title: Influence of chromium-enriched yeast on blood glucose and insulin variables, blood lipids, and markers of oxidative stress in subjects with type 2 diabetes mellitus Chromium Treatment Has No Effect in Patients With Type 2 Diabetes in a Western Population Beneficial effect of chromium supplementation on glucose, HbA1C and lipid variables in individuals with newly onset type-2 diabetes. 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 Picolinate and Biotin Combination Reduces Atherogenic Index of Plasma in Patients with Type 2 Diabetes Mellitus: A Placebo-Controlled, Double-Blinded, Randomized Clinical 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. Brewer's Yeast Improves Glycemic Indices in Type 2 Diabetes Mellitus 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. 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. 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 Nicotinate Has No Effect on Insulin Sensitivity, Glycemic Control, and Lipid Profile in Subjects with Type 2 Diabetes
abstract: The aim of this study was to determine the effect of chromium (Cr)-enriched yeast on blood glucose and insulin variables , blood lipids , and blood markers of oxidative stress in persons with type 2 diabetes mellitus ( median duration : 3.0 yr ) . Thirty-six subjects ( 9 men , 27 women ; mean age : 61.3 yr ; mean body mass index : 34.33 kg/m2 ) were supplemented with 400 μg Cr/d as Cr-enriched yeast ( n=19 ) or placebo ( n=17 ) for 12 wk in a r and omized , double-blind study . The most interesting results were obtained by comparison of the change in the placebo group to the change in the Cr group . The Cr group showed a significantly greater increase in serum Cr compared to the placebo group ( p<0.05 ) . Supplementation with Cr-enriched yeast was associated with a significant decrease in fasting serum glucose compared to placebo ( p<0.01 ) . Blood markers of oxidative stress glutathione peroxidase activity and levels of reduced glutathione were essentially unchanged in the Cr group after 12 wk , but decreased significantly in the placebo group ( p<0.05 , p<0.01 , respectively ) , Serum HbA1c and glycated protein ( fructosamine ) were essentially unchanged in the Cr group , whereas HbA1c tended to increase in the placebo group ( from 6.94 % to 7.11 % ) . Fasting serum insulin decreased in both groups , with a greater tendency in the Cr group ( −16.5 % vs −9.5 % ) . These data suggest that supplementation of well-controlled type 2 diabetics with Cr-enriched yeast is safe and can result in improvements in blood glucose variables and oxidative stress 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 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 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 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 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 Background : Brewer 's yeast may have beneficial effects on insulin receptors because of itsglucose tolerance factor in diabetic patients . This study was conducted to investigate the effects of brewer 's yeast supplementation on glycemic indices in patients with type 2 diabetes mellitus . Methods : In a r and omized double-blind controlled clinical trial , 84 adults ( 21 men and 63 women ) aged 46.3 ± 6.1 years old with type 2 diabetes mellitus were recruited and divided r and omly into two groups : Supplement group receiving brewer 's yeast ( six 300 mg tablets/day , total 1800 mg ) and control group receiving placebo ( six 300 mg tablets/day ) for 12 weeks . Body weight , height , body mass index , food consumption ( based on 24h food record ) , fasting blood sugar ( FBS ) , glycosylated hemoglobin , insulin sensitivity , and insulin resistance were measured before and after the intervention . Data analysis was performed using the Statistical Package for Social Sciences ( version 18.0 ) . Results : The changes in FBS , glycosylated hemoglobin , and insulin sensitivity were significantly different between the two groups during the study ( respectively P < 0.001 , P < 0.001 , P = 0.02 independent sample t-test ) . There was a significant difference in FBS , glycosylated hemoglobin , and insulin sensitivity at the end of the study between the two groups after removing the effects of baseline values ( respectively P = 0.002 , P < 0.001 , P = 0.02 , analysis of covariance ) . Changes in body mass index , 24h food record , insulin resistance were not significant . Conclusions : Dietary supplementation with brewer›s yeast besides the usual treatment of diabetes can ameliorate blood glucose variables in type 2 diabetes mellitus 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 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 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 : 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
target: The available evidence suggests favourable effects of chromium supplementation  on glycaemic control in patients with diabetes
background: 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 .