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Doctors Reject Dietary Supplement as Diabetes Treatment

old message Doctors Reject Dietary Supplement as Diabetes Treatment Darrell Miller 07/27/05


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Date: July 27, 2005 10:27 AM
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Subject: Doctors Reject Dietary Supplement as Diabetes Treatment

Doctors Reject Dietary Supplement as Diabetes Treatment

(2/23) SUZANNE LEIGH c.1999 Medical Tribune News Service

Doctors say they will not be recommending a drug that has been found to improve insulin resistance in type 2 diabetics.

In a study published in the current issue of the Journal of the American College of Nutrition, patients with type 2 diabetes had less insulin resistance after undergoing an infusion of the amino acid L-carnitine.

Oral and injectable forms of this amino acid _ which is produced naturally in the liver_ are already prescribed as the drug levocarnitine for patients with carnitine deficiency. The drug also is available as a dietary supplement. Makers claim it can enhance athletic performance and protect against liver, kidney and heart disease.

Unlike patients with type 1 diabetes, who do not produce insulin, patients with the type 2 variation may manufacture adequate levels of insulin but develop resistance to its effects. Insulin is essential for the transportation of blood sugar, or glucose, into cells so they can produce energy.

Dr. Geltrude Mingrone and colleagues from the Catholic University in Rome evaluated the effects of insulin and L-carnitine on 15 type 2 diabetics and 20 healthy volunteers.

Earlier studies cited in the report found that L-carnitine improved heart function in diabetics and increased the level of glucose oxidation, a process that helps cells make use of glucose. The researchers found that both the diabetic group and the healthy volunteers experienced an 8-percent increase in glucose use with L-carnitine compared with a placebo.

This 8-percent increase compares modestly with a previous study using a higher dose of L-carnitine that found glucose use was increased by 17 percent. Dr. Richard K. Bernstein, director of the New York Diabetes Center in Mamaroneck, said the study demonstrated benefits that were ``only slightly higher than marginal."

Bernstein said that he prescribed L-carnitine with some success to patients with poor circulation, but did not expect to recommend it for insulin resistance. ``If we were to see an increase of 50 percent in glucose utilization, then we might want to look at the study more closely," he said. A leading national diabetes expert, who refused to be named, described the results of the study as not impressive and ``certainly no breakthrough." He said the study indicated that L-carnitine was a long way from being clinically recommended for type 2 diabetics.

Doctors said they would continue to prescribe drugs like metformin and troglitazone for insulin resistance. Dr. David M. Nathan, director of the Diabetes Center and the General Clinical Research Center at Massachusetts General Hospital in Boston, said he was satisfied with the safety and effectiveness of both drugs provided the patient was monitored at regular intervals for kidney and liver function.



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