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Ray & Talison 1 Brittany Ray Leila Talison NFSC 345 Keiko Goto 31 October 2012 Type 2 Diabetes and

Cinnamon INTRODUCTION: The supplementation of cinnamon is growing in popularity as it is rumored to be associated with an increasing number of benefits. Some experts say that it may aid in weight loss, reduce inflammation, and act as an antioxidant. Various research shows that cinnamon supplementation can lower blood pressure as well as decrease insulin resistance, thus affecting individuals with Type II diabetes. We explored two different studies with conflicting positions on the effect of cinnamon in the body. We concluded that the study in support of cinnamon supplementation for Type 2 diabetes is strongest. We agree that there is good evidence, but more studies need to be performed before we give a strong conclusion. DISCUSSION: The first study observed is titled Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: a randomized, placebocontrolled, double-blind clinical trial. The objective of this study was to find the effect of cinnamon on HbA1c, blood pressure, and blood lipid profiles in patients with Type 2 diabetes. The study design was a 12-week prospective, randomized, placebo-controlled, double-blind clinical trial with two parallel groups.

Ray & Talison 2 The subjects were ages 18 and older with a diagnosis of Type 2 diabetes. Their HbA1c was greater than or equal to 7%. They were currently being treated with oral hypoglycaemic agents. Those excluded from the study were patients taking insulin, women who were pregnant or lactating, those already supplementing with cinnamon or other herbs in attempt to control blood glucose levels, and patients with other severe health problems. Twenty-eight patients were in a placebo group and thirty were in a cinnamon group. Fifty-five subjects completed the study, while three ended it because of new treatments. A questionnaire was filled out regarding socio-demographic characteristics and lifestyle characteristics; as well as physical activity, diabetes treatment, medical conditions, and a three day diet diary. Measurements acquired were height, weight, waist circumference, blood pressure, HbA1c fasting plasma glucose levels, and serum lipid profiles. Statistical analysis compared the data of the groups and showed no significant differences. The subjects were required to take two grams of either cinnamon powder capsules or starch-filled placebo capsules (.5 grams per capsule) every day for twelve weeks. One capsule was to be taken with breakfast, two with lunch, and one with dinner. Dosage was chosen based on the suggested amount of one to six grams each day to lower glucose. The corn-starch filled placebo was chosen for its potential in decreasing postprandial glucose elevation. Results showed a significant reduction in fasting plasma glucose, BMI, weight, and waist circumference in the cinnamon group over the twelve weeks. Also, higher cinnamon consumption had an association with decreased HbA1c levels. This study found that the intake of two grams of cinnamon per day significantly reduced HbA1c. The number of hypertensive subjects decreased from 55% to 22%. Systolic and diastolic blood pressure was also significantly

Ray & Talison 3 decreased in comparison to the placebo group, while there was no significant change in serum lipid profiles. This study has many strengths. First, the study design is very strong. Randomized, placebo-controlled, double-blind clinical trials leave little room for error and confounding factors. Also, subjects had many similar characteristics which limit confounding factors. The differences found in initial measurements and final measurements for the cinnamon group give reason to believe the study is valid. There are also some weaknesses of this study. One weakness is the number of subjects, which was fifty-five. For a stronger result, more people should be included in the study. Another weakness is the fact that subjects were not stratified by age, gender, type of glucose-lowering medication, or time since diagnosis of Type 2 diabetes. Stratifying subjects may indicate other significant findings relating to these things. Another factor that should be tested is the duration of treatment and the longer term effects, as well as the dosage and differences in varying amounts of cinnamon. As far as the results of this study go, we support the authors’ conclusions. However, we believe that further studies need to take place in order to fully support their results. Other studies should address the weaknesses mentioned. The results look promising and we believe cinnamon may benefit those with Type 2 diabetes in regards to blood pressure and HbA1c levels. The second article we referred to is entitled Effect of cinnamon on gastric emptying, arterial stiffness, postprandial lipemia, glycemia, and appetite responses to high-fat breakfast. It explores the question of whether cinnamon has a significant effect on gastric emptying, postprandial lipemic and glycemic responses, oxidative stress, arterial stiffness, and appetite sensations after eating. The cinnamon was used in the study because it was hypothesized to

Ray & Talison 4 cause a delay in gastric emptying following the consumption of a high-carbohydrate meal, as well as reduce postprandial glycemia. Delayed gastric emptying is a characteristic of diabetic individuals. The study design was a single-blind, placebo-controlled, randomized trial with nine subjects. There were three male, and six female subjects, all healthy and all between twentythree and twenty-nine years of age. All subjects had a history of either GI-related complaints, cardiovascular disease, or diabetes; and were not currently taking any medications for these conditions. This data was accumulated using a three month questionnaire which the participants answered themselves. Three days before the initial trial began, they were to record everything they consumed and this data was used to calculate macronutrient and fatty acid intake using computer software. On the day of the first trial, subjects were given a buffet meal from which they were asked to rate 50% of the food on a scale of 1-5. After consuming the “test meal” provided to the subjects of the study, gastric emptying was calculated by means of an octanoic acid breath test. Results found there was no significant effect of cinnamon on gastric emptying. The effects of cinnamon on cardiovascular aspects were also measured. No effect was found on neither systolic nor diastolic blood pressure after eating the meal provided. As far as plasma glucose is concerned, cinnamon supplementation did appear to increase the levels in comparison to the placebo, and this increase in plasma glucose lasted for three hours after consumption. No difference was noted in HDL or LDL cholesterol levels. The study failed to measure hyperglycemic and hyperlipidemic states. Dietary fat is said to delay gastric emptying, and the meal provided in the study was 65% fat. The cinnamon did not delay the gastric emptying any further, and was concluded to also not

Ray & Talison 5 impact postprandial glycemic and lipemic responses, arterial stiffness, or appetite. Based on these conclusions, the study found no evidence that the supplementation of cinnamon would have any influence on decreasing the risk of diabetes. There were a few strengths of this study. The design was very strong, because randomization ensured the even distribution of possible confounding factors. The use of a placebo also supported the results. The information required from subjects and the tests supported their conclusions well. There were also weaknesses of this study. First, the number of subjects, nine, was very small. Studies are much stronger with a lot more people. Also, this study only focused on a one day consumption of cinnamon. The long term effects were not addressed. CONCLUSION: We have concluded that cinnamon may assist in some aspects of Type 2 diabetes. The two studies are very different and focus on different aspects of cinnamon’s effect on the many parts of Type 2 diabetes. The first study showed us that it significantly decreased HbA1c levels. Glucose concentrations were not changed in the second study. We have more faith in the first study, because it focused on the longer-term consumption of cinnamon rather than the immediate effects. The two studies also differed in the conclusions on blood pressure change. We again believe the first study has more credibility due to the longer use of cinnamon, which gives it time to take effect rather than immediately in one day. We agree with the second study on the results on gastric emptying, because that occurs right after cinnamon consumption with food. Overall, we believe that cinnamon can help with Type 2 diabetes in regards to HbA1c levels and blood pressure, along with the regular blood glucose medication. To give a more

Ray & Talison 6 confident conclusion, we would like to see more studies on cinnamon and its effects in relation to Type 2 diabetes.

Ray & Talison 7 Works Cited Markey, Oonagh, et al. "Effect Of Cinnamon On Gastric Emptying, Arterial Stiffness, Postprandial Lipemia, Glycemia, And Appetite Responses To High-Fat Breakfast." Cardiovascular Diabetology 10.1 (2011): 78-87. Academic Search Premier. Web. 30 Sept. 2012. N. Robinson, et al. "Glycated Haemoglobin And Blood Pressure-Lowering Effect Of Cinnamon In Multi-Ethnic Type 2 Diabetic Patients In The UK: A Randomized, PlaceboControlled, Double-Blind Clinical Trial." Diabetic Medicine 27.10 (2010): 11591167. Academic Search Premier. Web. 30 Sept. 2012.