Hello, Curious PWD Friends. Doesn't it just seem like everything affects your diabetes? Yup — and today we're addressing two of them, marital relationships and the much-hyped idea that cinnamon can control your blood sugars.

Welcome to this latest edition of our weekly diabetes advice column, Ask D'Mine, hosted by veteran type 1, diabetes author and community educator Wil Dubois.

{Need help navigating life with diabetes? Email us at AskDMine@diabetesmine.com}

Innovation 2015

Phyllis from Vermont, type 2, asks: How can stress in a marriage affect blood sugars?

Wil@Ask D'Mine answers: As it turns out, in two distinct and very different ways. Now, for background, for many years I had assumed that any kind of stress messes up blood sugars for all of us. That's because I was a believer in the Caveman Effect (not to be confused with a Caveman Low). The Caveman Effect (or Cavewoman Effect) goes like this: in the old days if you were just wandering around the Pleistocene minding your own businesses, and a saber tooth tiger jumped out of the reeds, you'd scream, throw your spear into the air, and run for your frickin' life. To do that, your adrenal glands helpfully filled your blood stream with a sugary hormone called adrenaline to give you an extra little boost of speed.

If you are a caveperson running for your life this is no problem. You'll run off the sugar.

Now fast-forward 40,000 years. Instead of being in a real cave, you're in your husband's man-cave. And instead of a saber tooth tiger, your adrenaline comes from too many bills, too little money, and too little healthy conversation. You can't run away from that kind of stress. Oh, and you're not a healthy cavewoman either. You're a person with diabetes.

So this unusable adrenaline was thought to pile up and increase blood sugar across the board. The fancy word for it is "hormonal mediation," but I still prefer Caveman Effect.

However, a recent conversation with our best brain-and-diabetes guy, Dr. William Polonsky, set me straight. Dr. P tells me that "physical stress, like undergoing surgery, reliably raises blood sugars.  And, for some people, emotional or mental stress seems to raise blood sugars, but not for everyone.  For other people, mental stress seems to have no effect, or even lowers blood sugars!"

Wow. Who knew? Fighting with your spouse is good medication for some people with diabetes! I feel a book coming on...

Dr. P goes on to explain the conundrum of stress and diabetes: "stress does seem to reliably worsen long-term blood glucose control for most people, but not due to hormonal mediation. Instead, it is just behavior. 'I am stressed, so I don't give my diabetes the close attention it deserves,' and presto — A1C's rise. Also, it may only be certain kinds of stress and the actual timing of when the stress occurs that determines whether and how it affects blood sugars."

So the Caveman Effect still comes into play with some people some of the time, but not all people all of the time. And it looks like we need a new label for the long-term effects of stress on diabetes, which I'm going to label the Eff-it Effect. (Sorry, Dr. P).

So we now know that marriage stress can affect diabetes in two ways. The Caveman Effect might (or might not) raise your blood sugar at the time of stress, like during an argument; and the Eff-it Effect will almost certainly raise your blood sugar over time because you've taken your eye off the ball.

I guess knowing the two likely causes is a help. But neither are easily fixed. If your blood sugars are affected by the Eff-it Effect ya' just gotta slap yourself across the face and get focused on the basics of diabetes control again. If you're one of those people who suffers from the Caveman Effect, then you need to develop some new tricks to reduce your immediate stress when it hits during those 'charged' moments.

Maybe aroma therapy candles...? Maybe a massage? Or maybe you need to pick up your spear and work off some energy at the gym. Hey, it worked for our ancestors.

 

Brenda from Colorado, type 2, asks: Have you done any research on cinnamon? They have it in so many diabetic products and herbals nowadays. Does it really work?

Wil@Ask D'Mine answers: Cinnamon alternately generates a lot of excitement and a lot of disappointment among PWDs. When I first read that cinnamon might be the cure for diabetes, the first thing I did was run down to the nearest Cinnabon to get some of this new medicine.

That didn't work out so well for me.

One of the problems with the whole cinnamon thing is that the original study was done on six political prisoners in a maximum security lockup in Shi Lanka. OK, OK, OK. I exaggerate. But the truth is almost as bad. The first published cinnamon study back in 2003 was done in Pakistan on 60 type 2s, only half of which took the cinnamon, and the study ran just 40 days and 40 nights. No kidding. And the researchers demonstrated a respectable glucose drop. Or did they? More on that in a minute. But this was the face that launched a thousand ships. Or at least a thousand over-the-counter diabetes "supplements" with cinnamon in them.

Over the next several years following this first study, a number of other small (sometimes smaller!) studies looked at cinnamon with varying results — mainly unable to duplicate the original results.

Now, I need to interject my thoughts on clinical trials here. Well, more correctly, on the SIZE of clinical trials. I get suspicious when I read results from a small pool of participants, as very small trials are subject to errors because one or two people who have unusual reactions can throw the average results way off. I don't think it's a good idea to make sweeping statements about everyone who has diabetes if you only look at 20 of us. (Read the DiabetesMine Research Primer here for more insights on that.)

But back to cinnamon. As I said, most of the trails were very small, a fact that the mainstream media ignored or glossed over. Some were badly designed. Oh, right, and some were on rats.

Finally, in 2008, William Baker and his colleagues killed cinnamon once and for all in a meta-analysis (the same statistical torpedo that sunk Avandia) of all the assorted cinnamon trials, finding that cinnamon had only one scientifically demonstrable effect: it makes cinnamon rolls taste better. It doesn't improve A1C, it doesn't improve fasting blood glucose, and it doesn't improve lipids in either type 1s or type 2s—all claims of previous "research."

Now science aside, all you have to do is look at the comments sections of any blog posts on the cinnamon issue and you'll find lots of folks who would bet the farm on cinnamon, and who sing its praises. So what to make of that?

Well some might be "plants" from the folks making all those cinnamon supplements, but there's a whole class of people who don't want to take their medicine, but rather want to do things "naturally." (I find this silly, as most medicines are natural in the first place. Metformin is just French Lilac, aspirin is willow bark, and statins are red rice yeast.) But I think sometimes these folks have a problem with perspective. It can be hard to separate the wheat from the chaff. Sometimes when you start something new to help your diabetes, you do other things at the same time that you aren't even aware of. Maybe, in addition to taking cinnamon they're now more physically active. Or maybe they're eating a little better. Or maybe they lost some weight. Or maybe they're just kidding themselves.

When it comes to blood sugar numbers, I find that even my smartest, most focused patients are horrible historians. Just yesterday, one of my type 1s was telling me how he was "always" having lows around 3am, over the last few weeks. Alarmed, I started looking at his pump's basal rates. But then I looked at his CGM data. In his case, "always" turned out to be twice. In two weeks. Still, those two times made a big impression. In a similar fashion, sometimes the data we want to see makes a bigger impression than it deserves.

I know when I download my CGM it paints a worse picture on my control than I expect. Huh? I could'a sworn I was "flat-lining" my blood sugar...

A number of my type 2 patients have tried cinnamon. Some felt it didn't help. Some thought it helped a little. Some felt it made a huge difference in their diabetes control. But I couldn't see any change at all when I studied their meter downloads.

One woman I work with thought that cinnamon was doing such a great job she stopped all her prescription meds in favor of cinnamon.

Her A1C tripled.

Of course, for the most part, cinnamon is harmless. So if you want to try it, go for it. Just don't stop your other meds. Study your meter data carefully. Try to be honest with yourself on other changes in your life.

Oh...

And remember that I said the cinnamon was harmless for the most part? One last warning: while cinnamon can't be scientifically shown to lower blood sugar, it has been proven to be effective as a mild blood thinner. So if you are on Coumadin (a.k.a. Warfarin) or a similar medication for heart problems, be alert for easy bruising, etc.

The cinnamon can super-size the effects of your blood thinner.

So if you want to play with cinnamon, that's OK with me. Just play it smart. Play it safe. Keep your mind clear and focused on the facts, and remember you mileage may vary from 30 Pakistani PWDs who tried cinnamon back in 2003.

 

Disclaimer: This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional.

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This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.