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Cinnamon: A Sweet Medication for Type 2 Diabetes?
October 5, 2009
The high-calorie and high-sugar diet common in the United States today continues to lead to an increasing prevalence of a number of detrimental and even life-threatening health issues. One of the most prominent and serious health issues related to an unbalanced, high-fat diet is type 2 diabetes mellitus. Many internet sources including health store websites and private health information sources speak to the benefits of regular cinnamon consumption as an alternative to or enhancement of prescription medications in regulating blood glucose levels. This paper seeks to outline such claims and determine whether or not they are supported by scientific evidence.
History of Diabetes and Cinnamon
What is diabetes?
There are two different forms of diabetes known as type 1 diabetes and type 2 diabetes. Type 1 diabetes is usually diagnosed in children and young adults and occurs when the body does not produce insulin, an enzyme that is responsible for the breakdown of sugar, starches, and other foods into energy needed for cellular activity. Type 2 diabetes, the focus of this paper, is the most common form of diabetes and occurs when the body either does not produce enough insulin or when cells no longer respond efficiently to the presence of insulin (http://www.mayoclinic.com/health/type-2-diabetes/DS00585).
Overall, roughly 23.6 million children and adults in the United States have been diagnosed with diabetes (approximately 90 to 95% being type 2 diabetes), and another 57 million people have been categorized as being pre-diabetic, meaning their blood glucose levels are elevated but not enough to require formal diabetic treatment or medication (http://www.diabetes.org/diabetes-statistics/prevalence.jsp). There are a number of risk factors associated with type 2 diabetes including being older than 45, overweight, not physically active, and having high blood pressure or high cholesterol. A person suffering from type 2 diabetes faces an increased risk for different diseases such as heart disease, blindness, nerve damage, and kidney damage.
Cinnamon as a Medicinal Herb
The common spice cinnamon is derived from the bark of a small evergreen tree also named cinnamon which is native to Sri Lanka. Cinnamon has been known to human beings since remote antiquity and was valued for embalming and witchcraft in ancient Egypt (http://www.britannica.com/EBchecked/topic/118117/cinnamon). Traditional Chinese medicine used cinnamon in the treatment of a number of disorders including diarrhea, rheumatism, and certain menstrual disorders. Today, popular supposed medicinal uses of cinnamon include treatment of type 2 diabetes as well as colic in infants, indigestion and heartburn, menorrhagia, poor appetite, and yeast infection. Various terpenoids (naturally occurring organic chemicals) found within the volatile oil of cinnamon are thought to be the main source of medicinal benefit. Though some individuals may have an allergy to cinnamon which can restrict the airway due to swelling, there are no other serious, known side effects to cinnamon consumption (http://www.peacehealth.org/kbase/cam/hn-2069003.htm).
What’s On the Web?
General Nutrition Centers Inc. (GNC) http://www.gnc.com
Popular nutritional supplement store GNC lists six main products under the labels “Diabetic Nutrition” and “Blood Sugar Support.” Two of those products are cinnamon based including 500 milligram capsules of pure ground cinnamon as well as a different product called New Chapter Cinnamon Force AD. The New Chapter product claims to help maintain blood sugar already in normal range. Obviously, any claims from products sold in GNC stores or through the website are intended to persuade diabetics and other consumers to buy the product. Also, the Food and Drug Administration does not regulate herbal supplements such as the above mentioned products.
The well-known medical and health information site WebMD.com contains an article within the Diabetes Help Center by Jeanie Lerche Davis entitled “Cinnamon Helps Type 2 Diabetes.” The article is from 2002 and points to a clinical trial by Dr. Alam Kahn at the NWFP Agricultural University in Peshawar, Pakistan, in which sixty people diagnosed with type 2 diabetes were split into different groups and given varying doses of cinnamon or placebo pills. Through the analysis of blood samples taken at various points throughout the study, researchers discovered a significant reduction in blood glucose levels ranging from 18% to 29%. It must be noted that WebMD is a private company that seeks to make a profit through information and advertisements posted on their website, and the company goes so far as to make it clear to consumers that “WebMD does not provide medical advice, diagnosis or treatment.”
U.S. Organic is an organic supplement company which sales the New Chapter Cinnamon Force which was also sold by GNC. However, the USOrganic.com website goes as far as to claim that “Research at the United States Department of Agriculture (USDA) and other prestigious institutions suggest that cinnamon possesses a unique power amongst botanicals – it assists the body’s conversion of sugar (glucose) into energy.” Like GNC, U.S. Organic is a private company seeking to sale their products and to earn a profit.
The Scientific Verdict
A wide array of studies have been carried out over the years to study the effect of cinnamon on type 2 diabetes mellitus, and at least four prominent review papers have been compiled on the subject. The analysis of these review papers allows for a more large-scale determination of the demonstrated effects of cinnamon in blood glucose control and diabetes therapy.
Review Paper 1
Pham, Kourlas, and Pham (2007) conducted a literature search seeking to analyze all studies concerning the efficacy of cinnamon in treating diabetes in English-speaking human subjects. The researchers analyzed Medline from 1966 to August 2006, EMBASE from 1980 to August 2006, International Pharmaceutical Abstracts from 1970 to August 2006, and Iowa Drug Information Service from 1966 to August 2006. The researchers “found two prospective, randomized, double-blind, placebo-controlled, peer-reviewed clinical trials and one prospective, placebo-controlled, peer-reviewed clinical trial that evaluated the efficacy of cinnamon supplementation in patients with type 2 diabetes; a total of 164 patients were involved in these trials.” Two of the above mentioned studies showed modest improvements in blood glucose levels with cinnamon use, whereas the third study showed no benefit. Overall, the researchers concluded that cinnamon has a possible modest effect but should not be recommended in place of traditional standards of care such as lifestyle modifications, anti-diabetic agents, and insulin use.
Review Paper 2
Nahas and Moher (2009) sought to review scientific literature concerning the efficacy of alternative and complementary medicine interventions in controlling type 2 diabetes in human subjects. The researchers searched Medline and EMBASE material from January 1966 to August 2008 using the term “type 2 diabetes mellitus” in conjunction with a number of other terms including “cinnamon.” From the literature search, the researchers found that “cinnamon improved fasting blood glucose but its effects on HbA1C are unknown.” HbA1C refers to a form of glycated hemoglobin which is present in people suffering from diabetes. In conclusion, the researchers determined that more research into the benefits of cinnamon as an intervention for type 2 diabetes is warranted.
Review Paper 3
Dugoua, Seely, Perri, Cooley, Forelli, Mills, and Koren (2007) designed a review paper to gather scientific literature on the viability and safety of cinnamon as a pharmacological agent, including in the treatment of type 2 diabetes as well as a number of other diseases and conditions. The researchers scoured nine different databases and compiled data according to the grade of evidence found. Three significant clinical studies on the role of cinnamon in type 2 diabetes were found. The researchers found that “two of three randomized clinical trials on type 2 diabetes provided strong scientific evidence that cassia cinnamon demonstrates a therapeutic effect in reducing fasting blood glucose by 10.3-29%.”
Review Paper 4
Kleefstra, Logtenberg, Houweling, Verhoeven, and Bilo (2007) produced a literature search review paper to identify and summarize the findings of published studies on the efficacy of cinnamon in glycemic control. The writers searched the Medline database using all possible combinations of the words “cinnamon,” “diabetes mellitus,” “HbA1C,” and “glucose.” All research trials involving either humans or animals in which cinnamon was administered as a method of intervention were included as part of the review paper findings. The researchers were able to find a number of animal studies and 5 placebo-controlled, randomized human studies involving cinnamon as a means of diabetic intervention. The search revealed one placebo-controlled trial in patients with type 2 diabetes in which cinnamon intake was associated with a decrease in fasting plasma glucose levels. In conclusion, however, Kleefstra et al (2007) found that “Based on the currently available evidence, cinnamon should not be recommended for the improvement of glycemic control.”
The four major review papers came to a number of different conclusions leaving the true verdict unknown on the efficacy of cinnamon in the treatment of type 2 diabetes. While some studies concluded that cinnamon lowered blood glucose levels, others showed no benefit. Further research is warranted on the effects of cinnamon in blood glucose control, but probably will not occur for some time because there is such little focus on alternative medicine in today’s medical research. The best possible course for most individuals suffering from type 2 diabetes is to continue with traditional diabetic treatments while trying cinnamon as a supplement and closely watching blood sugar levels to see if any personal benefit occurs.
Dugoua, J.J., Seely, D., Perri, D., Cooley, K., Forelli, T., Mills, E., & Koren, G. (2007).
From type 2 diabetes to antioxidant activity: a systematic review of the safety and
efficacy of common and cassia cinnamon bark. Candian Journal of Physiological
Pharmacology, 85(9), 837-47.
Kleefstra, N., Logtenberg, S.J., Houweling, S.T., Verhoeven, S., & Bilo, H.J. (2007).
Cinnamon: not suitable for the treatment of type two diabetes mellitus. Ned
Tijdschr Geneeskd, 151(51), 2833-7.
Nahas, R., & Moher, M. (2009). Complementary and alternative medicine for the
treatment of type 2 diabetes. Canadian Family Physician, 55(6), 591-6.
Pham, A.Q., Kourlas, H., & Pham, D.Q. (2007). Cinnamon supplementation in patients
with type 2 diabetes mellitus. Pharmacotherapy, 27(4), 595-9.
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