Insulin

Paul Reller, L.Ac.

In patients diagnosed with either Type 1 or Type 2 diabetes, Complementary and Integrative Medicine is now playing a more important role as an adjunct therapy to help control the insulin metabolism. In Type 1 Diabetes Mellitus, many patients have apparent significant destruction of the pancreatic beta cells, requiring injection of insulin to maintain glucose control, but the amount of insulin needed may depend on the ability of the body to control the glucose metabolism, and diet, exercise, nutrient supplementation, and herbal medicine, as well as acupuncture, may help the body's glucose control and insulin metabolism, to decrease the need for insulin dosage in injection, thereby decreasing long-term risks and side effects. In patients without a need for insulin injection, the need for an improved glucose control, and aids to normal insulin metabolism are essential to health maintenance, and a more proactive and informed approach by the patient will insure a better glucose control and healthier outcome. Complementary and Integrative Medicine may be an important addition to the overall treatment protocol, and utilization of the knowledgable Licensed Acupuncturist and herbalist may be an important choice for these patients.

If you are an insulin-dependant diabetic you need to understand that there are herbs and treatments, such as acupuncture, as well as improved dietary and lifestyle regimens, that may improve your body's use of insulin, and so decrease you dosage needs. The choice is not between taking insulin and taking herbs, or utilizing acupuncture versus taking insulin, but about integrating these medical treatments intelligently into your protocol. The practice of TCM, or Traditional Chinese Medicine, is a Complementary Medicine that helps the patient and their medical doctor improve the efficacy of their treatments. By doing this, you do not introduce risk into the treatment protocol, you decrease risk, by reducing harm from pharmaceutical side effects, and by helping your body to handle your diabetes with a stronger and healthier body. Chronic insulin use comes with an array of side effects, including obesity and lowered metabolic rate. Decreasing the amount of insulin that you need is an option. As an example of the research into foods and herbs that improve insulin usage in the body, a small set of examples below is provided. This data is from the USDA ARS-GRIN website of Dr. Duke, who compiles phytochemical and ethnobotanical scientific study in a professional database. In recent years, research has also proven that pancreatic beta cells may regrow, and some reversal of loss of pancreatic function may occur. A thorough holistic treatment approach may be needed to stimulate the regrowth of pancreatic beta cells and return of pancreatic insulin production, and Complementary and Integrative Medicine may help provide this comprehensive protocol.

If you are not afflicted with Diabetes Type 1, or true diabetes, your insulin problems may be even more complex. The diagnosis of Diabetes Type 2 is actually referring to Metabolic Syndrome in most cases. This implies that you have developed an imbalance that led to insulin resistance (refer to the articles on this website concerning Diabetes/Metabolic Syndrome, Metabolic Syndrome and Pre-Diabetic states, and Obesity to gain a fuller understanding). Understanding the insulin metabolism will also help when trying to reverse the underlying health problems of this disorder, as well as in managing the disease. There is an array of treatment options that can be safely incorporated into your overall treatment plan, and here again, the decisions do not involve one type of medicine versus another, but rather integrating healthy medical protocols into your overall approach to the problem, and utilizing a proactive approach.

Taking a proactive approach to diseases related to insulin is going to insure a much better outcome. Of course, true diabetes is a complicated and serious health problem that requires professional guidance. Your own knowledge is important to your health, but to insure safe and effective use of herbs and nutrient medicines you need to turn to a professional that shows knowledge and experience that you can trust. Your care needs to be monitored and your health questions and concerns addressed in a professional manner. If you are interested in these Complementary Medicine aids to a healthier life as a diabetic, schedule a consultation and find out for yourself how a Licensed Acupuncturist can help you to avoid side effects, decrease pharmaceutical dependancy and improve your ability to manage your health. With Metabolic Syndrome as well, utilizing a knowledgeable Complementary Medicine physician will insure a well ordered and systematic approach to restoration of homeostatic health.

The first thing the patient must understand in true diabetes is that when the body's homeostatic mechanisms of maintenance are hindered, a proactive approach must be taken to insure that we compensate for the lack of automatic maintenance. The patient can do much to manage their metabolic functions as well as to increase the health of systems that compensate for the problems of pancreatic dysfunction. To do this, as with all proactive health approaches, the patient needs to gain an incresed understanding of the body's metabolism over time, and to utilize a knowledgeable physician to help in this process. By exerting control over the sugar and fat metabolism and the habits of energy usage in the body, one may compensate to a large degree for the lack of insulin, or the lack of an ordered insulin response. Injecting insulin does not completely replace the natural system of insulin feedback in the body, since insulin injections do not provide enough of a variable insulin response. We compensate for this by taking blood sugar samples with a device after eating and upon waking, and varying the insulin dosage, but more can be done to control the insulin levels by controlling diet and activity, as well as improving the overall function of metabolic systems in the body.

There has been a wealth of new knowledge of the insulin metabolism, as well as the tissues in the pancreas, called the Islets of Langerhans, that produce most of the insulin in the body. In the recent past, scientists believed that the these tissues could not regenerate when they were destroyed by the autoimmune processes that define Diabetes Type 1, or true diabetes. This has been disproven. While a person with this autoimmune destruction of the insulin producing tissues is not going to be well in a month by taking herbs and getting acupuncture, there is hope that a thorough integrated and holistic approach could restore insulin production over time. In addition, there has been much progress in research toward correction of autoimmune processes, and tissue regeneration and maintenance. While it will be many years in the future before thorough human testing reveals the extent to which we can stimulate a regrowth and restoration of insulin production with a holistic approach, the patient can only benefit by utilizing these therapeutic approaches today. Holistic and Complementary Medicine does not come with the same risks and side effects of standard pharmaceutical approaches, and the side effects in Complementary Medicine usually involve improved health overall.

Understanding the Insulin Metabolism and Physiology

Insulin is a protein steroid hormone. The insulin producing cells in the pancreas are dispersed throughout the organ in islets of endocrine cells. When these small groups of cells are attacked and destroyed in the autoimmune process, the rest of the pancreas continues to function normally, producing digestive enzymes as well as other hormones.

Insulin affects and regulates many important aspects of your metabolism. As well as regulating the transport of glucose across cell membranes and utilization and storage of fats, insulin also regulates the transport of some amino acids, some fatty acids, potassium, magnesium and certain key sugar molecules, or monosaccharides. Insulin also mediates the formation of important cellular components that relate to a variety of cell functions. In addition, insulin plays an essential role in stimulation of the breakdown and reassembly of a variety of important metabolic molecules, especially in the body's factory, the liver. This metabolism not only utilizes sugars, fats and proteins for energy, but produces a variety of molecules that regulate cellular processes throughout the body, such as protein messengers, DNA and RNA. Insulin also increses rates of oxidation and enzymatic activity that controls the rates of magnesium, sodium and potassium activated breakdown and recycling of the most important muscular fuel, ATP. In addition, insulin heavily influences other bodily functions, such as vascular compliance and cognition. Problems with the insulin metabolism thus affect a wide variety of systems over time, contributing to fatique and muscle weakness, memory and cognitive function, tissue repair and maintenance, defense against cancerous growth, etc. Improving insulin metabolism in your body may improve a variety of health concerns and help you to achieve a better quality of life.

Insulin, like all hormones, acts by stimulating the activity of various receptors. Steroid hormones are very similar to one another and act in a complex feedback system, called the endocrine system. Imbalances of other hormones can have a very big impact on the insulin metabolism. As with other hormones, such as thyroid hormone, parathyroid hormone, progesterone and estrogen, function of the receptors is very important in the overall picture. A variety of nutritional deficiencies and imbalances can affect the function of the hormone receptors, and just as in subclinical hypothyroid conditions, these nutritional imbalances may play a significant role in disruption of insulin metabolism. There exists between 100 and 100,000 of these insulin receptors per cell in different tissues in our bodies depending upon the degree to which the tissues depend on the hormonal signalling of insulin. Almost all cells in the body have some insulin receptors, and insulin-like molecules have been identified that play a significant role in our physiological regulation as well, especially in the realm of inflammatory mediation and tissue growth. Different tissues in the body react to insulin in very different ways, as well. For example, while insulin regulates glucose transport and utilization in most cells in the body, it does not regulate glucose transport and utilization in the brain tissues, despite the vast number of insulin receptors in the brain. Since a steady supply of glucose in necessary for proper brain function, there is an alternate system of glucose metabolic regulation in the brain. Instead, insulin plays important roles in the brain that regulate tissue growth and repair, as well as a host of other important maintenance issues. Lowered insulin and insulin receptor sites are now a key diagnostic marker for Alzheimer’s disease, and both metabolic syndrome with insulin resistance, and neurotoxicity with advanced glycation endproducts (AGEs) and protein amyloid beta toxins called diffusable ligands, are thought to be involved in the progression of this neurodegenerative disease.

Insulin has been shown to play a host of important functions in skeletal muscle, besides glucose and fat utilization. Transport of key molecules into cells has been linked to insulin conjugation. For example, in human lymphocytes, or immune white blood cells, insulin has been shown to act as a carrier for a light activated form of a chemical called psoralen, which is used to treat a variety of diseases, including psoriasis and vitiligo, two autoimmune diseases. Psoralen is a chemical that is found in foods, and a concentrated dosage is obtained from various Chinese herbs. We see from this the importance of insulin in a variety of health problems and the optimum function of the immune system.

The link between cancer control and insulin is also heavily researched. Breast and colon cancer cell membranes have been shown to have plentiful insulin receptors, and insulin-like molecules (PPARG and IGF) have been implicated in the stimulation as well as the stopping of cancerous growth. The key to these physiological functions is balance. When there is a the correct balance of insulin and insulin-like growth factors, as well as the correct balance of insulin receptors, there is a maintenance of health. While allopathic medicine continues to treat these problems as a simple matter of attacking unwanted chemicals, molecules, cells and cell receptors in the body, we are learning that the balance of the homeostatic mechanism is much more important than specifics. The body acts in a very complex symbiotic and quantum field manner. This homeostasis is what keeps us functioning optimally. Attacking specific aspects of the metabolism and function will have dramatic effects, but restoring homeostatic balances will have even more profound effects.

Toxic effects of dietary habits and common commercial sugars and fats may be the most important drivers of pancreatic dysfunction and inhibition of normal insulin metabolism

Sustained high circulating glucose and the subsequent effects on excess insulin hormone have long been studied, but the effects of toxicity from commercial sugars and fats is now emerging as an important factor in the pathology, as well as caffeine separated from natural sources, such as coffee and tea. Excess insulin hormone drives growth of fat cells and obesity, insulin resistance, and numerous inflammatory problems, especially with cardiovascular inflammation. To really affect the overall insulin pathology, though, avoidance of key dietary toxins may be needed. The effects of glucotoxic and lipotoxic actions are not simple to analyze, though, and research is finding that an array of factors needs to be considered to describe such toxicity in the individual.

Transfats and high fructose corn syrup are the two most studied of commercial food chemicals that may exert toxic effects on pancreatic insulin metabolism. In animal studies, short-term supplementation with transfats derived from altered palm oils doubled the insulin response to a high glucose in circulation in animals with induced diabetes, but not in normal control animals (study citd below). Avoidance of transfats in an early stage of diabetic dysfunction may prevent some of the pathological effects that occur with frequent high insulin stimulation. The effects of a high-glycemic index diet have long been noted as the key contributor to weight gain and diabetes type 2, or Metabolic Syndrome, but more recent research points to a more direct role in impaired pancreatic beta-cell function, insulin resistance at cell receptors, and the chronic inflammatory mechanisms that drive pancreatic destruction and enlarged fat cells (see the Harvard study cited below). High fructose corn syrup appears to be the worst offender, but sucrose and concentrated fruit juice sweeteners also appear to be potentially toxic to the pancreas, and insulin metabolism.

Energy drinks have been shown to exert significant potentially toxic effects, especially on young adults and children. These drinks are now heavily promoted, and usually contain commercial sugars, high caffeine content, and stimulant herbs that have a potentially toxic effect and may contribute to pancreatic and liver toxicity. Studies point to the levels of caffeine and commercial sugars in energy drinks as the cause of adverse health effects, and the elimination of guarana, ephedrine, ginseng and high levels of taurine, much touted in recent years, does not appear to reduce adverse effects, but diverts public attention from the hazards of high fructose, sucrose and caffeine consumption from energy drinks. The addition of beneficial nutrient supplements and herbs to these drinks do not make them safe, especially in patients with an early diabetic state, or a high risk of diabetes. Caffeine in high energy drinks presents much greater negative impact on cardiovascular health and oxidative stress than caffeine in quality tea and coffee. Natural teas and coffees contain a host of beneficial chemicals and antioxidants that counter potential toxic effects of caffeine, and limit dosage. Caffeine added to soft drinks and especially energy drinks is potentially much more toxic, with toxic overdoses noted in many thousands of cases each year in the United States, and the effects of caffeine divorced from the natural antioxidant protections found in natural teas and coffees particularly harmful in many patients.

Insulin affectors:

insulinotonic: saw palmetto, zexie, shanyao, garlic, danggui, ginger, absinthe, gentian, mate, Am ginseng, pea sprout, okra, onion, shallot, garlic, burdock, oats, beets, bokchoy, mustard greens, cabbage, kale, collards, hemp seed, chickpea, lime, endive, cucumber, pumpkin seed, carrot, fennel, barleygrass, mango, lentil, alfalfa sprouts, avocado, strawberry, guava, thyme, spinach,
insulinogenic: ginseng, danggui, baizhi, sangbaipi, shanyao, zexie, shengma, maidong, rougui, huangqi, dazao, garlic, zhike, duzhong, lianquiao, jinyinhua, longdancao, shenjincao, dahuang, aiye, xixin, mahuang, yarrow, gotu kola leaf, comfrey root, cardamon, chamomile, cha tea, feverfew, gentian, valerian, crampbark, nettle, kale, collards, endive, dandelion greens, soy, onion, garlic, chives, bell pepper, cashew, burdock, oats, beets, cabbage, mustard greens, papaya, mango, kiwi, tamarind, pumpkin seed, fennel, adzuki bean, corn, strawberry, St Johnswort, walnut, lentil, flaxseed, 400mg Magnesium, Quercetin
insulinase inhibitor: zhimu, zexie, shanyao, danggui, longdancao, American ginseng, gingko seed, saw palmetto, purslane, mate, banana, plantain, corn, pea sprouts, oregano, garlic, ginger, elephant garlic, kale, endive, okra, cashew, oats, buckwheat, lentil, barley, barleygrass, rye, adzuki bean, asparagus, beet, avocado, achiote, bokchoy, turnip, mustard leaf, kohlrabi, broadbean, fava bean, thyme, corn, bell pepper, papaya, watermelon, guava, blueberry, apricot, peach

Key Nutrients in the Insulin metabolism

Various nutrient formulas are being developed based on current research. One example is a formula from Vitamin Research called AGE Block, which combines L-Carnosine, L-Histidine, N-Acetyl Cysteine, L-Arginine, and R-Lipoic acid in a formula to decrease formation of advanced glycation endproducts (AGEs). An example of an AGE is A1C, a marker now used extensively to diagnose diabetes. Information below will tell you how these amino acids benefit insulin metabolism.

Tyrosine: tyrosine is an amino acid that is the first in a chain on a number of key protein enzymes and hormones related to the insulin metabolism. Tyrosine is an essential amino acid, meaning that we need a steady supply in the diet, and because of the importance of tyrosine in the body, excess need can also play a part in physiological deficiency.
Inositol: inositol molecules play an important part in the mechanism of insulin release, with IP3 (inositol triphosphate) binding to receptors to allow calcium ions to control insulin release. As nutriceutical or naturopathic research improves, specific nutrient molecules are discovered to improve treatment. One form of inositol that may have a beneficial effect is inositol hexacotinate, which is a form of niacin (non-flushing). Inositol hexacotinate is proven useful to control triglyceride levels, reducing free fatty acids in circulation, improving circulation and vasodilation, and various cardiovascular and neurological disorders.
Carnitine: carnitine is an essential amino acid that plays a big role in regulation of our sugar and fat metabolism, and supplementation with carnitine in various forms has been proven to be beneficial in improving the insulin metabolism. Specific formulas of cofactors, such as alpha-lipoic acid, R-lipoic acid, N-acetyl cysteine, etc. are heavily researched to achieve specific results. A combination L-carnitine L-tartrate and the formula AGE Block (Vitamin Research), with these cofactors, is recommended to improve insulin metabolism.
Zinc monomethionine and Histidine: insulin works best when a group of six insulin molecules are bound into a complex with zinc ions holding them together. Deficiencies and excesses of zinc in the body are both common. Mineral imbalances and excesses of specific zinc molecules may hurt the zinc metabolism, as well as accumulation of heavy metal toxins in the tissues. Zinc monomethionine is a nutrient that delivers an active form of zinc to improve metabolism and benefit cellular membranes. Histidine is also important in the zinc binding of insulin complexes, and the taking of a histidine or histamine affector may have an impact on the insulin metabolims as well. Histadine is also an essential amino acid, and histadine function depends on other amino acids as well, especially cysteine. Histadine is a precursor for histamine and carnosine biosynthesis. Anti-histamine medications may have a negative effect on this metabolism, and various nutrients may have a positive effect. Many anti-histamine drugs are related to control of stomach acidity, and problems with stomach function may play a big role in the insulin dysfunctions.
4-Hydroxyisoleucine: this active metabolite of the amino acid isoleucine is found in various herbs, especially fenugreek seed, and has been studied for decades due to its modulatory insulinogenic capability. The effects of 4-Hydroxyisoleucine are dependant on the level of circulating glucose, making this an ideal and safe insulin promoter. Fennel extracts, isoleucine, and now a standardized extract of 4-Hydroxyisoleucine, are novel tools in the treatment protocol for poor insulin production and regulation.
Chromium: chromium supplementation has been proven to exert modest improvement in insulin sensitivity in obese adults with a poor diet and consumption of high fructose corn syrup, and a 2011 study at the Ajou University School of Medicine in Suwon, South Korea, found that short-term chromium supplementation in obese children of ages 9-12 resulted in a lower percentage of body fat and leaner body mass (PMID: 21216583). The effects of chromium appear to be apparent in a select subset of patients and are dose dependent and recommended for a short course of therapy. A high dosage of chromium may adversely affect other minerals, such as iron, over time. Chromium picolinate or propionate are used to more effectively deliver chromium, and patients with a poor diet and overconsumption of simple carbohydrates such as high fructose corn syrup may benefit with the short term addition of chromium picolinate supplement as part of a more complex protocol. Other studies in China indicate that the effects of chromium picolinate may be more evident at the insulin receptors, rather than directly affecting circulating insulin levels. A study at the Shanghai Medical College in 2009 found that chromium affects a cell signalling chemical associated with chronic inflammation, the p38 MAPK pathway, that aids the effects of insulin on the resolution of inflammatory cell dysfunction that perpetuates insulin resistance syndrome.

Various Chinese herbs have been studied and proven effective in stimulating increased insulin secretion from pancreatic beta cells, or affecting insulin resistance at the target cells

Gynostemma: a few types of Gnynostemma are used in Asian medicine, including Gynostemma pentaphyllum in Southeast Asia, and Gynostemma grandiflora (Jioa gu lan) in China. Studies have shown that chemicals in Gynostemma, such as phanoside, exert specific effects on the direct release of insulin from pancreatic beta cells, in a modulated manner, with pancreatic cells increasing insulin release up to twofold with increased circulating glucose, but not more than this with increased glucose stimulation (see study cited below).
Anemarrhena asphodeloides: this Chinese herb (Zhi mu) has long been used to treat diabetes, and exerts significant affects increasing glucose metabolism in the body, and glycogen synthesis in the liver. The water extract of the herb is commonly used and dose dependent. A more recent study, cited below, shows that the alcohol extract contains other chemicals that potentially exert significant insulin secretion stimulation, exerting direct effects on the beta cells of the pancreas.
Lycium chinense: this Chinese herb (Di gu pi), utilizing the dried root bark, not the fruit (Gou qi zi, or Goji berry), has also been utilized for centuries in China to treat diabetes, and like the Anemarrhena, recent studies have shown that an alcohol extract is more effective in reducing serum glucose, triglycerides, cholesterol, LDL, and improving insulin resistance, as well as decreasing body weight, in animal studies, cited below.
Berberine: berberine is a chemical found in a few Chinese herbs, especially Coptidis rhizome, or Coptis chinensis (Huang lian). This herb has long been used to reduce inflammation and treat infection, but many recent studies have found a number of effective used in medical treatment, including the improvement of insulin sensitivity in liver cells, and reduction of the excess inflammatory mediators associated with both pancreatic degneration and dysfunction, and fat cell dysfunction related to insulin resistance.

Besides these helpful effects of herbs in the insulin metabolism, many other helpful treatment strategies are available in herbal medicine, nutrient medicine, and acupuncture. Decreasing inflammatory misregulation, improving liver metabolism, helping to restore blood sugar control quicker after you eat, and achieving better hormonal balance are all essential strategies for the diabetic. Instead of waiting for your disease to overtake your health, take a proactive approach and do all that you can to achieve and restore a healthy life despite having diabetes.

Information Resources

2007 studies at the Karolinksa Institute and University Hospital, in Stockholm, Sweden, found that a chemical in the herb Gynostemma (Jioa gu lan) significantly increased insulin release in animal studies, and in a modulatory manner: http://www.ncbi.nlm.nih.gov/pubmed/17283239
2004 studies at Hanoi Medical University in Vietnam found that an alcohol extract of the herb Anemarrhena asphodeloides (Zhi mu), long used in Chinese herbal medicine to treat diabetes, significantly stimulated increased insulin secretion at both modest and high circulating glucose levels in animal studies, exerting direct effects on the pancreatic beta cells in a modulatory manner: http://www.ncbi.nlm.nih.gov/pubmed/15505760
2008 studies at Zhejiang Medical University in Hangzhou, China, found that the alcohol extract of Cortex Lycii Radicis (Di gu pi) was more effective than the water extract, and in animal studies significantly lowered serum glucose, triglycerides, cholesterol, LDL, and improved insulin resistance: http://www.ncbi.nlm.nih.gov/pubmed/19003954
2010 studies at the Hospital of Traditional Chinese Medicine of Nanjing, China, showed that the herbal chemical berberine, from the herb Coptis chinensis (Huang lian) significantly improved insulin resistance in liver cells and reduced associated inflammatory mediators TNFalpha and IL-6: http://www.ncbi.nlm.nih.gov/pubmed/21110076
2010 studies at the China Pharmaceutical University found that the chemical Resveratrol, found in various Chinese herbs, improved insulin sensitivity and reduced the expression of inflammatory cytokines from fat cells: http://www.ncbi.nlm.nih.gov/pubmed/20188786
2011 studies at Shanghai Jiaotong University in China found that luteolin, an active chemical in various Chinese herbs, including Loniceris japonica (Jin yin hua), and Humulus scandens (Lu cao), effectively reduced the negative inflammatory effects of insulin resistance on arterial endothelium: http://www.ncbi.nlm.nih.gov/pubmed/21081149
2007 studies at the Karolinksa Institute and University Hospital, in Stockholm, Sweden, found that the transfatty acid palmitate induced a doubling response in insulin secretion from a high glucose circulation in diabetes-induced study animals, but no altertion in insulin response from normal animals: http://www.ncbi.nlm.nih.gov/pubmed/17414060
In 2010, the Harvard School of Public Health, in Boston, Massachusetts, reported that recent evidence implicates high fructose corn syrup and other commercial sweeteners, such as sucrose, and concentrated fruit juice, seen in most commercial sweet beverages, as a significant contributor to insulin resistance, impaired pancreatic beta-cell function, and chronic inflammatory dysfunction associated with insulin pathology: http://www.ncbi.nlm.nih.gov/pubmed/20138901

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.