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Canadian Diabetes Association Clinical Practice Guidelines Natural Health Products in Type 2 Diabetes Chapter 21 Richard Nahas, Jeannette Goguen.

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Presentation on theme: "Canadian Diabetes Association Clinical Practice Guidelines Natural Health Products in Type 2 Diabetes Chapter 21 Richard Nahas, Jeannette Goguen."— Presentation transcript:

1 Canadian Diabetes Association Clinical Practice Guidelines Natural Health Products in Type 2 Diabetes Chapter 21 Richard Nahas, Jeannette Goguen

2 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association Natural Health Product Checklist ASK about natural health products being used to treat diabetes BE AWARE that no natural health products are proven and some may be harmful 2013

3 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association Commonly Used by Patients, Poorly Understood by Practitioners Concerns Purity Standardization Contamination Lack of evidence for efficacy and safety Prospects May have some effect May be sources of future therapies (eg. metformin from French lilac)

4 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association Some Have Shown Benefit in Small Trials Coccinia cordifolia (ivy gourd) Ganoderma lucidum (reishi mushroom) Salacia reticulata Soybean-derived pinitol extract Touchi soybean extract Pterocarpus marsupium (Indian kino tree) Etc... ↓ A1C by ≥0.5% in trials lasting ≥3 months in T2DM

5 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association Citrullus colocynthis (bitter cucumber) can induce diarrhea Momordica charantia (bitter melon) is an abortifacient Hypericum perforatum (St. John’s wort) alters drug metabolism But Some Have Been Harmful

6 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association 1.Natural health products are not recommended for glycemic control for individuals with diabetes, as there is insufficient evidence at this time regarding efficacy and safety [Grade D, Consensus] Recommendation 1

7 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association Recommendation 2 2.Healthcare providers should ask about the use of natural health products [Grade D, Consensus]

8 guidelines.diabetes.ca | BANTING ( ) | diabetes.ca Copyright © 2013 Canadian Diabetes Association CDA Clinical Practice Guidelines – for professionals BANTING ( ) – for patients


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