Supplements are like dessert, extras not to be mistaken for the main course. The recognised essentials for dealing with T2 diabetes are diet, exercise and medication.

Warning. If you live in Canada or another country blessed with a paternalistic government you are obliged not to read this. Some government officials have come to the conclusion that herbs don't have pharmacological effects and/or that on balance their interactions with or displacement of mainstream medications would be injurious to their citizens. I find the notion that herbs don't have pharmacological effects laughable but the other issues are no laughing matter. So if your access to this material is legally proscribed ... go away.

For those who live in the USA and presumably other countries please note that supplements are less subject to quality controls than food and drugs because they are aren't classified as either. Purchasers depend heavily on the reputation of the vendor.

OK. Here is what I find sufficiently important to gamble my cash on. As a T2 diabetic I expect modest returns from my investment. Most supplements typically give improvements in measurable outcomes of 10 or 20%. My choices reflect what is readily available on the shelves in New Zealand pharmacies and give the most bang for the buck.

Milk thistle

Nutri-Life Milk Thistle 10 000 complex.

These tablets contain 10 grams of milk thistle providing
100 mg Silybin, the major active ingredient in milk thistle,
aka silybum marianum. They also contain minimal amounts of barberry, globe artichoke, astragalus, dandelion and taurine. IMHO the amounts are probably window dressing.

Why bother with milk thistle?

Protecting kidneys from sugar toxicity

The unfortunate fact is about one third of T2 diabetics suffer kidney failure within 15 yrs of diagnosis. The obvious ways to reduce that risk is to control blood glucose levels especially after meal spikes. That can reduce the 10 year risk of complications to about a fifth. The open question is what more can be done to reduce that risk even further.

Most people associate milk thistle with liver protection. It's role in reducing sugar toxicity in the kidneys is less well known.

The following paper by Wenzel S, Stolte H, Soose M is a bit technical but seems to support the contention.

Reference J Pharmacol Exp Ther 1996 Dec;279(3):1520-6


Protection against neuropathy

Sorbitol levels become elevated when nerve function is impaired by elevated blood glucose. Milk thistle lowers sorbitol levels suggesting protection from neuropathy has occured. Reduction in sorbitol levels reference.

Another paper suggesting some protection against neuropathy


Effect on HDL, triglycerides et al.

It is well established that one of the common symptoms of insulin resistance is the elevation of triglycerides TG and the depressing of high density lipoprotein HDL levels. The TG:HDL ratio is used as a quick and dirty indicator of insulin resistance. A high TG:HDL ratio is also associated with the LDL particles have becoming small, dense and thoroughly nasty. NIDDMs with a Body Mass Index, BMI below 27 AND a TG:HDL ratio of less than 4:3 using USA mg/100ml units are supposed to have normal insulin sensitivity and a normal coronary heart disease risk. Whether that is true or not I keep it as one of my safety guidelines.

Raising HDL reference

Triglyceride lowering reference.

Possible prostate cancer preventative

If there is anything to this then it is a bonus.


If you are a T2 diabetic should you be taking milk thistle?

Heck I don't know and you don't expect me to know.

It is up to you and your doctor to check out whether milk thistle might interact with other medication you are taking or with other conditions.

Quentin's diet

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