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Effect of chromium supplementation on lipid profile in patients with type 2 diabetes mellitus
Abstract
Although current data shows that chromium supplementation in type 2 Diabetic patients can improve control blood sugar and lipids there are controversial results about its relevance to improving blood sugar and lipids in diabetes. This study investigates the effect of chromium picolinate supplement on blood sugar and lipids control in patients with type 2 diabetes. Materials and Methods: This randomized, double-blind,placebo-controlled study was carried out at the Diabetes Clinic of the Loghman Hospital in collaboration with Taban Diabetes Clinic. In this clinical study of 60 patients with type 2 Diabetes, participants were randomized into the double-blind treatment and control groups for 3 months of treatment with 200 μg of chromium picolinate or placebo respectively. Blood sugar and lipids profile were assessed at the beginning and end of the study. Results: Based on the result of this study it has been found that 200 micrograms of chromium consumed over three months could decrease of TG levels dramatically, compared to placebos. TG changes were significantly different between the two groups, (P=0.048), without any change in other lipid profiles of the two groups. Findings showed that chromium picolinate treatment for 90 days produced significant improvements in glycemic control compared to placebo, based on significant reductions in both FPG and HbA1c levels in patients with type 2 diabetes mellitus, with significant changes between the two groups (P<0.001). Conclusions: Results of this study recommend that chromium picolinate prescribed to type 2 diabetes patients could decrease TG, HbA1c and FPG levels.
... When investigating full texts of articles, 6 papers were excluded due to a lack of reporting of desire data. Finally, 15 trials 15,16,[32][33][34][35][36][37][38][39][40][41][42][43][44] were included in this meta-analysis (Fig. 1). From these 15 trials, 6 studies evaluate the effects of chromium supplementation on BP, 9 studies determined the effect of chromium on BMI. ...
... Overall, 15 RCTs, published between 2001 and 2020, were included in our Meta-analysis, characteristics of the 15 randomized clinical trials, 15,16,[32][33][34][35][36][37][38][39][40][41][42][43]45 are reported in Table 1. These studies included a total of 806 participants (428 intervention and 378 control) aged ≥18 years. ...
... All studies were done on both genders. Three studies were performed in the United States, 32,34,40 three in Taiwan, 15,33,37 four in Iran, [41][42][43]45 two in Netherlands, 16,36 one in Denmark, 35 one in Poland 38 and one in India. 39 12 studies had parallel design, 15,16,32,33,[35][36][37][39][40][41][42][43][44] and 2 were crossover studies. ...
Background
Several studies reported beneficial effects of chromium supplementation for management of type 2 diabetes mellitus (T2DM). The present study aimed to provide a systematic review and meta-analysis of randomized controlled trials (RCTs) examining the effects of chromium supplementation on blood pressure, body mass index (BMI), liver function enzymes and malondialdehyde (MDA) in patients with T2DM.
Methods
PubMed, Scopus, and Embase were searched up to 15 November 2020 with no language and time restriction. RCTs that reported the effects of chromium supplementation on blood pressure, BMI, liver function enzymes and MDA in patients with T2DM were included. A random-effects model was used to compute weighted mean differences (WMDs) with 95 % confidence intervals (CIs). Between-study heterogeneity was assessed by Cochran's Q test and quantified by I2 statistic.
Results
Of 3586 publications, 15 RCTs were included for the meta-analysis. Pooled effect sizes indicated that chromium significantly reduced diastolic blood pressure (DBP) (WMD): -2.36 mmHg, 95 % CI: −4.14, −0.60; P = 0.008), and MDA (WMD: −0.55 umol/l, 95 % CI: −0.96, −0.14; P = 0.008). However, chromium supplementation did not significantly affect BMI, systolic blood pressure (SBP), alanine aminotransferase (ALT), aspartate aminotransferase (AST). Meta-regression analysis did not show significant linear relationship between dose of chromium and change in BMI (p = 0.412), SBP (p = 0. 319), DBP (p = 0.102), ALT (p = 0.923), AST (p = 0.986) and MDA (p = 0.055).
Conclusion
The present systematic review and meta-analysis shows that supplementation with chromium at dose of 200–1000 µg/day may reduce DBP and MDA in T2DM patients.
... All articles were published between 1983 and 2020. The trials were performed in the USA [32,37,42,48], China [54], Iran [34,40,46,47,51], India [35,39,50], Denmark [36], Finland [33], Israel [38,55], Poland [43], Brazil [41,49], Taiwan [52], Netherlands [44,45], and Saudi Arabia [53]. Chromium dosage ranged from 42 to 1000 μg /day. ...
... Chromium dosage ranged from 42 to 1000 μg /day. Included studies were used chromium picolinate [32,34,38,[40][41][42]44,46,47,50,51,54], chromium yeast [35,36,43,45,48], chromium chloride [33,37,52,53,55], chromium complex [39] and chromium nicotinate [49] as intervention. The duration of intervention also varied from 6 to 25 weeks. ...
... The duration of intervention also varied from 6 to 25 weeks. Based on Cochrane scores, 19 studies were classified as good-quality (score > 2) [32,[34][35][36][37][39][40][41][43][44][45][46][47][48][49][50][51][52][53]55], 4 studies were fair-quality (score = 2) [33,42,47,54] and one study were weak-quality (score < 2) [38]. The outcomes of the quality assessment are shown in Table 2. ...
Background
The purpose of this study was to determine the influence of chromium supplementation on lipid profile in patients with type 2 diabetes mellitus (T2DM).
Methods
A systematic search was performed in Scopus, Embase, Web of Science, the Cochrane library and PubMed databases to find randomized controlled trials (RCTs) related to the effect of chromium supplementation on lipid profile in patients with T2DM, up to June 2020. Meta-analyses were performed using the random-effects model, and I2 index was used to evaluate heterogeneity.
Results
The primary search yielded 725 publications. 24 RCTs (with 28 effect size) were eligible. Our meta-analysis indicated that chromium supplementation resulted in a significant decrease in serum levels of triglyceride (TG) (MD: -6.54 mg/dl, 95% CI: -13.08 to -0.00, P = 0.050) and total cholesterol (TC) (WMD: -7.77 mg/dl, 95% CI: -11.35 to -4.18, P < 0.001). Furthermore, chromium significantly increases high-density lipoprotein (HDL) (WMD: 2.23 mg/dl, 95% CI: 0.07 to 4.40, P = 0.043) level. However, chromium supplementation did not have significant effects on low-density lipoprotein (LDL) (WMD: -8.54 mg/dl, 95% CI: -19.58 to 2.49, P = 0.129) level.
Conclusion
Chromium supplementation may significantly improve lipid profile in patients with T2DM by decreasing TG and TC and increasing HDL. However, based on our analysis, chromium failed to affect LDL. It should be noted that the lipid-lowering properties of chromium supplementation were small and may not reach clinical importance.
... The sample size in the included trials ranged from 3(51) to 137 (46). The included studies were published between 1968 and 2019 and were conducted in the USA (32,36,41,46), Taiwan (37,39,43), Iran (44,48,49), India (35,47), Brazil (42,50), Island (51), Netherlands (31,45), Poland (40), Israel (52), Saudi Arabia (53), China (33), Denmark (38) and Indonesia (34). The design of all the included trials was parallel except for six trials that were crossover study (34)(35)(36)40,51,53). ...
... Finally, 23 trials were included in this metaanalysis. All studies had provided data for FPG except one trials (31), 14 trials reported data for insulin level(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44), 18 studies were on HbA1C(31)(32)(33)(35)(36)(37)(38)(39)(40)(41)(42)(43)(45)(46)(47)(48)(49)(50) and 7 studies were on HOMA-IR(37,(39)(40)(41)(42)44,45). ...
BACKGROUND
We aimed to investigate the effect of chromium supplementation on glycemic control indices in patients with type 2 diabetes (T2DM).
METHODS
Randomized controlled trials examining the effect of chromium supplementation on glycemic control indices and published before February 2020 were detected by searching online databases, including PubMed, Scopus, Embase, Web of sciences and The Cochrane Library, using a combination of suitable keywords. Mean change and standard deviation (SD) of the outcome measures were used to estimate the mean difference between the supplementation group and the control group at follow‐up.
RESULTS
Twenty-eight studies reported fasting plasma glucose (FPG), insulin, hemoglobin A1C (HbA1C) and homeostatic model assessment for insulin resistance (HOMA-IR) as an outcome measure. Results revealed significant reduction in FPG (weighted mean difference (WMD): -19.00 mg/dl, 95% CI: -36.15, -1.85, P = 0.030; I2: 99.8%, p < 0.001), insulin level (WMD: -12.35 pmol/l, 95% CI: -17.86, -6.83, P < 0.001), HbA1C (WMD: -0.71 %, 95% CI: -1.19, -0.23, P = 0.004) and HOMA-IR (WMD: -1.53, 95% CI: -2.35, -0.72, P < 0.001; I2: 89.9%, p < 0.001) after chromium supplementation.
Conclusion
The results of the current meta‐analysis study might support the use of chromium supplementation for the improvement of glycemic control indices in T2DM patients.
... Characteristics of the selection publications are described in Table 1. Included studies were published from 1981 and 2020 (July) and conducted in USA [24][25][26]29,[31][32][33]45,46,51,52,54,55,59], Finland [27,28], India [30,37], Canada [34,36], Iran [35,[38][39][40]43,[47][48][49], Poland [41], Brazil [42,56], Israel [44,57,58], Australia [50], Netherlands [60,61] and Czech Republic [53]. Among ...
Background and aim
This systematic review and meta-analysis aimed to evaluate the effects of chromium supplementation on lipid profile consisting of total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL) and very low-density lipoprotein (VLDL) in humans.
Methods
The PubMed/Medline, Scopus, Web of sciences, Google Scholar and Cochrane library were systematically searched for randomised control trails (RCTs) available which published before August 2020. The meta-analysis was conducted using Random or fixed-effects models, and between-study heterogeneity was assessed by I².
Results
Thirty-eight studies comprising 41 treatment arms and 7605 participants included to the present meta-analysis. Our results of overall analysis show only a significant reduction in serum TC level in response to chromium supplementation (WMD: -0.17 mmol/l, 95 % CI: -0.27, -0.07, P = 0.001). In accordance with the results of the subgroup analyses, the lowering-effect of chromium supplementation may be synergist during short-term (less than 12 weeks), low dose (less than 200), diabetics patient, younger adults (less than 54 years) and picolinate and elemental form for TC, older and non-obese subjects (>54 years and ≤ 29 kg/m2, respectively), women, Asian and Australian and picolinate form for TG, short-term, low dose, non-obese subjects, women, and Asian for VLDL, and nicotinate form for HDL-C, but had no effect on LDL-C.
Conclusion
Our meta-analysis reveals that there was only an overall significant association between chromium supplementation with decreases in the concentration of TC. Additionally, we found considerable evidence of subgroup analysis that support a significant lowering effect of chromium supplementation on TC, TG and VLDL. Further RCTs with short-term and low dose chromium supplementation in subjects with diabetes are necessitated for a firm conclusion of the lipid-modulating properties.
... 15 The abnormalities of lipoproteins in diabetic patients are being continuously proved by many studies done in various regions. [16][17][18] Insulin deficiency results in increased lipolysis in adipocytes releasing increased amount of free fatty acids. Poor insulinization also leads to decrease in the enzymatic activity of lipoprotein lipase (LpL) and hepatic lipase resulting in elevated VLDL and remnant lipoproteins. ...
BACKGROUND: Diabetes is a chronic metabolic disorder and a well-known risk factor
for atherosclerotic diseases. Atherosclerosis is mainly due to alterations in lipoprotein profile. HbA1C
is a marker of long term exposure to chronic hyperglycemia. HbA1C and dyslipidemia are
independent risk factors for atherosclerotic diseases. AIM: To evaluate the correlation between
HbA1C and dyslipidemia in type 2 diabetic patients and to find out whether HbA1C can predict
dyslipidemia. MATERIALS AND METHODS: We conducted a cross-sectional study of 103 type 2
diabetic patients attending diabetic outpatient clinic at Mahatma Gandhi Memorial Govt. Hospital,
Tiruchirappalli. Venous blood samples were collected from all the subjects after at least 8-10 hours of
fasting. Fasting and post-prandial Blood Glucose, Lipid Profile and HbA1c were estimated by standard
methods. NCEP-ATP III guideline was referred to define dyslipidemia. The data were analyzed using
SPSS version 21 software. RESULTS: In our study, the mean values of HbA1C, TGL, VLDL and
TGL/HDL were found to be significantly higher (p < 0.05) in women. 98% of the subjects under study
were dyslipidemic. 45% of the subjects had four abnormal lipid parameters, 29%-three, 7%-two and
14%-one abnormal parameter. The prevalence of inadequate glycemic control (HbA1C ≥ 7) in the
study population was 66%. The mean values of all the lipid parameters and atherogenic risk ratios
were found to be higher in the HbA1C ≥ 7 group and were statistically highly significant. Pearson’s
correlation test, showed that HbA1C was positively correlated with TC(p < 0.05), TGL(p < 0.001),
LDL(p < 0.05), VLDL(p < 0.001), TC/HDL(p < 0.001), TGL/HDL(p < 0.001), LDL/HDL(p < 0.001) and
negatively correlated with HDL(p < 0.001). By linear regression analysis, it was also found that HbA1C
could predict hypercholesterolemia (p=0.024; R2 = 0.049), hypertriglyceridemia (p=0.000; R2 =
0.254), high LDL (p=0.045; R2 = 0.039), high VLDL (p=0.000; R2 = 0.116), low HDL (p=0.000; R2 =
0.316) and the atherogenic ratios TC/HDL (p=0.000; R2 = 0.196), TGL/HDL (p=0.000; R2 = 0.399) and
LDL/HDL (p=0.000; R2 = 0.141). CONCLUSION: We therefore conclude that HbA1C is not only a
marker of chronic exposure of hyperglycemia but can also predict dyslipidemia. Lifestyle
modifications and earlier intervention by lipid lowering therapy can reduce the cardiovascular
mortality of this risk group. However for intervention by lipid lowering therapy, more prospective
studies with large sample sizes are essential
In the recent years, micronutrients play an important role in improving body health with preventing and treating of chronic diseases. Chromium is one of the vital minerals involved in the regulation of insulin action. According to abundant evidences this mineral seems to be an essential factor involved in the reduction of insulin resistance and decreasing the risk of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs). Moreover, it has been proposed that Chromium supplementation affects mechanisms involved in blood pressure, lipid metabolism, inflammation, and oxidative stress. For instance, it may affect blood pressure through alteration of the renin-angiotensin system, as well as reducing the angiotensin-converting enzyme activity. Furthermore, Chromium supplementation might help reduce the coronary heart disease rates. This study aims to provide a comprehensive review regarding to the effects of Chromium supplementation on CVDs risk factors with an emphasis on possible molecular mechanisms.
Previous studies have reported that vitamin C supplementation may decrease lipid profile in patients with type 2 diabetes mellitus (T2DM). This systematic review and meta-analysis evaluated the influence of vitamin C supplementation on lipid profile in patients with T2DM. Studies examining the effects of vitamin C supplementation on lipid profile in patients with T2DM, published up to November 2020, were identified through PubMed, SCOPUS, and Embase databases. 15 studies, including 872 participants, were included and analyzed using a random-effects model to calculate weighted mean differences (WMDs) with 95% confidence intervals (CI). Findings from 15 studies indicated that vitamin C supplementation significantly decreased Triglyceride (TG) (WMD: -16.48 mg/dl, 95% CI (-31.89, -1.08), P <0.001) and total cholesterol (TC) (WMD: -13.00 mg/dl, 95% CI (-23.10, -2.91), P <0.001) in patients with T2DM. However, vitamin C supplementation failed to improve LDL and HDL. The meta-regression analysis suggested that lipid profile improvement was affected by duration of vitamin C treatment. Dose-response analysis showed that vitamin C supplementation changed LDL significantly based on vitamin C dose. According to our findings, vitamin C supplementation significantly improved lipid profile via decreases in TG and TC. However, vitamin C failed to affect LDL and HDL in diabetic populations. It appears that vitamin C supplementation is more beneficial to lipid profile in long-term vs. short term interventions.
The role of chromium as a weight loss agent remains questionable, and although previous meta‐analyses findings have reported small reductions in body weight in individuals with overweight/obesity following chromium supplementation, there have been significant limitations with these findings. The objective of this meta‐analysis was to evaluate the current evidence for the efficacy of oral chromium supplementation in individuals with overweight/obesity from randomized controlled trials. Studies were identified by a search of electronic databases from inception to November 2018 and combined and stratified analyses were used. Twenty‐one trials from 19 studies were identified which met all inclusion criteria which were suitable for statistical pooling, and data from 1316 participants were included. Pooled analysis showed significant reductions in anthropometric indices associated with body composition; for weight loss (weighted mean difference [WMD]: −0.75 kg, 95% confidence interval [CI], −1.04, −0.45, P < 0.001), body mass index (WMD: −0.40, 95% CI, −0.66, −0.13, P = 0.003 and body fat percentage (WMD: −0.68%, 95% CI, −1.32, −0.03, P = 0.04) in individuals with overweight/obesity. No changes were detected in controls. Subgroup analysis showed significant improvements in weight loss and body fat percentage, particularly for study durations ≤12 weeks and doses ≤400 μg/d. Chromium supplementation was associated with some improvements in body composition in subjects with obesity/overweight. The effect size was medium and the clinical relevance of chromium as a weight loss aid remains uncertain. Further investigation from larger and well‐designed randomized controlled studies, especially in patients with diabetes, is warranted.
Altogether twenty-six elderly subjects (aged 65–74 years) with persistent impaired glucose tolerance (World Health Organization (1985) criteria) identified in a population-based study, were randomly treated either with chromium-rich yeast (160 μg Cr/d) or with placebo for 6 months. The 24 h urinary Cr increased from 0.13 (se 0.03) to 0.40 (se 0.06) μg/d in the Cr group (n 13) but no change was found in the placebo group (n 11) (0.13 (se 0.02) v. 0.11 (se 0.02) μg/d). No significant change was observed in the oral glucose tolerance test (glucose dose 75 g; 0, 1 and 2 h blood glucose respectively): 5.3 (se 0.1), 9.3 (se 0.3), 8.2 (se 0.3) mmol/l v. 5.0 (se 0.1), 8.5 (se 0.4), 7.3 (se 0.5) mmol/l in the Cr group; 4.9 (se 0.2), 9.2 (se 0.6), 8.1 (se 0.3) mmol/l v. 4.8 (se 0.2), 8.5 (se 0.5), 7.0 (se 0.6) mmol/l in the placebo group (baseline v. 6 months). Glycosylated haemoglobin, plasma insulin, C-peptide and apolipoprotein Al and B levels remained unchanged, and no improvement was seen in serum total cholesterol (6.2 (se 0.3) v. 6.4 (se 0.3) mmol/l for the Cr group, 6.2 (se 0.4) v. 6.5 (se 0.3) mmol/l for the placebo group), high-density-lipoprotein-cholesterol (1.1 (se 0.1) v. 1.2 (se 0.1) mmol/l for the Cr group, 1.0 (se 0.1) v. 1.1 (se 0.1) mmol/l for the placebo group) or triacylglycerols (2.5 (se 0.4) v. 2.0 (se 0.4) mmol/l for the Cr group, 2.4 (se 0.2) v. 2.5 (se 0.2) mmol/l for the placebo group). The present results indicate that Cr supplementation does not improve glucose tolerance or serum lipid levels in elderly subjects with stable impaired glucose tolerance.
Objective:
Diabetes is the fifth leading cause of death by disease in the U.S. Diabetes also contributes to higher rates of morbidity-people with diabetes are at higher risk for heart disease, blindness, kidney failure, extremity amputations, and other chronic conditions. The objectives of this study were 1). to estimate the direct medical and indirect productivity-related costs attributable to diabetes and 2). to calculate and compare the total and per capita medical expenditures for people with and without diabetes.
Research design and methods:
Medical expenditures were estimated for the U.S. population with and without diabetes in 2002 by sex, age, race/ethnicity, type of medical condition, and health care setting. Health care use and total health care expenditures attributable to diabetes were estimated using etiological fractions, calculated based on national health care survey data. The value of lost productivity attributable to diabetes was also estimated based on estimates of lost workdays, restricted activity days, prevalence of permanent disability, and mortality attributable to diabetes. RESULTS-Direct medical and indirect expenditures attributable to diabetes in 2002 were estimated at 132 billion US dollars. Direct medical expenditures alone totaled 91.8 billion US dollars and comprised 23.2 billion US dollars for diabetes care, 24.6 billion US dollars for chronic complications attributable to diabetes, and 44.1 billion US dollars for excess prevalence of general medical conditions. Inpatient days (43.9%), nursing home care (15.1%), and office visits (10.9%) constituted the major expenditure groups by service settings. In addition, 51.8% of direct medical expenditures were incurred by people >65 years old. Attributable indirect expenditures resulting from lost workdays, restricted activity days, mortality, and permanent disability due to diabetes totaled 39.8 billion US dollars. U.S. health expenditures for the health care components included in the study totaled 865 billion US dollars, of which 160 billion US dollars was incurred by people with diabetes. Per capita medical expenditures totaled 13243 US dollars for people with diabetes and 2560 US dollars for people without diabetes. When adjusting for differences in age, sex, and race/ethnicity between the population with and without diabetes, people with diabetes had medical expenditures that were approximately 2.4 times higher than expenditures that would be incurred by the same group in the absence of diabetes.
Conclusions:
The estimated 132 billion US dollars cost likely underestimates the true burden of diabetes because it omits intangibles, such as pain and suffering, care provided by nonpaid caregivers, and several areas of health care spending where people with diabetes probably use services at higher rates than people without diabetes (e.g., dental care, optometry care, and the use of licensed dietitians). In addition, the cost estimate excludes undiagnosed cases of diabetes. Health care spending in 2002 for people with diabetes is more than double what spending would be without diabetes. Diabetes imposes a substantial cost burden to society and, in particular, to those individuals with diabetes and their families. Eliminating or reducing the health problems caused by diabetes through factors such as better access to preventive care, more widespread diagnosis, more intensive disease management, and the advent of new medical technologies could significantly improve the quality of life for people with diabetes and their families while at the same time potentially reducing national expenditures for health care services and increasing productivity in the U.S. economy.
Obesity and diabetes are increasing in the United States.
To estimate the prevalence of obesity and diabetes among US adults in 2001.
Random-digit telephone survey of 195 005 adults aged 18 years or older residing in all states participating in the Behavioral Risk Factor Surveillance System in 2001.
Body mass index, based on self-reported weight and height and self-reported diabetes.
In 2001 the prevalence of obesity (BMI > or =30) was 20.9% vs 19.8% in 2000, an increase of 5.6%. The prevalence of diabetes increased to 7.9% vs 7.3% in 2000, an increase of 8.2%. The prevalence of BMI of 40 or higher in 2001 was 2.3%. Overweight and obesity were significantly associated with diabetes, high blood pressure, high cholesterol, asthma, arthritis, and poor health status. Compared with adults with normal weight, adults with a BMI of 40 or higher had an odds ratio (OR) of 7.37 (95% confidence interval [CI], 6.39-8.50) for diagnosed diabetes, 6.38 (95% CI, 5.67-7.17) for high blood pressure, 1.88 (95% CI,1.67-2.13) for high cholesterol levels, 2.72 (95% CI, 2.38-3.12) for asthma, 4.41 (95% CI, 3.91-4.97) for arthritis, and 4.19 (95% CI, 3.68-4.76) for fair or poor health.
Increases in obesity and diabetes among US adults continue in both sexes, all ages, all races, all educational levels, and all smoking levels. Obesity is strongly associated with several major health risk factors.
Diabetes mellitus is a common endocrine disorder characterized by hyperglycemia and long-term complications affecting the eyes, nerves, blood vessels, skin, and kidneys. Increased glycation of proteins and accumulation of advanced glycation endproducts (AGEPs) have been implicated in the pathogenesis of diabetic complications. Glycation and AGEP formation are also accompanied by formation of free radicals via autoxidation of glucose and glycated proteins. Compounds with combined antiglycation and antioxidant properties may offer therapeutic potential. Recent studies suggest that aged garlic extract (AGE) inhibits formation of AGEPs in vitro and formation of glycation-derived free radicals. S-Allylcysteine, a key component of aged garlic, is a potent antioxidant and can inhibit AGEP formation. Aged garlic extract and S-allylcysteine deserve more attention and should be investigated to see whether they can reduce AGEPs in vivo.
Chromium treatment has been reported to improve glycemic control and insulin sensitivity in specific populations of patients with type 2 diabetes. The aim of this study was to determine the effect of chromium treatment on glycemic control in a Western population of insulin-dependent patients with type 2 diabetes.
In this 6-month double-blind study, patients with an HbA(1c) (A1C) >8% and insulin requirements of >50 units/day were randomly assigned to receive treatment with placebo or 500 or 1,000 mug chromium daily in the form of chromium picolinate. The primary efficacy parameter was a change in A1C. Secondary end points were changes in lipid profile, BMI, blood pressure, and insulin requirements.
In this per-protocol analysis (n = 46), the decrease in A1C was approximately equal across the three groups (0.4%). All patients had a BMI >25 kg/m(2). No differences were found in the secondary end points. We found a weak relationship between an increasing serum chromium concentration and improvement of the lipid profile.
There is no evidence that high-dose chromium treatment is effective in obese Western patients with type 2 diabetes.
A diabetes epidemic emerged during the 20th century and continues unchecked into the 21st century. It has already taken an extraordinary toll on the U.S. population through its acute and chronic complications, disability, and premature death. Trend data suggest that the burden will continue to increase. Efforts to prevent or delay the complications of diabetes or, better yet, to prevent or delay the development of diabetes itself are urgently needed.
Objective
There is accumulating facts that the metabolism of essential trace elements is altered in diabetic patients. The aim of present study was to compare the status of essential trace elements, chromium (Cr), manganese (Mn), and zinc (Zn) in biological samples (whole blood, urine and scalp hair) of insulin dependent diabetic mothers (age ranged 30–40) and their newly born infants (n = 76). An age matched 68 non-diabetic mothers and their infants, residing in the same locality, were selected as referents. For a comparative study, the biological samples of non-diabetic and diabetic pregnant and non pregnant of same age group and socio-economics status were also analysed.
Methodology
The biological samples (scalp hair, blood and urine) were collected from study and referent groups. The Cr, Mn and Zn concentrations in all three biological samples were determined by a flame/electrothermal atomic absorption spectrometer, prior to microwave assisted acid digestion. The validity and accuracy of the methodology was checked by certified reference materials (CRMs) and using conventional wet acid digestion method on same CRMs.
Results
The mean values of Cr, Mn and Zn in scalp hair and blood samples of diabetic mothers and their infants were significantly lower as compared to the referent mothers-infants pairs (p < 0.01), while urinary excretion of all these elements were high in diabetic mother–infant pair samples.
Conclusion
The deficiencies of essential trace elements, Cr, Mn and Zn in biological samples of diabetic women, may play role in the pathogenesis of diabetes mellitus and impacts on their neonates.
it has been suggested that Chromium (Cr), one of the essential minerals, can be beneficial to type 2 diabetic patients because it lowers blood glucose levels by improving various steps in insulin action. A few studies reported that Cr might also have some beneficial effects in people with type 1 diabetes mellitus and in streptozotocin-treated rats, but direct beneficial effects of Cr on pancreatic beta cells have not been proven. We performed this study to determine whether Cr could have direct protective effects on INS-1 cells in high glucose conditions that mimic the actual diabetic state.
INS-1 cells were cultured for 48h in RPMI medium with 33mM glucose as the stress condition and 11mM glucose as a control. CrCl(3) was used to verify whether Cr could protect INS-1 cells from glucotoxic stress. Cell viability and apoptosis were evaluated by MTT assay and FACS. The level of insulin mRNA, by semi-quantitative RT-PCR, was significantly reduced at 33mM glucose concentration after 48h of incubation.
cell viability was reduced by 50%, and 35% of the cells underwent apoptosis at the same culture condition. Addition of various concentrations of CrCl(3) to INS-1 cells in 33mM glucose for different durations of time did not reveal any beneficial effects on cell viability, degree of apoptosis, insulin mRNA levels, and glucose stimulated insulin secretion.
we could not find any evidence that Cr had direct beneficial effects on INS-1 cells in high glucose induced stress conditions.
We estimated the number of people worldwide with diabetes for the years 2010 and 2030.
Studies from 91 countries were used to calculate age- and sex-specific diabetes prevalences, which were applied to national population estimates, to determine national diabetes prevalences for all 216 countries for 2010 and 2030. Studies were identified using Medline, and contact with all national and regional International Diabetes Federation offices. Studies were included if diabetes prevalence was assessed using a population-based methodology, and was based on World Health Organization or American Diabetes Association diagnostic criteria for at least three separate age-groups within the 20-79 year range. Self-report or registry data were used if blood glucose assessment was not available.
The world prevalence of diabetes among adults (aged 20-79 years) will be 6.4%, affecting 285 million adults, in 2010, and will increase to 7.7%, and 439 million adults by 2030. Between 2010 and 2030, there will be a 69% increase in numbers of adults with diabetes in developing countries and a 20% increase in developed countries.
These predictions, based on a larger number of studies than previous estimates, indicate a growing burden of diabetes, particularly in developing countries.
The effects of chromic chloride (CrCl3) administered orally for 12 weeks to five elderly subjects with glucose intolerance were assessed. Pretreatment and posttreatment, the hyperglycemic clamp technique was employed to determine glucose utilization, beta-cell sensitivity to glucose, and tissue sensitivity to insulin. In addition, erythrocyte insulin binding was studied. Urinary chromium excretion increased approximately 5 fold indicating good compliance with supplementation. The oral glucose tolerance curves following supplementation were lowered from 60 to 120 minutes but only the 60-minute values were significantly lowered. In agreement with this was significantly increased glucose utilization during the hyperglycemic clamp studies. Tissue sensitivity to insulin, receptor affinity, and total insulin binding were unchanged by supplementation while beta-cell sensitivity to glucose increased following supplementation (P less than 0.04), and explained the increased glucose utilization. HDL and LDL and total cholesterol levels were slightly lower after chromium supplementation, but no change reached statistical significance. The LDL/HDL cholesterol ratio was unchanged. This study shows small but statistically significant effects of CrCl3 on carbohydrate metabolism. The clinical relevance of these effects, that is, their prophylactic or therapeutic significance, remains to be determined.
The 1994 passage of Public Law 103-417, the Dietary Supplement and Health Education Act, resulted in an exponential increase in the number and variety of dietary supplements available for over-the-counter purchase. Surveys conducted on random samples of U.S. residents have shown that approximately half of all American women use dietary supplements regularly, but very little is known about the risks and benefits of long-term and widespread supplement use. To accurately evaluate the health effects of supplement use, it is important to characterize usage patterns, motivations and costs of supplement use. However, this is a considerable challenge because accurate supplement data are difficult to collect, product databases with consistent and reliable information are lacking and survey instruments or interview protocols currently in use may not capture information about product selection for specific health conditions, motivations for use, or out-of-pocket expenditures. Future research would benefit from collaborative efforts among governmental scientists, academic scientists and industry to improve dietary supplement data collection methods and develop appropriate tools for analysis.
Earlier studies from our laboratory have indicated insulin sensitizing action of chromium picolinate as the mechanism of its anti-diabetic activity in experimental models of type I and type II diabetes. In the present investigation, we have evaluated the effects of chronic administration of chromium picolinate on the functional and histological alterations of streptozotocin (STZ)-induced diabetes in rats. Type I diabetes was induced by intravenous injection of STZ (40 mg/kg) in adult rats, whereas, type II diabetes was induced by intraperitoneal injection of STZ (90 mg/kg) in 2-day old rat pups which in adulthood develop abnormalities resembling type II diabetes. Chromium picolinate was administered at 8 microg/ml in drinking water for 6 weeks and was found to improve glucose tolerance and increase insulin sensitivity of STZ-diabetic rats. This treatment decrease elevated serum creatinine and urea levels as well as elevated serum levels of hepatic enzymes of both groups of diabetic rats. Histopathological studies of kidney and liver show decrease in the intensity and incidence of vacuolations, cellular infiltration and hypertrophy of STZ and nSTZ (neonatal STZ) diabetic rats. Chronic treatment with chromium picolinate however, did not alter the normal function or morphology of control rats. Chronic chromium picolinate at the therapeutic doses that improved glucose tolerance, was observed to have no hepatotoxic or nephrotoxic potential. It was rather found to improve renal and hepatic function and to reduce abnormalities associated with STZ-diabetes. Chromium picolinate could play an important role in the long term management of diabetes mellitus.
A diabetes epidemic emerged during the 20th century and continues unchecked into the 21st century. It has already taken an extraordinary toll on the U.S. population through its acute and chronic complications, disability, and premature death. Trend data suggest that the burden will continue to increase. Efforts to pre- vent or delay the complications of diabetes or, better yet, to prevent or delay the development of diabetes itself are urgently needed.
The safety and effectiveness of over-the-counter (OTC) drugs are assessed through the Food and Drug Administration's (FDA's) OTC drug review. Prescription drugs are approved through the rigorous new drug application (NDA) process. In contrast, dietary supplements are regulated as foods, and the FDA must determine that a dietary supplement ingredient poses a "significant or unreasonable risk of illness or injury" instead of requiring the manufacturer to provide safety data. According to the FDA, there are more than 29,000 different dietary supplements available to consumers today. This momentum has its roots in consumer interest in health and self-care and suggests that Americans are searching for alternatives to conventional foods for physical and mental well being. The Committee on the Framework for Evaluating the Safety of Dietary Supplements was formed under the auspices of the Food and Nutrition Board that produced a report entitled Dietary Supplements: A Framework for Evaluating Safety. Categories of specific information identified for use are 1) human data, 2) animal studies, 3) in vitro experiments, and 4) information on related substances. Several factors were identified to guide the FDA in applying the framework. Two of these factors are expressed as follows: 1) "the appropriate scientific standard to be used to overturn this basic assumption of safety is to demonstrate significant or unreasonable risk, not prove that an ingredient is unsafe"; and 2) "approaches taken by diverse organizations and governmental bodies, both within and outside the United States, which evaluate the safety and at times efficacy of dietary supplement ingredients, vary in their relevance to the protection of the American public from risks associated with consumption of dietary supplement ingredients".
The objective of the Australian Diabetes and Lifestyle Study (AusDiab) was to determine the frequency of diabetes and other categories of glucose intolerance (impaired glucose tolerance (IGT) and impaired fasting glucose (IFG)), as well as other cardiovascular risk factors in Australia and to compare the prevalence with previous Australia data. The study involved a national sample involving 11 247 participants aged 25 years from the six states and the Northern Territory. They were examined in a cross-sectional survey using the 75-g oral glucose tolerance test to assess fasting and 2-h plasma glucose levels. The World Health Organization diagnostic criteria were used to determine the prevalence of abnormal glucose tolerance. The prevalence of diabetes in Australia was 8.0% in men and 6.8% in women, and an additional 17.4% of men and 15.4% of women had IGT or IFG. The overall diabetes prevalence in Australia was 7.4%, and an additional 16.4% had IGT or IFG. Diabetes prevalence has more than doubled since 1981, and this is only partially explained by changes in age profile and obesity. Almost one in four Australians 25 years and over has either diabetes or a condition of impaired glucose metabolism. This condition is associated with substantially increased immediate risk of heart disease as well as increased risk of diabetes in the future. In addition, there were high prevalences of other key cardiovascular disease risk factors. Australia has a rapidly rising prevalence of diabetes and other categories of abnormal glucose tolerance. The prevalence of abnormal glucose tolerance in Australia is one of the highest yet reported from a developed nation with a predominantly European background.
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