This article originally posted 05 May, 2002 and appeared in Issue 129
Supplementation with Chromium Picolinate: Therapeutic for Diabetes and Pre-Diabe
Supplementation with a form of the trace mineral chromium called chromium picolinate is prudent nutritional therapy for your patients with diabetes and pre-diabetes.
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To give you an overview of why I say this, most of the studies involving supplemental
chromium for type II diabetes have shown positive results of one type or another.
However, when chromium picolinate, which is the most bioavailable form, has
been used, all of the studies have yielded positive results (in blood sugar,
blood insulin and/or blood lipid [cholesterol and triglyceride] readings).[i]
One of these studies, a 1997 study involving 180 type II diabetes patients
in China, is a classic: it documented “spectacular” results in diabetes
patients who took 500 mcg chromium picolinate twice daily. After four months,
nearly all of the diabetes patients no longer had traditional signs of diabetes.
Their blood sugar and insulin levels dropped to near normal—something
that medications could not achieve. Even more importantly, the “gold standard”
diagnostic measure of diabetes—blood levels of hemoglobin A1c (sugar-damaged
proteins that age cells)—also dropped to normal.[ii]
A follow-up study by some of the same researchers monitored 833 type II diabetes
patients who took 500 mcg chromium picolinate twice daily: a significant reduction
in fasting blood sugar levels and in post-meal blood sugar levels was found
during the ten months of the study. No negative side effects were shown from
taking the supplements. In addition, more than 85 percent of the patients reported
improvements in the common diabetic symptoms of excessive thirst, frequent urination
and fatigue.[iii]
Although the incidence of type II diabetes is increasing in record numbers,
many people don’t yet have diabetes but are at high risk for developing
it. Chromium supplements can help in these cases, too. A study directed by William
Cefalu, M.D., of Wake Forest University, monitored individuals at risk—people
who were moderately obese and had a family history of diabetes. Some people
received a placebo; others, 1,000 mcg of chromium picolinate daily. After four
months of treatment with chromium, insulin resistance was reduced by 40 percent.[iv]
Chromium supplements, therefore, help reverse the underlying disease process
that leads to type II diabetes. In other words, they help both prevent and reverse
Type II diabetes
Chromium picolinate’s benefits for other types of diabetes patients
Many diabetes patients who inject insulin—both type I diabetes patients,
and type II diabetes patients who are in more advanced stages of the disease—respond
positively to chromium picolinate supplementation. About 70 percent of both
types of diabetes patients show improved insulin responsiveness after taking
200 mcg supplemental chromium per day. Some experience such improved insulin
sensitivity that they are able to reduce the amount of insulin they inject or
the amount of other blood-sugar-lowering medications they take.[v]
Chromium supplementation has been found helpful for still other types of diabetes.
Gestational diabetes is a transitional diabetes that develops during pregnancy
and can cause numerous health problems, including loss of the child. It’s
the most common medical complication of pregnancy today. According to one study,
just eight weeks of supplementation with chromium picolinate can significantly
improve glucose intolerance and reduce blood sugar and insulin levels in those
with gestational diabetes, thereby reducing the risk of health trouble for both
mother and child.[vi]
The use of certain pharmaceutical drugs, such as corticosteroids or Thiazide
diuretics, lead to significant chromium losses and can also sometimes induce
diabetes-like conditions. Fortunately, chromium supplementation can lead to
improvements in the body’s handling of blood sugar in both cases. In one
study, steroid-induced diabetes was ameliorated in 38 of 41 patients following
supplementation of 200 mcg of chromium three times per day. This occurred even
though blood-sugar-lowering drugs were reduced 50 percent in all patients who
were given chromium supplements.[vii]
Basics about Chromium and Supplementation Dosages
Although researchers still don’t know exactly how chromium does its magic,
chromium helps insulin work more efficiently to allow blood glucose to move
from the blood into the cells. The Recommended Daily Allowance Committee recommends
50-200 mcg of chromium per day. This amount seems reasonable for the average
healthy person, but higher amounts are needed for people with conditions involving
insulin resistance, such as type II diabetes and pre-diabetes. Type II diabetes
patients who have taken chromium picolinate in low doses—200 mcg per day—have
had some improvement in their condition; however, they have not the same spectacular
results as type II diabetes patients who have taken 1,000 mcg per day.
Unfortunately, the vast majority of Americans doesn’t obtain even the
minimum 50 mcg of chromium from their daily diets. Research from the USDA found
that men average 33 mcg of chromium per day in their diets and women average
25 mcg per day.[viii] Even diets, designed to be well balanced by nutritionists,
almost always contain less than 50 mcg of chromium.[ix]
The amount of chromium that people need varies. It depends primarily on their
intake from foods and their state of health. Those who are most lacking in the
nutrient need it the most.[x] It’s also important to understand that type
II diabetes patients have altered chromium metabolism—greater excretion
of chromium, lower tissue levels of chromium, and less of an ability to convert
chromium into a usable form in the body.
In animal experiments, chromium has demonstrated a lack of toxicity at extremely
high levels—levels several thousand times the estimated safe and adequate
daily dietary intake (ESADDI) limit of 200 mcg per day. There is no evidence
of toxic effects related to chromium supplementation in chromium supplementation
in humans or animals.
For all of these reasons, I think supplementation with chromium picolinate
is a must to try with diabetes patients. It’s a prudent, safe, well-tested
nutritional approach that more often than not will offer your patients impressive
benefits in their condition and their symptoms.
Adapted from excerpts from Basic Health Publications User’s Guide to
Chromium (Basic Health Publications, North Bergen, New Jersey, 2002) by Melissa
Diane Smith.
Melissa Diane Smith is a Phi Beta Kappa graduate from the University of Arizona,
earned a diploma in nutrition and Graduate of the Year honors from the American
Academy of Nutrition, and has received advanced nutrition training from the
Designs for Health. She is the author of User’s Guide to Chromium (Basic
Health Publications, 2002) and Going Against the Grain (McGraw-Hill/Contemporary
Books, 2002) and co-author of the national best-selling Syndrome X: The Complete
Nutritional Program to Prevent and Reverse Insulin Resistance (John Wiley &
Sons, 2000). Melissa combines the investigative research skills she honed in
journalism school with her nutrition training and clinical experience working
with clients to provide clients with personalized nutrition advice. To contact
Miss Smith directly please email her at info@melissadianesmith.com
[i] Anderson, RA. Chromium, glucose intolerance and diabetes. Journal of the
American College of Nutrition, 1998; 17: 548-555.
[ii] Anderson RA, Chen N, Bryden NA, et al. Elevated intakes of supplemental
chromium improve glucose and insulin variables in individuals with type 2 diabetes.
Diabetes, 1997;46:1786-1791.
[iii] Cheng N, Zhu X, Shi H, et al. Follow-up survey of people in China with
type 2 diabetes mellitus consuming supplemental chromium. The Journal of Trace
Elements in Experimental Medicine, 1999; 12:55-60.
[iv] Cefalu WT, Bell-Farrow AD, Stegner J, et al. Effect of chromium picolinate
on insulin sensitivity in vivo. The Journal of Trace Elements in Experimental
Medicine, 1999; 12: 71-83.
[v] Ravina A, Slezak L, Rubal A, et al. Clinical use of the trace element chromium
(III) in the treatment of diabetes mellitus. The Journal of Trace Elements in
Experimental Medicine, 1995; 8: 183-190.
[vi] Jovanovic-Petersen L, Gutierrez M, Peterson CM. Chromium supplementation
for gestational diabetic women improves glucose tolerance and decreases hyperinsulinemia.
Journal of the American College of Nutrition, 1995; 14: 530.
[vii] Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced
diabetes mellitus with supplemental chromium. Diabetic Medicine; 1999; 16: 164-167.
[viii] Anderson RA, Kozlovsky AS. Chromium intake, absorption and excretion
of subjects consuming self-selected diets. American Journal of Clinical Nutrition,
1985; 41: 1177-1183.
[ix] Anderson RA, Bryden NA, Polansky MM. Dietary chromium intake. Freely chosen
diets, institutional diet, and individual foods. Biological and Trace Element
Research, 1992; 32: 117-121.
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