There is some evidence that fermented foods containing lactic acid or acetic acid can lower blood sugar (glucose) by helping store excess glucose in the liver, thus reducing the body's rate of glucose production and absorption. Examples of fermented foods include apple cider vinegar, in which the main ingredient is acetic acid; the prepared rice used in sushi, which contains vinegar; and sourdough bread, which contains lactic acid. However, in findings so far, the reduction in glucose has been only about 4 to 6 percent, and these results have not been confirmed by large-scale trials. In addition, the quantity needed to control sugar has not been well defined. Therefore, neither acetic acid nor lactic acid is currently recommended for the control of sugar. Having said this, there is no harm in including fermented foods in your diet. If you see a significant reduction in your glucose levels, and this is reflected in your hemoglobin A1c level, then you might work with your doctor to see if you can reduce your medicine.
There has also been much interest in the effect of spices on insulin. Cinnamon, bay leaves, cloves, and turmeric have all been shown to increase insulin activity in laboratory studies using animals. Cinnamon extract has also been shown to increase both the use of glucose by the body and the conversion of glycogen (the form in which glucose is stored by the liver) into glucose in animal studies. However, the same effect hasn't been shown in human studies. In fact, after looking at all the studies on cinnamon's effect on glucose, there is no convincing evidence that cinnamon has a glucose- or hemoglobin A1c-reducing effect.
Overall, until there is a large-scale trial that proves that these foods reduce glucose significantly, I would caution you against stopping your diabetes medicines altogether. But if you enjoy the taste of fermented foods or spices such as cinnamon, by all means, continue to include them in your diet. Any effect on your glucose levels would be an added benefit.
Diabetes expert Asqual Getaneh, MD, answers your frequently asked questions on diabetes symptoms, diagnosis, treatment, diet, medications, and management. Dr. Getaneh is an assistant clinical professor of medicine at Columbia University in New York, where she specializes in diabetes and obesity.
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