by Varun
(India)
I know it is best to control blood sugar with diet, exercise and natural approaches, but what if glucose still does not come within target?
Should someone use conventional medicine such as Glucophage, or an Ayurvedic tablet such as Diabac? Is one safer or better than the other?
Answer by Dr. Albana Greca Sejdini, MD, MMedSc, Family Physician, IDF Fellow
Hello Varun,
I would not describe established diabetes medicines and Ayurvedic products as two equivalent choices.
Healthy eating, physical activity, weight management when appropriate and good sleep are important parts of type 2 diabetes care, but some people still need medication because lifestyle measures alone do not provide enough glucose control.
If your glucose or HbA1c remains above your individualized target, delaying effective treatment can increase the risk of diabetes complications.
Current diabetes guidance recommends choosing medication according to the individual. Important factors include your HbA1c, kidney function, heart disease risk, body weight, hypoglycemia risk, side effects, cost and personal preferences.
Our blood glucose target guide explains common treatment goals for adults with diabetes.
Metformin, also sold under brand names such as Glucophage, is one of the best-studied medicines for type 2 diabetes.
It is effective, widely available and usually has a low risk of causing hypoglycemia when used by itself. It may also be weight neutral or associated with modest weight reduction.
It is not suitable for everyone, and kidney function and other medical factors should be reviewed before and during treatment.
Some Ayurvedic herbs and preparations have been studied for diabetes, but most evidence is based on small or lower-quality studies. That is not enough to consider them equivalent to established glucose-lowering medication.
Another concern is product quality. Some Ayurvedic preparations have been found to contain lead, mercury or arsenic, either intentionally or through contamination.
I would not routinely recommend herbs specifically to lower glucose. Current diabetes guidelines state that herbal products and spices are not recommended for glycemic benefit because the evidence is insufficient.
If you already use an Ayurvedic or herbal product, tell your clinician the exact name, ingredients and dose. This is especially important if you are also taking prescription diabetes medication.
Our diabetes supplements guide explains why interactions and product quality matter.
Not necessarily. Diabetes treatment has changed considerably, and some people may benefit from other medicines instead of or in addition to metformin.
For example, people with cardiovascular disease, heart failure, chronic kidney disease or particular weight-management goals may benefit from medicines such as SGLT2 inhibitors or GLP-1 receptor agonists.
The best medicine therefore depends on your overall health, not simply on which treatment is called “natural” or “allopathic.”
If lifestyle measures are not enough, I would choose an evidence-based diabetes treatment with your clinician rather than delaying treatment while trying unproven alternatives.
Continue healthy eating and physical activity alongside medication. If you want to use an Ayurvedic product as well, discuss the exact product with your healthcare professional rather than assuming it is harmless.