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# Use and abuse of dietary supplements in persons with diabetes

Nutrition & Diabetes

Nature Publishing Group UK

Obesity, Diagnostics

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### Abstract

The dietary supplement industry has estimated sales of over $30 billion in the US and over$100 billion globally. Many consumers believe that dietary supplements are safer and possibly more effective than drugs to treat diabetes. The sheer volume of the literature in this space makes compiling them into one review challenging, so much so that primarily narrative reviews currently exist. By applying the interactive database supplied by the Office of Dietary Supplements at the National Institutes of Health, we identified the top 100 ingredients that appeared most often in dietary supplement products. One-hundred different keyword searches using the ingredient name and the word diabetes were performed using a program developed to automatically scrape PubMed. Each search was retained in a separate Excel spreadsheet, which was then reviewed for inclusion or exclusion. The studies that met the inclusion criteria were evaluated for effect of reducing and controlling diabetes. The PubMed scrape resulted in 6217 studies. For each keyword search only the most recent 100 were retained, which refined the total to 1823 studies. Of these 425 met the screening criteria. The ingredients, fiber, selenium and zinc had the most studies associated with improvement in diabetes. Several popular supplement ingredients (phosphorus, pantothenic acid, calcium, magnesium, glutamine, isoleucine, tyrosine, choline, and creatine monohydrate) did not result in any studies meeting our screening criteria. Our study demonstrates how to automate reviews to filter and collapse literature in content areas that have an enormous volume of studies. The aggregated set of studies suggest there is little clinical evidence for the use of dietary supplements to reduce or control diabetes.

### Most cited references42

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### Energy balance measurement: when something is not better than nothing.

(2015)
Energy intake (EI) and physical activity energy expenditure (PAEE) are key modifiable determinants of energy balance, traditionally assessed by self-report despite its repeated demonstration of considerable inaccuracies. We argue here that it is time to move from the common view that self-reports of EI and PAEE are imperfect, but nevertheless deserving of use, to a view commensurate with the evidence that self-reports of EI and PAEE are so poor that they are wholly unacceptable for scientific research on EI and PAEE. While new strategies for objectively determining energy balance are in their infancy, it is unacceptable to use decidedly inaccurate instruments, which may misguide health-care policies, future research and clinical judgment. The scientific and medical communities should discontinue reliance on self-reported EI and PAEE. Researchers and sponsors should develop objective measures of energy balance.
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### Trends in Dietary Supplement Use Among US Adults From 1999-2012.

(2016)
Dietary supplements are commonly used by US adults; yet, little is known about recent trends in supplement use.
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### Magnesium Intake and Risk of Type 2 Diabetes

(2011)
OBJECTIVE Emerging epidemiological evidence suggests that higher magnesium intake may reduce diabetes incidence. We aimed to examine the association between magnesium intake and risk of type 2 diabetes by conducting a meta-analysis of prospective cohort studies. RESEARCH DESIGN AND METHODS We conducted a PubMed database search through January 2011 to identify prospective cohort studies of magnesium intake and risk of type 2 diabetes. Reference lists of retrieved articles were also reviewed. A random-effects model was used to compute the summary risk estimates. RESULTS Meta-analysis of 13 prospective cohort studies involving 536,318 participants and 24,516 cases detected a significant inverse association between magnesium intake and risk of type 2 diabetes (relative risk [RR] 0.78 [95% CI 0.73–0.84]). This association was not substantially modified by geographic region, follow-up length, sex, or family history of type 2 diabetes. A significant inverse association was observed in overweight (BMI ≥25 kg/m2) but not in normal-weight individuals (BMI <25 kg/m2), although test for interaction was not statistically significant (P interaction = 0.13). In the dose-response analysis, the summary RR of type 2 diabetes for every 100 mg/day increment in magnesium intake was 0.86 (95% CI 0.82–0.89). Sensitivity analyses restricted to studies with adjustment for cereal fiber intake yielded similar results. Little evidence of publication bias was observed. CONCLUSIONS This meta-analysis provides further evidence supporting that magnesium intake is significantly inversely associated with risk of type 2 diabetes in a dose-response manner.
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### Author and article information

###### Contributors
diana.thomas@westpoint.edu
###### Journal
Nutr Diabetes
Nutr Diabetes
Nutrition & Diabetes
Nature Publishing Group UK (London )
2044-4052
27 April 2020
27 April 2020
2020
: 10
###### Affiliations
[1 ]ISNI 0000 0004 1936 9991, GRID grid.35403.31, Division of Nutritional Sciences, , University of Illinois at Urbana-Champaign, ; Urbana, IL USA
[2 ]ISNI 0000 0004 1936 9991, GRID grid.35403.31, Department of Kinesiology and Community Health, , University of Illinois at Urbana-Champaign, ; Urbana, IL USA
[3 ]ISNI 0000 0001 2287 2270, GRID grid.419884.8, Department of Mathematical Sciences, , United States Military Academy, ; West Point, NY USA
[4 ]ConscienHealth, Country Club Dr, Pittsburgh, PA USA
###### Article
117
10.1038/s41387-020-0117-6
7186221
32341338

###### Categories
Review Article

Endocrinology & Diabetes

obesity, diagnostics