We applaud the way this “The Healthy Skeptic” column raised some critical issues in this piece about the alleged therapeutic benefits of herbal drinks for diabetics. We wish, though, that this piece had done more than just raise issues and ask questions. We wish it had taken more care to answer these questions with a more thorough analysis of the evidence (or lack thereof) behind the marketing claims for these drinks. One company president got away with citing unpublished data. No comment was made about the limitations of drawing conclusions from talks at scientific meetings. And a study on another product was cited for showing an 8% fasting blood glucose drop in a study of 22 people – with no comment on the limitations of such a tiny study.
Diabetes is a chronic disease that affects more than 200 million people worldwide. It requires careful modulation of blood sugar through diet, exercise and other lifestyle changes, and sometimes by a medication regimen that can be costly and mentally taxing to maintain. Herbal elixirs such as the Sugar Crush described in the story hold out the promise of liberating diabetes patients from medication, but there appears to be little scientific proof of their success. This column could have more forcefully made the point – from the headline on – that these claims are uNPRoven.
Nonethless, we applaud the “Healthy Skeptic” column for its continued efforts.
The “Healthy Skepticism” column is usually good about reporting costs and they did it again this time. “Sugar Crush isn’t yet sold in stores — company President Uri Man says it will be widely available starting in March — but you can buy a 125 ml bottle of either variety online for $89.95. … Each capsule of Cinnulin PF from iVitals contains 125 milligrams of the extract. …A bottle of 120 capsules, available only online, costs about $30.”
The story does use some numbers here and there but none of them adequately quantify the benefits of any of these herbal remedies. This is tied in with the “evidence” criterion above. It is not sufficient to allow a company president to spout unpublished 40% reduced blood sugar level claims – even with an expert saying that’s “hard to believe.” Or to cite another company’s study claiming an 8% drop in fasting blood glucose in only 22 people – without commenting on the limitations of such observations.
No specific harms from taking the herbal remedies or from switching from clinically proven medication to these uNPRoven drinks are mentioned. This is a big omission given what can happen to diabetics if they don’t take their medication regularly.
The story attempted to evaluate the quality of the evidence but relied on a dueling quotes approach that did not actually provide readers with much analysis. Because so much of the story is spent on the herbal remedy makers’ claims, the story needed to either present the actual evidence used to make these claims or use other evidence to knock these claims down. It did neither. Instead, it muddied the picture further by just allowing quotes to compete with each other and allowing one company manufacturer to make the claim, that “company studies have found that the supplements, which are already very popular in Israel, have been shown to reduce blood sugar levels by up to 40% in just 30 days.” It was nice to see the story follow this bold statement up with this statement. “The company has not yet published any studies in medical journals, although it did present results at a recent meeting of the American Diabetes Assn. and the American Assn. of Diabetes Educators.” And near the end of the story, an expert is quoted saying, that it would be “hard to believe” that Sugar Crush could reduce blood sugar levels by 40%. What would have been more appropriate would have been for the writer to ask for whatever evidence was presented at the association meetings and to show that to relevant experts to decode them for readers. Absent that, readers are left with the overall impression, bolstered by the odd, potentially out-of-context comments from a USDA researcher, that these herbal remedies might truly have a proven clinical benefit.
The story does not engage in disease-mongering.
The story makes good use of independent sources. The third sentence is a quote from Dr. Daniel Einhorn, clinical professor of medicine at UC San Diego and the president of the American Assn. of Clinical Endocrinologists. Where the story falters, though, is in the way it uses a USDA researcher. “Richard Anderson, a research chemist with the U.S. Department of Agriculture’s Diet, Genomics and Immunology lab in Beltsville, Md., has a more optimistic view of the potential of herbs and supplements, especially cinnamon and chromium. Anderson says research in his lab — including human trials of Cinnulin PF — suggests that each of these ingredients can increase the body’s sensitivity to insulin.” Increasing a body’s sensitivity to insulin and acting as a substitute for diabetes medications are two different things, and we have to wonder if Anderson was given his due in this story.
We think that a more careful analysis of the evidence, using Anderson and Einhorn as guides, would have shown clearly that, while there are some potential benefits to some herbs, the 40% figure is not just “hard to believe,” it is flat out uNPRoven. The column’s final paragraph came close.
The story mentions diet and exercise, but it could have shown some of the evidence behind these two treatments. The last sentence in the story says, “Einhorn adds that there are exactly two proven and reliable ways to control blood sugar without resorting to prescription medications: regular exercise and a healthy diet.” That’s a great ender, but why not give some hard data to counter the “overblown” claims higher in the story. It wouldn’t have taken much time or space to do so.
The story makes it clear that there are a variety of products being sold by manufacturers as herbal remedies for diabetes. “Many current products take an herbal approach to blood sugar control. The liquid supplement Sugar Crush from NaturEra, for example, combines common sage, cinnamon, hibiscus and fenugreek, among other ingredients.” But it also makes it clear that Sugar Crush can, so far, only be found online.
The story says up high that there are many different herbal options vying for people’s money. “People who want to control their blood sugar without medications can choose from a huge variety of pills and elixirs. “I hear new claims on a nearly daily basis,” says Dr. Daniel Einhorn, clinical professor of medicine at UC San Diego and the president of the American Assn. of Clinical Endocrinologists. “There’s a constant market for new products.””
The story definitely does not rely on a news release, and we have to pause again to applaud the “Healthy Skeptic” enterprise. More news outlets should examine the marketing claims being made by herbal supplement manufacturers and others in the health arena.