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Abstract

Diabetes mellitus (DM) is the most common of the endocrine illnesses. It is a significant human disorder, affecting numerous, from several pieces of life in diverse countries. In spite of improvements in drug controlling of diabetes, the adverse drug effects have made experts to look towards hypoglycemic agents of natural source, particularly in the developing nations. Cinnamon is one medicinal universal plant which has been used daily by people all over the world, which has the probable to decrease the growth of diabetes and its problem. It also does not have much notable side effects. The current review presents the outstanding ability of cinnamon, to control diabetes by enhancing insulin release and insulin receptor signaling. It also points to the areas of prospect research regarding of the pathological mechanisms that cause diabetes.
International Research Journal of Pharmacy and Medical Sciences
ISSN (Online): 2581-3277
43
Ali Al-Samydai, Farah Al-Mamoori, Mayada Shehadeh, and Mohammad Hudaib, AntiDiabetic Activity of Cinnamon: A Review,”
International Research Journal of Pharmacy and Medical Sciences (IRJPMS), Volume 1, Issue 5, pp. 43-45, 2018.
AntiDiabetic Activity of Cinnamon: A Review
Ali Al-Samydai1*, Farah Al-Mamoori1, Mayada Shehadeh1, Mohammad Hudaib1
1Department of Pharmaceutical Sciences, School of Pharmacy, University of Jordan, Amman, Jordan
*Corresponding author Email: phalimahmoud2012@yahoo.com
AbstractDiabetes mellitus (DM) is the most common of the endocrine illnesses. It is a significant human disorder, affecting numerous, from
several pieces of life in diverse countries. In spite of improvements in drug controlling of diabetes, the adverse drug effects have made experts to
look towards hypoglycemic agents of natural source, particularly in the developing nations. Cinnamon is one medicinal universal plant which
has been used daily by people all over the world, which has the probable to decrease the growth of diabetes and its problem. It also does not
have much notable side effects. The current mini reviews present the outstanding ability of cinnamon, to control diabetes by enhancing insulin
release and insulin receptor signaling. It also points to the areas of prospect research regarding of the pathological mechanisms that cause
diabetes.
Keywords Cinnamon, Diabetes mellitus (DM), Fasting blood glucose, Hyperglycemia.
I. INTRODUCTION
onferring to the International Diabetes Federation
Atlas guideline report, presently, there are 352
million adults with impaired glucose tolerance who
are at high threat of developing diabetes in the future. In 2017,
it was expected that 425 million people (2079 years of age)
suffered from Diabetes mellitus (DM), and the number is
expected to rise to 629 million by20451.DM with its effect on
health, the healthcare system expenses of individuals
represents a severe international health burden 1,2.
II. COMPLICATIONS OF DIABETES
DM is a severe, chronic disease that occurs either when the
pancreas does not secrete sufficient insulin, or when the body
cannot effectively use the insulin it produces3. Atypically
extraordinary blood glucose can have a serious impact if it
triggers conditions such as diabetic ketoacidosis (DKA) in
type’s 1 and 2, and hyperosmolar coma in type24.
III. TREATMENTS:
Pharmacological therapy is intended at keeping the
glycaemia and reducing the long term problems of Diabetes.
Drug classes used for the treatment of type 2 diabetes
comprise the following:
(1) Insulin sensitizers: (a) Biguanides; (b) Thiazolidinediones
(TZDs); (2) Insulin secretagogues:
(a) Sulfonylureas; (b) Meglitinide derivatives; (3) Alpha-
glucosidase inhibitors; (4) Glucagonlike peptide1 (GLP-1)
agonists; (5) Dipeptidyl peptidase IV (DPP-4) inhibitors; (6)
Selective sodium-glucose transporter-2 (SGLT-2) inhibitors
(7) Insulin; (8)Amylinomimetic5.
IV. ANTI-DIABETIC MEDICINAL PLANTS
The global use of medicinal plants for the management of
diseases like diabetes has promptly increased over the last
decade. It is stated that up to 72.8% of people with diabetes
used herbal medicine6.
Moreover, a large number of medicinal plants are believed
to possess anti-diabetic activities and have been utilized to
control diabetes6. One of the medicinal plants that is emerging
as a possible therapeutic agent for the management of DM is
cinnamon6.
V. CINNAMON
Cinnamon is generally used in the aroma and industries
due to its smell, which can be combined into diverse varieties
of foodstuffs, perfumes, and medicinal products7. Overall,
around 250 species have been recognized among the
cinnamon genus, with trees being scattered all over the world7.
VI. BOTANICAL DESCRIPTION
Cinnamon is an evergreen tree belongs to Lauraceae
family, which grows from 20 to 30 feet; the leaves are dark
green on top and lighter green underneath. Fruits are black,
pulpy, and aromatic. A flower is small, yellow. The diverse,
spicy aroma of cinnamon inner bark, Cinnamomum cassia, is
the spice sold as cinnamon in the United States Fig.1. Ceylon
cinnamon, Cinnamomumzeylanicum, which is stated to as true
or sweetcinnamon8,9 Fig. 2.
Fig. 1. CInnamomum cassia.
Fig. 2. Cinnamomumzeylanicum.
C
International Research Journal of Pharmacy and Medical Sciences
ISSN (Online): 2581-3277
44
Ali Al-Samydai, Farah Al-Mamoori, Mayada Shehadeh, and Mohammad Hudaib, AntiDiabetic Activity of Cinnamon: A Review,”
International Research Journal of Pharmacy and Medical Sciences (IRJPMS), Volume 1, Issue 5, pp. 43-45, 2018.
Fig. 3. Cinnamaldehyde.
Fig. 4. Eugenol.
VII. CHEMICAL CONSTITUENTS
The main constituents of cinnamon are cinnamaldehyde,
cinnamate, cinnamic acid, and numerous essential oils10. They
all contribute to the odor and to the several biological
activities observed with cinnamon. It also contains
procyanidins tannins, mucilage, and a bit amounts of
coumarin11, 12. Cinnamaldehyde (trans-cinnamaldehyde) is the
foremost constituent in cinnamon barkoil Fig. 3. However, the
principal component of leaf oil is eugenol13 Fig. 4.
VIII. TRADITIONAL USES
Cinnamon is a prevalent cookery spice and is also used in
candy, incense, toothpaste and perfumes. Its oil is used as a
carminative, antiseptic and astringent. In traditional medicine
cinnamon has been used as agent and used in treatment of sore
pain and dentalharms 14.
IX. PHARMACOLOGICAL ACTIVITIES
Cinnamon displays animated role as a spice, but its
essential oils and other components also have significant
activities, including antimicrobial, antifungal and antioxidant.
Also, it has been used as anti-inflammatory, antitermitic,
insecticidal, antimycotic, and anticancer agent7. The
importance in cinnamon as a potentially valuable treatment for
DM instigated almost 20 years ago. The aim of this mini
review to provide a brief overview of anti-diabetic activity of
cinnamon.
X. CINNAMON AS ANTI-DIABETIC AGENT:
Established on the study of Zare, et al found, that
cinnamon supplementation (500 mg capsules twice daily) can
develop anthropometric considerations, glycemic indices, and
lipid profile of patients with type 2diabetes. These benefits are
considerably more prominent in patients with higher BMI
(BMI≥27)15.Shahibet alreported that the administration of 1 g
of cinnamon powder for 12 weeks decreases fasting blood
glucose level and glycosylated Hb among un-controlled type 2
diabetes patients, as well as increase the level of serum
glutathione and superoxide dismutase however, reduces serum
level of malondialdehyde, indicating the beneficial effect of
adjuvant cinnamon as anti-diabetic and antioxidant along with
conventional treatments to treat poorly controlled type 2
diabetes16.
Also, Kim et al. studied the anti-diabetic activity of
cinnamomum cassiaextract in type 2 diabetic animal models.
Cinnamon extract was administered at many dosages for 6
weeks. It was found that blood glucose level is significantly
diminished in a dose-dependent manner (P< 0.001) with the
most compared with thecontrol17.
Furthermore, serum insulin levels and HDLcholesterol
levels were significantly higher (P < 0.01) and intestinal
glycosidase activity was significantly lower after 6 weeks of
the administration. These results suggest that cinnamon extract
has a controlling part in blood glucose level and it may also
employ a blood glucose quashing effect by improving insulin
sensitivity or may be reducing the absorption of carbohydrates
in the smallintestine17.
Kumaret al.considered the effect of oral administration of
cinnamon extract to hyperglycemia induced rats. The Study
showed that oral administration of cinnamon extract produced
a significant decrease in the blood glucose level in the model
of induced diabetesrats18.
Anderson et al. demonstrated the effects of cinnamon
cassia 250 mg given twice a day to patients with type 2
diabetes. After, two months it was found that fasting blood
glucose decreased significantly (P< 0.001)19.
In addition, Al-Yasiry et al. proved the hypoglycemic
activity of cinnamon in poorly controlled patients with type 2
diabetics. The participants were given 0.5 g of crude cinnamon
15 minutes after each meal for a total of 1.5 g daily for three
months. They found that HbA1c decreased from 9.54+ 0.96
pre-treatment to 8.22 + 0.65 post treatment (P< 0.01)20.
Cinnamon cassia usage in type 2 diabetes was studied by
Akilen. Participants were given a total of 2g daily ingestion of
2 g of cinnamon each day was found to significantly reduce
the HbA1c level, p < 0.0521.
Governa et al., found that the consumption of
supplementation with cinnamon, usually in combination with
standard hypoglycemic therapies, has been related to modest
effects on fasting plasma glucose and hemoglobin A1c22.
XI. POTENTIAL MECHANISMS OF CINNAMON
Cinnamon hypoglycaemic activity may be recognized to
numerous mechanisms of action, comprising the stimulation
of insulin release and insulin receptor signaling, the activation
and regulation of enzymes involved in carbohydrate
metabolism, glycolysis, gluconeogenesis, stimulation of
cellular glucose uptake and increased glucose transporter-4
receptorsynthesis)23. Another study shown that cinnamtannin
B1, a proanthocyanidin isolated from the stem bark of ceylon
cinnamon, stimulates the phosphorylation of the insulin
receptor β-subunit on adipocytes as well as other insulin
receptors24.
XII. RECOMMENDED CINNAMON DOSAGE
The typical recommended dose is 1 to 4 grams daily of
ground according to New York University. Cinnamon oil is
generally used at a dose of 0.05 to 0.2 g daily25.
FIG.3:CINNAMALDEHYDE
International Research Journal of Pharmacy and Medical Sciences
ISSN (Online): 2581-3277
45
Ali Al-Samydai, Farah Al-Mamoori, Mayada Shehadeh, and Mohammad Hudaib, AntiDiabetic Activity of Cinnamon: A Review,”
International Research Journal of Pharmacy and Medical Sciences (IRJPMS), Volume 1, Issue 5, pp. 43-45, 2018.
XIII. SPECIFIC CINNAMON WARNINGS AND PRECAUTIONS
Medicinal doses are not recommended during pregnancy
because it can induce uterine contractions and in some cases
even cause prematurelabor26.
XIV. CONCLUSION
Cinnamon has been used as a natural traditional medicine
in numerous cultures throughout the world. From the findings
of various studies, it can be concluded that the oral
administration of cinnamon extracts has a valuable effect on
blood glucose levels. Additional studies are required to
determine the effectiveness of the active principles of
cinnamon and their therapeutic properties in the management
of diabetes.
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... A flavonoid obtained from Ceylon cinnamon stem bark was named cinnamtannin B1. It is proanthocyanidin and helps to phosphorylate the β-subunit of insulin receptor on adipose cells and other receptors of insulin [26]. Cinnamon oil when combined with oregano, cumin, myrtle and fennel essential oils, increase the insulin sensitivity and reduction in level of glucose in diabetic rats with Type 2 diabetes, was observed. ...
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... A flavonoid obtained from ceylon cinnamon stem bark was named cinnamtannin B1. It is proanthocyanidin and helps to phosphorylate the β-subunit of insulin receptor on adipose cells and other receptors of insulin [25]. Cinnamon oil when combined with oregano, cumin, myrtle and fennel essential oils, increase the insulin sensitivity and reduction in level of glucose in diabetic rats with Type 2 diabetes, was observed. ...
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Diabetes is one of the serious metabolic disorders occurred due to the imbalance of glucose level because of damaged pancreatic β-cells and lower production of insulin in body. Type 1 Diabetes Mellitus (TD1) and Type 2 Diabetes Mellitus (TD2) are main types of diabetes. Major portion of the world is suffering from Type 2 diabetes mellitus. Drugs used for diabetes are insulin, biguanides, sulfonylurea and inhibitors for a-glucosidase. Traditional medicines are under trial to reduce diabetic complications with no/minimum side effects. Many antidiabetic plants are under potential research i.e. strawberry, jamun, mulberry, fenugreek, turmeric, black pepper, garlic, ginger, grapefruit, and cinnamon. All of these have antidiabetic potential. These plants have bioactive compounds present in minute amounts. These compounds act against inflammation, diabetes, bacteria, fungi, other microbial infections, and obesity. These plants have antioxidant potential as well. Through HPLC “High- Performance Liquid Chromatography” screening, the compounds identified were caffeic acid, isoquercetin, kaempferol and other flavonoids. These compounds showed hypoglycemic activity. They are responsible for the increased uptake of glucose by the adipose and muscle tissues due to the activation of specific receptors i.e. PPARa “Peroxisome Proliferatoractivated Receptors a” and PPARγ (Peroxisome Proliferator-Activated Receptor γ). These activate the enzymes like glutathione, glutathione-S-transferase and catalase. Glutathione peroxidase inhibits the a-amylase then a-glucosidase lower glucose level. Effect of phytochemicals present in antidiabetic plants were studied in vitro and in vivo in animal models by inducing diabetes in them by streptozotocin, alloxan and diet on diabetic patients. Types of phytochemical compounds and their composition vary due to environmental factors, extraction and separation techniques which can have effect on clinical analysis. Bioavailability of oral drugs was also studied synergistically with these plants. Synthetic drugs, if are used with these natural compounds, they have no harmful effect but increase effectiveness. These herbal medications are more preferable, safe to use and cost effective due to which it is easily affordable by people. This review report covers the impact of these plants on diabetes mellitus reported so far.
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Phytotherapy has long been a source of medicinal products and over the years there have been many attempts to use herbal medicines for the treatment of diabetes. Several medicinal plants and their preparations have been demonstrated to act at key points of glucidic metabolism. The most common mechanisms of action found include the inhibition of α-glucosidase and of AGE formation, the increase of GLUT-4 and PPARs expression and antioxidant activity. Despite the large amount of literature available, the actual clinical effectiveness of medicinal plants in controlling diabetes-related symptoms remains controversial and there is a crucial need for stronger evidence-based data. In this review, an overview of the medicinal plants, which use in the management of diabetes is supported by authoritative monographs, is provided. References to some species which are currently under increasing clinical investigation are also reported.
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Diabetes is a complex condition with a variety of causes and pathophysiologies. The current single target approach has not provided ideal clinical outcomes for the treatment of the disease and its complications. Herbal medicine has been used for the management of various diseases such as diabetes over centuries. Many diabetic patients are known to use herbal medicines with antidiabetic properties in addition to their mainstream treatments, which may present both a benefit as well as potential risk to effective management of their disease. In this review we evaluate the clinical and experimental literature on herb–drug interactions in the treatment of diabetes. Pharmacokinetic and pharmacodynamic interactions between drugs and herbs are discussed, and some commonly used herbs which can interact with antidiabetic drugs summarised. Herb–drug interactions can be a double-edged sword presenting both risks (adverse drug events) and benefits (through enhancement). There is a general lack of data on herb–drug interactions. As such, more rigorous scientific research is urgently needed to guide clinical practice as well as to safeguard the wellbeing of diabetes patients.
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Background: The present study was undertaken with an objective to observe effectiveness of oral administration of cinnamon extract to hyperglycemic induced rats using alloxan. Male and female Wistar Rats were injected with alloxan to induce hyperglycemia.Methods: This is an experimental study to determine whether cinnamon has an ability to combat hyperglycemic rats. Blood glucose was estimated by GOD-PAP method using diagnostic kit supplied by Agappe diagnostics, Maharashtra.Results: The present experimental study provides further evidence that oral administration of Cinnamon extract for 21 days produced a significant decrease in the blood glucose level in the model of alloxan induced diabetes rats.Conclusion: From this study, we can conclude that the oraladministration of Cinnamon extracts have beneficial effect on blood glucose levels. However further pharmacological and biochemical investigations will clearly elucidate the mechanism of action and helpful in projecting these plant extracts as a therapeutic target in diabetes research.
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Type 2 diabetes is the most common form and is characterized by the failure of cells to recognize and respond to insulin which is if not treated accurately, many complication almost always will occur (include cardiovascular, neurological and many others) .This study aims to determine the hypoglycemic effect of cinnamon (a kind of spices used for food in eastern and middle-east countries) in patients with type II DM as adjuvant therapy. Forty male patient of age ranging from 35-61 years old with type II DM (poorly controlled on oral anti-diabetic drugs) where clinical assigned for this study. The results reveled that cinnamon has a significant anti-diabetic effect in reduction of FBS, RBS and HbA1c with less extent effect on body weight reduction at p value <0.01.