Type 2 Diabetes - Supplements

 
Type 2 Diabetes
Also known as adult-onset diabetes, type 2 diabetes can often be managed by carefully monitoring your diet. According to research or other evidence, the following self-care steps may be helpful. 
  • Keep an eye on the GI

    Follow a low-glycemic-index diet by avoiding sweet snacks and processed foods, and emphasizing healthy carbohydrates from whole grains, beans, vegetables, and whole fruit, to help keep blood sugar levels stable.

  • Fight back with fiber   

    In addition to eating plenty of high-fiber fruits and vegetables, consider using a fiber supplement such as glucomannan or psyllium with meals.

  • Energize insulin function with weight loss and exercise

    Lower your blood sugar and improve insulin function with weight loss and regular exercise.

  • Check out chromium

    Improve glucose tolerance by taking 200 to 1,000 mcg of this essential trace mineral every day.

  • Improve and protect with ALA

    Take 600 to 1,200 mg a day of an alpha lipoic acid supplement to improve insulin sensitivity and help protect against diabetic complications such as nerve damage.

  • Try a topical ointment

    An ointment containing 0.025 to 0.075% capsaicin four times a day might help control nerve pain.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
  • Aim for a healthy weight

    Lose excess weight with a program of healthy eating, regular exercise, and group support to maintain healthy insulin sensitivity and prevent type 2 diabetes.

  • Get moving

    Use regular aerobic and/or strength exercise to maintain healthy insulin sensitivity and prevent type 2 diabetes.

  • Keep an eye on the GI

    Choose carbohydrate foods with a low glycemic index, such as whole grains, beans (legumes), and other high-fiber, unprocessed foods, to stabilize blood sugar and reduce diabetes risk.

  • Go vegetarian or vegan

    Vegetarians have been shown to have a low risk of type 2 diabetes.

  • Add some olive oil

    Extra virgin olive oil is a good source of monounsaturated fat. Increasing monounsaturated fats relative to other dietary fats has been shown to improve glucose tolerance.

These recommendations are not comprehensive and are not intended to replace the advice of your doctor or pharmacist. Continue reading for more in-depth, fully referenced information.
Also indexed as:
  • adult diabetes,
  • adult onset diabetes,
  • adult onset diabetes mellitus,
  • AODM,
  • diabetes,
  • diabetes mellitus,
  • diabetes sacarina,
  • DM,
  • DM (diabetes mellitus),
  • DM type 2,
  • NIDDM,
  • non-insulin-dependent diabetes mellitus,
  • type 2 diabetes,
  • type II diabetes,
  • type II diabetes mellitus

About this treatment

What Are "Star" Ratings?

a7_3star Reliable and relatively consistent scientific data showing a substantial health benefit.

a7_2star Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.

a7_1star For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Our proprietary “Star-Rating” system was developed to help you easily understand the amount of scientific support behind each supplement in relation to a specific health condition. While there is no way to predict whether a vitamin, mineral, or herb will successfully treat or prevent associated health conditions, our unique ratings tell you how well these supplements are understood by the medical community, and whether studies have found them to be effective for other people.

For over a decade, our team has combed through thousands of research articles published in reputable journals. To help you make educated decisions, and to better understand controversial or confusing supplements, our medical experts have digested the science into these three easy-to-follow ratings. We hope this provides you with a helpful resource to make informed decisions towards your health and well-being.


SupplementAmountWhy
Alpha Lipoic Acid
600 to 1,200 mg a day 3 stars Taking alpha lipoic acid may improve insulin sensitivity and help protect against diabetic complications such as nerve damage.


3 stars Alpha Lipoic Acid

600 to 1,200 mg a day

Alpha lipoic acid is a powerful natural antioxidant. Preliminary and double-blind trials have found that supplementing 600 to 1,200 mg of lipoic acid per day improves insulin sensitivity and the symptoms of diabetic neuropathy.53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 In a preliminary study, supplementing with 600 mg of alpha lipoic acid per day for 18 months slowed the progression of kidney damage in patients with type 2 diabetes.61

SupplementAmountWhy
Brewer’s Yeast
9 grams per day3 stars Chromium-rich brewer’s yeast has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.


3 stars Brewer’s Yeast

9 grams per day

Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.62 , 63 In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.64 , 65 Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.66 Chromium supplements improve glucose tolerance in people with type 2 diabetes,67 apparently by increasing sensitivity to insulin.68 Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy.69 , 70 Chromium even helps healthy people,71 although one such report found chromium useful only when accompanied by 100 mg of niacin per day.72 Chromium may also lower levels of total cholesterol, LDL cholesterol, and triglycerides (risk factors in heart disease).73 , 74

A few trials have reported no beneficial effects from chromium supplementation.75 , 76 , 77 All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.78 Many doctors recommend up to 1,000 mcg per day for people with diabetes.79

Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia. Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.


SupplementAmountWhy
Cayenne Topical
(Diabetic Neuropathy)
Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain3 stars Topically applied capsaicin (from cayenne) may help relieve nerve pain.


3 stars Cayenne Topical

Apply an ointment containing 0.025 to 0.075% capsaicin four times a day to areas of nerve pain

Double-blind trials have shown that topical application of creams containing 0.025 to 0.075% capsaicin (from cayenne [Capsicum frutescens]) can relieve symptoms of diabetic neuropathy (numbness and tingling in the extremities caused by diabetes).80 , 81 Four or more applications per day may be required to relieve severe pain. This should be done only under a doctor’s supervision.

SupplementAmountWhy
Chromium
200 to 1,000 mcg daily3 stars Chromium has been shown to be useful in treating type 2 diabetes in several ways, including by improving glucose tolerance.


3 stars Chromium

200 to 1,000 mcg daily

Medical reports dating back to 1853, as well as modern research, indicate that chromium-rich brewer’s yeast (9 grams per day) can be useful in treating type 2 diabetes.82 , 83 In recent years, chromium has been shown to improve glucose levels and related variables in people with glucose intolerance and type 2, gestational, and steroid-induced diabetes.84 , 85 Improved glucose tolerance with lower or similar levels of insulin have been reported in more than ten trials of chromium supplementation in people with varying degrees of glucose intolerance.86 Chromium supplements improve glucose tolerance in people with type 2 diabetes,87 apparently by increasing sensitivity to insulin.88 Chromium improves the processing of glucose in people with prediabetic glucose intolerance and in women with diabetes associated with pregnancy.89 , 90 Chromium even helps healthy people,91 although one such report found chromium useful only when accompanied by 100 mg of niacin per day.92 Chromium may also lower levels of total cholesterol, LDL cholesterol, and triglycerides (risk factors in heart disease).93 , 94

A few trials have reported no beneficial effects from chromium supplementation.95 , 96 , 97 All of these trials used 200 mcg or less of supplemental chromium, which is often not adequate for people with diabetes, especially if it is in a form that is poorly absorbed. The typical amount of chromium used in research trials is 200 mcg per day, although as much as 1,000 mcg per day has been used.98 Many doctors recommend up to 1,000 mcg per day for people with diabetes.99

Supplementation with chromium or brewer’s yeast could potentially enhance the effects of drugs used for diabetes (e.g., insulin or other blood sugar-lowering agents) and possibly lead to hypoglycemia. Therefore, people with diabetes taking these medications should supplement with chromium or brewer’s yeast only under the supervision of a doctor.


SupplementAmountWhy
Evening Primrose Oil
4 grams daily3 stars Supplementing with evening primrose oil has been found to improve nerve function and to relieve pain symptoms of diabetic neuropathy.


3 stars Evening Primrose Oil

4 grams daily

Supplementing with 4 grams of evening primrose oil per day for six months has been found in double-blind research to improve nerve function and to relieve pain symptoms of diabetic neuropathy.100

SupplementAmountWhy
Fenugreek
2.5 to 15 grams daily3 stars Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption.


3 stars Fenugreek

2.5 to 15 grams daily

Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Animal research suggests that fenugreek may also contain a substance that stimulates insulin production and improves blood sugar control. In a controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in blood glucose following the meal. Another controlled trial found that taking 2.5 grams of fenugreek twice a day for three months reduced blood sugar levels in people with mild, but not those with severe, type 2 diabetes. In a double-blind study, 1 gram per day of an extract of fenugreek seeds for two months improved some measures of blood sugar control and insulin function in people with type 2 diabetes.

SupplementAmountWhy
Fiber (All Forms)

Talk to your doctor

3 stars Taking fiber supplements may help to stabilize your blood sugar.


3 stars Fiber (All Forms)

Talk to your doctor

High-fiber supplements, such as psyllium,101 guar gum (found in cluster beans),102 pectin (from fruit),103 oat bran,104 and glucomannan,105 , 106 have improved glucose tolerance in some studies. Positive results have also been reported with the consumption of 1 to 3 ounces of powdered fenugreek seeds per day.107 , 108 A review of the research revealed that the extent to which moderate amounts of fiber help people with diabetes in the long term is still unknown, and the lack of many long-term studies has led some researchers to question the importance of fiber in improving diabetes.109 Nonetheless, most doctors advise people with diabetes to eat a diet high in fiber. Focus should be placed on fruits, vegetables, seeds, oats, and whole-grain products.

SupplementAmountWhy
Glucomannan
500 to 700 mg per 100 calories in the diet3 stars Glucomannan delays stomach emptying, leading to more gradual sugar absorption and lower blood sugar levels after meals.


3 stars Glucomannan

500 to 700 mg per 100 calories in the diet

Glucomannan is a water-soluble dietary fiber derived from konjac root (Amorphophallus konjac)that delays stomach emptying, leading to a more gradual absorption of dietary sugar. This effect can reduce the elevation of blood sugar levels that is typical after a meal. 110 After-meal blood sugar levels are lower in people with diabetes given glucomannan in their food, 111 and overall diabetic control is improved with glucomannan-enriched diets, according to preliminary and controlled clinical trials. 112 , 113 , 114 One preliminary report suggested that glucomannan may also be helpful in pregnancy-related diabetes. 115 For controlling blood sugar, 500 to 700 mg of glucomannan per 100 calories in the diet has been used successfully in controlled research.

SupplementAmountWhy
Magnesium
200 to 600 mg daily3 stars People with type 2 diabetes tend to have low magnesium levels, supplementing with the mineral may restore levels and improve insulin production.


3 stars Magnesium

200 to 600 mg daily

People with type 2 diabetes tend to have low magnesium levels.116 Double-blind research indicates that supplementing with magnesium overcomes this problem.117 Magnesium supplementation has improved insulin production in elderly people with type 2 diabetes.118 However, one double-blind trial found no effect from 500 mg magnesium per day in people with type 2 diabetes, although twice that amount led to some improvement.119 Elders without diabetes can also produce more insulin as a result of magnesium supplements, according to some,120 but not all, trials.121 However, in people with type 2 diabetes who nonetheless require insulin, Dutch researchers have reported no improvement in blood sugar levels from magnesium supplementation.122 The American Diabetes Association acknowledges strong associations between magnesium deficiency and insulin resistance but has not said magnesium deficiency is a risk factor123 Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200 to 600 mg of magnesium per day.

Diabetes-induced damage to the eyes is more likely to occur in magnesium-deficient people with type 1 diabetes.124 In magnesium-deficient pregnant women with type 1 diabetes, the lack of magnesium may even account for the high rate of spontaneous abortion and birth defects associated with type 1 diabetes.125 The American Diabetes Association admits “strong associations...between magnesium deficiency and insulin resistance” but will not say magnesium deficiency is a risk factor.126 Many doctors, however, recommend that people with diabetes and normal kidney function supplement with 200–600 mg of magnesium per day.


SupplementAmountWhy
Psyllium
5.1 grams daily with meals3 stars Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol.


3 stars Psyllium

5.1 grams daily with meals

Supplementing with psyllium has been shown to be a safe and well-tolerated way to improve control of blood glucose and cholesterol. In a double-blind trial, men with type 2 diabetes who took 5.1 grams of psyllium per day for eight weeks lowered their blood glucose levels by 11 to 19.2%, their total cholesterol by 8.9%, and their LDL (bad) cholesterol by 13%, compared with a placebo.127

SupplementAmountWhy
Acetyl-L-Carnitine
(Diabetic Neuropathy)
500 to 1,000 mg three times daily 2 stars Taking acetyl-L-carnitine may improve symptoms of diabetic neuropathy.


2 stars Acetyl-L-Carnitine

500 to 1,000 mg three times daily

In a double-blind study of people with diabetic neuropathy, supplementing with acetyl-L-carnitine was significantly more effective than a placebo in improving subjective symptoms of neuropathy and objective measures of nerve function.128 People who received 1,000 mg of acetyl-L-carnitine three times per day tended to fare better than those who received 500 mg three times per day.


SupplementAmountWhy
Aloe
1 Tbsp (15 ml) of gel daily2 stars Aloe, either alone or in combination with the oral hypoglycemic drug glibenclamide, has been shown to effectively lower blood sugar in people with type 2 diabetes.


2 stars Aloe

1 Tbsp (15 ml) of gel daily

Animal research and preliminary controlled human trials have found that Aloe vera, either alone or in combination with the oral hypoglycemic drug glibenclamide, effectively lowers blood sugar in people with type 2 diabetes.129 , 130 , 131 , 132 The typical amount used in this research was 1 tablespoon (15 ml) of aloe gel per day.

SupplementAmountWhy
American Ginseng
3 grams with or following meals2 stars Supplementing with American ginseng may help improve blood sugar control.


2 stars American Ginseng

3 grams with or following meals

In a small preliminary trial, 3 grams of American ginseng was found to lower the rise in blood sugar following the consumption of a high-glucose drink by people with type 2 diabetes.133 The study found no difference in blood sugar–lowering effect if the herb was taken either 40 minutes before the drink or at the same time. A follow-up to this study found that increasing the amount of American ginseng to either 6 or 9 grams did not increase the effect on blood sugar following the high-glucose drink in people with type 2 diabetes.134 This study also found that American ginseng was equally effective in controlling the rise in blood sugar whether it was given together with the drink or up to two hours before.

SupplementAmountWhy
Asian Ginseng
200 mg of herbal extract containing approximately 5 to 7% ginsenosides daily2 stars Asian ginseng is commonly used in traditional Chinese medicine to treat diabetes.


2 stars Asian Ginseng

200 mg of herbal extract containing approximately 5 to 7% ginsenosides daily

Asian ginseng is commonly used in Traditional Chinese Medicine to treat diabetes. It has been shown in test tube and animal studies to enhance the release of insulin from the pancreas and to increase the number of insulin receptors.135 , 136 Animal research has also revealed a direct blood sugar–lowering effect of ginseng.137 A double-blind trial found that 200 mg of ginseng extract per day improved blood sugar control, as well as energy levels in people with type 2 diabetes.138

SupplementAmountWhy
Bilberry
160 mg twice per day of an herbal extract containing 25% anthocyanosides2 stars Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy.


2 stars Bilberry

160 mg twice per day of an herbal extract containing 25% anthocyanosides

Bilberry may lower the risk of some diabetic complications, such as diabetic cataracts and retinopathy. One preliminary trial found that supplementation with a standardized extract of bilberry improved signs of retinal damage in some people with diabetic retinopathy.139

SupplementAmountWhy
Biotin
9 to 16 mg daily2 stars Biotin may improve glucose levels and reduce pain from diabetic nerve damage.


2 stars Biotin

9 to 16 mg daily

Biotin is a B vitamin needed to process glucose. When people with type 2 diabetes were given 9 mg of biotin per day for two months, their fasting glucose levels dropped dramatically.140 Biotin may also reduce pain from diabetic nerve damage.141 Some doctors try 9 to 16 mg of biotin per day for a few weeks to see if blood sugar levels will fall.

SupplementAmountWhy
Bitter Melon
50 to 100 ml of juice daily or 5 grams three times daily of powdered fruit2 stars Whole, fried slices, water extracts, and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes.


2 stars Bitter Melon

50 to 100 ml of juice daily or 5 grams three times daily of powdered fruit

Whole, fried slices,142 water extracts,143 and juice of bitter melon may improve blood-sugar control in people with type 2 diabetes,144 according to preliminary trials. However, double-blind trials are needed to confirm this potential benefit.

SupplementAmountWhy
Cinnamon
1 to 6 grams daily2 stars Cinnamon may improve glucose utilization in people with type 2 diabetes.


2 stars Cinnamon

1 to 6 grams daily

Test tube studies have suggested that cinnamon may improve glucose utilization. In a study of people with type 2 diabetes, supplementing with cinnamon in the amount of 1, 3, or 6 grams per day for 40 days was significantly more effective than a placebo at reducing blood glucose levels.145 The reduction averaged 18 to 29% in the three treatments groups, and 1 gram per day was as effective as 3 and 6 grams per day. However, in a double-blind study, supplementation with 1.5 g of cinnamon per day for six weeks was no more effective than a placebo for reducing blood sugar levels.146 Cinnamon was also ineffective in another double-blind study.147 The different results in these studies may have been due in part to differences in body weight, initial blood sugar levels, and medication use among the different populations studied.

SupplementAmountWhy
Coenzyme Q10
120 mg daily of a standardized herbal extract 2 stars Supplementing with CoQ10 may improve blood sugar metabolism.


2 stars Coenzyme Q10

120 mg daily of a standardized herbal extract

Coenzyme Q10 (CoQ10) is needed for normal blood sugar metabolism. Animals with diabetes have been reported to be CoQ10 deficient. People with type 2 diabetes have been found to have significantly lower blood levels of CoQ10 compared with healthy people.148 In one trial, blood sugar levels fell substantially in 31% of people with diabetes after they supplemented with 120 mg per day of CoQ7, a substance similar to CoQ10.149 The importance of CoQ10 supplementation for people with diabetes remains an unresolved issue, though some doctors recommend approximately 50 mg per day as a way to protect against possible effects associated with diabetes-induced depletion.

SupplementAmountWhy
Crepe Myrtle
32 or 48 mg of an herbal extract standardized to contain 1% corosolic acid2 stars Crepe myrtle has been used in folk medicine to treat diabetes. It appears to work by lowering blood glucose levels.


2 stars Crepe Myrtle

32 or 48 mg of an herbal extract standardized to contain 1% corosolic acid

Lagerstroemia speciosa, commonly known as crepe myrtle, grows in various tropical countries and Australia. In folk medicine it has been used to treat diabetes. In a preliminary study of people with type 2 diabetes, supplementing with an extract from the leaves of Lagerstroemia speciosa for two weeks resulted in a fall in blood-glucose levels averaging 20 to 30%.150 The amount used was 32 or 48 mg of a product standardized to contain 1% corosolic acid (a putative active ingredient). The larger amount was somewhat more effect than the smaller amount. Although these results are promising, additional studies are needed to demonstrate the long-term safety and efficacy of this herbal preparation.

SupplementAmountWhy
Gymnema
800 mg daily of an herbal extract standardized for 25% gymnemic acids2 stars Gymnema may stimulate the pancreas to produce insulin and may help normalize blood sugar control in people with diabetes.


2 stars Gymnema

800 mg daily of an herbal extract standardized for 25% gymnemic acids

Gymnema may stimulate the pancreas to produce insulin in people with type 2 diabetes. Gymnema also improves the ability of insulin to lower blood sugar in people with both type 1 and type 2 diabetes. So far, no double-blind trials have confirmed the efficacy of gymnema for people with any type of diabetes. However, a preliminary study of type 2 diabetics reported that 400 mg per day of gymnema extract taken for periods of 18 months or longer resulted in improvement, according to diabetes blood tests, and allowed reduction of diabetic medications.151 In a controlled trial with type 1 (insulin-dependent) diabetics, a similar amount of gymnema extract reduced requirements for insulin.152 Whether the extract used in these studies was standardized for active constituents is unclear. Recently, a preliminary trial found improved blood sugar levels after three months in a group of type 1 and type 2 diabetics who took 800 mg per day of an extract standardized for 25% gymnemic acids.153 Gymnema is not a substitute for insulin, but insulin amounts may need to be lowered while taking gymnema to avoid hypoglycemia.

SupplementAmountWhy
Hairy Basil
10 grams three times per day with meals2 stars Taking hairy basil may help people with type 2 diabetes control their blood sugar levels.


2 stars Hairy Basil

10 grams three times per day with meals

Preliminary trials of leaves and hairy basil seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels. An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides, while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol. The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil would have similar effects.

SupplementAmountWhy
Holy Basil
1,000 to 2,500 mg daily2 stars Taking holy basil may help people with type 2 diabetes control their blood sugar levels.


2 stars Holy Basil

1,000 to 2,500 mg daily

Preliminary trials of holy basil (Ocimim sanctum) leaves and hairy basil (Ocimum canum) seeds have shown that these herbs may help people with type 2 diabetes control their blood sugar levels.154 , 155 , 156 An uncontrolled study reported that 1,000 mg per day of holy basil lowered blood sugar, LDL (“bad”) cholesterol, and triglycerides,157 while a controlled trial tested 2,500 mg per day and found similar changes in blood sugar, but only minor effects on total blood cholesterol.158 The mechanism of action of holy basil leaf is not understood and it is unknown whether common culinary sweet basil (Ocimum basilicum) would have similar effects.

SupplementAmountWhy
L-Carnitine
0.25 mg per 2.2 lbs (1 kg) of body weight2 stars Supplementing with L-carnitine may reduce cholesterol and triglyceride levels in people with diabetes.


2 stars L-Carnitine

0.25 mg per 2.2 lbs (1 kg) of body weight

L-carnitine is an amino acid needed to properly utilize fat for energy. When people with diabetes were given DL-carnitine (0.5 mg per 2.2 pounds of body weight), high blood levels of fats—both cholesterol and triglycerides—dropped 25 to 39% in just ten days in one trial.159

 


SupplementAmountWhy
Milk Thistle
200 mg per day of silymarin 2 stars Supplementing with silymarin (a component of milk thistle) may help lower blood sugar levels.


2 stars Milk Thistle

200 mg per day of silymarin

In a double-blind trial, supplementation with 200 mg per day of silymarin (a component of milk thistle) three times per day for four months significantly lowered blood sugar levels compared with a placebo in patients who were taking a blood sugar–lowering drug (glibenclamide).160

SupplementAmountWhy
Multivitamin
(Infection)
Follow label instructions2 stars Supplementing with a multivitamin–mineral may give your body the nutrients it needs to help prevent common infections.


2 stars Multivitamin

Follow label instructions

In a double-blind study, supplementation of middle-aged and elderly diabetics with a multiple vitamin and mineral preparation for one year reduced the risk of infection by more than 80%, compared with a placebo.161

SupplementAmountWhy
Onion
20 grams fresh onion three times per day2 stars Large amounts of onion have been shown to lower blood sugar levels in people with diabetes, possibly by blocking the breakdown of insulin in the liver.


2 stars Onion

20 grams fresh onion three times per day

Preliminary trials and at least one double-blind trial have shown that large amounts of onion can lower blood sugar levels in people with diabetes.162 , 163 , 164 The mechanism of onion’s blood sugar-lowering action is not precisely known, though there is evidence that constituents in onions block the breakdown of insulin in the liver. This would lead to higher levels of insulin in the body.165

SupplementAmountWhy
Pycnogenol
100 to 150 mg per day 2 stars Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes and slow progression of complications such as retinopathy.


2 stars Pycnogenol

100 to 150 mg per day

Preliminary research has suggested that Pycnogenol might help lower blood sugar in people with type 2 diabetes.166 Double-blind trials have shown that 100 to 125 mg per day of Pycnogenol lowers blood sugar in people with type 2 diabetes, but improvement in measures of long-term blood sugar control has not been consistent.167 , 168

Preliminary and double-blind studies have also shown Pycnogenol (typically 120 to 150 mg per day) slows the progression of diabetic retinopathy and improves vision.169 , 170 , 171 , 172 In a controlled trial of diabetic patients with symptoms of damage to the small blood vessels of the lower legs and feet, 150 mg per day of Pycnogenol improved measures of skin health and blood flow to the feet.173 In another controlled study, diabetic skin ulcers were treated with standard medications plus either 150 mg per day of Pycnogenol orally, 100 mg pycnogenol topically applied to the ulcers, or a combination of oral and topical Pycnogenol treatment.174 All treatments produced complete healing in more subjects after six weeks compared with a control group receiving no Pycnogenol treatment, but the group receiving oral and topical Pycnogenol had the greatest reductions in ulcer size and in pain and other associated symptoms.


SupplementAmountWhy
Vitamin B1 and Vitamin B12
(Diabetic Neuropathy)
Refer to label instructions 2 stars Taking vitamin B1 combined with vitamin B12 may improve symptoms of diabetic neuropathy.


2 stars Vitamin B1 and Vitamin B12

A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.175 However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.176 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.

SupplementAmountWhy
Vitamin B1 and Vitamin B6
(Diabetic Neuropathy)
25 mg daily, with 50 mg of vitamin B6 daily2 stars Taking vitamin B1 combined with vitamin B6 may improve symptoms of diabetic neuropathy.


2 stars Vitamin B1 and Vitamin B6

25 mg daily, with 50 mg of vitamin B6 daily

A controlled trial in Africa found that supplementing with both vitamin B1 (25 mg per day) and vitamin B6 (50 mg per day) led to significant improvement of symptoms of diabetic neuropathy after four weeks.177 However, since this was a trial conducted among people in a vitamin B1–deficient developing country, these improvements might not occur in other people with diabetes. Another trial found that combining vitamin B1 (in a special fat-soluble form) and vitamin B6 plus vitamin B12 in high but variable amounts led to improvement in some aspects of diabetic neuropathy in 12 weeks.178 As a result, some doctors recommend that people with diabetic neuropathy supplement with vitamin B1, though the optimal level of intake remains unknown.


SupplementAmountWhy
Vitamin B12
(Diabetic Neuropathy)
Consult a qualified healthcare practitioner2 stars Vitamin B12 is needed for normal nerve cell function, and supplementing with it may improve symptoms of diabetic neuropathy.


2 stars Vitamin B12

Consult a qualified healthcare practitioner

Vitamin B12 is needed for normal functioning of nerve cells. Vitamin B12 taken orally has reduced symptoms of nerve damage caused by diabetes in 39% of people studied; when given both intravenously and orally, two-thirds of people improved.179 In a preliminary trial, people with nerve damage due to kidney disease or to diabetes plus kidney disease received intravenous injections of 500 mcg of methylcobalamin (the main form of vitamin B12 found in the blood) three times a day for six months in addition to kidney dialysis. Nerve pain was significantly reduced and nerve function significantly improved in those who received the injections.180 Oral vitamin B12 up to 500 mcg three times per day is recommended by some practitioners.

SupplementAmountWhy
Vitamin B6
1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily2 stars People with diabetes often have low vitamin B6 levels. Supplementing with the vitamin may restore levels and improve glucose tolerance.


2 stars Vitamin B6

1,800 mg pyridoxine alpha-ketoglutarate daily or 50 mg daily pyridoxine daily

Many people with diabetes have low blood levels of vitamin B6.181 , 182 Levels are even lower in people with diabetes who also have nerve damage (neuropathy).183 Vitamin B6 supplementation has improved glucose tolerance in women with diabetes caused by pregnancy.184 , 185 Vitamin B6 supplementation is also effective for glucose intolerance induced by birth control pills.186 In a trial that included people with type 2 diabetes, 1,800 mg per day of a special form of vitamin B6—pyridoxine alpha-ketoglutarate—improved glucose tolerance dramatically.187 Standard vitamin B6 has helped in some,188 but not all, trials.189


SupplementAmountWhy
Vitamin C
500 mg twice per day2 stars Supplementing with vitamin C may benefit people with type 2 diabetes in several ways, including by reducing sorbitol levels, urinary protein loss, and glycosylation.


2 stars Vitamin C

500 mg twice per day

As with vitamin E, vitamin C may reduce glycosylation.190 Vitamin C also lowers sorbitol levels in people with diabetes.191 Sorbitol is a sugar that can accumulate inside the cells and damage the eyes, nerves, and kidneys of people with diabetes. Vitamin C may improve glucose tolerance in type 2 diabetes,192 , 193 although not every study confirms this benefit.194 Vitamin C supplementation (500 mg twice a day for one year) has significantly reduced urinary protein loss in people with diabetes. Urinary protein loss (also called proteinuria) is associated with poor prognosis in diabetes.195 Many doctors suggest that people with diabetes supplement with 1 to 3 grams per day of vitamin C. Higher amounts could be problematic, however. In one person, 4.5 grams per day was reported to increase blood sugar levels.196

One study examined antioxidant supplement intake, including both vitamins E and C, and the incidence of diabetic retinopathy (damage to the eyes caused by diabetes).197 Surprisingly, people with extensive retinopathy had a greater likelihood of having taken vitamin C and vitamin E supplements. The outcome of this trial, however, does not fit with most other published data and might simply reflect the fact that sicker people are more likely to take supplements in hopes of getting better. For the present, most doctors remain relatively unconcerned about the outcome of this isolated report.


SupplementAmountWhy
Vitamin D
1,332 IU daily 2 stars Vitamin D is needed to maintain adequate insulin levels, and supplementing with it may improve blood sugar control in people with type 2 diabetes.


2 stars Vitamin D

1,332 IU daily

Vitamin D is needed to maintain adequate blood levels of insulin.198 Vitamin D receptors have been found in the pancreas where insulin is made, and preliminary evidence suggests that supplementation can improve some measures of blood sugar control in people with type 2 diabetes.199 , 200 In addition, in a preliminary trial supplementation with about 2,000 IU of vitamin D per day for three months significantly improved pain by almost 50% in patients with diabetic neuropathy.201 Not enough is known about optimal amounts of vitamin D for people with diabetes, and high amounts of vitamin D can be toxic; therefore, people with diabetes considering vitamin D supplementation should talk with a doctor and have their vitamin D status assessed.

SupplementAmountWhy
Vitamin E
(Diabetic Retinopathy)
1800 IU daily2 stars Vitamin E supplementation may protect against diabetic retinopathy.


2 stars Vitamin E

1800 IU daily

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.203 , 204 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,205 , 206 , 207 but not all,208 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.209 , 210 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.211 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,212 , 213 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,214 , 215 , 216 , 217 , 218 although not all,219 , 220 , 221 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.222 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke, in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension) can benefit from small amounts of vitamin E (50 IU per day).223


SupplementAmountWhy
Vitamin E
(Diabetic Neuropathy)
900 IU daily2 stars Vitamin E supplementation may protect against neuropathy.


2 stars Vitamin E

900 IU daily

People with low blood levels of vitamin E are more likely to develop type 1 and type 2 diabetes.224 , 225 Vitamin E supplementation has improved glucose tolerance in people with type 2 diabetes in most,226 , 227 , 228 but not all,229 double-blind trials. Vitamin E has also improved glucose tolerance in elderly people without diabetes.230 , 231 Three months or more of at least 900 IU of vitamin E per day may be required for benefits to become apparent.

In one of the few trials to find vitamin E supplementation ineffective for glucose intolerance in people with type 2 diabetes, damage to nerves caused by the diabetes was nonetheless partially reversed by supplementing with vitamin E for six months.232 Animal and preliminary human data indicate that vitamin E supplementation may protect against diabetic retinopathy and nephropathy,233 , 234 serious complications of diabetes involving the eyes and kidneys, respectively, though no long-term trials in humans have confirmed this preliminary evidence.

Glycosylation is an important measurement of diabetes; it refers to how much sugar attaches abnormally to proteins. Excessive glycosylation appears to be one of the causes of the organ damage that occurs in diabetes. Vitamin E supplementation has reduced the amount of glycosylation in many,235 , 236 , 237 , 238 , 239 although not all,240 , 241 , 242 studies.

In one report, vitamin E was found to impair glucose tolerance in obese patients with diabetes.243 The reason for the discrepancy between reports is not known.

Vitamin E appears to lower the risk of cerebral infarction, a type of stroke, in people with diabetes who smoke. A review of a large Finnish study of smokers concluded that smokers with diabetes (or hypertension) can benefit from small amounts of vitamin E (50 IU per day).244


SupplementAmountWhy
Zinc
(Zinc Deficiency)
15 to 25 mg per day2 stars People with type 2 diabetes tend to be zinc deficient, supplementing with zinc may help restore levels.


2 stars Zinc

15 to 25 mg per day

People with type 2 diabetes tend to be zinc deficient,245 but some evidence indicates that zinc supplementation does not improve their ability to process sugar.246 Nonetheless, many doctors recommend that people with type 2 diabetes supplement with moderate amounts of zinc (15 to 25 mg per day) as a way to correct the deficit.

SupplementAmountWhy
Açaí
Refer to label instructions 1 star Açaí is reported to be a traditional remedy for diabetes.


1 star Açaí

Açaí is reported to be a traditional remedy for diabetes. Although oxidative stress may contribute to diabetes247 and anthocyanins may improve insulin secretion,248 there is no published evidence that açaí has any effect on diabetes.

SupplementAmountWhy
Amylase Inhibitors
Refer to label instructions 1 star Amylase inhibitors, when given with a starchy meal, can reduce the usual rise in blood sugar levels of people with diabetes.


1 star Amylase Inhibitors

Starch blockers are substances that inhibit amylase, the digestive enzyme required to break down dietary starches for normal absorption. Controlled research has demonstrated that concentrated starch blocker extracts, when given with a starchy meal, can reduce the usual rise in blood sugar levels of both healthy people and diabetics.249 , 250 , 251 , 252 , 253 While this effect could be helpful in controlling diabetes, no research has investigated the long-term effects of taking starch blockers for this condition.


SupplementAmountWhy
Fish Oil
Refer to label instructions 1 star Supplementing with fish oil may improve glucose tolerance and symptoms of diabetic neuropathy and nephropathy


1 star Fish Oil

Glucose tolerance improves in healthy people taking omega-3 fatty acid supplements,254 and some studies have found that fish oil supplementation also improves glucose tolerance,255 high triglycerides,256 and cholesterol levels in people with type 2 diabetes.257 And in one trial, people with diabetic neuropathy and diabetic nephropathy experienced significant improvement when given 600 mg three times per day of purified eicosapentaenoic acid (EPA)—one of the two major omega-3 fatty acids found in fish oil supplements—for 48 weeks.258 However, other studies have found that type 2 diabetes worsens with fish oil supplementation.259 , 260 , 261 , 262 Until this issue is resolved, people with diabetes should feel free to eat fish, but they should consult a doctor before taking fish oil supplements.

SupplementAmountWhy
Fructo-oligosaccharides
Refer to label instructions 1 star In one trial, supplementing with fructo-oligosaccharides significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.


1 star Fructo-oligosaccharides

In a preliminary trial, supplementation with fructo-oligosaccharides (FOS) (8 grams per day for two weeks) significantly lowered fasting blood-sugar levels and serum total-cholesterol levels in people with type 2 diabetes.263 However, in another trial, supplementing with FOS (15 grams per day) for 20 days had no effect on blood-glucose or lipid levels in people with type 2 diabetes.264 In addition, some double-blind trials showed that supplementing with FOS or galacto-oligosaccharides (GOS) for eight weeks had no effect on blood-sugar levels, insulin secretion, or blood lipids in healthy people.265 , 266 Because of these conflicting results, more research is needed to determine the effect of FOS on diabetes and lipid levels.

SupplementAmountWhy
Ginkgo
Refer to label instructions 1 star Ginkgo may help prevent and treat early-stage diabetic neuropathy.


1 star Ginkgo

Ginkgo biloba extract may prove useful for prevention and treatment of early-stage diabetic neuropathy, though research is at best very preliminary in this area.267

SupplementAmountWhy
Goldenseal
1 gram per day of berberine for two months 1 star Preliminary research with berberine (an active compound in goldenseal) for two months lowered blood glucose levels in people with type 2 diabetes.


1 star Goldenseal

1 gram per day of berberine for two months

In a preliminary trial, supplementation with 1 gram per day of berberine (one of the active compounds in goldenseal) for two months significantly lowered blood glucose levels in patients with type 2 diabetes.268

SupplementAmountWhy
Hibiscus
Refer to label instructions 1 star Hibiscus is a traditional remedy in India for diabetes, and is supported by preliminary research.


1 star Hibiscus

Hibiscus is a traditional remedy in India for diabetes; this treatment is supported by preliminary studies from that country and by animal studies.269 , 270 Hibiscus is usually taken as tea, such as 1 to 2 teaspoons (3 to 6 grams) of dried flower infused in to 1 cup (250 ml) three times per day.

SupplementAmountWhy
Inositol
Refer to label instructions 1 star Supplementing with inositol may improve diabetic neuropathy.


1 star Inositol

Inositol is needed for normal nerve function. Diabetes can cause a type of nerve damage known as diabetic neuropathy. This condition has been reported in some, but not all, trials to improve with inositol supplementation (500 mg taken twice per day).271

SupplementAmountWhy
Manganese
Refer to label instructions 1 star People with diabetes may have low manganese levels, which can contribute to glucose intolerance. Supplementing with the mineral may help.


1 star Manganese

People with diabetes may have low blood levels of manganese.272 Animal research suggests that manganese deficiency can contribute to glucose intolerance and may be reversed by supplementation.273 A young adult with insulin-dependent diabetes who received oral manganese chloride (3 to 5 mg per day as manganese chloride) reportedly experienced a significant fall in blood glucose, sometimes to dangerously low levels. In four other cases, manganese supplementation had no effect on blood glucose levels.274 People with diabetes wishing to supplement with manganese should do so only with a doctor’s supervision.

SupplementAmountWhy
Medium-Chain Triglycerides
Refer to label instructions 1 star Medium-chain triglycerides have been found to lower blood sugar levels and may be useful in treating type 3 diabetes.


1 star Medium-Chain Triglycerides

Based on the results of a short-term clinical trial that found that medium-chain triglycerides (MCT) lower blood glucose levels,275 a group of researchers investigated the use of MCT to treat people with type 2 diabetes mellitus. Supplementation with MCT for an average of 17.5% of their total calorie intake for 30 days failed to improve most measures of diabetic control.276

SupplementAmountWhy
Mistletoe
Refer to label instructions 1 star Mistletoe extract has been shown to stimulate insulin release from pancreas cells, and it may reduce diabetes symptoms.


1 star Mistletoe

Mistletoe extract has been shown to stimulate insulin release from pancreas cells,277 and animal research found that it reduces symptoms of diabetes.278 No research in humans has yet been published; however, given mistletoe’s worldwide reputation as a traditional remedy for diabetes, clinical trials are warranted to validate these promising preliminary findings. Traditionally, mistletoe is prepared by soaking 2 to 4 teaspoons (5 to 12 grams) of chopped mistletoe in 2 cups (500 ml) of water overnight. The mixture is drunk first thing in the morning and sweetened with honey if desired. Another batch may be left to steep during the day and drunk at bedtime.

SupplementAmountWhy
Olive Leaf
Refer to label instructions 1 star Olive leaf extracts have been used experimentally to lower high blood sugar in diabetic animals.


1 star Olive Leaf

Olive leaf extracts have been used experimentally to lower elevated blood-sugar levels in diabetic animals.279 These results have not been reproduced in human clinical trials.

SupplementAmountWhy
Quercetin
Refer to label instructions 1 star Quercetin may be helpful for its ability to reduce levels of sorbitol—a sugar that accumulates in cells and damages the nerves, kidneys, and eyes of people with diabetes.


1 star Quercetin

Doctors have suggested that quercetin might help people with diabetes because of its ability to reduce levels of sorbitol—a sugar that accumulates in nerve cells, kidney cells, and cells within the eyes of people with diabetes—and has been linked to damage to those organs.280 Clinical trials have yet to explore whether quercetin actually protects people with diabetes from neuropathy, nephropathy, or retinopathy.

SupplementAmountWhy
Reishi
Refer to label instructions 1 star Reishi may have some beneficial action in people with diabetes.


1 star Reishi

Animal studies and some very preliminary trials in humans suggest reishi may have some beneficial action in people with diabetes.281 , 282


SupplementAmountWhy
Selenium, Vitamin A, Vitamin C, and Vitamin E
(Diabetic Neuropathy)
Refer to label instructions 1 star A combination of the antioxidants selenium, vitamin A, vitamin C, and vitamin E has been shown to improve diabetic retinopathy.


1 star Selenium, Vitamin A, Vitamin C, and Vitamin E

Because oxidation damage is believed to play a role in the development of diabetic retinopathy, antioxidant nutrients might be protective. One doctor has administered a daily regimen of 500 mcg selenium, 800 IU vitamin E, 10,000 IU vitamin A, and 1,000 mg vitamin C for several years to 20 people with diabetic retinopathy. During that time, 19 of the 20 people showed either improvement or no progression of their retinopathy.283 People who wish to supplement with more than 250 mcg of selenium per day should consult a healthcare practitioner.

SupplementAmountWhy
Taurine
Refer to label instructions 1 star Supplementing with taurine may affect insulin secretion and action, and may help protect the eyes and nerves from diabetic complications.


1 star Taurine

Animal studies have shown that supplementing with taurine, an amino acid found in protein-rich food, may affect insulin secretion and action, and may have potential in protecting the eyes and nerves from diabetic complications.284 However, a double-blind trial found no effect on insulin secretion or sensitivity when men with high risk for developing diabetes were given 1.5 grams per day of taurine for eight weeks.285 In another double-blind trial, taurine supplementation (2 grams per day for 12 months) failed to improve kidney complications associated with type 2 diabetes.286

SupplementAmountWhy
Vanadium
Refer to label instructions 1 star Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.


1 star Vanadium

Vanadyl sulfate, a form of vanadium, may improve glucose control in people with type 2 diabetes.287 , 288 , 289 Over a six-week period, a small group of people with type 2 diabetes were given 75 to 300 mg of vanadyl sulfate per day.290 Only in the groups receiving 150 mg or 300 mg was glucose metabolism improved, fasting blood sugar decreased, and another marker for chronic high blood sugar reduced. At the 300 mg level, total cholesterol decreased, although not without an accompanying reduction in the protective HDL cholesterol. None of the amounts improved insulin sensitivity. Although there was no evidence of toxicity after six weeks of vanadyl sulfate supplementation, gastrointestinal side effects were experienced by some of the participants taking 150 mg per day and by all of the participants taking 300 mg per day. The long-term safety of the large amounts of vanadium needed to help people with type 2 diabetes (typically 100 mg per day) remains unknown. Many doctors expect that amounts this high may prove to be unsafe in the long term.

SupplementAmountWhy
Vitamin B3
Refer to label instructions 1 star Small amounts of niacin (a form of vitamin B3) may help some people with type 2 diabetes.


1 star Vitamin B3

The intake of large amounts of niacin (a form of vitamin B3), such as 2 to 3 grams per day, may impair glucose tolerance and should be used by people with diabetes only with medical supervision.291 , 292 Smaller amounts (500 to 750 mg per day for one month followed by 250 mg per day) may help some people with type 2 diabetes,293 though this research remains preliminary.

Last Review: 05-11-2011

LogoCpyrt.gif

Copyright © 2011 Aisle7. All rights reserved. www.Aisle7.net

Learn more about Aisle7, the company.

The information presented in Aisle7 is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2011.

© 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

Advertisement
Care Circle

It Seems That You Are Not Logged In...

OR

Join Now

Welcome to Care Circle, an exclusive tool to help you take care of yourself and your loved ones. Here's how it works:

  1. Create profiles for yourself and your loved ones.
  2. Select the topics and conditions that interest each of you.
  3. Get customized news updates, original content, tools, and expert advice for each Care Circle member delivered directly to your personalized homepage.

The information you input is strictly private; you choose who has access to your Care Circle.

How do I add myself or someone else to my care circle?

Click on "Add someone." Fill out the short profile. Choose an avatar. Select the topics and conditions that interest this person from the pulldown menu. You can select as many as you want, but you must choose at least one. Click on "Add Someone" again. You should start getting updates immediately.

How do I save content to my Care Circle?

Click on "Manage My Care Circle." Select the tab of the person for whom you're saving content. Put your cursor over the piece of content that you want to save; a disk icon will appear in the righthand corner. Click on the disk and the piece of content will be moved to a save folder.

How do I add additional topics and conditions for someone in my Care Circle?

Click on "Manage My Care Circle." Select the tab for the person whose preferences you'd like to update. Under "Add More to Follow," select additional topics and conditions.

How do I delete topics and conditions for someone in my Care Circle?

Click on "Manage My Care Circle." Select the tab for the person whose preferences you'd like to update. Under "Follows," scroll over the topic or condition you want to delete. An "X" should appear on the righthand side. Click on the "X" and the topic or condition will be deleted from the list.