Ginger Administration Lowers Serum Urea Levels and Improves Insulin Sensitivity in Diabetic Subjects with End-Stage Renal Disease

by | Jan 17, 2024 | 2023, Botanicals, Diabetes, Ginger, Kidney Health

Written by Taylor Woosley, Staff Writer. An 8-week intervention of 2000 mg/daily of ginger powder significantly lowered fasting blood glucose levels by 24% and HOMA-IR levels by 28%. 

curcumin - botanicalsEnd-stage renal disease (ESRD) is a serious public health problem fueled by aging populations and a substantial increase in chronic noncommunicable diseases1. ESRD is the fifth stage of chronic kidney disease in which renal replacement therapy or donor kidney transplantation is necessary2. Kidney disease related to diabetes is responsible for more than half of all new cases of ESRD in the United States, with chronic inflammation and oxidative stress playing a role in the development3.

Ginger and its bioactive compounds, such as gingerol and shogaol, have been widely researched for its potent anti-inflammatory properties4. Ginger has exhibited beneficial effects on blood levels of glucose, insulin, and HbA1c, along with reducing oxidative stress by scavenging free radicals5. Furthermore, ginger administration has been shown to reduce inflammation through NF-ĸB pathway suppression and inhibition of prostaglandin synthesis6.

Rostamkhani et al. conducted a randomized, double-blind, controlled parallel-group study to investigate the effect of ginger administration on renal function, glycemic control, and prooxidant-antioxidant balance in diabetic subjects with ESRD undergoing hemodialysis. Subject inclusion consisted of being age 18 or older, diagnosed with type 2 diabetes mellitus (T2DM), who were receiving hemodialysis at least twice a week for the past three months. Participants were informed to not consume any ginger-containing products for a month prior to the study. Subjects were randomized based on age, gender, and fasting blood glucose categories to either the ginger group or the placebo for the 8-week study. The ginger group consumed four capsules containing 2000 mg of ginger powder daily. The placebo group consumed four starch-containing capsules.

Fasted blood samples were obtained at baseline and at the end of the 8-week intervention to assess insulin concentrations, fasting blood glucose, urea, and creatinine. A modified version of the International Physical Activity Questionnaire was utilized to assess physical activity levels. A questionnaire completed at baseline and end of trial was used to gather information regarding weight, height, BMI, weight circumference, and hip circumference. A 3-day dietary recall was completed at the start and end of trial to measure dietary intakes. Primary study outcomes included prooxidant-antioxidant balance (PAB), fasting blood glucose (FBS), serum levels of fasting insulin, and HOMA-IR. Secondary outcomes included serum levels of urea and creatinine.

41 participants (ginger group, n = 20; placebo, n = 21) aged 31-77 years old were included in the final analysis. No significant differences were noted between groups regarding weight, BMI, waist circumference, hip circumference, and physical activity levels (p > 0.05). A paired samples t-tests or Wilcoxon signed ranks tests were utilized to compare parameters between groups based on the normal data distribution. Significant findings of the study are as follows:

  • A significant decrease in FBG levels was noted in the ginger group compared to baseline (p = 0.001). Furthermore, a statistically significant difference between the two groups was observed for FBG after adjustments for baseline values, calorie consumption, insulin intake, and weight change (p < 0.001).
  • HOMA-IR levels were significantly decreased in the ginger group compared to baseline (p = 0.001). Significant between group differences were noted after adjustments (p = 0.012).
  • A significant reduction was shown in the ginger group for serum levels of urea after adjustments (p = 0.028).
  • Although no statistically significant differences were observed between groups regarding serum PAB, the ginger group experienced a dramatic decrease in serum PAB (p = 0.013).

Results of the study show that an 8-week intervention of 2000 mg ginger powder daily significantly improved fasting blood glucose levels, HOMA-IR levels, and urea levels in diabetic subjects with ESRD undergoing hemodialysis. Further research using longer intervention periods and various doses and forms of ginger is necessary to better comprehend the potential renoprotective properties of ginger.

Source: Veisi, Parisa, Helya Rostamkhani, Bahram Niknafs, Mohammad Asghari Jafarabadi, and Zohreh Ghoreishi. “Effect of Zingiber officinale on Lipid Profile and Some Inflammatory Markers in Diabetic Hemodialysis Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial.” Evidence-Based Complementary and Alternative Medicine 2023 (2023).

© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

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Posted January 17, 2024.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Lee HJ, Son YJ. Prevalence and Associated Factors of Frailty and Mortality in Patients with End-Stage Renal Disease Undergoing Hemodialysis: A Systematic Review and Meta-Analysis. Int J Environ Res Public Health. Mar 27 2021;18(7)doi:10.3390/ijerph18073471
  2. Gusev E, Solomatina L, Zhuravleva Y, Sarapultsev A. The Pathogenesis of End-Stage Renal Disease from the Standpoint of the Theory of General Pathological Processes of Inflammation. Int J Mol Sci. Oct 23 2021;22(21)doi:10.3390/ijms222111453
  3. Niewczas MA, Pavkov ME, Skupien J, et al. A signature of circulating inflammatory proteins and development of end-stage renal disease in diabetes. Nat Med. May 2019;25(5):805-813. doi:10.1038/s41591-019-0415-5
  4. Mohd Sahardi NFN, Makpol S. Ginger (Zingiber officinale Roscoe) in the Prevention of Ageing and Degenerative Diseases: Review of Current Evidence. Evid Based Complement Alternat Med. 2019;2019:5054395. doi:10.1155/2019/5054395
  5. Veisi P, Zarezade M, Rostamkhani H, Ghoreishi Z. Renoprotective effects of the ginger (Zingiber officinale) on Diabetic kidney disease, current knowledge and future direction: a systematic review of animal studies. BMC complementary medicine and therapies. Nov 11 2022;22(1):291. doi:10.1186/s12906-022-03768-x
  6. Veisi P, Rostamkhani H, Niknafs B, Asghari Jafarabadi M, Ghoreishi Z. Effect of Zingiber officinale on Lipid Profile and Some Inflammatory Markers in Diabetic Hemodialysis Patients: A Randomized Double-Blind Placebo-Controlled Clinical Trial. Evid Based Complement Alternat Med. 2023;2023:7154172. doi:10.1155/2023/7154172