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Complementary health approaches, otherwise known as non-mainstream practices, are commonly used by patients with diabetes. Natural products, including dietary supplements, are the most frequently used complementary approach by patients with diabetes. While popular, there are regulatory, safety, and efficacy concerns regarding natural products. Commonly used dietary supplements for diabetes can be categorized as hypoglycemic agents, carbohydrate absorption inhibitors, and insulin sensitizers. Hypoglycemic agents of interest include banaba, bitter melon, fenugreek, and gymnema. American ginseng, banaba, berberine, chromium, cinnamon, gymnema, milk thistle, prickly pear cactus, soy, and vanadium are insulin sensitizers that have been studied in patients with diabetes. The carbohydrate absorption inhibitors aloe vera gel, fenugreek, flaxseed, prickly pear cactus, soy, and turmeric may be used in patients with diabetes. The mind body therapies yoga, massage, and tai chi have preliminary evidence to support use in patients with diabetes. Deceptive marketing tactics may be employed by sellers of natural products. Consumers and clinicians must be aware of potential risks and make informed choices. Resources such as the Food and Drug Administration's (FDA's) MedWatch may be helpful. The FDA's online health fraud website informs consumers on various types of fraud and how to avoid them. For complete coverage of all related areas of Endocrinology, please visit our on-line FREE web-text, WWW.ENDOTEXT.ORG