Monday, September 23, 2013

Cinnamon for Diabetes?

Controlling diabetes takes work.  If you do all you are supposed to do between checking your blood glucose, exercising, preparing healthy food, checking your feet, etc, it takes up a large chunk of time.  (One very small study estimated that doing all your self care tasks takes up to three hours per day).  So it is not surprising that people who really do want to decrease their blood glucose levels will find ways to try to minimize the amount of work that they are doing.   Often they are hoping that there is a supplement that they can take, and one of the supplements I get questioned about a lot is cinnamon.  But is there any evidence that taking cinnamon helps?

A meta-analysis released in this months Annals of Family Medicine, indicated the answer was "well maybe."  Even though there have been some good randomized studies conducted, the studies are often still too small to be extrapolated to a general population.  And there is also the problem that we still don't have enough evidence to tell people how much to take for them to have a benefit, or how long they have to take it, or even how long it is safe to take it.  I was also interested to see that while there seemed to be a reduction in the fasting blood glucose levels, there wasn't an overall reduction in hemoglobin A1C levels.  Usually when a person has "good" fasting blood glucose levels but a high A1C they are eating something that is causing their blood glucose levels to spike after a meal (often called elevated post prandial levels), so the ingestion of the cinnamon was likely not counteracting whatever they were eating during the day.

Now I do know that there are some of you who are still going to try this, or already trying this at home so to speak, so here are some safety guidelines using what we do know.

1) Taking cinnamon while eating a crappy diet isn't going to help you.  (You laugh, but I get to witness this sort of magical thinking on a daily basis).

2) Cinnamon seems to be safe if taken for up to 6 grams daily for up to six 6 weeks. 

3) If you are using this as a supplement, you will probably want to use capsules.  6 grams per day is roughly about 1.5 teaspoons per day (1/2 teaspoon = 2 grams if I did my math correctly) .  Now think about the last time you put just a 1/8-1/4 of cinnamon on your food, and how that small amount actually gave it flavor without burning like Red Hot Cinnamon candy.  Now think about what putting 6 times that amount on your food would do (feeling the burn yet?).  And as much as I like cinnamon, I only have a limited amount of foods that I want to eat it on (Note to self, try cinnamon bacon tomorrow).  So you will probably get what we call a "therapeutic dose" if you use capsules.

3) Since you are using cinnamon as a drug, it might interfere with certain drugs you are taking, like blood thinners.  Please discuss your medications with a doctor and/or pharmacist before trying this.  This advice applies to all supplements.

4) If you are taking medicine or insulin to control your blood sugars, please inform your provider and/or qualified diabetes educator because cinnamon combined with your other medications could cause your blood sugar to drop too low.  (Ask any person with diabetes why you don't want a low blood sugar.  Death is one reason).

5) If you are taking medicine for blood pressure, please inform your provider as cinnamon combined with those drugs could cause your blood pressure to drop too low.

5) If you have liver disease, seizure disorder, auto-immune diseases, or abnormal heart rhythm, use caution and discuss with your provider.

6) Hopefully the above stated guidelines remind you that "natural medicines" are still medicines and can have some bad side effects if you take too much, take them for too long, or take them with other things.

7) The amount you use in your Cincinnati style chili shouldn't interact with medicines; use it as you would any spice/seasoning to help your new and improved diet actually include food that is tasty.

Take home message--cinnamon shows promise for helping some people with diabetes, but discuss it with your health care team first.

References: Natural Standard Database


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