Diabetes mellitus is a major cause of morbidity and mortality worldwide with an increasing prevalence. The WHO estimates a prevalence of 347 million people with diabetes worldwide in 2013. The prevalence is expected to double between 2005–2030 and the greater proportion of this increase would be in the low to middle income countries of Asia, Africa and South America.
   There is an emerging trend worldwide for patients to use complementary and alternative medications (CAM) in an attempt to improve the outcomes of their illnesses as well as to improve general well being. In addition, CAMs have gained academic, industrial and economic interest due to its high prevalence of use.
   The National Centre for Complementary and Alternative Medicine of the United States defines CAM as “ a group of medical and health care systems, practices and products that are not presently considered to be part of conventional medicine”. Complementary medicine is used with conventional therapy, whereas Alternative medicine is used instead of conventional medicine. These agents seem to have become an attractive option because of the lesser-perceived adverse reactions in comparison to prescription medications. CAM incorporates herbal remedies and other forms of therapy like acupuncture, faith healing, massage therapy, hypnosis and music therapy.

    Diabetes mellitus is an illness, where a wide array of CAMs has been used with varying success. Medicinal plants worldwide still play a prominent role in human health care. During the last few years, even in the absence of good supporting evidence, the United States alone has recorded an increase of 380% in the use of herbal remedies. Around 2–3.6 million people in the United States rely on complementary and alternative medicines for the treatment of their diabetes mellitus.
   Recent estimates show that over 80% of people living in developing countries still depend on CAM for treatment health conditions. Metformin, the first choice in the treatment of type 2 diabetes originated from the plant Galega offcinalis (French lilac or goats rue) and was once considered a CAM. Over 400 plants and compounds have so far been evaluated for use in T2 diabetes patients and over 1200 have been claimed to be remedies for the same illness.
   The worldwide trend for the use of CAMs in diabetes has increased with an overall prevalence ranging between 30%-57% in some studies. Diabetics are 1.6 times more likely than non-diabetics to use a CAM for a host of reasons.
Australia and the United Kingdom records a prevalence of 46% among diabetics.
India, a country that is steeped in tradition and boasting a rich history of healing practices records a very high use of 67% among its diabetic population. The majority of these patients (97%) used naturopathy, which often included herbalism.
It is only recently that guidelines for investigation of such remedies have developed and few herbal remedies have been studied.
Cinnamon, garlic preparations and fenugreek and multi-vitamins are some of the popular over the counter CAMs used among diabetics.
This article will attempt to bridge the evidence for cellular mechanisms of action, and human studies for using some common CAMS such as Cinnamon and fenugreek and also attempt explore anti-diabetic properties of 2 herbs and the vegetable bitter gourd.


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