Apple cider vinegar is generally safe for people with diabetes when it’s consumed in moderate amounts, such as a few tablespoons or less daily.
People with diabetes can consume apple cider vinegar as the risk of adverse effects is low for them. Some research suggests vinegar can actually help with glucose management in people with diabetes — but more research is needed.
Knowing more about the benefits and risks of apple cider vinegar can help you manage your condition in a way that’s most effective for you.
Benefits
Apple cider vinegar might help manage the rise in blood glucose levels after meals and might help improve your fasting blood glucose levels, which refers to your baseline glucose levels when you aren’t eating.
When you eat foods with a high glycemic index (GI), your blood glucose rises faster than if you eat foods with a lower GI. Examples of high glycemic index foods include sugary foods, white bread, and potatoes.
Low or medium GI foods break down more slowly in your body, causing a slower rise in glucose levels. Oats and pulses are examples of these foods.
The body typically releases insulin to bring blood glucose levels down to an optimal level after you eat, preventing spikes. But with diabetes, the body doesn’t release insulin at all or doesn’t release enough insulin to help glucose levels. Eating lower GI foods can help keep blood sugar levels in a healthy range.
What the research says
The relationship between vinegar, including apple cider vinegar, and the body’s ability to process high GI foods has been studied widely.
A 2019 narrative review of research suggests taking 2–6 tablespoons (tbs.) of vinegar (acetic acid) per day can improve the body’s glycemic response to high carbohydrate meals.
A 2019 randomized controlled trial noted that a daily intake of 20 milliliters, or 4 teaspoons (tsp) of apple cider vinegar improved fasting blood sugar and blood sugar in people with type 2 diabetes.
A 2018 systematic review of studies on the effects of different types of vinegar, including apple cider vinegar, on blood glucose indicates that vinegar might have significant benefits. Vinegar might slow the digestion of complex carbohydrates, leading to smaller rises in glucose levels after eating.
It might also improve insulin release from the pancreas and glucose intake into the muscles.
Finally, a 2021 systematic review and meta-analysis of controlled trials noted apple cider vinegar decreased fasting glucose levels in the plasma (found in the blood) when taken for 8 weeks or more. There was no effect on fasting insulin concentrations.
Although these results are promising, researchers note the need for larger clinical trials to provide more conclusive evidence of the benefits of vinegar for people with diabetes.
Possible risks
Apple cider vinegar is generally safe when taken in recommended amounts. Research studies have looked at dosages such as 4 tsp and 2–6 tbs, per day.
But consuming apple cider vinegar can have side effects, and it’s a good idea to proceed with a little bit of caution. Some side effects include:
- Damaging teeth enamel: Consider diluting the apple cider vinegar or drinking water after taking it. It’s a harsh substance that can damage your teeth.
- Worsening of acid reflux: This is when stomach acid backs up into your esophagus. Acidic substances such as vinegar can make acid reflux worse.
- Inability of the kidneys to process the acid: This is a risk specific to people who have chronic kidney disease.
If you have any side effects you think might be connected to apple cider vinegar, you might want to stop taking it and speak with a healthcare professional.
Other treatments
People with type 1 diabetes need to take insulin regularly. You might also use other injectable or oral medications to help manage the condition. People with type 2 diabetes might also take oral or injectable medications for diabetes management, and you’re likely to be recommended lifestyle strategies such as weight loss as well.
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- Alpha-glucosidase inhibitors: Miglitol (Glyset) and acarbose (Precose) slow your body’s digestion of sugar.
- DPP-4 inhibitors: Examples such as alogliptin (Nesina) help your body release insulin.
- Sulfonylureas: Glimepiride (Amaryl) and glipizide (Glucotrol) help your body make insulin.
- Biguanides: Examples such as metformin (Riomet) reduce sugar production from the liver and help your body use sugar.
- GLP-1 receptor agonists: Examples such as semaglutide (Ozempic) and dulaglutide (Trulicity) help the body make more insulin and slow food digestion.
- Amylin analogs: Examples such as Symlipen slow food digestion after a meal.
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Summary
Large-scale research is still needed to show conclusively that apple cider vinegar can help manage blood sugar in diabetes. But recent studies look promising.
A few tablespoons of vinegar daily might manage glucose spikes after eating and contribute to a lower fasting blood glucose level. Side effects of apple cider vinegar include tooth erosion, so you might want to consider drinking diluted vinegar or drinking water immediately after vinegar consumption.
Even though research is somewhat inconclusive regarding apple cider vinegar and its benefits in diabetes, the risk of side effects is low, and the effects are generally mild. This means it might be worth trying to see if you notice any benefits. If you’re concerned, always consult with a healthcare professional.
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