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Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, CANADA
Clinical Nutrition and Risk Factor Modification Centre (V.V., J.L.S., Z.X., E.Y.Y.W., U.B.Z., A.L.J., L.A.L., R.G.J., M.P.S.), St. Michaels Hospital, Toronto, Ontario, CANADA
Division of Metabolism and Endocrinology (V.V., L.A.L., R.G.J.), St. Michaels Hospital, Toronto, Ontario, CANADA
Address reprint requests to: Vladimir Vuksan, Ph.D., Clinical Nutrition and Risk Factor Modification Centre, St. Michaels Hospital, #6 138-61 Queen Street East, Toronto, Ontario, M5C 2T2, Canada. E-mail: v.vuksan{at}utoronto.ca
Despite significant achievements in treatment modalities and preventive measures, the prevalence of diabetes has risen exponentially in the last decade. Because of these limitations there is a continued need for new and more effective therapies. An increasing number of people are using dietary and herbal supplements, even though there is a general lack of evidence for their safety and efficacy. Consequently, science based medical and government regulators are calling for more randomized clinical studies to provide evidence of efficacy and safety. Our research group has selected two such promising and functionally complementary therapies for further investigation as potentially emerging alternative therapies for type 2 diabetes: Konjac-mannan (KJM) and American ginseng (AG). We have generated a mounting body of evidence to support the claim that rheologically-selected, highly-viscous KJM, and AG with a specific composition may be useful in improving diabetes control, reducing associated risk factors such as hyperlipidemia and hypertension, and ameliorating insulin resistance. KJM has a demonstrated ability to modulate the rate of absorption of nutrients from the small bowel, whereas AG has post-absorptive effects. Consequently, it appears that KJM and AG are acting through different, yet complementary, mechanisms: KJM by increasing insulin sensitivity and AG likely by enhancing insulin secretion. Before the therapeutic potential of KJM and AG as novel prandial agents for treatment of diabetes can be fully realized, further controlled trials with larger sample sizes and of longer duration are required. A determination of the active ingredients in AG, and the rheology-biology relationship of KJM are also warranted.
Key words: type 2 diabetes mellitus, konjac-mannan, American ginseng
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