Complementary and Alternative Medicine (CAM) Supplement Use in People with Diabetes: A Clinician's Guide. Laura Shane-McWhorter
placed on placebo. A1C declined from 7.2% to 6.7% (P < 0.001) in those taking caiapo, but increased from 7.04 % at baseline to 7.1% in the placebo group. Fasting glucose declined from 144 mg/dl (8.0 mmol/l) to 129 mg/dl (7.2 mmol/l; P < 0.001), and 2-hour postprandial glucose declined from 193 mg/dl (10.7 mmol/l) to 163 mg/dl (9.1 mmol/l; P < 0.001). Mean cholesterol was significantly lower in the caiapo group than in the placebo group (215 mg/dl [5.6 mmol/l] vs. 249 mg/dl [6.4 mmol/l], P < 0.05). Weight also decreased by 3.7 kg in the caiapo group (P < 0.0001 vs. baseline) after 3 months. Blood pressure was unchanged.
Summary
Caiapo is an extract from the root of white-skinned sweet potatoes. There is preliminary information from a small study that 4 g taken once a day before breakfast may help treat type 2 diabetes. It also lowered elevated lipids and produced significant weight loss. Information regarding long-term human use is not available. There are no reports of its use in type 1 diabetes. Adverse effects are mostly gastrointestinal in nature. The dose of caiapo is 4 g/day, based on the randomized controlled trial in type 2 diabetes.116 It is important to check blood glucose frequently to make sure that it is not lowered excessively. Three months should be allowed to see whether there is an effect on A1C. Caiapo appears to be a potentially useful product, but it is not yet well-known in the U.S.
IVY GOURD (Coccinia indica)
Ivy gourd is a unique tropical member of the family Cucurbitaceae.120 It grows well in India, Southeast Asia, and the Philippines. It has spread to Australia and has been found in Fiji, Tonga, and Hawaii. It is an aggressive climbing perennial vine that spreads quickly over trees and shrubs. The leaves range from 5 to 10 cm (about 2–4 inches) in length and have five lobes that vary from a heart to a pentagon shape. Ivy gourd is a dioecious plant, and the white male and female flowers grow separately. The fruit starts out green and turns red when ripe. Ivy gourd has been classified as a medicinal herb in the traditional practice of ancient Thai medicine. For medicinal purposes, several parts of the plant have been used, including the leaves, roots, stems, and whole plant. The juice of the roots and leaves is used in diabetes, and the leaves are also used as a poultice for skin eruptions.
In Thailand, the young leaves and tips are blanched and prepared in stir-fry dishes, or the leaves are used in curries or for dipping chili paste. Leaves and stems are also added to soup dishes with different meats or noodles. The young leaves are boiled with porridge and then crushed and fed to young children. Other parts of the plant are also used for burns, insect bites, fever, gastrointestinal complaints, and various eye infections.120
Chemical Constituents and Mechanism of Action
Ivy gourd contains beta-carotene, a major vitamin A precursor from plant sources.120 As a food, it is thought to be a good source of protein and fiber, and it contains modest amounts of calcium. However, as a medicinal agent in diabetes, the active ingredients are unknown, although it does contain trace amounts of alkaloids.121 A quaternary base has been isolated that shows hypoglycemic activity in animal studies. It is thought to suppress the activity of certain enzymes involved in glucose production, such as glucose-6-phosphatase.122
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