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INSULIN-LIKE BIOLOGICAL ACTIVITY OF CINNAMON AND EFFECT ON BLOOD GLUCOSE

Meshal Samadzada Russell Sage College

Abstract
Type II Diabetes Mellitus is a condition in which either endogenous insulin levels are inadequate compared to the amount of insulin required for stabilization of blood glucose levels or there is impaired glucose utilization. The resulting effect is hyperglycemia. If left unmanaged, hyperglycemia may lead to various detrimental effects such as macrovascular or microvascular complications. Prolonged exposure of blood vessels to glucose can damage nerve cells responsible for sending and receiving messages involving pain or other internal stimuli. Several forms of management are currently implemented for patients with type II diabetes mellitus, including lifestyle modifications, as well as self-management education. Medical management of type II diabetes mellitus typically includes glucose-lowering medications and insulin. However, there has been increased interest in the use of natural remedies for the management of this chronic illness, specifically cinnamon. Cinnamon is a common household spice that has been shown to aid in the management of blood glucose levels, as well as in the enhancement of insulin sensitivity. Various studies have shown the positive effects of cinnamon on blood glucose management. One study found that the addition of cinnamon within a meal decreased post-prandial blood glucose in the 120 minutes following ingestion. A second study found that a small daily dose of cinnamon combined with usual treatment lowered glycosylated hemoglobin levels significantly. Lastly, a study of diabetic mice concluded that cinnamon extract supplementation reduced both fasting and post-prandial blood glucose in a dose-dependent manner. These studies have shown that there is a positive correlation between the ingestion of cinnamon and successful blood-glucose management.

Introduction

Type II Diabetes Mellitus


Inadequate endogenous insulin produced or inefficient use of produced insulin (insulin resistance) Uncontrolled hyperglycemia Micro/macrovascular complications

Blood Glucose Management

Lifestyle modifications Medical management

Glucose-lowering medications & insulin

Increased interest in natural remedies


Implications
Blood

for cinnamon

glucose management/enhanced insulin sensitivity (Hlebowicz et al., 2007) Diabetics are most likely to use supplements as alternative form of treatment (American Diabetes Association, 2009)

Components of Cinnamon

Main component = Cinnamaldehyde

(Jakhetia et al., 2010)

Study #1
Effect of Ground Cinnamon on Post-Prandial Blood Glucose Concentration in NormalWeight and Obese Adults (Magistrelli & Chezem, 2012)

Subjects:

Normal weight/obese adults Rice pudding w/ 6 g cinnamon Rice pudding NO cinnamon

Methods:

Post-prandial BG measured @ 0, 15, 30, 45, 60, 90, 120 min

Study #1: Results

Significantly lower post-prandial BG in patients consuming rice pudding w/ Cinnamon during 120 min. period following meal (Magistrelli & Chezem, 2012)

Study #2
Effectiveness of Cinnamon for Lowering Hemoglobin A1C in Patients with Type 2 Diabetes: A Randomized, Controlled Trial (Crawford, 2009)

Subjects:

Poorly controlled type 2 diabetic patients

Methods:

Usual Care (U/C) U/C plus management (1g/d cinnamon capsule) HgA1c measured at baseline and 90 days

Study #2: Results

Over a 90-day period, HbA1C is significantly lowered (by .83%) with usual care plus 1 g/d cinnamon (Crawford, 2009)

Study #3
Anti-diabetic Effect of Cinnamon Extract on Blood Glucose in db/db Mice (Kim, et al., 2005)

Subjects: Diabetic mice Methods: 50 mg incremental doses from 50-200 mg Fasting and post-prandial BG

Study #3: Results

FBG and PB2 significantly decreased in a dose-dependent manner (Kim, et al., 2005)

Possible Mechanisms

Cinnamaldehyde

Promotes insulin release Enhances insulin sensitivity (Hlebowicz et al., 2009) Decrease post-prandial spike in blood glucose (Hlebowicz et al., 2009)

Delayed gastric emptying

Decreased alpha-glycosidase activity

Prevents rapid blood glucose increase Decreases CHO absorption rate in small intestine (Kim et al., 2005)

Conclusion

Recommendations: 1-6 grams cinnamon/daily 0.07-0.4 tbsp/daily Not a sole form of BG management Cinnamon consumption in conjunction with well-balanced diet

References

American Diabetes Association (2009). Retrieved from http://www.diabetes.org/living-withdiabetes/treatment-and-care/medication/herbs-supplements-and-alternative-medicines/ Crawford, P. MD. (2009). Effect of cinnamon for lowering hemoglobin a1c in patients with type 2 diabetes; a randomized, controlled trial. The Journal of the American Board of Family Medicine, 22, 507-512. Hlebowicz, J., Darwiche, G., Bjorgell, O., Almer, L.O., (2007). Effect of cinnamon on postprandial blood glucose, gastric emptying, and satiety in healthy subjects. American Journal of Clinical Nutrition, 85, 15521556. Jakhetia V., Patel R., Khatri P., Pahuja N., Garg S., Pandey A., Sharma S. (2010). Cinnamon: A pharmacological review. Journal of Advanced Scientific Research. 1(2): 19-23. Kim, S.H., Hyun, S.H., Choung, S.Y. (2005). Anti-diabetic effect of cinnamon extract on blood glucose in db/db mice. Journal of Ethnopharmacology, 104, 119-123. Lu, T., Sheng, H., Wu, K., Cheng, Y., Zhu, J., Chen, Y. (2012). Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutrition Research Journal, 32, 408-412. Magistrelli, A. MS, RD, LDN; Chezem, J.C. PhD, RD. (2012). Effects of ground cinnamon on postprandial blood glucose concentration in normal-weight and obese adults. Journal of the Academy of Nutrition and Dietetics, 112, 1806-1809.