Vinegar Ingestion at Bedtime Moderates Waking Glucose Concentrations in Adults With Well-Controlled Type 2 Diabetes | Diabetes Care | American Diabetes Association

Given the importance of maintaining acceptable blood glucose concentrations, there is much interest in identifying foods and diet patterns that will help individuals with diabetes manage their condition. Based on previous data indicating that vinegar consumption at mealtime reduces postprandial glycemia ( 1 – 4 ), the draw a bead on of this pilot program study was to examine whether vinegar consumption at bedtime reduces the next-morning fast glucose concentration in individuals with character 2 diabetes. Fasting glucose was recorded with a calibrated glucometer by each participant during the test : at service line ( day 0 ) and day 2 at 0700 h. These results were downloaded by the research staff from each participant ‘s glucometer memory. A multivariate repeated-measures ANOVA trial with body weight as a covariate was used to determine a meaning time-by-treatment effect using SPSS ( version 14 for Windows ; SPSS, Chicago, IL ). Participants maintained 24-h diet records for 3 days and measured fasting glucose at 0700 h for 3 consecutive days with a calibrate glucometer before the start of the study. Participants were instructed to continue common prescription medicine habit during the study. Utilizing a randomized crossover design with a 3- to 5-day flop period between treatments, participants followed a standardized meal design for 2 days, consuming either 2 Tbsp apple cider vinegar or water at bedtime with 1 oz cheese ( 8 g protein, 1 deoxyguanosine monophosphate carbohydrate, and 1.5 g fat ). The standardize meal plan was designed to reflect the person ‘s typical diet. Participants were instructed to record all foods and beverages ingested during each 2-day treatment period. Four men and seven women ( aged 40–72 years ) diagnosed with type 2 diabetes ( by a doctor ) who were not taking insulin completed the report. Participants provided a clinically determined A1C reading from a holocene ( < 2 months ) blood psychoanalysis. All participants gave written informed consent, and the survey was approved by the institutional review board at Arizona State University.

The duration of diabetes averaged 4.9 ± 1.0 years for the participants, and 73 % of participants ( 8 of 11 ) used prescription drug hypoglycemic agents during the study. Before the initiation of the study, a BMI of 29.1 ± 1.2 kg/m 2, a typical fast glucose of 7.6 ± 0.3 mmol/l, and an A1C of 6.7 ± 0.2 % were recorded for the participants. Participants complied with the dietary protocol as indicated by the diet records maintained during the discipline ; hence, food consumption for the two treatment periods was identical within subjects. Fasting glucose was reduced 0.15 mmol/l ( 2 % ) and 0.26 mmol/l ( 4 % ) for the placebo and vinegar treatments, respectively ( time-by-treatment effect, P = 0.033 ) ( Fig. 1 ). Closer examination of the data revealed that the vinegar treatment was particularly effective for the participants with a typical fast glucose > 7.2 mmol/l ; in these individuals ( nitrogen = 6 ), fasting glucose was reduced 6 % compared with a reduction of 0.7 % in those participants with a typical fast glucose < 7.2 mmol/l ( newton = 5 ). These data suggest that vinegar consumption at bedtime may favorably shock waking glucose concentrations in type 2 diabetes. The antiglycemic consequence of acetic acid, the active ingredient in vinegar, has been attributed to reduced starch digestion ( 5 ) and/or delayed gastric emptying ( 6 ). Neither of these proposed mechanisms probably explains the effects noted herein ; furthermore, to our cognition, this is the first report describing a hypoglycemic effect of vinegar apart from mealtime. Fushimi et alabama. ( 7, 8 ) have published a series of trials in rats demonstrating that acetic acidic alters hepatic and bony glucose metamorphosis. These investigations show that acetic acid feed ( 0.2 acetic acid/100 gigabyte diet ) reduced xylulose-5-phosphate collection in liver-colored and phosphofructokinase-1 bodily process in bony muscle—metabolic changes consistent with reduce glycolysis and the promotion of glycogen synthesis. Hence, acetic acid may possibly alter the glycolysis/gluconeogenic cycle in liver-colored, which may benefit diabetic individuals with metabolic disturbances contributing to a prebreakfast raise in fasting glucose ( besides known as the “ dawn phenomenon ” ) ( 9 ) . Reductions in fasting glucose of the magnitudes noted in this cogitation ( 4–6 % ) are less than that observed in trials examining the efficacy of pharmaceutical hypoglycemic agents for inadequately controlled diabetes. In these trials, pretrial A1C values averaged 7.8–8.8 %, and fasting glucose concentrations were reduced 10–15 % by long-run drug therapy ( 10 – 12 ). In comparison, the diabetic circumstance of our subjects was well controlled ( A1C 6.7 ± 0.2 % ). notably, although 72 % of our subjects regularly used hypoglycemic medications and continued their medication use during the survey, the vinegar treatment significantly impacted fasting glucose. In individuals with early diabetes ( A1C < 6.3 % ) or well-controlled diabetes ( A1C 6.8–7.0 % ), pharmaceutical interventions had a more moderate consequence, reducing fasting glucose 3–6 % ( 13, 14 ) . The see cheese plus water treatment reduced fasting glucose 2 % ( P = 0.928 ), whereas the cheese plus vinegar discussion reduced fasting glucose 4 % ( P = 0.046 ). We can not rule out the possibility of a synergetic effect for cheese and vinegar. Based on our previous work, we felt that the subjects needed a little total of food to take with the vinegar for ease of application. Fasting hyperglycemia in type 2 diabetes has been related to an intrahepatic malfunction that increases overall liverwort glucose output, possibly the inhibition of glycogen synthesis ( 15 ). In type 2 diabetes, dietary protein has a minimal effect on glycemia, even though gluconeogenesis is increased ( 16, 17 ). amino acids from cheese may provide glucogenic substrates, which in the presence of insulin convert to glycogen ( 18, 19 ), a scenario that may benefit individuals with type 2 diabetes. We were ineffective to find research investigating a function for night snacks in managing waking hyperglycemia in type 2 diabetes ; our data suggest that this hypothesis should be explored.

Although this discipline is limited by the small sample distribution size ( newton = 11 ), the within-subject plan reduced mistake variability due to person differences. besides, nephritic function and a detail history of medicine use were not assessed in this survey and may have impacted these results .
Vinegar is widely available, it is low-cost, and it is appealing as a remedy, but much more solve is required to determine whether vinegar is a useful accessory therapy for individuals with diabetes. Investigations are needed to study the mechanisms by which vinegar alters postprandial glycemia and fasting glucose and to examine the efficacy of vinegar consumption in individuals with inadequately controlled diabetes .
Figure 1—

View largeDownload slide Fasting glucose concentrations at baseline and on day 2 of placebo or vinegar treatment in type 2 diabetic patients ( newton = 11 ). Values are means ± SE. The P measure represents the time-by-treatment effect ( multivariate repeated-measures ANOVA test ). Figure 1—View largeDownload slide Fasting glucose concentrations at baseline and on day 2 of placebo or vinegar treatment in type 2 diabetic patients ( north = 11 ). Values are means ± SE. The P respect represents the time-by-treatment impression ( multivariate repeated-measures ANOVA test ) .

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