A Review of the Hypoglycemic Effects of Vinegar and its Potential Benefit in Gestational Diabetes Mellitus (GDM)

Abstract

The current first line management for women with gestational diabetes mellitus (GDM) is dietary modification and exercise, which emphasizes the elimination or reduction of foods with high glycemic index. However, evidence suggests there may be a complimentary hypoglycemic effect of substances such as vinegar. This literature review explores vinegar’ s hypoglycemic effects, proposed physiological mechanisms of action, and whether these effects have been demonstrated during pregnancy with particular attention given to women affected by GDM. MEDLINE, PubMed and Google Scholar were searched for randomized controlled trials and prospective cohort studies of vinegar ingestion by individuals affected by diabetes. Search terms used were delayed gastric emptying, postprandial glycemia and glycemic Index (GI). Fifteen articles describing 21 studies were identified that evaluated the hypoglycemic effects of vinegar in groups of individuals without diabetes, with Type I diabetes (T1D), Type 2 diabetes, (T2D) or those at risk for diabetes, as well as hypoglycemic effects of vinegar in rats and intestinal human cells. Our review found that vinegar significantly reduced postprandial glucose, fasting blood glucose, and increased response to insulin We found significant support for a proposed physiological mechanism for the hypoglycemic effects of vinegar, delayed gastric motility, inhibition of carbohydrate digestion, increased satiation with associated decreased caloric intake, and glycogen repletion in skeletal muscle and liver cells. There is strong evidence supporting vinegar as a complimentary component of nutrition therapy for nonpregnant individuals with diabetes, but a paucity of data evaluating the use of vinegar during pregnancy affected by GDM.