensive approach to managing type 2 diabetes, including improving insulin sensitivity, stimulating insulin secretion, and protecting pancreatic function. This approach offers a complementary option to conventional treatments like Metformin.

Table of Contents

Understanding Type 2 Diabetes
TCM Approach to Type 2 Diabetes
Natural Alternatives to Metformin
- Bitter Melon
- Ginseng
- Cinnamon
- Fenugreek
Mechanisms of Action: Diabetes Management
TCM Herbs and Conventional Treatment
Conclusion
Q&A

Understanding Type 2 Diabetes

Type 2 diabetes – a chronic metabolic disorder characterized by elevated blood sugar levels due to insulin resistance and impaired insulin secretion.

Type 2 diabetes is the most common form of diabetes, comprising around 95% of all cases worldwide. Several factors contribute to the development of type 2 diabetes, including genetics, lifestyle factors such as obesity and sedentary behavior, and environmental influences.

While lifestyle modifications such as diet and exercise play a crucial role in its management, conventional treatment options often include oral medications like Metformin, which help improve insulin sensitivity and reduce glucose production in the liver.

However, these treatments may have limitations such as side effects or inadequate glycemic control over time, necessitating additional therapies or adjustments. Despite their efficacy, these treatments only address symptoms rather than addressing the underlying causes of the disease.

A Natural Approach to Managing Type 2 Diabetes

TCM employs unique diagnostic methods for diabetes, focusing on identifying patterns of disharmony within the body, including:

pulse palpation
tongue examination
questions about symptoms and medical history.

From a TCM perspective, diabetes is often viewed as a manifestation of imbalances in the body’s internal organs, particularly the spleen-pancreas and kidneys. Herbal treatment principles aim to restore balance by addressing these underlying imbalances, rather than simply treating symptoms.

TCM herbal treatments for diabetes are tailored to each individual based on their specific TCM diagnosis and other patient-specific factors such as constitution/genetics, lifestyle, and environmental influences. By creating individualized herbal treatment plans, TCM practitioners can address the unique needs of each patient.

A 2002 scientific review examined the effectiveness of Chinese herbal medicines in treating type 2 diabetes. Sixty-six randomized trials involving 8302 participants were analyzed. Some herbal medicines, such as Holy basil leaves and Xianzhen Pian, showed significant hypoglycemic effects compared to placebos. Additionally, certain herbal medicines exhibited better metabolic control compared to hypoglycemic drugs like glibenclamide. Some herbal preparations, when combined with hypoglycemic drugs, showed additional benefits.

Read More: Anti Inflammatory Herbs

Natural Alternatives to Metformin

If you are looking for natural ways to get your blood sugar under control, consider:

Bitter melon – also known as Momordica charantia; a tropical and subtropical vine from the Cucurbitaceae family; known for its distinctive bitter taste; the fruit is oblong and warty, typically green in color, though it turns yellow or orange as it ripens; has potential health benefits, including blood sugar regulation, digestion aid, and immune system support
Ginseng – a slow-growing perennial plant belonging to the genus Panax, with roots that are highly valued for their adaptogenic properties, which are believed to help the body resist stress and restore balance; commonly used to boost energy, enhance mental focus, improve immune function, and support overall well-being
Cinnamon Twig – refers to the young, tender branches of the cinnamon tree; also known as Gui Zhi; believed to have warming properties and are used to improve circulation, relieve pain, and support the immune system.
Cinnamon Bark – the most common form of cinnamon used as a spice; outer bark of the cinnamon tree is stripped away, and the inner bark is then rolled into sticks, also known as quills, or ground into a powder; valued for its potential benefits, including blood sugar regulation, anti-inflammatory effects, and antimicrobial properties.
Fenugreek – an herb native to the Mediterranean region, southern Europe, and western Asia; belongs to the legume family and is known for its aromatic seeds and leaves; believed to have various health benefits, including aiding digestion, improving blood sugar levels, reducing cholesterol, and enhancing milk production in breastfeeding mothers

Bitter Melon

Several TCM herbs show potential in managing diabetes effectively. Bitter melon, known for its bitter taste and cooling properties, has been utilized for centuries in TCM for its purported ability to lower blood sugar levels.

Research suggests that bitter melon may improve insulin sensitivity, promote glucose uptake by cells, and inhibit glucose absorption in the intestines. A 2020 study aimed to evaluate bitter melon as an adjunct treatment for type 2 diabetes through a randomized, placebo-controlled trial. After 12 weeks, while there were no significant differences in age, sex, or glycated hemoglobin levels between groups, the bitter melon group showed a decrease in average fasting glucose levels compared to placebo. No serious adverse events were reported. This suggests that bitter melon may have glucose-lowering effects in type 2 diabetes patients.

Ginseng

Similarly, ginseng, a well-known adaptogenic herb, has demonstrated antidiabetic effects by enhancing insulin secretion, improving glucose tolerance, and reducing oxidative stress.

A 2022 systematic review of 20 randomized controlled trials assessed the effects of ginseng supplementation on cardiometabolic biomarkers in individuals with prediabetes and type 2 diabetes. Ginseng supplements were found to lower fasting plasma glucose, total cholesterol, and markers of inflammation while increasing heart rate and a marker of inflammation.

The effects on insulin resistance and cholesterol levels varied based on the dose and duration of supplementation. Higher doses of ginseng were associated with significant changes in total and LDL cholesterol. Overall, ginseng supplementation appears promising for improving cardiovascular and metabolic health in people with prediabetes and type 2 diabetes.

Cinnamon Twig and Bark

Cinnamon twig and bark, another commonly used herb in TCM, has shown promise in improving insulin sensitivity and reducing fasting blood sugar levels in individuals with type 2 diabetes.

A 2022 scientific review examined the potential benefits of cinnamon on type 2 diabetes mellitus, focusing on its bioactive compounds. Using PubMed, Medline, and Cochrane Library databases, studies from 2000 to 2022 were analyzed. Cinnamon demonstrated improvements in glycemic and lipid profiles, with evidence suggesting anti-inflammatory effects.

In vitro and in vivo studies indicate cinnamon’s regulation of glucose metabolism via insulin-mimetic effects and improved enzyme activity. Additionally, it appears to reduce cholesterol and fatty acid absorption in the gut. However, comparing results is challenging due to variations in cinnamon doses, extracts, administration forms, and concurrent antidiabetic therapies across studies.

Fenugreek

Fenugreek, with its rich history in both TCM and Ayurveda, has been found to lower blood sugar levels by slowing down carbohydrate digestion and improving insulin sensitivity.

A 2015 study aimed to investigate whether dietary supplementation with Fenugreek could prevent the progression to type 2 diabetes mellitus in individuals with prediabetes. Over three years, one group took fenugreek powder (66 people), while another group didn’t (74 people).

The fenugreek group had fewer cases of diabetes and better blood sugar and cholesterol levels. Their insulin levels went up. People in the non-fenugreek group were 4.2 times more likely to get diabetes. The study suggests fenugreek could help prevent diabetes in people with prediabetes by improving insulin resistance, with no side effects noticed.

Mechanisms of Action: Diabetes Management

These TCM herbs’ mechanisms of action vary, but often involve multiple pathways. For instance, bitter melon contains bioactive compounds like charantin and momordicin, which mimic insulin and stimulate glucose uptake by cells.

Ginseng compounds called ginsenosides have been found to modulate insulin secretion and improve pancreatic beta-cell function. Cinnamon contains polyphenols that enhance insulin signaling and increase glucose transport. Fenugreek seeds are rich in soluble fiber and trigonelline, which delay carbohydrate digestion and absorption, consequently reducing postprandial blood sugar levels.

Herb	Bioactive Compound	Mechanism of Action
Bitter Melon	Charantin, Momordicin	Mimic insulin and stimulate glucose uptake by cells.
Ginseng	Ginsenosides	Mimic insulin and stimulate glucose uptake by cells.
Cinnamon	Polyphenols	Enhance insulin signaling and increase glucose transport.
Fenugreek	Soluble Fiber, Trigonelline	Delay carbohydrate digestion and absorption, reducing postprandial blood sugar levels.

Read More: 5 Surprising Facts About Ginseng

Watch: The 7 Most Powerful Healing Herbs

TCM Herbs and Conventional Treatment

By combining TCM herbs with conventional treatments such as oral medications like Metformin or insulin therapy, patients with diabetes may experience enhanced therapeutic outcomes. TCM herbs can complement conventional treatments by addressing underlying imbalances, improving insulin sensitivity, and promoting overall well-being.

According to a 2011 scientific article, type 2 diabetes mellitus affects 95% of diabetic individuals and presents a significant management challenge. TCM is often used alongside standard antidiabetic drugs to improve symptoms. Certain single herbs like Ginseng, Bitter melon, and Cinnamon, as well as specific TCM formulas, show promise in treating T2DM by improving insulin sensitivity, stimulating insulin secretion, and protecting pancreatic function.

However, pinpointing the exact antidiabetic components in TCM remains difficult. Despite this, TCM is gaining popularity as a complementary treatment for T2DM. Future research should focus on validating the chemical, pharmacological, and clinical aspects of TCM, particularly for frequently prescribed herbs.

This article also listed 30 traditional Chinese herbal formulas approved by China SFDA (Table 1). The majority of these Chinese formulas were administered alongside standard compounds like glibenclamide or metformin, demonstrating superior efficacy in reducing blood glucose levels and ameliorating diabetic symptoms compared to standard drugs alone in patients with Type 2 Diabetes Mellitus (T2DM).

Additionally, this article assembled a helpful infographic depicting Antidiabetic effects of classic traditional Chinese herbs and their action model in treatment of T2DM patients based on the theory of traditional Chinese medicine.

To ensure safe and effective integration of TCM herbal therapy into diabetes management, collaboration between TCM practitioners and healthcare providers is crucial. Healthcare providers can provide valuable insights into patients’ medical history, current treatments, and potential interactions with TCM herbs, while TCM practitioners can offer expertise in herbal formulations and individualized treatment plans based on TCM diagnosis.

Conclusion

As you navigate natural alternatives to metformin, it’s essential to consider the potential benefits of incorporating TCM herbal options into your treatment regimen under professional guidance. By consulting with qualified TCM practitioners, you can explore herbal remedies tailored to your specific needs and health conditions, complementing conventional diabetes treatments.

By looking into natural alternatives to metformin, you can unlock new avenues for improving glycemic control, enhancing quality of life, and nurturing holistic wellness.

Read More: 4 Chinese Herbs for Allergies

Watch: Here’s What Happens When You Stop Eating Sugar for 14 Days

Metformin, Type 2 Diabetes, and TCM Q & A

1. What is metformin, and how does it help with insulin regulation?

Answer: Metformin is a widely prescribed oral medication for type 2 diabetes. It works by reducing the liver’s production of glucose, increasing insulin sensitivity, and enhancing the uptake of glucose by cells. This helps lower blood sugar levels and improves the body’s response to insulin.

2. Can TCM herbs be used alongside metformin to manage insulin resistance?

Answer: Some TCM herbs, like berberine (found in Coptis chinensis), have been studied for their insulin-sensitizing effects. These herbs may complement metformin’s action, but it’s crucial to consult with a healthcare provider before combining them to avoid potential interactions or side effects.

3. How do TCM approaches differ from metformin in managing blood sugar and insulin levels?

Answer: TCM focuses on balancing the body’s energy, or “Qi,” and often uses a holistic approach involving diet, lifestyle changes, acupuncture, and herbal remedies to regulate blood sugar and insulin levels. Metformin, on the other hand, is a pharmacological approach that directly targets glucose production and insulin sensitivity.

4. Are there any TCM herbs known to mimic the effects of insulin similar to metformin?

Answer: Bitter melon (Momordica charantia) is a TCM herb known for its insulin-like properties. Compounds like charantin and momordicin in bitter melon can mimic insulin and stimulate glucose uptake by cells, similar to how metformin enhances insulin sensitivity.

5. Can metformin and TCM treatments be used together to treat insulin resistance?

Answer: In some cases, metformin and TCM treatments may be used together to manage insulin resistance, but this should only be done under the guidance of a healthcare provider. The combination could potentially offer a more comprehensive approach, but careful monitoring is required to ensure safety and efficacy.