Earlier this winter a California herbalist was sentenced to jail time after a 13-year-old boy with Type 1 died while under his care in 2014.

The herbalist, Timothy Morrow, visited the boy when he was critically ill with diabetes-related complications and recommended the boy’s parents use the herbal treatment products and herbs Morrow sold for treatment instead of giving their child his pediatrician-prescribed insulin. The boy went into cardiac arrest and died the following day. Medical examiners in the case testified that the death could have been prevented with proper medical treatment.

“This case underscores the serious health and safety risks of taking medical advice from someone who lacks a license and the proper training that goes with it,” Los Angeles City Attorney Mike Feuer said in a statement released after the sentencing.

While traditional medical doctors, herbalists, and naturopaths all agree that this case is an extreme example of medical negligence, it has again raised the question of how and when diabetes can be treated naturally. And it comes at a time when an increasing number of people are exploring alternative medical careers. According to the U.S. Bureau of Labor Statistics, careers in naturopathic medicine are growing at a steady rate of 10 percent per year.

We talked to several naturopaths, herbalists, and medical doctors. With their help we came to the following recommendations. The number one takeaway we found: while there are definitely benefits of herbal medicine for people with diabetes, herbal approaches can’t replace insulin. (Yup!)

Naturopathic medicine blends centuries-old natural, non-toxic therapies with current medical advances in the study of health and human body systems. It concentrates on the idea of whole-patient wellness. Medicine and treatment is tailored to the individual patient, and prevention and self-care is emphasized.

So what should you expect when seeing a naturopath? What should you ask? What should he or she ask you?

The scenario depends on your relationship to diabetes, advises Dr. Mona Morstein, an Arizona-based naturopathic physician with a medical practice focused on integrative diabetes treatment and the author of “Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes.”

First, find a naturopathic physician who specializes on your diagnosis. For example, are you Type 1? Type 2? Have you developed gestational diabetes? How long have you been diabetic? Some practitioners work with multiple forms of diabetes, while others might specialize in Type 1 or Type 2. During an initial visit for a Type 2 patient, a naturopath might investigate various controllable obstacles and complication creators (poor diet, nutritional deficiencies, lack of exercise, obesity, environmental toxins or hormonal imbalances noted for initiating insulin resistance) to discover what etiologic factors to specifically address for each patient, Morstein explains.

“The naturopathic physician will then do a thorough physical exam, including basic evaluations as well as those specifically associated with diabetes, like checking the feet for nerve damage,” says Morstein.

These doctors will also order the standard lab tests to check cholesterol levels, evaluate liver and kidney function, screen for anemia, and all the blood sugar monitoring lab work. Morstein added they may also do tests to measure vitamin D (necessary for glucose regulation), inflammatory markers, and cardiac risk profiles, including checking for environmental toxemia and thyroid, adrenal, and reproductive hormonal imbalances.

Not all that different really than a traditional physician visit.

After the initial appointment, a naturopathic doctor will determine what areas pose the highest risk and what approaches are likely to be most effective, creating a personalized treatment plan.

According to the Institute for Natural Medicine, a naturopathic treatment approach for diabetes generally includes a combination of the following:

• A review of a patient’s diet diary and/or blood sugar log.

• Dietary guidance to strive for more balanced blood sugar throughout the day.

• A thorough review of other systems impacted by diabetes, including the heart, kidney, liver, and brain.

• Lifestyle counseling strategies to engage patients in their own disease management and encourage lifestyle improvement.

• Preventative strategies to avoid disease progression and worsening.

• Herbs and/or nutritional supplements to correct nutritional deficiencies and/or support blood sugar management.

• Consultation on medication management (including insulin).

We know diabetes is a condition that upends lifestyles. Changes are everywhere—both the ways it changes one’s daily routine to how a person has to change his or her environment to gain control. This process of lifestyle shifting, which can be very hard to do, is a place where naturopathic practitioners, who are generally known to be excellent at instructing and supporting the change process via a more holistic patient approach, often shine.

But what about the balance and blend between dietary supplements, herbs, and traditional medicine?

Herbalists and naturopathic doctors we spoke with advised that supplements and herbs are not ever meant to replace insulin for patients who require insulin therapy. No supplement will fix a pancreas that has stopped producing insulin, and nobody with Type 1 diabetes can continue living without insulin.

Instead, supplements and herbs are meant to work synergistically with other aspects of a comprehensive treatment plan. They might be used to replace deficient nutrients, help lower glucose levels, decrease insulin resistance, and reduce body reduce inflammation or other diabetic side effects. A good naturopath will monitor the needs and balance between natural remedies and prescription medications.

While evidence and studies of the effects of this are limited, the following herbs and remedies have been shown to have some efficacy in treating Type 2 diabetes, according to care providers we spoke with:

• Curcumin. A compound found in the spice tumeric, curcumin has been shown to both boost blood sugar control and help prevent the onset of diabetes. In a nine-month study of 240 adults with pre-diabetes, those who took over-the-counter curcumin capsules avoided developing diabetes, while a sixth of patients in the placebo group did.

• Ginseng. Used as a traditional medicine for millennia, studies suggest that both Asian and American ginseng may help lower blood sugar in people with diabetes. Extract from the ginseng berry was able to normalize blood sugar and improve insulin sensitivity in mice who were bred to develop diabetes in one study.

• Fenugreek. Fenugreek, another spice and long-time traditional medicine for diabetes, has demonstrated efficacy in both animal and human trials. In one recent study of 60 people with Type 2 diabetes, adding fenugreek seeds to their diet was found to have a significant effect on controlling blood sugar.

• Psyllium. A plant fiber found in common bulk laxatives and fiber supplements, psyllium has also been used to treat diabetes historically by lowering both cholesterol and blood sugars.

• Cinnamon. Numerous studies have shown that consuming about half a teaspoon of cinnamon per day can result in significant improvement in blood sugar, cholesterol, and triglyceride levels in people with Type 2 diabetes.

• Aloe vera. Normally thought of as a topical remedy for cuts, some studies suggest juice from the aloe vera plant can help lower blood sugar. Dried sap from the aloe vera plant has traditionally been used to treat diabetes in the Middle East.

• Bitter melon. A staple of traditional Chinese medicine, bitter melon is believed to relieve thirst and fatigue, two possible symptoms of Type 2 diabetes. Research has shown that extract of bitter melon can reduce blood sugar.

• Holy basil. This herb is commonly used in India as a traditional medicine for diabetes. Studies in animals suggest that holy basil may increase the secretion of insulin. A controlled trial of holy basil in people with Type 2 diabetes some years ago showed a positive effect on both fasting and post-meal blood sugar.

As for Type 1 diabetes, the naturopathic goal is generally to reduce insulin requirement to a minimum while maintaining the best possible health, especially of the cardiovascular system. Common focuses are vigilant control of blood sugar levels and attention to diet, exercise, and stress reduction.

That means maintaining a healthy weight; eating small, frequent meals to keep sugars in a healthy range; limiting refined sugars and starches and chemically altered fats; and eating increased levels of omega-3 rich foods and non-starchy vegetables (cucumbers, bell peppers, dark leafy greens, zucchini, eggplant, squash, asparagus, broccoli, cabbage, beans, radishes, and spinach).

As for herbs and supplements, practitioners we spoke with recommended people with T1D explore the above-mentioned herbs and the following supplements with your naturopath, never alone but in combination with appropriate medicines:

• Chromium. A trace element that plays a role in blood sugar regulation by working with insulin to help transport glucose into cells. Recommended dose: up to 1,000 micrograms of GTF (gluten-tolerance factor) chromium daily.

• Alpha lipoic acid (ALA). An antioxidant, ALA can enhance the uptake of glucose into cells and help inhibit glycosylation (the abnormal attachment of sugar to proteins that hinders their normal functioning), as well as help promote and maintain eye health and potentially prevent and treat diabetic peripheral neuropathy. Recommended dose: 100 mg per day.

• Coenzyme Q10. An antioxidant that may help maintain heart health. Recommended dose: 60-100 mg in a softgel form with your largest meal of the day.

Sadly, almost all medical realms are filled with snake-oil salespersons pushing miracle cures. The herbal realm is no different, and particularly susceptible to this predatory behavior it sometimes seems. Morrow, the herbalist in the case of that teenage death, who also sentenced for practicing medicine without a license, is a prime example. In YouTube videos and herbal product promotions, he had claimed that “insulin is very poison to the system” and that watermelon, zucchini and green beans are “natural insulin.”

First, make sure any herbalist or naturopath you see is licensed to practice medicine. Find out about his or her medical background, academic background, and training.

The American Association of Naturopathic Physicians (AANP) is a good place to start your search. Founded in 1985, the organization is the national society that represents licensed naturopathic doctors. You can find a helpful provider search online here.

Of course, be suspicious of any claims for treatments that “cure” things or guarantee the efficacy of herbs or supplements. Diabetes cannot be cured, only managed. If something seems too good to be true, it almost always is.

“All in all, naturopathic protocols for diabetes are detailed, safe, and responsible,” according to Dr. Morstein. “Patients can lose weight, gain significant energy, and reduce their glucose numbers, lipid values, and blood pressure. They can at times see their damaged nerves and kidneys recover full functioning, and those without such damage will have protection from developing it. Naturopathic treatment of diabetes can be incredibly effective, if done right.”

Greg Brown is a freelance writer living in western Maine. He has written for Consumer Reports Magazine, Consumer Reports Online, The New York Times, and the Chicago Tribune, among other publications. He can be found online at www.yellowbarncreative.com.