Characterization of the metabolic and physiologic response to chromium supplementation in subjects with type 2 diabetes mellitus

Abstract

OBJECTIVE To provide a comprehensive evaluation of chromium (Cr) supplementation on metabolic parameters in a cohort of Type 2 DM subjects representing a wide phenotype range and to evaluate changes in “responders” and “non-responders”. DESIGN After pre-intervention testing to assess glycemia, insulin sensitivity (assessed by euglycemic clamps), Cr status, body composition, subjects were randomized in a double-blind fashion to placebo or 1,000 μg Cr. A sub-study was performed to evaluate 24 hour energy balance/substrate oxidation and myocellular/intra-hepatic lipid content. RESULTS There was not a consistent effect of chromium supplementation to improve insulin action across all phenotypes. Insulin sensitivity was negatively correlated to soleus and tibialis muscle intramyocellular lipids and intra-hepatic lipid content. Myocellular lipids were significantly lower in subjects randomized to Cr. At pre-intervention, “responders”, defined as insulin sensitivity change from baseline > 10%, had significantly lower insulin sensitivity and higher fasting glucose and A1c when compared to placebo and “non-responders”, i.e. insulin sensitivity change from baseline < 10%. Clinical response was significantly correlated (p < 0.001) to the baseline insulin sensitivity, fasting glucose and A1c. There was no difference in Cr status between “responders”, and “non-responders”. CONCLUSIONS Clinical response to chromium is more likely in insulin resistant subjects who have more elevated fasting glucose and A1c levels. Cr may reduce myocellular lipids and enhance insulin sensitivity in subjects with type 2 DM independent of effects on weight or hepatic glucose production. Thus, modulation of lipid metabolism by Cr in peripheral tissues may represent a novel mechanism of action.

Effect of Chromium on Glucose and Lipid Profiles in Patients with Type 2 Diabetes; A Meta-analysis Review of Randomized Trials

“…They included both type 1 and type 2 DM, gestational DM, and even steroid-induced diabetes. In the present meta-analysis, four studies showed that Cr has no significant effect on HbA1c (13,15,16,19). In two other studies (17,18), a 0.7% and 1.16% reductions in HbA1c was reported for Cr, respectively.…”

“…The summary for effect size of weighted mean differences of BMI change "∆BMI" in diabetic patients in Cr supplement therapy for six included trials comparing to Pl retrieved from five studies (13,(15)(16)(17)19) was -0.07 with 95% CI= -0.37 to 0.23 (P= 0.66, Figure 9-a). The Cochrane Q test for heterogeneity indicated that the studies are not heterogeneous (P= 0.73) and could be combined, thus the fixed effects for individual and summary of effect size for weighted mean differences was applied.…”

Chromium supplements for glycemic control in type 2 diabetes: limited evidence of effectiveness

“…Abbreviations: Cr, chromium; IGT, impaired glucose tolerance; RCTs, randomized controlled trials. 22 Cefalu et al (2010) 23 Chen et al (2014) 24 Crawford et al (1999) 25 Evans (1989) 26 Ghosh et al (2002) 27 Gunton et al (2005) 28 Grant and McMullen. (1982) 29 Grant et al (1997) 30 Hermann et al (1998) 31 Hermann et al (1994) 32 Jain et al (2012) 40 Lee and Reasner (1994) 41 Li et al (1992) 42 Li (1994) 43 45 Martinez et al (1985) 46 Mossop (1983) 47 Offenbacher and Pi-Sunyer (1980) 48 Offenbacher et al (1985) 49 Pasman et al (1997) 50 Pei et al (2006) 51 Rabinovitz et al (1983) 52 Rabinovitz et al (2004) 53 Racek et al (2006) 54 Riales et al (1981) 55 Singer and Geohas (2006) 56 Sharma et al (2011) 57 Sherman et al (1968) 58 Thomas and Gropper (1996) 59 Urberg and Zemel (1987) …”

Aerobic training reduces oxidative stress in skeletal muscle of rats exposed to air pollution and supplemented with chromium picolinate

“…In relation to the lack of effect of supplementation, CrPic can play an antioxidant effect when there is an oxidative disruption, because CrPic supplementation could preserve the antioxidant status when there are a depletion of antioxidant enzymes and an increase in oxidative stress [51][52][53]. In the present study, positive action of CrPic was not observed, likely because there was no depletion of antioxidant enzymes or increased oxidative stress in our sample.…”