Can Apple Cider Vinegar Lower Blood Glucose Levels in Diabetics?
Sara Son and Daniel Atwood
Apple Cider Vinegar comes from the fermented juice of apples and gets its acidic portion from acetic or citric acid. Apple Cider Vinegar is well known as a salad dressing and food additive. It has historically been used as a wound disinfectant. Apple Cider Vinegar is still used as a food additive but has gained popularity as a natural medicine. Current proposed uses of Apple Cider Vinegar include Diabetes, Hyperlipidemia, and Osteoporosis, among many others. This research poster aimed to look at the potential benefit Apple Cider Vinegar may have in lowering blood glucose levels in diabetic patients.
A systematic review of meta-analyses by Siddiqui et al. was conducted to determine the effects of vinegar on diabetic markers. The primary outcomes looked at were fasting blood glucose, postprandial blood glucose, and A1c levels. The authors looked at randomized and nonrandomized controlled clinical trials that included adults with type 1 and type 2 diabetes who were treatment naïve or on medication. The studies also had to report at least one of the primary outcomes, and the control intervention had to be a placebo or no intervention. The authors found small reductions in mean A1c levels were observed after 8 to 12 weeks and long-term, short-term, and adverse effect profiles favoring vinegar though the outcomes seen were not significant. The authors concluded the promise of vinegar in diabetes mellitus management and suggestions for future research, including long-term effectiveness and safety studies and more extensive and diverse studies.
Liljeberg et al. looked at the influence of acetic acid on postprandial glucose and insulin response. They did this using different bread types, one as a reference meal and another with acetic acid. They then measured blood glucose and insulin levels in ten healthy volunteers involved with the study. The authors found that the bread with acetic acid in the thirty- and seventy-minute postprandial phase resulted in lower blood glucose levels, and insulin responses were closely associated with the glucose levels. The authors concluded that acetic acid reduces postprandial glucose levels and insulin responses to bread meals in healthy subjects and that food products with organic acids should be included in the diet to reduce blood sugar levels and insulin demands.
A study done by Johnston et al. aimed to assess the effectiveness of vinegar in reducing postprandial glycemia and insulinemia in subjects with insulin sensitivity. It included eight insulin-sensitive subjects and eleven insulin-resistant subjects as controls and compared them to ten subjects with type two diabetes. Subjects were randomly assigned to consume either vinegar or a placebo drink along with a test meal 2 minutes later. Blood tests were collected to measure fasting and postprandial glucose levels. The authors found that acetic acid can improve postprandial insulin sensitivity in resistant subjects and concluded that it should be studied further to determine if it could be used as an antidiabetic therapy.
The studies used in our review do show a benefit when using apple cider vinegar in diabetes. However, common areas of concern in all the studies were the small sample size and lack of detail regarding study type and controlling for bias. More studies with larger sample sizes and increased quality are needed to ensure the efficacy and safety of Apple Cider Vinegar use in diabetes. Apple Cider Vinegar should not be used as a first-line treatment for diabetes. Still, it may be beneficial in some instances where patients struggle taking prescription medications and if potential interactions with other prescriptions and other supplements can be ruled out.
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- 2. Johnston CS, Kim CM, Buller AJ. Vinegar improves insulin sensitivity to a high-carbohydrate meal in subjects with insulin resistance or type 2 diabetes. Diabetes Care. 2004 Jan;27(1):281-2. doi: 10.2337/diacare.27.1.281. PMID: 14694010.
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