Vinegar Decreases Postprandial Hyperglycemia in Patients With Type 1 Diabetes

Abstract

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...

Vinegar reduces postprandial hyperglycaemia in patients with type II diabetes when added to a high, but not to a low, glycaemic index meal

“…It was shown that the consumption of 20 g apple cider vinegar immediately before a CHO-rich mixed meal (87 g total CHO) improved (non-significantly) postprandial insulin and glucose fluxes and insulin sensitivity (estimated using a composite score). Postprandial increase in glucose after vinegar addition to a CHO-rich mixed meal has also been examined in type I diabetes (Mitrou et al, 2010), using artificial pancreas. It was shown that vinegar, compared with placebo, reduced glucose AUC 0À240 by almost 20%.…”

A Review of the Hypoglycemic Effects of Vinegar and its Potential Benefit in Gestational Diabetes Mellitus (GDM)

“…The fifteen articles consisted of thirteen randomized control trials, two uncontrolled trials, three animal experiments, and 1 in vitro experiment (Table 1). Eleven articles, described 16 trials, explored the effects of vinegar ingested with carbohydrates on postprandial blood glucose levels (PPG) [13][14][15][16][17][18][19][23][24][25]. Vinegar was found to reduce postprandial glucose, delayed glycemic response, or reduced the glycemic index of the carbohydrate ingested.…”

“…Vinegar was found to reduce postprandial glucose, delayed glycemic response, or reduced the glycemic index of the carbohydrate ingested. Seven trials explored the effect of vinegar on the postprandial insulin response, of which six demonstrated a statistically significant reduction in insulin response [13,16,18,19,24,25]. Only two studies, both by Johnston et al [17] explored the effect of vinegar on fasting glucose levels [17,26], one demonstrated that bedtime vinegar ingestion reduced morning fasting glucose [17], while the other demonstrated that ingestion of vinegar during meals over a 12 week period leads to a reduction in fasting blood glucose [26].…”

“…Of the 13 randomized control trials, 1 animal experiment and 2 uncontrolled trials that explored the effects of vinegar with ingestion of carbohydrates on postprandial blood glucose (PPG), found a reduction in either PPG or glycemic index (GI) [13][14][15][16]18,19,23,[24][25][26], of which 10 were statistically significant (Table 1). Reductions were reported in healthy populations around the world [14][15][16][17]24,25], as well as among individuals with and without a diagnosis of diabetes (including those taking oral hypoglycemic agents) [18,23] and individuals identified as having prediabetes [18,26], and rats [13].…”

“…Complementary foods, however, that helps lower blood glucose without additional changes to the diet present a promising, simpler dietary approach to GDM management. Evidence suggests that acetic acid found in vinegars and pickled foods lowers postprandial and fasting glycemia [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27]; thus, we undertook a literature review to explore these hypoglycemic effects, their proposed physiological mechanisms of action, and whether these effects have been shown in the pregnant population, and in particular, those with GDM.…”