Patients may choose to supplement their pharmacological regimen with dietary supplementation in many forms, for example, vitamin and/or mineral mixtures, but the most popular supplements taken by the patients are those considered to be from natural products, that is, herbal or botanical sources. Unfortunately, considerable controversy exists regarding the efficacy of dietary supplements in general and of botanical supplements, particularly regarding pathophysiological factors related to the treatment of patients with type 2 diabetes. The controversy exists because reported efficacy data for many of the natural products are only in the form of uncontrolled studies and anecdotal reports. Poor quality control measures may also cause inconsistent effects for certain natural products. Currently, there is a paucity of consistent and reproducible efficacy data in humans to suggest any recommendations for most botanical or bioactive supplements as adjunct treatments for risk factors related to metabolic syndrome or type 2 diabetes. Firm recommendations for general use would also require an understanding of the mechanism of action, which is not known for most botanicals.
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