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      Effects of Chromium Picolinate Supplementation on Cardiometabolic Biomarkers in Patients with Type 2 Diabetes Mellitus: a Randomized Clinical Trial

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          Abstract

          Type 2 diabetes mellitus (T2DM) is a serious public health problem accompanies with several complications. This study was conducted to evaluate the effects of chromium picolinate (CrPic) supplementation on the glycemic status and lipid profile in patients with T2DM. The patients with T2DM (n = 52) were randomly allocated into 2 groups. One group received 400 µg CrPic per day and the other group took placebo; the intervention duration was 8 weeks. Anthropometric indices and metabolic factors were measured at the beginning, and at end of the study. The patients were recommended not to change their normal diet, life style and medication. No significant changes were observed for weight, body mass index, and fasting blood glucose (FBG) in both groups; while intra-groups changes in homeostatic model assessment for insulin resistance (HOMA-IR) value was significant (p < 0.05). Results of analysis of covariance showed that there were significance differences between groups in total cholesterol, low density lipoprotein cholesterol and HOMA-IR at the end of the intervention adjusting for baseline levels (p = 0.035, 0.030 and < 0.001, respectively). In this study, oral supplementation with 400 µg CrPic for eight weeks did not alter FBG concentration as well as anthropometric parameters in individuals with T2DM. However, the modest beneficial effects of chromium supplementation on insulin resistance as indicated by HOMA-IR and lipid profile were found.

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          Homeostasis model assessment is a reliable indicator of insulin resistance during follow-up of patients with type 2 diabetes.

          To investigate the usefulness of the homeostasis model assessment as an index of insulin resistance (HOMA-IR) for evaluating the clinical course of patients with type 2 diabetes. The usefulness of HOMA-IR and its relationship with insulin resistance assessed by the hyperinsulinemic-euglycemic clamp study (clamp IR) were evaluated in 55 Japanese patients with type 2 diabetes before and after treatment. The patients were subjected to diet (approximately 1,440-1,720 kcal/day) and exercise therapy (walking 10,000 steps daily) for 6 weeks during their hospitalization. Univariate regression analysis disclosed a significant correlation between log-transformed HOMA-IR and log-transformed clamp IR before (r = -0.613, P < 0.0001) and after ( = -0.734, P < 0.0001) treatment. Neither the slopes (-0.71 +/- 0.12 vs. -0.79 +/- 0.09, F = 0.25, P = 0.61) nor the intercepts (y-intercept = 1.67 vs. 1.70, x-intercept = 2.36 vs. 2.15, F = 0.02, P = 0.88) of the regression lines between HOMA-IR and clamp IR were significantly different before and after treatment. There was a significant correlation between the decrease in log-transformed HOMA-IR and the increase in clamp IR during treatment (r = -0.617, P < 0.0001). HOMA-IR may constitute a useful method not only for diagnosing insulin resistance, but also for follow-up during the treatment of patients with type 2 diabetes.
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            Role of chromium in human health and in diabetes.

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              Effect of chromium supplementation on glucose metabolism and lipids: a systematic review of randomized controlled trials.

              A systematic review of the effect of chromium supplementation on glucose metabolism and lipid levels. A literature search was conducted in MEDLINE and the Commonwealth Agricultural Bureau. Eligible studies were English language randomized controlled trials of chromium supplement intake > or = 3 weeks, with > or = 10 participants receiving chromium. All trials with glucose metabolism outcomes and trials of individuals with diabetes or glucose intolerance for lipid outcomes were included. Meta-analyses were performed as appropriate. Forty-one studies met criteria, almost half of which were of poor quality. Among participants with type 2 diabetes, chromium supplementation improved glycosylated hemoglobin levels by -0.6% (95% CI -0.9 to -0.2) and fasting glucose by -1.0 mmol/l (-1.4 to -0.5) but not lipids. There was no benefit in individuals without diabetes. There were some indications of dose effect and differences among chromium formulations. Larger effects were more commonly observed in poor-quality studies. The evidence was limited by poor study quality, heterogeneity in methodology and results, and a lack of consensus on assessment of chromium status. No significant effect of chromium on lipid or glucose metabolism was found in people without diabetes. Chromium supplementation significantly improved glycemia among patients with diabetes. However, future studies that address the limitations in the current evidence are needed before definitive claims can be made about the effect of chromium supplementation.
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                Author and article information

                Journal
                Clin Nutr Res
                Clin Nutr Res
                CNR
                Clinical Nutrition Research
                Korean Society of Clinical Nutrition
                2287-3732
                2287-3740
                April 2020
                24 April 2020
                : 9
                : 2
                : 97-106
                Affiliations
                [1 ]Be'sat Hospital, Hamadan University of Medical Sciences, Hamadan 6517838678, Iran.
                [2 ]Department of Nutrition, Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851351, Iran.
                [3 ]Islamic Azad University; Tehran Medical Branch and Science & Research Branch, Tehran 1477983855, Iran.
                [4 ]Students' Research Committee, Faculty of Nutrition, Tabriz University of Medical Sciences, Tabriz 5166614711, Iran.
                [5 ]Department of Internal Medicine, Faculty of Medicine, Urmia University of Medical Sciences, Urmia 5714783734, Iran.
                [6 ]Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences, Tehran 1593716615, Iran.
                [7 ]Department of Biostatistics, Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6715847141, Iran.
                Author notes
                Correspondence to Hadi Abdollahzad. Department of Nutrition, Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851351, Iran. hadi_nut@ 123456yahoo.com ; abdollahzad@ 123456kums.ac.ir
                Author information
                https://orcid.org/0000-0001-7542-9424
                https://orcid.org/0000-0003-2367-9573
                https://orcid.org/0000-0002-7265-3495
                https://orcid.org/0000-0001-8682-5721
                https://orcid.org/0000-0002-9112-6391
                https://orcid.org/0000-0002-1038-9369
                https://orcid.org/0000-0001-8826-4585
                https://orcid.org/0000-0002-9720-8267
                https://orcid.org/0000-0002-1840-6186
                https://orcid.org/0000-0001-7062-6971
                https://orcid.org/0000-0002-6507-7928
                Article
                10.7762/cnr.2020.9.2.97
                7192664
                32395440
                64efc7c9-5250-4aa3-87bd-e5baf1a96419
                Copyright © 2020. The Korean Society of Clinical Nutrition

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 February 2020
                : 17 April 2020
                : 19 April 2020
                Categories
                Original Article

                type 2 diabetes mellitus,chromium,blood glucose,dyslipidemia

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