Bioactivity of cinnamon with special emphasis on diabetes mellitus: A review

Cinnamon is the oldest spice and has been used by several cultural practices for centuries. In addition to its culinary uses, cinnamon possesses a rising popularity due to many stated health benefits. Out of the large number of cinnamon species available, Cinnamomum aromaticum (Cassia) and Cinnamomum zeylanicum have been subjected to extensive research. Available in vitro and in vivo evidence indicates that cinnamon may have multiple health benefits, mainly in relation to hypoglycaemic activity. Furthermore, the therapeutic potential of cinnamon is stated also to be brought about by its anti-microbial, anti-fungal, antiviral, antioxidant, anti-tumour, blood pressure-lowering, cholesterol and lipid-lowering and gastro-protective properties. This article provides a summary of the scientific literature available on both C. aromaticum and C. zeylanicum. All studies reported here have used cinnamon bark and its products. Although almost all the animal models have indicated a pronounced anti-diabetic activity of both cinnamon species, conflicting results were observed with regard to the few clinical trials available. Therefore, the necessity of evaluating the effects of cinnamon for its therapeutic potential through well-defined and adequately powered randomized controlled clinical trials is emphasized, before recommendations are made for the use of cinnamon as an effective treatment for humans.     

Vitamin B12 malabsorption and omeprazole therapy.

The media is the most popular vehicle through which consumers receive nutrition information, and is powerful in influencing food selection and health behaviors. Unfortunately, media messages surrounding nutrition are often inconsistent, confusing, and do not enable the public to make positive changes in health behaviors. The process to improve this scenario begins with communication between scientists and journalists. Scientists can take several steps to insure the results of their research are reported to the public accurately and, thereby, contribute to the achievement of the nation's public health goals.     

Results of Prefrontal Lobotomy on Chronic Psychotic States

To provide the general practitioner, as well as the specialist with concise, readily available information on the latest, proved methods of treatment of conditions commonly encountered in an average practice, POSTGRADUATE MEDICINE offers this department to its readers. It is not, of course, intended to present these discussions as the only acceptable therapeutic procedures to be used, but rather to offer simple regimens and recommendations based on the extensive experience of the physicians who prepared these summaries.     

Role of cyclic AMP in glucagon-induced stimulation of hepatic glucose output in man

The interrelationship between glucagon action on splanchnic glucose output and cyclic AMP production was studied in healthy volunteers after hepatic venous catheterization. Glucagon was infused according to four different protocols to achieve arterial levels ranging from 300 to 9000 ng/I. Infusion of glucagon which resulted in arterial levels of the hormone of 4000-9000 ng/1 was associated with a marked increase in net splanchnic cyclic AMP production and in the arterial levels of the cyclic nucleotide. The rise in cyclic AMP efflux from the splanchnic area was transient but an augmented splanchnic production was still evident after 30 min of glucagon infusion. Splanchnic glucose output rose 3-5 fold. Infusion of glucagon at lower rates, resulting in arterial levels of 300-900 ng/I, did not measureably stimulate the efflux of cyclic AMP from the splanchnic area. In spite of this, splanchnic glucose output rose 2-3 fold and the blood glucose level increased 20-50% during glucagon infusion at these lower rates.

It is concluded that (1) factors other than cyclic AMP are rate limiting in the stimulation of hepatic glucose production, and (2) although cyclic AMP is an established 'second messenger' of glucagon action, other factors may also be of importance in mediating the physiological response of this hormone.     

Glucose metabolism parameters during an oral glucose tolerance test in patients with autosomal dominant polycystic kidney disease

Abstract

Objective. The aim of the study was to estimate the pancreatic beta cell function and insulin resistance indexes in a group of Autosomal Dominant Polycystic Kidney Disease (ADPKD) patients with normal kidney function and no previous diabetes mellitus diagnosis. Methods. A total of 49 adult patients with ADPKD aged 36 ± 11 years, and 50 healthy controls, all of Caucasian origin, were included in the study. Blood glucose, insulin and C-peptide concentrations were measured during an oral glucose tolerance test (OGTT with 75 g glucose) performed according to WHO recommendations in all subjects. Results. The insulin/glucose ratio at the 30th and 120th minute of the OGTT and the insulinogenic index [(insulin at 30 min – insulin at 0 min)/glucose at 30 min] were significantly lower (p = 0.018, p = 0.031 and p = 0.013, respectively) in the ADPKD group. Four other indexes of beta cell function were lower with the borderline statistical significance (p = 0.054–0.076) than in controls. None of the calculated insulin sensitivity indexes differed between the study and control groups. Conclusions. Presence of ADPKD in patients with normal kidney function is associated with impaired beta cell function after an oral glucose load, without a significant decrease in insulin sensitivity.     

Joint analysis of individual participants’ data from 17 studies on the association of the IL6 variant -174G>C with circulating glucose levels,interleukin-6 levels,and body mass index

Background. Several studies have investigated associations between the -174G>C single nucleotide polymorphism (rs1800795) of the IL6 gene and phenotypes related to type 2 diabetes mellitus (T2DM) but presented inconsistent results.

Aims. This joint analysis aimed to clarify whether IL6 -174G>C was associated with glucose and circulating interleukin-6 concentrations as well as body mass index (BMI).

Methods. Individual-level data from all studies of the IL6-T2DM consortium on Caucasian subjects with available BMI were collected. As study-specific estimates did not show heterogeneity (P>0.1), they were combined by using the inverse-variance fixed-effect model.

Results. The main analysis included 9440, 7398, 24,117, or 5659 non-diabetic and manifest T2DM subjects for fasting glucose, 2-hour glucose, BMI, or circulating interleukin-6 levels, respectively. IL6 -174 C-allele carriers had significantly lower fasting glucose (?0.091 mmol/L, P=0.014). There was no evidence for association between IL6 -174G>C and BMI or interleukin-6 levels, except in some subgroups.

Conclusions. Our data suggest that C-allele carriers of the IL6 -174G>C polymorphism have lower fasting glucose levels on average, which substantiates previous findings of decreased T2DM risk of these subjects.     

Early Lifestyle Intervention in Patients with Non-insulin-dependent Diabetes Mellitus and Impaire Glucose Tolerance

Non-insulin-dependent diabetes mellitus (NIDDM) is preceded by impaired glucose tolerance (IGT) lasting for years before manifesting as overt hyperglycaemia. Both genetic and environmental factors contribute to the development of IGT and NIDDM. Obesity, physical inactivity and high-fat diet have been found to predict IGT and NIDDM. Therefore, a diet and exercise intervention from diagnosis of NIDDM could improve the treatment outcome and prognosis of patients with NIDDM. Furthermore, because subjects with IGT are at increased risk for diabetes and atherosclerotic vascular diseases, it is reasonable to assume that in terms of reducing the incidence and long-term consequences of NIDDM an intervention at this phase is more effective than in overt diabetes. Although the nonpharmacological approach is generally accepted as the first-line treatment for NIDDM its efficacy has often been questioned. Therefore, it is important to carry out long-term controlled studies to find out to what extent lifestyle modification could improve the metabolic control and level of major cardiovascular risk factors known to be associated with poor outcome in NIDDM. This kind of study also gave relevant experience in planning studies aiming at primary prevention of NIDDM. One-year dietary and exercise intervention on newly diagnosed NIDDM patients in Kuopio, Finland resulted in a better metabolic control and a moderate reduction in cardiovascular risk factors as compared to the conventional treatment group. After the second year of follow-up only 12.5% in the intervention group were receiving oral antidiabetic drugs vs. 34.8% in the conventional treatment group. Weight reduction and a reduced use of saturated fats appeared to be the main determinants of successful treatment results. Good aerobic capacity was associated with an increase in HDL cholesterol. A multicentre primary prevention study on IGT patients is continuing in Finland applying the same principles of intervention as used in the study on newly diagnosed NIDDM patients. Pilot results show that glucose tolerance can be improved by lifestyle changes.