Chromium Picolinate Supplementation Attenuates Body Weight Gain and Increases Insulin Sensitivity in Subjects With Type 2 Diabetes

Abstract

OBJECTIVE -Chromium picolinate (CrPic) supplementation has been suggested to improve glycemia, but there are conflicting reports on efficacy. We sought to determine the effect of CrPic on insulin sensitivity, glycemic control, and body composition in subjects with type 2 diabetes.RESEARCH DESIGN AND METHODS -Thirty-seven subjects with type 2 diabetes were evaluated. After baseline, subjects were placed on a sulfonylurea (glipizide gastrointestinal therapeutic system 5 mg/day) with placebo for 3 months. Subjects were then randomized in a double-blind fashion to receive either the sulfonylurea plus placebo (n ϭ 12) or the sulfonylurea plus 1,000 g Cr as CrPic (n ϭ 17) for 6 months. Body composition, insulin sensitivity, and glycemic control were determined at baseline, end of the 3-month single-blind placebo phase, and end of study.RESULTS -Subjects randomized to sulfonylurea/placebo, as opposed to those randomized to sulfonylurea/CrPic, had a significant increase in body weight (2.2 kg, P Ͻ 0.001 vs. 0.9 kg, P ϭ 0.11), percent body fat (1.17%, P Ͻ 0.001 vs. 0.12%, P ϭ 0.7), and total abdominal fat (32.5 cm 2 , P Ͻ 0.05 vs. 12.2 cm 2 , P Ͻ 0.10) from baseline. Subjects randomized to sulfonylurea/CrPic had significant improvements in insulin sensitivity corrected for fat-free mass (28.8, P Ͻ 0.05 vs. 15.9, P ϭ 0.4), GHb (Ϫ1.16%, P Ͻ 0.005 vs. Ϫ0.4%, P ϭ 0.3), and free fatty acids (Ϫ0.2 mmol/l, P Ͻ 0.001 vs. Ϫ0.12 mmol/l, P Ͻ 0.03) as opposed to sulfonylurea/placebo.CONCLUSIONS -This study demonstrates that CrPic supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control. Further, CrPic supplementation significantly attenuated body weight gain and visceral fat accumulation compared with the placebo group. Diabetes Care 29:1826 -1832, 2006T he primary strategy to improve metabolic control in patients with type 2 diabetes consists of lifestyle modification combined with pharmacologic intervention (1). However, alternative strategies, e.g., nutritional supplementation with over-the-counter agents, are extensively practiced by a large number of patients and are frequently undertaken without first informing the medical provider. According to the Food and Drug Administration, there are more than 29,000 different nutritional supplements available to consumers, and Americans spend over 12 billion dollars per year on these supplements (2,3). Unfortunately, considerable controversy exists regarding use of dietary supplements in subjects with diabetes because efficacy data for many of the supplements consist of only uncontrolled studies and anecdotal reports. As such, there is a paucity of data in humans in regard to the effect of most commercially available supplements to improve metabolic abnormalities.One supplement that has attracted considerable clinical interest is chromium (4). However, routine use of chromium in subjects with diabetes is not currently recommended, and the most recent 2006 Clinical Practice Recommendations from the A...

Chromium (d‐Phenylalanine)3 Improves Obesity‐Induced Cardiac Contractile Defect in ob/ob Mice

“…Anderson et al (14) revealed that chromium ingestion in both short (2 months) and longer (4 months) terms displays beneficial effects on plasma glucose, insulin, and hemoglobin A 1c concentrations. In another study, Cr(pic) 3 supplementation significantly improved insulin sensitivity and glucose control and attenuated BW gain and visceral fat in type 2 diabetic patients taking sulfonylurea (38). Further study is warranted to scrutinize the longitudinal effect of chromium treatment in diabetes, obesity, and insulin resistance.…”

“…Patients receiving total parenteral nutrition devoid of chromium display signs of insulin resistance, which can be reversed by chromium supplementation, suggesting the role of chromium as an essential trace metal for carbohydrate and lipid metabolism (36). Further experimental and clinical studies have consolidated the efficacy of chromium in the management of type 2 diabetes and associated comorbidities such as insulin resistance and obesity (37,38). In a recent clinical trial, effects of chromium on cardiac function were assessed in diabetic patients with a focus on Q-T interval prolongation, a parameter associated with high fasting glucose levels, high plasma insulin levels, and increased fasting C-peptide levels in diabetes.…”

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

“…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) 60 …”

“…Baseline HbA1c levels were 8.2%, and these fell to 7.6 % post treatment; however, mean standard deviations or mean standard errors were not reported, nor were final HbA1c values reported in the control group, precluding statistical analysis. Martin et al 45 enrolled 17 T2DM patients whose FPG values were >125 mg/dL and <170 mg/dL at baseline and who were also taking hypoglycemic medications (sulfonylureas). Patients received chromium picolinate 1000 lg/d for 24 weeks in a double-blind RCT using a per-protocol analysis.…”

Dietary Supplementation During Diabetes Therapy and the Potential Risk of Interactions

“…Chromium supplementation can be beneficial for fasting serum glucose, total cholesterol and triglyceride concentrations and the percentage of HbA1c, as well as body weight and insulin sensitivity in T2DM patients [18][19][20]. On the other hand, it was not possible to evaluate chromium intake from the participants' diets, so it is unknown whether there was any necessity to supplement their diets with this trace mineral.…”