Apple Cider effect in the treatment of type 2 diabetes

Introduction.

Type 2 diabetes is a chronic disease characterized by insulin resistance and persistent hyperglycemia. It is one of the most prevalent chronic diseases, with an increasing number of cases due to factors such as obesity and population aging. According to the World Health Organization (WHO), it is estimated that more than 400 million people worldwide live with type 2 diabetes.

Conventional treatment typically includes medications, dietary modifications, and regular exercise. However, recent studies suggest that it is beneficial to approach this disease from a holistic perspective. The holistic approach to treating type 2 diabetes involves managing the disease from multiple angles, not only focusing on lowering blood glucose, but also improving insulin sensitivity, reducing inflammation, and supporting cardiovascular and metabolic health. This approach includes integrating natural compounds that act synergistically to optimize glycemic control.

In recent years, there has been a growing interest in the use of alternative and complementary treatments, such as apple cider vinegar, due to its potential health benefits. In this sense, the purpose of this work is to describe, based on the available literature, the benefits of apple cider vinegar in the control of this disease, as well as the recommended doses and the optimization of its use based on synergy with other organic compounds.

Composition of apple cider vinegar.

Apple cider vinegar is produced by fermenting apples, during which sugars are first converted into alcohol and then into acetic acid, which is its main active ingredient. In addition to acetic acid, apple cider vinegar contains small amounts of vitamins, minerals, polyphenols and probiotics. Since it is made using a natural process and does not usually contain additives or synthetic chemicals, it is classified as a natural product.

It's important to note that, although natural, not all apple cider vinegar is created equal. Some commercial versions may contain preservatives or have been pasteurized, which could affect its natural properties. To get the most benefits, it's often recommended to use organic, raw, unfiltered apple cider vinegar.

Benefits of apple cider vinegar in controlling type 2 diabetes.

Several clinical trials have evaluated the impact of apple cider vinegar on glycemic control. A study published in the journal Diabetes Care in 2004 found that consuming vinegar before carbohydrate-rich meals significantly improved insulin sensitivity in people with insulin resistance or type 2 diabetes. Likewise, several scientific studies agree that this natural product could have beneficial effects on glycemic control in people with type 2 diabetes, through the mechanisms described below:

Reducing postprandial blood glucose: Apple cider vinegar may reduce glucose absorption in the intestine and improve insulin sensitivity, which may lead to less of a rise in blood glucose after meals.

Improved insulin sensitivity: Some studies have shown that acetic acid can increase the efficiency of insulin, allowing cells to better utilize available glucose, which is crucial for people with insulin resistance.

Reduction of hepatic glucose production: Acetic acid may inhibit some liver enzymes involved in glucose production, thus helping to reduce blood glucose levels.

Recommended dosage of apple cider vinegar.

It is of utmost importance that before you start using apple cider vinegar regularly, you consult a doctor or nutritionist, especially if you are taking diabetes medication, to ensure that it is safe and suitable for your particular situation. In addition, blood glucose levels should be closely monitored, as vinegar can enhance the effect of anti-diabetic medications and increase the risk of hypoglycemia.

Dose:

Before meals:

Quantity: 1 to 2 tablespoons (15 to 30 ml) of apple cider vinegar diluted in a glass of water (about 240 ml).

Frequency: Take this dose before main meals, especially before carbohydrate-rich meals, to help reduce the postprandial glucose spike.

Before sleeping:

Amount: Some people may benefit from a smaller dose, such as 1 tablespoon (15 ml) diluted in water, taken at bedtime.

Purpose: This dose may help reduce morning fasting glucose levels.

Note: Apple cider vinegar should always be diluted in water to avoid possible negative effects on tooth enamel and the gastrointestinal tract.

Synergy between apple cider vinegar and some natural compounds.

For the holistic treatment of type 2 diabetes, combining apple cider vinegar with certain natural compounds can provide a synergistic effect that optimizes glycemic control, enhancing blood sugar reduction and improving overall health. Among the main natural products used in combination with apple cider vinegar are:

Cinnamon: Cinnamon is obtained from the inner bark of trees of the Cinnamomum genus and has been traditionally used in both cooking and herbal medicine. Cinnamon, especially the Cinnamomum cassia variety, has been widely studied for its ability to lower blood glucose levels and improve insulin sensitivity. There are two types of cinnamon: Ceylon and Cassia. Ceylon, also known as "true cinnamon," is considered the safest and purest variety, with a lower content of coumarin, a substance that, in large quantities, can be toxic to the liver. In contrast, the Cassia variety is more common and less expensive, but contains higher levels of coumarin. Although moderate consumption is generally safe, prolonged use in large quantities can have adverse effects.

Berberine: An alkaloid found in several plants, including Berberis vulgaris (verjuice) and Coptis chinensis, it is commonly used in traditional medicine. Berberine has been studied for its potential health benefits, including its use as an adjunctive treatment for type 2 diabetes. Additionally, it has anti-inflammatory and antioxidant properties that may contribute to better overall health.

Turmeric: Turmeric is a spice derived from the root of the Curcuma longa plant, which belongs to the ginger family. Its main active compound is curcumin, which is responsible for most of its medicinal properties and its characteristic yellow color. Turmeric has been used in traditional medicine for centuries, especially in Ayurvedic medicine and traditional Chinese medicine, due to its anti-inflammatory, antioxidant, and anticancer properties. In the context of type 2 diabetes, curcumin has shown several potentially beneficial properties: it improves insulin sensitivity, has anti-inflammatory and antioxidant effects, and improves endothelial function (the layer of cells that lines blood vessels), which may contribute to better cardiovascular health, an important aspect for people with type 2 diabetes.

Dietary Fiber (psyllium or oat bran):

Psyllium: This is a soluble fiber obtained from the seeds of the Plantago ovata plant, native to the Indian subcontinent. The soluble fiber present in psyllium has the particularity of forming a gel in the digestive tract, which slows down the absorption of carbohydrates and therefore helps control blood glucose levels after meals.

Oat bran: Oat bran is the outer shell of the oat grain, obtained during the milling process to produce oat flour or processed oats. It is rich in soluble fiber, specifically beta-glucan. This fiber can help regulate blood sugar levels by slowing down the absorption of carbohydrates and promoting a gradual release of glucose.

Green Tea: Comes from the leaves of the Camellia sinensis plant and is considered a natural product. Green tea is rich in catechins, especially epigallocatechin gallate (EGCG). These catechins can improve insulin sensitivity, making it easier for cells to respond better to this hormone. Some studies have suggested that regular consumption of green tea may help reduce fasting blood glucose levels.

Below are some recommended combinations:

a. Apple Cider Vinegar and Cinnamon

Usage: Mix 1 to 2 tablespoons (15 to 30 ml) of apple cider vinegar with 1/2 to 1 teaspoon (2 to 4 grams) of cinnamon powder in a glass of water.

Benefits: This combination can significantly improve insulin sensitivity and reduce glucose spikes after meals. Cinnamon enhances the effect of apple cider vinegar in regulating blood glucose.

b. Apple Cider Vinegar and Berberine

Usage: Take 1 to 2 tablespoons of apple cider vinegar diluted in water before meals, along with 500 mg of berberine, two to three times a day.

Benefits: Berberine acts in a similar way to metformin, improving insulin sensitivity and reducing glucose production in the liver. Combined with apple cider vinegar, this combination can have a potent effect in lowering blood sugar.

c. Apple Cider Vinegar and Green Tea

Usage: Consume 1 to 2 tablespoons of apple cider vinegar in water before meals, followed by 1 cup of green tea.

Benefits: Green tea contains catechins that improve insulin sensitivity and support cardiovascular health. This combination may help reduce blood glucose levels and improve overall metabolic health.

d. Apple Cider Vinegar and Dietary Fiber (psyllium or oat bran)

Usage: Take 1 to 2 tablespoons of apple cider vinegar in water before meals, along with a serving of dietary fiber (such as psyllium or oat bran).

Benefits: Dietary fiber slows down the absorption of glucose in the intestine, helping to prevent blood glucose spikes. In combination with apple cider vinegar, it can be effective in maintaining stable glucose levels.

e. Apple Cider Vinegar and Curcumin (Turmeric)

Usage: Take 1 to 2 tablespoons of apple cider vinegar diluted in water before meals, along with 500 to 2000 mg of curcumin (with piperine to improve absorption).

Benefits: Curcumin has anti-inflammatory and antioxidant properties that may improve insulin sensitivity. Combined with apple cider vinegar, this combination may be effective in reducing inflammation and improving glycemic control.

Recommendations and precautions.

Medical Consultation: It is critical that any decision about reducing or eliminating medications for type 2 diabetes be made under the guidance of a physician. Type 2 diabetes is a complex condition that can have serious consequences if not managed properly.

Regular Monitoring: People looking to take a holistic approach should monitor their blood glucose levels regularly to ensure that natural treatments are working properly.

Moderation: Use apple cider vinegar in moderate amounts and always diluted to minimize risks.

Precautions: Apple cider vinegar should always be diluted in water to avoid possible negative effects on tooth enamel and the gastrointestinal tract.

Scientific Evidence: Although there are studies supporting the use of certain natural compounds for the management of type 2 diabetes, scientific evidence supporting the complete elimination of medications in favor of natural treatments is limited. Most studies recommend the use of these compounds as complements, not as substitutes for prescribed medication.

Case Reports: There have been reports of people gradually reducing their medication dosage under the supervision of their physician and seeing improvements in their blood glucose levels with the use of natural compounds. In some cases, and to a lesser extent, people have been able to eliminate their dependence on type 2 diabetes medications through a holistic approach that includes dietary changes, exercise, apple cider vinegar, and other natural supplements such as cinnamon, berberine, and alpha lipoic acid.

Conclusion.

Although some people have found success with a holistic approach that includes apple cider vinegar and other natural compounds, it is crucial to do so under medical supervision. The integration of these natural treatments can be beneficial, but should not replace conventional medication without the evaluation and approval of a health care professional.

The use of apple cider vinegar as an adjunctive treatment has been studied primarily in the context of type 2 diabetes, where some research suggests that it may help improve insulin sensitivity and reduce blood glucose levels after meals. This is especially relevant for people with type 2 diabetes, who typically still produce insulin, but their bodies don't use it efficiently.

References

Johnston, C.S., Kim, C.M., & Buller, A.J. (2004). Vinegar Improves Insulin Sensitivity to a High-Carbohydrate Meal in Subjects with Insulin Resistance or Type 2 Diabetes. Diabetes Care, 27(1), 281-282.