Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. The effect of chromium picolinate and biotin supplementation on glycemic control in poorly controlled patients with type 2 diabetes mellitus: a placebo-controlled, double-blinded, randomized trial. Elevated Intakes of Supplemental Chromium Improve Glucose and Insulin Variables in Individuals With Type 2 Diabetes Chromium supplementation does not improve glucose tolerance, insulin sensitivity, or lipid profile: a randomized, placebo-controlled, double-blind trial of supplementation in subjects with impaired glucose tolerance. Beneficial Effect of Chromium Supplementation on Serum Triglyceride Levels in NIDDM Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. Trivalent chromium and the diabetes prevention program. Effect of chromium dinicocysteinate supplementation on circulating levels of insulin, TNF-α, oxidative stress, and insulin resistance in type 2 diabetic subjects: randomized, double-blind, placebo-controlled study.
PROJECT Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism . It influences glucose metabolism by potentiating the action as taking part in insulin signal amplification mechanism . A placebo-controlled single blind , prospect i ve study was carried out to investigate the effect of chromium supplementation on blood glucose , HbA(1)C and lipid profile in newly onset patients with type-2 diabetes . PROCEDURE Total 40 newly onset type-2 diabetics were selected and after 1 month stabilization further r and omly divided into two groups viz . study group and placebo group . The study group received 9 g brewer 's yeast ( 42 μg Cr ) daily and the other placebo group received yeast devoid of chromium for 3 months . Subjects were instructed not to change their normal eating and living habits . Fasting blood glucose , HbA(1)C and lipid profile were analyzed at beginning and completion of the study . RESULTS Results revealed that fasting blood glucose level significantly reduced in the subjects consuming yeast supplemented with chromium ( 197.65±6.68 to 103.68±6.64 mg/dL ; p<0.001 ) . HbA(1)C values improved significantly from 9.51±0.26 % to 6.86±0.28 % ; p<0.001 indicating better glycaemic control . In experimental group total cholesterol , TG and LDL levels were also significantly reduced from 199.66±3.11 to 189.26±3.01 mg/dL ; p<0.02 , 144.94±8.31 to 126.01±8.26 ; p<0.05 and 119.19±1.71 to 99.58±1.10 ; p<0.001 respectively . CONCLUSIONS These data demonstrate beneficial effect of chromium supplementation on glycaemic control and lipid variables in subjects with newly onset type-2 diabetes The aim of this study is to evaluate the effect and safety of chromium-containing milk powder in patients with type 2 diabetes mellitus . A r and omized , double-blind , placebo-controlled trial was conducted in Taiwan . A total of 60 patients with type 2 diabetes mellitus , aged 30 to 75 years , and on a dose of gliclazide sulfonylurea agent ( < or = 160 mg/d ) for at least 3 months were enrolled . Their glycosylated hemoglobin ranged from 7.5 % to 12 % , fasting plasma glucose ( FPG ) from 140 to 250 mg/dL , and body mass index from 20 to 35 kg/m(2 ) . The subjects were divided into 2 groups , one group to receive chromium-containing milk powder ( chromium 200 microg/20 g milk powder ) and the other to receive placebo twice a day for 16 weeks . Frequently sample d intravenous glucose tolerance test ( IVGTT ) was performed before and after treatment . The chromium group demonstrated a lower FPG and fasting insulin ( -38.1 + /- 9.2 vs 63 + /- 8 . 5 mg/dL and -1.7 + /- 0.2 vs 1.9 + /- 0.3 microU/mL , respectively ; P < .05 ) , especially in male patients ( -41 + /- 9.2 vs 85 + /- 11.7 mg/dL and -2.7 + /- 0.2 vs 3.1 + /- 0.3 microU/mL , respectively ; P < .01 ) , at the end of the study . Lower glycosylated hemoglobin was observed in chromium-treated male patients ( -1.1 + /- 0 . 5 vs 0.7 + /- 0 . 2 ; P < .05 ) . However , there were no significant changes in other metabolic parameters ( lipid profiles including total cholesterol , triglyceride , low-density lipoprotein cholesterol , and high-density lipoprotein cholesterol ) , except improvement of insulin resistance ( homeostasis model assessment for insulin resistance and insulin sensitivity index from frequently sample d intravenous glucose tolerance test ) observed in male patients ( -2.1 + /- 1.1 vs -0.41 + /- 1.12 and 0.18 + /- 0.11 vs -0.15 + /- 0 . 2 , respectively ; P < .05 ) . There were no adverse events in both groups , except for mild complaints in the chromium group on constipation ( 5 % ) and flatulence ( 5 % ) . Intake of milk powder containing 400 microg/d of chromium for 16 weeks in subjects with type 2 diabetes mellitus result ed in lowering of FPG , fasting insulin , and improvement of metabolic control in male patients BACKGROUND Pre clinical studies have shown that the combination of chromium picolinate and biotin significantly enhances glucose uptake in skeletal muscle cells and enhances glucose disposal . The present pilot study was conducted to determine if supplementation with chromium picolinate and biotin can improve glycemic control in patients with type 2 diabetes mellitus with suboptimal glycemic control despite use of oral antihyperglycemic agents . METHODS Forty-three subjects with impaired glycemic control ( 2-h glucose > 200 mg/dL ; glycated hemoglobin > or=7 % ) , despite treatments with oral antihyperglycemic agents  , were r and omized to receive 600 microg of chromium as chromium picolinate and biotin ( 2 mg/day ) ( Diachrome ( , Nutrition 21 , Inc. , Purchase , NY ) in addition to their pre study oral antihyperglycemic agent therapy . Measurements of glycemic control and blood lipids were taken at baseline and after 4 weeks . RESULTS After 4 weeks , there was a significantly greater reduction in the total area under the curve for glucose during the 2-h oral glucose tolerance test for the treatment group ( mean change -9.7 % ) compared with the placebo group ( mean change + 5.1 % , P < 0.03 ) . Significantly greater reductions were also seen in fructosamine ( P < 0.03 ) , triglycerides ( P < 0.02 ) , and triglycerides/ high-density lipoprotein cholesterol ratio ( P < 0.05 ) in the treatment group . No significant adverse events were attributed to chromium picolinate and biotin supplementation . CONCLUSIONS This pilot study demonstrates that supplementation with a combination of chromium picolinate and biotin in poorly controlled patients with diabetes receiving antidiabetic therapy improved glucose management and several lipid measurements .  Chromium picolinate/ biotin supplementation may represent an effective adjunctive nutritional therapy to people with poorly controlled diabetes with the potential for improving lipid metabolism Chromium is an essential nutrient involved in normal carbohydrate and lipid metabolism . The chromium requirement is postulated to increase with increased glucose intolerance and diabetes . The objective of this study was to test the hypothesis that the elevated intake of supplemental chromium is involved in the control of type 2 diabetes . Individuals being treated for type 2 diabetes ( 180 men and women ) were divided r and omly into three groups and supplemented with : 1 ) placebo , 2 ) 1.92 μmol ( 100 μg ) Cr as chromium picolinate two times per day , or 3 ) 9.6 μmol ( 500 μg ) Cr two times per day . Subjects continued to take their normal medications and were instructed not to change their normal eating and living habits . HbA1c values improved significantly after 2 months in the group receiving 19.2 pmol ( 1,000 pg ) Cr per day and was lower in both chromium groups after 4 months ( placebo , 8.5 ± 0.2 % ; 3.85 pmol Cr , 7.5 ± 0.2 % ; 19.2 pmol Cr , 6.6 ± 0.1 % ) . Fasting glucose was lower in the 19.2-μmol group after 2 and 4 months ( 4-month values : placebo , 8.8 ± 0.3 mmol/1 ; 19.2 μmol Cr , 7.1 ± 0.2 mmol/1 ) . Two-hour glucose values were also significantly lower for the subjects consuming 19.2 μmol supplemental Cr after both 2 and 4 months ( 4-month values : placebo , 12.3 ± 0.4 mmol/1 ; 19.2 μmol Cr , 10.5 ± 0.2 mmol/1 ) . Fasting and 2-h insulin values decreased significantly in both groups receiving supplemental chromium after 2 and 4 months . Plasma total cholesterol also decreased after 4 months in the subjects receiving 19.2 μmol/day Cr . These data demonstrate that supplemental chromium had significant beneficial effects on HbA1c , glucose , insulin , and cholesterol variables in subjects with type 2 diabetes . The beneficial effects of chromium in individuals with diabetes were observed at levels higher than the upper limit of the Estimated Safe and Adequate Daily Dietary Intake Chromium supplements are thought to be the second most commonly taken nutritional supplement , used by an estimated 10 million Americans ( 1 ) . Chromium is an essential element in humans , and deficiency is associated with the development of diabetes , which was first noted in patients receiving long-term parenteral nutrition before the advent of routine chromium supplementation  ( 2,3 ) . In these patients , diabetes resolved following chromium replacement ( 2–4 ) . The dietary requirement for chromium is controversial , with the recommended daily intake in the U.S. being 0.05–0.20 μg ( 5 ) . Chromium is abundant in the environment ; however , aside from the extreme situation of unsupplemented parenteral nutrition , it has proven difficult to ascertain any clinical effects , due solely to chromium deficiency . Despite these difficulties , chromium supplements are widely promoted in the complementary health industries . There are many studies examining the effects of various forms of chromium supplementation ( rev . in 6,7 ) . These studies utilized a variety of chromium formulations , varying doses , and patients with normal glucose tolerance , diabetes , or gestational diabetes . The outcomes have been inconsistent . Some studies showed no benefit , and other studies have shown inconsistent improvements in glucose , insulin resistance , and /or lipids . The paucity of data has prompted the National Institutes of Health to release a program announcement to address the issue : “ Chromium as an adjuvant therapy OBJECTIVE To investigate the effect of chromium picolinate supplementation on the lipid profile of the predominantly Hispanic population of non-insulin-dependent diabetes mellitus ( NIDDM ) patients in San Antonio , Texas . RESEARCH DESIGN AND METHODS A prospect i ve , double-blind , placebo-controlled , crossover study was performed on 14 men and 16 women . Initially , each patient was r and omly assigned to receive either chromium picolinate or placebo for 2 months . This initial treatment phase was followed by a 2-month washout period . Subjects were then crossed-over and received the alternate capsule for an additional 2 months . Fasting blood glucose , HbA1c , and serum lipids were compared at the end of each treatment phase . RESULTS Twenty-eight of the originally enrolled 30 patients completed the study . There were no adverse reactions to chromium reported . There were no differences noted between the control and chromium-treated subjects in glucose control , high-density lipoprotein cholesterol levels , or low-density lipoprotein cholesterol levels . Triglyceride ( TG ) levels were reduced significantly ( 17.4 % ; P < 0.05 ) during the 2 months of chromium supplementation . CONCLUSIONS Ours is the first report of a significant reduction in serum TGs in a group of NIDDM patients treated with chromium . The low cost and excellent safety profile of chromium make it an attractive lipid-lowering agent for this population . Long-term studies are needed to determine if the short-term changes in plasma lipids can be sustained Objective : To investigate the effect of chromium nicotinate supplementation on insulin sensitivity , glycemic control , and lipid profile in subjects with type 2 diabetes . Material s and Methods : In a double-blind clinical trial , 56 overweight individuals with type 2 diabetes were r and omized into 3 groups : placebo ( NC0 ) , 50 μg ( NC50 ) , and 200 μg ( NC200 ) of chromium as chromium nicotinate .  Chromium status , sensitivity to insulin , glycemic control , and lipid profile were assessed at the beginning of the study and 45 days and 90 days after . Results : In the beginning , most subjects showed low concentrations of serum chromium ( 71.88 % ) , regular levels of urinary chromium ( 80.65 % ) , and insulin resistance ( 73.80 % ) . The serum chromium concentrations did not differ among the groups over time ( p = 0.2549 ) . The changes in serum chromium and urine concentrations did not relate to changes in fasting glucose ( p > 0.05 ) . At 90 days of intervention , there was no significant difference between groups in fasting glucose , glycosylated hemoglobin , homeostasis model assessment insulin resistance ( HOMA-IR ) , total cholesterol , and low-density lipoprotein ( LDL ) ; there was increase in homeostasis model assessment β-cell function ( HOMA-β ; p = 0.0349 ) and high-density lipoprotein ( HDL ; p = 0.0425 ) in the NC0 group and a reduction of triglycerides in the NC0 ( p = 0.0177 ) and NC50 ( p = 0.0336 ) groups . Conclusion : Supplementation at 50 and 200 μg of chromium as chromium nicotinate did not promote glycemic control , increase insulin sensitivity , or change the lipid profile of subjects with diabetes Abstract Through the use of a double-blind cross-over investigative method , the effect of trivalent chromium supplements on blood sugar concentrations of normal and diabetic human subjects was evaluated . Four normal and 10 diabetic subjects took 50 μg . of trivalent chromium and a chromium-placebo thrice daily by mouth for 16-week periods . Chromium did not improve hyperglycemia in diabetic patients , and there was no difference in diabetic glucose tolerance measured after placebo and chromium treatment . Normal glucose tolerance was also unaffected . Despite evidence that trivalent chromium may be an essential micronutrient for maintenance of normal glucose tolerance in rats , results of this investigation do not support suggestions of a similar role in man OBJECTIVE To study the effects of supplementation with organic and inorganic chromium on glucose tolerance , serum lipids , and drug dosage in type 2 diabetes patients , in the hope of finding a better and more economical method of control . METHODS Seventy eight type 2 diabetes patients were divided r and omly into two groups and given Brewer 's yeast ( 23.3ug Cr/day ) , and CrCl3 ( 200ug Cr/day ) sequentially with placebo in between , in a double blind cross-over design of four stages , each lasting 8 weeks . At the beginning and end of each stage , subjects were weighed , their dietary data and drug dosage recorded , and blood and urine sample s were collected for analysis of glucose ( fasting and 2 hour post 75 g glucose load ) fructosamine , triglycerides , total and HDL-cholesterol , and serum and urinary chromium . RESULTS Both supplements caused a significant decrease in the means of glucose ( fasting and 2 hour post glucose load ) , fructosamine and triglycerides . The means of HDL-cholesterol , and serum and urinary chromium were all increased . The mean drug dosage decreased slightly ( and significantly in case of Glibenclamide ) after both supplements and some patients no longer required insulin . No change was noted in dietary intakes or Body Mass Index . A higher percentage of subjects responded positively to Brewer 's yeast chromium , which was retained more by the body , with effects on fructosamine , triglycerides , and HDL-cholesterol maintained in some subjects when placebo followed it , and mean urinary chromium remaining significantly higher than zero time mean . CONCLUSION Chromium supplementation gives better control of glucose and lipid variables while decreasing drug dosage in type 2 diabetes patients . A larger scale study is needed to help decide on the convenient chemical form , and dosage required to achieve optimal response The Diabetes Prevention Program is a new , 150 million dollar , NIH-sponsored study design ed to determine whether non-insulin-dependent diabetes mellitus can be prevented or delayed in persons with impaired glucose tolerance . Four thous and subjects will be r and omly assigned to one of four study groups and followed for 4.5 years . Study groups include intensive lifestyle intervention with diet and exercise ; metformin ( Glucophage ) or troglitazone ( an investigational drug ) with st and ard diet and exercise ; and a control group . Insulin resistance is an important pathogenic factor in impaired glucose tolerance . Trivalent chromium , a dietary supplement that potentiates the action of insulin , was not included in the program . Like metformin and troglitazone , trivalent chromium decreases insulin resistance and has an acceptable side-effect profile ; furthermore , it is available at a fraction of their cost . Trivalent chromium should have been included in the Diabetes Prevention Program ; it is unfortunate that it was omitted SCOPE Chromium and cysteine supplementation have been shown to improve glucose metabolism in animal studies . This study examined the hypothesis that chromium dinicocysteinate ( CDNC ) , a complex of chromium and l-cysteine , is beneficial in lowering oxidative stress , vascular inflammation , and glycemia in type 2 diabetic subjects . METHODS AND RESULTS Type 2 diabetic subjects enrolled in this study were given placebo for 1 month for stabilization and then r and omized into one of three groups : placebo ( P ) , chromium picolinate ( CP ) , or CDNC , after which they received daily oral supplementation for 3 months . Of the 100 patients enrolled in the study , 74 patients completed it . There were 25 patients in the P supplemented group , 25 in the CP supplemented and 24 in the CDNC supplemented group who completed the study . Blood markers of glycemia , vascular inflammation , HOMA insulin resistance , and oxidative stress were determined at r and omization and after 3 months of supplementation with P , CP , or CDNC . There was a significant decrease at 3 months in insulin resistance ( p = 0.02 ) and in the levels of protein oxidation ( p = 0.02 ) and TNF-α ( p = 0.01 ) in the CDNC supplemented cohort compared to baseline . However , there was no statistically significant change in these markers in the CP supplemented group compared to baseline . Insulin levels significantly decreased ( p = 0.01 ) for subjects receiving CDNC but not CP . There was no significant impact of supplementation on HbA(1c ) or glucose levels in either of the groups . CONCLUSION CDNC supplementation  lowers insulin resistance by reducing blood levels of TNF-α , insulin , and oxidative stress in type 2 diabetic subjects . Therefore , CDNC supplementation has potential as an adjunct therapy for individuals with type 2 diabetes
The available evidence suggests favourable effects of chromium supplementation  on glycaemic control in patients with diabetes
INTRODUCTION Chromium is an essential trace mineral for carbohydrate and lipid metabolism , which is currently prescribed to control diabetes mellitus .
Results of previous systematic review s and meta-analyses of chromium supplementation and metabolic profiles in diabetes have been inconsistent .
AIM The objective of this meta- analysis was to assess the effects on metabolic profiles and safety of chromium supplementation in type 2 diabetes mellitus and cholesterol .