Cinnamon Reduces Blood Sugar in Diabetic Patients

Getting Better All the Time

Cinnamon Reduces Blood
Sugar in Diabetic Patients

Clinical trial shows that an aqueous extract of
the delightful spice benefits Western patients
By Richard P. Huemer, M.D.

I really don’t think I need buns of steel.
I’d be happy with buns of cinnamon.
— Ellen DeGeneres

omposer-performer Neil Young sang, in 1969, that he could be happy the rest of his life with a cinnamon girl. It’s not clear whether he was referring to pigmentation, a spicy disposition, a lingering fragrance, or perhaps even a state of robust health. “You see us together, chasing the moonlight,” he offered by way of explanation, which only added to the mystery.

Two years earlier, the Beatles had sung, “I’ve got to admit it’s getting better, a little better all the time.” Although they were no strangers to herbal substances, they probably didn’t have cinnamon in mind when they composed that line. Intentions notwithstanding, though, the Beatles’ words fit the story of cinnamon very well—it just keeps getting better and better. Here’s why.

Cinnamon Gets an Early Start

The recorded history of cinnamon began at least as far back as 2700 B.C., when a Chinese herbalist wrote of its usefulness for fever, diarrhea, and menstrual problems. Down through the centuries—in Pharaonic Egypt, in ancient Rome, during the Middle Ages—cinnamon has been used as a medicinal herb as well as a seasoning. In the Middle Ages, it was thought to be an aphrodisiac. The spice was so esteemed in Europe that commerce in cinnamon contributed toward making Venice a wealthy city-state, and even centuries later, the persistent demand for it touched off warfare, conquests, and the occasional massacre.

In modern times, cinnamon lost favor (but not flavor) as an appetite stimulant, digestant, antispasmodic, and antidiarrheal, at least in Western countries. In America it was relegated to the spice rack as a tasty ingredient for sweet desserts, such as apple pie, and as something to sprinkle on toast or outrageously costly cups of coffee.

More Apple Pie, Mom!

Then, in 1990, lightning struck when Dr. Richard Anderson, a chemist at the U.S. Department of Agriculture’s Beltsville Human Nutrition Research Center in Maryland, was searching for foods that might mimic the action of insulin in controlling blood sugar (glucose) levels. Dr. Anderson and his colleagues discovered their prime candidate in a most unlikely source: apple pie. The spice mix typically used in making the quintessential American dessert boosted insulin’s glucose-regulating activity more than threefold. Subsequent research narrowed the focus to the cinnamon in the spice mix, and finally to a class of water-soluble compounds in cinnamon called procyanidins (type A), which boost insulin’s activity about 20-fold.1

The procyanidins (type A)* are natural polymers, each unit of which is a type of molecule called a polyphenol; there are innumerable kinds of polyphenols, many of which are strong antioxidants. And many polyphenols, including the procyanidins (type A) belong to a broad class of beneficial, biologically active compounds called bioflavonoids.


*Type A” refers to a particular feature of the chemical bonding that links the polyphenol units in the polymeric structure; there are also type B procyanidins, but they’re of no concern to us.


And a Cinnamon Role!

It’s fortunate that the procyanidins (type A) are found in the water-soluble portion of cinnamon powder, because the fat-soluble portion contains coumarin, an anticoagulant that’s potentially harmful in large amounts, as well as cinnamaldehyde, which is potentially allergenic. By extracting and using only the water-soluble portion, therefore, the risk from these compounds is eliminated.

The strong insulin-mimetic properties of the procyanidins (type A) explain why there’s a cinnamon role (no pun intended) in diabetes. It’s useful to think of cinnamon as a sort of “Hamburger Helper®” for insulin: it makes this vital hormone go further. Several other herbs also potentiate insulin, including cloves, turmeric, bay leaves, and fenugreek, as do the minerals chromium and vanadium. However, cinnamon is by far the best of the lot. (OK, the pun was intended.)

The Looming Diabetes Crisis

We are in the grip of a worldwide diabetes epidemic, fueled by sedentary habits and calorie-rich junk foods, which lead to the primary risk factor for the disease: obesity. This situation is not getting better—it’s getting worse. Right now, about 16 million Americans have diabetes (overwhelmingly type 2), and nearly as many are estimated to be at risk for it. A dire prediction by the World Health Organization and the International Diabetes Foundation sets the worldwide tally of diabetics in the year 2030 at more than twice the current number. Many future citizens will likely be blind or lame owing to diabetes, and healthcare systems throughout the world will be overwhelmed.

ALA—Defender of Podocytes

Realizing how easily some jihadists get ticked off, and wishing to preserve the integrity of head and body, we will refrain from any wordplay with the acronym ALA. It means only alpha-lipoic acid here, nothing more.* And yes, ALA is good and all-powerful.


*Whether you see it called alpha-lipoic acid or just lipoic acid, it’s the same thing, so don’t sweat the terminology.


In the December 2003 issue (“Lipoic Acid Helps Fight Diabetes”), we discussed this remarkable natural substance’s ability to mitigate all sorts of diabetic complications through its antioxidant, antiglycation, neuroprotective, vascular-protective, and insulin-mimetic actions. As it turns out, there’s more: ALA also protects podocytes.

What, you may ask, are podocytes? They are (ready?) epithelial cells of the visceral layer of Bowman capsule in the renal corpuscle, attached to the outer surface of the glomerular capillary basement membrane by cytoplasmic foot processes (pedicels). Now aren’t you sorry you asked? All you really need to know is that podocytes (“foot cells”) are believed to play a role in the filtration of blood by your kidneys, and that diabetes causes a serious reduction in their numbers. That loss is one of the signs of diabetic nephropathy (kidney disease), one of the major causes of illness and death in diabetics.

Because diabetes is believed to be very much a disease of oxidative stress, researchers at the University of Michigan wondered whether antioxidants could protect podocytes from degradation early in the course of the disease.1 After injecting rats and mice with streptozotocin, a diabetes-inducing drug, they treated some of the animals with regular injections of either ALA or insulin. The ALA was started 48 hours after the induction of diabetes.

The animals’ diabetes killed podocytes in droves, and insulin provided only modest protection to those animals that received it. By contrast, podocyte loss was “substantially prevented in rats treated with ALA. Thus the researchers confirmed that oxidative stress plays an important role in diabetic kidney failure, by showing that the right antioxidant could help forestall it. ALA is great!

Reference

  1. Siu B, Saha J, Smoyer WE, Sullivan KA, Brosius FC III. Reduction in podocyte density as a pathologic feature in early diabetic nephropathy in rodents: prevention by lipoic acid treatment. BMC Nephrol 2006;7:6 (www.biomedcentral.com/1471-2369/7/6).

Diabetes is characterized by high levels of blood glucose. This condition is harmful because the excess glucose causes chemical reactions that lead to the formation of deleterious, cross-linked protein complexes aptly called AGEs (advanced glycation end products), whose prevalence in our tissues increases with age. High glucose levels also wreck blood vessels, trash kidneys, and erode cognitive function, among other things.

Beware of Insulin Resistance

In healthy individuals, blood glucose is controlled by insulin, a protein produced in the pancreas and the brain.* Insulin molecules “dock” with insulin receptors (which are also proteins) on the surface of cells. This causes the molecular structure of the receptor complex to change so that a channel is opened, selectively allowing glucose molecules to enter the cells. Thus, blood glucose levels are reduced, and the cells are nourished.


*The dramatic implications of the fact that our brains produce insulin (a recent discovery) are discussed in “Is Alzheimer’s Disease a Type of Diabetes?” and “More Evidence that Alzheimer’s Is Type 3 Diabetes” in the May 2005 and February 2006 issues, respectively.


When this system goes seriously awry, the result is diabetes, of which there are two main kinds, boringly called type 1 and type 2. They once bore the more descriptive names juvenile-onset and adult-onset, but because more and more children are now developing “adult” diabetes, owing to their atrocious diet and lack of exercise, those names no longer fit.

In type 1 diabetes, there’s not enough insulin to do the job, because an inflammatory process has destroyed the pancreatic cells that produce it. Type 2 diabetes is very different: here the problem is not a lack of insulin, but rather a reduced sensitivity of the cells’ insulin receptors to insulin. This reduces insulin’s effectiveness, causing the pancreas to produce more and more of it in an increasingly futile attempt to compensate. In its early stages, this pernicious condition is called insulin resistance. If uncontrolled, it can evolve to full-fledged diabetes. The various therapies for the disease (drugs, exercise, diet, and nutritional supplements) are directed at increasing insulin sensitivity, i.e., reducing insulin resistance.

A Cinnamon Study in Pakistan . . .

As an insulin “extender,” cinnamon offers hope for millions of diabetics worldwide, especially in poor countries where drugs are unavailable or unaffordable. This was first verified in a human clinical trial conducted in Pakistan 13 years after Anderson’s original report.2 The study’s lead author, Dr. Alam Khan, was a longtime associate of Anderson, who was a coauthor.

The researchers divided 60 middle-aged men and women with diabetes into groups treated with 1, 3, or 6 g of whole cinnamon powder daily, or placebo. After 40 days, all three of the cinnamon groups showed reductions (from 18% to 29%) in fasting blood glucose levels, whereas the control group showed no change. The cinnamon groups also had significant reductions in blood levels of LDL-cholesterol, total cholesterol, and triglycerides. Moreover, their improvements persisted for 20 days after the treatment was stopped. Thus it appeared that as little as 1 g/day of cinnamon, and perhaps less, could help control undesirably high levels of glucose and lipids in diabetics.

As dramatic as those results were, however, their broader relevance has been questioned. The Pakistani patients’ genetic background and dietary habits were quite different from those of most Westerners. More tellingly, their diabetes was not under what we would consider good control: their blood glucose levels were higher than those ordinarily attained (or at least targeted) in diabetic patients in the West. It’s not surprising that they had high lipid levels, which are a common complication of diabetes, especially when it’s poorly controlled.

. . . Sets the Stage for Further Success in Germany

A German research team in Hannover has now published a human study that seems to remove any doubts about cinnamon’s effectiveness in diabetes.3 In a randomized, placebo-controlled, double-blind trial, they assigned 65 men and women with type 2 diabetes to either a treatment group or a placebo group. The former received an aqueous extract of cinnamon (in capsule form) equivalent to 3 g of whole cinnamon powder, daily, for 4 months.

Fasting blood glucose levels in the cinnamon group were reduced by 10%, vs. 3.4% in the control group. The authors speculated that the lower percentage reduction seen here than in the Pakistani study was probably because the baseline levels in the German patients were substantially lower than those in the Pakistani patients; the German baseline levels were, in fact, comparable to the Pakistani post-treatment levels.

In contrast to the Pakistani study, the German study showed no significant changes in cholesterol or triglyceride levels, nor were there any changes in the levels of glycosylated hemoglobin (a measure of the extent to which high glucose levels are causing the formation of AGEs), probably because the decline in blood glucose levels was insufficient to cause this.

From all the results obtained, the researchers concluded that the more poorly controlled the diabetes is in any given case, the more effective cinnamon supplementation is likely to be. They also concluded that the lower percentage reduction in their study was probably not attributable to their having used an aqueous extract of cinnamon rather than whole cinnamon powder (as in the Pakistani study), because laboratory studies have shown that aqueous extracts of cinnamon do have insulin-mimetic activity, and the substances thought to be responsible—the procyanidins (type A)—are indeed water-soluble.

Cinnamon—As Sweet by Any Name

Cinnamon, by the way, comes from the bark of trees of the genus Cinnamomum (there are about 250 species), which is native to Sri Lanka. “True” cinnamon (Cinnamomum verum) is relatively expensive, so most commercial cinnamon comes from the more abundant Cinnamomum cassia tree, commonly known by its species name, cassia (not to be confused with an unrelated tree of the genus Cassia, which is also called cassia). It’s also called Chinese cinnamon, false cinnamon, and (less politely) bastard cinnamon.


The researchers concluded that the
more poorly controlled the diabetes
is, the more effective cinnamon
supplementation is likely to be.


Regardless of any aspersions cast upon its pedigree, C. cassia is perfectly respectable cinnamon. It seems to have been the kind favored by the ancient Egyptians. The two human studies on cinnamon and blood sugar discussed above were both done with cassia.

Although cassia is coarser and more astringent than true cinnamon, they have similar biological activities, and both are approved by the German Commission E (the world’s most respected authority on the medicinal uses of herbal products) for loss of appetite and dyspeptic complaints. But as similar as cassia and true cinnamon may be, our sources suggest that the kind once valued as an aphrodisiac was the true cinnamon. Perhaps that could be a clue as to why Neil Young wanted to spend his life with a cinnamon girl. We can imagine that a cassia girl just wouldn’t have met the requirements.

References

  1. Anderson RA, Broadhurst CL, Polansky MM, Schmidt WF, Khan A, Flanagan VP, Schoene NW, Graves DJ. Isolation and characterization of polyphenol type-A polymers from cinnamon with insulin-like biological activity. J Agric Food Chem 2004;52:65-70.
  2. Khan A, Safdar M, Khan MMA, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003;26(12):3215-8.
  3. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006;36:340-4.


Dr. Richard P. Huemer received his M.D. from UCLA and did postdoctoral research in cancer immunology at CalTech. He has specialized in orthomolecular medicine for most of his career, has written and lectured extensively on alternative medicine, and has served on the editorial boards of professional journals. His published books include The Roots of Molecular Medicine: A Tribute to Linus Pauling and, with coauthor Jack Challem, The Natural Health Guide to Beating the Supergerms.

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