Expert: herbs, lifestyle changes can be effective in diabetes.(CLINICAL ROUNDS)

SAN DIEGO -- Use of natural herbs along with a holistic approach of diet, exercise, stress management, and a variety of nutritional supplements should serve as frontline treatment for diabetes whenever possible, according to a specialist in the practice of complementary and alternative medicine.

Dr. Edward Linkner, a founding member of the American Board of Integrative Holistic Medicine and current member of their board of directors, addressed a meeting sponsored by the Scripps Center for Integrative Medicine and the American Board of Integrative Holistic Medicine.

Although Dr. Linkner, who practices in Ann Arbor, Mich., prescribes diabetes medications for his patients with the disease, he said he does so reluctantly because the available drugs on the market "can't correct the underlying nutrient deficiencies."

Diabetes drugs "treat numbers such as high lipids, glucose, or blood pressure; some may not treat the insulin resistance," he added. "Then there are side effects. For example, metformin will decrease folic acid and vitamin [B.sub.12] and increase homocysteine levels."

Similarly, herbs need to be used with caution by patients who are already on prescription medications, Dr. Linkner noted, because they may lower glucose and possibly cause hypoglycemia in combination. His list of recommendations includes:

* Ginseng. Taking 1-3 g 40 minutes before a meal "will lower postprandial glucose levels," Dr. Linkner said. It may also slow digestion and absorption of carbohydrates, "and it helps mood and helps people lose weight." He cautioned that ginseng may inhibit the effect of warfarin in patients.

* Bitter melon (Memordica charantia). Native to Asia, Africa, and South America, this herb contains polypeptide-p, which resembles insulin. It can reduce insulin resistance by increasing glucose transport proteins in muscle. The recommended dose is 5-15 mL of tincture or 100-200 mg caps of standardized extract t.i.d.