Chromium
| Author: Judy Kohn, RN, BSN, CDE |
| Last Updated: Tuesday, February 14, 2006 |
Q: "I have type 2 diabetes. I read on a USDA website about a study where 1000 mcg Chromium Picolinate spread out through the day went a long way towards lowering blood sugar. I showed the report to my doctor. He said he could not believe it, but to give it a try. I did, and for the last 3 weeks my blood glucose has been normal in the morning, noon and night even though I stopped taking the oral medication. Have you seen any other reference to using Chromium at high levels for this purpose?"
A: Chromium is an essential trace mineral required for normal glucose metabolism. It appears to act by enhancing or increasing insulin's actions. There have been several research studies as well as numerous articles and debates about chromium and diabetes in the past several years.
Clinical Diabetes, January/February 1997, quoted the ADA position statement on chromium that "the only known circumstance in which chromium replacement has any beneficial effect on glycemic control is for people who are chromium deficient as a result of long-term chromium-deficiency…it appears that most people with diabetes are not chromium deficient and, therefore, chromium supplementation has no known benefit."
In Diabetes Self-Management, November/December 2001, Belinda O'Connell, M.S., R.D., L.D., explained that research is inadequate at this time to set a Recommended Dietary Allowance (RDA) or safe Tolerable Upper Intake Level (UL) for chromium. Adequate Intakes (AIs) are recommended intakes assumed to be adequate for a group of healthy people; these are given when there is inadequate information to create an RDA. The AI for adult men over age 50 is 30 micrograms/day, and for women over age 50 the AI is 20 micrograms/day. The previous Estimated Safe and Adequate Daily Dietary Intake (ESADDI) set by the federal government for chromium had an upper limit of 200 micrograms/day. She stated it is felt that chromium intake in the United States is generally adequate, though the potential for deficiency is present with poor diets, strenuous exercise, and high blood glucose levels.
Diabetes Forecast, April 1996, pointed out that chromium supplements contain more than chromium. The FDA has received several complaints from people taking chromium supplements who complained of chest pain, seizures, hair loss, and irregular heart rate. Because other ingredients can be in chromium supplements, it is difficult to determine the cause of these symptoms. The article stressed that "…there is no way to measure exactly how much chromium we need, how much we have, how much we are getting from our regular foods, whether the body can use any of the chromium it receives in the form of supplements, and even whether an otherwise healthy person is chromium deficient or not."
Finally, Diabetes Care, volume 25, #1, January 2002, provided the technical review as well as the "Evidence-Based Nutrition Principles and Recommendations for the Treatment and Prevention of Diabetes and Related Complications." The review explained that there were two randomized, placebo-controlled studies in Chinese diabetic subjects where chromium supplements had beneficial effects on diabetes control. However, it was felt that the study population might have had marginal baseline chromium status. Other studies have suggested a role in managing diabetes and indicated that the dosage and formulation of chromium used influenced the outcome-i.e. 1000 micrograms of chromium picolinate was more effective than 200 micrograms/day. In contrast, two well-designed studies in the U.S. and two in Finland failed to demonstrate any significant benefit of chromium supplementation in diabetes. These latter studies used chromium chloride, which may not be as bio available. The final conclusion was that "at the present, benefit from chromium supplementation in persons with diabetes has not been conclusively demonstrated."
Diabetes Care, vol. 27, #11, November 2004, provided an updated review, and still concluded that more clinical trials are needed in the U.S. population to assess the effects of chromium on people with type 2 diabetes along with long-term trials to assess safety.
Conclusion: As you can tell, this is a controversial subject. I would encourage you to discuss this further with your physician.
Important Notice: The responses provided by the team of Diabetes Educators are based on their personal experiences and expertise as practicing diabetes healthcare professionals, and are not to be considered diabetes management advice from Abbott Laboratories. Remember that information provided by the team of Diabetes Educators is for general background purposes and is not intended as a substitute for medical diagnosis or treatment by a trained professional. You should always consult your physician about any healthcare questions you may have, especially before trying a new medication, diet, fitness program, or approach to healthcare issues.
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