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Archive for February 2nd, 2007

Chromium picolinate as a nutritional supplement for diabetics does have a significant positive effect on blood sugar, insulin, and cholesterol levels, says a new review.

Chromium is an essential trace mineral that occurs naturally in small amounts in some foods, including brewer’s yeast, lean meat, cheese, pork kidney and whole grain bread and cereals. It is poorly absorbed by the human body but is known to play an important role in the metabolism of carbohydrate, fat and protein.

Several reports have indicated that chromium picolinate is better absorbed by humans than other forms of the mineral. The review, co-authored by Philip Domenico from Nutrition 21 who produce chromium picolinate supplements, is a timely summary of the state-of-play for the mineral that could offer significant benefits to the growing number of diabetics. C. Leigh Broadhurst and Domenico reviewed data from fifteen studies (14 focused in type-2 diabetes) with a total of 1,690 subjects, including 1,505 receiving chromium picolinate. Doses ranged from 200-1000 micrograms of chromium per day and supplementation periods ranged from one week to nine months.
“The data indicate that chromium picolinate supplementation represents a uniquely efficacious modality for glycaemic control in subjects with diabetes,” wrote reviewers C. Leigh Broadhurst and Philip Domenico. “Indeed, 13 of 15 clinical studies reported significant improvement in at least one outcome of glycaemic control.” Broadhurst and Domenico report that six out of ten studies measuring fasting glucose levels showed a significant improvement of 15.3 per cent, and postprandial glucose levels of 18.9 per cent. Fasting insulin levels, measured in four studies, improved by 29.8 per cent, while postprandial insulin improved by 15 per cent from baseline as a result of chromium picolinate supplementation.
The authors note that a recent meta-analysis of chromium supplementation with respect to diabetes did not report significant benefits, but this may due to the form of the mineral and that people with type-2 diabetes may need higher doses than normal people for a benefit to be observed.
“The main messages are that all forms of chromium are not equivalent, and that higher doses of chromium picolinate are required for people with type 2 diabetes,” said Broadhurst in a statement. “Previous chromium reviews examined all types of chromium at widely varying doses. But separating out chromium picolinate, which yields highly consistent results in research studies, compared to other chromium supplements shows that at doses between 200–1000 mcg it is a superior nutritional adjunct to diabetes treatments.”
The supplement has a “compelling safety profile”, said the researchers, and is an inexpensive and efficacious way of improving diabetes control and could be used in combination with existing medications, as well as reducing the requirement of these expensive medications.
“Though the data supporting the benefits of supplemental chromium picolinate for subjects with diabetes are strong, future studies may require a more careful selection of subjects to pinpoint its usefulness,” they concluded.
Source: Diabetes Technology and Therapeutics
Volume 8, Number 6, Pages 677-687
“Clinical Studies on Chromium Picolinate Supplementation in Diabetes Mellitus - A Review”
Authors: C.L. Broadhurst, P. Domenico

Researchers have begun a clinical study of oral insulin to prevent or delay type 1 diabetes in at-risk people, the National Institutes of Health (NIH) announced today. Type 1 Diabetes TrialNet, an NIH-funded network of researchers dedicated to the understanding, prevention, and early treatment of type 1 diabetes, is conducting the study in more than 100 medical centers across the United States, Canada, Europe, and Australia.

“Our goal is to prevent type 1 diabetes or to delay it as long as possible. If diabetes can be delayed, even for several years, those at risk will be spared the difficult challenges of controlling glucose and the development of complications for that much longer,” said TrialNet study chair Jay Skyler, M.D., of the University of Miami.

A press release by EurekAlert, says, researchers are testing whether an insulin capsule taken by mouth once a day can pr?vent or delay diabetes in a specific group of people at risk for type 1 diabetes. An earlier trial suggested that oral insulin might delay type 1 diabetes for about four years in some people with auto-antibodies to insulin in their blood. Animal studies have also suggested that insulin taken orally may prevent type 1 diabetes.

Some scientists think that introducing insulin via the digestive tract induces tolerance, or a quieting of the immune system. Insulin taken orally has no side effects because the digestive system breaks it down quickly. To lower blood glucose, insulin must be injected or administered by an insulin pump.

In type 1 diabetes, a person’s own immune cells destroy the beta cells of the pancreas. Beta cells sense blood glucose and produce the hormone insulin, which regulates glucose and converts it to energy. The immune attack on beta cells begins well before a person develops diabetes and continues long after the disease is diagnosed.

In the early stages of autoimmunity, up to 10 years before diabetes is diagnosed, autoantibodies may appear in the blood. These autoantibodies to glutamate decarboxylase (GAD), IA-2, and to insulin itself indicate a greater risk for developing type 1 diabetes. For a person with high-risk genes and all three antibodies, the risk of developing diabetes in the next 5 years is greater than 50 percent.

First- and second-degree relatives of people with type 1 diabetes who may be at risk are being screened through TrialNet’s natural history study, which is examining the immune and metabolic events that precede diabetes symptoms.

Screening involves a simple blood test for the autoantibodies that signify diabetes risk. Individuals enrolled in the natural history study are closely monitored for diabetes development and may be eligible to participate in the oral insulin trial or future studies that try to arrest the autoimmune process.

Studies for the Newly Diagnosed TrialNet studies are also aimed at safely preserving insulin production in people recently diagnosed with type 1 diabetes. In the few months after diagnosis, most patients still have a supply of functioning beta cells that, with the help of insulin injections, contribute to good control of blood glucose. If beta cells can be protected, more patients would be able to tightly control their blood glucose, which prevents or delays damage to the eyes, nerves, kidneys, heart, and blood vessels.

One TrialNet study seeks to turn off the immune attack on beta cells with Rituximab, a monoclonal antibody that binds to and temporarily destroys a specific class of immune cells. The Rituximab trial is recruiting patients with type 1 diabetes diagnosed within the previous 3 months. Rituximab is approved by the Food and Drug Administration (FDA) to treat specific forms of lymphoma and moderate to severe rheumatoid arthritis. It is not approved for the prevention of type 1 diabetes.

Also under way is a study testing whether mycophenolate mofetil (MMF) or MMF plus daclizumab (DZ, drugs approved by FDA to prevent rejection after an organ transplant, can slow or arrest the autoimmunity of type 1 diabetes. This study has recruited the needed number of patients.

Study for Newborns at Risk for Type 1 Diabetes

The Nutritional Intervention to Prevent Type 1 Diabetes (NIP) Trial is a pilot study of docosahexaenoic acid (DHA), an omega-3 fatty acid that may have anti-inflammatory benefits that prevent development of the autoimmunity that leads to type 1 diabetes. The NIP study is being conducted in:

* Babies less than 5 months old who have immediate family members with type 1 diabetes, and pregnant mothers in their third trimester whose babies are at r?sk for type 1 diabetes, either because the mother has type 1 diabetes herself or other immediate relatives have the disease.* About 5 to 10 percent of the nearly 21 million people with diabetes have type 1, formerly known as juvenile onset diabetes or insulin-dependent diabetes. Type 1 diabetes tends to arise in children and young adults but is also diagnosed in older people.

* Patients need three or more insulin injections a day or treatment with an insulin pump to maintain blood glucose control. To prevent complications, they must regularly monitor their blood glucose, striving for a range that is as close to normal as possible. The constant challenge of managing the disease poses an enormous burden on patients and their families.