Apple cider vinegar has become increasingly popular as a health supplement in recent years. Some research suggests that it may provide benefits for blood sugar control and weight management. For people with diabetes, apple cider vinegar is often claimed to improve insulin sensitivity and lower blood sugar levels.
However, the evidence behind these claims is mixed. While some studies have shown a modest blood sugar lowering effect, others have shown no impact. Overall, more research is still needed on the effects of apple cider vinegar in diabetics.
This article will provide an overview of the current evidence on apple cider vinegar and diabetes. It will look at possible benefits, optimal dosage, safety concerns, and potential side effects to help diabetics determine if and how much apple cider vinegar they should consume.
What is Apple Cider Vinegar?
Apple cider vinegar is made by fermenting apple cider. This fermentation process produces acetic acid, which is the main active component in vinegar. Acetic acid makes up about 5–6% of apple cider vinegar.
Apple cider vinegar also contains small amounts of other acids, vitamins, minerals, and polyphenols, which are antioxidants. Unfiltered, unpasteurized apple cider vinegar contains a substance called the “mother”, which consists of strands of enzymes, proteins, and friendly bacteria.
Some people believe the “mother” adds extra health benefits, although there is limited evidence supporting this.
Possible Benefits for Diabetes
Several potential benefits have been proposed for using apple cider vinegar in diabetes:
May improve insulin sensitivity
Insulin resistance occurs when your cells stop responding properly to the hormone insulin. This causes higher blood sugar levels.
Some studies suggest vinegar may improve insulin sensitivity after meals in insulin resistant people. One study found taking 2 tablespoons of apple cider vinegar at bedtime improved insulin sensitivity by 34% in people with type 2 diabetes (1).
Another study showed improved insulin sensitivity and lower fasting blood sugars in people who took 2 tablespoons of vinegar before meals (2).
Can lower fasting blood sugar levels
In several studies, vinegar has also been found to decrease fasting blood sugar levels in people with prediabetes and diabetes.
In one study, taking 2 tablespoons of apple cider vinegar before bed lowered fasting blood sugar by 4% in people with prediabetes after 12 weeks (3).
Other studies combining vinegar with carb-containing meals have shown reductions in post-meal blood sugar of 6–25% in people with prediabetes or diabetes (4, 5).
May support weight loss
Limited evidence suggests vinegar may also promote weight loss and belly fat reduction.
In one study, taking 1–2 tablespoons of apple cider vinegar per day for 3 months caused moderate weight loss of 2.6–3.7 pounds (1.2–1.7 kg) and a 0.9% decrease in body fat (6).
Another 3-month study showed that drinking 1 to 2 tablespoons of apple cider vinegar each day reduced belly fat and weight in overweight people (7).
Weight loss may help improve insulin resistance and blood sugar levels.
Slows starch digestion
Vinegar has been shown to reduce the glycemic response to starchy foods like bread, pasta, or potato. This may support slower absorption of sugar into the blood (8).
Slower starch digestion may be useful for controlling post-meal spikes in blood glucose.
How Much Should You Take?
Most studies investigating vinegar and diabetes have used 1–2 tablespoons (15–30 ml) of apple cider vinegar per day. This amount has been shown to provide some benefits for blood sugar and weight control.
Taking 1–2 tablespoons (15–30 ml) mixed with water once or twice per day appears safe for most people.
It’s best to start with 1 teaspoon (5 ml) and gradually increase the dosage to assess your tolerance.
Apple cider vinegar has a strong, pungent taste, so many people prefer to drink it diluted with water. It can also be added to salad dressings, sauces, soups, or smoothies.
When to take it
The timing of when you take apple cider vinegar appears to affect the potential blood sugar lowering benefits.
Several studies showed the best results when vinegar was consumed just before a high carb meal.
Taking apple cider vinegar right before bedtime also seems to improve overnight insulin sensitivity and fasting blood glucose levels.
To maximize the benefits on blood sugar levels, try taking:
- 1-2 tablespoons (15-30 ml) mixed with water before a high carb meal like breakfast or dinner
- 1-2 tablespoons (15-30 ml) mixed with water before bedtime
Dosage Considerations
It’s important to note the serving size when taking apple cider vinegar.
Many commercial apple cider vinegar drinks or gummies contain only very small amounts of apple cider vinegar per serving. For example, 1 tablespoon or less.
Research suggests 1-2 tablespoons (15-30 ml) per dose is required to get results for blood sugar levels or weight loss.
Read labels carefully and look for products that provide at least 15 ml of apple cider vinegar per serving.
Should you take apple cider vinegar pills?
Apple cider vinegar pills or tablets have become a popular supplemental form of vinegar. However, there is limited evidence on whether apple cider vinegar pills provide the same benefits as liquid vinegar.
One study found vinegar pills may improve post-meal blood sugar levels. However, the pills contained a higher dose of acetic acid than vinegar, so it’s unclear if the results would apply to vinegar specifically (9).
More studies are needed comparing vinegar pills or tablets to the liquid form before conclusions can be made.
Safety and Side Effects
Drinking diluted apple cider vinegar as part of the diet is generally safe. However, there are some things to keep in mind.
Enamel erosion
Apple cider vinegar is acidic, with a pH around 3. Due to its high acidity, vinegar may erode tooth enamel if swished around the mouth. It’s best to dilute apple cider vinegar and avoid taking it undiluted.
After taking it, rinse your mouth with plain water to minimize the acidity remaining on your teeth.
Throat irritation
Apple cider vinegar may also cause throat irritation or reflux symptoms in some people. It’s best to start with a small amount diluted in water to assess your tolerance.
Drug interactions
Vinegar can interact with some medications, including diuretics, insulin, and laxatives. Speak with your doctor before starting apple cider vinegar if you take any prescription medications.
Vinegar may amplify the blood sugar lowering effects of diabetes medications. Monitor your blood sugar levels closely when starting vinegar to avoid hypoglycemia.
Gastrointestinal symptoms
Some people report nausea or upset stomach at higher doses of vinegar. Start with a small amount diluted in water to minimize side effects.
Vinegar is also highly acidic and can irritate existing ulcers or reflux.
Low potassium
There are some case reports of low potassium levels (hypokalemia) occurring in people taking apple cider vinegar. This can be dangerous for people taking medications that already lower potassium.
If you have kidney disease or are taking potassium-lowering drugs, talk to a doctor before starting apple cider vinegar.
Erosion of tooth enamel
Apple cider vinegar is highly acidic. Regularly drinking it undiluted or swishing it around the mouth can erode tooth enamel over time.
To protect your teeth, dilute apple cider vinegar and avoid taking it undiluted. Rinse your mouth with plain water after drinking it.
Who Should Avoid Apple Cider Vinegar?
While vinegar is safe for most people in moderation, the following groups should exercise caution or avoid it:
- People with gastroparesis. Vinegar may delay stomach emptying.
- Anyone with ulcers or reflux issues. Vinegar can irritate these conditions.
- Individuals at risk of low potassium, such as those taking loop diuretics.
- People with kidney disease.
- People taking medications that can interact with vinegar, including insulin, digoxin, laxatives, and certain blood pressure drugs.
- People with damaged tooth enamel. Vinegar can further erode enamel.
Speak with your healthcare provider before starting apple cider vinegar if you have any concerns.
Should You Drink Apple Cider Vinegar if You Have Diabetes?
Based on the current evidence, apple cider vinegar may provide some benefits for blood sugar control and weight management in people with prediabetes or type 2 diabetes.
However, there are no miracle cures for diabetes. The strongest evidence supports using apple cider vinegar as an additive to a healthy diet and active lifestyle.
Vinegar should not be relied upon as the sole strategy for managing diabetes. Work with your healthcare team to create an integrated plan that also includes exercise, nutrition, medication, and stress management.
To add vinegar to your regimen:
- Take 1–2 tablespoons (15–30ml) diluted with water up to twice per day, before meals or bedtime.
- Monitor blood sugar closely for interactions with diabetes medication and to prevent low blood sugar.
- Use it as an addition to a balanced diet and healthy lifestyle.
- Stop use if it causes throat irritation, nausea, erosions, or worsened blood sugar control.
- Avoid taking undiluted shots for safety and to protect your tooth enamel.
At the end of the day, speak to your doctor to determine if apple cider vinegar is a helpful supplemental strategy for you.
The Bottom Line
In summary, the current evidence suggests 1–2 tablespoons (15–30 ml) of apple cider vinegar per day may:
- Improve insulin sensitivity and lower fasting blood sugar in some individuals with insulin resistance.
- Lower blood sugar when taken with high carb meals.
- Promote moderate weight loss.
However, some studies show no effect, so more research is still needed. Vinegar should always be used as an addition to a healthy lifestyle, not a cure-all remedy.
To incorporate apple cider vinegar into your diabetes management, use 1–2 tablespoons (15–30 ml) diluted with water up to twice per day with meals or before bedtime. Monitor your blood sugar closely and work with your healthcare provider to determine if vinegar fits into your diabetes treatment plan.
Frequently Asked Questions
Is apple cider vinegar good for diabetics?
Some research shows apple cider vinegar may improve insulin sensitivity and lower blood sugar levels in people with prediabetes or diabetes. However, not all studies have found a benefit. More evidence is still needed. Vinegar should not replace standard diabetes care or other healthy habits.
What are the side effects of apple cider vinegar?
Potential side effects of apple cider vinegar include erosion of tooth enamel, throat irritation, nausea, and decreased potassium levels. It may also interact with certain medications. Diluting apple cider vinegar and consuming it in moderation reduces the risk of side effects.
Can I drink apple cider vinegar at night?
Drinking 1–2 tablespoons (15–30ml) of diluted apple cider vinegar at night may improve overnight blood sugar control and insulin sensitivity. However, it may worsen reflux or interact with certain blood pressure medications taken at night. Check with your doctor if you take medications.
How much apple cider vinegar should I drink per day?
Most research uses a dosage of 1–2 tablespoons (15–30 ml) of apple cider vinegar per day. This amount, either taken before meals or bedtime, may provide benefits for blood sugar levels and weight management. Start with 1 teaspoon (5 ml) diluted with water and gradually increase to assess your tolerance.
When should you drink apple cider vinegar when you have diabetes?
The best times to take apple cider vinegar for diabetes are before meals containing carbs or before bedtime. Taking 1–2 tablespoons (15–30ml) diluted with water before breakfast, dinner, or bedtime may provide the greatest benefits for blood sugar and insulin levels.
Is apple cider vinegar a cure for diabetes?
No, there are no cure-all remedies for diabetes. While vinegar may support blood sugar control, it should not replace diabetes medication or other healthy habits advised by your doctor. Vinegar is an adjunct, not a cure. Work with your healthcare team to create a comprehensive diabetes management plan.
