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Oct. 9, 2000 -- In a way, 71-year-old Marianne Shedron is a doctor's worst nightmare. About four years ago, she walked into a pharmacy in her hometown of Avon, Ohio, and walked out with an herbal product promoted as a blood sugar regulator -- Beta Fast GXR. "I wanted to get off medicine and go to something more herbal." She adds, "I was hitting [blood sugar] highs and lows so much."
The drug causing those highs and lows, she says, was glyburide, a widely used prescription product for type 2 diabetes. Shedron had been using it for six years, ever since doctors diagnosed her with the disease -- a disorder that led to the death of her mother and affected another relative, as well. Nonetheless, Shedron immediately dumped glyburide in favor of the herbal product. What she didn't do was tell her doctor -- until recently. "I told him a year ago," she says. "But I've been on it for four years." Shedron says her doctor may not have noticed the change because her blood sugar checks always turned out so well.
"I do think people need to consult their health professional before using this product," says Informulab's David Goldberg, the man behind Beta Fast GXR. But he says there's no getting away from the fact that diabetics these days are largely left on their own. "In this day and age, huge numbers of people diagnosed with diabetes do test themselves, and as a result, they are taking their care into their own hands." But when it comes to products like Beta Fast GXR, should they be?
Goldberg says the product, which contains the herb gymnema, acts in ways similar to prescription drugs.
It appears to be working for Shedron -- though she also watches her diet and tests her blood sugar daily. "I don't want to scare anybody by telling them to get off of medication," she says. "But this is satisfactory for me. This works for me."
Still, diabetes experts don't like the idea of patients keeping their doctors out of the loop. "If want to use the herbals, they have to discuss it with their diabetes management team," says Beverly Holt, RD, MPH, a certified diabetes educator in Boston.
"I think what disturbs me the most is that people have no good way to judge the safety or efficacy [of these herbal products]," says Betty Brackinridge, MS, RD, director of professional training at the Diabetes Management and Training Centers in Phoenix. "My experience is most folks just go out, buy them, and try them -- but have no basis to say whether they are safe or effective."
Brackinridge says those planning to try an herbal should first make sure it's safe, then check blood sugar levels for two days before using it and two days after -- just to get a picture as to whether it's doing anything. "That's my issue," she says. "They should be monitoring. They should have some process for including the herbal into their care so it can be done safely."
"What frequently happens is that patients start to discontinue more traditional forms of therapy in favor of these things and not monitoring their blood glucose," says Charles H. Raine, MD, of the Diabetes Control Center in Orangeburg, S.C. "Our approach for patients who come in with these kinds of things is to say, 'Let's try and see if there's anything harmful in them.'"
Even if an herb clears that hurdle, Raine says the products could be ineffective. "It's very difficult to get data on these things."
That said, Beta Fast GXR is the subject of a study at Creighton University in Omaha, Neb., involving 20 to 30 type 2 diabetics. "The goal is to find out whether it's safe and effective in promoting healthy sugar levels," Goldberg says. Results should be available next spring.
Researchers have submitted study results to the journal Diabetes Care for another natural product -- alpha lipoic acid, known by the brand name Glucotize. The product "lowers blood sugar levels, which is excellent," says Edward Byrd, of the Medical Research Institute in San Francisco, developer of the product. "Because that's what causes a lot of diabetic complications."
Forty-five-year-old Julio Castro of San Francisco says he's been taking the product for a year: "Honestly, I didn't believe it would do anything to me." He adds, "Well, I can tell you it really helps." Castro says results were so good that he dumped his daily dosage of another medication, metformin, and now gets by with a single nightly shot of insulin and the Glucotize tablets.
Diabetes educators say such experimentation should, in a sense, come as no surprise. Holt says about 35% of patients in Massachusetts never get any kind of diabetes education after they're diagnosed. "They're told to eat less. What does eating less mean? They should be eating more vegetables. If people aren't told specifics, what do you expect?"
Adds Brackenridge, "They're taking care of their diabetes. They're frustrated looking for something they can do for themselves."