Understanding The Use of Fenugreek in Type 2 Diabetes Mellitus

The Use of Fenugreek in Type 2 Diabetes Mellitus

fenugr05gFenugreek (Trigonallafoenum-graecum) is an herbal product that has been used for many centuries as a spice in the Middle East, the Mediterranean, Africa and Asia. The seeds and leaves of this herb also are used for medicinal purposes.  Studies have shown that fenugreek helps lower blood sugar and increases insulin activity while at the same time decreasing bad cholesterol.

Fenugreek may help prevent Type 2 Diabetes Mellitus (T2DM) in patients with pre-diabetes – blood sugar levels higher than normal but not enough to be diagnosed with diabetes.  A three year study in people with pre-diabetes who took 5 grams of fenugreek powder twice a day in water showed a significant reduction in fasting blood glucose, blood glucose after meals and “bad” cholesterol (ldl).  It also increased insulin levels significantly.  Taking it showed a lower likelihood of developing type 2 diabetes.

The effect of fenugreek on T2DM is thought to be due a substance in fenugreek known as 4-hydroxyisoleucine. This substance may help increase insulin levels. Another effect it may have is to enhance insulin activity because some patients’ with type 2 diabetes do not process insulin effectively. Fenugreek seeds are high in fiber, which may decrease glucose absorption. An added benefit of consuming fenugreek is that since it is a fiber, it can form a web-like structure in the stomach and attach to bad cholesterol, moving it out of the body through the feces before the bad cholesterol is absorbed. However, the use of fenugreek with antidiabetic medications, specifically glyburide, might cause blood sugar levels to be low, so patients need to be careful about combining fenugreek with medications for diabetes.3 Fenugreek may also cause blood thinning, so patients should be careful using fenugreek with certain drugs used to anticoagulated the blood  (warfarin, This means fenugreek may further increase the risk of bleeding if you take these drugs.

Fenugreek is generally safe when used in meal preparation. Patients with an allergy to peanuts, chickpeas, soybeans, or green peas should avoid fenugreek because they all share a similar chemical property and may cause the same allergy.4 Fenugreek should be avoided during pregnancy because fenugreek may stimulate the contraction of uterine muscles, which may cause complications during pregnancy. Low blood sugar or low potassium levels may result from use. When fenugreek is consumed, urine, sweat and breast milk may smell like maple syrup. It should not be used when breast-feeding.

Fenugreek comes in capsule, powdered seed, and seed formulations. For hyperglycemia, doses range from 5 grams to 100 grams of powdered fenugreek seed daily, in 2 divided doses.

Fenugreek may be a viable supplement for patients with type 2 diabetes, but should not be used instead of diabetes medications. Metformin is still the first drug of choice for type 2 diabetes.  Fenugreek can be tried in addition to medications. Do not take fenugreek without discussing with your health care provider first. Additional blood sugar testing may be necessary.  Don’t take it if you take anticoagulant drugs, are pregnant or breast feeding.

This Article is Brought to you By Our Guest Staff Writers:
Abdulaziz Alqarni, PharmD candidate 2017
Shahista Kassam, PharmD, Post-PharmD Fellow, MCPHS University
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, Professor of Pharmacy Practice, School of Pharmacy-Boston, MCPHS University, Boston, MA, Clinical Pharmacist, Well Life Medical, Peabody, MA

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