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The Effect of Cinnamon on Glucose of Type II Diabetes Patients

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The incidence of type II diabetes is increasing across the world. Dietary modifications help the patients to control blood glucose. Traditional herbs and spices are commonly used for control of glucose among which cinnamon (Ròu Guì; Cinnamomum cassia) has the greatest effect. Research has shown that adding cinnamon to diet can help to lower the glucose level. The aim of this study was to determine the effect of cinnamon on the glucose level in blood. This was a Randomized clinical trial in which 70 Patients with type II diabetes were assigned randomly two groups (35 in cinnamon and 35 in placebo group). The groups were matched in terms of body mass index (BMI), HbAlc and fasting blood sugar (FBS). Patients were treated with cinnamon and the placebo group was treated with placebo in addition to their routine treatment for 60 days. FBG levels and glycosylated hemoglobin of patients on the first day, and 1 and 2 months after treatment were measured. Data were analyzed using t-test and paired t-test in Statistical Package for the Social Sciences (SPSS).16 software. The mean levels of FBS before, and 1 and 2 months after the intervention were 174 ± 59, 169 ± 43 and 177 ± 45; respectively. The levels of HbAlc before and after the intervention in the cinnamon group were (8.9 ± 1.7 and 8.9 ± 1.6). There was no significant difference in FBS and glycosylated hemoglobin levels between the two groups (P = 0.738 and P = 0.87, respectively). Results showed that using certain amount of cinnamon for 60 days did not change the glucose level of diabetic patients. So, using cinnamon to type II diabetes patients cannot be recommended and more studies are needed in future.
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Journal of Tradional and Complementary Medicine
Journal homepage http://www.jtcm.org
INTRODUCTION
Prevalence of diabetes type II was increasing across the world.
Studies showed that more than 220 million suffer from diabetes
worldwide. [1] The WHO report in the year 2000, put the estimates at
171 million. Which is expected to rise to 366 million in 2030.[2,3] Dia-
betes mellitus is a chronic disorder of glucose metabolism resulting
The Effect of Cinnamon on Glucose of Type II Diabetes
Patients
Farzaneh Hasanzade1, Maryam Toliat2, Seyyed Ahmad Emami3, Zahra Emamimoghaadam4
1Lecturer in Internal Surgery, Faculty of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.
2M.S.c in Internal Surgery, Faculty of Paramedical, Birjand University of Medical Science, Birjand, Iran.
3Professor in Pharmacognosy, School of Pharmacy, Mashhad University of Medical Science, Mashhad, Iran.
4Lecturer in General Health, Faculty of Nursing and Midwifery, Mashhad University of Medical Science, Mashhad, Iran.
ABSTRACT
The incidence of type II diabetes is increasing across the world. Dietary modications help the patients to control blood glucose.
Traditional herbs and spices are commonly used for control of glucose among which cinnamon (肉桂 Ròu Guì; Cinnamomum cassia)
has the greatest effect. Research has shown that adding cinnamon to diet can help to lower the glucose level. The aim of this study
was to determine the effect of cinnamon on the glucose level in blood. This was a Randomized clinical trial in which 70 Patients with
type II diabetes were assigned randomly two groups (35 in cinnamon and 35 in placebo group). The groups were matched in terms of
body mass index (BMI), HbAlc and fasting blood sugar (FBS). Patients were treated with cinnamon and the placebo group was treated
with placebo in addition to their routine treatment for 60 days. FBG levels and glycosylated hemoglobin of patients on the rst day, and
1 and 2 months after treatment were measured. Data were analyzed using t-test and paired t-test in Statistical Package for the Social
Sciences (SPSS).16 software. The mean levels of FBS before, and 1 and 2 months after the intervention were 174 ± 59, 169 ± 43 and
177 ± 45; respectively. The levels of HbAlc before and after the intervention in the cinnamon group were (8.9 ± 1.7 and 8.9 ± 1.6).
There was no signicant difference in FBS and glycosylated hemoglobin levels between the two groups (P = 0.738 and P = 0.87,
respectively). Results showed that using certain amount of cinnamon for 60 days did not change the glucose level of diabetic patients.
So, using cinnamon to type II diabetes patients cannot be recommended and more studies are needed in future.
Key words: Cinnamon, Diabetes, Fasting blood sugar, Herbal medicine
Journal of Traditional and Complementary Medicine Vo1. 3, No. 3, pp. 171-174
Copyright © 2013 Committee on Chinese Medicine and Pharmacy, Taiwan
from dysfunction of pancreatic beta cells and insulin resistance. It
is still a serious global health problem. The disease prevails in both
genders and all age groups, so there is concern among the general
public about its control and treatment. The therapeutic goal of dia-
betes control is reaching the normal level of blood glucose without
hypoglycemia and without causing any disturbance in the daily life
activities of patients. In type II diabetes, if the fasting blood sugar
Correspondence to:
Prof. Maryam Toliat, M.S.c in Internal Surgery, Faculty of Nursing and Midwifery, Birjand University of Medical Science, Birjand, Iran.
Telefax: 0098451513777. E-mail: tolyatm@yahoo.com
DOI: 10.4103/2225-4110.114900
This is an open access article under the CC BY-NC-ND license.
Toliat, et al. / Journal of Traditional and Complementary Medicine 3 (2013) 171-174
172
(FBS) cannot be controlled by diet, oral drugs are used for the con-
trol of blood glucose which is associated with side effects resulting
from long – term drug use.[4] Using complementary medicine among
patients with diabetes is different but the major therapies used
among the patients are nutritional supplements, herbal medicines,
spiritual therapies, relaxation techniques and Yoga.[5] Studies showed
that most of the diabetic patients use herbal medicines more than
the other supplemental therapies because they believe that herbal
medicines are natural, and healthy, whereas in poor quality and with
improper use, they can be harmful and cause adverse effects.[6,7]
Many studies conrmed that complementary medicine could be
effective for diabetic patients they cause decrease in blood glucose
levels by different mechanisms that could be helpful in patients’
care and for their better quality of life.[8]
Studies showed that spices such as cinnamon (肉桂 Ròu Guì;
Cinnamomum cassia), and carnation, walnut, green tea, and mint
have similar effects on insulin action and the most active of them
is cinnamon.[6] Cinnamon is the most bioactive product.
Cinnamon is commonly used as a spice across the world and in
Iran, its solution is used which is not toxic.[9] Several studies have
been conducted to conrm the effect of cinnamon on decreasing
the blood glucose of diabetic patients.[10] Khan[11] and Crawford[12]
showed that cinnamon has anti- diabetic effect, but Steve Blevins[13]
was not in agreement on the effect of cinnamon. In this respect,
no study has been conducted in Iran on human subjects. Gheibi
and Parvizi (2005) performed their study or rats and showed that
cinnamon could decrease blood glucose in diabetes.[10] Therefore,
keeping in mind the controversy on the effect of cinnamon in
decreasing the blood glucose and due to the widespread use of
cinnamon among Iranian people, this study was designed to see the
effect of cinnamon on blood glucose in Type II diabetic individuals.
MATERIALS AND METHODS
Subjects
This study was a double blind randomized clinical trial that was
done to determine the effect of cinnamon on the blood glucose of
patients with diabetes type II in Mashhad. Samples were selected
randomly and assigned to two groups of treatment and placebo.
The study tools included demographic data, biochemistry auto
analyzer, Pars Azmoon glucose kit and Bio-system kit. Validity
of demographic form was conrmed by content validity and the
other instruments used for measurement of blood glucose and gly-
cosylated hemoglobin were valid. To determine a power of 0.80,
we calculated a sample size of 70, with α = 0.05. The sample size
in each group was 35 and the study duration was 2 months. The
inclusions criteria were: Age > 18 years, no pregnancy, no acute
and severe stern in recent 8 weeks, not intake of herbs or other
complementary cinnamon in recent 8 weeks, HbAlc > 7, 140 < FBS
< 250, no allergy or sensitivity to cinnamon or other foods, no his-
tory of hemolytic anemia or hemoglobinopathy, no acute infection
(pneumonia, urinary tract infection, otitis) and no insulin therapy.
Study design and dietary intervention
Subjects were selected based on the inclusion criteria among
the patients who came to the (Endocrinology and Metabolism Cen-
ter, Mashhad University of Medical Science. The Samples selected
and assigned randomly to two groups (treatment and placebo).
We randomized the patients by blocking (a designed tech-
nique). Investigators and subjects were blinded to group assign-
ment and to capsule content. Cinnamon and placebo were ground
nely and put into capsules which could not be distinguished by
color, odor, or taste. Each capsule contained 500 mg product.
After explaining the research objectives to the patients and
taking their consent, demographic and related data were collected
by interview and using patient’s medical le. Then, boxes of A and
B that included 60 capsules of cinnamon (Cinnamomum cassia)
or placebo, prepared by collage of pharmacy, were given to the
patients. Patients had to use two capsules after breakfast and din-
ner with their drugs for rst 30 days, then after 8h of fasting, 5 ml
of blood was collected for glucose test. Then two capsules were
given to patients for use for second 30 days and also, their blood
glucose at the end of the second 30 days was evaluated.
Thirty and sixty days after using capsules, necessary infor-
mation such as change of drugs, cinnamon use, diet change, and
Physical Activity was collected for the samples. Medications and
diet of subjects were not changed during the study. Researcher
used phone call for follow-up to ensure the use of capsules and
recorded data about changing drug, diet and physical activity in
a checklist. Researcher did not know the contents of the capsules
until the end of the sampling and all the experiments were carried
out by one laboratory.
Compliance to the supplementation protocol was supervised by
a research technician who contacted the subjects once a week. Each
subject was required to return the original bottle of their respective
supplement for capsule counts and compliance was monitored by
counting the unconsumed capsules each week.
Statistical methods and data analysis
Data are presented as Mean ± SD or percentage. Statistical
analyses were performed using Statistical Package for the Social
Sciences (SPSS) software (version 11.5). The normal distribu-
tion of the variable was checked by Kolmogorov–Smirnov test.
Qualitative variables, such as physical activity, were analyzed
using Chi-square test. For comparison of variables before and
after the intervention within each group, paired t test was used.
Signicant differences between groups were determined by using
an independent t test. Statistical signicance was set at P < 0.05.
RESULTS
The sample consisted of 70 Type II diabetes patients di-
Table 1. Baseline characteristics of the study population*
Placebo (n=36)Cinnamon (n=35)Variable
54.7±8.153.7±9.7Age, years
28.7±427.1±3.2BMI
Gender (%)
33.3 (n=12)34.3 (n=12)
Men
66.7 (n=24)65.7 (n=23)
Women
Values are mans±SD or percentage; The groups did not differ with respect
to any variable, P>0.05, BMI: Body mass index
Toliat, et al. / Journal of Traditional and Complementary Medicine 3 (2013) 171-174
173
vided into two groups (35 cinnamon (肉桂 Ròu Guì; Cinnamo-
mum cassia) and 35 placebos). The mean age of patients was
54.3 ± 8.9 years. Of them, 33.8 % (24) were males and the rest
were females. Most of the patients in the groups were housekeepers
(65.8% and 58.3%, respectively in cinnamon and placebo groups).
The mean of body mass index (BMI) in cinnamon and placebo
groups was 27.1 and 28.4, respectively [Table 1]. There was no
signicant different between FBS and glycosylated hemoglobin in
the two groups before the intervention [Table 2]. Results showed
that there was no signicant difference between the mean of blood
glucose in 30 and 60 days after the intervention in the two group
(P > 0. 05) [Table 3]. There was no signicant different between
FBS and glycosylated hemoglobin in the two groups after the
intervention (P > 0.05).
DISCUSSION
In this study, the blood glucose of type II diabetes patients did
not decreased by using 1 g cinnamon (肉桂 Ròu Guì; Cinnamo-
mum cassia) during 60 days. There was no signicant difference
in FBS and glycosylated hemoglobin levels before and after the
intervention between the two groups. In vitro studies have shown
that cinnamon extract has increasing effect on Phosphorylation
activity of insulin receptors and decreasing effect on tyrosine
phosphatase activity, and so, it shows insulin-like properties.[14]
Some studies have shown that cinnamon, like insulin hormone,
inhibits glycogen synthase activity.[15]
Vance Chonbic et al., (2005) studied the effect of cinnamon
on blood glucose of 25 type II diabetics during menopause and
showed that there was no signicant difference in terms of FBS,
glycosylated hemoglobin, glucose tolerance test, insulin concen-
tration and serum lipids concentration on using 1.5 g cinnamon
for 6 weeks.[16] Steave Belvin et al., (2007) reported that using
cinnamon 1 g daily for 3 month had no signicant effect on glu-
cose, lipid, and HbAlc levels in type II diabetics.[13] Justin et al.,
(2007) reported that using cinnamon 1 g daily had no signicant
effect on HbAlc of 72 type I diabetics and the result was similar
to that of our study.[17] Soni et al., (2009) in one study showed that
using 2g cinnamon had signicant effect on the blood glucose
of type II diabetics after 40 days and the ndings conrmed that
cinnamon is an effective material in decreasing the blood glucose
of diabetic patients, which was not similar to our study results.[16]
The difference could be attributed to the fact that in Soni’ s study,
the experimental groups were formed by only males, so probably,
hormonal difference and more consumption of cinnamon could
be effective in the control of glucose, but it has not been proven
yet. Khan et al., studied the effects of 1, 3, and 6 g day of whole
cinnamon powder on FBG and serum lipids in 60 people with
poorly controlled type II diabetes from Pakistan. After 40 days of
supplementation, FBG decreased by 18-29%, cholesterol by 12-
26%, low density lipoprotein (LDL) cholesterol by 7-27%, and
triacylglycerol decreased by 23-30%.[11] The result of our study was
not similar with that of Khan and Craw ford, as it could be related
to the difference in base of FBS, using no standard diet and short
duration of intervention compared to the present study. [11,12] On
the other hand, the capsules were packaged in a local store and use
these capsules were not controlled in terms of purity. The other
weakness of Crawford’s study in comparison with our study was
lack of placebo group and blindness.
Our study result was similar to those of Justin,[18] and Steve
Blevin but different from the results of Crawford, Khan, and Soni’s
studies. Comparing the result of this study with those of others and
considering their limitations, we can point as the limitations of
the present study its duration (8 weeks) and dose of the cinnamon
used (1 g per day). There are some studies with longer duration[19]
and it would be better if we could have the possibility for continu-
ing the intervention. Which was impossible because subjects had
time limitations to come to the study center (Endocrinology and
Metabolism Center, Mashhad University of Medical Sciences) and
extension of time would have led to limited compliance. There are
some studies that used more than 1 g per day cinnamon and have
reported signicant effects,[11] and it would be better if we could
have another group with higher dose of cinnamon for comparing
the doses, which was impossible because of nancial limitations.
CONCLUSION
Taking cinnamon (肉桂 Ròu Guì; Cinnamomum cassia) at
a dose of 1 g daily for 30 and 60 days has no effect in decreas-
ing the blood glucose of type II diabetes patients. Based on the
controversial information obtained on the effect of cinnamon in
decreasing the blood glucose, it can be said that race, life style,
BMI, type of drugs, and duration of taking cinnamon inuence
diabetes treatment. Many studies have been done reporting dif-
ferent results and it seems the effect of cinnamon was different
in various populations. The results of this study showed that cin-
namon use at the study dose and duration was no effective and it
is recommended to perform many studies in future with cinnamon
at various doses and treatment duration.
Table 2. Comparison of means of FBS and HbAlc in patients’ before and after the intervention period in the two groups
Placebo group (n=36)Cinnamon group (n=35)Variables
DifferencesAfter (60 days)BeforeDifferencesAfter (60 days)Before
8±2.8151±38159±313±2.4174±59177±45FBS
1.4±0.188.3±1.38.4±1.40.03±0.018.9±1.68.9±1.7HbAlc
FBS: Fasting blood sugar; HbAlc: Hemoglobin A1c
Table 3. Comparison of means of FBS in patients’ 30 and 60 days after
the intervention in the two groups
PlaceboCinnamonVariables
165±36169±43FBS after 30 days
164±34174±59FBS after 60 days
FBS: Fasting blood sugar
Toliat, et al. / Journal of Traditional and Complementary Medicine 3 (2013) 171-174
174
ACKNOWLEDGMENTS
Authors offer their special thanks to School of Nursing and
Midwifery authorities, diabetic patients who participated in this
study and Dr. Mir Hussein and Ms. Boland the authorities of
diabetes section. This study was fully funded by MUMS vice –
presidency for Research and is an extract form an MSc thesis.
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... It has been stated that cinnamon increases glycogen storage by affecting glycogen synthesis activity [19]. A randomized controlled trial found that not enough evidence is available to support the use of cinnamon as a method for controlling blood sugar [20], and another study also found no improvement in blood glucose levels [21]. Despite numerous studies, some studies have shown a benefit from the cinnamon; some studies have not found any significant changes. ...
... The current study is limited to observing the measurement ofHbA1C, lipid profile, and oxidative stress among patients with type 2 diabetes mellitus. A study by Farzaneh Hasanzade et al., 2013 found that cinnamon consumption for 60 days did not change the glucose level of diabetic patients [21]. This finding is in contrast with current study findings. ...
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Complementary interventions could be effective for type 2 diabetic patients as they cause a decrease in blood glucose levels within the clinical range. Hence the study was aimed to conduct to determine the effectiveness of cinnamon on blood glucose levels in patients with type 2 diabetes. A quasi-experimental research design was adopted to conduct the study at Dr.Padmanaba polyclinic with samples of 30 type 2 diabetes patients who met the inclusion criteria. Patients were assigned to the experimental group (n=15) and the control group (n=15). Demographic variables were collected from the participants using a structured questionnaire followed by pre-test was done by checking the fasting and post-prandial blood sugar level for both the groups. The experimental group received 2gms of cinnamon daily in the morning on an empty stomach for 30 days along with routine medical management, whereas the control group received regular routine care. Post-test was done at the end of 30 days for both groups. Data were tabulated and analyzed using the SPSS package. The result of the study reveals that there is a statistically significant reduction in the level of in the fasting blood glucose level and post-prandial blood glucose level of p<0.0001 and p<0.05 among patients with type 2 diabetes. The findings of the present study concluded that the prescribed cinnamon is effective in lowering the blood glucose level among patients with type 2 diabetes mellitus. Hence, the cinnamon administration can be incorporated as an effective method in the management of diabetes mellitus after replicating the large study samples.
... Cinnamomum aromaticum significantly increased HDL-C (2 mg/dl; 1-2) (see Figure 9). (Mang et al., 2006;Suppapitiporn et al., 2006;Blevins et al., 2007;Crawford, 2009;Akilen et al., 2010;Wainstein et al., 2011;Lu et al., 2012;Sharma et al., 2012;Hasanzade et al., 2013;Tangvarasittichai et al., 2015;Sengsuk et al., 2016). ...
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... At present, Cinnamon is available within the market as a prophylactic supplement for metabolic syndrome, insulin resistance and Type 2 diabetes mellitus [40]. Some clinical trials exhibited that Cinnamon and its extracts achieved a therapeutic effect on diabetic patients [18,41,42]. ...
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... Several dietary agents have been successfully reported for the therapeutic treatment of diabetic secondary complications like diabetic retinopathy [15,16], diabetic cataract [17,18], diabetic nephropathy [19], and DCM [12]. Most of the dietary agents reported are targeting diabetes and diabetic complications by inhibiting the formation of non-enzymatic glycation and sorbitol, reducing oxidative stress and lowering the blood glucose levels [12,17,[20][21][22]. ...
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There is an increase in the incidence and prevalence of type-2 diabetes and obesity which leads to the structural and functional changes in myocardium leading to a lethal complication called diabetic cardiomyopathy (DCM). In the present study, we investigated the preventive effect of cinnamon (3% of Cinnamomum zeylanicum bark powder in AIN-93 diet for 3 months) feeding on DCM and the concerned mechanisms in a rodent model. Experimental diabetes was induced by a single intraperitoneal injection of 40 mg/kg b.w streptozotocin (STZ), 15 min after the ip administration of 60 mg/kg b.w of nicotinamide (NA) in Wistar-NIN (WNIN) male rats. The oxidative stress parameters were investigated by assessing superoxide dismutase (SOD), glutathione-s-transferase (GST) enzyme activity, protein carbonyls and malondialdehyde (MDA) levels. The histopathology of myocardium was analyzed by H&E and Masson’s trichrome staining, and scanning electron microscopy. The changes in diabetic rat heart involved the altered left ventricular parietal pericardium, structural changes in myocardial cells, enhanced oxidative stress. Masson’s trichrome and H&E staining have shown increased fibrosis, and perinuclear vacuolization in NA-STZ induced diabetic rat myocardium. Cinnamon feeding prevented the oxidative stress and myocardial alterations in the heart of diabetic rats. Taken together, these results suggest that cinnamon can effectively prevent the metabolic and structural changes in NA-STZ induced diabetic cardiomyopathy.
... Several dietary agents have been successfully reported for the therapeutic treatment of diabetic secondary complications like diabetic retinopathy [15,16], diabetic cataract [17,18], diabetic nephropathy [19], and DCM [12]. Most of the dietary agents reported are targeting diabetes and diabetic complications by inhibiting the formation of non-enzymatic glycation and sorbitol, reducing oxidative stress and lowering the blood glucose levels [12,17,[20][21][22]. ...
Article
Background and Objectives Cardiovascular diseases are the leading source of global deaths, and obesity is an independent risk factor. An obese mutant (WNIN/Ob) rat strain was identified and propagated at the animal facility of National Institute of Nutrition (NIN), India. In the current study, we have investigated alterations in WNIN/Ob rat heart in comparison with its lean littermates. Methods Six- and 12- month-old male WNIN/Ob rats along with their age-matched lean controls were overnight fasted to collect heart tissue. The sorbitol levels, aldose reductase activity, advanced glycation end products, and hydroxyproline of the cardiac tissue were measured by spectrophotometric and fluorometric methods. Masson’s trichrome staining was done for studying fibrosis. The status of endoplasmic reticulum stress markers was analyzed by quantitative PCR and immunofluorescence. TUNEL assay was performed to know the extent of apoptosis. Results While the heart weight was significantly higher in 12-month-old obese rats, organ to body weight ratio was lower in both 6 and 12 months of age. Histology revealed enlarged interstitial space and perinuclear vacuoles and increased cardiomyocyte size in the 12-month-old obese rats. Further, we have observed an increase in aldose reductase activity, sorbitol levels, fibrosis, ER stress markers and apoptosis in the 12-month-old obese rats. Conclusion WNIN/Ob rat displayed the typical obesity-associated cardiac alterations like that of both genetic- and diet-induced animal models of obesity and thus may serve as a valuable animal model to investigate obesity-associated cardiac alterations.
... According to WHO the use of herbal medicines is well established and widely acknowledged to be safer and effective and may be accepted by national authorities as well (1). Hasanzade et al (9) confirms that complementary medicine could be effective for diabetes patients and they effectively decrease blood glucose levels in the human body using different mechanisms that could be helpful in patient care and to enhance the quality of life. ...
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The prevalence of diabetes mellitus has become a global public health issue. Natural herbal treatments for type 2 diabetes mellitus have been widely used in traditional societies but has recently become popular among western societies as well. The aim of this study was to explore the experience of type 2 patients with diabetes mellitus who are currently on natural herbal treatment. A qualitative, phenomenological design has been used. Twelve participants from both males and females, aged between 25 and 75 years, who were on medical treatment, were selected for sampling. In-depth interviews were conducted at the diabetes clinic in a selected hospital in southern Sri Lanka. The athematic analysis was conducted, and 6 themes were derived. The majority of participants (75%) were motivated to use natural herbal treatments other than oral glycemic therapy. Experiences have been identified as the most influential factors in the use of natural herbal treatments. The need for educational interventions on natural herbal treatments and to propose the integration of herbal medicine into current medical systems is recommended.
Article
Objective The purpose of this study was to evaluate the effect of Saffron and its active ingredient, crocin, as a natural antioxidant in the treatment of type II diabetes. Methods A total of 150 uncontrolled type 2 (non-insulin-dependent) diabetic patients were selected based on inclusion criteria, randomly divided into three groups (crocin, saffron and placebo) for three months’ clinical trial. Fasting blood glucose (FBS), insulin level, glycosylated hemoglobin (HbA1c), lipid profile, kidney and liver function tests were performed before and three months after the study. The patients were followed every two weeks for possible clinical side effects. Results Our results showed that after three months of treatment with crocin and saffron, FBS reduction was significant in all groups (P-value<0.05). In addition, reduction of HbA1c was significant in the crocin and saffron groups compared to placebo group. Comparison between groups showed that treatment with crocin and saffron led to a significant reduction in HbA1c than placebo, and FBS level significantly reduced only in crocin compared to saffron and placebo groups. In addition, changes in lipid profile were not significant in any of the three groups. Also, there was no significant difference in liver and liver parameters in all three groups. Inter-group comparison of insulin levels showed significant difference only between the saffron and placebo groups. Conclusion Crocin can be effective in controlling the level of FBS and HbA1c in patients with type 2 diabetes.
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The paper highlights the use of Andrographis paniculata (Kalmegh) to cure diabetes.
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Background: The effect of training on the gene expression of GLUT4 and insulin receptor (IR) has been investigated in some studies, but the simultaneous effect of swimming training along with cinnamon consumption is unknown. Objective: This study aimed to examine the effect of six weeks of swimming training with cinnamon consumption on the gene expression of GLUT4 and IR in the brown adipose tissue of diabetic rats. Methods: In this experimental study, 28 diabetic rats were randomly divided into four groups of seven animals, including 1-control (C), 2-cinnamon (Ci), 3-swimming (S), and 4-swimming plus cinnamon (S + Ci). Rats in groups 3 and 4 trained for six weeks and five sessions. Groups 2 and 4 received 200 mg/kg/day. Data were analyzed using one-way analysis of variance and Tukey's post hoc test
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The present study was conducted to find out the effect of oral administration of cinnamon (Cinnamomum cassia) on non insulin dependent diabetes mellitus (NIDDM) patients of Udaipur city (Rajasthan). Thirty type 2 diabetics were divided into two groups (15 in each) experimental and control group. Experimental group was supplemented with 2g cinnamon powder filled in capsules (4capsules/day/person) for 40 days. Another group of 15 subjects served as control. Fasting and post prandial blood sugar were estimated at initial level (0 day), after 20 days and finally after 40 days. Diet of diabetics when compared with dietary modifications was found to be high in fat (131%), calcium (190.37%), thiamine (180.58%), vitamin C (117.40%) and niacin (110%) adequate in energy (103.82%), carbohydrates (80.35%), β carotene (96.14%) and riboflavin (90.86%). In addition diet was moderately low in protein (72.67%) and iron (54.73%) where as extremely low in fibre (15.94%).Data regarding blood glucose level showed that at initial level fasting blood glucose of experimental group was 148.73±3.69 mg/dl which reduced to 134.0±3.12 mg/dl after 20 th day and further reduced to 120.66±4.70 mg/dl at the completion of the study and was statistically significant (p>0.05,p>0.01) . Post prandial blood sugar also reduced significantly (p>0.05, p>0.01) from 187.66±3.29 mg/dl (0 day) to 172.93±3.51 mg/dl (20th day) and again reduced to 163.6±5.09 mg/dl after 40 days of intervention in the experimental group. This was also statistically significant at both 5 percent and 1 percent level of significance. No significant reduction was observed in both fasting and post prandial blood sugar in control group. The study reveals that cinnamon is effective in controlling blood sugar of people with type 2 diabetes.
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The objective of this study was to determine whether cinnamon improves blood glucose, triglyceride, total cholesterol, HDL cholesterol, and LDL cholesterol levels in people with type 2 diabetes. A total of 60 people with type 2 diabetes, 30 men and 30 women aged 52.2 +/- 6.32 years, were divided randomly into six groups. Groups 1, 2, and 3 consumed 1, 3, or 6 g of cinnamon daily, respectively, and groups 4, 5, and 6 were given placebo capsules corresponding to the number of capsules consumed for the three levels of cinnamon. The cinnamon was consumed for 40 days followed by a 20-day washout period. After 40 days, all three levels of cinnamon reduced the mean fasting serum glucose (18-29%), triglyceride (23-30%), LDL cholesterol (7-27%), and total cholesterol (12-26%) levels; no significant changes were noted in the placebo groups. Changes in HDL cholesterol were not significant. The results of this study demonstrate that intake of 1, 3, or 6 g of cinnamon per day reduces serum glucose, triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce risk factors associated with diabetes and cardiovascular diseases.
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In vitro and in vivo animal studies have reported strong insulin-like or insulin-potentiating effects after cinnamon administration. Recently, a human intervention study showed that cinnamon supplementation (1 g/d) strongly reduced fasting blood glucose concentration (30%) and improved the blood lipid profile in patients with type 2 diabetes. The objective of this study was to investigate the effects of cinnamon supplementation on insulin sensitivity and/or glucose tolerance and blood lipid profile in patients with type 2 diabetes. Therefore, a total of 25 postmenopausal patients with type 2 diabetes (aged 62.9 +/- 1.5 y, BMI 30.4 +/- 0.9 kg/m2) participated in a 6-wk intervention during which they were supplemented with either cinnamon (Cinnamomum cassia, 1.5 g/d) or a placebo. Before and after 2 and 6 wk of supplementation, arterialized blood samples were obtained and oral glucose tolerance tests were performed. Blood lipid profiles and multiple indices of whole-body insulin sensitivity were determined. There were no time x treatment interactions for whole-body insulin sensitivity or oral glucose tolerance. The blood lipid profile of fasting subjects did not change after cinnamon supplementation. We conclude that cinnamon supplementation (1.5 g/d) does not improve whole-body insulin sensitivity or oral glucose tolerance and does not modulate blood lipid profile in postmenopausal patients with type 2 diabetes. More research on the proposed health benefits of cinnamon supplementation is warranted before health claims should be made.
Article
In vitro and in vivo animal studies have reported strong insulin-like or insulin-potentiating effects after cinnamon administration. Recently, a human intervention study showed that cinnamon supplementation (1 g/d) strongly reduced fasting blood glucose concentration (30%) and improved the blood lipid profile in patients with type 2 diabetes. The objective of this study was to investigate the effects of cinnamon supplementation on insulin sensitivity and/or glucose tolerance and blood lipid profile in patients with type 2 diabetes. Therefore, a total of 25 postmenopausal patients with type 2 diabetes (aged 62.9 +/- 1.5 y, BMI 30.4 +/- 0.9 kg/m(2)) participated in a 6-wk intervention during which they were supplemented with either cinnamon (Cinnamomum cassia, 1.5 g/d) or a placebo. Before and after 2 and 6 wk of supplementation, arterialized blood samples were obtained and oral glucose tolerance tests were performed. Blood lipid profiles and multiple indices of whole-body insulin sensitivity were determined. There were no time X treatment interactions for whole-body insulin sensitivity or oral glucose tolerance. The blood lipid profile of fasting subjects did not change after cinnamon supplementation. We conclude that cinnamon supplementation (1.5 g/d) does not improve whole-body insulin sensitivity or oral glucose tolerance and does not modulate blood lipid profile in postmenopausal patients with type 2 diabetes. More research on the proposed health benefits of cinnamon supplementation is warranted before health claims should be made.
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Aim. This paper is a report of a literature review to explore the prevalence of complementary and alternative medicine use amongst people with diabetes to inform nursing practice, education and research. Background. Diabetes mellitus affects the entirety of a person's being and increasingly people use complementary and alternative medicine in conjunction with other medical treatments and lifestyle modifications to manage their condition and improve well-being. Methods. The CINAHL, Medline, ProQuest nursing journals and Psych INFO databases were searched for the period 1990–2006 using identified keywords. Results. A total of 18 studies from nine countries were found. The results suggest that the prevalence of complementary and alternative medicine use among people with diabetes ranges from 17% to 72·8%. The most widely used therapies among diabetic populations are nutritional supplements, herbal medicines, nutritional advice, spiritual healing and relaxation techniques. The characteristics which influence complementary and alternative medicine use are age, duration of diabetes, degree of complications and self-monitoring of blood glucose. Conclusion. Although inconsistency in the definition of complementary and alternative medicine and varying research designs make estimation of usage prevalence difficult, evidence suggests that a high proportion of people with diabetes use these therapies concurrently with conventional healthcare services. Healthcare professionals need to be aware of this issue and may need to incorporate complementary and alternative medicine information into patient assessment and intervention.
Article
Multiple trials in the past have shown conflicting results of whether cinnamon lowers glucose or hemoglobin A1C (HbA1C). The purpose of this study was to determine whether cinnamon lowers HbA1C in patients with type 2 diabetes. I performed a randomized, controlled trial to evaluate whether daily cinnamon plus usual care versus usual care alone lowers HbA1c. I randomized 109 type 2 diabetics (HbA1C >7.0) from 3 primary care clinics caring for pediatric, adult, and geriatric patients at a United States military base. Participants were randomly allocated to either usual care with management changes by their primary care physician or usual care with management changes plus cinnamon capsules, 1g daily for 90 days. HbA1c was drawn at baseline and 90 days and compared with intention-to-treat analysis. This study was approved by an institutional review board. Cinnamon lowered HbA1C 0.83% (95% CI, 0.46-1.20) compared with usual care alone lowering HbA1C 0.37% (95% CI, 0.15-0.59). Taking cinnamon could be useful for lowering serum HbA1C in type 2 diabetics with HbA1C >7.0 in addition to usual care.
Article
'Alternative' medicines are becoming increasingly popular, and in this paper we describe our experience with alternative approaches to orthodox diabetes management. Four patients with insulin-dependent diabetes reduced or stopped their insulin in favour of therapeutic approaches including prayer, faith healing, unusual diets, and supplements of vitamins and trace elements. This resulted in ketoacidosis in three, in one case life-threatening; and weight loss and hyperglycaemia in the other. One patient developed serious retinopathy. Additionally, eight other types of alternative diabetic treatment are described, not as far as we know associated with such serious complications. These include homeopathy, reflexology, meditation, herbal treatment, 'cellular nutrition', 'subconscious healing', 'pearl therapy' (drinking milk in which pearls have been boiled) and 'astrotherapy' (typing pieces of coral around the arm). Diabetes is a chronic incurable disease, for which modern treatments remain somewhat unsatisfactory. It is therefore perhaps not surprising that some patients seek alternative treatments with more attractive claims. Diabetes health professionals need to be aware of the potential dangers associated with some of these treatments.
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The classification of diabetes mellitus and the tests used for its diagnosis were brought into order by the National Diabetes Data Group of the USA and the second World Health Organization Expert Committee on Diabetes Mellitus in 1979 and 1980. Apart from minor modifications by WHO in 1985, little has been changed since that time. There is however considerable new knowledge regarding the aetiology of different forms of diabetes as well as more information on the predictive value of different blood glucose values for the complications of diabetes. A WHO Consultation has therefore taken place in parallel with a report by an American Diabetes Association Expert Committee to re-examine diagnostic criteria and classification. The present document includes the conclusions of the former and is intended for wide distribution and discussion before final proposals are submitted to WHO for approval. The main changes proposed are as follows. The diagnostic fasting plasma (blood) glucose value has been lowered to > or =7.0 mmol l(-1) (6.1 mmol l(-1)). Impaired Glucose Tolerance (IGT) is changed to allow for the new fasting level. A new category of Impaired Fasting Glycaemia (IFG) is proposed to encompass values which are above normal but below the diagnostic cut-off for diabetes (plasma > or =6.1 to <7.0 mmol l(-1); whole blood > or =5.6 to <6.1 mmol l(-1)). Gestational Diabetes Mellitus (GDM) now includes gestational impaired glucose tolerance as well as the previous GDM. The classification defines both process and stage of the disease. The processes include Type 1, autoimmune and non-autoimmune, with beta-cell destruction; Type 2 with varying degrees of insulin resistance and insulin hyposecretion; Gestational Diabetes Mellitus; and Other Types where the cause is known (e.g. MODY, endocrinopathies). It is anticipated that this group will expand as causes of Type 2 become known. Stages range from normoglycaemia to insulin required for survival. It is hoped that the new classification will allow better classification of individuals and lead to fewer therapeutic misjudgements.
Article
Insulin resistance is a characteristic feature of most patients with type 2 diabetes mellitus and is almost a universal finding in type 2 diabetic patients who are overweight (1–3). The presence of insulin resistance leads to increased β-cell insulin secretion with compensatory hyperinsulinemia (1–3). As long as the hyperinsulinemia is adequate to overcome the insulin resistance, glucose tolerance remains normal. In patients destined to develop type 2 diabetes, the β-cell compensatory response declines, and relative, or absolute, insulin insufficiency develops. At this point, insulin secretion cannot keep pace with the underlying insulin resistance, and glucose intolerance and eventually frank type 2 diabetes occur. Based on these observations it is evident that, except for very unusual patients, type 2 diabetes only develops in the context of insulin resistance plus β cell dysfunction. Although there is still some debate as to whether the insulin resistance or the β-cell defect comes first, most epidemiologic studies have indicated that in the early, prediabetic state, insulin resistance is the antecedent abnormality (4, 5).
Article
These studies investigated the ability of a hydroxychalcone from cinnamon to function as an insulin mimetic in 3T3-LI adipocytes. Comparative experiments were performed with the cinnamon methylhydroxychalcone polymer and insulin with regard to glucose uptake, glycogen synthesis. phosphatidylinositol-3-kinase dependency, glycogen synthase activation and glycogen synthase kinase-3beta activity. The phosphorylation state of the insulin receptor was also investigated. MHCP treatment stimulated glucose uptake and glycogen synthesis to a similar level as insulin. Glycogen synthesis was inhibited by both wortmannin and LY294002, inhibitors directed against the PI-3-kinase. In addition, MHCP treatment activated glycogen synthase and inhibited glycogen synthase kinase-3beta activities, known effects of insulin treatment. Analysis of the insulin receptor demonstrated that the receptor was phosphorylated upon exposure to the MHCP. This supports that the insulin cascade was triggered by MHCP. Along with comparing MHCP to insulin, experiments were done with MHCP and insulin combined. The responses observed using the dual treatment were greater than additive, indicating synergism between the two compounds. Together, these results demonstrate that the MHCP is an effective mimetic of insulin. MHCP may be useful in the treatment of insulin resistance and in the study of the pathways leading to glucose utilization in cells.