by Glickman-Simon R

Diabetes is a disease that makes it hard for your body to use or store glucose. Glucose is a type of sugar the body needs for energy. Insulin is a hormone that helps move glucose into the cells. If insulin is unavailable or can’t interact with cells, glucose builds up in your blood.

Regular high blood glucose can cause damage to blood vessels and nerves. This can lead to problems with the eyes, kidneys, nerves, heart, and immune system. Good control of diabetes can help to reduce complications.

Natural Therapies

Natural therapies may help you decrease or manage symptoms. They should be used along with standard medical care not in place of.

Likely Effective

  • Topical capsaicin (extract of hot chili peppers) may reduce the pain associated with diabetic nephropathyA13, A17

Possibly Effective

The following dietary supplements may help treat problems from diabetes:

  • Acetyl-L-Carnitine is a substance produced by the body to help turn fat in energy for cells. It may also be helpful in diabetic neuropathy. A1, A4
  • Alpha-lipoic acid (oral or intravenous) is an antioxidant in foods like spinach, broccoli, yams, and tomatoes. It may reduce symptoms in patients with diabetic neuropathy. A3, A5, A10, A14
  • Astragalus membranaceus (Traditional Chinese Herb) may improve kidney function in people with diabetes related kidney diseaseA9
  • Omega-3 fatty acids in the diet may help reduce the risk of diabetic retinopathy. A16

Alternative therapies that may help include:

  • Acupuncture may reduce some symptoms in patients with diabetic neuropathy. B1

Unlikely to Be Effective

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about all herbs or supplements you are taking. Some may interact with your treatment plan or health conditions.

  • Too much vitamin E may cause problems for people who take blood thinners, are diabetic, or are taking chemotherapy for cancer treatment.A11
  • Vitamin B may worsen kidney function and increase the risk of blood vessel disease in people with diabetes A11


REFA Supplements

REFA1 De Grandis D, Minardi C. Acetyl-L-carnitine (levacecarnine) in the treatment of diabetic neuropathy. A long-term, randomised, double-blind, placebo-controlled study. Drugs R D. 2002;3(4):223-31.

REFA2 Lonn E, Yusuf S, et al; HOPE Study; MICRO-HOPE Study. Effects of vitamin E on cardiovascular and microvascular outcomes in high-risk patients with diabetes:results of the HOPE study and MICRO-HOPE substudy. Diabetes Care. 2002 Nov;25(11):1919-27.

REFA3 Ziegler D, Nowak H, et al. Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid: a meta-analysis. Diabet Med. 2004 Feb;21(2):114-21.

REFA4 Sima AA, Calvani M, et al; Acetyl-L-Carnitine Study Group. Acetyl-L-carnitine improves pain, nerve regeneration, and vibratory perception inpatients with chronic diabetic neuropathy: an analysis of two randomized placebo-controlled trials. Diabetes Care. 2005 Jan;28(1):89-94.

REFA5 Ziegler D, Ametov A, et al. Oral treatment with {alpha}-lipoic acid improves symptomatic diabetic polyneuropathy: The SYDNEY 2 trial. Diabetes Care. 2006;29:2365-2370.

REFA6 Hartweg J, Perera R, et al. Omega-3 polyunsaturated fatty acids (PUFA) for type 2 diabetes mellitus. Cochrane Database Syst Rev. 2008 Jan 23;(1):CD003205.

REFA7 Hartweg J, Farmer AJ, et al. Potential impact of omega-3 treatment on cardiovascular disease in type 2 diabetes. Curr Opin Lipidol. 2009 Feb;20(1):30-38.

REFA8 House AA, Eliasziw M, et al. Effect of B-vitamin therapy on progression of diabetic nephropathy: a randomized controlled trial. JAMA. 2010 Apr 28;303(16):1603-9.

REFA9 Li M, Wang W, et al. Meta-analysis of the clinical value of Astragalus membranaceus in diabetic nephropathy. J Ethnopharmacol. 2011 Jan 27;133(2):412-9.

REFA10 Ziegler D, Low PA, et al. Efficacy and safety of antioxidant treatment with a-lipoic acid over 4 years in diabetic polyneuropathy: the NATHAN 1 trial. Diabetes Care. 2011 Sep;34(9):2054-2060.

REFA11 Lewis EJ, Greene T, et al; Collaborative Study Group. Pyridorin in type 2 diabetic nephropathy. J Am Soc Nephrol. 2012 Jan;23(1):131-6.

REFA12 ORIGIN Trial Investigators, Bosch J, et al. n-3 fatty acids and cardiovascular outcomes in patients with dysglycemia. N Engl J Med. 2012 Jul 26;367(4):309-318.

REFA13 Derry S, Moore RA. Topical capsaicin (low concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD010111.

REFA14 Han T, Bai J, et al. A systematic review and meta-analysis of a-lipoic acid in the treatment of diabetic peripheral neuropathy. Eur J Endocrinol. 2012 Oct;167(4):465-71.

REFA15 Raval AD, Thakker D, et al. Vitamin B and its derivatives for diabetic kidney disease. Cochrane Database Syst Rev. 2015 Jan 12;1:CD009403.

REFA16 Sala-Vila A, Díaz-López A, et al. Dietary marine ω-3 fatty acids and incident sight-threatening retinopathy in middle-aged and older individuals with type 2 diabetes: Prospective investigation from the PREDIMED trial. JAMA Ophthalmol. 2016 Oct 1;134(10):1142-1149.

REFA17 Simpson DM, Robinson-Papp J, et al. Capsaicin 8% patch in painful diabetic peripheral neuropathy: A randomized, double-blind, placebo-controlled study. J Pain. 2017 Jan;18(1):42-53.

REFA18 Waldfogel JM, Nesbit SA, et al. Pharmacotherapy for diabetic peripheral neuropathy pain and quality of life: A systematic review. Neurology. 2017 May 16;88(20):1958-1967. doi: 10.1212/WNL.0000000000003882.

REFB Other Therapies

REFB1 Chen W, Yang GY, Liu B, Manheimer E, Liu JP. Manual acupuncture for treatment of diabetic peripheral neuropathy: a systematic review of randomized controlled trials. PLoS One. 2013 Sep 12;8(9):e73764.

Revision Information

  • Reviewer: EBSCO NAT Review Board Richard Glickman-Simon, MD
  • Review Date: 03/2019
  • Update Date: 03/02/2019