A DIET FOR DIABETICS...

Cinnamon, one of the most widely used flavouring agents used in the food and beverage industry worldwide has also been well recognized for its medicinal properties since antiquity. Traditional Ayurvedic medicine has used cinnamon extracts for ailments such as arthritis, diarrhea and menstrual irregularities.

    To date, about 250 species of cinnamon has been identified, 4 of which are used to obtain the spice cinnamon. True or Ceylon Cinnamon (Cinnamomum verum) (syn C. zeylanicum) is a small evergreen tree native to Sri Lanka. Chinese cassia cinnamon (Cinnamomum aromaticum) is the other most widely available species.
Preparation of cinnamon involves stripping of the outer bark of the tree and letting the inner bark to dry and curl up into its customary cinnamon quills. Cinnamon is available in either its whole quill form (Cinnamon sticks) or as ground powder in the market.
At present Cinnamon is sold as both a preventative and therapeutic supplement for many ailments including, metabolic syndrome, insulin resistance, T2 diabetes, hyperlipidemia and arthritis.
Cinnamon is known to have anti-diabetic properties, in addition to which, it is also perceived to have antioxidant, anti-inflammatory and anti-bacterial properties.

Mechanisms of lowering plasma glucose     
    A multitude of in-vitro studies have demonstrated that cinnamon increases glucose entry into cells by enhanced insulin receptor phosphorylation and translocation of the glucose transporter GLUT4 to the plasma membrane. Cinnamon increases the amount of GLUT4 receptors as well as Insulin Receptor (IR) and Insulin Receptor substrate, thereby facilitating glucose entry into cells. The active compound responsible is believed to be a watersoluble poly-phenolic compound comprising procyanidin type A polymers. Another possible mechanism for its hypoglyaemic properties, is an increase in the expression of PPAR (alpha) and PPAR (gamma), thereby increasing insulin sensitivity.
It has also been demonstrated that Cinnamon posses an inhibitory effect on intestinal glucosidases and pancreatic amylase. Ceylon cinnamon is the most potent inhibitor of pancreac amylase and intestinal sucrase. Cinnamon also possesses the ability to increase glycogen synthesis and inhibit gluconeogenesis, by increasing the activity of Pyruvate Kinase (PK) and decreasing that of Phoshoenol pyruvate carboxy kinase (PEPCK).
A human study demonstrated its ability to delay gastric emptying as well as curb the postprandial glucose surge.

Important Safety Information    
    In animal studies there is no significant toxicity of Cinnamon on the liver, but the results relating to renal functions are controversial, raising the need for more studies to evaluate its effect on the kidney.
    A search of the literature for RCTS using human subjects did not reveal any reported significant adverse events when Cinnamon cassia is used in doses of  1-6 g per day. However there were four instances where patients reported a rash, hives, nausea and one hypoglycaemic seizure.
    Although short-term trials have not demonstrated any significant adverse outcomes with Cinnamon cassia use, its high coumarin content is a concern in prolonged use. Coumarins are naturally occurring plant compounds with anti-coagualnt, carcinogenic and hepatotoxic properties. Cinnamon cassia which was used in almost all the human trials, has a coumarin content varying between 0.31 to 6.97 g/kg, while the coumarin content of true cinnamon or Ceylon cinnamon was only 0.017 g/Kg.
    This high coumarin content of C. cassia has led some agencies to advocate against the regular use of cassia Cinnamon as a supplement in diabetes. On the other hand, the very low content of coumarins found in Cinnamomum zeylanicum makes it a potentially useful medication or supplement for long-term use.


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