Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
Cinnamon, a spice found abundantly in pantries across America, has been purported
to help lower blood glucose and blood lipids in patients with Type-2 Diabetes. Although
conflicting evidence raises question to the validity of the statement, and the specific
mechanisms leading to this result of lowered blood glucose remains nebulous, there is
strong support for cinnamon supplementation in diabetics from medical practitioners. This
paper will explore the specifics of type-2 diabetes and cinnamon, and shed light on the
evidence surrounding the influence of cinnamon on type-2 diabetes.
Type-2 diabetes is characterized by an inability of muscle, lipid, and liver cells to use
insulin correctly (Eckman, 1). Insulin is a hormone that is produced exclusively by the beta
cells of the pancreas. Insulin acts as the “key” to allow entry of glucose into virtually all
cells, but most predominately the cells of muscle, lipid, and the liver. When insulin is not
working properly, it cannot deposit glucose into the cells, and a condition of heightened
blood glucose results. The pancreas interprets the increased need for insulin as a call for
additional insulin production (Nelms, 499). Eventually, the pancreas becomes unable to
create insulin, and a state of relative insulin deficiency ensues (Nelms, 499). In healthy
individuals, insulin inhibits glycogenolysis and gluconeogenesis when blood glucose is high.
In individuals with insulin resistance, the liver produces excess glucose. This excess
glucose, paired with an insulin deficiency, results in type-2 diabetes.
Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
Hyperglycemia can go undetected for several years, but symptoms will eventually
develop. Common symptoms of type-2 diabetes include blurred vision, erectile dysfunction,
polyuria, increased thirst, pain or numbness in hands and extremities, fatigue, and hunger
(MedlinePLUS, 1). Diabetes can be tested by taking a fasting blood glucose test (Eckman, 2).
It a patient has fasting blood glucose levels of higher than 126 mg/dL two times. Other tests
include the Hemoglobin A1C test, and the oral glucose tolerance test. Nutritionally
speaking, diabetes can be managed by maintaining a diet that doesn’t exceed 20% of
energy from protein, has 25%-35% of kilocalories from fat, and 50%-60% of kilocalories
from carbohydrate. Low carbohydrate diets are not recommended. Weight management,
however, is strongly recommended in individuals with a BMI of higher than 25 (Nelms,
505).
Cinnamon is a spice that comes from the inner bark of a tropical evergreen tree of
the genus cinnamomum (Ranasinghe, 73). Despite common belief, the purpose of cinnamon
extends beyond the kitchen. In recent studies, cinnamon has been proven to act as a potent
antibiotic, and have anti-inflammatory and antibacterial properties (Rafehi, 494). The two
major forms of cinnamon are Ceylon cinnamon (Cinnamomum zeylanicum) and Chinese
Cassia (Cinnamomum aromaticum). Ceylon cinnamon is deemed as being “true” cinnamon.
The main difference between the two types of cinnamon is the content of coumarin, an
anticoagulant. Coumarin has been proven to have a potentially toxic effect on the liver, and
thus should not be consumed in high quantities (Ranasinghe, 74). Unfortunately, the
cinnamon most commonly found in the spice cabinets of American citizens is Chinese
Cassia. The differences in the two types of cinnamon also account for some of the
Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
inconsistencies in test results of the efficacy of cinnamon supplementation or consumption
in the lowering of fasting blood glucose in patients, or rats, with type-2 diabetes (Rafehi,
496).
The mechanisms that lead cinnamon to decrease fasting blood glucose levels in
patients with type-2 diabetes have been explored at great depth, although little has been
elucidated. Accordint to Rafeji, a major contributing factor to this uncertainty is the makeup of cinnamon. Cinnamon has numerous components, including “cinnamaldehyde,
eugenol, camphor and polyphenols, as well as trace elements (calcium, chromium, copper,
iodine, iron, manganese, phosphorus, potassium and zinc) and vitamins…” (Rafeji 495). It
has been proposed that cinnamon can increase glucose uptake by increasing the amount of
insulin receptors and GLUT4. Additionally, it has been proposed that cinnamon could
activate the , peroxisome proliferator-activated receptors (PPARs). PPARs have been
proven to be involved in insulin resistance (Rafeji, 495). One study concluded that
cinnamon was effective in lowering fasting blood glucose, however this was not due to
increased insulin secretion, but rather through gastrointestinal mechanisms (Kirkham,
1110). These mechanisms include reducing gastric emptying and glucose absorption.
The role of cinnamon in lowering blood glucose levels in type-2 diabetes is an
extremely hot topic that is surrounded by a cloud of uncertainty and contradictions.
Although it is difficult to argue the claim that cinnamon is effective in this role, the
mechanisms through which cinnamon lowers blood glucose, and the compound found in
cinnamon that lowers glucose, will continue to be debated and studied for years to come.
Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
Until that point, supplementing Ceylon Cinnamon under Doctor’s supervision is not likely
to cause harm to a patient, and may prove to be effective.
Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
RESOURCES:
Rafehi, H., Ververis, K., & Karagiannis, T. (2012). Controversies
surrounding the clinical potential of cinnamon for the management of
diabetes. Diabetes, Obesity & Metabolism, 14(6), 493-499.
doi:10.1111/j.1463-1326.2011.01538.x
Kirkham, S., Akilen, R., Sharma, S., & Tsiami, A. (2009). The potential of cinnamon to reduce
blood glucose levels in patients with type 2 diabetes and insulin resistance. Diabetes,
Obesity & Metabolism,11(12), 1100-1113. doi:10.1111/j.1463-1326.2009.01094.x
Ranasinghe, P., Perera, S., Gunatilake, M., Abeywardene, E., Gunapala, N., Premakumara, S.,
& ... Katulanda, P. (2012). Effects of Cinnamomum zeylanicum (Ceylon cinnamon) on
blood glucose and lipids in a diabetic and healthy rat model. Pharmacognosy
Research, 4(2), 73-79. doi:10.4103/0974-8490.94719
Eckman, A. (2011). Type 2 diabetes. Retrieved from
http://www.nlm.nih.gov/medlineplus/ency/article/000313.htm
Khan, M., Safdar, M., Ali Khan, M., Khattak, M., & Anderson, R. (2003). Retrieved from
http://care.diabetesjournals.org/content/26/12/3215.
Taylor Pond
KNH 304
10/22/2013
Cinnamon and Type-2 Diabetes
Nelms, M., Sucher, K., Lacey, K., Roth, S. L., & Habash, D. (2010). Nutrition therapy and
pathophysiology. (2/e ed.). Belmont: Brooks/Cole Pub Co.