Blood sugar management is vital for individuals living with prediabetes or diabetes. Alongside traditional approaches that include lifestyle changes and medication, dietary supplements are gaining popularity for their perceived natural and cost-effective qualities for managing blood sugar.
This article examines natural supplements that claim to lower blood sugar, and discusses their potential benefits and risks.
What Is Blood Sugar?
When you eat carbohydrates, glucose (or sugar) is released into your body, providing energy for your cells, explains Rekha B. Kumar, M.D, a New York City-based endocrinologist and the chief medical officer at Found, a weight management program. Keeping blood sugar balanced is important for maintaining energy and keeping other systems in our body running properly.
Insulin, a hormone produced by the pancreas, is what helps regulate blood sugar. Type 2 diabetes is caused by the body’s inadequate response to insulin, while type 1 diabetes (an autoimmune disorder) is caused by insufficient insulin production, Dr. Kumar goes on to explain.
Expert Recommended Supplements to Help Lower Blood Sugar
While some research supports the positive effects supplements can have on blood sugar, our experts agree that supplements should be used in addition to medication, diet and exercise. “It may help to view supplements as part of the toolkit but not necessarily a treatment on their own,” notes Dr. Kumar.
Additionally, it’s always a good idea to consult your physician before adding a supplement to your routine.
“Cinnamon is a spice derived from the inner bark of trees belonging to the Cinnamomum genus,” says Amy Beney, a registered dietitian and certified diabetes care and education specialist at Nutrition Insights, a nutrition private practice in Lockport, New York.
“Cinnamon is thought to increase insulin sensitivity (how well the body responds to insulin),” says Beney.
Dr. Kumar cites a 2019 meta-analysis and meta-regression in Diabetes Research and Clinical Practice that shows cinnamon significantly reduces fasting blood sugar and HOMA-IR scores (a measurement of insulin resistance) in people with type 2 diabetes and prediabetes compared to placebo. However, the researchers note that more studies are needed.
“Some individuals may be allergic to cinnamon,” says Beney. “Reactions may include skin irritation or hives, difficulty breathing and throat swelling.” Side effects from taking cinnamon may include gas and indigestion. Taking too much cinnamon may also cause or worsen liver disease.
While not often linked to blood sugar management, “aloe vera is a succulent plant that’s been used for centuries for medicinal purposes,” says Beney. “Aloe vera supplements come in pill or capsule form and contain a concentrated form of aloe vera extract or gel.”
A 2022 systematic review and meta-analysis in Journal of Pharmacy and Pharmacognosy Research examined the effect of aloe vera in individuals living with diabetes and prediabetes. The research suggests that aloe vera may reduce fasting blood sugars and the effect was more remarkable in male participants and in participants with a body mass index of less than 30. However, there was significant variation in the results, and the relationship between dosage and response couldn’t be confirmed. In other words, the study didn’t find a clear link between how much aloe vera supplement someone took and how well it worked. More research with standardized aloe vera preparation and rigorous design is needed.
“Excess consumption of low-quality aloe vera products may have adverse effects, including gastrointestinal disturbances and electrolyte imbalances,” says Beney. “Aloe vera may also interact with some medications, including those for diabetes.” Because of this possible interaction, it’s important to talk with your doctor before adding aloe vera to your diabetes regimen.
“Vitamin D is a fat-soluble vitamin that is produced naturally in our bodies in response to direct sunlight,” explains Jana Davis, a registered dietitian and certified diabetes care and education specialist at Carolina Green Living, a nutrition private practice in South Carolina. “It’s also found in foods and supplements.” Interestingly, low vitamin D levels have recently been linked in several studies to an increased risk of type 2 diabetes as well as insulin resistance. Researchers believe this link may be due to vitamin D’s ability to help lower inflammation, as more inflammation means a higher possibility of insulin resistance.
Vitamin D supplementation may be beneficial in reducing fasting blood sugar, HbA1c (a three-month blood sugar average) and HOMA-IR scores (a measurement of insulin resistance) in people with type 2 diabetes and vitamin D deficiency, according to both Dr. Kumar and Davis. Both cite a 2023 systematic review and meta-analysis in BMC Endocrine Disorders indicating these benefits. The effect was particularly notable when high doses of vitamin D were administered for a brief duration.
Vitamin D supplements may interact with some medications like statins. Excess supplementation can cause high blood calcium levels, which can lead to symptoms like nausea, vomiting and kidney stones.
Magnesium is a mineral that’s involved in over 300 bodily reactions, explains Davis, adding that adequate magnesium is necessary for vitamin D metabolism.
“Magnesium supplements can help improve blood sugars in people with diabetes or at risk of diabetes,” says Dr. Kumar, noting a 2021 systematic review and meta-analysis in Nutrients. The research additionally showed that magnesium supplementation improved insulin sensitivity. To validate these findings, researchers note that larger studies with a longer follow-up are needed.
Taking magnesium supplements on an empty stomach may cause gastrointestinal discomfort. To minimize this, Davis advises taking magnesium with food. Magnesium supplements can also interact with some medications like antibiotics.
“Berberine is a natural compound found in several plant species such as Berberis and Coptis,” says Beney. ”It has a long history of use in Chinese and Ayurvedic medicines,” often for inflammation and infection.
In a 2021 systematic review and meta-analysis in Oxidative Medicine and Cellular Longevity, berberine was shown to have several positive effects in people with type 2 diabetes. When comparing the control group to the groups treated with berberine alone or in combination with standard diabetic therapies, a significant decrease in HbA1c levels was observed in those taking berberine. Berberine also positively affected glucose metabolism, insulin resistance and inflammation. There were some limitations with this review, restricting the generalizability of these findings to a broader population.
Berberine supplements may cause gastrointestinal side effects and it’s best to consume them with a meal to minimize this, says Beney. She adds that they may interact with medications for managing diabetes, high cholesterol and high blood pressure. Additionally, berberine can interact with metformin and may increase bleeding risk. Because berberine may interact with many diabetes medications, it’s important to speak to your healthcare provider before supplementing.
“Chromium is a trace mineral that plays a role in insulin action and glucose metabolism,” says Beney. Chromium is found in many foods including meats, grains, fruits and vegetables. It also comes in supplement forms like chromium picinolate and chromium polynicotate, says Beney.
A 2020 systematic review and meta-analysis in Pharmacological Research evaluated the effects of chromium supplementation in people with type 2 diabetes. Results showed significant reductions in fasting blood sugar, insulin, HbA1c and HOMA-IR levels. However, in a 2022 systematic review and meta-analysis in Biological Trace Element Research involving people with type 2 diabetes, chromium supplementation only significantly reduced HbA1c, and didn’t improve fasting blood sugar and blood lipid levels.
Long-term safety of chromium supplementation hasn’t been extensively studied, says Beney. Isolated case reports indicate that chromium supplementation may cause adverse effects including weight loss, anemia and liver failure. Chromium supplements may interact with some medications including levothyroxine (used to treat hypothyroidism) and diabetes medications.
Because supplements don’t follow the same stringent testing that medications do, Beney recommends consulting your physician before taking a supplement and to choose a brand that adheres to the Food and Drug Administration’s current good manufacturing practices (cGMP). Always follow the directions provided by the manufacturer. And if you experience any adverse effects, discontinue use and seek medical advice.