Role of Cinnamon Supplementation on Glycemic Markers, Lipid Profile and Weight Status in Patients with Type II Diabetes
Type II diabetes has been on the rise for the past few decades and the current management plan of diabetes is challenging to individuals in keeping their blood glucose levels within normal limits. There is a constant search of new ways to tackle these challenges. Cinnamon is suggested to have antihyperglycemic and lipid lowering effect and has been proposed to be utilized in type II diabetes. The aim behind this review is to explore the role of cinnamon in improving the glycemic status, lipid profile, and weight status of patients with type II diabetes. PubMed and ScienceDirect databases have been searched for eligible studies conducted until February 2022, the outcomes measured were glycemic markers as primary outcome and lipid profile and weight status as secondary outcomes. A total of ten trials involving 861 patients were included in the study. Five studies have demonstrated reductions in glycemic markers (ranging between −0.56 and −1.9 mmol/L for fasting blood sugar and between −0.21% and −0.93% for glycated hemoglobin) whereas the remaining four did not show any significant reduction. The most improvements in glycemic markers are seen in patients with poorly controlled diabetes and patients with higher body mass index (BMI) values. The majority of the studies did not record improvement in lipid profile. Changes in weight status are only observed in overweight patient category (BMI between 25 and 30). Overall, there is no coherent evidence to decide about antihyperglycemic, lipid lowering, and weight reducing effects of cinnamon in type II diabetes.
Akilen, R., Tsiami, A., Devendra, D. and Robinson, N., 2010. Glycated haemoglobin and blood pressure-lowering effect of cinnamon in multi-ethnic Type 2 diabetic patients in the UK: A randomized, placebo-controlled, doubleblind clinical trial. Diabetic Medicine, 27(10), pp.1159-1167.
Akilen, R., Tsiami, A., Devendra, D. and Robinson, N., 2012. Cinnamon in glycaemic control: Systematic review and meta analysis. Clinical Nutrition, 31(5), pp.609-615.
Allen, R.W., Schwartzman, W., Baker, W.L., Coleman, C.I. and Phung, O.J., 2013. Cinnamon use in Type 2 diabetes: An updated systematic review and meta-analysis. Annals of Family Medicine, 11(5), pp.452-459.
Alwhaibi, M., Balkhi, B., Alhawassi, T.M., Alkofide, H., Alduhaim, N., Alabdulali, R., Drweesh, H. and Sambamoorthi, U., 2018. Polypharmacy among patients with diabetes: Across-sectional retrospective study in a tertiary hospital in Saudi Arabia. BMJ Open, 8(5), p.e020852.
Amin, K.A. and Abd El-Twab, T.M., 2009. Oxidative markers, nitric oxide and homocysteine alteration in hypercholesterolimic rats: Role of atorvastatine and cinnamon. International Journal of Clinical and Experimental Medicine, 2, pp.254-265.
Blevins, S.M., Leyva, M.J., Brown, J., Wright, J., Scofield, R.H. and Aston, C.E., 2007. Effect of cinnamon on glucose and lipid levels in non insulin-dependent Type 2 diabetes. Diabetes Care, 30(9), pp.2236-2237.
Bradley, R., Kozura, E., Buckle, H., Kaltunas, J., Tais, S. and Standish, L.J., 2009. Description of clinical risk factor changes during naturopathic care for Type 2 diabetes. Journal of Alternative and Complementary Medicine, 15(6), pp.633-638.
Bui, D.H.T., Nguyen, B.X., Truong, D.C., Meyrowitsch, D.W., Søndergaard, J., Gammeltoft, T., Bygbjerg, I.C. and Jannie.N., 2021. Polypharmacy among people living with Type 2 diabetes mellitus in rural communes in Vietnam. PLoS One, 16(4), p.e0249849.
Camacho, S., Michlig, S., de Senarclens-Bezençon, C., Meylan, J., Meystre, J., Pezzoli, M., Markram, H. and Le Coutre, J., 2015. Anti-obesity and antihyperglycemic effects of cinnamaldehyde via altered ghrelin secretion and functional impact on food intake and gastric emptying, Scientific Reports, 5(1), p.7919.
Costello, B.R., Dwyer, J.T., Saldanha, L., Bailey, R.L., Merkel, J. and Wambog, E., 2016. Do cinnamon supplements have a role in glycemic control in Type 2 diabetes-a narrative review? Journal of the Academy of Nutrition and Dietetics, 116(11), p.1794.
Crawford, P., 2009. Effectiveness of cinnamon for lowering hemoglobin A1C in patients with Type 2 diabetes: A randomized, controlled trial. Journal of the American Board of Family Medicine, 22(5), pp.507-512.
Diabetesatlas., 2022. IDF Diabetes Atlas 2021. IDF Diabetes Atlas. Available from: https://www.diabetesatlas.org/atlas/tenth-edition [Last accessed on 2022 Mar 14].
Governa, P., Baini, G., Borgonetti, V., Cettolin, G., Giachetti, D., Magnano, A.R., Miraldi, E. and Biagi, M., 2018. Phytotherapy in the management of diabetes: A review. Molecules , 23(1), p.105.
Gupta Jain, S., Puri, S., Misra, A., Gulati, S. and Mani, K., 2017. Effect of oral cinnamon intervention on metabolic profile and body composition of Asian Indians with metabolic syndrome: A randomized double-blind control trial. Lipids in Health and Disease, 16(1), p.113.
Jadad, A.R., Moore, R.A., Carroll, D., Jenkinson, C., Reynolds, D.J., Gavaghan, D.J. and McQuay, H.J., 1996. Assessing the quality of reports of randomized clinical trials: Is blinding necessary? Controlled Clinical Trials, 17(1), pp.1-12.
Jamali, N., Kazemi, A., Saffari-Chaleshtori, J., Samare-Najaf, M., Mohammadi, V. and Clark, C.C.T., 2020. The effect of cinnamon supplementation on lipid profiles in patients with Type 2 diabetes: Asystematic review and meta-analysis of clinical trials. Complementary Therapies in Medicine, 55, p.102571.
Khan, A., Safdar, M., Khan, M.M.A., Khattak, K.N. and Anderson, R.A., 2003. Cinnamon improves glucose and lipids of people with Type 2 diabetes. Diabetes Care, 26(12), pp.3215-3218.
Khan, N.M., Ahmad, A., Tiwari, R.K., Kamal, M.A., Mushtaq, G. and Ashraf, G.M., 2014. Current challenges to overcome in the management of Type 2 diabetes mellitus and associated neurological disorders. CNS Neurological Disorders Drug Targets, 13(8), pp.1440-1457.
Lameijer, A., Fokkert, M.J., Edens, M.A., Slingerland, R.J., Bilo, H.J.G. and van Dijk. P.R., 2020. Determinants of HbA1c reduction with FreeStyle Libre flash glucose monitoring (FLARE-NL 5). Journal of Clinical and Translational Endocrinology, 22, p.100237.
Lee, J.S., Jeon, S.M., Park, E.M., Huh, T.L., Kwon, O.S., Lee, M.K. and Choi, M.S., 2003. Cinnamate supplementation enhances hepatic lipid metabolism and antioxidant defense systems in high cholesterol-fed rats. Journal of Medicinal Food, 6(3), pp.183-191.
Lira Neto, J.C.G., Damasceno, M.M.C., Ciol, M.A., de Freitas, R.W.J.F., de Araújo, M.F.M., de Souza Teixeira, C.R., Carvalho, G.C.N., Lisboa,
K.W.S.C., Marques, R.L.L., Alen M.P.G. and Zanetti, M.L., 2021. Efficacy ofcinnamon as an adjuvant in reducing the glycemic biomarkers of Type 2 diabetes mellitus: A three-month, randomized, triple-blind, placebo-controlled clinical trial. Journal of the American College of Nutrition, 41, pp.266-274.
Lu, T., Sheng, H., Wu, J., Cheng, Y., Zhu, J. and Chen, Y., 2012. Cinnamon extract improves fasting blood glucose and glycosylated hemoglobin level in Chinese patients with Type 2 diabetes. Nutrition Research, 32(6), pp.408-412.
Mandal, A., Sharma, S., Rani, R., Ranjan, S., Kant, R. and Mirza, A., 2021. Impact of cassia bark consumption on glucose and lipid control in Type 2 diabetes: An updated systematic review and meta-analysis. Cureus, 13(7), p.e16376.
Mang, B., Wolters, M., Schmitt, B., Kelb, K., Lichtinghagen, R., Stichtenoth, D.O. and Hahn, A., 2006. Effects of a cinnamon extract on plasma glucose, HbA1c, and serum lipids in diabetes mellitus Type 2. European Journal of Clinical Investigation, 36(5), pp.340-344.
Mirfeizi, M., Tourzani, Z.M., Mirfeizi, S.Z., Jafarabadi, M.A., Rezvani, H.R. and Afzali, M., 2016. Controlling Type 2 diabetes mellitus with herbal medicines: Atriple-blind randomized clinical trial of efficacy and safety. Journal of Diabetes, 8(5), pp.647-656.
Mollazadeh, H. and Hosseinzadeh, H., 2016. Cinnamon effects on metabolic syndrome: Areview based on its mechanisms. Iranian Journal of Basic Medical Sciences, 19(12), pp.1258-1270.
Mousavi, S.M., Rahmani, J., Kord-Varkaneh, H., Sheikhi, A., Larijani, B. and Esmaillzadeh, A., 2020. Cinnamon supplementation positively affects obesity: Asystematic review and dose-response meta-analysis of randomized controlled trials. Clinical Nutrition, 39(1), pp.123-133.
Namazi, N., Khodamoradi, K., Khamechi, S.P., Heshmati, J., Ayati, M.H. and Larijani, B., 2019. The impact of cinnamon on anthropometric indices and glycemic status in patients with Type 2 diabetes: A systematic review and metaanalysis of clinical trials. Complementary Therapies in Medicine, 43, pp.92-101.
Polonsky, W.H. and Henry, R.R., 2016. Poor medication adherence in Type 2 diabetes: Recognizing the scope of the problem and its key contributors. Patient Preference and Adherence, 10, p.1299-1307.
Ross, S.A., Dzida, G., Vora, J., Khunti, K., Kaiser, M. and Ligthelm, R.J., 2011. Impact of weight gain on outcomes in Type 2 diabetes. Current Medical Research and Opinion, 27(7), pp.1431-1438.
Santos, H.O. and da Silva, G.A.R., 2018. To what extent does cinnamon administration improve the glycemic and lipid profiles? Clinical Nutrition ESPEN, 27, pp.1-9.
Sharma, S., Mandal, A., Kant, R., Jachak, S. and Jagzape, M., 2020. Is cinnamon efficacious for glycaemic control in Type-2 diabetes mellitus? The Journal of the Pakistan Medical Association, 70(11), pp.2065-2069.
Sun, H., Saeedi, P., Karuranga, S., Pinkepank, M., Ogurtsova, K., Duncan, B.B., Stein, C., Basit, A., Chan, J.C.N., Mbanya, J.C., Pavkov, M.E., Ramachandaran, A., Wild, S.H., James, S., Herman, W.H., Zhang, P., Bommer, C., Kuo, S., Boyko, E. and Magliano, D.J., 2022. IDF diabetes atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice, 183, p.109119.
Talaei, B., Amouzegar, A., Sahranavard, S., Hedayati, M., Mirmiran, P. and Azizi, F., 2017. Effects of cinnamon consumption on glycemic indicators, advanced glycation end products, and antioxidant status in Type 2 diabetic patients. Nutrients, 9, p.991.
Zare, R., Nadjarzadeh, A., Zarshenas, M.M., Shams, M. and Heydari, M., 2019. Efficacy of cinnamon in patients with Type II diabetes mellitus: A randomized controlled clinical trial. Clinical Nutrition, 38(2), pp.549-556.
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