Introduction: Cinnamon is currently marketed as a remedy for obesity, glucose intolerance, diabetes mellitus and\ndyslipidaemia. Integrative medicine is a new concept that combines conventional treatment with evidence-based\ncomplementary therapies.\nAim: The aim of this review is to critically evaluate the experimental evidence available for cinnamon in improving\nglycaemic targets in animal models and humans.\nResults: Insulin receptor auto-phosphorlylation and de-phosphorylation, glucose transporter 4 (GLUT-4 ) receptor\nsynthesis and translocation, modulation of hepatic glucose metabolism through changes in Pyruvate kinase (PK)\nand Phosphenol Pyruvate Carboxikinase (PEPCK), altering the expression of PPAR (�³) and inhibition of intestinal\nglucosidases are some of the mechanisms responsible for improving glycaemic control with cinnamon therapy.\nWe reviewed 8 clinical trials that used Cinnamomum cassia in aqueous or powder form in doses ranging from\n500 mg to 6 g per day for a duration lasting from 40 days to 4 months as well as 2 clinical trials that used\ncinnamon on treatment na�¯ve patients with pre-diabetes. An improvement in glycaemic control was seen in\npatients who received Cinnamon as the sole therapy for diabetes, those with pre-diabetes (IFG or IGT) and in\nthose with high pre-treatment HbA1c. In animal models, cinnamon reduced fasting and postprandial plasma\nglucose and HbA1c.\nConclusion: Cinnamon has the potential to be a useful add-on therapy in the discipline of integrative medicine\nin managing type 2 diabetes. At present the evidence is inconclusive and long-term trials aiming to establish the\nefficacy and safety of cinnamon is needed. However, high coumarin content of Cinnamomum cassia is a concern,\nbut Cinnamomum zeylanicum with its low coumarin content would be a safer alternate.
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