vinegar cand reduce A1C in type 1 diabetics

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Although previous studies show that vinegar improves insulin sensitivity in

healthy or insulin-resistant subjects, 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 ± 3 years, BMI 24 ± 1 kg/m2, diabetes

duration 14 ± 3 years, A1c 6.7 ± 0.2%) treated with rapid-acting insulin

preprandially

and long-acting insulin once daily were studied after an overnight fast.

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 and placebo.

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 ± 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.

Fasting BG was similar in the vinegar (5.5 ± 0.2 mmol/l) and placebo (5.5 ±

0.2 mmol/l) experiments and remained comparable until 30 min postprandially

(7.4 ± 0.4 vs. 7.7 ± 0.6 mmol/l, respectively). In the placebo experiments, BG

continued to rise thereafter with a peak (11.6 ± 1 mmol/l) at 94 min, whereas

after the consumption of vinegar, BG increased to 8.6 ± 0.9 mmol/l (P = 0.005)

and remained unaltered without postprandial spikes until the end of the

experiment. As a result, vinegar compared to placebo reduced BG (AUC0−240 min

1,884 ± 169 vs. 2,282 ± 195 mmol/l*min, P = 0.01) by almost 20%.

Basal and postprandial (AUC0−240 min) plasma insulin levels were the same in

the vinegar (5.2 ± 0.8 μU/ml and 4,152 ± 285 μU/ml*min, respectively) and

placebo

(5.7 ± 0.5 μU/ml and 4,192 ± 375 μU/ml*min, respectively) experiments.

The mechanisms by which vinegar reduces postprandial BG levels are obscure.

Previous studies have shown that vinegar delays gastric emptying. Moreover,

acetic acid has been shown to suppress disaccharidase activity and to enhance

glycogen repletion in liver and muscle.

In conclusion, two tablespoons of vinegar could be easily used as a

complementary food (e.g., in a salad dressing) to reduce hyperglycemia.

Diabetes Care Feb. 2010