Chromium treatment has no effect in patients with poorly controlled, insulin-treated type 2 diabetes in an obese Western population: a randomized, double-blind, placebo-controlled trial. 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. Chromium Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes Elevated Intakes of Supplemental Chromium Improve Glucose and Insulin Variables in Individuals With Type 2 Diabetes Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. 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. Beneficial Effect of Chromium Supplementation on Serum Triglyceride Levels in NIDDM The influence of chromium chloride-containing milk to glycemic control of patients with type 2 diabetes mellitus: a randomized, double-blind, placebo-controlled trial. Chromium Treatment Has No Effect in Patients With Type 2 Diabetes in a Western Population The effects of inorganic chromium and brewer's yeast supplementation on glucose tolerance, serum lipids and drug dosage in individuals with type 2 diabetes. A Dietary Supplement Containing Cinnamon, Chromium and Carnosine Decreases Fasting Plasma Glucose and Increases Lean Mass in Overweight or Obese Pre-Diabetic Subjects: A Randomized, Placebo-Controlled Trial Failure of trivalent chromium to improve hyperglycemia in diabetes mellitus. 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. A double-blind, randomized pilot trial of chromium picolinate for binge eating disorder: results of the Binge Eating and Chromium (BEACh) study. Potential Antioxidant Effects of Zinc and Chromium Supplementation in People with Type 2 Diabetes Mellitus Chromium Picolinate and Biotin Combination Reduces Atherogenic Index of Plasma in Patients with Type 2 Diabetes Mellitus: A Placebo-Controlled, Double-Blinded, Randomized Clinical Trial Trivalent chromium and the diabetes prevention program.
OBJECTIVE Chromium treatment has been reported to improve glycemic control and insulin sensitivity in specific population s of patients with type 2 diabetes . The aim of this study was to determine the effect of chromium treatment on glycemic control in a Western population of insulin-dependent patients with type 2 diabetes . RESEARCH DESIGN AND METHODS In this 6-month double-blind study , patients with an HbA(1c ) ( A1C ) > 8 % and insulin requirements of > 50 units/day were r and omly assigned to receive treatment with placebo or 500 or 1,000 mug chromium daily in the form of chromium picolinate . The primary efficacy parameter was a change in A1C . Secondary end points were changes in lipid profile , BMI , blood pressure , and insulin requirements . RESULTS In this per- protocol analysis ( n = 46 ) , the decrease in A1C was approximately equal across the three groups ( 0.4 % ) . All patients had a BMI > 25 kg/m(2 ) . No differences were found in the secondary end points . We found a weak relationship between an increasing serum chromium concentration and improvement of the lipid profile . CONCLUSIONS There is no evidence that high-dose chromium treatment is effective in obese Western patients with type 2 diabetes 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 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 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 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 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 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 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 OBJECTIVE —Chromium treatment has been reported to improve glycemic control in patients with type 2 diabetes . However , concern exists about the possible toxic effects of chromium picolinate . The aim of this study was to determine the effect of chromium treatment in the form of chromium yeast on glycemic control in a Western population of patients with type 2 diabetes who were being treated with oral hypoglycemic agents . RESEARCH DESIGN AND METHODS —In this 6-month , double-blind study , patients with moderate glycemic control , being treated with oral hypoglycemic agents , were r and omly assigned to receive either a placebo or treatment with 400 μg of chromium daily in the form of chromium yeast . The primary efficacy parameter was a change in A1C . Secondary end points were changes in lipid profile , BMI , blood pressure , body fat , and insulin resistance . RESULTS —No differences were found for the change in A1C between the intervention and placebo groups , nor were any differences found between the groups for the secondary end points . CONCLUSIONS —There is no evidence that chromium in the form of chromium yeast is effective in improving glycemic control in Western patients with type 2 diabetes who are taking oral hypoglycemic agents 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 Background Preventing or slowing the progression of prediabetes to diabetes is a major therapeutic issue . Objectives Our aim was to evaluate the effects of 4-month treatment with a dietary supplement containing cinnamon , chromium and carnosine in moderately obese or overweight pre-diabetic subjects , the primary outcome being change in fasting plasma glucose ( FPG ) level . Other parameters of plasma glucose homeostasis , lipid profile , adiposity and inflammatory markers were also assessed . Methods In a r and omized , double-blind , placebo-controlled study , 62 subjects with a FPG level ranging from 5.55 to 7 mmol/L and a body mass index ≥25 kg/m2 , unwilling to change their dietary and physical activity habits , were allocated to receive a 4-month treatment with either 1.2 g/day of the dietary supplement or placebo . Patients were followed up until 6 months post-r and omization . Results Four-month treatment with the dietary supplement  decreased FPG compared to placebo ( -0.24±0.50 vs + 0.12±0.59 mmol/L , respectively , p = 0.02 ) , without detectable significant changes in HbA1c . Insulin sensitivity markers , plasma insulin , plasma lipids and inflammatory markers did not differ between the treatment groups . Although there were no significant differences in changes in body weight and energy or macronutrient intakes between the two groups , fat-free mass ( % ) increased with the dietary supplement compared to placebo ( p = 0.02 ) . Subjects with a higher FPG level and a milder inflammatory state at baseline benefited most from the dietary supplement . Conclusions Four-month treatment with a dietary supplement containing cinnamon , chromium and carnosine decreased FPG and increased fat-free mass in overweight or obese pre-diabetic subjects . These beneficial effects might open up new avenues in the prevention of diabetes . Trial Registration Clinical Trials.gov 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 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 OBJECTIVE Chromium treatment has been shown to improve mood , appetite , and glucose regulation in various psychiatric and medical patient population s. The authors propose that chromium may be useful in the treatment of  binge eating disorder ( BED ) .  METHOD Twenty-four overweight adults with BED were enrolled in a 6-month double-blind placebo-controlled trial and r and omly assigned to receive either 1000mcg chromium/day ( " high dose " ; n=8 ) or 600mcg chromium/day ( " moderate dose " ; n=9 ) as chromium picolinate or placebo ( n=7 ) . Mixed linear regression models were used to estimate mean change in binge frequency and related psychopathology , weight , symptoms of depression , and fasting glucose . RESULTS Fasting glucose was significantly reduced in both chromium groups compared to the placebo group ; similarly , numerically , but not significantly , greater reductions in binge frequency , weight , and symptoms of depression were observed in those treated with chromium versus placebo , although statistical power was limited in this pilot trial . For fasting glucose , the findings suggest a dose response with larger effects in the high dose compared to moderate dose group . CONCLUSION These initial findings support further larger trials to determine chromium 's efficacy in maintaining normal glucose regulation , reducing binge eating and related psychopathology , promoting modest weight loss , and reducing symptoms of  depression  in individuals with BED . Studies design ed to link the clinical effects of chromium with changes in underlying insulin , serotonin , and dopamine pathways may be especially informative . If efficacious , chromium supplementation may provide a useful , low-cost alternative to or augmentation strategy for selective serotonin reuptake inhibitors , which have partial efficacy in BED . Clinical Trials.gov NCT00904306 Objective : To determine the effects of combined zinc ( Zn ) and chromium ( Cr ) supplementation on oxidative stress and glucose homeostasis of people with type 2 diabetes . Design : Tunisian adult subjects with HbA1C > 7.5 % were supplemented for 6 months with 30 mg/d of Zn as Zn gluconate or 400 μg/d of Cr as Cr pidolate or combined Zn/Cr supplementation or placebo . The effects of supplementation on plasma zinc ( Zn ) , copper ( Cu ) , selenium ( Se ) , urinary Zn , Cr , plasma thiobarbituric acid reactive substances ( TBARS ) , Cu-Zn superoxide dismutase ( SOD ) and Se glutathione peroxidase ( GPx ) in red blood cells , blood lipids and lipoproteins , HbA1C and fasting glucose were measured at the beginning of the study and after six months . Results : At the beginning of the study , more than 30 % of the subjects may have been Zn deficient with plasma Zn values less than 10.7 μmol/L , whereas levels of plasma Cu , Se and antioxidant RBC enzyme activities were in the normal ranges . Following supplementation , there were significant decreases of plasma TBARS in the Cr ( 13.6 % ) , Zn ( 13.6 % ) and Zn/Cr ( 18.2 % ) groups with no significant changes in the placebo group . The value for the TBARS of the control healthy Tunisian subjects was 2.08 ± 0.04 μmol/L and that of the Tunisian subjects with diabetes was 3.32 ± 0.05 μmol/L. This difference of 1.24 μmol/L between the control group and the subjects with diabetes was reduced from 36 % to 50 % in the three supplemented groups . Supplementation did not modify significantly HbA1C nor glucose homeostasis . No adverse effects  of Zn supplementation were observed on Cu status , HDL cholesterol nor interactions in Zn or Cr . Conclusions : These data suggest the potential beneficial antioxidant effects of the individual and combined supplementation of Zn and Cr in people with type 2 DM . These results are particularly important in light of the deleterious consequences of oxidative stress in people with diabetes Background : The atherogenic index of plasma ( AIP ) , defined as logarithm [ log ] of the ratio of plasma concentration of triglycerides to high-density lipoprotein ( HDL ) cholesterol , has recently been proposed as a predictive marker for plasma atherogenicity and is positively correlated with cardiovascular disease risk . The nutrient combination of chromium picolinate and biotin ( CPB ) has been previously shown to reduce insulin resistance and hyperglycemia in patients with type 2 diabetes ( T2DM ) . Methods : Thirty-six moderately obese subjects with T2DM and with impaired glycemic control were r and omized to receive CPB or placebo in addition to their oral hyperglycemic agents for 4 weeks .  Measurements of blood lipids ( including ratio of triglycerides to HDL cholesterol ) , fructosamine , glucose , and insulin were taken at baseline and after 4 weeks . Results : At the final visit , the active group had a significantly lower AIP compared to the placebo group ( P < 0.05 ) . A significant difference in triglyceride level ( P < 0.02 ) and the ratio of low-density lipoprotein ( LDL ) to HDL cholesterol ( P < 0.05 ) was also observed between the groups at the final visit . In the active group , the changes in urinary chromium levels were inversely correlated with the change in AIP ( P < 0.05 ) . Urinary chromium levels were significantly increased in the CPB group . In the CPB group , glucose levels decreased at 1 hour and 2 hours and glucose area under the curve and fructosamine level were significantly decreased . Ratios of total to HDL cholesterol , LDL to HDL cholesterol , and non-HDL to HDL cholesterol were significantly decreased between the treatments at final visit . No significant adverse events were observed in the CPB or placebo groups . Conclusions : These results suggest that the combination of chromium picolinate and biotin may be a valuable nutritional adjuvant therapy to reduce AIP and correlated CVD risk factors in people with T2DM 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
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 .