Chromium Supplementation Does Not Improve Glucose Tolerance, Insulin Sensitivity, or Lipid Profile

Gunton, Jenny E.; Cheung, N. Wah; Hitchman, Rosemary; Hams, Graham; O’Sullivan, Christine; Foster‐Powell, Kaye; McElduff, Aidan

doi:10.2337/diacare.28.3.712

Cited by 68 publications

(46 citation statements)

References 7 publications

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“…Among the nine studies of participants with glucose intolerance (20,(32)(33)(34)39,46,53,54,58), only Anderson et al (32,33), in two separate studies of 200 g/day chromium chloride, reported statistically significant improvements in postload glucose levels with chromium supplementation: in one, an 8% reduction in 4-h AUC-Glu (but not in 3-h AUCGlu) and in the other a 1.1 mmol/l reduction in 90-min postload glucose. Other studies of all four chromium formulations reported nonsignificant changes in AUC-Glu of Ϫ21 to ϩ3% and in various timed postload glucose levels of Ϫ1.5 to ϩ0.4 mmol/l.…”

Section: Participants With Glucose Intolerancementioning

confidence: 99%

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Effect of Chromium Supplementation on Glucose Metabolism and Lipids

Tatsioni²,

et al. 2007

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OBJECTIVE -A systematic review of the effect of chromium supplementation on glucose metabolism and lipid levels. RESEARCH DESIGN AND METHODS -A literature search was conducted in MED-LINE and the Commonwealth Agricultural Bureau. Eligible studies were English language randomized controlled trials of chromium supplement intake Ն3 weeks, with Ն10 participants receiving chromium. All trials with glucose metabolism outcomes and trials of individuals with diabetes or glucose intolerance for lipid outcomes were included. Meta-analyses were performed as appropriate.RESULTS -Forty-one studies met criteria, almost half of which were of poor quality. Among participants with type 2 diabetes, chromium supplementation improved glycosylated hemoglobin levels by Ϫ0.6% (95% CI Ϫ0.9 to Ϫ0.2) and fasting glucose by Ϫ1.0 mmol/l (Ϫ1.4 to Ϫ0.5) but not lipids. There was no benefit in individuals without diabetes. There were some indications of dose effect and differences among chromium formulations. Larger effects were more commonly observed in poor-quality studies. The evidence was limited by poor study quality, heterogeneity in methodology and results, and a lack of consensus on assessment of chromium status.CONCLUSIONS -No significant effect of chromium on lipid or glucose metabolism was found in people without diabetes. Chromium supplementation significantly improved glycemia among patients with diabetes. However, future studies that address the limitations in the current evidence are needed before definitive claims can be made about the effect of chromium supplementation. Diabetes Care 30:2154-2163, 2007C hromium is an essential mineral that is thought to be necessary for normal glucose and lipid homeostasis (1-3). Trivalent chromium in a complex known as glucose tolerance factor is considered the biologically active form. It was originally discovered in brewer's yeast (4). Chromium chloride, chromium nicotinate, and chromium picolinate are commonly used formulations of trivalent chromium. Chromium picolinate is a formulation designed to improve absorption (5). Severe chromium deficiency is known to cause reversible insulin resistance and diabetes (6 -8). However, the effect of chromium supplementation in individuals who are not severely chromium deficient is unclear. Manufacturers aggressively promote the benefits of chromium in the prevention and treatment of insulin resistance and its associated conditions (type 2 diabetes, dyslipidemia, and cardiovascular disease), and the public has embraced its use. Chromium supplement sales represent ϳ6% of the U.S. mineral supplement market (9).To clarify the role of chromium supplementation in the prevention and management of abnormal glucose and lipid homeostasis, we performed a systematic review of randomized controlled trials on the effect of chromium supplement intake on glucose metabolism and lipid profile. RESEARCH DESIGN AND METHODS Literature search and eligibility criteriaWe conducted a systematic review of the English-language literature on the effects of chromium supplementa...

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Section: Participants With Glucose Intolerancementioning

confidence: 99%

“…Participants with glucose intolerance Eight studies with 11 arms included participants with glucose intolerance (20,(32)(33)(34)39,40,53,54) (Fig. 2B).…”

Section: Balk and Associatesmentioning

confidence: 99%

Effect of Chromium Supplementation on Glucose Metabolism and Lipids

Tatsioni²,

et al. 2007

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“…In addition, this dose, in controlled clinical trials, has not been observed to result in any adverse effects (21,35,36). A recent study that evaluated much lower daily doses (ϳ100 g/day of elemental chromium as CrPic) reported negative results in individuals with impaired glucose tolerance (37,38). In addition, Kleefstra et al (39) evaluated 1,000 g/day of chromium as CrPic and reported no significant benefit in obese patients with type 2 diabetes.…”

Section: Metabolic and Physiologic Parametersmentioning

confidence: 99%

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

Martin

Wang²,

Zhang³

et al. 2006

Diabetes Care

176

152

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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...

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“…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) …”

Section: Studies Measuring Hba1cmentioning

confidence: 99%

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

2016

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Some adults with type 2 diabetes mellitus (T2DM) believe that chromium-containing supplements will help control their disease, but the evidence is mixed. This narrative review examines the efficacy of chromium supplements for improving glycemic control as measured by decreases in fasting plasma glucose (FPG) or hemoglobin A1c (HbA1c). Using systematic search criteria, 20 randomized controlled trials of chromium supplementation in T2DM patients were identified. Clinically meaningful treatment goals were defined as an FPG of 7.2 mmol/dL, a decline in HbA1c to 7%, or a decrease of 0.5% in HbA1c. In only a few randomized controlled trials did FPG (5 of 20), HbA1c (3 of 14), or both (1 of 14) reach the treatment goals with chromium supplementation. HbA1c declined by 0.5% in 5 of 14 studies. On the basis of the low strength of existing evidence, chromium supplements have limited effectiveness, and there is little rationale to recommend their use for glycemic control in patients with existing T2DM. Future meta-analyses should include only high-quality studies with similar forms of chromium and comparable inclusion/exclusion criteria to provide scientifically sound recommendations for clinicians.

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Chromium Supplementation Does Not Improve Glucose Tolerance, Insulin Sensitivity, or Lipid Profile

Cited by 68 publications

References 7 publications

Effect of Chromium Supplementation on Glucose Metabolism and Lipids

Effect of Chromium Supplementation on Glucose Metabolism and Lipids

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

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

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