Cinnamon reduces hemoglobin A1c and blood glucose

As ancient as Chinese cinnamon is, at last comes proof that …

The case rests for the power of cinnamon

Fisherman on the Li River in Guilin, Guangxi Province, searching for catch against the backdrop of the Cinnamon Forest (the meaning of Guilin), with the use of cormorant birds, a technique used for thousands of years.

Cinnamon has been known and used for many thousands of years, going back to early Egypt. There, as early as 2000 BCE, it was used for embalming, probably because of its antibiotic effects. However, much of Egyptian cinnamon came out of China where writings about cinnamon, Cinnamomum zeylanicum, and Cinnamomum cassia, date back to 2800 BCE. Eventually, gui (the Chinese name for cinnamon) was exported from south China to Java, whose inhabitants then discovered that cinnamon trees grew wild on their own island. As a result, they cultivated and exported it, together with the Chinese gui, giving it the Malayan name of Kayu manis which literally means “sweet wood.” Kayu manis is assumed to be the origin of the English word “cinnamon.”

In China, for millenia, cinnamon has been used as a traditional treatment and appreciated for its food flavoring and medicinal properties, which essentially mean the same thing. This is because in China, food is medicine. As a hot or heating remedy, it was traditionally used to eliminate cold influences, particularly lung and liver diseases, along with malarial fevers and chills. It was especially valued as a catalyst to activate other ingredients in compound medicines. And it was used to treat “thirsty disease,” which was an old term for diabetes in China before the term diabetes mellitus came into use.

Cinnamon caused a significant 
decrease in platelet counts.

At last, research from China

Nonetheless, there have been no studies to date that have investigated whether cinnamon supplements are able to aid in the treatment of type 2 diabetes in Chinese subjects. So in a new study, researchers hypothesized that cinnamon should be effective in improving blood glucose control in Chinese patients with type 2 diabetes.¹ To address this hypothesis, the Chinese researchers performed a randomized, double-blinded clinical study to analyze the effect of cinnamon extract on glycosylated hemoglobin A1c (HbA1c) and fasting blood glucose levels in Chinese patients with type 2 diabetes.

Long-term use of cinnamon 
might provide benefit against 
diabetic conditions.

The beginnings of cinnamon research …

This study follows in the footsteps of other recent studies demonstrating that cinnamon is effective in improving blood glucose control in subjects with type 2 diabetes. The initial spearhead for cinnamon/diabetes research began in 1998, when a group of scientists at Iowa State University found that bioactive compounds from cinnamon could interfere with insulin signaling.² These results were followed by Turkish researchers concluding in 1999 that cinnamon caused a significant decrease in platelet counts of rats with induced tissue injury.³ Furthermore, their findings indicated that long-term use of cinnamon might provide benefit against diabetic conditions.

The positive effects of cinnamon, on 
insulin activity suggested a possible 
role of cinnamon for improving 
glucose and insulin metabolism.

Cinnamon most bioactive for improved glucose metabolism

Then, in 2000, Richard Anderson et al at Beltsville Human Nutrition Research Center, Agricultural Research Service, U.S. Department of Agriculture in Beltsville, Maryland set out to evaluate the possible effects on insulin function by examining 49 herb, spice, and medicinal plant extracts for the insulin-dependent utilization of glucose using a rat epididymal* fat assay.⁴ Far and away, cinnamon was the most bioactive substance, and its glucose oxidation enhancing bioactivity was lost, indicating that its active phytochemicals are likely to be phenolic in nature. By measuring the direct stimulation of cellular glucose metabolism by cinnamon, the researchers concluded that the active phytochemicals in cinnamon, and some other plants (but to a lesser degree) improved glucose metabolism via other mechanisms. In summary, the positive effects of specific plant extracts, especially cinnamon on insulin activity suggested a possible role of cinnamon for improving glucose and insulin metabolism.

* The epididymis is a long, narrow, convoluted tube, part of the spermatic duct system, that lies on the posterior aspect of each testicle, connecting it to the vas deferens (also called ductus deferens), part of the male anatomy of many vertebrates; these ducts transport sperm from the epididymis in anticipation of ejaculation.

Cinnamon was able to reduce the 
fasting blood glucose (FBG) level and 
improve hyperlipidemia in human 
patients with type 2 diabetes.

Cinnamon reduces fasting blood glucose

Three years later in 2003, Pakistani researchers under the tutelage of Dr. Richard Anderson reported for the first time that cinnamon was able to reduce the fasting blood glucose (FBG) level and improve hyperlipidemia in human patients with type 2 diabetes.⁵ Since then, a series of clinical studies have been conducted in a number of countries, but not China, finding the potential effectiveness of cinnamon or cinnamon extract in improving blood glucose control in patients with type 2 diabetes.

Cinnamon extract could 
decrease FBG among patients of 
metabolic syndrome.

In Germany at the University of Hannover in 2006, researchers reported that cinnamon extract could reduce the FBG level in type 2 diabetic patients.⁶ Also in 2006, researchers at Wadsworth Medical Center, Wadsworth, Ohio, also led by Dr. Richard Anderson, reported that cinnamon extract could decrease FBG among patients of metabolic syndrome in the United States.⁷

Cinnamon improves hemoglobin A1c levels

Two years later, a randomized study performed in the United States indicated that cinnamon was able to improve HbA1c levels in type 2 diabetic patients.⁸ In 2010, a study performed in the United Kingdom demonstrated similar results showing that cinnamon was able to reduce the level of HbA1c in type 2 diabetic patients.⁹Nonetheless, a few studies have revealed that cinnamon has no effect in improving blood glucose control. This includes a study published in 2007, from work done in the United States in which researchers reported that cinnamon could not alter the levels of FBG and HbA1c in type 2 diabetic patients.¹⁰ Other studies, both of which compared healthy subjects and those with impaired FBGs found that cinnamon had no effect in decreasing FBG levels.^11,12 The “healthy” subjects in the second study, also overseen by Dr. Anderson, used overweight or obese subjects (BMIs ranges from 25 to 45). This study, however, found that cinnamon could reduce other risk factors associated with diabetes, as well as cardiovascular disease.

Cinnamon was able to 
improve HbA1c levels in 
type 2 diabetic patients.

The differences in the outcomes could have resulted from the types of cinnamon administered, the duration of the study, and the studied population. And, only a few of these studies used HbA1c to monitor the blood glucose homeostasis, and HbA1c is better than FBG as a parameter in gauging the long-term change of hyperglycemia.

Minimizing confounding effects

As a result of these variables, the Chinese researchers of the current considered study undertook an investigation, as previously described on page 17. To minimize the potential confounding effects of different medications, all subjects took the same kind of prescribed antidiabetic medication.

Cinnamon May Help Alzheimer’s An increasing body of evidence indicates that accumulation of soluble oligomeric assemblies of b-amyloid polypeptide (Aβ) play a key role in Alzheimer’s disease (AD) pathology. Specifically, 56 kDa oligomeric species were shown to be correlated with impaired cognitive function in AD model mice. Several reports have documented the inhibition of Aβ plaque formation by compounds from natural sources. Yet, evidence for the ability of common edible elements to modulate Aβ oligomerization had remained an unmet challenge. These results present a novel  prophylactic approach for inhibition  of toxic oligomeric Aβ species  formation in AD through the  utilization of a compound that is  currently in use in human diet. In a recent study, researchers identified a natural substance, based on cinnamon extract (CEppt), which markedly inhibits the formation of toxic Aβ oligomers and prevents the toxicity of Aβ on neuronal PC12 cells.1 This is consistent with extensive research over the last 10 years indicating that extracts derived from such spices as turmeric and cinnamon target inflammatory pathways, which may prevent neurodegenerative diseases. When administered to an AD fly model, CEppt rectified their reduced longevity, fully recovered their locomotion defects and totally abolished tetrameric species of Aβ in their brain. Furthermore, oral administration of CEppt to an aggressive AD transgenic mice model led to marked decrease in 56 kDa Aβ oligomers, reduction of plaques, and improvement in cognitive behavior. These results present a novel prophylactic approach for inhibition of toxic oligomeric Aβ species formation in AD through the utilization of a compound that is currently in use in the human diet. Reference Frydman-Marom A, Levin A, Farfara D, Benromano T, Scherzer-Attali R, Peled S, Vassar R, Segal D, Gazit E, Frenkel D, Ovadia M. Orally administrated cinnamon extract reduces β-amyloid oligomerization and corrects cognitive impairment in Alzheimer’s disease animal models. PLoS One 2011 Jan 28;6(1):e16564.

All subjects were outpatients from Xuhui Central Hospital, Shanghai. Sixty-nine patients (including 44 women and 25 men with age >48 years) with type 2 diabetes and who had levels of HbA1c greater than 7.0% and FBG greater than 8.0 mmol/L were randomly divided into 3 groups: placebo, lowdose, and high-dose groups. The low- and high-dose groups took either 2 or 6 cinnamon tablets, respectively, with each tablet containing 60 mg of cinnamon extract. The placebo group took 2 control tablets a day with the same size, shape, and color as the cinnamon-containing tablet. The cinnamon or placebo tablets were taken just before breakfast. All of the participating patients were taking gliclazide (an oral anti-diabetic drug classified as a sulfonylurea) during the study period.

Throughout the study, all subjects received weekly telephone calls from the hospital’s medical staff to communicate about their medication. During the 3-month study period, 3 subjects withdrew from the study, but a total of 66 subjects successfully continued to completion. This was a double-blinded study with neither the physician nor the patient knowing whether the tablet contained cinnamon extract. Cleverly, cinnamon was placed under the cap of the placebo to equal the give-away odor of the test material.

Solutions to type 2 diabetes imperative

Therapy alternatives for type 2 diabetes is imperative because the number of people with it are rapidly increasing throughout the world, rising from approximately 171 million in 2000 to a projected 366 million by 2030. There are currently 90 million people in China with type 2 diabetes, along with over 150 million prediabetics. When combined with the fact that this disease is a prolonged chronic metabolic disorder with many causal complications, such as cardiovascular diseases, treatment expenses have placed a huge burden upon the Chinese economy, not to mention health systems everywhere. Therefore, developing an economic and efficient method to treat this multifaceted disease is especially sought-after.

Cinnamon supplementation is able to 
significantly improve blood glucose 
control in Chinese patients with 
type 2 diabetes, and at the same time 
reduce HbA1c and triglycerides.

The results reiterate prior findings

Both HbA1c and FBG levels were significantly reduced in patients in the low- and high-dose groups, whereas they were not changed in the placebo group. The blood triglyceride levels were also significantly reduced in the low-dose group. The blood levels of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and liver transaminase remained unchanged in the 3 groups.

In conclusion, this carefully designed study indicates that cinnamon supplementation is able to significantly improve blood glucose control in Chinese patients with type 2 diabetes, and at the same time, reduce HbA1c and triglycerides. When combined with its well-noted safety, anchored by historical data, it would be unfortunate if you did not try out a well-designed cinnamon formulation for yourself to see if it can’t make an important difference in your supplement program.

References

1. Lu T, Sheng H, Wu J, Cheng Y, Zhu J, Chen Y. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with type 2 diabetes. Nutr Res 2012 Jun;32(6):408-12.
2. Imparl-Radosevich J, Deas S, Polansky MM, Baedke DA, Ingebritsen TS, Anderson RA, Graves DJ. Regulation of PTP-1 and insulin receptor kinase by fractions from cinnamon: implications for cinnamon regulation of insulin signaling. Horm Res 1998 Sep;50(3):177-82.
3. Onderoglu S, Sozer S, Erbil KM, Ortac R, Lermioglu F. The evaluation of long-term effects of cinnamon bark and olive leaf on toxicity induced by streptozotocin administration to rats. J Pharm Pharmacol 1999 Nov;51(11):1305-12.
4. Broadhurst CL, Polansky MM, Anderson RA. Insulin-like biological activity of culinary and medicinal plant aqueous extracts in vitro. J Agric Food Chem 2000 Mar;48(3):849-52.
5. Khan A, Safdar M, Ali Khan MM, Khattak KN, Anderson RA. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care 2003 Dec;26(12):3215-8.
6. Mang B, Wolters M, Schmitt B, Kelb K, Lichtinghagen R, Stichtenoth DO, Hahn A. Effects of a cinnamon extract on plasma glucose, HbA, and serum lipids in diabetes mellitus type 2. Eur J Clin Invest 2006 May;36(5):340-4.
7. Ziegenfuss TN, Hofheins JE, Mendel RW, Landis J, Anderson RA. Effects of a water-soluble cinnamon extract on body composition and features of the metabolic syndrome in pre-diabetic men and women. J Int Soc Sports Nutr 2006 Dec 28;3:45-53.
8. Crawford P. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with type 2 diabetes: a randomized, controlled trial. J Am Board Fam Med2009;22:507–12.
9. Akilen R, Tsiami A, Devendra D, Robinson N. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic type 2 diabetic patients in the UK: a randomized, placebo-controlled, double-blind clinical trial. Diabet Med 2010;27:1159–67.
10. Blevins SM, Leyva MJ, Brown J, Wright J, Scofield RH, Aston CE. Effect of cinnamon on glucose and lipid levels in non insulin-dependent type 2 diabetes. Diabetes Care 2007;30: 2236–7.
11. Tang M, Larson-Meyer DE, Liebman M. Effect of cinnamon and turmeric on urinary oxalate excretion, plasma lipids, and plasma glucose in healthy subjects. Am J Clin Nutr 2008;87:1262–7.
12. Roussel AM, Hininger I, Benaraba R, Ziegenfuss TN, Anderson RA. Antioxidant effects of a cinnamon extract in people with impaired fasting glucose that are overweight or obese. J Am Coll Nutr 2009;28:16–21.