Chromium and Insulin Action

The primary clinical strategy to improve metabolic control in patients with Type 2 diabetes
consists of lifestyle modification combined with pharmacologic intervention. 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. Unfortunately, considerable controversy exists
regarding use of dietary supplements in subjects with diabetes because efficacy data for
many of the supplements consists 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 (Cr). However,
routine use of Cr in subjects with diabetes is not currently recommended. In part, the
controversy surrounding Cr supplementation stems from the lack of definitive randomized
trials, the lack of "gold standard" techniques to assess glucose metabolism in the studies
reported, the use of differing doses and formulation , and the study of heterogeneous study
populations (4). As such, conflicting data has been reported that has contributed greatly to
the confusion among healthcare providers concerning Cr supplementation. In order to provide
a comprehensive clinical evaluation of Cr, we conducted a randomized, double-blinded,
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.

Inclusion Criteria:

Type 2 diabetes on diet therapy or low dose oral agent -

Exclusion Criteria:

Significant cardiovascular, hepatic or renal disease