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June 25, 2013

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I would be a strong proponent for CAM therapy in pre diabetes. It seems to be a little-talked-about fact that drugs like glyburide and the sulfonylureas actually tax the remaining beta-cell function of a diabetic patient and thus ultimately accelerate the disease process! its good to see that there are other alternatives at such a crucial stage for intervention.

This is promising news for those at-risk of developing diabetes since preventative treatment options are so limited. It’s important for individuals to be aware of their risk factors and be active in prevention. In addition to getting checked for diabetes every one to two years, individuals with prediabetes should be engaging in moderate exercise and weight loss strategies, as recommended by the ADA.

http://www.diabetes.org/diabetes-basics/prevention/pre-diabetes/

I firmly believe that preventative measures are key to providing optimal health for individuals. Diabetes is prevalent condition that can be diminished if more preventative methods were implemented. Once more studies are done, I think Salacia is promising to prevent individuals from becoming diabetic and diabetics from worsening. I am curious as to the form Salacia is given to individuals. This is my first time hearing about it.

Salacia is an herb common to native Indians and Sri Lanka. It is used to treat diabetes, gonorrhea, asthma, itchiness, joint pain, obesity, thirst, and menstrual problems. With regards to diabetes, it works by preventing the absorption of sugar by the body. It binds to intestinal enzymes in the body and breaks down carbohydrates. When the enzyme binds to the herbal extract of Salacia instead of carbohydrate, less glucose gets into the blood stream, resulting in lowered blood glucose and insulin levels. Like the study suggested, more research needs to be done on a large scale to investigate this remarkable finding.

This is the first time I have heard about Salacia, it looks as though it may be extremely useful. The results of this study look very promising in regards to Salacia's usefulness in treating patients with pre or actual diabetes as well as hyperlipidemia. It would be interesting to see future studies to determine if these results can be replicated. If they can be this could be a great find.

It is good to see a study that monitors efficacy in secondary endpoints like cholesterol levels for a metabolic disease. The two studies found in the monograph for Salacia on the Natural Standard website focus strictly on diabetic markers and research has consistently shown that uncontrolled lipids can increase chances of diabetes. Also, I like that this study looked at Salacia's use as a preventative therapy rather than after-the-fact. Look forward to seeing more studies done with this one.

Great point about the lifestyle changes Justin. However, it is unclear from the wording in the abstract if the Salacia group also received lifestyle changes or if the comparison was Salacia alone vs. placebo plus lifestyle changes. It would make more sense if it were the former, and if that were the case then both the salacia and placebo group would have done lifestyle changes adding to the strength of the evidence of benefit from salacia.

I was reading the monograph on salacia on natural standard database. It receives scientific evidence grade C for diabetes but it does not mention cholesterol. It would be great to see more studies on its use for diabetes and high cholesterol. As mentioned in the article, along with taking the herb, there were some lifestyle changes made which could have contributed in lowering blood sugar and cholesterol.

I agree with Andrew, Salacia may not be a standard of therapy for any of these conditions, but understanding the effects of these herbal supplements is a great jumping off point for future pharmaceutical research. It also may be a good starting point for patients with less serious co-morbidities, and limit future medication use and insulin needs.

I often see articles about supplements that describe the intervention as being better than the placebo. The important thing is to look for a difference that would make one obviously better than another. If placebo decreases cholesterol by 1 point and the intervention decreases it by 1.2 points, then neither are really that effective if the goal is ever to decrease levels by 50 points. Regardless, Salacia reticulate does sound promising as a possible way to help people who have problems with this very common disease known as high cholesterol. This supplement could turn out to be an extremely useful tool in decreasing cholesterol for patients who cannot afford prescription medication but more studies need to be done to verify the safety and efficacy of this treatment.

Janet, you are right about lifestyle modifications but who is ready to make a change first? Most people believe that even with pills they can continue without making lifestyle changes and we have to let them know is wrong. The best results are when both are combined with lifestyle first. Moreover, its mechanism of action is similar to acarbose then may be further studies can be done to compare both together. Presently I see only acarbose and miglitol as the only alpha-glucosidase blocker in the market adding one more wouldn't be a bad idea.

Janet, you are right about lifestyle modifications but who is ready to make a change first? Most people believe that even with pills they can continue with making lifestyle changes and we have to let them know is wrong. The best results are when both are combined with lifestyle first. Moreover, its mechanism of action is similar to acarbose then may be further studies can be done to compare both together. Presently I see only acarbose and miglitol as the only alpha-glucosidase blocker in the market adding one more wouldn't be a bad idea.

AJ made some great comments regarding changing diets in people with diabetes and how effective it is. We spoke with an herbalist yesterday and she stated in many cases she has her clients change their diet and lifestyle before recommending taking herbal supplements. Though integrative medicine can be beneficial in chronic disease states, I think we all need to remember that the most beneficial therapy for most chronic diseases would be starting a healthy lifestyle. If only our healthcare system gave support to patients who need constant follow up to help with lifestyle modification.

Given the rate of diabetes in our country, this is such an important area to explore further. So many people are turning to natural products and it would be great to have the evidence to show the benefit. I look forward to seeing the results from future studies.

Salacia seems to show great promise in helping treat these conditions. However, as mentioned above, this was a very small study and further research needs to be done to validate its true benefit.

Diabetes, primarily type 2, is a disease that can be improved and sometimes prevented with proper diet and exercise. In one of my classes we watched a documentary called “Simply Raw: Reversing Diabetes in 30 Days”; it is about people with diabetes who drastically improved their condition by eating a raw diet for 30 days. The documentary really highlighted the impact that a proper diet can have on this disease. Neuropathies and other complications associated with diabetes are severe so prevention of disease progression and proper glucose control are so important. Herbal products either as supplements or consumed as food can be a great way to prevent or improve diabetes and I think that is important that patients are aware of resources where they can find information on potentially beneficial therapies.

Although the study showed positive results I would have liked to see a third group taking the salacia alone without the dietary changes. Lifestyle modification can introduce a lot or variance in compliance and restrictions. Still its great to see some more promise in the push toward More naturopathic healing.

This supplement appears to be a good example of how some natural compounds can work through multiple mechanisms of action to produce potentially beneficial effects for different disease states. A contrast to the linear ligand -> receptor -> effect paradigm that we normally think of in pharmacology.

It's always great to hear about a product to help reduce blood sugar and cholesterol, since diabetes mellitus has almost become epidemic in the United States. I find it interesting that the leaf extract did not show a benefit in cholesterol, whereas the root extract did. This is an important distinction that I think is often lost on the public. CAM is a complicated science, and so two Salacia products may be quite different in composition and therefore effect.

I think it is interesting that this study targeted patients who were pre-diabetic. A lot of studies focus on patient’s who have already developed a chronic disease state, instead of looking at preventative measures. I also think it’s interesting that patients treated with root bark extract benefited more than those treated with leaf extract. Based on this study Salacia seems to be beneficial in lowering cholesterol and blood sugars for patients categorized as pre-diabetic.

I found it quite interesting that there was a difference in the bark extract and the leaf extract within the short peiod of time. Given the small numbers, I would like to see an expanded study comparing the Bark Extract to the Leaf Extract for six months to see if the leaf would catch up and meet the outcomes of the bark. Given the magnitude of the problem in the United States today, in terms of the pre-diabetic population, having another alternative solution is a good thing.

I wonder how much effect will account for the lifestyle modification in the management of glucose levels of the participants of this study.

This is an interesting study since diabetes is such a common occurrence in the population today. However, the study is very small, so further research is definitely warranted before conclusions can be made.

It’s great if salacia does actually lower lipid and blood sugar levels. These are definitely growing problems in the United States, so anything that is effective in controlling these levels will absolutely be beneficial. It sounds like the lifestyle changes were implemented in both the salacia and placebo groups, so it seems likely that the benefits were actually due to salacia. Even if not, at least the participants got to learn about appropriate diet and lifestyle changes to maintain health!

I have never heard about salacia before but it is interesting to know its importance in pre-diabetes- a stage that most people are in now unknowingly and you can imagine the huge impact this study can make. Its an area I will definitely look into in the nearest future as more studies are conducted. One other interesting aspect to know is that both the root bark extracts and leaves show beneficial qualities.

It is awesome that so many natural remedies are being brought to light for the management of such an important condition. Seeing as pre-diabetes effects so many people, it is great that something natural, such as salacia has shown beneficial effects. Of course, the sample size is small and it is clear that further, more extensive studies are needed. However, I think it is interesting that these effects were seen in only six weeks, which is how long it also takes a prescription medication for these conditions to work!

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