In individuals with IGT, vinegar ingestion before a mixed meal results in an enhancement of muscle blood flow, an improvement of glucose uptake by the forearm muscle and a reduction of postprandial hyperinsulinaemia and hypertriglyceridaemia. From this point of view, vinegar may be considered beneficial for improving insulin resistance and metabolic abnormalities in the atherogenic prediabetic state.

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A lthough previous studies show that vinegar improves insulin sensitivity in healthy or insulin-resistant subjects (1,2), information on the effect of vinegar in type 1 diabetes is absent. Given the beneficial effects of maintaining tight glycemic control on the development of complications, there is much interest in identifying diet patterns that could possibly reduce hyperglycemia. The aim of this study was to investigate the effect of vinegar in type 1 diabetes.Ten men with type 1 diabetes (aged 32 Ϯ 3 years, BMI 24 Ϯ 1 kg/m 2 , diabetes duration 14 Ϯ 3 years, A1C 6.7 Ϯ 0.2%) treated with rapid-acting insulin preprandially and long-acting insulin once daily were studied after an overnight fast.The study was approved by the Attikon Hospital ethics committee, and subjects gave informed consent.All subjects were asked not to inject the long-acting insulin for 2 days and the rapid-acting insulin for 8 h and not to consume vinegar for the last 2 weeks.To study all subjects under similar metabolic conditions, insulin (Actrapid; Novo Nordisk, Copenhagen, Denmark) was infused in a hand vein with a pump. During the last hour prior to the beginning of the experiment, the patients were in a steady state regarding blood glucose (BG) and insulin infusion rate. Then, the infusion of insulin was stopped and the subjects were connected to the artificial pancreas (Glucostator, Lonsee, Germany) for continuous BG monitoring.The total amount of intravenous insulin was the same in the experiments with vinegar (6.16 Ϯ 1.5 U) and placebo (6.14 Ϯ 1.2 U).The subjects were randomly assigned to consume vinegar (30 ml vinegar, 20 ml water) or placebo (50 ml water) 5 min before a meal composed of bread, cheese, turkey ham, orange juice, butter, and a cereal bar (566 kcal; 75 g carbohydrates, 26 g protein, 6 g fat).Before the meal, the subjects received a dose (8.9 Ϯ 1 U) of Actrapid subcutaneously, which was assessed according to each patient's insulin-to-carbohydrate ratio and was the same in the crossover study that was conducted 1 week later.Blood samples were collected preprandially and at 30, 60, 90, 120, 180, 240 min postmeal for measurements of insulin (Linco Research, St. Charles, MO).Results are presented as means Ϯ SEM. Differences within groups were tested with paired Student t test.Fasting BG was similar in the vinegar (5.5 Ϯ 0.2 mmol/l) and placebo (5.5 Ϯ 0.2 mmol/l) experiments and remained comparable until 30 min postprandially (7.4 Ϯ 0.4 vs. 7.7 Ϯ 0.6 mmol/l, respectively). In the placebo experiments, BG continued to rise thereafter with a peak (11.6 Ϯ 1 mmol/l) at 94 min, whereas after the consumption of vinegar, BG increased to 8.6 Ϯ 0.9 mmol/l (P ϭ 0.005) and remained unaltered without postprandial spikes until the end of the experiment. As a result, vinegar compared to placebo reduced BG (AUC 0Ϫ240 min 1,884 Ϯ 169 vs. 2,282 Ϯ 195 mmol/ l*min, P ϭ 0.01) by almost 20%.Basal and postprandial (AUC 0Ϫ240 min) plasma insulin levels were the same in the vinegar (5.2 Ϯ 0.8 U/ml and 4,152 Ϯ 285 U/ml*min, respectively) and place...

Background and Aims. Vinegar has been shown to have a glucose-lowering effect in patients with glucose abnormalities. However, the mechanisms of this effect are still obscure. The aim of this randomised, crossover study was to investigate the effect of vinegar on glucose metabolism in muscle which is the most important tissue for insulin-stimulated glucose disposal. Materials and Methods. Eleven subjects with DM2 consumed vinegar or placebo (at random order on two separate days, a week apart), before a mixed meal. Plasma glucose, insulin, triglycerides, nonesterified fatty acids (NEFA), and glycerol were measured preprandially and at 30–60 min for 300 min postprandially from the radial artery and from a forearm vein. Muscle blood flow was measured with strain-gauge plethysmography. Glucose uptake was calculated as the arteriovenous difference of glucose multiplied by blood flow. Results. Vinegar compared to placebo (1) increased forearm glucose uptake (p = 0.0357), (2) decreased plasma glucose (p = 0.0279), insulin (p = 0.0457), and triglycerides (p = 0.0439), and (3) did not change NEFA and glycerol. Conclusions. In DM2 vinegar reduces postprandial hyperglycaemia, hyperinsulinaemia, and hypertriglyceridaemia without affecting lipolysis. Vinegar's effect on carbohydrate metabolism may be partly accounted for by an increase in glucose uptake, demonstrating an improvement in insulin action in skeletal muscle. This trial is registered with Clinicaltrials.gov NCT02309424.