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Type II Diabetes and Insulin Resistance Overview:
The supplements in this page are those that are able to take somebody from an insulin resistant state (type II diabetes, metabolic syndrome, polycystic ovarian syndrome, etc.) and improve insulin sensitivity and the subsequent glucose disposal rates.Some additional supplements that do not improve insulin sensitivity but are known to aid comorbidities of diabetes (diabetic neuropathy, nephropathy, retinopathy, etc.) may also be included, and these supplements will be made note of.
1,500mg of Berberine taken in three daily doses of 500mg; some studies also use 900mg Berberine taken in three daily doses of 300mg.
The dosing method above has been demonstrated to be as effective as 1,500mg Metformin therapy for reducing blood glucose and HbA1c in diabetic humans; Both Metformin and Berberine reduce triglycerides (roughly equal potency) with Berberine also reducing cholesterol. They share a similar mechanism of AMPK activation at similar potencies too.
It would be advisable to consume Berberine with coconut oil or dairy products to enhance absorption (a small amount, via sodium caprate) or to also purchase a P-Glycoprotein inhibitor to enhance absorption; there are a few (listed in the editor's comments on the Berberine page) but Milk Thistle via Silymarin has human evidence for it.
Nigella sativa is able to activate AMPK similar to berberine (albeit less potent) but has two other mechanisms of action that are unique, it appears to stimulate PPARγ activity (similar to the Thiazolidinedione class of diabetic treatment) and can promote insulin secretion from the pancreas.
Two grams of the seeds themselves appears to be the dose required for these effects, and no specific extraction process is needed; seasoning food with black cumin seeds (and even buying a large bag of it at an Indian grocer) should be effective.
30mg elemental zinc (see dosing instructions on the zinc page) is in the upper range of the tolerable supplemental limit. It seems to be important in states of insulin resistance and diabetes since urinary elimination is increased and ingesting more zinc (which sort of serves a 'bandaid' effect) seems to be slightly therapeutic.
2-4g is the standard dosage range for improving insulin sensitivity in humans, with the majority of studies being conducted in polycystic ovarian syndrome but the same mechanisms seeming to benefit any instance of insulin resistance.
Similar to zinc, urinary excretion of inositol derivatives seems to increase during the state of insulin resistance and thus extra oral inositol is therapeutic.
This recommendation is for people who are also currently exercising (which itself is beneficial for insulin resistance and diabetes), as creatine supplementation appears to augment the exercise-induced uptake of glucose into muscle tissue without necessarily affecting fasting glucose levels. Increased glucose uptake into muscle tissues associated with exercise is associated with less HbA1c, and creatine doesn't appear to interfere with other drugs in this list.