Can apple cider vinegar be used to manage diabetes?

From the Guidelines

Apple cider vinegar should not be relied upon as a primary treatment for diabetes management. While some small studies suggest it may modestly improve insulin sensitivity and slightly lower blood glucose levels after meals, the evidence is limited and inconsistent. If you want to try apple cider vinegar as a complementary approach, use 1-2 tablespoons diluted in water before meals, but never consume it undiluted as it can damage tooth enamel and irritate your digestive tract. The proposed mechanism involves acetic acid potentially slowing carbohydrate digestion or improving cellular glucose uptake. However, proper diabetes management requires proven approaches including prescribed medications (like metformin, insulin, or other diabetes medications), regular blood glucose monitoring, a balanced diet, regular physical activity, and maintaining a healthy weight. Always consult your healthcare provider before adding apple cider vinegar to your diabetes management plan, especially if you take insulin or medications that lower blood sugar, as dangerous interactions could occur 1.

Some key points to consider in diabetes management include:

• Individualized medical nutrition therapy programs, preferably provided by a registered dietitian nutritionist, are recommended for all people with type 1 or type 2 diabetes, prediabetes, and gestational diabetes mellitus 1.
• Carbohydrate intake should emphasize nutrient-dense carbohydrate sources that are high in fiber and minimally processed, and reducing overall carbohydrate intake may be beneficial for improving glycemia 1.
• There is no clear evidence that dietary supplementation with vitamins, minerals, herbs, or spices can improve outcomes in people with diabetes who do not have underlying deficiencies, and they are not generally recommended for glycemic control 1.
• Adults with diabetes who drink alcohol should do so in moderation (no more than one drink per day for adult women and no more than two drinks per day for adult men) 1.

It is essential to prioritize evidence-based treatments and consult with a healthcare provider before making any changes to a diabetes management plan.

From the Research

Apple Cider Vinegar and Diabetes Management

• Apple cider vinegar (ACV) has been studied for its potential effects on managing diabetes, with some studies suggesting it can improve glycemic control and insulin sensitivity in patients with type 2 diabetes 2, 3.
• The evidence suggests that ACV can reduce fasting blood sugar (FBS) and HbA1c levels, and increase insulin levels, although the effects on hemostatic model assessment for insulin resistance (HOMA-IR) are unclear 2.
• A randomized controlled clinical trial found that daily consumption of 30 ml of ACV for 8 weeks decreased FBS, HbA1c, and LDL cholesterol, and improved lipid profile in patients with type 2 diabetes 3.

Mechanisms of Action

• The exact mechanisms by which ACV exerts its effects on glucose metabolism are not fully understood, but may involve inhibition of α-amylase action, increased glucose uptake, and mediation by transcription factors 4.
• ACV has also been shown to have antioxidant effects, increasing the activity of antioxidant enzymes and reducing lipid peroxidation levels in diabetic rats 5.

Dosage and Consumption

• The optimal dosage of ACV for diabetes management is not established, but studies have used doses ranging from 10-30 ml per day 2, 3, 4.
• It is unclear whether the effects of ACV on glucose metabolism are sustained with long-term consumption, as most studies have been short-term interventions 4.

Animal Studies

• Animal studies have demonstrated that ACV can improve glycemic control, lipid profile, and antioxidant status in diabetic rats 5, 6.
• These studies suggest that ACV may have potential as a complementary therapy for managing diabetes, although further human studies are needed to confirm these findings.