Insulin Resistance: Controlling & Reversing

Posted on April 19, 2021 by Cat

by Catherine M. Haug,  January 2007; reorganized and updated February 2007; updated and moved to Cat’s Kitchen April 19, 2021

Insulin resistance is a growing problem among humans; for many years, it was largely misunderstood by medical practitioners. But now, that’s beginning to change. For example, it has been long believed that Type-2 Diabetes is a blood sugar problem, but now that the problem of insulin not being able to bind to cell receptors leads to the rise of blood glucose levels, insulin resistance is becoming more known and understood as the precursor to Type-2 Diabetes.

Includes:

Refer to Insulin: Master Regulator to learn more about insulin’s amazing functions, and how it regulates blood sugar. 

Type-2 Diabetes and Blood Glucose Levels

Added in April 2021 update of this article:  The “rules” for diagnosis changed in 1997, lowering the fasting glucose levels, as follows (1):

  • Fasting glucose level less than 110 mg/dL is considered normal
  • Fasting glucose level between 110 and 126 mg/dL indicates impaired glucose tolerance (insulin resistance)
  • Fasting glucose level at or above 126 mg/dL indicates diabetes.

Prior to that change, the number for diabetes diagnosis was 140 mg/dL.

How to Keep Insulin Resistance in Check

Exercise

Health practitioners advise moderate exercise, about 30 minutes per day.  This could be as simple as taking your dog for a walk.

Carb Control

Many health researchers speculate that control of carbohydrates in the diet (along with daily exercise) can modulate the effects of IR. One recommendation is to start on a 60-gram-per-day carb regimen until insulin and sugars normalize.  Then can increase up to about 72 grams per day (base your personal upper limit on what is needed to keep your blood sugar and insulin in normal range). (6)  

NOTE:  to determine carb content from food labels, subtract ‘dietary fiber’ from ‘total carbohydrate.

A popular form of carb control is the ketogenic diet (see “Diet and Health Menu” section, beginning with Ketogenic Diet (Intro) for more about this).

Any carb you consume should be a “complex carb,” meaning fruits and veggies (whole and raw is preferred), legumes (beans, peas, lentils), and baked goods made with whole grains* and minimum of sugar (look for ways to use stevia instead).  Nuts and seeds* also contain carbohydrates, but are very good for you to eat because of their fiber, fat and protein content, all of which make the sugars less accessible.

*NOTES:

  • There is some evidence that lectins in grains play a role in IR. Lectins are substances produced in the seed as a means of species preservation. They act to discourage predators  from eating the seed, by making them ill. WGA, a lectin in the germ of wheat and other true grains, appears to be a culprit in IR. Lectin levels can be greatly reduced by fermenting the grain (as in sourdough, or overnight soak/sprouting), together with long cooking times (for example, old fashioned porridge).
  • Nuts and seeds should also be sprouted or pre-soaked (fermented) before consumption. 
  • The effect of moisture is to start the germination process which frees up minerals for absorption, makes many new vitamins, activates enzymes that break down lectins and other anti-nutrients in the grain/nut/seed, and changes the proteins such as gluten to a less problematic structure.

Fats

Remember that fats (such as olive oil, butter, sour cream, cheeses, avocado, nuts) consumed with any carbohydrate food slows the absorption of glucose into the blood stream.  This means that you can–and should–add butter to your whole grain toast!  See also my article on Cat’s Kitchen: Good Fats for Cooking.

Worried that increased consumption of fats, especially saturated fats, will increase your cholesterol?  Despite the harangue of allopathic medicine, moderate natural fat* intake does not raise blood cholesterol.  In fact, research has shown, time and again, that dietary saturated fat lowers blood cholesterol.   Refer to my article on Saturated Fats, Part 3: A Bad Rap for more on this.

* Trans- and interesterified-fats are not natural and may indeed increase cholesterol. See Chemically-Altered Fats for more.

Eliminate Trans Fats and Other Man-Made Fats

Stop consuming hydrogenated/partially-hydrogenated (trans) fats, and interesterified fats. Refer to my articles on the harmful effects of hydrogenated fats and interesterified fats, for more detail on this subject.

However, interesterification is not indicated on food labels (there is no law to require this). The only way to avoid intertesterified fats, is to avoid all:

  • margarine – all brands;
  • vegetable shortenings (except pure coconut oil or pure palm oil shortenings);
  • all commercial baked products, unless you can inquire of the baker as to the fats used;
  • all deep fried foods, unless you can inquire of the cook as to the fat used for deep frying.

Also, increase supplementation with essential Omega-3 oils.  For ideas on how to do this, refer to my article Omega-3 Fatty Acids. I get mine supplementally from fermented cod liver oil, and from wild-caught salmon and cod, and to a lesser extent, oysters and sardines.

Get Checked for Heavy Metal Toxicity

Anyone who has, or has had, silver amalgam fillings in their teeth probably has high levels of mercury hiding in body tissues.  Toxic mercury is known to interfere with sugar metabolism by binding to critical enzymes and cofactors, disabling them from assisting in the production of energy at the cellular level. 

If the mercury is stored in the brain, it can also lead to depression, as it interferes with the production of neurotransmitters (serotonin and dopamine). Depression can drive one to crave sugary foods as an upper.

Get Good Sleep

We’ve long known that sleep is important for detoxification, tissue repair, and the building of muscle.  New studies suggest that lack of restful sleep disrupts endocrine functions related to diabetes and adrenal fatigue.  Long-term sleep loss triggers increased insulin resistance.  It also affects the regulation of appetite by increasing the hormone that makes you hungry (ghrelin) and decreasing the hormone that indicates satiety (leptin).   

Insulin and cortisol work in a delicate balance to regulate available energy; lack of restful sleep can lead to adrenal fatigue, marked by initial increase in cortisol production, and eventual adrenal burn-out as cortisol levels drop.  High cortisol leads to decreased production of DHEA, a precursor to the sex hormones.  The resulting hormone imbalance contributes to fatigue, bone loss, loss of muscle mass, depression, aching joints, decreased sex drive, impaired immune function, and even makes it harder to get a good night’s sleep.  For more on this subject, check out “Insomnia in women: reset your inner clock.” (2) 

How can you help yourself sleep better?  

  • Obey the urging of your natural clock:  don’t force yourself to stay up too late, or get up too early.  
  • If at all possible, don’t use an alarm clock.  
  • Start dimming your lights a couple hours before you go to bed (this encourages your body to produce melatonin, which helps you to sleep).  
  • Drink a calming cup of herbal tea in the evening (and avoid caffeine after lunch).  
  • Sleep in a darkened room (invest in room-darkening shades or drapes); consider eliminating a lighted clock.
  • Open a window for cool, fresh air.  
  • Use your bedroom only for sleep and other natural bedroom activities; avoid eating, reading or watching TV in bed.

If none of these suggestions work, consult with your doctor about possible hormone imbalances.

Cook with Spices

The following herbs and spices likely possess anti-diabetic potential (as indicated by various studies, references: (14, 25) for cinnamon, and (15) for the others in the list):

  • Ceylon cinnamon* (recognized by the USDA for ability to improve insulin sensitivity)
  • coriander
  • cumin seeds
  • curry leaves
  • fenugreek seeds
  • garlic
  • ginger
  • mustard
  • onion
  • turmeric

I add Ceylon cinnamon and fenugreek to my raw breakfast smoothie each morning, and raw crushed garlic to all my homemade salad dressings, then eat a salad every evening.  Adding coriander to baked winter squash or baked yams adds a nice flavor. April 2021 update: I recently learned about liposomal turmeric, and take a softgel twice daily. I also like to drink a cup of Golden Milk/Turmeric Tea before bed.

‘* April 2021, Cat’s note: There are several commercial varieties of cinnamon including Ceylon cinnamon  and cassia or  Saigon cinnamon; only Ceylon cinnamon (a.k.a. true cinnamon) improves IR. Unfortunately, the variety on most grocery shelves is Saigon cinnamon. See All Recipes (25) for more about the different types. See also my Cat’s Kitchen article: Cinnamon Treatment for Blood Sugar and Insulin Sensitivity.

Apple Cider Vinegar (Raw) before Meals 

A January 2004 study from Diabetes Care (January 2004), by Carol S. Johnston, PHD, Cindy M. Kim, MS and Amanda J. Buller, MS (16) compares effect of vinegar vs placebo on plasma glucose and insulin responses after a standard meal in control subjects, insulin-resistant subjects, and subjects with type 2 diabetes.  It showed marked improvement in insulin sensitivity in both pre-diabetic/insulin resistant volunteers and those with type-2 diabetes, compared to a control group. 

The test involved drinking a glass water containing 2 Tbsp apple cider vinegar, and sweetened with saccharine* before a high carb meal.  Glucose and insulin were measured before the meal, 30 minutes post-prandial, and 60 minutes post-prandial.  Note, this was a high-carb meal (white bagel, butter and orange juice). 

*Cat’s NOTE: I do not recommend saccharine. Instead, I would dissolve 2 – 4 drops of liquid stevia extract in the vinegar, then add water. A friend of mine uses balsamic vinegar instead of cider vinegar, for its natural sweetness. The recommendation for taking this as a medication is to take 2 Tbsp vinegar in water before meals. Or take the 2 Tbsp before bed. 

You can view the study chart as a pdf: ACV-Improves-Insulin-Sensitivity_2004study-1. [saved:  CATSFORK / PDF FILES > ACV-Improves-Insulin-Sensitivity_2004study.pdf, 271 KB.]

Food sources of vitamins and minerals

Getting vitamins and minerals from foods are always the best form, but if you eat a processed food diet, you are not getting these essential nutrients. Taking them as supplements – especially minerals – is recommended by many practitioners. But it may not be helpful and may cause harm, unless they are in whole-food form (also referred to as “organic” form), as opposed to salts. Consult with a qualified healthcare practitioner before adding any of these to your daily regimen.  Refer to my articles on Supplements (See Diet and Health Menu, under “Supplements”) for more on these recommendations. See also several intriguing/informative articles listed under reference (20).

Supplements

The addition of certain nutritional supplements might modulate IR and prevent diabetes, or keep existing diabetes in check.  

I don’t intend to suggest that taking supplements can provide the same health benefits as eating healthful meals.  That means eating whole foods as much as possible, especially organic or biodynamic foods grown by someone you know.  Know your ingredients; know your cook.  Refer to my “Diet and Health” article series on the Diet and Health Menu for more on this:

Vitamins:

Vitamin A: People with IR or diabetes lack ability to convert plant carotenes into true vitamin A. (6) . Therefore, taking a true (animal source) vitamin A supplement is probably a good idea; for example, cod liver oil, which contains both vitamins A and D in a healthful balance.  

Other vitamins: Many dietary vitamins are needed to keep the complications of diabetes in check (A, B-family and E). (1, 3, 6)

Minerals and Trace Minerals:

High insulin levels (from IR) cause excess excretion of many vitamins and minerals, especially calcium and magnesium. (1, 5)  Trace mineral deficiencies, particularly of zinc, vanadium and chromium, inhibit insulin production and utilization.  

NOTE: It’s important to take the right form of certain minerals for the maximum benefit: chromium in a niacin complex (polynicotinate), such as chromium GTF; selenium bound to protein or amino acid, etc.. See an informative article on Doctor’s Research (20).

Other Supplements:

Berberine: see Mercola article on PQQ and Berberine (24). Both are essential for proper mitochondrial function (mitochondria are your cells’ batteries).  

Berberine is one of the active ingredients in goldenseal, barberry and Oregon Grape root; it is used in the treatment of Type 2 diabetes, gastrointestinal infections, liver problems and a number of other health conditions. Typical dose is 500 mg of berberine two or three times daily.

(Cat’s note: Berberine is an excellent anti-microbial treatment. However, unless you have an infection or a microbial disease, you should not take berberine every day, because your body will stop responding to it. For this reason, I take it one-week on/off.)

Mulberry leaves and grape seed extract (24) are also used to treat insulin resistance.

PQQ (pyrroloquinoline quinone): has been identified as an essential nutritional component in 1994, and will eventually be classified as a vitamin. PQQ is important for brain health and protects against Alzheimer’s and other dementia. 

Colostrum: (This section added Oct 2012) Colostrum is the first lacteal secretion produced by mammary glands of mammals prior to the production of milk, and is intended to help the survival of the newborn through its amazing immune-enhancing abilities. But it has many other benefits when taken supplementally. See BioLife: Benefits of consuming colostrum (22). [my original article also included a link to reference 23, but that site no longer exists)]

Twenty years ago a friend recommended colostrum for my insulin resistance/hypoglycemia, because it contains naturally occurring IGF-1 (Insulin-like Growth Factor-1), which is very similar to insulin in structure,  and a substance that increases the insulin receptors on the surface of cells (this also has something to do with a peptide that binds chromium). I started taking it in capsules back in the 1990s, and it really did help. But for some reason, I stopped taking it. I restarted colostrum capsules in March 2021. 

Lipoic Acid, as Alpha Lipoic Acid (ALA), or R-Lipoic Acid, the biologically active form which makes up only half of ALA). See Mercola.com (17) and OSU/Linus Pauling Institute (18) for more.

Myo-inositol (recommended by my naturopath, Dr. Gordon: ⅛ -¼ tsp/day of Pure Encapsulations brand) helps with insulin resistance. See Dr. Westin Childs (26). and Theralogix blog (27) for more. NOTE: the various brand labels all have just “Inositol” as the product title, but in the contents part of the label, indicate “myo-inositol.”

About myo-inositol dosage: ¼ tsp/day of Pure Encapsulations brand provides about 656 mg, which compares well with other brands (see below). Their label says 2 scoops provides 4200 mg; 2 scoops is roughly 1.6 tsp or 2625 mg/tsp, or 656 mg/ per ¼-tsp. Other brands provide an average of 658 mg per ¼ tsp:

    • Jarrow brand (iHerb code JRW-01016): provides 600 mg inositol as myo-inositol in ¼ tsp;
    • Healthy Origins brand (iHerb code HOG-40208): provides 600 g inositol in ¼ tsp; they do not indicate it is only myo-inositol.
    • Now brand (iHerb code NOW-00527):  provides 730 mg inositol as myo-inositol in ¼ tsp, which is more than the other 2 brands; not sure why.
    • Standard Process brand (28) (which you can only get from practitioners) provides 700 g per ¼ tsp.

Specific herbs & spices:

True cinnamon (Ceylon cinnamon – see above), Gymnema sylvestre leaf, bitter melon fruit, and Banaba leaf (Lagerstroemia speciosa) are examples. Check out a couple articles about Banaba leaf benefits (29, 30).

June 2021 update: While cassia cinnamon (the kind found in grocery stores) and Ceylon cinnamon (true cinnamon) can help with insulin resistance and type-2 diabetes, both contain coumarin, a toxic aromatic oil. However, cassia contains far more than Ceylon cinnamon; while it is safe to use cassia in small amounts, such as in baked goods, it is not so safe when used in medicinal amounts. Therefore, I recommend using only Ceylon cinnamon if you take it medicinally on a daily basis.

From Healthline (31): “Cassia contains approximately 1% coumarin, while Ceylon contains only 0.004%, or 250 times less. This is so low that it’s often undetectable.”

See Cinnamon: Treatment for Blood Sugar and Insulin Sensitivity or IR – Hormone Imbalance-1 for more about this.

Supplements with a mix of vitamins, minerals and herbal/spice extracts: This includes whole food multis, and others with specific applications such as the following, which have similar ingredients; of the two, I would trust Gluco-Secure (available on Green Valley’s website):

    • Gluco-Secure: a mix of specific minerals with herb and spice extracts believed to be helpful for reducing insulin and/or blood sugar levels. I learned about this from a sales pitch (21) by Lee Euler (of Awakening from Alzheimer’s), whose company, Green Valley, makes the supplement. Ingredients: Chromium polynicotinate, Gymnema Sylvestre leaf extract, Cinnamon bark extract, Alpha lipoic acid, Bitter melon fruit extract, Banaba leaf extract (Lagerstroemia speciosa) and Vanadium (as vanadyl sulfate).
    • DBX-13: A supplement said to enhance your body’s ability to utilize sugar. (19a) It is a combination of 11 ingredients: Vitamin C, Biotin, chromium aspartate, garcinia cambogia, cinnamon, bitter melon, betaine HCL, banaba, gymnema sylvestre, fenugreek, and vanadium. As of this writing (April 2021), it is not FDA approved.(19b) However, one could try some of its ingredients. 

I currently take liposomal vitamin C, betaine HCL, cinnamon and fenugreek; and I get a safe version of chromium in my multi. I’ve tried gymnema sylvestre (a.k.a gurmar) in the past (along with cinnamon and fenugreek), but did not notice any benefit.

Diet Recommendations

This section moved to separate articles:

Reversing Insulin Resistance

The most important factor is what you eat. Processed and junk foods are high in sugar/starch that overwhelm the body’s cells and organs. Our ancient ancestors evolved eating a whole food diet including both plants and animals. Those living in tropical regions ate mainly plants; those in arctic regions (such as my paternal ancestors) ate mainly animals, primarily because for much of the year, there were no plants available under all the snow and ice.

If you cannot prepare your own meals using whole foods, do not resort to processed foods. Find someone who can prepare meals for you. Note that most “meals on wheels” foods are made from processed ingredients – canned foods in particular.

Especially avoid:

  • alcohol
  • sugar; raw local honey is far better, but in moderation
  • white flour and goodies made with white flour (sprouted whole grain flour is far better)
  • gluten-free goodies made with starches (those made with almond and coconut flour are far more healthful)
  • trans fats and other man-made fats (see Fats in the Diet, below, for more about this
  • heat-treated “salad oils” (corn, soy, canola oils)
  • over-cooked meats and vegetables
  • deep-fried foods (unless fried in good fats with high smoke point, such as duck or goose fat, or avocado oil)
  • any GMO food

Fats in the Diet: 

Based on a review of literature on this subject, and his own personal experience, one researcher (Thomas Smith) believes that insulin resistance can actually be reversed by making certain dietary changes over a period of weeks or months (depending on now long the insulin resistance problem has run rampant). (4)  For example, a 1994 study by the British Nutrition foundation reported a 20% lowering of glucose intolerance when study subjects consumed seal oil (high in omega-3) on a daily basis. (5)  

He contends that Insulin Resistance is the result of a lifelong diet of trans-fat consumption coupled with a dietary shortage of the healthful Omega-3 fats.  He bases this contention on history and his own personal experience.  The problems now associated with IR went from rare to common, shortly after the introduction of hydrogenated fats in the American Diet in 1911, and reached epidemic proportions beginning in the 1950s when hydrogenated fats were incorporated in most processed and fast foods. (4) I note, however, that at the same time (1960s-70s), low-fat and high-carb diet was highly touted, and may also have played a role in insulin resistance.

The modern American diet includes excessive Omega-6 fats from junk and fast foods prepared with polyunsaturated vegetable oils that are high in Omega-6, and insufficient Omega-3 fats.  And to make matters worse, those omega-3 fats normally found in some vegetable oils are made toxic by the hydrogenation process. 

And it’s not just the trans fats from partial hydrogenation that are toxic.  Now food processors are poised to introduce fully-hydrogenated vegetable oils as a replacement for trans fats (the “New Crisco” is an example of this).  While it is true that total hydrogenation turns these poly-unsaturated vegetable oils into fully saturated oils containing mostly harmless stearic acid, these manufacturers go one step further.  

The fully-hydrogenated fat is too stiff for most uses, so they “mix” it with regular vegetable oil to produce a more desirable texture.  The problem here is in the word “mix.”  They don’t just simply stir them together.  They hydrolyze them to remove the fatty acids from the glycerol backbone.  After allowing the fatty acids to become well mixed, they reverse the hydrolysis process so that the fatty acids will reconnect, randomly, with the glycerol backbone to make triglycerides again.  

This process, known as “interesterification,”  results in yet another unnatural fat shown by research to be even more problematic for health than trans fats (refer to my articles, below, for more on this research):

It is unnatural because of the random combination of the fatty acids in the resultant triglycerides.  In biological systems, the process is not random, but a highly specific, enzyme-controlled process.  The random, unnatural fats are as likely to put the stearic acid in the wrong position (for bio-activity) as in the correct one.   And when in the wrong position, the body cannot process it properly. 

I’ve not yet bought Mr. Smith’s book to get the details, but from reading his website I’ve concluded his plan to reverse IR includes: 

  1. Eliminate all partially-hydrogenated (trans), hydrogenated fats, and interesterified fats in the diet (including any food products made with these fats).  This probably means that you will need to prepare all your food or supervise its preparation to ensure this dictum is met. Refer to my articles on Trans Fats, Hydrogenated Fats, and chemically-altered fats for more on this subject.
  2. Addition of sufficient Omega-3 fats (from flax, and especially from fish, krill, shark or seal oils). (5) Refer to my article on Essential Fats for more on this subject.
  3. Keep blood sugar and insulin levels as moderate as possible, to minimize the damage caused by elevated sugar and insulin in the blood.  This includes:
    • revamping your diet by consulting the glycaemic index tables, consuming frequent small meals, increasing fiber in the diet. 
    • Cease consumption of all forms of sugar [table sugar, fructose, corn syrup, sugar alcohols such as erythritol, honey, molasses, maple syrup, etc.].  Sweeten only with non-toxic sweeteners such as stevia. 
    • Refer to my “Diet for Health” 3-article series (listed above, under “Diet Recommendations”) for more on the subject of diet. 
    • Avoid alcohol as well as caffeine and other stimulants until blood sugar stabilizes. 
    • Exercise regularly after meals. 
    • Monitor progress with a pin-prick type glucose meter. 
    • Also consider adding foods rich in inulin to your daily or weekly diet. (4)

Conclusion

My ongoing review of the literature and health docu-series on Insulin Resistance & Type-2 Diabetes leads me to conclude that many factors can lead to cells’ resistance to insulin.  I do think the theory about trans fats is on to something, and I suspect trans fats affect both glucose uptake and also downstream consequences of high blood sugar in ways that have not yet been studied. I also suspect that trans fats affect other metabolic processes besides the insulin response; for example, the active transport of other nutrients besides glucose across cell and mitochondrial membranes.

Go to: Insulin:  Master Regulator for more on insulin’s amazing functions.

References and Sources: 

All links from original 2007 article have been reviewed and updated as needed (April 2021).

  1. yourhealthbase.com/diabetes.htm (not secure)
  2.  Insomnia in women: reset your inner clock  (www.womentowomen.com/fatigueandstress/insomnia.asp)
  3. power-surge.com/educate/holt_syndromex.htm < link no longer valid; if “Syndrome-X” is meant (a.k.a. Metabolic Syndrome), see my article: Insulin, Insulin Resistance (IR), and Metabolic Syndrome); see also:
  4. healingmatters.com; specifically, the following  (note: these links are not secure):
    1. diabetes,
    2. hyperinsulinemia, and
    3. deception articles
  5. omega3sealoil.com/Chapter3_2.html < link is no longer valid (moved from #9)
  6. Weston A. Price Foundation:
    1. westonaprice.org/moderndiseases/diabetes.html <original link no longer valid. Try:
    2. 2004 article: westonaprice.org/health-topics/modern-diseases/treating-diabetes-practical-advice-for-combatting-a-modern-epidemic/
    3. 2006 article: westonaprice.org/health-topics/know-your-fats/do-saturated-fats-and-trans-fats-cause-type-2-diabetes/
    4. 2017 article: https://www.westonaprice.org/podcast/62-diabetes-and-diet/
  7. nutritionandmetabolism.com/content/4/1/3
  8. verywellhealth.com/side-effects-of-glucosamine-88199 replaces the original link: altmedicine.about.com/cs/arthritis/a/Glucosamine.htm
  9.  not used
  10. Mitochondrial Factors in the Pathogenesis of Diabetes: A Hypothesis for Treatment by Davis W. Lamson and Steven M. Plaza, in Alternative Medicine Review, April 2002: anaturalhealingcenter.com/documents/Thorne/articles/mitochondrial%20factors.pdf (not secure) replaced original link (http://www.highbeam.com/doc/1G1-85522983.html)
  11. www.pdrhealth.com/drug_info/nmdrugprofiles/nutsupdrugs/glu_0122.shtml <link no longer valid; cannot find new
  12. hopkinsmedicine.org/press/2002/APRIL/020415.htm < link no longer valid; cannot find new
  13. see  #8 (very well health) link, above
  14. ars.usda.gov/is/video/vnr/cinnamon.htm < link no longer valid; instead, search at: search.usa.gov/search?utf8=✓&affiliate=agriculturalresearchservicears&query=cinnamon+insulin+video; 
  15. Plant foods in the management of diabetes mellitus: spices as beneficial antidiabetic food adjuncts: pubmed.ncbi.nlm.nih.gov/16361181/ (old link no longer valid: ncbi.nlm.nih.gov/sites/entrez?db=pubmed&cmd=Retrieve&dopt=AbstractPlus&list_uids=16361181&query_hl=5&itool=pubmed_docsum)
  16. care.diabetesjournals.org/content/27/1/281.full (Study on effect of vinegar-water on plasma glucose and insulin levels)
  17. articles.mercola.com/sites/articles/archive/2009/05/16/This-Antioxidant-Can-Smash-Insulin-Resistance-and-Autoimmune-Disease.aspx 
  18. lpi.oregonstate.edu/mic/dietary-factors/lipoic-acid 
  19. Original link is no longer valid; instead, try:
    1. izpomedical.com/index.php/2016/10/08/dbx-13-a-complete-natural-cure-for-diabetes/
    2. blogarama.com/health-and-fitness-blogs/1300685-public-health-nigeria-blog/23417884-complete-overview-dbx-uses-side-effects-review
  20. Original link no longer valid: doctorsresearch.com/articles3.html; try this instead: The Truth About Minerals in Nutritional Supplements
  21. greenvalleynaturalsolutions.com/GLUCO/G-pun/Gluco-Secure-B.php; NOTE: this is a sales pitch for a particular supplement, but it does contain some useful info 
  22. Benefits of Consuming Colostrum; original BioLife link is not secure: biolifenz.com/Colostrum+Info/Frequently+asked+questions/Whats+Benefits+of+Colostrum.html; see also: secure.zeald.com/biolife/results.html?q=benefits+of+colostrum (link is secure)
  23. The HealthyBelly: http://thehealthybelly.com/healthy_baby.php?article_id=242 Link no longer valid – that site has been closed.
  24. articles.mercola.com/sites/articles/archive/2018/04/15/pqq-berberine-mitochondrial-enhancers.aspx; 5/3/23: that article is no longer available online
  25. allrecipes.com/article/types-of-cinnamon/
  26. Dr. Westin Childs: restartmed.com/myoinositol/ 
  27. Theralogix blog: blog.theralogix.com/how-inositol-benefits-these-6-health-conditions/ 
  28. Standard Process brand of myo-inositol: standardprocess.com/Products/Standard-Process/Inositol-Powder#.W-y8ja3MxZ0
  29. Health Benefits of Banaba Leaf Extract
  30. Banaba Leaf (on Examine.com)
  31. Healthline, on cassia vs Ceylon cinnamon: .healthline.com/nutrition/ceylon-vs-cassia-cinnamon 

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