Apple Vinegar Reduces Blood Glucose

Published Date: 02 Nov 2017

Ahmed Saber Abu-zaiton

Department of Biological Science

Al-Hussein Bin Talal University

Jordan - Ma’an P.O Box (20)

Abstract

Apple vinegar, a folklore anti-diabetes fern, was evaluated for its hypoglycaemic and anti-diabetic properties using rats. The blood glucose lowering activity of the apple vinegar was studied in normal and alloxan-induced diabetic rats. Blood samples were collected from the tail of rats and serum glucose measured on the 1st, 7th, 14th days of the experiment. The apple vinegar produced dose-dependent reduction in blood glucose of both normal and diabetic rats and comparable with that of the standard drug, Glibenclamide. A significant reduction in blood glucose of diabetic animal’s 8.3±0.75 mmol/L in case of administration of Apple Vinegar in comparison with diabetic control 24.6±8.45 mmol/L, while Glibenclamide drug produced a reduction in blood glucose 12.27 ± 4.77 mmol/L. The results indicate a prolonged action in reduction of blood glucose by apple vinegar and the mode of action of the active compounds of apple vinegar is probably mediated through enhance secretion of insulin from the β-cells of Langerhans or through extrapancreatic mechanism. The present study clearly indicated a significant antidiabetic activity with the apple vinegar and supports the traditional usage of the apple vinegar for the control of diabetes.

Key Words: Diabetes Mellitus, Apple Vinegar, Alloxan.

Introduction

Diabetes mellitus is one of the chronic diseases affecting about 1% of the Western countries and 5–10% of the world population (Hamdan and Afifi, 2004). Diabetes characterized by decreased insulin sensitivity leading to insulin resistance in its target tissues (Boden and Shulman, 2002: McGarry and Banting, 2002). On the other hand, impaired glucose-induced insulin secretion with a decrease in pancreatic β cell mass will eventually lead to chronic hyperglycaemia (Sebbagh et al., 2009).In spite of the hypoglycemic agents, diabetes and the related complications continue to be a major medical problem (Srinivas at el., 2003).

Since time immemorial, patients with non-insulin dependent diabetes mellitus have been treated orally by folklore with a variety of plant extracts. In the indigenous Jordan system of medicine, a mention was made on good number of plants and compounds for the cure of diabetes and some of them have been experimentally evaluated and the active principles were isolated (Hamdan and Afifi, 2004). However, search for new anti diabetic drugs continues.

Apple vinegar products are advertised in the popular press and over the Internet for treatment of a variety of conditions, including: aging, weight loss, hemorrhoids, high blood pressure, arthritis, sore throat, and diabetes (Goldstein L, 2000; Anonymous, 2002).

Apple vinegar is a powerful detoxifying and purifying agent, it breaks down fatty, mucous and phlegm deposits within the body. By breaking down these substances it improves the health and function of the vital organs of the body, such as the kidneys, bladder and liver, by preventing excessively alkaline urine. It also oxidizes and thins the blood, which is important in preventing high blood pressure (Johnston and Buller, 2005). Antiglycemic effect of apple vinegar was seen after consumption of a starch load co administered with a 2% acetic acid solution (Ebihara and Nakajima, 1988; Arline et al., 2009).

Simple, inexpensive diet strategies to help manage blood glucose are greatly needed to delay the progression of diabetes. Accumulating evidence indicates that a single dose of Apple vinegar may attenuate postprandial glycemia (PPG). Since PPG is a strong predictor of hemoglobin A1C, particularly in well controlled diabetic patients (Carol et al., 2009). Simple but effective ways to lower blood glucose levels, applicable to a wide variety of dietary habits, are strongly needed.

A longitudinal trial has not been conducted to determine whether regular Apple vinegar ingestion has therapeutic value for individuals with diabetes.

Hence, in the present study the apple vinegar has been evaluated for hypoglycemic activity in normal and alloxan diabetic rats.

2. Materials and Methods

2.1 Samples and Chemicals

Apple (Malus domestica) vinegar was obtained from the supermarket in Irbid City, Jordan. Acetic acid contents of the vinegar was 4.5% and solid contents was 13.3%.

Glibenclamide was provided by Diamond Pharmaceutical company, Amman, Jordan, while alloxan (Sigma Chemical Company, USA). All other reagents used were of analytical grade.

2.2 Animal Experiments

Rats of original Wistar strain bred in the Central Animal

House, Department of Biological sciences, College of Science, Yarmouk University were used in this study. Experiments were carried out in male rats weighing between 180 and 220 g. Rats provided with a standard diet and water ad libitum. All they kept in cages with Wide Square mesh at the bottom and maintained in a well-ventilated animal house with 12 h light and dark cycle. They were fasted for 18 h prior to the experiment, allowing access to water only, and were deprived of both food and water during the 24 h monitoring period of the experiment after the treatment either with the drug or distilled water (control) to minimize the changes in plasma volume.

2.3. Induction of experimental diabetes

Diabetes was induced in the rats by a single intraperitoneal injection of alloxan (150 mg /kg body weight). Since alloxan is capable of producing fatal hypoglycaemia as a result of massive pancreatic insulin release, rats were treated with 20% glucose solution (15–20 ml) intraperitoneally after 6 h. The rats were then kept for the next 24 h on 5% glucose solution bottles in their cages to prevent hypoglycaemia (Stanely Mainzen Prince et al., 1998a). Diabetes was confirmed by the use of an Ames One Touch Glucometer (LifeScan; Johnson and Johnson, New Brunswick, NJ). After 5 days when the condition of diabetes was stabilized, rats with blood glucose range of 200 - 300 mg/dl were selected for the study.

2.4 Experimental procedures

Serum glucose was estimated spectrophotometrically using a commercial assay kit (Diamond, Jordan Ltd.). Blood glucose values were measured on the 1st, 7th, 14th days of the experiment. Rats were divided into five experimental groups of five rats each:

Group 1. Received normal saline, and served as control.

Group 2. Received Apple vinegar orally through intragastric intubation at doses of 2 ml/kg body weight and served as control

Group 3. Diabetic rats received 10 ml/kg tap water and served as diabetic control

Group 4. Diabetic rats received orally apple vinegar 2 ml/kg and served as treated group.

Group 5: Diabetic rats were given glibenclamide 600 μg/kg body weight (Pari and Uma, 1999) in aqueous solution daily using an intragastric tube for 14 days.

2.5 Collection of blood

Blood samples (approx. 0.3 ml) were collected by tail of each rat of a group at 0, 7, 14 days after oral administration of the drug. The samples were collected into plain tubes and allowed to clot, the centrifuged to obtain serum using a bench to centrifuge.

Data and Statistical Analysis

Data was expressed as mean ± standard deviation of means. Statistical analysis was made by using Student's unpaired t-test.

Results

Table 1. Shows mean values of changes in body weight in the treatment and control groups. The Apple Vinegar had no effect on the weight of the studied animals.

Apple Vinegar produced a dose-dependent hypoglycemia in normal rat’s 7.44±0.93 mmol/L. It produced maximum reduction in blood glucose at the 14th day of experiment in comparison with normal control 7.74 ± 0.96 mmol/L (Table 2).

Dose-dependent reduction in blood glucose was also observed in alloxan-induced diabetic rats treated with Apple vinegar. The percent reduction in blood glucose tended to be higher in the diabetic condition compared to the normal state. A significant reduction in blood glucose of diabetic rats 8.3±0.75 mmol/L in case of administration of Apple Vinegar in comparison with diabetic control 24.6±8.45 mmol/L (Table 2). Glibenclamide drug (600μg/kg) produced a significant reduction in blood glucose 12.27 ± 4.77 mmol/L compared to control.

Discussion

Diabetes is growing epidemic around the world, which consider as chronic incurable condition due to insulin deficiency that affects 10% of the population (Abu-zaiton, 2010).Traditional plant medicines are used throughout the world for a range of diabetic complications. The study of such medicines might offer a natural key to unlock a diabetologist's pharmacy for the future (Srinivas at el., 2003).

Apple Vinegar is used traditionally by diabetic patients in Jordan and is taken as different concentrations. Due to this reason the Apple Vinegar was evaluated and the data also confirmed the traditional indications. Studies by Brighenti et al., 2005; Ostman et al., 2005 indicated the antidiabetic activity of the Apple Vinegar which substantiate the results of our studies in rats and rabbits. Moreover, the fact that the Apple Vinegar has a more prolonged effect than the glibenclamide dose after treatment indicates a prolonged duration of antidiabetic action and could be due to multiple sites of action possessed by the active principles of Apple Vinegar.

Alloxan induces diabetes by damaging the insulin secreting cells of the pancreas leading to hyperglycaemia (Stanely et al., 2004)

The cytotoxic action of this diabetogenic agent is mediated by reactive oxygen species, Alloxan and the product of its reduction, dial uric acid; establish a redox cycle with the formation of super oxide radicals. These radicals undergo dismutation to hydrogen peroxide (Colca et al., 1983). Therefore, highly reactive hydroxyl radicals are formed by the Fenton reaction. The action of reactive oxygen species with a simultaneous massive increase in cytosolic calcium concentration causes rapid destruction of ß-cells. (Mansi and Lahham, 2008).

It is well established that sulphonylureas produce hypoglycemia by increasing the secretion of insulin from pancreas and these compounds are active in mild alloxan-induced diabetes whereas they are inactive in intense alloxan diabetes nearly all β-cells have been destroyed (Grodsky et al., 1971).

Since our results showed that the administration of apple vinegar and glibenclamide to diabetic rats restored the level of blood glucose. Alloxan-treated rats receiving the Apple Vinegar showed rapid normalization of blood glucose levels in comparison to control and this could be due to the possibility that some β-cells are still surviving to act upon by Apple Vinegar to exert its insulin releasing effect also glibenclamide reduced blood glucose levels in hyperglycemic animals, the state of diabetes is not severe. Moreover, oral administration of Apple Vinegar produced hypoglycemia in normal animals. This suggests that the mode of action of the active ingredients of Apple Vinegar is probably mediated by an enhanced secretion of insulin, like sulphonylureas (Sakanaka and Ishihara, 2008; Laura et al, 2005).

Furthermore several mechanisms to account for these effects have been proposed, including interference with enzymatic digestion of complex carbohydrate (Ogawa et al., 2000), delayed gastric emptying , and enhanced peripheral glucose uptake and conversion to glycogen (Arline et al., 2009)

Acetic acid is the active ingredient in Apple vinegar, which has been suggested to explain vinegar’s antiglycemic effects. Acetic acid may slow gastric emptying (Johnston et al., 2004) alternatively, acetic acid may inhibit disaccharidase activity in the small intestine blocking the complete digestion of starch molecules or promote glucose uptake by muscle (Carol et al., 2009).

Study carried by Brighent et al., 1995, showed that the insulin response curve was reduced after ingestion of sucrose 20%, when administered with Apple vinegar reduced the glycemic response to a mixed meal by more than 30%. Our results also demonstrated that the Apple Vinegar had a dose-response effect to reduce blood glucose concentration in normal and diabetic rats. The reduction in blood glucose noted in this trial is significant; however, any diet strategy that improves glycemic control is welcomed. Furthermore, the addition of Apple Vinegar to meal plans is simplistic, inexpensive, and appetizing.

Conclusions

Our study clearly indicated a significant antidiabetic activity with the apple vinegar and supports the traditional usage to control of diabetes. Hence it might help in preventing diabetic complications and serve as a good adjuvant in the present armamentarium of antidiabetic drugs.

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Table 1. Mean values of body weights of the different groups of rats (g).

Groups

Inititial body weight

Body weight after 14 d of experiment

Normal control

221.4±14.92

277.6±12.85

Normal+Apple vinegar

210.2±8.37

247.8±24.87

Diabetic control

205.8±8.34

231.2±11.42

Diabetic+Apple vinegar

167.6±6.05

172.33±26.92

Diabetic+Glibenclamide

182.2±3.76

207.8±36.91

Values are given as mean ± S.D. for six rats in each group

Table 2. Blood glucose concentration (mmol/L) of normal and experimental animals.

Groups

0 Day

7 days

14 days

Normal control

6.84 ± 0.65

7.33±1.5

7.74 ± 0.96

Normal + Apple vinegar

8.00±1.93

7.80±1.3

7.44±0.93

Diabetic control

20.4±7.45

22.52±8.65

24.6±8.45

Diabetic+Apple Vinegar

10.30±2.75

9.78±1.98

8.3±0.75

Diabetic+Glibenclamide

13.26±3.77

12.88±2.97

12.27±4.77

Values are given as mean ± S.D. for six rats in each group