Thursday, May 17, 2012

Cinnamon and Type II Diabetes

Of all of the herbal medicines that have gained attention in the past twenty years, few have generated the same enduring interest that cinnamon has. Of course, turmeric has now gathered piles of research large enough to cow skeptics, but turmeric doesn’t have quite the same appeal – even those of us who are great fans of curry wouldn’t think of sprinkling a little turmeric on a meal to enhance the flavor, and it remains largely an herb that people take as a supplement, but not in their food. Cinnamon, by contrast, evokes a warm familiarity from many Americans, who associate it with apple cider, oatmeal, and other delicious foods – is it any wonder, then that we’ve been excited to learn of its medicinal properties? The research into cinnamon has found that it can be quite effective in helping to manage type II diabetes, and in doses that would be added to food. I’m trying to keep this article short and sweet, so I’m only going to touch on meta-analyses and research reviews today – these are both types of scholarly articles that compile data from several smaller studies and draw larger results.

Before going into the meta-analyses surrounding cinnamon, let me mention dosing. A 2010 study found that cinnamon was effective in lowering both hemoglobin A1C (HbA1C) and blood pressure over a period of twelve weeks. Non-significant decreases were also observed in fasting blood glucose, waist circumference, and BMI. Without discussing the effects observed, let me mention that the dose of cinnamon used was 2 grams per day. According to the research I have done, this equates to a little bit less than a half teaspoon of ground cinnamon, or, to put it in other terms, exactly as much cinnamon as you’d want to add to a bowl of oatmeal to make it taste delicious. This, I think, is cinnamon’s true appeal – you can add it to your food in palatable levels and get true medicinal effects. A final note about this study – it found that cinnamon lowered HbA1C by about 0.40%, a number that may be unfamiliar to some, but to a diabetic, this is an important decrease.

Of course, supplements are available, but many of these are simply water extracts of cinnamon. Most supplements made from herbs are made using solvents to extract active compounds, which are then purified further so that just a few components are present in the final product. Cinnamon, by contrast, is largely extracted using water methods, and these extracts are generally not processed further. Cinnamon is largely effective in its natural state and doesn’t require a lot of extra work to get great benefit from it.

Several studies have found that cinnamon has significant effects on fasting blood sugar in type II diabetics. The pool of articles on the topic is somewhat small, and the meta-analyses and research reviews reference many of the same works, so it’s not surprising that they share conclusions. One team of researchers found that, after compiling eight clinical studies of cinnamon or a cinnamon extract, it was clear that cinnamon had a very strong effect on lowering blood sugar. They even quantified this effect, saying that, on average, cinnamon lowered blood sugar by 0.49 mmol/L. Many of us in the US are probably not familiar with this measure of blood glucose, but it’s equivalent to about 10 mg/dL. This isn’t an earth-shatteringly large number, but to a person working to lower their blood sugar through diet and lifestyle changes, this number could make a significant difference.

A research review working from eight studies found that cinnamon could reduce blood sugars in a type II diabetic by 10-29%. These numbers are well over the 10 mg/dL difference noted previously. Were they borne out by other studies, these numbers would have the potential to be extremely clinically significant. I always tend on the conservative side of things, so am waiting to see if these numbers can be reproduced. A final review found results similar to these results, but did not find significant changes in HbA1C.

Of course, no body of scientific evidence would be complete were it not for research contradicting it, and of course we find that another group of researchers, compiling data from five studies on cinnamon, found no significant benefit from cinnamon on either HbA1C, fasting blood glucose, or lipids (cholesterol). In a clinical setting, of course, we often have to weigh conflicting evidence, and make a decision based on the patient’s unique needs and situation.

As always, if you’re interested in managing your diabetes by using cinnamon, do so in concert with a health care provider. Diabetes is far too complicated a condition with far too serious outcomes to consider managing it on your own. A physician needs to monitor your condition and progress, and can help direct you along the way. Cinnamon has some great potential benefit, but this may not be the case for all people, and you’ll need to have a provider who can help direct you through challenges. Finally, remember that diet and lifestyle are the two most important determinants of a person’s health, and that any herb or medication is a tool, a thing which can’t of its own accord make a person healthy. Health comes from dedication, work, positive thought, and belief in one’s own ability to overcome challenges to emerge stronger and healthier.