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  1. Josefson D. Complementary medicine is booming worldwide. BMJ. 1996;313:131-133.
  2. Marwick C. Alterations are ahead at the OAM. JAMA. 1998;280:1553-1554.
  3. Eisenberg DM, Kessler RC, Foster C, Norlock FE, Calkins DR, Delbanco TL. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med. 1993;328:246-352.
  4. Miller LG, Hume A, Mehra Harris I, et al. White paper on herbal products. Pharmacotherapy. 2000;20:877-891.
  5. Eisenberg DM, Davis RB, Ettner SL, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. JAMA. 1998;280:1569-1575.
  6. Sabo CE, Rush Michael S, Temple LL. The use of alternative therapies by diabetes educators. Diabetes Educ. 1999;25:945-946;949-950;952-954;956.
  7. Gill GV, Redmond S, Garratt F, Paisey R. Diabetes and alternative medicine: cause for concern. Diabet Med. 1994;11:210-213.
  8. Astin JA. Why patients use alternative medicine - results of a national study. JAMA. 1998;279:1548-1553.
  9. Elder NC, Gillcrist A, Minz R. Use of alternative health care by family practice patients. Arch Fam Med. 1997;6:181-184
  10. Anderson DL, Shane-McWhorter L, Crouch B, Andersen SJ. Alternative medication use in rheumatology and geriatric patients. Pharmacotherapy. 2000;8:958-966.
  11. Shaw D, Leon C, Koley S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf. 1997;17:342-356.
  12. Boullata JI, Nace AM. Safety issues with herbal medicine. Pharmacotherapy. 2000;20:257-269.
  13. Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158:220-222.
  14. Fugh-Berman A. Herb-drug interactions. Lancet.2000;355:134-138.
  15. Bonati A. How and why should we standardize phytopharmaceutical drugs for clinical validation? J Ethnopharmacol. 1991;32:195-197.
  16. Grant KL. Patient education and herbal dietary supplements. Am J Health-Syst Pharm. 2000;57:1997-2003.
  17. Nortier JL, Muniz Martinez MC, Schmeiser HH, et al. Urothelial carcinoma associated with the use of a chinese herb (Aristolochia fangchi). N Engl J Med. 2000;342:1686-1692.
  18. U.S. Food and Drug Administration: Regulation on statements made for dietary supplements concerning the effect of the product on the structure or function of the body. Federal Register. January 6, 2000;65:1000-1050.
  19. Norcross WA, Ganiats TG, Ralph LP, Seidel RG, Ikeda TS. Accidental poisoning by warfarin-contaminated herbal tea. Western J Med. 1993;159:80-82.
  20. Blumenthal M. Industry alert: plantain adulterated with digitalis. Herbal Gram. 1997;350:1598-1599.
  21. U.S. Food and Drug Administration. Dietary supplement strategy (ten year plan). Center for Food Safety and Applied Nutrition. Washington, DC, January 2000. Available at:
  22. Sarubin A. The Health Professional's Guide to Popular Dietary Supplements. Chicago, IL: American Dietetic Association; 2000.
  23. Blumenthal M, Busse WR, Goldberg A, et al. eds. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Trans. S.Klein. Boston, MA: American Botanical Council; 1998.
  24. The Review of Natural Products by Facts and Comparisons. St Louis, Mo: Wolters Kluwer Co; 1999.
  25. Jellin JM, Batz F, Hitchens K. Pharmacist's Letter/Prescribers Letter Natural Medicines Comprehensive Database. Stockton, Ca: Therapeutic Research Faculty; 2000.
  26. Kapoor LD. Handbook of Ayurvedic Medicinal Plants. Boca Raton, Fl: CRC Press Inc; 1990:200-201.
  27. Shanmugasundaram ER, Panneerselvam C, Samudram P, Shanmugasundaram ERB: Enzyme changes and glucose utilisation in diabetic rabbits: the effect of gymnema sylvestre. J Ethnopharmacol 1983;7:205-34.
  28. Persaud SJ, Al-Majed H, Raman A, Jones PM. Gymnema sylvestre stimulates insulin release in vitro by increased membrane permeability. J Endocrinol. 1999;163:207-212.
  29. Shanmugasundaram ERB, Gopinath KL, Radha Shanmugasundaram KR, Rajendran VM. Possible regeneration of the islets of langerhans in streptozotocin-diabetic rats given gymnema sylvestre leaf extracts. J Ethnopharmacol. 1990;30:265-279.
  30. Shanmugasundaram ERB, Rajeswari G, Baskaran K, et al. Use of gymnema sylvestre leaf extract in the control of blood glucose in insulin-dependent diabetes mellitus. J Ethnopharmacol. 1990;30:281-294.
  31. Baskaran K, Kizar B, Ahamath K, Radma Shanmugasundaram K, Shanmugassundaram ERB. Antidiabetic effect of a leaf extract from gymnema sylvestre in non-insulin-dependent diabetes mellitus patients. J Ethnopharmacol. 1990;30:295-306.
  32. Madar Z. Fenugreek (trigonella foenum-graceum) as a means of reducing postprandial glucose levels in diabetic rats. Nut Rep Inter. 1984;29:1267-1273.
  33. Raghuram TC, Sharma R, Sivakumar D, Sahay BK. Effect of fenugreek seeds on intravenous glucose disposition in non-insulin dependent diabetic patients. Phytotherapy Research. 1994;8:83-86.
  34. Patil SP, Niphadkar PV, Bapat MM. Allergy to fenugreek (trigonella foenum graecum). Ann Allergy Asthma Immunol. 1997;78:297-300.
  35. Sharma RD, Raghuram TC, Sudhakar Rao N. Effect of fenugreek seeds on blood glucose and serum lipids in type 1 diabetes. Eur J Clin Nutr. 1990;44:301-306.
  36. Madar Z, Abel R, Samish S, Arad J. Glucose-lowering effect of fenugreek in non-insulin dependent diabetics. Eur J Clin Nutr. 1988;42:51-54.
  37. Sharma RD, Sarkar A, Hazra DK, et al. Use of fenugreek seed powder in the management of non-insulin-dependent diabetes mellitus. Nutr Res. 1996;16:1331-1339.
  38. Ali, K, Khan AK, Mamum MI, Mosihuzzaman M, Nahar N, Nur-e-Alam M, Rokeya B: Studies on hypoglycaemic effects of fruit pulp, seed, and whole plant of momordica charantia on normal and diabetic model rats. Planta Med 1993;56:408-12.
  39. Aslam M, Stockley IH: Interaction between curry ingredient (karela) and drug (chlorpropamide). Lancet. 1979;i:607.
  40. Ahmad N, Hassan MR, Halder H, Bennoor KS. Effect of momordica charantia (karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients. Bangladesh Med Res Counc Bull. 1999;25:11-13.
  41. Khanna P, Jain SC, Panagariya A, Dixit VP. Hypoglycemic activity of polypeptide-p from a plant source. J Nat Prod. 1981;44:648-655.
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  44. Vogler BK, Pittler MH, Ernst E. The efficacy of ginseng, a systematic review of randomized clinical trials. Eur J Clin Pharmacol. 1999;55:567-575.
  45. Vuksan V, Sievenpiper JL, Koo VY, et al. American ginseng (Panax quinquefolius L) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus. Arch Intern Med. 2000;160:1009-1013
  46. Siegel RK. Ginseng abuse syndrome: problems with the panacea. JAMA. 1979;241:1614-1615.
  47. Cui J, Garle M, Eneroth P, Bjorkhem I. What do commercial ginseng preparations contain? [letter] Lancet. 1994;344:134.
  48. Sotaniemi EA, Haapakoski E, Rautio A. Ginseng therapy in non-insulin dependent diabetic patients. Diabetes Care. 1995;18:1373-1375.
  49. Ibanez-Camacho R, Roman-Ramos R. Hypoglycemic effect of opuntia cactus. Arch Invest Med. 1979;10:223-230.
  50. Frati-Munari AC, Gordillo BE, Altaminrano P, Ariza CR. Hypoglycemic effect of Opuntia streptacantha Lemaire in NIDDM. Diabetes Care. 1988;11:63-66.
  51. Frati AC, Gordillo BE, Altamirano P, Ariza CR, Cortes-Franco R, Chavez-Negrete A. Acute hypoglycemic effect of opuntia streptacantha lemaire in NIDDM. [letter] Diabetes Care. 1990;13:455-456.
  52. Ghannam N. The antidiabetic activity of aloes: preliminary clinical and experimental observations. Horm Res. 1986;24:288-294.
  53. Muth ER, Laurent JM, Jasper P. The effect of bilberry nutritional supplementation on night visual acuity and contrast sensitivity. Altern Med Rev. 2000;5:164-173.
  54. Pepping J. Alternative therapies-milk thistle: silybum marianum. Am J Health-Syst Pharm. 1999;56:1195-1197.
  55. Velussi M, Cernigoi AM, De Monte A, Dapas F, Caffau C, Zilli M. Long-term (12 months) treatment with an anti-oxidant drug (silymarin) is effective on hyperinsulinemia, exogenous insulin need and malondialdehyde levels in cirrhotic diabetic patients. J Hepatol. 1997;26:871-879.
  56. Flora K, Hahn M, Rosen H, Benner K. Milk thistle (silybum marinum) for the therapy of liver disease. Am J Gastroenterol. 1998;93:139-143.
  57. Food and Nutrition Board. Institute of Medicine. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington DC: National Academy Press; 2001.
  58. Anderson R, Polansky M, Bryden N, Canary J. Supplemental chromium effects on glucose, insulin, glucagon, and urinary chromium losses in subjects consuming controlled low-chromium diets. Am J Clin Nutr. 1991;54:909-916.
  59. Anderson RA, Cheng N, Bryden NA, et al. Elevated intakes of supplemental chromium improves glucose and insulin variables in individuals with type 2 diabetes. Diabetes. 1997; 46:1786-1791.
  60. Cefalu WT, Bell-Farrow AD, Stegner J, et al. Effect of chromium picolinate on insulin sensitivity in vivo. J Trace Elem Exp Med. 1999;12:71-83.
  61. Jovanovic L, Gutierrez M, Peterson CM. Chromium supplementation for women with gestational diabetes mellitus. J Trace Elem Exp Med. 1999;12:91-07.
  62. Abraham AS, Brooks BA, Eylath U. The effects of chromium supplementation on serum glucose and lipids in patients with and without non-insulin-dependent diabetes. Metabolism. 1992;41:768-71.
  63. Uusitupa MJ, Mykkanen L, Siitonen O, Laakso M, Sarlund H, Kolehmainen P, Rasanen T, Kumpulainen J, Pyorala K. Chromium supplementation in impaired glucose tolerance of elderly: effects on blood glucose, plasma insulin, C-peptide and lipid levels. Br J Nutr. 1992;68:209-216.
  64. Fawcett JP, Farquhar SJ, Walker RJ, Thou T, Lowe G, Goulding A. The effect of oral vanadyl sulfate on body composition and performance in weight-training athletes. Int J Sport Nutr. 1996;6:382-390.
  65. Fantus IG, Tsiani E. Multifunctional actions of vanadium compounds on insulin signaling pathways: Evidence for preferential enhancement of metabolic versus mitogenic effects. Mol Cell Biochem. 1998;182:109-119.
  66. Cohen N, Halberstam M, Shlimovich P, Chang CJ, Shamoon H, Rossetti L. Oral vanadyl sulfate improves hepatic and peripheral insulin sensitivity in patients with non-insulin-dependent diabetes mellitus. J Clin Invest. 1995;95:2501-2509.
  67. Domingo JL, Gomez M, Llobet JM, Corbella J, Keen CL: Oral vanadium administration to streptozotocin-diabeic rats has marked negative side effects which are independent of the form of vanadium used. Toxicology 1991;66:279-87.
  68. Boden G, Chen X, Ruiz J, van Rossum GDV, Turco Sl. Effects of vanadyl sulfate on carbohydrate and lipid metabolism in patients with non-insulin dependent diabetes mellitus. Metabolism. 1996;45:1130-1135.
  69. Goldfine AB, Simonson DC, Folli F, Patti ME, Kahn CR. Metabolic effects of sodium metavanadate in humans with insulin-dependent and non-insulin-dependent diabetes mellitus: In vivo and in vitro studies. J Clin Endrocrinol Metab. 1995;80:3311-3320.
  70. Pepping J. Alternative therapies - Coenzyme Q10. Am J Health-Syst Pharm. 1999;56:519-521.
  71. McCarty MF: Can correction of sub-optimal coenzyme Q status improve beta-cell function in type II diabetics? Med Hypotheses 1999;52:397-400.
  72. Shigeta Y, Izumi K, Abe H. Effect of coenzyme Q7 treatment on blood sugar and ketone bodies of diabetics. J Vitaminol. 1966;12:293-298.
  73. Henriksen JE, Andersen CB, Hother-Nielsen O, et al. Impact of ubiquinone (coenzyme Q10) treatment on glycaemic control, insulin requirement and well-being in patients with type 1 diabetes mellitus. Diabetic Med. 1999;16:312-318.
  74. Elliott RB, Pilcher CC, Fergusson DM et al. A population-based strategy to prevent insulin-dependent diabetes using nicotinamide. J Pediatr Endocrinol Metab. 1996;501-509.
  75. Pozzilli P, Browne PD, Kolb H and the Nicotinamide Trialists. Meta-analysis of nicotinamide treatment in patients with recent-onset IDDM. Diabetes Care. 1996;19:1357-1363.
  76. Polo V, Saibene A, Pontiroli AE. Nicotinamide improves insulin secretion and metabolic control in lean type 2 diabetic patients with secondary failure to sulphonylureas. Acta Diabetol. 1998;35:61-64.
  77. Head KA. Type 1 diabetes: prevention of the disease and its complications. Alt Med Rev. 1997;2:256-281.
  78. Schatz DA, Rogers DG, Brouhard BH. Prevention of insulin-dependent diabetes mellitus: an overview of three trials. Cleveland Clinic Journal of Medicine. 1996;63:270-274.
  79. Nichols TW. Alpha-lipoic acid: Biological effects and clinical implications. Alt Med Rev. 1997;2:177-183.
  80. Evans JL, Goldfine ID: alpha-Lipoic Acid: a multi-functional antioxidant that improves insulin sensitivity in patients with type 2 diabetes. Diabetes Technol Ther 2000;2:401-13.
  81. Packer L. Antioxidant properties of lipoic acid and its therapeutic effects in prevention of diabetes complications and cataracts. Ann NY Acad Sci.1994;738:257-264.
  82. Giugliano D, Ceriello A, Paolisso G. Oxidative stress and diabetic vascular complications. Diabetes Care.1996;19:257-267.
  83. Ziegler D, Hanefeld M, Ruhnau K-J, et al, The ALADIN Study Group. Treatment of symptomatic diabetic peripheral neuropathy with the anti-oxidant alpha-lipoic acid. A 3-week multicentre randomized controlled trial (ALADIN Study I). Diabetologia. 1995;38:1425-1433.
  84. Reljanovic M, Reichel G, Rett K, et al, and the ALADIN II Study Group. Treatment of diabetic polyneuropathy with the antioxidant thioctic acid (alpha-lipoic acid): a two year multicenter randomized double-blind placebo controlled trial (ALADIN II). Alpha Lipoid Acid in Diabetic Neuropathy. Free Radic Biol Med. 1999;31:171-179.
  85. Ziegler D, Hanefeld M, Ruhnau K-J, et al. The ALADIN III Study Group: Treatment of symptomatic diabetic polyneuropathy with the antioxidant alpha-lipoic acid. a 7-month multicenter randomized controlled trial (ALADIN III Study). Diabetes Care. 1999;22:1296-1301.
  86. Ziegler D, Reljanovic M, Mehnert H, Gries FA: Alpha-lipoic acid in the treatment of diabetic polyneuropathy in Germany: current evidence from clinical trials. Exp Clin Endocrinol Diabetes 1999;107:421-30.
  87. Jamal GA, Carmichael H. The effect of gamma-linolenic acid on human diabetic peripheral neuropathy: a double-blind placebo-controlled trial. Diabetic Medicine. 1990;7:319-323.
  88. The Gamma-Linolenic Acid Multicenter Trial Group, Keen H, Payan J, Allawi J, et al. Treatment of diabetic neuropathy with gamma-linolenic acid. Diabetes Care. 1993;16:8-15.
  89. Kleijnen J, Knipschild P. Ginkgo biloba. Lancet. 1992;340:1136-1139.
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  93. Le Bars PL, Katz MM, Berman N, Itil TM, Freedman AM, Schatzberg AF. A placebo-controlled, double-blind, randomized trial of an extract of ginkgo biloba for dementia. North American Egb Study Group. JAMA. 1997;278:1327-1332.
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  97. German K, Kumar U, Blackford HN. Garlic and the risk of TURP bleeding. [letter] Br J Urol. 1995;76:518.
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Laura Shane-McWhorter, PharmD, BCPS, FASCP, CDE, BC-ADM
November 24, 2001

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