Complementary Therapies in Medicine (2014) 22, 916

Available online at www.sciencedirect.com

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journal homepage: www.elsevierhealth.com/journals/ctim

The effect of ginger powder

supplementation on insulin resistance and
glycemic indices in patients with type 2
diabetes: A randomized, double-blind,
placebo-controlled trial
Hassan Mozaffari-Khosravi a,, Behrouz Talaei a,
Beman-Ali Jalali b, Azadeh Najarzadeh a,
Mohammad Reza Mozayan c

a
Department of Nutrition, Faculty of Health, Yazd Diabetes Research Center, Shahid Sadoughi University of
Medical Sciences, Yazd, Iran
b
Department of Biochemistry, Faculty of Medical Sciences, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran
c
Department of English Language, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences,
Yazd, Iran
Available online 8 January 2014

KEYWORDS Summary
Objective: To identify the effect of some herbal products on insulin resistance. Regarding the
Ginger;
scientic evidences existing about ginger, this research was therefore carried out to identify
Diabetes mellitus;
the effect of ginger supplementation on insulin resistance and glycemic indices in diabetes
Insulin resistance
mellitus.
Methods: This is a randomized, double-blind, placebo-controlled trial in which 88 participants
affected by diabetes were randomly assigned into ginger (GG) and placebo (PG) groups. The
GG received 3 one-gram capsules containing ginger powder whereas the PG received 3 one-
gram microcrystalline-containing capsules daily for 8 weeks. HbA1c, fructosamine, fasting blood
sugar (FBS), fasting insulin, homeostasis model assessment insulin resistance index (HOMA-IR),
-cell function (%), insulin sensitivity (S%) and the quantitative insulin sensitivity check index
(QUICKI) were assessed before and after the intervention.
Results: FBS mean showed a decrease of 10.5% (p = 0.003) in the GG whereas the mean had
an increase of 21% in the PG (p = 0.01). Variation in HbA1c mean was in line with that of FBS.
Statistical difference was found in the two groups before and after the intervention in terms of
median of fasting insulin level, S% and HOMA-IR (P < 0.005). Moreover QUICKI mean increased
signicantly in the two groups, the mean difference, however, was signicantly higher in the
GG.

Corresponding author. Tel.: +98 351 7249333; fax: +98 351 7258413.
E-mail address: mozaffari.kh@gmail.com (H. Mozaffari-Khosravi).

0965-2299/$ see front matter 2014 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.ctim.2013.12.017
10
Conclusions: The study demonstrated that daily consumption of 3 one-gram capsules of ginger
powder for 8 weeks is useful for patients with type 2 diabetes due to FBS and HbA1c reduction
and improvement of insulin resistance indices such as QUICKI index.
2014 Elsevier Ltd. All rights reserved.
Introduction
Diabetes mellitus (DM) is a disease which is diagnosed by
increase in blood sugar concentration. This can be due to
deciency of insulin secretion or of insulin function or both.
Patients with diabetes are estimated to amount to more than
366 million in 2030 being more than twice of the rate in
2000.1 Most of the new cases will be from the developing
countries and seemingly Middle East will suffer most from
diabetic prevalence till 2020.1,2 The prevalence of type 2
diabetes is high in the Middle East; the rate of 7.7% has been
reported for Iran.3 In another study in Iran, the rate has been
estimated 8.7% in 1564 years old population.4 This type of
diabetes has been estimated to be 14.2% from +30 y which
is the highest in Yazd, Iran.5
Insulin resistance has an important role in causing type
2 diabetes and the resultant cardiovascular disease and is
an independent risk factor for cardiovascular diseases even
in nondiabetic patients.6 Insulin resistance which exists in
all patients with type 2 diabetes is dened as cells inef-
ciency in uptake of glucose from blood in the presence of
insulin. This rst causes increase in insulin secretion and
later insufciency of pancreas in overcoming insulin resis-
tance which nally leads to diabetes symptoms.7 In other
words, insulin resistance is a metabolic condition in which
tissues response to physiologic rate of insulin is lower than
normal.8
The prevalence of DM in the developing countries of the
Middle East gives credence to the urgency of nding new
treatment strategies. Virtually about 3/4 of the people of
the world have trust in traditional treatments especially
herbal treatments; until the mid-19th century at least 8%
of the medicines were herbal derivatives.9
Ginger plant, with the scientic name of Zingiber Ofci-
nale is a highly-utilized spice in the world and has been in use
for more than 2500 years in China traditional medicine for
treating problems such as rhinitis, rheumatism, nervous sys-
tem diseases, gingivitis, toothache, asthma, constipation,
diabetes,10 maldigestion, diarrhea, nausea and vomiting,
cardiopathy, hypertension and palpitation.9
Ginger is a herb, the herbal properties of which are
similar to non-steroid anti-inammatory drugs (NSAIDs),
therefore, it can regulate biochemical pathways which are
activated with chronic inammation such as diabetes.11
Laboratory studies have shown that ginger bears anti-
inammatory effect which can prevent arachidonic acid
metabolism with inhibition of cyclooxygenase and lipooxy-
genase pathways.12,13 As a result, there is the possibility of
ginger having this effect due to inhibition of prostaglandins
and leukotrienes production.14
Gingerols are one of the ginger active components which
inhibit production of inammation-causing prostaglandins.15
One of the possible effects of ginger is inhibition of hepatic
phosphorylase to reduce hepatic glycogenolysis and to
increase activity of the enzymes which cause progression
H. Mozaffari-Khosravi et al.
of glycogenesis. Another possible effect of ginger can be
inhibition of the activity of hepatic glucose-6-phosphatase
enzyme thereby causing reduction of blood glucose.16
In a study conducted by Shirdel et al. in Iran (2009), the
antidiabetic and antilipidemic effects of ginger on diabetic
mice were affected by aloxanmonohydrate and their com-
parison with glibenclamide was investigated the results of
which represented a signicant decrease of serum glucose by
ginger in the diabetic mice.17 In another study accomplished
by Singh et al. (2009) in India, the blood glucose lower-
ing, lipid lowering, and antioxidant effect of [6]-gingerol in
type 2 diabetic db/db mice was investigated.18 Also Goyal
et al. (2006) in India produced signicant reduction in body
weight, glucose, insulin and lipid concentration as compared
to controlled obese mice.19
Despite different scientic evidences there is no agree-
ment regarding various ginger effects and few studies to
date have been conducted on ginger and its relation with
insulin resistance in patients with diabetes. This study was,
therefore, carried out to determine the effect of ginger
powder supplementation on insulin resistance and glycemic
indices in patients with type 2 diabetes.
Material and methods
Type of study, participants and sample size
This is a randomized, double-blind, placebo-controlled trial
with the participation of 88 patients with type 2 dia-
betes conducted in Yazd Diabetes Research Center between
January to July 2012. Considering = 0.05, power of the test
equal to 80%, and achieving two units of signicant differ-
ences between groups in mean insulin resistance, sample
size was estimated to be 40. Assuming a10% attrition, 44
patients in each group were included.
Inclusion criteria were: Having type 2 diabetes for at
least 10 years, FBS <180 and 2 h-blood-sugar <250 mg/dl, no
pregnancy or lactation, no autoimmune disorder, no cardiac
ischemic or renal diseases, no thyroid and chronic inam-
matory diseases, peptic ulcer and infection, no regular
consumption of ginger or other herbal drugs, no sensitivity
to ginger, body mass index (BMI) <40 kg/m2 , no consumption
of triglyceride or cholesterol-, estrogen-, progesterone-
lowering drugs, and no consumption of any supplements such
as vitamin C, E, and omega 3 during 2 months before starting
the research.
Exclusion criteria were: No observation of research pro-
tocol (no consumption of more than 20% of the capsules),
any sensitivity due to ginger consumption reported by the
patient or noticed after the outset of the study, consump-
tion of vitamin, mineral or other nutritional supplements,
consumption of alcohol or narcotic drugs, and any variation
in patients routine treatment according to physicians res-
olution (i.e., variation in type and dose of the drugs to be
consumed, and treatment with insulin).
Ginger supplementation and insulin resistance in diabetes mellitus
Dose, type of supplement, and intervention
duration
The patients were categorized into 2 groups of ginger (GG)
and placebo (PG) through table of random numbers, the GG
consumed daily 3 one-gram capsules containing ginger pow-
der whereas the other group received capsules of the same
color and number as GG but containing cellulose microcrys-
talline, both after taking meals and for 8 weeks.
The researchers gained access to these supplements by
Bou-Ali Sina herbal drug Researchers Corporation in Ghom,
Iran. Follow-up of the patients so as to control them for con-
sumption of capsules, response to the relevant questions,
and prevention of sample loss, was performed weekly by
phone and every other week via monitoring the patients
referring to Yazd Diabetes Research Center to receive cap-
sules for the couple of weeks to come.
Note that not all the supplements were totally delivered
to the participants. To be assured of the consumption of sup-
plement and placebo by the participants and calculation of
rate of capsules consumption compliance, the participants
were asked to rst deliver the empty boxes of capsules and
then receive the new ones needed for the next two weeks.
The participants were also advised not to change their usual
diet, to stop self-reliant changes of their supplements doses,
to stop physical activities during the intervention, and to
stop consuming other ginger products.
Measurements
General information including age, weight, height, gender,
marital status, occupation, education, duration of being
affected by the disease, type and dose of the drugs required
for diabetes control, were all accessed and recorded through
interview with the patients. Weight of the patients with light
clothing but without shoes, was measured through a balance
with 100 g accuracy; height, in standing position and without
shoes, was measured through a height-measurer with 0.5 cm
accuracy both at the beginning and the 8th week of the inter-
vention. Body mass index (BMI) was calculated by weight
(kg) divided by height squared (m). To study the patients
diet in terms of daily intake of energy, carbohydrate, pro-
tein, ber, and total fat, a 24 h-dietary-recall questionnaire
was used both at the beginning and the end of the interven-
tion. Nutritionist IV software (Nutritionist IV Diet Analysis,
First Data Bank Division, Hearst Corp., San Bruno, CA) was
used to analyze 24 h dietary recall data.
After 12 h of fasting, a 10 ml sample of venous blood was
taken from each patient by the laboratory technician at
the beginning and the end of intervention. The centrifuge
of the samples was performed at the room temperature
and at 3000 rpm for 10 min so as to separate serum. FBS
was assessed using an enzymatic (glucose oxidize-peroxides)
in vitro test (Autoanalyser; Echo Plus Corporation, Roma,
Italy). HbA1c was measured using ion exchange chromatog-
raphy. Measuring fructosamine was also accomplished using
colorimetric method through alpha-classic autoanalyzer
(made in Iranazma Corporation, Mashhad, Iran). Fasting
serum insulin concentration was also assessed using ELISA
kits (Diametra Corporation, Milan, Italy) with a sensitivity
of 2 IU/ml. Homeostasis model assessment insulin resistance
11
index (HOMA-IR), beta-cell function (%) and insulin sen-
sitivity (S%) were calculated using a software calculation,
HOMA (HOMA calculator, version 2.2.2; Diabetes Trial Unit,
University of Oxford, www.dtu.ox.ac.uk) and the quantita-
tive insulin sensitivity check index (QUICKI) was calculated
using the logarithmic transformation: 1/[log fasting insulin
(U/ml) + log fasting glucose (mg/dl)] 20
Ethical considerations
The study aims and methods were explained to the patients
and the informed written consent was received from them
provided they appeared to be interested in the participa-
tion. On the other hand, the research was approved by
Ethics Commission of Deputy for Research in Shahid Sadoughi
University of Medical Sciences. This study has also been reg-
istered at the Iranian registry of clinical trials (www.irct.ir)
with IRCT 201104246278N1 code.
Data analysis
The data were analyzed by SPSS version 11 (SPSS Inc.,
Chicago, IL, USA). KolmogorovSmirnov test was used to
determine quantitative data distribution, paired t-test to
compare mean of normal distribution variables in the two
groups before and after the intervention, and student t-
test to compare the mean of variables between the two
groups. The quantitative data not following normal distri-
bution were analyzed through Wilcoxon and MannWhitney
tests. The results of the quantitative data with normal dis-
tribution were reported as mean SD, but quantitative data
not normally distributed was reported using percentiles 25,
50 (median) and 75. The signicance level was set at P-value
equal or less than 0.05.
Results
Out of 88 patients who participated in the study, the follow-
ing cases were excluded from the intervention: 4 patients
who had no tendency to continue, 1 for her husbands death,
and 2 for travel; the remaining 81 who continued to the end
were all investigated (Fig. 1).
The compliance in consuming capsules in the two groups
turned out to be higher than 98% thus demonstrating a well
observation of the study protocol by the patients. All the
patients received oral hypoglycemic agents, 50 (61.7%) were
female and 31 (38.3%) male. The mean age of the patients in
the GG and PG showed to be 49.83 7.23 and 51.05 7.70
respectively. The basic characteristics of the patients before
the study have been reported in Table 1 showing no statisti-
cal difference between the variables of the two groups.
Daily dietary intake of energy and some nutrients has
been reported in Table 2. According to the results, no statis-
tical difference was found between the groups in terms of
daily dietary intake of energy and nutrients at the beginning
and the end of the intervention.
The glycemic indices, QUICKI index, and BMI are shown
in Table 3. There was a signicant decrease of FBS mean
(10.5%) in the GG after the intervention (p = 0.003); how-
ever a signicant increase of it (21%) was identied in the
12 H. Mozaffari-Khosravi et al.

Enrollment Assessed for eligibility (n= 150)

Excluded (n= 62 )
Not meeting inclusion criteria (n= 40 )
Declined to participate (n=10 )
Other reasons (n=12 )

Randomized (n=88)

Allocation
Allocated to ginger group (n= 44) Allocated to placebo group (n= 44)

Follow-Up

Lost to follow-up (give reasons) (n=2) Lost to follow-up (give reasons) (n= 2)
Discontinued intervention (give reasons) (n=2) Discontinued intervention (give reasons) (n= 1)

Analysis
Analysed (n=40 ) Analysed (n= 41 )
Excluded from analysis (give reasons) (n= 0) Excluded from analysis (give reasons) (n=0 )

Figure 1 Diagram of the study.

the two groups before and after the intervention (P = 0.014

Table 1 Comparison of the qualitative and quantitative
and p < 0.005) turned out to show a signicant increase, but
variables between the two groups before the intervention.
the mean of differences of this index was signicantly higher
Groups Placebo Ginger P- in GG than PG (p = 0.014). Moreover, as to BMI mean, no sig-
variables (N = 41) (N = 40) value nicant difference was observed between the two groups at
Mean SD Mean SD the beginning and at the end of this study.
Other insulin resistance indices are represented in
Age (year) 51.05 7.70 49.83 7.23 0.46 Table 4. A signicant decrease in the median of fasting
Height (cm) 162.21 9.24 159.00 10.08 0.15 insulin concentration and HOMA-IR was detected in the two
Weight (kg) 74.63 11.48 71.20 16.08 0.27 groups before and after the intervention (P < 0.005) whereas
Body mass 28.51 4.95 28.09 5.29 0.71 no signicant difference was observed between the groups
index before and after the intervention. A signicant increase
(kg/m2 ) in the median of S% was depicted in the two groups at
the beginning and the end of the intervention (P < 0.005)
Gender N (%) N (%) whereas no signicant difference was observed between the
Male 18 (43.9) 13 (32.5) 0.2 groups before and after the intervention.
Female 23 (56.1) 27 (67.5) The researchers did not identify a signicant differ-
ence in the median of % in the GG before and after the
intervention (p = 0.75) whereas a signicant decrease was
PG (p = 0.01). The mean difference of FBS between the two found in the PG (P < 0.005). On the other hand, a signi-
groups was signicant at the outset (P = 0.002), its signicant cant difference was detected between the groups before
decrease in the GG and its signicant increase in the PG at the intervention (P = 0.008) whereas no such a difference
the end of the study were compared. With regard to the dif- was discerned at the end.
ference at the beginning of the study, FBS at this stage was
taken as covariate and covariance analysis was carried out. Discussion
The results indicated that statistical difference of FBS mean
was observed after the intervention (p < 0.005). Meanwhile, The present study indicated that daily consumption of 3 g of
the mean variation of HbA1c was similar to that of FBS. ginger powder in capsules by patients with type 2 diabetes
No statistical difference was recognized within and for 8 weeks causes improvement of indices related to dia-
between the groups before and after the intervention betes control. One of its denite outcomes is a signicant
regarding fructozamine mean. The QUICKI index mean of decrease of FBS and HbA1c in the GG in comparison with
Ginger supplementation and insulin resistance in diabetes mellitus 13

Table 2 Comparison of daily dietary intake of energy and some nutrients before and after the intervention in ginger and
placebo groups.

Variables Baseline End P-value

Energy (kcal)
Ginger 1331.74 329.70 1321.22 452.99 0.36
Placebo 1363.35 457.28 1389.14 549.28 0.60
P-value 0.79
Carbohydrate (g)
Ginger 151.04 60.93 145.85 76.99 0.18
Placebo 170.07 72.77 158.07 70.05 0.06
P-value 0.28
Protein (g)
Ginger 54.22 21.44 52.03 16.63 0.58
Placebo 50.91 24.24 54.37 24.94 0.47
P-value 0.62
Fat (g)
Ginger 58.52 14.22 61.04 19.56 0.66
Placebo 55.34 15.65 61.76 26.83 0.06
P-value 0.66
Cholesterol (mg)
Ginger 250.18 362.66 177.58 232.84 0.17
Placebo 170.54 252.64 168.76 179.60 0.15
P-value 0.78
Fiber (g)
Ginger 8.65 4.26 8.31 6.64 0.25
Placebo 9.29 4.01 7.99 4.97 0.07
P-value 0.84
Salt (g)
Ginger 3.47 0.54 3.51 0.65 0.99
Placebo 3.39 0.47 3.63 0.97 0.31
P-value 0.85

the PG thereby showing the effect of ginger in controlling
diabetes. On the other hand, among the insulin resistance
indices, a signicant decrease was found in fasting insulin
and HOMA-IR index in both groups, a signicant increase in
S% in both groups, and a signicant increase of QUICKI index
in the GG. Therefore, considering the results of these indices
especially OUICKI index, FBS and HbA1c related to which the
mean of their differences (Table 3), it can be concluded that
ginger is effective in glycemic control and in lowering insulin
resistance.
As to the effect of ginger consumption, several studies
have been carried out on human and animals the results
of which are comparable to those of us. In a study con-
ducted by Shirdel et al. in Iran (2009), the antidiabetic and
antilipidemic effects of ginger on diabetic mice affected
by aloxanmonohydrate and their comparison with gliben-
clamide were investigated the result of which represented
a signicant decrease of serum glucose by ginger in the
diabetic mice17 thus being in line with our FBS results. In
another study accomplished by Singh et al. (2009) in India,
the blood glucose lowering, lipid lowering, and antioxidant
effect of [6]-gingerol in type 2 diabetic db/db mice was
investigated.18 The results depicted that treatment of mice
with [6]-gingerol (100 mg/kg bw) for 12 days can signicantly
(p < 0.05) lower FBG and improve the glucose tolerance,
decrease plasma triglycerides, total cholesterol, free fatty
acid, low-density lipoprotein cholesterol, and plasma insulin
concentration. The study is thus consistent with the FBS
results in our study.
Also Goyal et al. (2006) in India studied the impact of gin-
ger on goldthioglucose-induced obesity in mice.19 Treatment
with 250 mg/kg of methanol and ethyl acetate extracts of
ginger for 8 weeks produced signicant reduction in body
weight, glucose, insulin and lipid concentration as com-
pared to controlled obese mice. The reduction in elevated
glucose along with elevated insulin levels indicated that
ginger improves insulin sensitivity thus being in line with
FBS results of our study. Al-amin et al. (2006) in Kuwait21
indicated that an aqueous extract of raw ginger adminis-
tered daily (500 mg/kg, intraperitoneally) for a period of
7 weeks to streptozotocin-induced diabetic rats produces
hypoglycaemic, hypocholesterolaemic and hypolipidaemic
properties. The glucose-lowering effect of ginger in this
study is consistent with what we detected in relation to FBS.
Also in Bhandaris study (2005) in India, the effect of oral gin-
ger ethanolic extract on diabetic mice was investigated the
14 H. Mozaffari-Khosravi et al.

Table 3 Comparison of glycemic indices, QUICKI index, and body mass index before and after the intervention in ginger and
placebo groups.

Variables Baseline End Changes P-value

Fasting blood sugar (mg/dl)

Ginger 171.30 54.91 153.12 48.34 18.17 35.82 0.003
Placebo 136.17 40.53 153.73 50.57 17.56 41.31 0.01
P-value 0.95 <0.005
HbA1c
Ginger 8.2 1.6 7.7 1.7 0.4 1.2 0.02
Placebo 6.9 1.3 8.2 1.9 1.2 1.4 <0.005
P-value 0.26 <0.005
HbA1c (mmol/mol)
Ginger 66 18 61 19 14 16 0.02
Placebo 52 15 66 21 5 13 <0.001
P-value 0.25 <0.001
Fructosamine (mol/l)
Ginger 292.32 45.42 291.95 42.33 0.37 33.83 0.94
Placebo 285.65 29.94 281.43 41.20 4.21 27.85 0.33
P-value 0.26 0.57
QUICKI
Ginger 0.316 0.025 0.337 0.303 0.02 0.01 <0.005
Placebo 0.324 0.031 0.333 0.031 0.009 0.02 0.014
P-value 0.59 0.01
Body mass index (kg/m2 )
Ginger 28.09 5.29 28.05 5.33 0.04 0.32 0.44
Placebo 28.51 4.95 28.53 0.03 0.02 0.34 0.64
P-value 0.67 0.38

Table 4 Comparison of insulin resistance indices before and after the intervention in ginger and placebo groups.

Variables Baseline End P-value

Percentiles Percentiles

25th 50th 75th 25th 50th 75th

Fasting insulin (mU/L)

Ginger 6.2 9.3 13.9 4.4 6.6 11 <0.005
Placebo 6.5 10 14.5 4.4 6.6 6.6 <0.005
P-value 0.55
HOMA-IR
Ginger 0.92 1.35 1.90 0.60 0.95 1.60 <0.005
Placebo 0.90 1.40 2.15 0.60 1.00 1.60 <0.005
P-value 0.54
Insulin sensitivity (%)
Ginger 52.90 73.80 105.50 62.10 105.80 160.95 <0.005
Placebo 46.75 69.30 109.80 64.10 95.80 156.70 <0.005
P-value 0.62
Beta-cell function (%)
Ginger 22.02 32.40 64.62 19.75 33.20 54.15 0.75
Placebo 36.40 56.10 85.75 23.50 43.30 56.40 <0.005
P-value 0.54
Ginger supplementation and insulin resistance in diabetes mellitus
results of which indicated its signicant antihyperglycemic
effect and signicant lipid lowering activity after 20 days.22
In a counter-evidence study by Bordia et al. (1997) in
India23 the effect of ginger and fenugreek on blood sugar
and lipid concentration was investigated. For the subjects
subsuming healthy individuals, patients with coronary artery
disease (CAD), and diabetic patients (with CAD or without
CAD), 4-gram consumption of ginger powder for 3 months
was not effective on lipids and blood sugar, thereby being
inconsistent with our results on FBS and HbA1c.
For assessing insulin resistance, our study focused on
indices such as fasting insulin, HOMA-IR, S%, %, and OUICKI,
the results of which were not the same. That is, although
median of fasting insulin and HOMA-IR index showed sig-
nicant decrease before the intervention compared with
the end in each group, no such median signicant differ-
ence was detected between the groups (both before and
after the intervention). Moreover, median of S% was not
signicantly different between the two groups. % had a
signicant decrease in the PG; in this regard a signicant
difference was identied between the groups at the outset.
Therefore, considering the results of these indices espe-
cially OUICKI index in which the mean and the mean of its
difference have signicantly increased in the GG it can be
concluded that ginger is effective in lowering insulin resis-
tance. The fact that all the indices did not come to the same
consequences may be due to the disparity in sensitivity or
properties of these indices or due to other causes.
Overall, the reexamination of the previous studies indi-
cated that research to date as to the impact of ginger
powder on sugar indices of the diabetic patients has been
very constrained. Moreover the results of the researches
conducted on human and animals have turned out to be
contradictory. This contradiction may be the consequence of
disparity in peoples response. And this disparity of response
can be the sequel of the patients difference at the onset
of research, experimental group weight, severity of insulin
resistance and other measured indices at the beginning of
the study. Moreover, most of the articles published have not
had any reference to the type and dose of the drug con-
sumed by the patients; this, however, is not the case in our
study. We investigated patients with type 2 diabetes. Ginger
supplement for eight weeks contributed to signicant varia-
tion in FBS and HbA1c, fasting insulin, insulin resistance, S%,
and QUICKI index. The results of HbA1c however, represent
the effect of ginger supplementation in diabetes control.
Ginger is a herbal drug the herbal properties of which
are similar to NSAIDs. Therefore it can regulate biochemi-
cal pathways which are activated with chronic inammation
(such as diabetes).11 Of the mechanisms suggested as to the
function of ginger on sugar indices are the following. One
is likely the inhibition of hepatic phosphorylase so as to
prevent the glycogenolysis in hepatic cell and to increase
enzyme activities which contributes to progression of glyco-
genesis. Another possible effect of ginger can be inhibition
of the activity of hepatic glucose-6-phosphatase thereby
lowering segregation of phosphate from glucose and nally
contributing to lowering blood glucose.16
The high percentage of the patients compliance in con-
suming capsules can be regarded as strong point of the study.
Of the limitations of the present study, we can refer to the
rather short period of supplementation i.e., two months;
15
therefore, for the forthcoming similar investigation a longer
duration of the study is suggested. Moreover, the efcacy
examination of a longer use of ginger supplement and its
impact on parameters pertinent to inammation and hor-
mones which are related to inammation are suggested as
well.
Conclusions
This study demonstrated that daily consumption of 3 g of gin-
ger in capsules for 8 weeks by patients with type 2 diabetes
leads to lowering FBS and HbA1c means as well as variation
in fasting insulin, insulin resistance, increase of sensitivity
to insulin and QUICKI index. Therefore, consumption of this
supplement is appropriate for patients; for identifying its
other effects, however, some further studies are needed.
Conict of interests
Nothing to declare.
Funding
This work has been funded by Shahid Sadoughi University of
Medical Sciences.
Acknowledgements
We hereby appreciate the participation of the patients as
well as the cooperation of the staff in diabetes research
center of Yazd specially Dr. Farzaneh Dehghan, Dr. Sima
Mohammad Zadeh, Mrs. Azod, Mrs. Ghiasi, Mrs. Karimi, and
Mrs Barzegari.
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