Effect of Chromium Picolinate/Biotin Supplementation with Diabetes Education on Blood Sugar Levels in Type 2 Diabetes: A Pilot Program
V Juturu, J Komorowski
Keywords
biotin, chromium, type 2 diabetes
Citation
V Juturu, J Komorowski. Effect of Chromium Picolinate/Biotin Supplementation with Diabetes Education on Blood Sugar Levels in Type 2 Diabetes: A Pilot Program. The Internet Journal of Nutrition and Wellness. 2006 Volume 3 Number 1.
Abstract
The abstract was published in Obesity Research 2003; 11: A106 (Abstr.436P)
Introduction
Glucose control remains the cornerstone of therapeutic strategies designed to reduce the risk of long-term complications in people with type 2 DM. The goal of diabetes treatment is to achieve and maintain fasting blood glucose levels within or near the normal range (90 to 126 milligrams per deciliter [mg/dL]). One of the most important tasks for healthcare professionals in diabetes care is educating patients about their diabetes and ways they can improve self-care. Chromium (Cr) is an essential trace mineral for normal insulin function. Recent studies suggest that Cr status is associated with type 2 DM 1and cardiovascular disease2 . Type 2 DM subjects have been shown to have low levels of plasma Cr and high levels of urine Cr3 . Experimental4,5 and clinical trials suggest that chromium picolinate (CrPic) improves insulin sensitivity, glycemic control, and symptomatology in diabetes6 , while biotin favorably affects abnormalities in glucose regulation7 .
Subjects And Methods
Subjects
This pilot program was designed to improve blood glucose levels in people with poorly controlled type 2 DM through an initiative involving diabetes education, nutrition intervention [CrPic (300 mcg Cr) and biotin (150 mcg) twice daily] and self-glucose monitoring. Twenty-three subjects with type 2 DM were enrolled in the 90-day program. Subjects were on prescribed oral medications (≥ previous 6 months), had HbA1c ≥7%, and had at least a one-year history of type 2 DM. Fasting and postprandial blood glucose levels (after 2 hours of taking a regular meal) were measured at baseline, 30 days, 60 days and 90 days treatment. Blood pressure and body mass index (BMI) were recorded.
Statistical Methods
Statistical analyses were performed using SAS v 8.2 (SAS institute, Cary, NC, USA). Data are presented as mean ± SD. Comparisons between baseline and final visits were carried out using paired t tests. P<0.05 was taken as conventionally significant.
Results
Table 1 shows the subject characteristics at baseline and after treatment. No significant changes were noted for BMI and blood pressure. The HbA1 levels decreased after treatment, although not significantly. Figure 1 shows fasting and post prandial blood glucose levels at baseline, 30 days, 60 days and 90 days. Fasting blood glucose (FBG) and postprandial blood glucose (PPG) levels decreased significantly with diabetes education and with CrPic and biotin supplement. The change in FBG levels at 90 days was -21 mg/dL, p<0.05. The change in PPG levels at 90 days was -28 mg/dL, p<0.01.
Figure 1
aMedications such as metformin, glucophage, Actos, Avandia, glucovance, zocor, lipitor mevacor and lovastatin; N: Number of subjects; HbA1c: glycosylated hemoglobin;
SBP : Systolic blood pressure; DBP: Diastolic blood pressure
Figure 2
Fasting and Post Prandial Blood Glucose Levels in Type 2 diabetes individuals following 90 days twice daily supplementation with 300 mcg of chromium as chromium picolinate and 150 mcg of biotin. [N=23, * p<0.05 – difference from baseline , ** p<0.01-difference from baseline ( pre-supplementation)]
Discussion
We report here a substantial decrease in fasting and post prandial blood glucose levels in diabetic subjects following diabetes education materials and taking a nutritional supplement containing CrPic and biotin. In this pilot program, glycosylated hemoglobin was not significantly reduced, but showed a decrease from baseline (mean difference: 0.5%). The effect would likely have been greater in a controlled study with more participants, or at higher levels of chromium supplementation. Nevertheless, the results indicate that diabetes education to the patients in combination with CrPic and biotin supplementation decreases blood sugar levels in type 2 diabetes. This study is in line with earlier studies, which show significant beneficial effects for subjects with type 2 DM with CrPic supplementation and diabetes education6,8 . It is concluded that a program including nutrition education, glucose monitoring and supplementation with CrPic and biotin can be safely and effectively used with hypoglycemic medications to help lower elevated FBG and PPG levels in individuals with diabetes. Large-scale, randomized, controlled, double blind clinical trials are ongoing to evaluate the direct effects of CrPic and biotin on glycemic control, lipids and lipoproteins in diabetics. Such studies are necessary to substantiate any benefit of these dietary supplements with life style modifications and glucose monitoring might provide high-risk patients.
Acknowledgements
The authors are grateful to the co-operation of the participants in the study. This is a part of the nutrition research program of Nutrition 21 Inc.
Correspondence to
Vijaya Juturu, Ph.D, Department of Technical Services and Scientific Affairs, Nutrition 21 Inc, 4 Manhattanville Road, Purchase, NY 10577 Phone: 914-701-4508 Fax: 914-696-0860 Email:vjuturu@nutrition21.com