As more individuals with diabetes incorporate complementary and alternative medicine therapies in to their health care routines, clinicians often find themselves acting as resources in an area that is unfamiliar, controversial, and rapidly changing. This article outlines an evidence-based, open-minded, and collaborative approach to counseling designed to promote safe and effective therapies while respecting patients' individual beliefs.

Individuals with diabetes are more likely than those without diabetes to use different modalities that may not be considered part of mainstream allopathic or conventional medicine. Many dietary supplements of botanical and nonbotanical origin are available over the counter to treat diabetes or its comorbidities. Clinicians must maintain a respectful attitude toward patients' health care values and beliefs, encourage open dialogue, and provide accurate, nonjudgmental information about different supplements. It is essential that clinicians stay informed about dietary supplements to evaluate whether side effects or potential interactions among medications, dietary supplements, medical conditions, or nutrients may occur.

With the exceptions of folate for prevention of birth defects and calcium for prevention of bone disease, currently there is no evidence of benefit from vitamin or mineral supplementation in diabetic patients without underlying deficiencies. Given the recent revelations about antioxidant vitamins, it is prudent to refrain from using vitamin E, vitamin C, or vitamin A in excess of the Dietary Reference Intakes.

This review explores the available evidence for the benefits of performing conventional (cardiovascular, resistance, and combined) or alternative forms of exercise training (yoga, tai chi, and qigong) on glycemic control for individuals with impaired glucose tolerance and type 2 diabetes. Based on the available evidence, it appears that a combined cardiovascular and resistance exercise training program should be part of a comprehensive treatment program for the prevention and management of type 2 diabetes, as recommended by American Diabetes Association guidelines.

Diabetes poses a major life stress that requires considerable physical, emotional, and psychological accommodation and coping. Mind-body therapies have drawn significant interest for their potential to assist in managing stress and adaptation to chronic illness. This review highlights the literature and research on Mindfulness-Based Stress Reduction to improve the health and well-being of individuals with diabetes.