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Chromium Improves Glycemic Control When Sulfonylurea Is Insufficient

Posted: Wednesday, August 09, 2006

Chromium picolinate (CrPic) supplementation improves glycemic control in patients with type 2 diabetes not adequately controlled while taking sulfonylurea, according to the results of a randomized, double-blind study.

"CrPic supplementation has been suggested to improve glycemia, but there are conflicting reports on efficacy," write Julie Martin, MS, RD, from the University of Vermont in Burlington, and colleagues. "To provide a comprehensive clinical evaluation of chromium, we conducted a randomized, double-blind, placebo-controlled trial in subjects with type 2 diabetes and over a 10-month period of observation, used established techniques to assess changes in insulin sensitivity, body composition, and glycemic control."

After baseline evaluation, 37 subjects with type 2 diabetes were treated with a sulfonylurea (glipizide gastrointestinal therapeutic system, 5 mg/day) with placebo for 3 months. These subjects were then randomized in a double-blind fashion to receive for 6 months either the sulfonylurea plus placebo (n = 12) or the sulfonylurea plus 1000 µg of chromium as CrPic (n = 17). End points included body composition, insulin sensitivity, and glycemic control at the end of the 3-month single-blind placebo phase and at study end.

The group receiving sulfonylurea/placebo fared worse than the sulfonylurea/CrPic group in terms of increase from baseline in body weight (2.2 kg; P < .001 vs 0.9 kg; P = .11), percent body fat (1.17%; P < .001 vs 0.12%; P = .7), and total abdominal fat (32.5 cm2; P < .05 vs 12.2 cm2; P < .10) from baseline. Compared with the sulfonylurea/placebo group, the sulfonylurea/CrPic group had significant improvements in insulin sensitivity corrected for fat-free mass (28.8; P < .05 vs 15.9; P = .40), glycated hemoglobin levels (HbA1c; -1.16%; P < .005 vs -0.4%; P = .30), and free fatty acids (-0.2 mmol/L; P < .001 vs -0.12 mmol/L; P < .03).

"This study demonstrates that CrPic supplementation in subjects with type 2 diabetes who are taking sulfonylurea agents significantly improves insulin sensitivity and glucose control," the authors write. "Further, CrPic supplementation significantly attenuated body weight gain and visceral fat accumulation compared with the placebo group.... The mechanisms for these findings are not precisely known, but clinical research studies addressing dietary intake, skeletal muscle fat oxidation, and insulin signaling are ongoing."

Source: Diabetes In Control: Diabetes Care. 2006;29:1826-1832