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Apple cider vinegar — also known as “ACV” — is a trendy ingredient these days. Personally, I love pouring a big splash of it into an ice-cold glass of fruit-flavored seltzer!

But recently, apple cider vinegar is also being touted as a home remedy for people living with diabetes, with claims suggesting that it can help manage blood sugars and lower A1c levels.

In this article, we’ll discuss the general benefits of apple cider vinegar, examine what research has to say about its impact on blood sugar levels, highlight important precautions for adding it into your diet, and discuss who might need to exercise caution with its regular use.

Glass bottle of apple cider vinegar in front of basket with apples

Key Points

  • Apple cider vinegar is claimed to offer a variety of health benefits, including potential positive effects on blood sugar levels and A1c for people with diabetes, when incorporated alongside other diabetes management practices.
  • Research indicates that ACV can slightly reduce fasting blood sugar levels in people with well-managed type 2 diabetes and improve insulin sensitivity, although its impact on A1c levels appears to be minimal.
  • ACV should be consumed in moderation (around 1 to 2 tablespoons per day, diluted in water or another beverage) due to its high acidity, which can cause damage to the teeth, throat, and stomach if consumed undiluted or in excessive amounts.
  • Certain people, including those with a history of stomach ulcers, gastroparesis, low potassium levels, kidney disease, bulimia, or specific mouth/throat health conditions, should consult with a healthcare professional before adding ACV to their diet.

First, make sure you buy the right apple cider vinegar

Choosing the right apple cider vinegar is crucial for its health benefits. Opt for varieties made through the traditional method of crushing, fermenting, and distilling apples, which preserve the “mother” — a colony of beneficial bacteria vital to the fermentation process. 

“The mother refers to the combination of yeast and bacteria formed during fermentation,” explains the University of Chicago Medicine. “If you look at an apple cider vinegar bottle, you can see strands of the ‘mother’’ floating around.”

“Many people attribute apple cider vinegar’s effects to the ‘mother.’ There’s some truth to this since the mother counts as a probiotic.”

When shopping for ACV, look for a product that is raw, unfiltered, and retains the mother. These characteristics should be clearly indicated on the packaging, preferably a glass container to avoid potential leaching from plastic. 

High-quality ACV can be readily found in the baking section of most grocery stores, as well as from reputable online retailers such as Trader Joe’s and Amazon.

An important note for safe consumption: You should not drink ACV without diluting it in water or another beverage. The high acidity content can damage your teeth, mouth, and throat if consumed regularly without diluting.

General health benefits of drinking apple cider vinegar

Before we discuss how ACV affects blood sugar and A1c (a measure of glucose control over the previous 2 to 3 months) for people living with diabetes, it’s important to explore the broader claims surrounding its general health benefits.

ACV has been around for a long time

ACV has a long history of use, with its applications ranging from food preservation to traditional remedies. 

There are some potential health benefits associated with moderate ACV consumption, supported by preliminary research. These include possible improvements in digestive health, modest effects on weight management, and blood sugar management. 

Nevertheless, it’s essential to approach these claims with a balanced perspective, recognizing that ACV is not a cure-all solution and its effectiveness can vary among individuals. 

As with any supplement or dietary change, it’s important to consider ACV as part of a holistic approach to health, complementing a balanced diet and regular medical care, rather than as a standalone remedy.

Let’s take a look at some of the claims:

Understanding the antimicrobial properties of ACV

ACV is known for its antimicrobial properties, which enable it to inhibit the growth of various microorganisms, including certain bacteria and fungi, much like other natural antimicrobials. 

While ACV does exhibit antibacterial activity as part of its broader antimicrobial effects, it’s crucial to understand that this doesn’t equate to it being a replacement for medical-grade antibacterials or treatments for infections. 

Studies have shown that ACV can act against specific bacteria such as E. coli, Staphylococcus aureus, and Candida albicans in controlled laboratory environments. 

However, these findings do not imply that ACV is an effective or safe treatment for infections caused by these organisms in humans. Always consult with healthcare professionals before considering ACV for medicinal purposes.

Aside from its health-related applications, ACV’s antimicrobial qualities make it a popular choice for eco-friendly household cleaning solutions. Diluting ACV with water creates a natural cleaning agent suitable for surfaces like floors, counters, and bathrooms, offering a mild disinfectant option for those looking to reduce the use of harsh chemicals in their homes. 

Exploring the role of ACV in supporting digestive health

ACV, particularly when raw and unfiltered, includes, as noted above, the mother — a mix of yeast and bacteria involved in the fermentation process.

While these microbial elements contribute to ACV’s unique composition, it’s important to note that they differ from the probiotics found in products like yogurt or kombucha, which are known for their well-documented health benefits to gut health.

The concept of gut health being central to overall well-being is widely recognized, with an imbalance in gut microbiota linked to a range of health issues.

A healthy gut microbiome is crucial for digestion, immune function, and even mental health, influencing conditions such as depression, anxiety, obesity, and various metabolic diseases like diabetes.

However, the direct impact of ACV on gut health and these related conditions is less clear. The fermentation bacteria in ACV do contribute to its acidic properties and may offer some health benefits, but the extent of these benefits, particularly in comparison to those offered by recognized probiotics, remains an area for further research.

Therefore, while incorporating raw, unfiltered ACV into your diet may be beneficial for various reasons, it should not be solely relied upon for probiotic benefits or as a cure for gut health-related conditions.

Apple cider vinegar and diabetes: Can ACV lower blood sugar levels in people with diabetes?

Let’s cut right to the chase: ACV has garnered attention for its potential to modestly lower blood sugar levels in people with diabetes. But while some studies suggest a slight benefit, particularly in managing after-meal glucose levels, it’s important to manage expectations regarding its ability to impact A1c levels.

Research primarily focuses on type 2 diabetes, showing that ACV might complement other diabetes management strategies by providing a modest improvement to blood glucose levels when combined with a healthy diet, regular exercise, and prescribed medications. 

The evidence for ACV’s effectiveness in type 1 diabetes, however, is less clear and warrants further investigation.

In addition to potential blood sugar benefits, ACV may offer other health advantages, although these should be viewed as supplemental to its possible role in diabetes management. 

Let’s take a look at some of the most significant research.

In well-managed type 2 diabetes, drinking ACV before bed was shown to help manage morning blood sugars

A 2021 review and meta-analysis looked at the impact of ACV on blood sugar and lipid (blood fat) levels. 

The study, covering data from nine clinical trials, found that ACV intake could significantly reduce fasting glucose and A1c levels in adults with type 2 diabetes. 

Additionally, a notable decrease in total cholesterol was found, suggesting ACV’s potential in managing both blood sugar and cholesterol levels, which are key factors in cardiovascular health. 

ACV may have a small immediate effect on blood sugar levels

According to a 2018 evaluation of 11 studies involving 278 adults with type 1 or type 2 diabetes, ACV may have a small effect on lowering blood sugar levels in the short term, and especially after-meal blood sugar levels.

In the study, people consuming apple cider vinegar had a lower average difference in their glucose levels at 30 minutes compared to a control group that was not consuming vinegar. At later points in time, however (60, 90, and 120 minutes), average glucose levels were lower in the vinegar group, but not significantly so. 

This suggests that while there may be an immediate effect on blood sugar levels, the effect is minimal and requires further investigation.

12 weeks of drinking ACV showed relatively insignificant reductions in A1c levels

In the same 2018 meta-analysis (analysis of data from several studies) revealed modest improvements in after-meal blood sugar levels, but the reductions in A1c levels were minimal. 

These slight improvements suggest that while ACV may have a supportive role in managing blood sugar levels, it should not be viewed as a substitute for prescribed diabetes medications or an overall lifestyle.

ACV may improve insulin sensitivity

In a 2019 study, 70 participants with type 2 diabetes and high blood lipids consumed 20 milliliters of ACV daily for 8 weeks. 

Results showed significant improvements in fasting blood sugar. 

Measures including insulin and insulin resistance markers also improved significantly in the ACV group compared to controls, suggesting beneficial effects on insulin sensitivity.

ACV may delay stomach emptying and reduce after-meal blood sugar levels

ACV may influence stomach emptying and affect after-meal blood sugar levels. Another 2019 study reviewed multiple clinical trials to understand ACV’s effects on people with type 2 diabetes, with a focus on blood sugar control, lipid levels, and weight management. 

It highlighted ACV’s potential in reducing after-meal blood sugar spikes, possibly by delaying stomach emptying. This includes the slower release of glucose into the bloodstream. 

While this effect might theoretically lessen blood sugar spikes after meals in people without gastroparesis (a condition in which stomach emptying is delayed), it poses a concern for those with gastroparesis, as they already experience significantly delayed and unpredictable digestion. This could complicate insulin timing and dosing. 

Therefore, while ACV might potentially offer some benefits in managing after-meal glucose levels for those without gastroparesis, its use should be carefully considered, especially in people with pre-existing digestive issues.

(Given the small scale of much of the highlighted research, further studies are needed to fully understand the implications of ACV in diabetes and general health.)

If you decide to add ACV to your diet (and who shouldn’t)

While some preliminary research such as the studies outlined above suggests a slight potential for ACV to modestly improve blood sugar levels, it’s important to maintain realistic expectations about its effects, which are likely to be minimal.

If you do decide to add ACV to your diet, either as a possible complement to your standard diabetes management strategies or simply because it’s tasty, there are some important guidelines to keep in mind. 

Remember these three crucial details when consuming ACV:

  • Always dilute it with another beverage (water, seltzer, tea) or by mixing it into your food.
  • Only consume approximately 1 to 2 tablespoons (15 to 30 milliliters) per day (due to individual tolerance, some people may need to start with less).
  • Be aware that consuming too much ACV can wreak havoc on your teeth, throat, and stomach because of its high acidity content.

How to take apple cider vinegar to lower blood sugar:

If you plan to try ACV to lower your blood sugar, experts recommend diluting 1 to 2 tablespoons in a large glass of water and taking it either before a meal or before bedtime.

And remember that ACV should not be used as a substitute for your usual diabetes medications.

Even if the apple cider vinegar is diluted with another liquid (as it always should be), there are some people who may be advised against drinking it all.

If you have any of the following health concerns, talk to your doctor before consuming ACV:

ACV may have some potential small health benefits to offer, and it can be a delicious addition to a salad. Just be sure to manage your expectations with regard to any possible benefits for your diabetes management and to discuss the use of ACV with your healthcare provider prior to adding it to your routine.

Drug interactions

It’s also important to be aware that ACV can potentially interact with a variety of medications, including the following: 

  • Insulin and medications that stimulate the release of (insulin such as those in the sulfonylurea and meglitinide drug classes). This combination has the potential to cause low blood sugar or low potassium levels.
  • Lanoxin (generic name digoxin). Combining this potassium-lowering drug with ACV has the potential to cause low potassium levels.
  • Certain diuretics (water pills). Some diuretics cause the excretion of potassium, which could cause low potassium levels if they are combined with large amounts of ACV.

Speak with your doctor or pharmacist about any medicines you are taking to ensure the use of ACV is safe for you.

Final thoughts

While apple cider vinegar has become a popular natural treatment for various health conditions, its effectiveness in managing diabetes remains a topic of interest rather than a proven solution. 

The research suggests that ACV may have modest benefits in lowering blood sugar levels and improving insulin sensitivity, especially when consumed with high-carbohydrate meals. However, these effects are relatively small and should not be considered a replacement for traditional diabetes management approaches or medications.

If you use it at all, it’s important to approach ACV as a supplementary aid rather than a primary treatment. The potential health benefits, including its antimicrobial properties and probiotic content, make ACV a worthy addition to a balanced diet, but always within the recommended safe amounts and properly diluted.

Before integrating apple cider vinegar into your diabetes management plan, it’s crucial to consult with your healthcare professional to ensure it’s safe and appropriate for your individual health needs. 

And whether you’re managing diabetes or simply looking to maintain good health, it’s essential to focus on evidence-based treatments and practices, keeping in mind that natural approaches like ACV can potentially complement but not replace medical advice and treatment plans.