title: Vinegar Consumption Increases Insulin-Stimulated Glucose Uptake by the Forearm Muscle in Humans with Type 2 Diabetes.
abstract: OBJECTIVE
  Vinegar has been shown to have a glucose-lowering effect in patients with glucose abnormalities. However, the mechanisms of this effect are still obscure. The aim of this randomised, crossover study was to investigate the effect of vinegar on glucose metabolism in muscle which is the most important tissue for insulin-stimulated glucose disposal.
  
  
  METHODS
  Eleven subjects with DM2 consumed vinegar or placebo (at random order on two separate days, a week apart), before a mixed meal. Plasma glucose, insulin, triglycerides, nonesterified fatty acids (NEFA), and glycerol were measured preprandially and at 30-60 min for 300 min postprandially from the radial artery and from a forearm vein. Muscle blood flow was measured with strain-gauge plethysmography. Glucose uptake was calculated as the arteriovenous difference of glucose multiplied by blood flow.
  
  
  RESULTS
  Vinegar compared to placebo (1) increased forearm glucose uptake (p = 0.0357), (2) decreased plasma glucose (p = 0.0279), insulin (p = 0.0457), and triglycerides (p = 0.0439), and (3) did not change NEFA and glycerol.
  
  
  CONCLUSIONS
  In DM2 vinegar reduces postprandial hyperglycaemia, hyperinsulinaemia, and hypertriglyceridaemia without affecting lipolysis. Vinegar's effect on carbohydrate metabolism may be partly accounted for by an increase in glucose uptake, demonstrating an improvement in insulin action in skeletal muscle. This trial is registered with Clinicaltrials.gov NCT02309424.
authors.affiliation: Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), 3 Ploutarchou Street, 10675 Athens, Greece.
authors.forename: Panayota
authors.initials: P
authors.lastname: Mitrou
authors.affiliation: 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: Eleni
authors.identifier: 0000-0002-3944-1415
authors.initials: E
authors.lastname: Petsiou
authors.affiliation: 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: Emilia
authors.identifier: 0000-0002-7753-8154
authors.initials: E
authors.lastname: Papakonstantinou
authors.affiliation: Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), 3 Ploutarchou Street, 10675 Athens, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Maratou
authors.affiliation: 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: Vaia
authors.initials: V
authors.lastname: Lambadiari
authors.affiliation: Department of Water Resources and Environmental Engineering, School of Civil Engineering, NTUA, Heroon Polytechniou 5-9, 15780 Athens, Greece.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Dimitriadis
authors.affiliation: 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: Filio
authors.initials: F
authors.lastname: Spanoudi
authors.affiliation: Hellenic National Center for Research, Prevention and Treatment of Diabetes Mellitus and Its Complications (HNDC), 3 Ploutarchou Street, 10675 Athens, Greece ; 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: Sotirios A
authors.initials: SA
authors.lastname: Raptis
authors.affiliation: 2nd Department of Internal Medicine and Research Institute, Athens University Medical School, Attikon University Hospital, 1 Rimini Street, 12462 Haidari, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Dimitriadis
mesh_terms: D019342:Acetic Acid / Q000008:administration & dosage*; D001786:Blood Glucose / Q000378:metabolism; D018592:Cross-Over Studies; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D005542:Forearm; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000097:blood*; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000378:metabolism; D019518:Postprandial Period; D012039:Regional Blood Flow / Q000187:drug effects
chemical_list: D001786:Blood Glucose; D007328:Insulin; D008055:Lipids; D005947:Glucose; D019342:Acetic Acid