120 likes | 235 Views
Cinnamon: Not Your Grandma’s Spice Anymore. Christie Seibert, MD Primary Care Conference May 14, 2008. The Patient. Susan is a 50 yo woman with type 1 diabetes On insulin pump HbA1C = 6.0 Computer Scientist Emailed about internet claims about cinnamon use in diabetes.
E N D
Cinnamon: Not Your Grandma’s Spice Anymore Christie Seibert, MD Primary Care Conference May 14, 2008
The Patient • Susan is a 50 yo woman with type 1 diabetes • On insulin pump • HbA1C = 6.0 • Computer Scientist • Emailed about internet claims about cinnamon use in diabetes
Cinnamon(Cinnamomon cassia) • Chromium (Cr) • Chromium deficiency • glucose intolerance • visceral obesity • low HDL • Decreases cortisol concentrations in small human trials
Chromium Data • Effects of supplemental Cr on lean body mass, glucose and insulin vary in reported studies • Meta-analysis of human trials for weight loss: stat sig (-1.1 kg), not clinically sig • Most pts are not marginally or overtly deficient in Cr • Cr is “not the dominant factor”
Cinnamon(Cinnamomon cassia) • Cinnamon Polyphenols • Increases activation of insulin receptors • increasing tyrosine phosphorylation activity • Decreases inactivation of insulin receptors • decreasing phosphatase activity • Increases glycogen synthease activity
The DataKhan et al: Diabetes Care, 2003 • Done in Pakistan • 60 people with type 2 diabetes • 30 men and 30 women • aged 52.2 +/- 6.32 years • Poorly controlled, many on sulfonylureas • Divided randomly into six groups • Groups 1, 2, and 3 took 1, 3, or 6 g of cinnamon daily, respectively • Groups 4, 5, and 6 were given placebo capsules • Duration = 40 days
Results Khan et al: Diabetes Care, 2003 Khan et al, Diabetes Care. 2003 Dec; 26(12):3215-8
More Data Blevins et al. Diabetes Care. 2007 • 58 subjects • Avg age 58-63 • Baseline FBS 139, TG 144 • ¾ of subjects taking Metformin • 500mg cinnamon caps BID vs placebo • Duration = 3 months • No change in glucose, insulin or cholesterol Blevins et al. Diabetes Care. 2007 Sep;30(9):2236-7.
Bottom Line • Mixed results • Cinnamon supplementation should not be used as a replacement for standard treatments. • Cinnamon supplements have not consistently shown any adverse effects in trials. • Except for allergies to cinnamon (mouth sores)
Taking Cinnamon • The capsule form may be more easily tolerated than the tablet. • The cost is ~ $15/mo for a 500mg dose (amazon.com) • Extract in the studies was cinnulin PF (available from many supplement manufacturers)
Do NOT use raw cinnamon • Raw cinnamon has some chemicals that may be harmful at high doses.
References • Anderson R. Chromium and polyphenols from cinnamon improve insulin sensitivity, Proceedings of the Nutrition Society (2008), 67: 48-53 Cambridge University Press. • Khan, A et al. Cinnamon improves glucose and lipids of people with type 2 diabetes. Diabetes Care (2003) 26, 3215–3218. • Blevins S et al. Effect of Cinnamon on Glucose and Lipid Levels in Non–Insulin-Dependent Type 2 Diabetes. Diabetes Care (2007) Sep;30(9):2236-7.