Can Ginger Be Beneficial for Diabetes Management?

The number of people with diagnosed diabetes has reached “epidemic” proportions.1 Diabetes can lead to various complications including retinopathy, heart attack, stroke, diabetic nephropathy, nerve damage, and sexual problems in both men and women.2 Each year, the number of people exposed to these risks increases dramatically. In 2004,3 experts projected that the global number of people with diabetes would rise from 171 million in 2000 to 366 million in 2030. However, the International Diabetes Federation4 reported that there were 151 million people with diabetes worldwide in 2000 and projected a number of 536 million in 2021. This is significantly higher than the estimated number for 2030, surpassing it by over 150 million. The pharmaceutical industry is now racing to find drug interventions due to the growing number of people with diabetes and obesity. The most recent drug, Wegovy (semaglutide), received FDA approval5 with the intention of increasing weight loss. Wegovy is said to work by suppressing a person’s natural appetite, leading to fewer calorie intake and subsequent weight loss.6 Novo Nordisk, the manufacturer of Wegovy, has imposed limits on the number of doses patients can use. This is because the demand for the drug currently exceeds the company’s manufacturing capacity.7 However, the medication comes with a boxed warning about the risk of thyroid C-cell tumors, including medullary thyroid carcinoma, in animal models. There are also serious side effects associated with the drug, including anxiety, blurred vision, confusion, depression, difficulty swallowing, seizures, slurred speech, and trouble breathing.8 Wegovy lists additional potential side effects such as pancreatitis, low blood sugar, kidney failure, increased heart rate, and thoughts of suicide. As the pharmaceutical industry develops drugs that require additional drugs to treat the side effects of the initial drug, researchers have discovered that antioxidants like ginger may help lower blood sugar, reduce insulin resistance, and improve insulin sensitivity. Combining ginger with behavior modification strategies, such as eating less and exercising more, may be sufficient to achieve desired goals. Dr. Michael Greger, the founder of NutritionFacts.org, explains in a video that there is mounting scientific evidence supporting the use of ginger to lower blood sugar and improve insulin sensitivity.9 He refers to a case report of a 45-year-old businessman from Austria who successfully stopped using diabetes medication by changing his diet and incorporating specific nutritional ingredients.10 This businessman was able to discontinue oral medication after four weeks and achieve hemoglobin A1c levels of 6.4% after three months and 6.0% after six months. Normal hemoglobin A1c levels for individuals without diabetes are below 5.7%, while levels between 5.7% and 6.4% indicate prediabetes.11 The report highlighted that multiple drug therapies are typically required to manage glucose levels in diabetes patients. Ginger is not only potentially effective in treatment but also in prevention. In a 2014 study,12 researchers found that ginger compounds exhibited a blood sugar uptake comparable to the diabetes drug metformin when tested on muscle cells in a petri dish. While these studies have shown promise in rodent models, human trials are necessary to establish efficacy in human health. In a 2013 randomized double-blind placebo-controlled trial,13 64 patients with Type 2 diabetes received either ginger or a placebo. The data suggested that ginger supplementation improved insulin sensitivity and certain aspects of lipid profile in patients with Type 2 diabetes. Researchers14 also monitored the effect of 1,600 mg of ginger over 12 weeks in participants with Type 2 diabetes and observed improvements in fasting plasma glucose, HbA1C, insulin, triglycerides, and C-reactive protein levels. The researchers concluded that ginger could be considered an effective treatment for preventing diabetes complications. Another study16 examined the effects of ginger over eight weeks using a higher dose. The results showed that consuming a capsule with 3 grams of ginger powder for eight weeks helped lower fasting blood sugar and hemoglobin A1c levels while improving insulin resistance. In a similar study17, participants with Type 2 diabetes received 2 grams of ginger powder per day and experienced significant reductions in fasting blood sugar, hemoglobin A1c levels, and other biomarkers compared to baseline and the control group. Greger also presented18 findings from a study19 where participants received 3 grams of ginger powder, showing improvements in glucose and hemoglobin A1c levels in the intervention group, while the biomarkers in the control group worsened. Chronic inflammation is a common feature of many diseases, including obesity, cancer, and heart disease. While inflammation is a normal and beneficial response to protect the body against foreign invaders, chronic inflammation has the opposite effect. Diet plays a significant role in this process and can be a starting point for addressing inflammation. Ginger is known for its anti-inflammatory properties and can be included in a diet to help lower inflammation. However, simply adding ginger to a diet cannot counteract the effects of consuming a highly processed, high-carbohydrate diet or one high in refined sugar and omega-6 linoleic acid. A crucial aspect of reducing inflammation involves excluding refined vegetable oils, as they are considered harmful. By avoiding processed foods and most restaurant meals, one can significantly reduce their intake of these oils. Another important dietary change is eliminating seed oils, as excessive consumption of omega-6 linoleic acid is believed to play a major role in the development of chronic diseases by limiting mitochondrial function and energy production in cells. A 2012 paper20 reported that clove, ginger, rosemary, and turmeric were all effective in reducing the expression of tumor necrosis factor (TNF-α), a cytokine involved in systemic inflammation induced by oxidized LDL. Ginger specifically demonstrated the ability to lower three inflammatory biomarkers, indicating superior anti-inflammatory action. Inflammation also contributes to the perception of pain. Scientific evidence shows that ginger extract can help alleviate pain in various situations. A study21 conducted in 2001 found that a highly purified and standardized ginger extract had a statistically significant effect in reducing symptoms of knee osteoarthritis (OA). The study concluded that the effect was moderate, and adverse events in the ginger extract group were mostly mild gastrointestinal (GI) issues. Another study22 published in 2018 in the Taiwanese Journal of Obstetrics and Gynecology compared ginger to Novafen, a nonsteroidal anti-inflammatory drug (NSAID), and found that ginger was equally effective in relieving menstrual pain in women with primary dysmenorrhea. The researchers recommended using natural herbal medicine, like ginger, for reducing primary dysmenorrhea. Ginger has also demonstrated properties23 that improve pain relief, including reducing inflammation and pain associated with osteoarthritis, providing benefits for participants with migraines, and exhibiting pain reduction when used in Swedish massage with aromatic ginger oil. An analysis24 of the main components of ginger, 6-gingerol and 6-shogaol, demonstrated their analgesic effects. Gingerols and shogaols have medicinal properties and including them in nutraceutical formulations may help protect against heart disease, diabetes, and liver disorders.25 Spices like ginger also have a favorable effect on the gut microbiome, which in turn affects the development and management of diabetes.26 A cross-sectional study27 found that a higher microbiome alpha diversity, along with an abundance of butyrate-producing gut bacteria, was associated with lower rates of type 2 diabetes and reduced insulin resistance in individuals without diabetes. In 2022,28 researchers demonstrated that cinnamon, ginger, oregano, black pepper, and cayenne pepper positively influenced gut bacterial composition after four weeks in adults at risk for cardiovascular disease. The researchers from Penn State29 concluded that a diverse gut microbiome promoted better health compared to individuals with less bacterial diversity. The study specifically noted an increase in the beneficial Ruminococcaceae bacterial group, which aids immune function and liver metabolism. The enrichment of the Ruminococcaceae family has also been linked to suppressed long-term weight gain and diet-induced obesity.30 The study also observed an increase in Faecalibacterium and Agathobacter genus, known to produce anti-inflammatory short-chain fatty acids (SCFAs) like butyrate and propionic acid. These SCFAs contribute to strengthening the gut barrier and reducing the permeability of disease-causing microorganisms.31

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